title: The use of the iCare tonometer reduced the need for anesthesia to measure intraocular pressure in children.
abstract: OBJECTIVE
  To determine whether the introduction of iCare rebound tonometry in a pediatric ophthalmology clinic resulted in fewer examinations under anesthesia to evaluate children with glaucoma.
  
  
  METHODS
  The medical records of consecutive glaucoma patients were retrospectively reviewed. The numbers of examinations under anesthesia (EUAs) and office visits that included measurement of intraocular pressure (IOP) were compared for three periods relative to introduction of the Icare (Icare Finland Oy, Helsinki, Finland) rebound tonometer into our clinical practice: before device introduction, learning/transition period, and routine use.
  
  
  RESULTS
  A total of 87 subjects were included: 48 subjects met inclusion criteria for the first period; 58 patients met inclusion criteria for the third period (some subjects straddled all three periods). The average patient age for the first period was 4.2 years and 4.9 years (P = 0.3) for the third period. The number of EUAs performed before the introduction of the Icare was 55 and after the introduction of the Icare was 18 (P < 0.001). The number of office visits at which IOP was measured increased from 34 to 151 (P < 0.001). Data from the transition period suggest a trend and a short learning period.
  
  
  CONCLUSIONS
  The use of Icare tonometry decreased the need for EUAs to evaluate children with glaucoma and significantly increased successful IOP measurement in clinic.
authors.affiliation: Children's Mercy Hospital, Kansas City, Missouri, USA. grigorian_florin@yahoo.com
authors.forename: Florin
authors.initials: F
authors.lastname: Grigorian
authors.forename: A Paula
authors.initials: AP
authors.lastname: Grigorian
authors.forename: Scott E
authors.initials: SE
authors.lastname: Olitsky
mesh_terms: D000772:Anesthesia, Local / Q000706:statistics & numerical data*; D002675:Child, Preschool; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005901:Glaucoma / Q000175:diagnosis; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D009819:Office Visits / Q000706:statistics & numerical data; D010808:Physical Examination; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014065:Tonometry, Ocular / Q000295:instrumentation*