September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Intraocular pressure measurement in the emergency department is inconsistently documented and significantly varies from ophthalmologist IOP
Author Affiliations & Notes
  • Akhilesh S Pathipati
    Stanford University School of Medicine, Stanford, California, United States
  • Edward Wood
    Ophthalmology, Stanford University School of Medicine, Byers Eye Institute, Palo Alto, California, United States
  • Carson K Lam
    Ophthalmology, Stanford University School of Medicine, Byers Eye Institute, Palo Alto, California, United States
  • Christopher Sanchez Sales
    Opthalmic Consultants of Boston, Boston, Massachusetts, United States
  • Darius M Moshfeghi
    Ophthalmology, Stanford University School of Medicine, Byers Eye Institute, Palo Alto, California, United States
  • Footnotes
    Commercial Relationships   Akhilesh Pathipati, None; Edward Wood, None; Carson Lam, None; Christopher Sales, None; Darius Moshfeghi, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 6430. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to Subscribers Only
      Sign In or Create an Account ×
    • Get Citation

      Akhilesh S Pathipati, Edward Wood, Carson K Lam, Christopher Sanchez Sales, Darius M Moshfeghi; Intraocular pressure measurement in the emergency department is inconsistently documented and significantly varies from ophthalmologist IOP. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6430.

      Download citation file:


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

      ×
  • Supplements
Abstract

Purpose : Intraocular pressure (IOP) is a critical sign in the workup of any emergent ophthalmic complaint, but few studies have evaluated the measurement of IOP in the emergency department (ED). We performed a prospective, comparative study to assess the documentation and accuracy of IOP measured by ED providers.

Methods : The study included 64 subjects who presented to the Stanford Hospital ED for whom an ophthalmology consult was requested. Per standard practice at the hospital, we asked ED providers to measure IOP for any patient with an ophthalmic complaint. Values were benchmarked against IOP measured by the consulting ophthalmologist. Ophthalmologist IOP was used as the gold standard because it is the measurement that is ultimately used to make decisions regarding ophthalmologic care at Stanford Hospital. Both ED providers and ophthalmologists used a Tono-pen tonometer to measure IOP.

Results : The ED documented IOP on 16 patients (32 eyes) out of the 64 patients (128 eyes) enrolled in the study (25%). A numeric measurement was recorded for 23 eyes, with 9 measurements recorded in patient charts as "normal." Ophthalmologists documented IOP for all 128 eyes. Numeric values measured in the ED varied from ophthalmology by an average of 4.30 +/- 4.39 mmHg (p = 0.0179; Power > 0.99 at alpha 0.05).

Conclusions : IOP is inconsistently documented and is often inaccurately measured in the ED. The ED did not record IOP for a large majority of patients presenting with eye complaints (75%). When they did, measurements were significantly different than those of consulting ophthalmologists. Both of these factors limit the ability of ophthalmologists to triage opthalmic emergencies and make recommendations regarding care before they see the patient. Future studies should evaluate why IOP is poorly documented and whether non-ophthalmic providers can more accurately measure IOP with automated tonometers that minimize the role of operator skill. Doing so may help standardize and improve ED ophthalmologic care.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×