Measuring intraocular pressure (IOP) plays a major role in glaucoma care as IOP is a parameter, along with visual field progression and optic disc cupping used to assess treatment effect. While Goldmann tonometry (GAT) is the gold standard, it only provides a snapshot. The influence of IOP fluctuation on the glaucoma process is controversial. This study evaluated the accuracy of the IOP measured by 60 healthy subjects with icare® Home and to observe the IOP fluctuation and pattern of IOP fluctuation in healthy subjects over three consecutive days. Twenty-three percent of the study eyes were excluded in the statistical analysis due to dropout or non-compliance to the schedule. Approximately 70% of the icare® Home measurements were within 3mmHg of the GAT measurements. Sixteen percent of the study eyes had IOP peaks outside office hours; 63% had different IOP patterns on consecutive days. Rebound self-tonometry appears to be accurate and could be used to monitor short- and long-term IOP variations. The difference between IOP patterns on consecutive days raises questions as to the certainty of a single IOP measurement as a measure of treatment effect. It will be interesting to see if using rebound self-tonometry will become more common in future, and in particular if patient compliance will be an issue considering the 23% dropout rate in this study. 

Monitoring daily intraocular pressure fluctuations with self-tonometry in healthy subjects.
Quérat L, Chen E.
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Eulee Seow

University Hospital of Wales, UK.

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