The Effect of Yoga on Intraocular Pressure Using the “iCare HOME2” Tonometer

Abstract

Background Various yoga positions may have an unfavorable impact on intraocular pressure (IOP) and may therefore be seen as a potential risk factor for the progression of glaucoma. The new “iCare HOME2” is a handheld self-tonometer for IOP measurements outside clinical settings. This is the first study to evaluate the immediate effect of common yoga postures on the IOP of healthy and glaucomatous eyes using the “iCare HOME2” self-tonometer and to compare the time of IOP recovery in both groups.

Methods This is a single-center, prospective, observational study including 25 healthy and 25 glaucoma patients performing the following yoga positions: “legs up” (Viparita Karani), “bend over” (Uttanasana), “plough pose” (Halasana), and the “down face dog” (Adho Mukha Svanasana) for 90 s each, with a 2-min break in between. IOP was measured with the “iCare HOME2” before, during, and after each position.

Results IOP significantly increased in all eyes in all positions (p < 0.05), showing no statistically significant difference between healthy or glaucomatous eyes (p > 0.05). The mean rise in IOP in healthy subjects was 1.6 mmHg (SD 1.42; p = 0.037), 14.4 mmHg (SD 4.48; p < 0.001), 7.5 mmHg (SD 4.21; p < 0.001), and 16.5 mmHg (SD 3.71; p < 0.001), whereas in glaucoma patients, IOP rose by 2.8 mmHg (SD 2.8; p = 0.017), 11.6 mmHg (SD 3.86; p < 0.001), 6.0 mmHg (SD 2.24; p < 0.001), and 15.1 mmHg (SD 4.44; p < 0.001) during the above listed yoga positions, repsectively. The highest increase in IOP was seen in the down face position, reaching mean IOP values above 31 mmHg in both study groups. IOP elevation was observed immediately after assuming the yoga position, with no significant change during the following 90 s of holding each pose (p > 0.05). All IOP values returned to baseline level in all individuals, with no significant difference between healthy and glaucoma participants.

Conclusion Our data show that common yoga positions can lead to an acute IOP elevation of up to 31 mmHg in healthy as well as glaucoma eyes, with higher IOP values during head-down positions. Given that IOP peaks are a major risk factor for glaucomatous optic neuropathy, we generally advise glaucoma patients to carefully choose their yoga exercises. If and to what extent practicing yoga leads to glaucoma progression, however, remains unclear and warrants further research.

Zusammenfassung

Hintergrund Einige Yoga-Positionen haben einen erhöhenden Effekt auf den Intraokular Druck (IOD) gezeigt und könnten demnach als potenzieller Risikofaktor für die Progression eines Glaukoms erachtet werden. Das „iCare HOME2“ ist ein Handtonometer, das für die Ermittlung des Augeninnendrucks außerhalb klinischer Rahmenbedingungen eingesetzt werden kann. Dies ist die erste Studie, die den Effekt von 4 geläufigen Yoga-Positionen auf den IOD von gesunden und Glaukomaugen mit einem „iCare HOME2“ untersucht und die Erholungszeit zwischen den Gruppen vergleicht.

Methodik Dies ist eine monozentrische, prospektive, Beobachtungsstudie mit 25 gesunden und 25 Glaukompatienten, welche die folgenden Yoga-Positionen durchführen: „Umkehrhaltung“ (Viparita Karani), „stehende Kopf-Knie-Stellung“ (Uttanasana), „Pflugstellung“ (Halasana), „herabschauender Hund“ (Adho Mukha Svanasana). Jede Pose wird für 90 s gehalten, mit einer 2-minütigen Pause dazwischen. IOD-Werte werden mit einem „iCare HOME2“ vor, während und nach jeder Position gemessen.

Resultate Der IOD stieg in allen Augen in allen Positionen signifikant an (p < 0,05), ohne signifikanten Unterschied zwischen gesunden und glaukomatösen Teilnehmern (p > 0,05). Während den oben aufgeführten Yoga-Stellungen betrug der durchschnittliche IOD-Anstieg in gesunden Probanden 1,6 mmHg (SD 1,42; p = 0,037), 14,4 mmHg (SD 4,48; p < 0,001), 7,5 mmHg (SD 4,21; p < 0,001) und 16,5 mmHg (SD 3,71; p < 0,001), und bei Glaukompatienten 2,8 mmHg (SD 2,8; p = 0,017), 11,6 mmHg (SD 3,86; p < 0,001), 6,0 mmHg (SD 2,24; p < 0,001) und 15,1 mmHg (SD 4,44; p < 0,001). Der höchste IOD-Anstieg konnte im „herabschauenden Hund“ nachgewiesen werden, wobei in beiden Untersuchungsgruppen Druckwerte über 31 mmHg erreicht wurden. Es erfolgte jeweils ein umgehender IOD-Anstieg, ohne eine weitere signifikante Erhöhung, solange die Position gehalten wurde (p > 0,05). Die IOD-Werte kehrten bei allen Teilnehmern auf den Ausgangswert zurück, ohne signifikanten Unterschied zwischen beiden Gruppen (p > 0,05).

Schlussfolgerung Herkömmliche Yoga-Positionen führen zu einem akuten IOD-Anstieg in gesunden und Glaukompatienten, wobei höhere Augendruckwerte in Kopfüberpositionen verzeichnet wurden. Angesichts der akuten IOD-Spitzen und dem hiermit verbundenen Risiko einer Glaukomprogression, empfehlen wir den Glaukompatienten ihre Yoga-Übungen mit Vorsicht auszuwählen. Inwiefern das Praktizieren von Yoga jedoch zu einer glaukomatösen Nervenschädigung führt, bleibt ungewiss.

Key words

intraocular pressure - yoga-sports - glaucoma - iCare HOME2 - self-tonometer

Schlüsselwörter

Augendruck - Yoga - Glaukom - iCare HOME2 - iCare home

Publication History

Received: 18 September 2023

Accepted: 26 October 2023

Article published online:
23 April 2024

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