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Rebound tonometry in children: a report by the American Academy of Ophthalmology

Scott R Lambert1, Michele Melia, Angela N Buffenn

  • 1R. Howard Dobbs Professor, Departments of Ophthalmology and Pediatrics, Emory University, Atlanta, Georgia, USA.

Ophthalmology
|February 12, 2013
PubMed

Insights

Rebound tonometry offers a feasible method for measuring intraocular pressure (IOP) in children, though readings may differ from applanation tonometry. This technique allows IOP measurement without general anesthesia in many pediatric cases.

Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Tonometry

Background:

  • Accurate intraocular pressure (IOP) measurement is crucial for diagnosing and managing pediatric glaucoma.
  • Traditional applanation tonometry can be challenging in young children, often requiring sedation or general anesthesia.
  • Rebound tonometry presents a potential alternative for IOP assessment in pediatric populations.

Purpose of the Study:

  • To compare intraocular pressure (IOP) measurements obtained by rebound tonometry and applanation tonometry in children.
  • To evaluate the feasibility of using rebound tonometry and applanation tonometry in pediatric patients.
  • To assess the accuracy and reliability of rebound tonometry in pediatric IOP assessment.

Main Methods:

  • A systematic literature search of PubMed and Cochrane Library databases was conducted (last search June 2012).
  • Four studies met the inclusion criteria after full-text review, with evidence levels assigned.
  • Data from level II and level III studies were analyzed to compare IOP measurements and assess feasibility.

Main Results:

  • No level I evidence was found; 2 level II and 2 level III studies were included.
  • Rebound tonometry yielded IOP readings 2-3 mmHg higher than Goldmann applanation tonometry in most studies.
  • Bland-Altman analysis indicated that IOP differences increased with higher IOP values.
  • Rebound tonometry demonstrated a higher success rate for IOP measurement in children aged 3 years and younger compared to noncontact tonometry.

Conclusions:

  • Rebound tonometry appears to be a reasonably accurate device for measuring IOP in children.
  • This method facilitates IOP measurement in many pediatric cases without the need for general anesthesia.
  • Further research is needed to better understand how IOP measurement differences vary across different instruments and IOP levels.
Abstract

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