The effect of repeated measurements and the use of topical anesthetic on rebound tonometry values in children

Dosunmu, Eniolami O.; Marcus, Inna; Tung, Irene T.; Thiamthat, Warakorn; Freedman, Sharon F.

doi:10.1016/j.jaapos.2014.07.167

Cited by 16 publications

(8 citation statements)

References 4 publications

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“…The tonographic effect of repeated rebound tonometry in equids is unknown and can possibly influence the results. This effect has earlier been detected in mice, but not in children 20,26 …”

Section: Discussionmentioning

confidence: 57%

Comparison of two rebound tonometers in healthy horses

Mustikka

Pietilä²,

Mykkänen

et al. 2020

Veterinary Ophthalmology

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Objective To obtain a reference range for evaluation of intraocular pressure (IOP) in horses using Tonovet Plus®, to compare the IOP readings obtained with Tonovet® and Tonovet Plus®, and to evaluate the repeatability of readings. Animals studied and Procedures Intraocular pressure of 30 client‐owned horses (60 eyes) with no signs of illness or ocular disease was evaluated using Tonovet® and Tonovet Plus® rebound tonometers. Horses’ mean age was 10.7 (range 6‐17) years. Triplicate measurements were performed without using sedatives or local anesthetics, with minimal restraint. Results Calculated reference intervals (the CLSI robust method) were 14.4‐27.2 mmHg for Tonovet® and 16.0‐26.1 mmHg for Tonovet Plus®. Mean values (± standard deviation, SD [± coefficient of variation, CV]) obtained with Tonovet Plus® (21.6 ± 2.45 mmHg [11.3%]) were on average 0.6 mmHg higher than with Tonovet® (21.0 ± 3.14 mmHg [15.0%]), and a negligible statistical difference between the devices was found using the paired sample t test (P = .049). The correlation coefficient for the averaged triplicate measurements was 0.73. The average CV was 4.6% and 4.4% for Tonovet® and Tonovet Plus®, respectively. Conclusions The repeatability of measurements was very good with both devices. The readings between the two devices differed statistically significantly, but the correlation was considered good and the variation was numerically small, and thus, the difference was considered clinically irrelevant. When monitoring disease process or treatment response in an individual patient, repeated readings are best performed using a similar device to avoid false interpretation of results.

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“…The tonographic effect of repeated rebound tonometry in equids is unknown and can possibly influence the results. This effect has earlier been detected in mice, but not in children 20,26 …”

Section: Discussionmentioning

confidence: 57%

Comparison of two rebound tonometers in healthy horses

Mustikka

Pietilä²,

Mykkänen

et al. 2020

Veterinary Ophthalmology

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“…However, it is well known that some applanation tonometers produce the tonographic effect, which is a phenomenon in which IOP values decline with repeated tonometry (Stocker, 1958;Moses, 1961;Krakau and Wilke, 1971;Gaton et al, 2010;Zimmermann et al, 2017). In a study of repeated rebound tonometry in children, the tonographic effect did not occur (Dosunmu et al, 2014). However, in mice, repeated rebound tonometry resulted in a significant reduction of IOP readings, a reduction of 2 mmHg after 10 measurements (Morris et al, 2006).…”

Section: Probe Positionmentioning

confidence: 99%

“…Additionally, it is the most accurate hand-held tonometer (Tofflemire et al, 2017) and can provide accurate readings even in inexperienced hands (Abraham et al, 2008;Sahin et al, 2008). The technique of rebound tonometry was first reported in laboratory animals in the early 2000´s (Kontiola et al, 2001;Danias et al, 2003) and its use became widespread in medical (Abraham et al, 2008;Muttuvelu et al, 2012;Dosunmu, et al, 2014) and veterinary (Reuter et al, 2010;Rusanen et al, 2010;Nagata et al, 2011;Selleri et al, 2012;Slack et al, 2012;Thompson-Hom and Gerding, 2012;Zhang et al, 2014;) ophthalmology in subsequent years. The Tonovet® tonometer (Tiolat Ltd., Helsinki, Finland) uses a small magnetized probe, which is directed toward the corneal surface by an electric coil.…”

Section: Introductionmentioning

confidence: 99%

The influence of the tonometer position on canine intraocular pressure measurements using the Tonovet<sup>®</sup> rebound tonometer

Oliveira¹,

Montiani‐Ferreira²,

Williams³

2018

Open Vet J.

