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Wearing swimming goggles can elevate intraocular pressure

Submitted by dave on Sun, 05/24/2009 - 1:53pm

We list three studies below that show swim googles can elevate eye pressure. Thanks to FitEyes member "togburn" we have a product recommendation for swimmers. The recommendation comes by way of optometrist Michelle Solomon in Richmond, VA, USA. Dr. Solomon is recommending swim goggles like the Aqua Sphere Seal Swim Mask by Aqua Sphere. Read the three studies below for more information about how swimming goggles can affect intraocular pressure.

1. Wearing swimming goggles can elevate intraocular pressure.

AIM: To examine the acute effects of wearing swimming goggles upon intraocular pressure (IOP).

METHODS: This research consisted of a Pilot study and a Validation study. Holes were drilled into the faces of 13 different goggles to allow IOP measurement by applanation tonometry. IOP was measured before goggles wear, 2 min after goggles application, 20 min after goggles application and after goggles removal. The Pilot study (n = 15) was initially performed to investigate changes in IOP while wearing five different types of swimming goggles. Anatomical and goggles design parameters from the Pilot study were then used to generate a predictive model and design a Validation study (n = 20). The Validation study tested the predictive model, examined IOP changes using another eight goggles and clarified whether IOP changes were sustained for the duration of goggles wear.

RESULTS: IOP increased while wearing goggles by a mean pressure of 4.5 mm Hg (SD 3.7, p<0.001) with this pressure rise being sustained for the duration of goggles wear. A smaller goggles face area (p = 0.013), was consistently associated with greater IOP elevation.

CONCLUSION: These measurements were not taken while swimming, but they suggest that some swimming goggles can elevate IOP.

Br J Ophthalmol. 2008 Sep;92(9):1218-21
Morgan WH, Cunneen TS, Balaratnasingam C, Yu DY.
Department of Physiology and Pharmacology, Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Western Australia, Australia.

2. Swimming goggles and elevated intraocular pressure.

We would like to congratulate Dr Morgan and colleagues on their recent paper "Wearing swimming goggles can elevate intraocular pressure." We performed a similar study and presented our data at the Association for Research in Vision and Ophthalmology in 2007. Our findings demonstrated that in healthy participants, intraocular pressure (IOP) measurements taken during goggle wear were significantly higher at both 1 and 3 min, with an average increase of 12.5% or +1.5 mm Hg. A small subset of eyes (10%) in our study had an increase in IOP greater than 5 mm Hg at both 1 and 5 min of goggle wear. We applaud the use of a predictive model in evaluating which goggles may be associated with IOP elevation. In our study, utilising a single goggle design (Speedo), the IOP did not increase significantly in 40% of subjects but increased over 5 mm Hg in others.

C E Starr and N M Radcliffe
Weill Cornell Medical College, New York, USA
British Journal of Ophthalmology 2009;93:700; doi:10.1136/bjo.2008.152686

Here is another study with the full text:

3. The Effect of Swimming Goggles on Intraocular Pressure and Blood Flow within the Optic Nerve Head

Yonsei Med J. Oct 31, 2007; 48(5): 807–809.
Published online Oct 31, 2007. doi:  10.3349/ymj.2007.48.5.807
PMCID: PMC2628147



Goggles are frequently worn in the sport of swimming and are designed to form a
seal around the periorbital tissue orbit. The resultant pressure on the
eye may have the potential to affect intraocular pressure and blood
flow of the optic nerve head. This study evaluates the influence of
wearing swimming goggles on intraocular pressure (IOP) and blood flow
of the ocular nerve head (ONH) in normal subjects.

Materials and Methods

Thirty healthy participants took part in this study. The IOP of each
participant was measured using a Goldmann tonometer. Measurements were
taken immediately before putting on swimming goggles, at 5, 10, 30, and
60 minutes after putting on swimming goggles, and then immediately after
taking off the goggles. Blood flow of the ONH was measured using the
Heidelberg retinal flowmeter.


