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Influence of mental stress on intraocular pressure and visual field testing: is there a white coat syndrome in glaucoma?

  • Glaucoma
  • Published:
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Abstract

Purpose

To investigate the effects of mental stress stimulus on intraocular pressure (IOP) measurement and visual field (VF) testing.

Methods

Patients with open angle glaucoma underwent a baseline IOP measurement and VF testing. Afterwards, they completed a computerized mental stress test (Stroop test) which is a known standardized method to induce mental stress. After test completion, patients underwent a second IOP measurement and VF testing.

Results

Seventy-two eyes of 36 patients were enrolled. Mean age was 67.0 ± 9.5 years (range 47–84 years). The mean baseline IOP was 15.0 mmHg, and after the Stroop mental stress test, IOP increased to 16.0 mm Hg (P < 0.001). There was a trend towards significant mean deviation decreased from -6.9 dB to -8.0 dB (P = 0.054, t-test) following the stress test. This difference became significant using the Wilcoxon nonparametric test (P = 0.008). Correlation was found between glaucoma severity and change in IOP (P = 0.02) and PSD (P < 0.01).

Conclusions

We found a small but statistically significant increase in IOP and a trend towards deterioration of visual field mean deviation, following a short mental stress test. Patients with more severe glaucoma showed more pronounced changes. Our results suggest that mental stress could affect IOP measurement in the clinic.

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Data availability

Data is available to authors and is protected to avoid misuse of patients’ personal information.

Code availability

Not applicable.

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Author information

Author notes

  1. Shay Keren and Michael Waisbourd contributed equally to this paper.

Authors and Affiliations

  1. Division of Ophthalmology, Tel-Aviv Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Shay Keren, Michael Waisbourd, Nir Gomel, Yael Cohen & Shimon Kurtz

Authors
  1. Shay Keren
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  2. Michael Waisbourd
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  3. Nir Gomel
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  4. Yael Cohen
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  5. Shimon Kurtz
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by all authors. The first draft of the manuscript was written by Drs. Shay Keren and Michael Waisbourd. All authors revised the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Shimon Kurtz.

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Research was approved by the Tel-Aviv Medical Center ethics committee.

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Not applicable as no personal and identifiable data is being published.

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The authors declare no competing interests.

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Keren, S., Waisbourd, M., Gomel, N. et al. Influence of mental stress on intraocular pressure and visual field testing: is there a white coat syndrome in glaucoma?. Graefes Arch Clin Exp Ophthalmol 260, 209–214 (2022). https://doi.org/10.1007/s00417-021-05315-9

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  • DOI: https://doi.org/10.1007/s00417-021-05315-9

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