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The objective of this study was to assess the variability of readings made using the Tonovet® rebound tonometer for measurement of intraocular pressure (IOP) in the peripheral cornea and in angulated positions on the canine corneal surface. Forty-six client-owned dogs admitted for ophthalmic evaluation at the Queen’s Veterinary School Hospital, University of Cambridge were included in the study. IOP readings were taken at a variety of locations and using the tonometer at a number of different angles to the cornea: 1) Perpendicularly at center of the cornea (CC); 2) At the center of the cornea but with the tonometer positioned at four angles, and 3) At four different points on the peripheral cornea. All values were compared with the values recorded at the recommended CC position. IOP values were significantly underestimated in seven positions, with median and interquartile range from 12.1 ± 4 mmHg (nasal on periphery) to 15 ± 5 mmHg (laterally angled at center), varying between 0 mmHg to 2.9 mmHg from the CC value. While dorsally angled in the central cornea were not significantly different from those at CC (p = 0.09). Median values were lower for measurements in peripheral positions when compared to angled central positions. These results demonstrate that angling the tonometer or measuring in peripheral regions can result in small but statistically significant underestimation of IOP values.

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“…The ‘gold standard’ for measuring IOP remains undefined, but with the advent of iCare and its greater tolerability in children, much work has ensued to evaluate its accuracy. 2 A retrospective analysis of IOP as measured by noncontact tonometry, rebound tonometry(iCare PRO) and Goldmann applanation tonometry(GAT) on 419 children with a mean age of 8.89 (range 3–15 years) showed that for children less than 10 years old, there was greatest success in obtaining an IOP measurement with noncontact tonometry, followed by rebound and GAT(89%, 75%, 64%, respectively). 3 Not surprisingly there was greater success with all types of tonometry when measuring children greater than 10 years of age, with success at obtaining and IOP measurement at 100%, 98% and 94%, respectively.…”

Section: Intraocular Pressure Measurementmentioning

confidence: 99%

Pediatric glaucoma

Giangiacomo

Beck

2017

Current Opinion in Ophthalmology

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Purpose of review The purpose of this review is to update the clinician on the recent work in the field of pediatric glaucoma. Recent findings Using the iCare tonometer to measure intraocular pressure in children is highly successful. New data from the Infant Aphakia Treatment Study shows that after 5 years of follow-up the risk of developing glaucoma is similar between patients that receive initial intraocular lens implantation and those who are left aphakic. New data shows effective lowering of intraocular pressure using either approach to trabeculotomy: treating the angle partially with trabeculotomes or circumferentially with a suture or iTrack microcatheter. Recent data on an updated approach to trabeculectomy in children shows success in lowering intraocular pressure with few complications, however visual outcomes continue to be suboptimal. A separate study shows that the addition of tenonectomy may not increase surgical success, but may increase survival time and reduce bleb encapsulation. Glaucoma drainage devices in general, and the Ahmed implant in particular, continue to be found to be moderately successful to control intraocular pressure, and are therefore employed, especially after initial angle surgery has failed. Summary Continued work to evaluate the techniques used in the clinical and surgical management of pediatric glaucoma patients support that both newer and older approaches remain standard of care.

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The effect of repeated measurements and the use of topical anesthetic on rebound tonometry values in children

Cited by 16 publications

References 4 publications

Comparison of two rebound tonometers in healthy horses

Comparison of two rebound tonometers in healthy horses

The influence of the tonometer position on canine intraocular pressure measurements using the Tonovet<sup>®</sup> rebound tonometer

Pediatric glaucoma

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