Purchase this article with an account.
Daniel Apple, Bethany Markowitz; Comparison of Intraocular Pressure Measurements Using a Tono-Pen with Ocufilm + Cover Versus Examination Glove Fingertip Cover. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5663.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To compare intraocular pressure (IOP) measurements taken with a Tono-Pen XL (Reichert Technologies) using Ocufilm + covers (Reichert Technologies) to measurements taken using the fingertip of a Criterion Pure Nitrile examination glove (Henry Schein Medical).
Subjects without glaucoma, known ocular pathology, history of intraocular surgery, or trauma were recruited into this study. Proparacaine was applied to both eyes of subjects seated in an upright position. IOP was obtained in the right eye immediately followed by the left eye using Ocufilm + covers. After resting for 5 minutes, proparacaine was reapplied and the IOP was measured in the same fashion using the fingertip of a nitrile examination glove. A single operator measured the IOP in each eye, and only measurements with a 95% confidence interval noted by the Tono-pen were accepted.
The IOP of 12 eyes was studied. The average right eye IOP when checked with Ocufilm and gloves was 13 mmHg using both methods with a standard deviation of 2.8 mmHg and 5.5 mmHg respectively and an average difference of 0. The average left eye IOP was 14.5 mmHg when checked with Ocufilm covers with a standard deviation of 2.4 mmHg. Using gloves, the average left eye IOP was 15.0 mmHg with a standard deviation of 5.1 mmHg. The average difference was 0.5 mmHg. The absolute IOP difference between Ocufilm covers and gloves was 4.3 mmHg (range 1-9 mmHg) for the right eye and 4.5 mmHg (range 1-8 mmHg) for the left eye.
The IOP measurements varied when taken with Ocufilm and fingertips in the same eye with an average difference of approximately 4 mmHg. Variability within the glove tip measurements is evidenced by a standard deviation nearly twice the amount of that the Ocufilm when performed on the same subjects. Also of note, the subjects of this study noted significant increase in time required to obtain an acceptable measurement with 95% confidence interval while using the nitrile glove. Not only were multiple attempts more commonly required, but measurements themselves were more lengthy. Time required for measurements was not objectively monitored during this study. From this preliminary study, we conclude that glove tips should not be relied on for clinical decision making; however, further study involving more subjects and timing of measurements would be beneficial to further explore this topic further.
This PDF is available to Subscribers Only