Abstract
Purpose :
The COVID-19 pandemic has spurred innovation beyond traditional healthcare.1 At our institution, a drive-through intraocular pressure (IOP) measurement protocol using the iCare tonometer was established to facilitate low-contact monitoring of select glaucoma patients. However, the iCare may be prone to error due to variable measurement technique and local air currents.2 We endeavored to assess the reliability of drive-through IOP measurements by comparing them with recent measurements taken in clinic settings.
Methods :
Inclusion criteria were all patients with drive-through IOP measurements performed from May 11-Aug. 11, 2020; exclusion criteria were any patients with IOP medication change or ophthalmic procedure between the studied IOP measurements. Drive-through IOP measurements were compared with the most recent prior in-clinic IOP measurements. Data was gathered using the Sight Outcomes Research Collaborative (SOURCE) data repository.2
Results :
The study group consisted of 338 patients receiving drive-through IOP measurements. Significant differences were found between drive-through IOPs and prior in-clinic measurements. The mean drive-through vs. in-clinic IOP OD was 17.0 mmHg (SD 5.3) vs. 14.5 mmHg (SD 4.2), and OS was 17.8 mmHg (SD 5.6) vs. 15.1 mmHg (SD 4.5), a difference of 17.6% OD and 17.8% OS. Differences between individual measurements ranged from -5.5 mmHg to +12 mmHg. 71.4% of drive-through IOPs were higher than corresponding in-clinic IOPs; 22.7% were lower. 30.5% of drive-through IOPs were higher than >5 mmHg. In 18.4% of cases, drive-through IOP measurements resulted in management changes (typically, the addition of an IOP-lowering drop). In comparison, only 10.5% of in-clinic measurements resulted in management changes--the equivalent of a 75% increase in intervention.
Conclusions :
Low-contact forms of IOP monitoring will continue to play a role in tele-ophthalmology. However, our data reveals potential inaccuracies in drive-through iCare IOP measurements which tend to overestimate IOP, thus triggering interventions in more drive-through cases than typically seen in clinic.
This is a 2021 ARVO Annual Meeting abstract.