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Normal intraocular pressure in children: a comparative study of the Perkins applanation tonometer and the
1Department of Ophthalmology, Children's National Medical Center, Washington, DC.
Insights
Intraocular pressure (IOP) is lower in young children than adults when measured with the Perkins tonometer. However, the Digilab pneumatonographer showed no significant difference in IOP between these age groups.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Optometry
Background:
- Intraocular pressure (IOP) is a critical factor in diagnosing and managing glaucoma.
- Accurate IOP measurement in pediatric populations is essential for early detection of eye conditions.
- Existing methods for IOP measurement may yield different results in children compared to adults.
Purpose of the Study:
- To compare intraocular pressure measurements in awake, cooperative children under 5 years old and adults using two different tonometers.
- To evaluate the influence of age on IOP readings obtained with the Perkins tonometer and the Digilab pneumatonographer.
- To determine if there are significant differences in IOP between pediatric and adult populations using non-sedated methods.
Main Methods:
- Recruited 50 normal children under 5 years and 12 normal adult volunteers.
- Measured intraocular pressure (IOP) using the Perkins hand-held applanation tonometer and the Digilab pneumatonographer-tonometer.
- Measurements were performed without sedation, general anesthesia, or lid specula, in the supine position for children and sitting for adults.
Main Results:
- The Perkins tonometer showed significantly lower IOP in children (mean 5.89 mm Hg) compared to adults (mean 13.21 mm Hg; P < .0001).
- The Digilab pneumatonographer showed no significant difference in IOP between supine children (mean 14.76 mm Hg) and sitting adults (mean 14.42 mm Hg; P = .497).
- Regression analysis indicated that Perkins IOP may equalize between children and adults around age 12.
Conclusions:
- The Perkins tonometer reveals lower IOP in young children compared to adults, supporting previous findings.
- The Digilab pneumatonographer provides comparable IOP readings between young children and adults, irrespective of position.
- Age-related differences in IOP measurement are device-dependent, highlighting the importance of selecting appropriate tonometry methods for pediatric assessments.
Abstract:
We measured the intraocular pressure (IOP) of 50 normal, cooperative, awake children below 5 years of age and 12 normal, volunteer adults with the Perkins hand-held applanation tonometer (Perkins) and the Digilab pneumatonographer-tonometer (Pneuma). Neither sedation, general anesthesia, nor lid specula were used. We confirmed others' findings that the normal IOP, measured in the supine position with the Perkins, is lower in infants and young children (mean = 5.89 mm Hg) than in adults (mean = 13.21 mm Hg; P < .0001). On the other hand, with the Pneuma, the supine pediatric IOP (mean = 14.76 mm Hg) was not significantly different from the adult sitting IOP (mean = 14.42 mm Hg; P = .497). Regression analysis suggests that children and adult Perkins IOP may become equal at around age 12 years.
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