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EW GLAUCOMA 96 September 2016 Ritch found that her pressure went up to 60 mm Hg. "We got excited and measured everyone in the department while standing on their heads," he said. Everyone else's pressures doubled, while her pressure quadrupled. This patient's pressure doubled to 30 mm Hg when she was just lying flat on her back. Dr. Ritch heard from some other practitioners who had similar patients, including a patient who had been a hostage in Iran. "They hung him upside down every day for a year and he had pressures of 50 mm Hg and was blind from glauco- ma," Dr. Ritch said. Somehow such early patients were never written up. Still, the idea of doing a study on yoga patients remained on Dr. Ritch's agenda. When the recent study was launched, however, patients were not standing on their heads, but instead assumed four common yoga positions with their heads lower than their bodies. The four positions included downward- facing dog, standing forward fold, plow pose, and legs-up-the-wall pose. Studying the four poses In this prospective single-cen- ter study, investigators measured the pressures of 10 open-angle glaucoma patients as well as 10 normal subjects. They found that within 1 minute of assuming the downward-facing dog pose, IOP in glaucoma patients rose from 17 to 28 mm Hg, while in normal subjects this went from a mean of 17 to 29 mm Hg. In the standing forward fold pose, IOP went from 17 to 27 by Maxine Lipner EyeWorld Senior Contributing Writer was something that Dr. Ritch had in mind for decades. Back in the 1980s, he had a patient who, despite having an IOP of just 15 mm Hg, had end-stage visual field loss. "She had gone to about 12 centers around the country and no one could figure it out," he said. "It turned out that, after questioning, we learned she had been doing yoga and standing on her head for 20 minutes a day for 20 years." When she was examined while standing on her head, Dr. which the head is down, 1 according to Robert Ritch, MD, Shelley and Steven Einhorn Distinguished Chair, New York Eye and Ear Infirmary, New York. For glaucoma patients, having the head in such upside down positions during yoga or other exercises may be cause for concern, Dr. Ritch said. Early concerns Examining the idea that certain yoga positions could be problematic Why glaucoma patients should be wary of certain yoga positions W hile many rely on yoga to enhance their health, for those with glaucoma, certain positions may spell trouble. In a recent study, investi- gators found that IOP dramatically rises in four common positions in Heads up on head-down yoga maneuvers

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