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[Comparative study of pneumotonometer and Goldmann tonometer for screening high intraocular pressure in primary care]
M Jara Peñacoba1, A López Traynor, S Duce Tello
1Centro de Salud Luengo Rodríguez, Móstoles, Madrid. julianjp@santandersupernet.com
Objective:
Evaluation of reliability of measurements of IOP obtained with air-puff noncontact tonometer respect the obtained with the conventional Goldmann tonometer. As well, analysis of the possibility of a higher difference between the measurements by both methods respect the fact of being myope or hypermetrope.
Design:
Comparative study of two measurement methods.
Setting:
General ophthalmology clinic and primary care clinic of our sanitary area.
Patients:
Aleatory sample among the patients who went to the general ophthalmology clinic for any cause from the first of May to the thirtieth of June of 1996. The patients with predisposing processes for glaucoma were excluded, as well as those who suffered ocular surgery or those who took drugs which influenced the IOP.
Interventions:
The ophthalmologist made three measurements of IOP in each eye and the sight of all the patients were tested. The arithmetic average was made among every three measurements. The physician of primary care made three measurements of IOP in each eye with the air-puff noncontact tonometer, and the arithmetic average was made.
Results:
81 patients were included, from whom 7 presented high IOP. The sensibility of the air-puff noncontact tonometer, compared with Goldmann tonometer, was 86% (95% CI, 18.20-99.63%), and the specificity 84% (95% CI, 89.66-78.08%). The air-puff noncontact tonometer obtained measurements between 1.116 and 2.008 mmHg higher than the Goldman tonometer. This difference, worthless from the clinic point of view, didn't find a relationship with the fact of being myope or hypermetrope. It was found a positive lineal association between the measurements made by both methods, with a correlation coefficient of 0.8086 (p < 0.001, 95% CI, 0.7476-0.8560).
Conclusions:
The results obtained are similar to the ones of other published series. A tendency of higher measurements with the air-puff noncontact tonometer is observed. It hasn't been observed a higher difference between both methods in myopes. The air-puff tonometer is a valid reliable technique to be used in primary care, it is easy to use, it doesn't transmit infectious illnesses, and it isn't necessary to use anaesthetic or staining eyedrops.