April 2014
Volume 55, Issue 13
ARVO Annual Meeting Abstract  |   April 2014
Patient Education Tool for Estimating Intraocular Pressure
Author Affiliations & Notes
  • Kimberly Pham
    University of California, Berkeley, San Jose, CA
  • Gloria Wu
    Ophthalmology, Stanford Hospital & Clinics, Stanford, CA
  • Byongdo Kim
    University of California, Berkeley, San Jose, CA
  • Evelyn Ross
    University of Iowa, College of Public Health, Iowa City, IA
  • Vidhya Gunasekaran
    Aravind Eye Hospital, Madurai, India
  • Jenny Nguyen
    University of Southern California, Los Angeles, CA
  • Agastya Gupta
    Stanford University School of Medicine, Stanford, CA
  • David A Lee
    Ophthalmology, University of Texas Medical School at Houston, Houston, TX
  • Footnotes
    Commercial Relationships Kimberly Pham, None; Gloria Wu, None; Byongdo Kim, None; Evelyn Ross, None; Vidhya Gunasekaran, None; Jenny Nguyen, None; Agastya Gupta, None; David Lee, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 143. doi:
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    • Get Citation

      Kimberly Pham, Gloria Wu, Byongdo Kim, Evelyn Ross, Vidhya Gunasekaran, Jenny Nguyen, Agastya Gupta, David A Lee; Patient Education Tool for Estimating Intraocular Pressure. Invest. Ophthalmol. Vis. Sci. 2014;55(13):143.

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

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Use of cost-effective educational tool, Glaucoma Ball, for self-estimation of intraocular pressure (IOP)


Glaucoma Ball(™ patent pending*) is a set of 40 A, 20 A, 10 A durometer rubber balls, each representing 40, 20,10 mmHg, respectively. The ball measures 2 cm in diameter. Controls (C) and Patients (PT) had routine slit lamp applanation tonometry (Ta) for IOP by ophthalmologist (GW). After initial measured IOP (I-IOP), PTs were given instructions on self-palpation of globe through closed eyelids, then palpate the 3 Glaucoma Balls. The patient estimated IOP is PTE-IOP. Then, final measured IOP by ophthalmologist (GW) (F-IOP) by Ta was taken. Inclusion criteria: Normal volunteers, ophthalmology patients. Exclusion criteria: peripheral neuropathy. The Stata statistical software program was used. Informed consent was obtained.


A total of 22 patients (n=11) and controls (n=11) were enrolled. IOP range: 12-20 mmHg. See Table. PTE-IOP (overestimates = 16, equal= 4, underestimates = 2) were significantly different than I-IOP (t-test, p = 0.03) and F-IOP (t-test, p = 0.01). Using Fisher’s Exact test, C v PT based on ability to choose between the correct and incorrect glaucoma ball: p=0.008.


Glaucoma is a leading cause of blindness in the US. Using Glaucoma Ball(™), patients may be able to self-monitor IOP as part of their glaucoma care. We are hopeful that this educational tool will improve patient compliance and health outcomes for glaucoma treatment. *uspto file no. 61913241/2013

Keywords: 568 intraocular pressure • 462 clinical (human) or epidemiologic studies: outcomes/complications • 579 learning  

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