title: Comparison of Intraocular Pressure Measurements Obtained by Rebound, Noncontact, and Goldmann Applanation Tonometry in Children.
abstract: OBJECTIVE
  To compare intraocular pressure (IOP) among rebound, noncontact, and Goldmann applanation tonometry (GAT) and their relationships to central corneal thickness in children.
  
  
  METHODS
  Diagnostic protocol comparison and evaluation.
  
  
  METHODS
  In right eyes of 419 children, mean IOP, rates of successful measurement with 3 tonometries, and intermethod agreement by Bland-Altman plot were assessed. The influences of central corneal thickness, and of average IOP of 3 tonometries on IOP differences between tonometries, were evaluated.
  
  
  RESULTS
  The mean age was 8.89 ± 3.41 years (3-15 years). There was significant difference in mean IOP of each tonometry; GAT showed the lowest values (P < .05). The IOP was successfully measured by noncontact tonometry in 89%, by rebound tonometry in 75%, and by GAT in 64% of children less than 10 years old, and in 100%, 98%, and 94% of children older than 10 years, respectively. The IOP of each tonometer positively correlated with central corneal thickness (P < .05). The mean differences and limits of agreement were 0.81 ± 6.19 mm Hg (noncontact minus rebound), 2.56 ± 4.62 mm Hg (rebound minus GAT), and 1.81 ± 4.76 mm Hg (noncontact minus GAT). Rebound and noncontact tonometry overestimated IOP relative to GAT for thicker central corneal thicknesses. Rebound tonometry overestimated IOP relative to GAT and noncontact tonometry at higher average IOP of 3 tonometries.
  
  
  CONCLUSIONS
  Rebound, noncontact, and Goldmann applanation tonometries can be considered appropriate methods for children, though noncontact tonometry is the most accessible. Given the risk of false-positive diagnosis of pediatric glaucoma, attention should be devoted to children with IOP within a suspicious range or thicker cornea.
authors.affiliation: Department of Ophthalmology, Hallym University College of Medicine, Seoul, South Korea; Somang Ophthalmic Clinic, Incheon, South Korea.
authors.forename: Chi Shian
authors.initials: CS
authors.lastname: Feng
authors.affiliation: Department of Ophthalmology, Hallym University College of Medicine, Seoul, South Korea.
authors.forename: Ki Won
authors.initials: KW
authors.lastname: Jin
authors.affiliation: Department of Ophthalmology, Hallym University College of Medicine, Seoul, South Korea.
authors.forename: Kayoung
authors.initials: K
authors.lastname: Yi
authors.affiliation: Department of Ophthalmology, Hallym University College of Medicine, Seoul, South Korea. Electronic address: eyechoi@hallym.or.kr.
authors.forename: Dong Gyu
authors.initials: DG
authors.lastname: Choi
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003315:Cornea / Q000473:pathology; D004867:Equipment Design; D005260:Female; D005901:Glaucoma / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014065:Tonometry, Ocular / Q000295:instrumentation*