Ocular complications are common in patients with end-stage renal disease treated with hemodialysis. Disability due to visual impairment in these patients represents a global pub-lic health problem. The study aimed to estimate the hemodialysis effect on intraocular pres-sure (IOP) fluctuation and related factors. A cross-sectional study of 60 patients with he-modialysis (120 eyes) from the hemodialysis unit at a major tertiary teaching hospital in Palestine. Clinical tests were carried out using the Goldman application tonometry and the volk 90d non-contact slit lamp lens. Participant's mean age was 55.5±12.6 years. Thirty-two of them were males (53.3%), and 22 (36.7%) were diabetic. IOP changed significantly af-ter hemodialysis compared to pre hemodialysis level; (14.28±2.68mmHg before versus 12.39±2.24 after hemodialysis) (P<0.001). This change was more significant among fe-males (P<0.001) and patients with diabetes (P=0.001) and correlated significantly with baseline systolic blood pressure (P=0.002), serum sodium (P<0.001), chloride (P=0.034), BUN (P=0.01), and osmolarity (P<0.001). In conclusion, hemodialysis treatment affects IOP and several other laboratory parameters significantly. It likely causes underestimation of IOP and corneal morphometry changes, and these changes may be necessary when plan-ning corneal or lenticular surgeries in hemodialysis patients.

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