Home Tonometry in Glaucoma: Physician and Patient Perspectives on Indications, Benefits, and Barriers to Wider...

Glaucoma physician and patient perspectives on home tonometry revealed benefits such as improved physician treatment confidence and reduced patient anxiety, while highlighting cost, device accuracy concerns, and patient proficiency as potential barriers to broader integration.

To assess physician and patient perspectives on home tonometry (HT) in glaucoma and understand its impact on glaucoma care, and barriers to its broader clinical integration.

Separate surveys were sent to ophthalmologists and patients: 1 distributed by the American Glaucoma Society to its members, and the other through MyEyes to its patient clients. Physician surveys included training background, prescribing practices, and attitudes toward HT, while patient surveys included glaucoma history, HT use, and attitudes toward HT. Surveys incorporated mirrored questions to compare perspectives between HT prescribers and nonprescribers, and between physicians and patients, comparing frequency distributions and Likert-scale scores.

Among 157 ophthalmologists, 59% reported prescribing HT, most often for patients with moderate-to-severe glaucoma. HT data influenced clinical management in 85% of prescribers and increased treatment confidence in 92%. Compared with HT prescribers, nonprescribers more frequently cited device inaccuracy and patient stressas reasons not to prescribe HT ( P <0.01), while both groups found patient financial cost and device proficiency to be moderate or higher concerns. Among 188 patient respondents, 85% had moderate-to-severe glaucoma, and 72% found HT easy to use. Furthermore, nearly half reported decreased anxiety with HT. Both physicians and patients identified cost as the primary barrier to obtaining HT, with most patients paying out of pocket despite insurance coverage.

HT was generally valued by physicians and patients, increasing physician confidence and positively influencing patient well-being. Broader integration remains limited by patient financial barriers and physician skepticism about device reliability and patient proficiency. Further research on outcomes of HT use versus nonuse may help address these limitations.