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
PECZON JD, GRANT WM. Sedatives, Stimulants, and Intraocular Pressure in Glaucoma. Arch Ophthalmol. 1964;72(2):178–188. doi:10.1001/archopht.1964.00970020178008
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