Effect of Oral Chloral Hydrate Sedation on the Intraocular Pressure Measurement

We measured the intraocular pressure (IOP) of 50 normal, cooperative, awake children below 6 years of age and 10 glaucoma patients with the Perkins' hand-held applanation tonometer (Perkins) and the Digilab pneumatonographer-tonometer (Pneuma). The measurements were repeated after oral chloral hydrate administration in the dose of 100 mg/kg body weight for the first 10 kg plus 50 mg/kg for every additional kg. There were no clinically or statistically significant changes in IOP measured before and after chloral hydrate in the 50 normal children (Pneuma: mean = 14.74 +/- 1.27 mm Hg vs 14.74 +/- 0.96 mm Hg; P > .05; Perkins: mean = 5.86 +/- 1.69 mm Hg vs 5.61 +/- 1.50 mm Hg; P > .05) or in the 15 glaucomatous eyes (Pneuma: mean = 28.93 +/- 5.26 vs 28.47 +/- 4.42 mm Hg; Perkins: mean = 20.27 +/- 5.36 vs 19.53 +/- 4.49 mm Hg; P > 0.05). Although some children did resist swallowing the bitter-tasting medicine, no significant side effects were encountered. The high-dose oral chloral hydrate protocol resulted in efficient sedation in children below the age of 6 years, without any alteration of the IOP levels in both normal and glaucomatous eyes.