Initial experience in self-monitoring of intraocular pressure

Area of Science:

• Ophthalmology
• Glaucoma Management
• Intraocular Pressure Monitoring

Background:

• Diurnal variation in intraocular pressure (IOP) is crucial for glaucoma management.
• Patient self-tonometry offers potential for patient empowerment and hospital resource optimization.
• Previous studies indicated that 74% of patients can effectively use the Icare® HOME tonometer.

Purpose of the Study:

• To explore the feasibility and clinical utility of patient self-monitoring of intraocular pressure using the Icare® HOME tonometer.
• To compare patient self-tonometry with Goldmann applanation tonometry (GAT).
• To assess the diurnal variation of IOP when measured at home by patients.

Main Methods:

• Patients were trained on the standard protocol for using the Icare® HOME rebound tonometer.
• Self-tonometry measurements were compared against Goldmann applanation tonometry (GAT) during a clinical day.
• Patients subsequently collected IOP data at home over two additional days, including evening and morning readings.

Main Results:

• Good agreement between GAT and Icare® HOME was observed for IOPs up to 15 mmHg; the Icare® tended to over-read at higher IOPs, particularly in patients with thicker corneas (>600 µm).
• The average IOP range was significantly greater during three-day home monitoring (9.8 mmHg) compared to single-day clinic (5.0 mmHg) or home (7.0 mmHg) measurements (p < 0.001).
• Eyes with prior trabeculectomy showed a lower IOP range (6.1 mmHg) compared to those without (12.2 mmHg).

Conclusions:

• Self-tonometry with the Icare® HOME device is a feasible approach for patients.
• Home monitoring phases revealed higher peak and trough IOPs, providing additional clinically relevant information.
• Home IOP monitoring is a viable alternative to traditional clinic-based assessments, though cost-effectiveness requires further investigation.