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Evaluation of a new rebound tonometer for self-measurement of intraocular pressure

Dabasia, PL; Lawrenson, JG; Murdoch, IE; (2016) Evaluation of a new rebound tonometer for self-measurement of intraocular pressure. British Journal of Ophthalmology , 100 (8) pp. 1139-1143. 10.1136/bjophthalmol-2015-307674. Green open access

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Abstract

BACKGROUND/AIMS: To compare the accuracy of self-obtained, partner-obtained and trainer-obtained measurements using the handheld Icare Home rebound tonometer with Goldmann applanation tonometry (GAT), and to evaluate the acceptability to subjects of Icare Home measurement. METHODS: 76 subjects were trained to use Icare Home for self-measurement using a standardised protocol. A prespecified checklist was used to assess the ability of a subject to perform self-tonometry. Accuracy of Icare Home self-measurement was compared with GAT using one eye per subject, randomly selected. Bland-Altman difference analysis was used to compare Icare Home and GAT intraocular pressure (IOP) estimates. Acceptability of self-tonometry was evaluated using a questionnaire. RESULTS: 56 subjects (74%, 95% CI 64 to 84) were able to correctly perform self-tonometry. Mean bias (95% limits of agreement) was 0.3 mm Hg (−4.6 to 5.2), 1.1 mm Hg (−3.2 to 5.3) and 1.2 mm Hg (−3.9 to 6.3) for self-assessment, partner-assessment and trainer-assessment, respectively, suggesting underestimation of IOP by Icare Home tonometry. Differences between GAT and Icare Home IOP were greater for central corneal thickness below 500 µm and above 600 µm than data points within this range. Acceptability questionnaire responses showed high agreement that the self-pressure device was easy to use (84%), the reading was quick to obtain (88%) and the measurement was comfortable (95%). CONCLUSIONS: Icare Home tonometry can be used for self-measurement by a majority of trained subjects. IOP measurements obtained using Icare Home tonometry by self-assessment and third party-assessment showed slight underestimation compared with GAT.

Type: Article
Title: Evaluation of a new rebound tonometer for self-measurement of intraocular pressure
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bjophthalmol-2015-307674
Publisher version: http://dx.doi.org/10.1136/bjophthalmol-2015-307674
Language: English
Keywords: Science & Technology, Life Sciences & Biomedicine, Ophthalmology, Ocular Hypertension, Blood-pressure, Glaucoma, Home, Population, Precision, Agreement, Accuracy, Pattern
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology
URI: https://discovery.ucl.ac.uk/id/eprint/1513276
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