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Initial experience in self-monitoring of intraocular pressure.

McGarva, E., Farr, J., Dabasia, P. , Lawrenson, J. G. & Murdoch, I. E. (2020). Initial experience in self-monitoring of intraocular pressure.. European Journal of Ophthalmology, doi: 10.1177/1120672120920217


Background/aims: Diurnal variation in intraocular pressure (IOP) is a routine assessment in glaucoma management. Providing patients the opportunity to perform self-tonometry might empower them and free hospital resource. We previously demonstrated that 74% of patients can use the Icare® HOME tonometer. This study further explores Icare® HOME patient self-monitoring.

Methods: Patients were trained by standard protocol to use the Icare® HOME rebound tonometer. Patient self-tonometry was compared to Goldmann applanation tonometry (GAT) over one clinical day. Following this, each patient was instructed to undertake further data collection that evening and over the subsequent two days.

Results: Eighteen patients (35 eyes) participated. Good agreement was demonstrated between GAT and Icare® HOME for IOPs up to 15 mm Hg. Above this IOP the Icare® tended to over-read, largely explained by 2 patients with corneal thickness >600 um. The mean peak IOP during ‘clinic hours’ phasing was 16.7 mm Hg and 18.5 mm Hg (p = 0.24) over three days. An average range of 5.0, 7.0 and 9.8 mm Hg was shown during single day clinic, single day home and three day home phasing respectively (p =<0.001). The range of IOP was lower in eyes with prior trabeculectomy (6.1 mm Hg vs 12.2 mm Hg). All patients undertook one reading in the early morning at home with an average of 4.8 readings during, and 3.1 readings after office hours.

Conclusions: This small study shows that self-tonometry is feasible. The findings from home phasing demonstrated higher peak and trough IOPs, providing additional clinical information. Home phasing is a viable alternative. The cost-effectiveness of this approach has yet to be addressed.

Publication Type: Article
Additional Information: McGarva, E., Farr, J., Dabasia, P., Lawrenson, J. G. and Murdoch, I. E. (2020). Initial experience in self-monitoring of intraocular pressure.. European Journal of Ophthalmology, doi: 10.1177/1120672120920217. Copyright © 2020 The Authors DOI: 10.1177/1120672120920217.
Publisher Keywords: Glaucoma, self-tonometry, phasing, methods comparison study
Subjects: R Medicine > RE Ophthalmology
Departments: School of Health & Psychological Sciences > Optometry & Visual Sciences
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