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The Importance of Measuring Intraocular Pressure Using a Tonometer in Order to Estimate the Postmortem Interval

Balci, Yasemin MD, PhD*; Basmak, Hikmet MD; Kocaturk, B. Kenan MD*; Sahin, Afsun MD; Ozdamar, Kazim PhD

The American Journal of Forensic Medicine and Pathology: June 2010 - Volume 31 - Issue 2 - p 151-155
doi: 10.1097/PAF.0b013e3181dd7933
Original Article

Aim: The purpose of this study is to evaluate postmortem eye changes and to investigate the relationship between these changes and time elapsed after death.

Material and Method: The eyes of 100 noncriminal cases who had died while being treated at Eskisehir Osmangazi University (ESOGU) hospital were evaluated for corneal turbidity and tache noire macroscopically, and also repeatedly evaluated by ophthalmoscope, pupilometer, and tonometer at intervals until removal from hospital. The postmortem time, corneal turbidity, development of tache noire, pupil size, intraocular pressure (IOP), and fundus findings were recorded. The relationship between these findings and the postmortem interval (PMI) was evaluated.

Results: No relationship between tache noire development and postmortem time (P > 0.05) was found. The corneal turbidity ratio increased significantly at 8 hours after decease (P < 0.01). No relationship between right-left pupil size and postmortem time (P > 0.05) was found. There was, however, a significant relationship between the fundus findings and postmortem time. Over time, the first optic disc becomes pale, then vascular clarity decreases and segmentation increases. The right and left IOP related significantly to postmortem time and decreased gradually as time passed (P < 0.05). Application of linear, exponential, and power equations showed that IOP can be used to estimate postmortem time by a 2 hour interval with a 95% probability.

Conclusions: This study shows that corneal turbidity and IOP have a significant relationship with postmortem time and can be used to estimate a postmortem interval with other postmortem findings. This study provides data that would support the idea that such examination might be useful in estimating postmortem interval.

From the Departments of *Forensic Medicine, †Ophthalmology, and ‡Biostatistics, Eskisehir Osmangazi University, Eskisehir, Turkey.

Manuscript received September 10, 2007; accepted February 6, 2008.

Supported by ESOGU Commission of Scientific Research Projects.

Presented at the 3rd Mediterranean Academy of Forensic Sciences Congress, 21–23 June 2007, in Porto.

Reprints: Yasemin Balci, MD, PhD, Department of Forensic Medicine, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir-Turkey. E-mail:

© 2010 Lippincott Williams & Wilkins, Inc.