Reproducibility of self-measured intraocular pressure with the phosphene tonometer in patients with ocular hypertension and early to advanced glaucoma.
OBJECTIVE
To evaluate the reproducibility of self-measured intraocular pressure with the Proview tonometer in ocular hypertensives and early to advanced glaucoma patients.


METHODS
Thirty-three patients with glaucoma and three with ocular hypertension (72 eyes) were prospectively enrolled. History of cornea surgery was the only exclusion criterion. A trainer took a set of three readings first. Subsequently, the patient (after successful training) took one set of three readings and a physician took two sets of three Goldmann readings. One hour later this was repeated.


RESULTS
72% of patients could see the phosphene in both eyes, 8% could see it in one eye, and 19% could not see it in either eye. Patients who could not see the Phosphene had an average mean deviation of -10.9 compared with -3.4 for those who could see it (P = 0.01). Eyes that could not see the phosphene were excluded from further analysis. The average absolute difference between two Proview measurements one hour apart was 1.76 +/- 1.76 mm Hg (r = 0.71). The measurement error (difference between Goldmann and Proview readings) tended to remain constant between sets of measurements taken one hour apart (average error was 2.4 +/- 2.1 mm Hg, r = 0.85). No adverse event was recorded.


CONCLUSIONS
Repeated self-tonometry measurements showed very good reproducibility. The systematic, reproducible error between Proview and Goldmann readings may be clinically acceptable and suggests that a baseline "calibration" should be obtained for each patient before the Proview values are used clinically. Self-administered tonometry can play a role in the clinical care of ocular hypertensive and glaucoma patients with the possible exception of very advanced cases.
Brigatti
Luca
L
Department of Ophthalmology, University of Rochester, School of Medicine and Dentistry, Rochester, NY, USA. lbrigatti@eyes.arizona.edu
Maguluri
Srigouri
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005189:False Positive Reactions; D005260:Female; D005901:Glaucoma / Q000175:diagnosis*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008365:Manometry / Q000379:methods*; D008875:Middle Aged; D009798:Ocular Hypertension / Q000175:diagnosis*; D010719:Phosphenes; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012648:Self Care / Q000379:methods*