Intraocular pressure changes during high-altitude acclimatization

  • Mitrofanis PavlidisEmail author
  • Tobias Stupp
  • Ilias Georgalas
  • Evi Georgiadou
  • Michail Moschos
  • Solon Thanos
Clinical Investigation



To evaluate the relationship between hypobaric hypoxia acclimatization and intraocular pressure (IOP) during ascent, acclimatization, and descent between 2286 m and 5050 m.


The following acclimatization-indicative physiological parameters were compared daily with IOP changes in eight healthy climbers of the 2003 Greek Karakorum expedition in altitude stages between 500 m and 5050 m: hemoglobin oxygen saturation (PO2), resting heart rate, blood pressure, retinal findings, and the Lake Louise score for acclimatization grading.


IOP decreased significantly in the ascent phase (0.58 mmHg/100 m) and recovered (0.71 mmHg/100 m) during acclimatization and descent. A direct proportional correlation between decreases in PO2 and IOP was evaluated. Arterial blood pulse and pressure increased during acclimatization, while IOP decreased. No retinal hemorrhages were observed in well-acclimatized and incompletely acclimatized climbers.


Every new active exposure to hypobaric hypoxia in the ascent phase induced a decrease in the IOP parallel to the PO2 decrease and to the level of acclimatization. The results from our study suggest that IOP changes are related to hypoxia-induced respiratory alkalosis and acclimatization stage, which could be used as a simple mobile screening test for acclimatization level to reveal acute mountain sickness and its severe consequences.


Intraocular pressure High altitude Acclimatization 


  1. 1.
    Appleton F (1967) Possible influence of altitude on blood pressure. Circulation 36 [Suppl 11]:35Google Scholar
  2. 2.
    Brinchmann-Hansen O, Myhre K (1989) Blood pressure, intraocular pressure, and retinal vessels after high altitude mountain exposure. Aviat Space Environ Med 60:970–976PubMedGoogle Scholar
  3. 3.
    Butler FK, Harris DJ Jr, Reynolds RD (1992) Altitude retinopathy on Mount Everest, 1989. Ophthalmology 99:739–746PubMedGoogle Scholar
  4. 4.
    Canepa A, Chavez R, Hurtardo A, Rotta A, Velasquez T (1956) Pulmonary circulation at sea level and at high altitudes. J Appl Physiol 9:328–336PubMedGoogle Scholar
  5. 5.
    Carapancea M (1977) Experimental and clinical hyperophthalmotony of high altitudes. Arch Ophthalmol (Paris) 37:775–784Google Scholar
  6. 6.
    Chatterjee SK, Chakraborty A (2001) Intraocular pressure changes and mountaineering—preliminary observations and possible application. J Assoc Phys India 49:248–252Google Scholar
  7. 7.
    Clarke C, Duff J (1976) Mountain sickness, retinal hemorrhages, and acclimatisation on Mount Everest in 1975. BMJ 2:495–497PubMedGoogle Scholar
  8. 8.
    Firsching R, Schutze M, Motschmann M, Behrens-Baumann W, Meyer-Schwickerath R (1998) Non-invasive measurement of intracranial pressure. Lancet 351:523–524PubMedCrossRefGoogle Scholar
  9. 9.
    Frayser R, Houston CS, Bryan AC, Rennie ID, Gray G (1970) Retinal hemorrhage at high altitude. N Engl J Med 282:1183–1184PubMedCrossRefGoogle Scholar
  10. 10.
    Frayser R, Houston CS, Gray GW, Bryan AC, Rennie ID (1971) The response of the retinal circulation to altitude. Arch Intern Med 127:608–611CrossRefGoogle Scholar
  11. 11.
    Heath D, Williams DR (1981) Man at high altitude. Churchill Livingstone, New York, p 139 and p 187Google Scholar
  12. 12.
    Honigman B, Theis MK, Koziol-McLain J, Roach R, Yip R, Houston C, Moore LG, Pearce P (1993) Acute mountain sickness in a general tourist population at moderate altitudes. Ann Intern Med 118:587–592PubMedGoogle Scholar
  13. 13.
    Lehman RAW, Krupin T, Podos SM (1972) Experimental effect of intracranial hypertension upon intraocular pressure. J Neurosurg 36:60–66PubMedCrossRefGoogle Scholar
  14. 14.
    Lempert P, Cooper KH, Culver JF, Tredici TJ (1967) The effect of exercise on intraocular pressure. Am J Ophthalmol 63:1673–1676PubMedGoogle Scholar
  15. 15.
    Lenfant C, Sullivan K (1971) Adaptation to high altitude. N Engl J Med 284:1298–1308PubMedCrossRefGoogle Scholar
  16. 16.
    Lubin JR, Rennie D, Hackett P, Albert DM (1982) High altitude retinal hemorrhage: a clinical and pathological case report. Ann Ophthalmol 14:1071–1076PubMedGoogle Scholar
  17. 17.
    Marticorena E, Ruiz L, Severino J, Galvez J, Penaloza D (1969) Systemic blood pressure in white men born at sea level: changes after long residence at high altitudes. Am J Cardiol 23:364–368PubMedCrossRefGoogle Scholar
  18. 18.
    McFadden DM, Houston CS, Sutton JR, Powles AC, Gray GW, Roberts RS (1981) High-altitude retinopathy. JAMA 245:581–586PubMedCrossRefGoogle Scholar
  19. 19.
    Ng JD, White LJ, Parmley VC, Hubickey W, Carter J, Mader TH (1996) Effects of simulated high altitude on patients who have had radial keratotomy. Ophthalmology 103:452–457PubMedGoogle Scholar
  20. 20.
    Ortiz GJ, Cook DJ, Yablonski ME, Masonson H, Harmon G (1988) Effect of cold air on aqueous humor dynamics in humans. Invest Ophthalmol Vis Sci 29:138–140PubMedGoogle Scholar
  21. 21.
    Passo MS, Goldberg L, Elliot DL, Van Buskirk EM (1991) Exercise training reduces intraocular pressure among subjects suspected of having glaucoma. Arch Ophthalmol 109:1096–1098PubMedGoogle Scholar
  22. 22.
    Rennie D, Morrissey J (1975) Retinal changes in Himalayan climbers. Arch Ophthalmol 93:395–400PubMedGoogle Scholar
  23. 23.
    Viestenz A, Lausen B, Junemann AM, Mardin CY (2002) Comparison of precision of the TonoPen XL with the Goldmann and Draeger aplanation tonometer in a sitting and recumbent position of the patients—a clinical study on 251 eyes. Klin Monatsbl Augenheilkd 219:785–790PubMedCrossRefGoogle Scholar
  24. 24.
    Wiedman M (1975) High altitude retinal hemorrhage. Arch Ophthalmol 93:401–403PubMedGoogle Scholar
  25. 25.
    Wilmer WH, Berens C Jr (1918) Medical studies in aviation: V. The effect of altitude on ocular functions. Aviat Space Environ Med 60:1018–1023Google Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Mitrofanis Pavlidis
    • 1
    Email author
  • Tobias Stupp
    • 1
  • Ilias Georgalas
    • 2
  • Evi Georgiadou
    • 3
  • Michail Moschos
    • 3
  • Solon Thanos
    • 1
  1. 1.Department of Experimental OphthalmologyUniversity Eye Hospital of MünsterMünsterGermany
  2. 2.Moorfields Eye Hospital NHS TrustLondonUK
  3. 3.University Eye Hospital of AthensAthensGreece

Personalised recommendations