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Abstract #46454 Published in IGR 13-3
Home tonometry for management of pediatric glaucoma
Flemmons MS; Hsiao Y-C; Dzau J; Asrani S; Jones S; Freedman SFAmerican Journal of Ophthalmology 2011; 152: 470-478
See also comment(s) by James Brandt •
Purpose: To use iCare rebound tonometry in the home setting for documentation of diurnal intraocular pressure (IOP) fluctuations in children. Design: Nonrandomized, prospective clinical study. Methods: Pediatric ophthalmology clinic patients were recruited between October 2009 and February 2010 who were able to cooperate with IOP measurement by iCare rebound tonometry and whose caregiver was willing and able to obtain iCare measurements at home. The child's IOP was measured first by iCare tonometry followed by a second method (Goldmann applanation [GAT]). The caregiver was instructed on the use of the iCare tonometer. The subject's IOP was measured by the caregiver at home at designated time periods for at least 2 consecutive days. Results: Seventeen children (17 eyes) with known or suspected glaucoma and 11 normal children were included. Excellent reliability was obtained by caregivers in 70% of iCare measurements. Mean difference between iCare and GAT in clinic was 2.0 (plus or minus) 4.0 mm Hg, P =.08. Daily IOP fluctuation occurred in both subjects with glaucoma and normal subjects. In children with known or suspected glaucoma, relative peak and trough IOPs occurred in the early morning (45%) and late evening (43.5%), respectively. Comparison of the peak IOP measured at home vs in the clinic was >6 mm Hg in 5 of 16 subjects (31%) and affected glaucoma management in several subjects. Conclusions: In selected children with glaucoma, home tonometry by iCare rebound tonometry was reliable, easily performed by caregivers, and well tolerated, and offered IOP information valuable in clinical management.
S.F. Freedman. Department of Ophthalmology, Duke Eye Center, Box 3802, 2351 Erwin Rd, Durham, NC 27710, United States.
Classification:
6.1.1 Devices, techniques (Part of: 6 Clinical examination methods > 6.1 Intraocular pressure measurement; factors affecting IOP)
9.1.2 Juvenile glaucoma (Part of: 9 Clinical forms of glaucomas > 9.1 Developmental glaucomas)