Department of Ophthalmology and Visual Sciences, Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN.
J Glaucoma. 2021 Mar 1;30(3):e47-e49. doi: 10.1097/IJG.0000000000001746.
The coronavirus (COVID-19) pandemic has impacted ophthalmology practices significantly. American Academy of Ophthalmology and Center for Disease Control guidelines suggest mandatory masking of patients and physicians during outpatient visits. We have recently become aware of a mask-induced phenomenon, whereby the intraocular pressure (IOP) as measured by Goldmann applanation tonometry (GAT) is artificially elevated due to mechanical interference from the mask.
A 37-year-old male with a history of primary open-angle glaucoma on triple therapy presented for a routine visit.
When measuring IOP by GAT the right eye measured 16 mm Hg, but the left eye measured 20 mm Hg. The patient's mask was noted to be touching the base of the sensor rod on the tonometer. This patient's IOP was falsely elevated due to the lateral edge of his mask touching the base of the applanation tonometer, changing the relationship between the bi-prism tip and the weighted balance below, and eliminating the weighted balance from the pressure measuring mechanism. The patient's mask was adjusted to ensure there was no touch and repeat measurement showed an IOP of 16 mm Hg in the left eye.
Recognizing mask-induced alteration in IOP is essential as it could lead to unnecessary escalation of treatment. We recommend flattening the area of mask protrusion during applanation and ensuring that the sensor arm remains clear of the mask while the tonometer tip approaches the cornea, especially at the moment the mires become visible during corneal contact.
冠状病毒（COVID-19）大流行对眼科实践产生了重大影响。美国眼科学会和疾病控制中心的指南建议在门诊就诊时对患者和医生强制进行掩蔽。我们最近发现了一种口罩引起的现象，即由于口罩的机械干扰，Goldmann 压平眼压计（GAT）测量的眼压（IOP）会被人为升高。
一名 37 岁男性，患有原发性开角型青光眼，三联疗法治疗，因常规就诊。
使用 GAT 测量右眼 IOP 时，右眼测量值为 16mmHg，但左眼测量值为 20mmHg。注意到患者的口罩触及眼压计传感器杆的底部。由于患者口罩的边缘触碰到眼压计的扁平部，改变了双棱镜尖端和下方的加权平衡之间的关系，因此该患者的 IOP 被错误地升高，从而使加权平衡脱离压力测量机制。调整患者的口罩以确保无接触，重复测量显示左眼 IOP 为 16mmHg。
认识到口罩引起的 IOP 改变至关重要，因为这可能导致不必要的治疗升级。我们建议在压平期间使口罩突出部位变平，并确保在眼压计尖端接近角膜时传感器臂保持清晰，特别是在角膜接触时，当视标变得可见的那一刻。
