Risk for Glaucoma Among Patients With Hemifacial Spasm
Narrative Responses:
Purpose
Hemi facial spasm(HFS) characterized by spontaneous, spasmodic, unilateral, involuntary contractions of the orbicularis muscles. The patients who present with the disease have repetitive and spasmodic eyelid contractions. We evaluated the intraocular pressure of the patients to understand if the spasms have a risk for glaucoma occurance.
Methods
Patients underwent intraocular pressure (IOP) measurement in both eyes using Goldmann applanation tonometry (GAT) and non contact tonometer (NCT) when they first had the diagnosis of the disease. Subjects all accepted to be a part of the study and the data collected prospectively. They all had Botulinum toxin injection for the relief of the spasms . IOP measurements repeated 14 days after Botulinum toxin injection as the effect of the agent is known to be maximum.
Results
Forty eight eyes of 24 subjects (eight men, sixteen women) were enrolled to the study. Mean age was 45,33±9,55. Before botulinium toxine injection mean IOP was found to be 14.54±1,76 mmHg with GAT and 16,21±1,5 mmHg with NCT in the eyes with spasms. The IOP values were 14,67±2,05 mmHg and 16,29±1,70 mmHg respectively at the other eye. There was no statistically significant difference among eyes (p=0,52, p=0,90). When the results evaluated with Wilcoxon Signed Ranks test we could not find any significant alteration at the IOP values before and after toxin injections using both tonometer (p=0,214, p=0,758).
Conclusion
Although attempted forced eyelid closure is a common source of error in routine measurement of intraocular pressure and could influence the IOP measurements the involuntary contractions in HFS do not change the IOP results.