This article is more than 5 years old. Information may no longer be current.
Various IOP measurements appropriate for monitoring children
Click Here to Manage Email Alerts
Rebound, noncontact and Goldmann applanation tonometries demonstrated similar results when measuring intraocular pressure in children, according to a study recently published in the American Journal of Ophthalmology.
Feng and colleagues conducted a diagnostic protocol comparison and evaluation to assess the various methods.
Researchers evaluated IOP measurements from the right eyes of 419 children between the ages of 3 and 15 years old. IOP was measured by rebound tonometer (ICare PRO, ICare), noncontact tonometer (Topcon CT80, Topcon) and Goldmann applanation tonometer (Haag-Streit AG).
Results showed that the mean IOP obtained by rebound tonometry was 16.87 ± 3.06 mm Hg, by noncontact tonometry was 17.69 ± 2.44 mm Hg and by GAT was 15.21 ± 2.06 mm Hg.
"IOP readings obtained with the three tonometries evaluated in this study showed a reasonable concordance with each other, and all of them can be considered appropriate methods for routine clinical use," the authors concluded. "Because the rebound and noncontact tonometries can be used without an anesthetic, either of them can be a positive alternative for comfortable, high-success-rate measurement of child IOP."
The researchers suggested that eye care providers pay specific attention to children with thicker central corneas or with IOPs within a suspicious range because of the possibility of overestimation.
They wrote: "In light of this risk of false-positive diagnosis of pediatric glaucoma, patients with high IOP readings should be retested by other methods, including GAT." – by Chelsea Frajerman Pardes
Disclosure: The authors report no relevant financial disclosures.
Perspective
Back to Top
Blair Lonsberry, OD, FAAO
Elevated intraocular pressure is the only known identifiable and modifiable risk factor for the development/progression of glaucoma. Accurate measurement of IOP is a crucial component of an eye exam to identify those patients who may have glaucoma and to monitor treatment. Goldmann applanation tonometry (GAT) has been considered the gold standard for tonometry, but is often challenging in the pediatric population. In this study, IOP was successfully measured by noncontact tonometry (NCT) in 89%, by rebound tonometry (RT) in 75% and by GAT in 64% of children younger than 10 years old, and in 100%, 98% and 94% of children older than 10 years, respectively.
The IOPs obtained by the three techniques showed reasonable correlation and are all considered acceptable means of measuring IOP in children, although NCT and RT tend to overestimate IOP as compared to GAT.
IOP measurement is an important aspect of all eye exams, including pediatric exams. NCT is likely to be the most available and successful means to check IOP in children, and extra suspicion should occur in those children where IOP readings are above normal, and central corneal thickness and other risk factors for glaucoma should be addressed.
Click Here to Manage Email Alerts