The average IOP before, during and after wearing the swimming goggles were
11.88 ± 2.82 mmHg, 14.20 ± 2.81mmHg and 11.78 ± 2.89 mmHg, respectively.
The IOP increased immediately after putting on the goggles (p < 0.05) and then returned to normal values immediately after removal (p > 0.05). Blood flow of the ONH was 336.60 ± 89.07 Arbitrary Units
(AU) before and 319.18 ± 96.02 AU after the goggles were worn (p < 0.05).


A small but significant IOP elevation was observed immediately after the
swimming goggles were put on. This elevated IOP was maintained while the
goggles were kept on, and then returned to normal levels as soon as
they were taken off. Blood flow of the ONH did not change significantly
throughout the experiment. These facts should be considered for safety
concerns, especially in advanced glaucoma patients.

Keywords: Swimming goggles, intraocular pressure, blood flow of optic nerve head

Elevation of intraocular pressure is an important risk factor in the progression
of glaucoma. Swimming goggles induce pressure around the periocular area
and might have an influence on the intraocular pressure (IOP). Swimmers
who wear goggles are exposed to this pressure, and several patients in
our clinic have asked whether this could have an influence on the
progression of glaucoma. We are unaware of any previous reports
discussing the relationship between goggles and an IOP elevation. In
this study, we evaluated whether swimming goggles have an influence on
the IOP as well as on the blood flow of the optic nerve head (ONH).1


We obtained informed consent from each participant, and our study was
approved by the Institutional Review Board. The study was comprised of
30 eyes from 30 healthy volunteers (18 male, 12 female). One eye of each
patient was selected randomly for the analysis. The average age of the
subjects was 27.4 years (26 - 32). The criteria for this study required a
completely normal ophthalmic examination after pupil dilation with a
best-corrected vision ≥ 20/25, IOP < 20 mmHg and no family history of
glaucoma. IOP was measured in all patients before the goggles were
applied, at 5, 10, 30 and 60 minutes after the goggles were put on, and
then immediately after the goggles were removed. Blood flow of the ONH
was measured immediately before and after the goggles were worn. As
shown in Fig. 1,
the lenses of the goggles were removed to allow the measurement of the
IOP. The IOP was measured at each time-point by one examiner (CWS) three
times, and the readings were averaged. A Heidelberg retinal flowmeter
(HRF) (Heidelberg Engineering GmbH, Heidelberg, Germany) was used to
measure the blood flow of the ONH. One examiner measured all the
patients, and then the data was analyzed using an Automatic Full-Field
Perfusion Image Analyzer (AFFPIA) program, which calculated the 'average
flow'.2,3 Arbitrary units (AU) were used in the HRF software to measure blood
flow, volume and velocity measurements. The conventional method to
measure blood flow in the ONH, which uses a sampling technique in a 10 ×
10 pixel frame, can show a fluctuation according to the selection of
the pixels. In this case to analyze the blood flow, the AFFPIA uses two
circles with one just inside the margin of the optic disc and the other
just outside the optic pit, ensuring precision in the measurements.

Fig. 1  
Swimming goggles with anterior part of lens removed to measure IOP while wearing them.

The difference between IOP before and after wearing swimming goggles was
analyzed using repeated measurements and Analysis of Variance(ANOVA)
with Bonferroni correction. The statistical significance was set at p < 0.05.


The IOP before the swimming goggles were worn was 11.88 ± 2.82 mmHg (mean ± SD; n=30). The IOP increased by 2.32 mmHg (p < 0.05) to 14.20 ± 2.82 mmHg (mean ± SD; n=30) immediately after the
goggles were put on. Over the 60 minutes while the goggles were worn,
the average IOP was 14.63 ± 2.92 mmHg (mean ± SD; n=30) at five minutes,
14.72 ± 2.94 mmHg (mean ± SD; n=30) at 10 minutes, 14.60 ± 2.78 mmHg
(mean ± SD; n=30) at 30 minutes and 14.51 ± 2.82 mmHg (mean ± SD; n=30)
at 60 minutes (p < 0.05). The IOP decreased to 11.78 ± 2.89 mmHg (mean ± SD; n=30) immediately after the goggles were taken off(Fig. 2).
The HRF showed an average flow of 336.60 ± 89.07 AU (mean ± SD; n=30)
before the goggles were put on, and decreased to 319.18 ± 96.02 AU (mean
± SD; n=30) immediately after they were taken off. However, the
difference between these two values did not show statistical
significance (p =0.58).

