Eye retraction and rotation during Corvis ST 'air puff' intraocular pressure measurement and its quantitative analysis.

Purpose: The aim of this study was to analyse the indentation and deformation of the corneal surface, as well as eye retraction, which occur during air puff intraocular pressure (IOP) measurement.

Methods: A group of 10 subjects was examined using a non-contact Corvis ST tonometer, which records image sequences of corneas deformed by an air puff. Obtained images were processed numerically in order to extract information about corneal deformation, indentation and eyeball retraction.

Results: The time dependency of the apex deformation/eye retraction ratio and the curve of dependency between apex indentation and eye retraction take characteristic shapes for individual subjects. It was noticed that the eye globes tend to rotate towards the nose in response to the air blast during measurement. This means that the eye globe not only displaces but also rotates during retraction. Some new parameters describing the shape of this curve are introduced. Our data show that intraocular pressure and amplitude of corneal indentation are inversely related (r  = -0.83, P = 0.0029), but the correlation between intraocular pressure and amplitude of eye retraction is low and not significant (r  = -0.24, P = 0.51).

Conclusions: The curves describing corneal behaviour during air puff tonometry were determined and show that the eye globe rotates towards the nose during measurement. In addition, eye retraction amplitudes may be related to elastic or viscoelastic properties of deeper structures in the eye or behind the eye and this should be further investigated. Many of the proposed new parameters present comparable or even higher repeatability than the standard parameters provided by the Corvis ST.