High Altitude and the Eye: A Case Controlled Study in Clinical Ocular Anthropometry of Changes in the Eye

Abstract

Tribal natives of two spatially separate districts of Lahaul-Spiti (mean altitude = 3300 m) and Kinnaur (mean altitude = 1,700 m) in the Himalayan state of Himachal Pradesh have lived for centuries as closed isolated groups, marrying within the local community up to the recent past. Studies on highland natives in the Andes have shown differences in chest diameters, lung volumes, hematocrit, and the like, in those living at high altitudes. We wanted to study whether stay at high altitude for generations confers any change in the ocular anthropometry. No study of this nature is available in the literature. We studied the ocular parameters using Snellen's charts, Standard Royal-Air-Force Rule, A-2,500 Sonomed A-Scan, Goldmann's aplanation tonometer, and S-7,000 Autorefractometer on 50 healthy volunteers at the Indira Gandhi Medical College Out Patient Department at Shimla (mean altitude = 2,100 m). Those living at higher altitudes in Lahaul-Spiti [LS] (n = 10) had significantly wider nose bridge width (p < 0.05); inter-inner canthal distance [IICD] (p < 0.05); inter-outer canthal distance [IOCD] (p < 0.05); and interpupillary distance [IPD] (p < 0.05) than the group living at Kinnaur (n = 40) at lower elevation. The LS group also had narrower palpebral fissure length in the vertical dimension (p = 0.05) and a lower IOP (p = 0.002) than the Kinnaur group. The axial length, lens thickness, and anterior chamber depth were comparable in the two groups. It appears that the eye and its adnexa respond to hypoxia, ultraviolet radiations, and persistent snow cover at high altitude by altering its anthropometry in a subtle but discernible manner. This was a hitherto unexplored area in the literature. Further studies to elucidate and substantiate the findings of the study are indicated.

Prevalence of refractive errors in Tibetan adolescents

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Craniofacial Anthropometric Profile of Adult Bangladeshi Buddhist Chakma Females

“…The mean intercanthal index in the Chakma females indicated that their eyes were intermediate. Bali et al [33] reported that the individuals who are living at a high altitude has significantly wider intercanthal width and biocular width, thus larger intercanthal index. As the study populations of the present study live in high altitude, they show larger intercanthal index.…”

Prevalence and pattern of refractive error and visual impairment among schoolchildren: the Lhasa childhood eye study

“…Other distinguishing features of Tibetan include a relative lower education level than China inland, lower population mobility and easy to follow up. The differences of regional environment and economics are reported to have influence on human body development and disease composition [8]. Whether the above unique differences affect pediatric eye diseases is not known until recently.…”