title: Comparison of handheld rebound tonometry with Goldmann applanation tonometry in children with glaucoma: a cohort study.
abstract: OBJECTIVE
  To test agreement of two methods to measure intraocular pressure (IOP): rebound tonometry (RBT) and gold standard Goldmann applanation tonometry (GAT) in children with glaucoma.
  
  
  METHODS
  Observational prospective cohort study.
  
  
  METHODS
  Tertiary paediatric glaucoma clinic at a single centre.
  
  
  METHODS
  102 individuals attending a paediatric glaucoma clinic, mean (SD) age 11.85 (3.17), of whom 53 were male.
  
  
  METHODS
  Intraocular pressure, central corneal thickness, child preference for measurement method.
  
  
  RESULTS
  Limits of agreement for intraobserver and interobserver were, respectively, (-2.71, 2.98) mm Hg and (-5.75, 5.97) mm Hg. RBT frequently gave higher readings than GAT and the magnitude of disagreement depend on the level of IOP being assessed. Differences of 10 mm Hg were not uncommon. RBT was the preferred method for 70% of children.
  
  
  CONCLUSIONS
  There is poor agreement between RBT and GAT in children with glaucoma. RBT frequently and significantly overestimates IOP. However, 'normal' RBT readings are likely to be accurate and may spare children an examination under anaesthesia (EUA). High RBT readings should prompt the practitioner to use another standard method of IOP measurement if possible, or consider the RBT measurement in the context of clinical findings before referring the child to a specialist clinic or considering EUA.
authors.affiliation: Department of Paediatric Ophthalmology, NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.
authors.forename: Annegret Hella
authors.initials: AH
authors.lastname: Dahlmann-Noor
authors.forename: Renata
authors.initials: R
authors.lastname: Puertas
authors.forename: Shenille
authors.initials: S
authors.lastname: Tabasa-Lim
authors.forename: Ahmed
authors.initials: A
authors.lastname: El-Karmouty
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kadhim
authors.forename: Nicholas Kloster
authors.initials: NK
authors.lastname: Wride
authors.forename: Amanda
authors.initials: A
authors.lastname: Lewis
authors.forename: Dawn
authors.initials: D
authors.lastname: Grosvenor
authors.forename: Poornima
authors.initials: P
authors.lastname: Rai
authors.forename: Maria
authors.initials: M
authors.lastname: Papadopoulos
authors.forename: John
authors.initials: J
authors.lastname: Brookes
authors.forename: Catey
authors.initials: C
authors.lastname: Bunce
authors.forename: Peng Tee
authors.initials: PT
authors.lastname: Khaw
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