What is the best way to measure intraocular pressure (IOP) in a virtual clinic?

Mostafa, Islam; Bianchi, Eleonora; Brown, Lyndsay; Tatham, Andrew J.

doi:10.1038/s41433-020-0868-2

Cited by 7 publications

(9 citation statements)

References 27 publications

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“…A VC could also play a role in patient follow-up. These types of VCs included the virtual triaging clinic established in Bristol, Nuneaton and Kingston, referred to as the glaucoma classifying clinic (GCC) [ 51 ] in this paper, the virtual clinic in Princess Alexandra Eye Pavilion (VC-PAEP) [ 52 , 53 ], the virtual clinic in Manchester Royal Eye Hospital (VC-MREH) [ 54 ] and in Bristol Eye Hospital (VC-BREH) [ 54 ], the virtual clinic in The Royal Eye Infirmary Plymouth (VC-REIP) [ 55 ] and the Stable Monitoring Service [ 56 , 57 , 58 ] (SMS) which was the other part of the virtual service transformation implemented at the MEH [ 50 ]. The complete virtual service at MEH was named the Glaucoma Screening and Stable Monitoring Service (GSMS) [ 59 ], implementing both the GSC [ 49 ] for initial assessment and the SMS [ 56 , 57 , 58 ] for patient follow-up.…”

Section: Results Of Virtual Clinics’ Studiesmentioning

confidence: 99%

“…In the GCC, patients were taken from the general follow-up pool and could have any type of glaucoma at any stage [ 51 ]. In the VC-PAEP, patients with mild to moderate stable open-angle glaucoma or patients with mild to moderate stable primary closed-angle glaucoma who are bilaterally pseudophakic were suitable [ 52 , 53 ].…”

Section: Results Of Virtual Clinics’ Studiesmentioning

confidence: 99%

“…The expanded monitoring service studied by Nikita et al did not specify the exclusion criteria [ 58 ]. Both the SMS and the VC-PAEP excluded phakic angle-closure glaucoma/glaucoma suspects and patients who had a history of glaucoma filtration surgery [ 52 , 53 , 57 ].…”

Section: Results Of Virtual Clinics’ Studiesmentioning

confidence: 99%

“…The sensitivity amounted to 75.0% for the consultant and 60.0% for the fellow [ 57 ]. The study of Mostafa et al showed that Goldmann applanation tonometry measurements only have moderate agreement when performed by different operators and that repeat Ocular Response Analyzer (ORA) IOP measurements were more consistent [ 53 ].…”

Section: Results Of Virtual Clinics’ Studiesmentioning

confidence: 99%

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Shared Care and Virtual Clinics for Glaucoma in a Hospital Setting

Simons

Vercauteren

Breda

et al. 2021

JCM

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Glaucoma patients require lifelong management, and the prevalence of glaucoma is expected to increase, resulting in capacity problems in many hospital eye departments. New models of care delivery are needed to offer requisite capacity. This review evaluates two alternative schemes for glaucoma care within a hospital, i.e., shared care (SC) and virtual clinics (VCs), whereby non-medical staff are entrusted with more responsibilities, and compares these schemes with the “traditional” ophthalmologist-led outpatient service (standard care). A literature search was conducted in three large bibliographic databases (PubMed, Embase, and Trip), and the abstracts from the prior five annual meetings of the Association for Research in Vision and Ophthalmology were consulted. Twenty-nine were included in the review (14 on SC and 15 on VCs). Patients with low risk of vision loss were considered suitable for these approaches. Among the non-medical staff, optometrists were the most frequently involved. The quality of both schemes was good and improved with the non-medical staff being trained in glaucoma care. No evidence was found on patients feeling disadvantaged by the lack of a doctor visit. Both schemes increased the hospital’s efficiency. Both SC and VCs are promising approaches to tackle the upcoming capacity problems of hospital-based glaucoma care.