Fig. 2  
Mean IOP (mean ± SD) change before and while the goggles were worn, and
after they were removed(Repeated measures of ANOVA with Bonferroni
correction, *p < 0.05).


Various activities in everyday life have been reported to increase intraocular
pressure. Playing the trumpet has been reported to elevate the IOP by 20
mmHg,4 the Sirsasana posture in yoga has been shown to induce IOP to rise up to 15.8 mmHg,5 and the necktie has been shown to be responsible for a 1.58 mmHg rise in IOP.6,7 In this study, swimming goggles resulted in a 2.4 mmHg increase in IOP.
This rise may not be as high as that of musicians playing the trumpet
or yoga practitioners in the Sirsasana posture, but it is greater than
the IOP rise caused by neckties. Although this increase in IOP may not
have a significant effect on normal participants, any elevation of IOP,
such as that caused by the wearing of swimming goggles, may be
detrimental to patients with advanced glaucoma.8 The IOP elevation was observed immediately after the goggles were put
on, and this elevation returned to a normal level immediately after they
were removed. Although the decrease in IOP immediately after removing
the goggles did not have statistical significance, it does imply that
the change in IOP is a result of direct pressure on the periorbital

This preliminary study has been performed in
normal subjects who are much younger than the average glaucoma patient,
so further studies in glaucomatous subjects are necessary. Also, this
study simulates only partial effects of the swimming goggles because the
anterior section of the lens was removed. The vacuum pressure inside
the chamber formed in each eye by the goggles should also be considered.

This study used one common type of swimming goggles, and so a different
goggle design which has less pressure around periorbital tissue could
have a different effect on IOP. Therefore, advanced glaucoma patients
who use swimming goggles regularly should be carefully monitored, or
should use specially-designed swimming goggles that produce minimal
pressure around the eyelid.


1. Sato
EA, Ohtake Y, Shinoda K, Mashima Y, Kimura I. Decreased blood flow at
neuroretinal rim of optic nerve head corresponds with visual field
deficit in eyes with normal-tension glaucoma. Graefes Arch Clin Exp Ophthalmol. 2006;244:795–801. [PubMed]
2. Boehm AG, Pillunat LE, Koeller U, Katz B, Schicketanz C, Klemm M, et al. Regional distribution of optic nerve head blood flow. Graefes Arch Clin Exp Ophthalmol. 1999;237:484–488. [PubMed]
3. Logan JF, Rankin SJ, Jackson AJ. Retinal blood flow measurements and neuroretinal rim damage in glaucoma. Br J Ophthalmol. 2004;88:1049–1054. [PMC free article] [PubMed]
4. Schuman
JS, Massicotte EC, Connolly S, Hertzmark E, Mukherji B, Kunen MZ.
Increased intraocular pressure and visual field defects in high
resistance wind insrutment players. Ophthalmology. 2000;107:127–133. [PubMed]
5. Baskaran
M, Raman K, Ramani v, Roy J, Vijaya L, Badrinath SS. Intraocular
pressure changes and ocular biometry during sirsasana (headstand
posture) in yoga practitioners. Ophthalmology. 2006;113:1327–1332. [PubMed]
6. Talty P, O'Brien PD. Does extended wear of a tight necktie cause raised intraocular pressure? J Glaucoma. 2005;14:508–510. [PubMed]
7. Teng C, Gurses-Ozden R, Liebmann JM, Tello C, Ritch R. Effect of a tight necktie on intraocular pressure. Br J Ophthalmol . 2003;87:946–948. [PMC free article] [PubMed]
8. The
Advanced Glaucoma Intervention Study (AGIS) 7. The relationship between
control of intraocular pressure and visual field deterioration. The
AGIS Investigators. Am J Ophthalmol. 2000;130:429–440. [PubMed]

Articles from Yonsei Medical Journal are provided here courtesy of Yonsei University College of Medicine


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