April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
An audit of ICare rebound tonometry in a tertiary glaucoma centre
Author Affiliations & Notes
  • Parham Azarbod
    Ophthalmology, Imperial College London, London, United Kingdom
  • Richard Holder
    Ophthalmology, Imperial College London, London, United Kingdom
  • Laura Crawley
    Ophthalmology, Imperial College London, London, United Kingdom
  • Philip Bloom
    Ophthalmology, Imperial College London, London, United Kingdom
  • M Francesca Cordeiro
    Ophthalmology, Imperial College London, London, United Kingdom
    Institute of Ophthalmology, UCL, London, United Kingdom
  • Faisal Ahmed
    Ophthalmology, Imperial College London, London, United Kingdom
  • Footnotes
    Commercial Relationships Parham Azarbod, None; Richard Holder, None; Laura Crawley, None; Philip Bloom, None; M Francesca Cordeiro, None; Faisal Ahmed, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 132. doi:
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      Parham Azarbod, Richard Holder, Laura Crawley, Philip Bloom, M Francesca Cordeiro, Faisal Ahmed, ; An audit of ICare rebound tonometry in a tertiary glaucoma centre. Invest. Ophthalmol. Vis. Sci. 2014;55(13):132.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: In tertiary referral centres there is continuing strive towards improving patient pathway in often very busy clinics. As part of our departments effort in achieving this goal, the use of ICare rebound tonometer during the patients’ initial assessment before examination by the doctor, was introduced. This audit was carried out to assess the accuracy of ICare rebound tonometry in an outpatient clinic setting.

Methods: A retrospective case note review of patients attending the glaucoma clinic over a four-week period, commencing two weeks after the introduction of ICare, was carried out. ICare rebound tonometry was performed by the nursing and ancillary staff as part of the initial patient assessment. All patients also had Goldman Applanation tonometry (GAT), using easyton disposable prisms, carried out by the attending doctor, which included senior residents, fellow or consultants in the glaucoma clinic. The results from the two measurements were compared, and any correlation between the magnitude of difference between the two methods and patient factors including age, central corneal thickness (CCT) and visual acuity (VA) was also examined.

Results: Seventy-two patients (152 eyes) were analyzed. The average age of the patients was 67 years. The average difference between ICare and GAT was 1.14±4.30 mmHg with a minimum and maximum difference of -10 and +17 mmHg. The Bland Altman Plot had a level of agreement of -7.3 to 9.6 mmHg. An accuracy of ±1 mmHg in the ICare measure was found in only 34% of the eyes. There was no correlation between age (r=-0.12, p<0.27), CCT (r=0.15, p<0.14), VA (r=-0.01, p<0.88) and the difference in values obtained between the two intraocular pressure measurement devices.

Conclusions: The accuracy of the ICare rebound tonometer when compared to GAT as described above, appears to be unpredictable and has no relationship with any patient factors that could potentially affect measurements. It is possible that there may be a discrepancy in the exact method of use of the ICare device amongst the operators in the current study. Until this is further explored, Goldman Applanation tonometry remains the current preferred method of intraocular pressure measurement.

Keywords: 465 clinical (human) or epidemiologic studies: systems/equipment/techniques  
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