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Section: Results Of Virtual Clinics’ Studiesmentioning

confidence: 99%

Section: Results Of Virtual Clinics’ Studiesmentioning

confidence: 99%

Section: Results Of Virtual Clinics’ Studiesmentioning

confidence: 99%

Section: Results Of Virtual Clinics’ Studiesmentioning

confidence: 99%

See 2 more Smart Citations

Shared Care and Virtual Clinics for Glaucoma in a Hospital Setting

Simons

Vercauteren

Breda

et al. 2021

JCM

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“…Comparison studies between three NTC devices showed that, when taking GAT as the gold standard and aiming to detect IOP > 21 mmHg, sensitivities greatly differed from 40%, 48% and 80%, which showed that NCT readings are device dependent and that devices require regular calibration [ 38 ]. Although NCT offers a non-contact mode of measuring that limits the risk of infection due to contaminated drops or Goldmann prisms, the risk of air-borne infection could be greater considering the air-puff nature, which should be considered in the midst of the recent COVID era [ 42 , 43 , 44 , 45 ].…”

Section: Non-contact Tonometry (Air-puff Tonometry)mentioning

confidence: 99%

How to Measure Intraocular Pressure: An Updated Review of Various Tonometers

Brusini

Salvetat

Zeppieri

2021

JCM

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Intraocular pressure (IOP) is an important measurement that needs to be taken during ophthalmic examinations, especially in ocular hypertension subjects, glaucoma patients and in patients with risk factors for developing glaucoma. The gold standard technique in measuring IOP is still Goldmann applanation tonometry (GAT); however, this procedure requires local anesthetics, can be difficult in patients with scarce compliance, surgical patients and children, and is influenced by several corneal parameters. Numerous tonometers have been proposed in the past to address the problems related to GAT. The authors review the various devices currently in use for the measurement of intraocular pressure (IOP), highlighting the main advantages and limits of the various tools. The continuous monitoring of IOP, which is still under evaluation, will be an important step for a more complete and reliable management of patients affected by glaucoma.

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Audit of outcomes following attendance at the City West drive-through IOP glaucoma clinic during the COVID-19 pandemic

et al. 2022

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Background Glaucoma is the leading cause of irreversible blindness globally. During the COVID-19 pandemic, an enforced reduction in capacity resulted in the deferral of routine outpatient appointments for glaucoma patients. Aim This study analyses patient outcomes following the establishment of a drive-through intra-ocular pressure (IOP) clinic during the COVID-19 pandemic to alleviate increased pressure on the tertiary glaucoma services at Royal Victoria Eye and Ear Hospital (RVEEH) and Mater Misericordiae University Hospital (MMUH) between August 2020 and June 2021. Methods A 1-lane driveway system was established in a marquee on the grounds of City West hotel. IOPs were measured in patients’ cars using a hand held iCare100 tonometer. Results were reviewed by a consultant ophthalmologist. At hospital follow-up clinic visits, IOP was measured using the Goldmann applanation tonometer (GAT). Results Three hundred one patients of a total of 672 who attended the drive-through clinic have subsequently attended a designated hospital follow-up appointment. In this cohort, the mean drive-through iCare IOP of 19.4 mmHg ± 6.0 was significantly higher (< 0.005) than the mean GAT IOP at the pre-drive through clinic visit (16.3 mmHg ± 3.7) and the post drive-through hospital follow-up visit (17.2 mmHg ± 4.1). Two hundred twenty-six (75%) patients did not need any treatment change, 53 (18%) required eye drop medication changes, 10 (3%) underwent a laser procedure, 4(1%) required surgical intervention, and 8 (3%) were discharged. When patient outcomes were analysed according to IOP grade assigned at the drive-through clinic, those with an iCare IOP < 21 were significantly less likely to require a treatment change. The cohort with iCare IOP ≥ 30 were significantly more likely to have a laser or surgical intervention. Conclusion The implementation of a drive-through IOP clinic was a safe and effective way to monitor glaucoma patients during COVID-19, and identify those at high risk of poor IOP control or requiring a change in treatment.

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What is the best way to measure intraocular pressure (IOP) in a virtual clinic?

Cited by 7 publications

References 27 publications

Shared Care and Virtual Clinics for Glaucoma in a Hospital Setting

Shared Care and Virtual Clinics for Glaucoma in a Hospital Setting

How to Measure Intraocular Pressure: An Updated Review of Various Tonometers

Audit of outcomes following attendance at the City West drive-through IOP glaucoma clinic during the COVID-19 pandemic

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