Home tonometry could change glaucoma management
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WASHINGTON — Take-home devices can provide IOP monitoring over longer periods of time and give physicians a better understanding of their patients’ glaucoma progression.
At Glaucoma Day at the American Society of Cataract and Refractive Surgery meeting, Barbara M. Wirostko, MD, said IOP measurements have traditionally been limited to a single time point when the patient is tested in the office.
“When we bring a patient into the office a few times a year, we spend a few seconds measuring their IOP,” she said. “There’s over 31 million seconds in a year. We’re only getting a small snapshot.”
Wirostko said IOP has a lot of variability and fluctuates depending on many factors, including time of day, cortisol levels and exercise.
She said the same principles used in diabetes or blood pressure monitoring can be used in glaucoma and gave some examples of monitoring systems that can be used to capture IOP levels across a longer period of time.
The Triggerfish (Sensimed) is a contact lens that patients wear for 24 hours, including overnight, and the Eyemate (Implandata Ophthalmic Products) is an implantable sensor currently undergoing clinical studies in the United States.
The iCare tonometer has already received clearance in the U.S. and shares similar technology to what is traditionally used in the office, Wirostko said. Patients use the device at home, and previous research has shown that it can supplement in-clinic tonometry, she said.
Wirostko said home tonometry has the potential to change the way glaucoma specialists manage patients, particularly in the world of telehealth.
“I’ve used it to see responses to surgery and to laser,” she said. “It will allow us to intervene earlier.”
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Wirostko BM. IOP from the comfort of their home: Now and beyond. Presented at: American Society of Cataract and Refractive Surgery meeting; April 22-26, 2022; Washington.
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