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Clément Gisquet, Louis Lhuillier, Zaidi Mohamed, Zerin HEKALO, Sarah Stoebener, Vianney Malleron, christophe goetz, Jean-Marc Perone; Intraocular pressure assessment by finger palpation: is it worth practicing?. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2430.
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© ARVO (1962-2015); The Authors (2016-present)
We performed a prospective study to assess the impact of the practitioner experience and training on the accuracy of intraocular pressure (IOP) estimation by finger palpation (FP).
We included 116 eyes of 29 women and 29 men (mean age 62 years (SD 18)) over a period of 3 weeks.Two examiners assessed IOP by FP for both eyes of each patient: a first year ophthalmology resident (FYR) and an attending physician (AP).The two examiners had to provide a quantitative assessment of IOP to the nearest mmHg. The index finger of both hands was used to apply pressure consecutively on the eyeball through the upper eyelids and attempt to assess the eye stiffness.Measurements with a non-contact tonometer were performed by an optometrist. Both FYR and AP estimated the IOP by FP without the knowledge of the previously measured data. The data obtained were divided into four groups, in chronological order, to analyze the evolution of results over time.
FYR accuracy rates within ±5mmHg were: 47% for the first quarter of the sample; 100% for the second quarter; 80% for the third quarter and 100% for the last quarter.AP accuracy rates within ±5mmHg were: 93% for the first quarter of the sample; 93% for the second quarter; 93% for the third quarter and 100% for the last quarter.Accuracy rates for the FYR were significantly improved after a training on 15 eyes (p=0.002). After a longer training, no significant improvement was noted (p=0.22).Accuracy rates for the AP did not improve significantly over the time (p=1).For the first quarter of the sample, accuracy within ±5mmHg was significantly better for the AP (p=0.01). Then, no significant difference was showed between the two examiners (p=0.99; p=0.60; p=1).
Experienced ophthalmologists are more accurate than inexperienced resident in assessment of IOP by FP. But an inexperienced examiner is able to accurately estimate IOP by FP after a little training on a few patients. FP remains an effective method when tonometry can not be performed: severe ocular surface disease, early post-operative penetrating keratoplasty…Thus, every ophthalmology resident should train since accuracy significantly improves after a short training period.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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