Intraocular Pressure Changes During EGD

This prospective observational study evaluates short-term changes in intraocular pressure (IOP) during elective esophagogastroduodenoscopy (EGD) performed under routine sedation. IOP is measured bilaterally using a handheld rebound tonometer (Icare IC200) at four predefined procedural time points: baseline in the sitting position (T0), after routine administration of 500 mL isotonic intravenous fluid in the sitting position (T1), after sedation in the left lateral decubitus position before endoscopy (T2), and when the endoscope reaches the second portion of the duodenum (T3). The primary outcome is the within-subject change in IOP across these procedural stages. Secondary analyses include differences between the dependent and non-dependent eyes in the left lateral decubitus position and exploratory assessment of factors associated with the change in left-eye IOP from baseline to duodenal passage. No study-specific intervention or treatment allocation is performed; all clinical procedures follow routine institutional practice.

Inclusion Criteria: * Age ≥18 years * Scheduled for elective esophagogastroduodenoscopy (EGD) * Acceptance of the procedure under sedation * Ability to cooperate with intraocular pressure (IOP) and central corneal thickness (CCT) measurements Exclusion Criteria: * Diagnosis of glaucoma or ocular hypertension * Corneal diseases that could affect intraocular pressure or central corneal thickness measurements * Ocular infection * Severe dry eye disease * Hemodynamic instability * Heart failure * Renal failure * Cirrhosis or other clinical conditions contraindicating fluid loading * Use of topical ocular medications, including antiglaucoma drugs or topical steroids * History of ocular surgery * History of refractive laser procedures