PRESSURE FROM EYE EXAM

Is it normal to have a retina specialist press underneath the eyeballs pushing the eyeballs so that they roll up (feeling as if they are going to be pushed  right out of the socket and causing a lot of discomfort) in order to see the blood vessels more clearly with the light? My friend was wondering if the eyeballs could possibly detach from pushing the eyeballs so hard, since they already have white flashes,  some floaters and at times pain in the eyeballs? What else can be done to look at blood vessels more closely and is it really necessary since so far blood vessels are all inactive?

[Sandy Feldman, MD, MS]

Dear Dnas1,

It is normal for a retinal specialist to exert some pressure to examine the peripheral retina if you were experience floaters and flashes of light.

Dr. Feldman

Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California

[berrywoo]

I think you might be talking about a scleral depression. This is where you're reclined back and the doctor takes a depressor to press on the sclera (white part of the eyes). It is done so he/she can get a better look at the peripheral retina. It may be a bit uncomfortable but it does not cause any harm.

In a retinal exam different lenses held close to the eye can help the doctor to get a better view of the retina. Sometimes it is not enough and other tests may be done like an OCT or flourescein (sp?) angiogram.

They eye won't pop out during an exam so don't worry!!!

[Dnas1]

Thank you for your reply back on 4/10/09 re: question on PRESSURE FROM EYE EXAM
by Dnas1
My friend doesn't recall the use of a "scleral depression" held on the eye, just the doctors' fingers.  Is it safe for one do the same thing with just their fingers to look at the peripheral retina, if this is the purpose?  Thanks.

[des900]

I too have such an incident

one doctor applied pressure using his thumb directly on bottom of eye to examine meibomian gland secretions

i am bit worried about that pressure applied,is it safe to apply pressure on eyes?

thanks

[berrywoo]

There should have been a scleral depressor used. Nevertheless, using the thumbs to apply a bit of pressure should not cause any harm.

[des900]

thanks a lot

[dukey]

If you have a pre-existing condition which can be worsened by spikes in intra-occular pressure it is definitely not OK to apply pressure to the eyes on a regular basis. High myopia is one example where rubbing the eyes or squeezing them closed forcefully is 100% not recommended as this can very much worsen the situation, especially if it is habitual (many myopes exhibit these kind of ticks!). I would imagine glaucoma is another example.  

Scleral indentation, however, is a very important procedure and should be performed whenever needed. It is only done once in a while and so the risks seem very minimal.