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70th AIOC Proceedings, Cochin 2012Implications of Repeated Valsalva’s ManouverIn High Resistance Wind Instrument PtayersDr. Lt. Col (Mrs.) Sagarika Patyal, Dr. (Brig) Ahluwalia T.S., Dr. (Lt. Col.)Partha Sarthi Moulivk, Dr. Poninder Kumar DograValsalva’s maneuver is performed by moderately forceful attemptedexhalation against a closed glottis.It is known to significantly increase intraocular pressure by elevation ofepiscleral venous pressure and increase of orbicularis tone. 1,2 It occurs duringcoughing, lifting heavy weights and playing wind instruments. Comparisonof elevation of intraocular among bending, lifting of fifteen kg weight andperforming the valsalva manouver has shown maximum pressure elevationwith bending over and valsalva maneuver. 3This study was conducted to examine the intraocular pressure changesthat occurred during playing high resistance wind instruments and to do acomprehensive ocular examination of the wind instrument players for effectsthat may have occurred due to many years of playing such instruments.296Aim of this study is:1. To study intraocular pressure (IOP) changes that occurs while playingwind instruments.2. To evaluate ocular findings suggestive of transient iridocorneal contactthat may occur during repeated valsalva maneuver.MATERIALS AND METHODS22 members of a band were examined on two separate occasions while theywere playing music they used to regularly play. An baseline Intraocularpressure was measured before they started playing, IOP was repeated afterthey had played one musical piece lasting 5 minutes and then IOP was repeatedafter 10 minutes and again after 15 minutes after they had stopped playing. 22normals who played other instruments not involving valsalva manouvre, ofsame sex and age group were taken as controls.The entire experiment was repeated twice, after a gap of 2 months to ensurethat the readings of IOP were reproducible.The tonometer used for the procedure was a hand held; anesthetic freeRebound tonometer called iCare (Tiolat, Helsinki, Finland). This tonometerfeatures a small single use disposable probe of 0.9 mm radius held in positionby an electromagnetic field. The probe collides with the central cornea whilethe instrument is aligned 4–8 mm from the patient’s eye. The movement of