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Ocular Rigidity: Clinical Approach

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Ocular Rigidity, Biomechanics and Hydrodynamics of the Eye

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Abstract

The term ocular rigidity is widely used in clinical ophthalmology. Generally it is assumed as a resistance of the whole eyeball to mechanical deformation and relates to biomechanical properties of the eye and its tissues. Basic principles and formulas for clinical tonometry, tonography and pulsatile ocular blood flow measurements are based on the concept of ocular rigidity. There is evidence for altered ocular rigidity in aging, in several eye diseases and after eye surgery. Unfortunately, there is no consensual view on ocular rigidity: it used to make a quite different sense for different people but still the same name. Foremost there is no clear consent between biomechanical engineers and ophthalmologists on the concept. Moreover ocular rigidity is occasionally characterized using various parameters with their different physical dimensions. In contrast to engineering approach, clinical approach to ocular rigidity claims to characterize the total mechanical response of the eyeball to its deformation without any detailed considerations on eye morphology or material properties of its tissues. Further to the previous chapter this section aims to describe clinical approach to ocular rigidity from the perspective of an engineer in an attempt to straighten out this concept, to show its advantages, disadvantages and various applications.

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Notes

  1. 1.

    Friedenwald explained that: “within the pressure range that is of clinical interest the fit is sufficiently good for practical purposes”. Thus the solution of Friedenwald’s equation should theoretically work for every initial condition IOP(V0) = IOP0 since the volume of the eye before distension V0 is consistent and the corresponding IOP is not extremely low. Obviously for hypotonic eyes that do not maintain its shape this simplified theoretical model does not work at all. An already pre-distended eyeball should theoretically fit to its corresponding pressure-volume relation curve with the initial condition being shifted to the right along the volume curve (Fig. 2.3). But how small can be V0 to fit Friedenwald’s equation? At what pressure the eyeball is not hypotonic anymore but still is not yet distended? From biomechanical point of view “the eye just before distension” or stress free configuration of the eye represents an important idealized concept, which is considered in detail elsewhere, e.g. [57].

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Acknowledgement

I would like to acknowledge my teacher Ivan Koshitz for inspiring me and granting me the astounding world of ocular biomechanics.

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  1. Department of Medical Engineering and Technomathematics, FH Aachen University of Applied Sciences, Jülich, Germany

    Konstantin Kotliar

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  1. Department of Ophthalmology, University of Crete, Heraklion, Crete, Greece

    Ioannis Pallikaris

  2. Department of Ophthalmology, University of Crete, Heraklion, Crete, Greece

    Miltiadis K. Tsilimbaris

  3. 2nd Ophthalmology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Anna I. Dastiridou

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Kotliar, K. (2021). Ocular Rigidity: Clinical Approach. In: Pallikaris, I., Tsilimbaris, M.K., Dastiridou, A.I. (eds) Ocular Rigidity, Biomechanics and Hydrodynamics of the Eye. Springer, Cham. https://doi.org/10.1007/978-3-030-64422-2_2

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