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August 1964

Sedatives, Stimulants, and Intraocular Pressure in Glaucoma

Author Affiliations

Massachusetts Eye and Ear Infirmary (Glaucoma Consultation Service and Howe Laboratory of Ophthalmology).

Arch Ophthalmol. 1964;72(2):178-188. doi:10.1001/archopht.1964.00970020178008

A question yet unsatisfactorily answered is whether state of mind influences the intraocular pressure in patients having primary open-angle glaucoma. Most of what has been published on the subject is vague and speculative, lacking in adequate controls, or failing to distinguish open-angle glaucoma from angle-closure glaucoma. We know that tonometry in tense individuals often indicates during the initial measurements a slight transitory elevation of intraocular pressure which is apparently associated with apprehension, probably merely reflecting the patient's instinctive self-protective tendency to try to close the lids and withdraw from the approaching tonometer, possibly also reflecting a transient elevation of blood pressure from fear. This reflex is ordinarily of only a few seconds' duration. Also we have many legends of acute angle-closure glaucoma precipitated by or associated with emotional upset, possibly involving changes in pupillary diameter or transient vascular variations. However, we have little valid evidence relating state of mind to