Abstract Recent experience with endarterectomy and bypass grafting for carotid occlusive disease has made the early diagnosis of this condition clinically important.1 Unfortunately, ophthalmodynamometry, which is often helpful in making this diagnosis, is an inaccurate and unreliable procedure.2-5 It has been suggested that ocular hemodynamics might be better evaluated using a sensitive instrument to amplify the ocular pulse seen during tonometry and tonography.6 With this principle in mind, the following apparatus was developed in the ophthalmic laboratories of University Hospitals. Materials and Methods A perilimbal suction cup was attached to a transducer, vacuum trap, and 50 cc syringe as described in Fig 1. The suction cup was modified by the addition of a polyethylene sidearm tube to facilitate removal of air from the system. In order that the transducer might be used in its optimum pressure range, the pressure gradient across the transducer was reduced to zero. This References 1. DeBakey, M.E., et al: Surgical Considerations of Occlusive Disease of Innominate, Carotid, Subclavian, and Vertebral Arteries , Ann Surg 149:670-710, 1959. 2. Croll, M., et al: Evaluation of Ophthalmodynamometric and Angiographic Findings in Patients With Internal Carotid Artery Thrombosis , J Neurosurg 17:394, 1960.Crossref 3. Hollenhorst, R.M.: Poor Reliability of Ophthalmodynamometry , Amer J Ophthal 47:753, 1959. 4. Russell, R.W., and Cranston, W.I.: Ophthalmodynamometry in Carotid Artery Disease , J Neurol Neurosurg Psychiat 24:281, 1961.Crossref 5. Tindall, G.T., et al: Simultaneous Determinations of Retinal and Carotid Artery Pressures: Comparison of Percent Reductions After Occlusion of the Common Carotid Artery , Neurology 10:623, 1960.Crossref 6. Lawrence, C., and Knox, D.L.: Personal communication to author, June 1963. 7. Ewing, C.C.: Ophthalmodynamometry in Retinal Infarction , Amer J Ophthal 58:759, 1964. 8. Smith, J.L.: Central Retinal and Internal Carotid Arterial Occlusions: Ophthalmodynamometric Differentiation , Arch Ophthal 65:550, 1961.Crossref 9. Chao, P., and Bettman, J.: The Relative Volume of Blood in the Choroid and Retina , abstracted, Amer J Ophthal 43:294, 1957. 10. Hedges, T.R.: Ophthalmic Artery Cannulation , Trans Amer Ophthal Soc 61:560, 1963. 11. Hedges, T.R., and Weinstein, J.D.: Ophthalmic Artery Pressure Response to Carotid Occlusion , Neurology 14:192-201, 1964.Crossref 12. Suzuki, I.: Corneal Pulsation and Corneal Pulse Waves , Jap J Ophthal 6:190-194, 1962. 13. Hager, H.: Objective Elektrische Dynamometric mit Hilfe des Bulbus-orbite Pulses , Concilium Ophthalmologicum Belgica , vol 18, 1958. 14. Caramazzo, R., et al: Tono-oscellometrici dell'a Oftalmica in Rapporto alla P.A.O. nei Soggetti Normo ell Ipertesi , Riv Otoneurooftal 37:565-572, 1962. 15. Caramazzo, R., and Frasca, G.: Registrazione Eletrografica dei Valori Pressori dell' Arteria Oftalmica , Riv Otoneurooftal 37:14-27, 1962. 16. Caramazzo, R.: La Tono-oscillometria dell'a Oftalmica e dell's Temporale Superficiale Uella Diagnosi delle Offezioni Cerebrovascolari di tipo Occlusivo , Riv Otoneurooftal 37:333-384, 1962. 17. Thorner, M.: Ophthalmic Artery Pulsensor , Trans Amer Neurol Assoc 86:161-164, 1961. 18. Hayreh, S.S.: Arteries of the Orbit in Human Beings , Brit J Surg 50:1938-1953, 1963.Crossref 19. Walsh, F.B., and King, A.B.: Ocular Signs of Intracranial Saccular Aneurysms—Experimental Work on Collateral Circulation Through the Ophthalmic Artery , Arch Ophthal 27:1-33, 1942.Crossref 20. Fisher, M.: Occlusion of Carotid Arteries , Arch Neurol Psychiat 72:187-204, 1954.Crossref 21. Webster, J.E., and Gurdjian, F.S.: Observations Upon the Response to Digital Carotid Compression , Neurology 7:757-762, 1957.Crossref 22. Calverly, J.R., and Millikan, C.H.: Complications of Carotid Manipulation , Neurology 11:185, 1961.Crossref 23. Gurdjian, E.S., et al: Analysis of Cerebrovascular Disease , Neurology 10:373-380, 1960.Crossref 24. Silverstein, A., et al: Manual Compression of the Carotid Vessels, Carotid Sinus Hypersensitivity and Carotid Occlusions , Ann Intern Med 52:172-179, 1960.Crossref 25. Nelson, D.A., and Mahru, M.M.: Death Following Digital Carotid Artery Occlusion , Arch Neurol 8:640-643, 1963.Crossref 26. Askey, J.M.: Hemiplegia Following Carotid Sinus Stimulation , Amer Heart J 31:131, 1946.Crossref 27. Marmar, J., and Saperstein, M.R.: Bilateral Thrombosis of Anterior Cerebral Artery Following Stimulation of a Hyperactive Carotid Sinus , JAMA 117:1089,1941.Crossref 28. Smith, J.L.: Carotid Compression , Amer J Ophthal 56:369-377, 1963. 29. Galin, M.A., et al: Measurements of Aqueous Flow Utilizing the Perilimbal Suction Cup , Arch Ophthal 66:65, 1961.Crossref 30. Galin, M.A., et al: A Comparison of Tonography and Suction , Arch Ophthal 70:202, 1963.Crossref 31. Smith, J.L., et al: Observations on Ophthalmodynamometry , JAMA 170:1403, 1959.Crossref 32. Szapiro, J., and Swietliczko, I.: Significance of Retinal Artery Pressure in Cerebrovascular Insufficiency , J Neurol Neurosurg Psychiat 26:410-413, 1963.Crossref 33. Yttebory, J.: Intraocular Blood Volume and Ocular Rigidity , Acta Ophthal 38:410-436, 1960.Crossref
Archives of Ophthalmology – American Medical Association
Published: Sep 1, 1966
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