Self Tonometry monitoring

[icmor]

My MD asked if I knew where to get a portable tonometer that a patient can do self monitoring for their pressures. I'm not aware of home units for this purpose. Is there such a product available? Are they accurate if there is such a thing?

[fjpod]

There is (or was) a "tonometer" that one would apply with the eyelids closed. I forget the name, and I think it was made by a division of B&L, but I could be wrong. Tried it a few times on glaucoma patients with uni-lateral glaucoma, thinking they would at least be able to tell if the affected eye was higher than the normal. the device was useless.

I don't think self-monitoring IOP is a wise idea. This may sound strange, but glaucoma is about a lot more than just IOP. It's about optic nerve topography, capillary blood flow, and visual fields It's not like monitoring blood pressure or blood sugar. Your glaucoma can still be getting worse even if your pressure reads normal.

[Oedema]

don't think self-monitoring IOP is a wise idea. This may sound strange, but glaucoma is about a lot more than just IOP. It's about optic nerve topography, capillary blood flow, and visual fields It's not like monitoring blood pressure or blood sugar. Your glaucoma can still be getting worse even if your pressure reads normal.

Agreed, I'd also worry about the patient that isn't happy with his/her IOP and all of sudden starts to overdose. Worst case scenario a patient with a relative contraindication to beta blockers on timolol,etc...

[rbaker]

There is (or was) a "tonometer" that one would apply with the eyelids closed. I forget the name, and I think it was made by a division of B&L, but I could be wrong. Tried it a few times on glaucoma patients with uni-lateral glaucoma, thinking they would at least be able to tell if the affected eye was higher than the normal. the device was useless.

You are correctimundo fjp. It was a B&L product and of no value clinically. We did trials at Mass Eye & Ear for nearly a year and found mostly bogus date when the darn thing worked. The time frame of this device was about the same as the "Ocusert" sp. if my failing memory serves.

I'll bet we see a lot of devices like this in the future thanks to nanotechnology and telecommunications as we enter the George Jetson era. But of what clinical value are ten million static data points of IOP over an eight hour period of time?

Just because we can do it - should we?

[fjpod]

Gee whiz...my memory is better than I thought.

[rbaker]

Gee whiz...my memory is better than I thought.

Either that or we are both passing the same mile marker as we both sink into the morass of senility.

[Oedema]

But of what clinical value are ten million static data points of IOP over an eight hour period of time?]

That would actually be nice to know... if it were accurate. But likely it would just raise more new questions than provide any answers.