Elevated IOP following a bladder filling protocol: A case report
Purpose: We describe a patient with elevated intraocular pressure (IOP) secondary to an oral water bolus and examine the utility of the water-drinking test. Observations: A 66-year-old male with a history of hypertension presented with headache, bilateral retro-orbital ache, and blurry vision. Sympt...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-03-01
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| Series: | American Journal of Ophthalmology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993622005321 |
| _version_ | 1797904302204780544 |
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| author | Vivian L. Qin Brian J. Nguyen Patrick Tripp Amanda Lehman Victoria M. Addis Qi N. Cui |
| author_facet | Vivian L. Qin Brian J. Nguyen Patrick Tripp Amanda Lehman Victoria M. Addis Qi N. Cui |
| author_sort | Vivian L. Qin |
| collection | DOAJ |
| description | Purpose: We describe a patient with elevated intraocular pressure (IOP) secondary to an oral water bolus and examine the utility of the water-drinking test. Observations: A 66-year-old male with a history of hypertension presented with headache, bilateral retro-orbital ache, and blurry vision. Symptoms began shortly after his radiation treatment for prostate cancer, for which he consumed a water bolus to fill his bladder 30 minutes prior to treatment initiation. On exam, he had bilateral elevated IOP that responded to topical IOP-lowering medications. Gonioscopy demonstrated open angles and fundus exam showed non-glaucomatous optic nerves with pronounced retinal venous tortuosity. The water-drinking test showed a peak intraocular pressure of 20 mmHg in the right eye (5 mmHg increase from baseline) and 23 mmHg in the left eye (8 mmHg increase from baseline), suggesting impairment of the outflow system in the left compared to the right eye. He was started on topical IOP-lowering therapy and followed in our clinic as a glaucoma suspect. Conclusions: Consumption of a water bolus can be associated with IOP elevation and may be a risk factor in patients with otherwise normal IOPs at risk for glaucoma. The water-drinking test was historically used as provocative testing for open-angle glaucoma and may have an updated role in evaluating at-risk patients without ocular hypertension. |
| first_indexed | 2024-04-10T09:46:46Z |
| format | Article |
| id | doaj.art-abca5ff8736e4464b2b4836576355b4c |
| institution | Directory Open Access Journal |
| issn | 2451-9936 |
| language | English |
| last_indexed | 2024-04-10T09:46:46Z |
| publishDate | 2023-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj.art-abca5ff8736e4464b2b4836576355b4c2023-02-17T04:55:12ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362023-03-0129101786Elevated IOP following a bladder filling protocol: A case reportVivian L. Qin0Brian J. Nguyen1Patrick Tripp2Amanda Lehman3Victoria M. Addis4Qi N. Cui5Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA, 19104, USAScheie Eye Institute, University of Pennsylvania, Philadelphia, PA, 19104, USACorporal Michael J. Crescenz Philadelphia VA Medical Center, Philadelphia, PA, 19104, USACorporal Michael J. Crescenz Philadelphia VA Medical Center, Philadelphia, PA, 19104, USAScheie Eye Institute, University of Pennsylvania, Philadelphia, PA, 19104, USAScheie Eye Institute, University of Pennsylvania, Philadelphia, PA, 19104, USA; Corresponding author. 51 N 39th Street, Philadelphia, PA, 19104, USA.Purpose: We describe a patient with elevated intraocular pressure (IOP) secondary to an oral water bolus and examine the utility of the water-drinking test. Observations: A 66-year-old male with a history of hypertension presented with headache, bilateral retro-orbital ache, and blurry vision. Symptoms began shortly after his radiation treatment for prostate cancer, for which he consumed a water bolus to fill his bladder 30 minutes prior to treatment initiation. On exam, he had bilateral elevated IOP that responded to topical IOP-lowering medications. Gonioscopy demonstrated open angles and fundus exam showed non-glaucomatous optic nerves with pronounced retinal venous tortuosity. The water-drinking test showed a peak intraocular pressure of 20 mmHg in the right eye (5 mmHg increase from baseline) and 23 mmHg in the left eye (8 mmHg increase from baseline), suggesting impairment of the outflow system in the left compared to the right eye. He was started on topical IOP-lowering therapy and followed in our clinic as a glaucoma suspect. Conclusions: Consumption of a water bolus can be associated with IOP elevation and may be a risk factor in patients with otherwise normal IOPs at risk for glaucoma. The water-drinking test was historically used as provocative testing for open-angle glaucoma and may have an updated role in evaluating at-risk patients without ocular hypertension.http://www.sciencedirect.com/science/article/pii/S2451993622005321GlaucomaProvocative testingWater-drinking testIntraocular pressure |
| spellingShingle | Vivian L. Qin Brian J. Nguyen Patrick Tripp Amanda Lehman Victoria M. Addis Qi N. Cui Elevated IOP following a bladder filling protocol: A case report American Journal of Ophthalmology Case Reports Glaucoma Provocative testing Water-drinking test Intraocular pressure |
| title | Elevated IOP following a bladder filling protocol: A case report |
| title_full | Elevated IOP following a bladder filling protocol: A case report |
| title_fullStr | Elevated IOP following a bladder filling protocol: A case report |
| title_full_unstemmed | Elevated IOP following a bladder filling protocol: A case report |
| title_short | Elevated IOP following a bladder filling protocol: A case report |
| title_sort | elevated iop following a bladder filling protocol a case report |
| topic | Glaucoma Provocative testing Water-drinking test Intraocular pressure |
| url | http://www.sciencedirect.com/science/article/pii/S2451993622005321 |
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