Visual Impairments May Accompany Reduced Hand Grip Strength

Hand grip strength measures may be indicative of functional and structural ocular changes.

Reduced hand grip strength (HGS) is significantly associated with  visual impairment, as well as shorter axial length, thinner peripapillary retinal nerve fiber layer, lower intraocular pressure (IOP), and a higher prevalence of diabetic retinopathy, according to the study published in British Journal of Ophthalmology. HGS may provide clinical insight to ophthalmologists on their patient’s general and visual health. 

In this population-based cohort study, researchers examined 5899 participants in Bashkortostan, Russia from 2015 to 2017 to explore the correlation between HGS and patients’ wellness, including ocular parameters. Participants were brought to Ufa Eye Institute where their socioeconomic background, medical history, physical and ophthalmological exams, clinical labs, and HGS were recorded. A total of 5381 participants (mean age, 58.6±10.6 years; 45.4 % men; 54.6% women) received HGS measurements. The study group compared with individuals without HGS measurements was young and had a higher proportion of men vs women.

A reduced HGS is associated with visual impairment, shorter axial length, thinner peripapillary retinal nerve fiber layer, lower IOP and higher prevalence of diabetic retinopathy. HGS dynamometry or a handshake may provide the ophthalmologist additional clinical information about the general health and some ocular parameters of the patient.

HGS was higher for the right hand compared with the left hand. In the original analysis, a higher HGS was associated with improved systemic and ocular parameters: better BCVA, lower prevalence of dry eye, longer axial length, higher IOP, thicker peripapillary retinal nerve fiber layer, lower prevalence of retinopathy, and lower prevalence of stage of chronic open-angle glaucoma

In the final model, a higher HGS correlated with better visual acuity (beta: 0.02, P =.02), longer ocular axial length (beta: 0.03, P =.003), higher IOP (beta=0.03, P =.001), thicker peripapillary retinal nerve fiber layer (beta=0.03, P =.001), and lower prevalence of diabetic retinopathy (beta=-0.03, P =.003).

HGS was not correlated with the prevalence of other major ocular disorders, such as cataracts, glaucoma, and dry eye disorders.

One limitation of the study was the technique to measure HGS varied between investigations. The correlation coefficient for the single ocular parameters was low, indicating that the major parameter for HS was age and sex, and ocular parameters played a minor role.


Bikbov MM, Zainullin RM, Gilmanshin TR, et al. Hand grip strength and ocular associations: the Ural Eye and Medical Study. Br J Ophthalmol. Published online August 11, 2022 doi:10.1136/bjo-2022-321404