الفهرس 
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Abstract
Hemodialysis (HD) is an essential and common treatment for end stage renal disease, and ocular alterations associated with HD are wide ranging and include refractive changes, central corneal thickness changes, retinal nerve fiber layer thickness changes, and changes in intraocular pressure.
Although several works in the past have examined the effect of HD on intraocular pressure (IOP), reported finding, theories, and conclusions are very different.
Increased IOP is a major risk factor for inducing glaucoma, causing irreversible loss of vision, where medical and surgical approaches are the treatment of choice.
In our study we aimed to measure IOP before, during and after a single hemdialysis session on patients undergoing regular hemodialysis and observing the effect of HD on the intraocular pressure.
Patients were chosen according to inclusion criteria and exclusion of corneal abnormalities, corneal surface irregularities or surgeries, current eye infection and secondary glaucoma.
A good medical history was taken, visual acuity was tested, and examination of anterior segment was done. We measured IOP by Schiotz tonometer in 88 eyes at site of dialysis 15 minutes before
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starting HD, one hour after starting HD, and 15 minutes after a single session of HD.
Measurement of IOP by Goldmann applanation tonometer mounted on slit-lamp in 18 eyes at the ophthalmic out patient clinic 15 minutes before and after HD. The obtained data was collected in a sheet for each patient.
This study included 106 eyes of 53 patients undergoing regular hemodialysis where IOP is measured in a single session with the following results:-
The cases show that 7.5% of them are known to be glaucomatous and are on antiglaucoma medication and 92.5% are not known to have glaucoma. Also 22.6% of cases are pseudophakics with history of cataract surgery and 77.4% are phakics with no history of cataract surgery.
The cases show that 30.6% of them have cataract as an ocular disease and 69.4% are non cataractous.
The patients in general show decreased IOP reading in 46.6% of eyes during HD and in 46.2% of eyes after HD, Non changed IOP in 29.5% of eyes during HD and in 29.3% of eyes after HD, Increased IOP reading in 23.9% of eyes during HD and in 24.5% of eyes after HD.
All glaucomatous eyes showed increased IOP readings either during or after HD. While the non-glaucomatous show that 41.8% of them had decreased IOP, 26.5% had non changed IOP and 13.2% had
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increased IOP during HD. While, after HD 50% of non-glaucomatous had decreased IOP, 31.6% had non changed IOP and 18.4% had increased IOP.
In pseudophakic eyes during HD 58.3% of eyes had non changed IOP, 41.7% of them had decreased IOP. While after HD 8.3% of pseudophakic eyes had increased IOP, 37.5% had decreased IOP and 54.2% of them had non changed IOP.
It seems to be clear that in patients with glaucoma, the possibility of acute IOP rise during HD could be much more frequent than in normal patients. So in these patients, an ophthalmic scheduled examination seems to be feasible to avoid large IOP fluctuations.
Accordingly we conclude that hemodialysis decrease IOP in dialysis patients during and after HD. Glaucomatous eyes showed increased IOP during and after HD while pseudophakic eyes had non changed IOP during and after HD.