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Intraocular Pressure and Associated Factors: The Central India Eye and Medical Study

Jonas, Jost B. MD*,†; Nangia, Vinay MS, FRCS, MD*; Matin, Arshia MS, MD*; Sinha, Ajit DO, MD*; Kulkarni, Maithili DO, MD*; Bhojwani, Krishna MD*

Journal of Glaucoma:
doi: 10.1097/IJG.0b013e3181f7af9b
Original Studies

Purpose: To determine the range of intraocular pressure (IOP) in a rural Central Indian population and to evaluate existing and identify potential new ocular, medical, and socioeconomic factors associated with IOP.

Methods: This is a population-based study carried out in Nagpur in Central India. A single IOP measurement was taken using Goldmann applanation tonometry and population IOP was described using standard descriptive statistics.

Results: Of 5885 eligible patients, 9338 eyes of 4686 patients were included in the study. The mean IOP was 13.6±3.4 mm Hg (median: 14 mm Hg; range: 2 to 56 mm Hg). In multivariate regression analysis, the following factors, with correlation coefficients (r) and P values reported in parenthesis, were found to be associated with IOP. Ocular factors included higher corneal power (0.12; P=0.004), lower central corneal thickness (0.02; P<0.001), and higher myopic refractive power (−0.13; P=0.001). Medical factors included diastolic blood pressure (0.05; P<0.001), pulse rate (0.02; P=0.005), and body mass index (0.05; P=0.01). Socioeconomic factors included level of education (0.15; P=0.05) and livestock ownership (−0.18; P=0.008).

Conclusion: Low mean IOP was found when compared with other epidemiologic studies and this may be explained by the low central corneal thickness found in the study population. Several known ocular and medical factors and new socioeconomic factors were found to be associated with IOP. Identifying risk factors associated with IOP in different populations may allow clinicians to better define and recognize subgroups of patients at risk of elevated IOP. Newly identified socioeconomic-IOP associations will need to be validated in future studies.

Author Information

*Suraj Eye Institute, Nagpur, Maharashtra, India

Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University, Heidelberg, Mannheim, Germany

Supported by an unrestricted grant from Om Drishti Trust, Nagpur; Heidelberg Engineering Co., Heidelberg, Germany; Rotary Sight Saver Netherlands; Orbis India; and Carl Zeiss Meditec Co., Jena, Germany.

Jost B. Jonas and Vinay Nangia have contributed equally to this study.

Disclosure: The authors declare no conflict of interest.

Reprints: Dr Vinay Nangia, MS, FRCS, MD, Suraj Eye Institute, 559, New Colony, Nagpur India (e-mail: and Jost B. Jonas, MD, Universitäts-Augenklinik, Theodor-Kutzer-Ufer 1-3, Mannheim 68167, Germany (e-mail:

Received October 30, 2009

Accepted August 16, 2010

© 2011 Lippincott Williams & Wilkins, Inc.