From FitEyes email discussion forum posts
Henry wrote 1-7-2017
Anyone have experience with the ICare Home tonometer?
I got one last August in England. Readings have been pretty close to my Opthamologist’s readings during office visits.
Hi Henry, was there any specific info you wanted? As far as accuracy goes, as far as I can remember, several people on this list have reported that their readings match or are a point higher than the ophthalmologist's. For various reasons, I haven't so far taken my Home in to the ophthalmologist office, but now that I'm familiar with the workings of my IOP I'm pretty confident that my readings and those of the dr are in line.
Using the Home for just over a year has enabled me to bring down my IOP significantly, and my last two OCTs showed no further damage to my optic nerve after a pre-tonometer period of rapid deterioration. (I hope to post about this on the main list one day but am trying to use the computer less!)
I hope your Home pays off for you as much as mine has!
My investment in the Icare Home has paid off tremendously. I wanted opinions from other users.
Because of the Icare home, I have also been able to detect and track significant swings in my IOP.
Twice now, the IOP in my left eye ( the eye originally diagnosed with glaucoma ) spiked from 12 to 40 on thanksgiving weekend and Xmas weekend. My regular IOP in both eyes are between 10-15.
Sticking to my Opthamologist’s regime of Combigan twice a day on both eyes brought the IOP under control after less than 2 days. I am on combigan on both eyes. No change in my routine or drugs over the period.
Wondering if it had to do with a change in my diet or other factors.
I have had one for a few months now. I was pleased by how close it was to my doctor's readings. The only problem I have with it is lining it up to get measurements. Do you have any tips for taking measurements?
I concur with Alix's post on the match between my readings and the doctors'. I have taken mine to both my optometrist and my ophthalmologist and my ICare is always pretty similar. I don't have the software to download readings (and my IOP is not high enough that I'm concerned at this point so I only know the point range not the exact number (Note: ICare ONE model). But my in office readings are always either within the range or 1 point higher.
One note of caution on something I found I was doing wrong and it was making it hard to get accurate readings (I was getting many red and orange lights). I was wiping the ball of the probe with an alcohol wipe while holding it in my hand. I did that in the ophthalmologist's office and she showed me that I was actually imperceptibly causing the probe stem to bend thus giving the bad reading. She demonstrated the "wobble" by twisting the probe to rotate it between thumb and forefinger. I thought I needed to grind the ball of the probe with the wipe to get it sterile but she showed me to just drag the wipe across the top of the ball while it was in the machine. Since learning that I don't have trouble with error readings unless I'm just off position.
The Icare Home is very accurate when used properly. It is a good choice for home IOP monitoring.
Keep in mind that IOP normally fluctuates minute by minute. You would expect to find a difference in IOP from one measurement to the next even when using the same tonometer and even if only a few minutes apart.
This is more true for automatic tonometers. The manually operated Goldmann tonometer used by most ophthalmologists has several types of operator bias, including the tendency for an operator to obtain the same IOP value as the previous measurement. Without bias, no two sequential IOP measurements should ever be exactly the same value because IOP is dynamic.
IOP goes through a range of about 10 mmHg (or more) in a day, and it varies by up to 5 mmHg with each heartbeat. The view of IOP as a relatively static thing that can be checked once every few months is outdated thinking.
Thank you all. The Icare Home has a made a lot of positive difference in managing and monitoring my eye pressure.
Alix Followed up June 2017:
I have an icare home so can't help with the questions about the Reichert 7CR. But in response to your conflicting concerns about monitoring your IOP - I haven't been on the main fiteyes list for a while so am not up to date with ongoing conversations, but in 2015 I got quite a few responses to my questions about home IOP monitoring, and no one reported that they had started pestering their doctor! So this might be something that some drs worry about more than being anything real. One person did say she stopped using her tonometer because the monitoring was stressful for her but that was the only negative experience reported.
I did take many many readings (thousands) for a year or more, not so much out of anxiety as because I was trying to figure out what caused my IOP to go up or down. It took a lot of "experiments" to isolate different factors and get a clear picture of what i should pay most attention to. So it was major project for me for a long time. Some of my earliest conclusions turned out not to be correct - there was just so much "noise" to be sorted through. These days I do fewer readings since I do seem to have figured out the most consistent patterns, although i still have a few 'experiments" left to do when time & energy allow. I do start feeling uneasy when I haven't checked my IOP for a week or so and then run through a series of readings to make sure it's still behaving the way I expect. At the moment I try not to get bogged down in decoding small variations but focus on the big picture.
Some of my early readings were a good bit higher than those done in the dr's office. I went with the assumption that they were accurate (there have been some different views about how far the Home is dependent on the user for accuracy, but people who had taken theirs into the dr office reported a high degree of accuracy) and just treated them as information about what had been going on while my back was turned (that is, during every moment other than the 4 seconds a year my IOP was measured by the dr!). Fortunately I was able to bring them down pretty quickly myself so I didn't feel compelled to tell the dr about them.
I was wary about telling my doctor I was using a tonometer but did mention it after a few months. I'd describe his attitude as apparent benign/neutral tolerance/ lack of or mild interest - he might have been more engaged if the appts weren't so rushed. He treated office readings as the sole basis for any treatment decisions. A few weeks ago we finally set up a special appt to check my Home's accuracy and it was spot on, which was reassuring. So it's been a process, and my use of a home tonometer has been completely "offstage". Now he's leaving town so i'll be starting over with a new dr! By the way, I had had an unusually high office reading which could have caused some upheaval, but my home monitoring gave me reassurance (confirmed at the compare & contrast appt) that it was an anomaly (which I had to figure out the reason for). So this was an example of how home monitoring can help alleviate rather than provoke anxiety.
I can certainly understand your worry about the cost of a tonometer - the Home, which is much cheaper, was a big step for me financially, and unfortunately it must be the case that most people with glaucoma just can't afford a tonometer at all. For myself, I have no regrets about the expenditure. My IOP came down & my OCT & visual field stabilized, and I was able to lay discussions about surgery to rest, at least for now. This might change at any time, of course, but if it does I'll know i did what i could.
Hope this feedback is helpful.