Clinical investigation of the effect of topical anesthesia on intraocular pressure

BACKGROUND/AIMS Contact tonometry is generally considered more accurate than non-contact tonometry in the assessment of intraocular pressure (IOP). This study was designed to investigate the effect of ocular anesthesia, a pre-requisite for contact tonometry, on the IOP in a sample of visually normal subjects. METHOD In a random sample of 120 young visually normal subjects (divided equally among three groups), the Topcon CT80 non-contact tonometer was used to measure IOP before, at the second minute and at the fifth minute following instillation of one drop of one of three eyedrops - carboxymethylcellulose sodium 0.5% (control), oxybuprocaine hydrochloride 0.4% and proparacaine hydrochloride 0.5%. RESULTS The IOP measured before instilling the ophthalmic drops did not vary significantly among the three groups of subjects (p > 0.05). In the control group, the average IOP of 15.1 +/- 2.6 mmHg did not vary significantly (p > 0.05) 2 minutes and 5 minutes following instillation of one drop of Carboxymethylcellulose sodium. There were statistically significant reductions of IOP 2 minutes (p < 0.01) and 5 minutes (p < 0.001) after the instillation of one drop of oxybuprocaine hydrochloride. One drop of proparacaine hydrochloride caused significant reductions in the average IOP after 2 minutes (p < 0.001) and after 5 minutes (p < 0.001). CONCLUSIONS One drop of topical proparacaine or oxybuprocaine may cause a small but a statistically significant reduction in IOP which could lead to lower IOP readings.