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R. J. Peralta, A. Miller; Efficacy of Finger Palpation in the Estimation of Intraocular Pressure. Invest. Ophthalmol. Vis. Sci. 2008;49(13):707.
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To assess the efficacy of finger palpation in the estimation of intraocular pressure by resident physicians.
Four porcine eyes were filled with normal saline to achieve intraocular pressures (IOP) within three pre-determined ranges : "low" (<10 mmHg), "normal" (10 to 22 mmHg) and "high" (>22 mmHg), as measured by Goldmann applanation tonometry (GAT). To ensure consistency of results, corneal pachymetry was performed on each eye and the appropriate IOP adjustments were made.Sixteen ophthalmology residents were asked to perform finger palpation on the four porcine eyes and provide both a qualitative (low, normal or high) and quantitative (in mmHg) assessment of IOP. GAT measurements were taken immediately after finger palpation.
Sixteen residents participated in the study and a total of 64 IOP measurements were made. Qualitatively, 81% of finger palpation measurements were in accord with actual (GAT) IOP. The residents were particularly efficacious in estimating "low" (18 of 64 measurements) and "high" (20 of 64) pressures, correctly identifying these pressures via finger palpation 100% and 90% of the time, respectively. Results were more varied for "normal" (26 of 64) pressures, with a success rate of 69%. Quantitatively, 56% of finger palpation pressures were within ±5 mmHg and 84% were within ±10 mmHg of the actual IOP. Corneal pachymetry ranged from 715 to 731 µm.
Finger palpation may be an effective means of qualitatively assessing intraocular pressure, particularly in cases of either high or low pressures. This may be especially useful in estimating IOP in patients who cannot undergo traditional applanation tonometry (i.e. severe ocular surface disease, post-operative penetrating keratoplasty).
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