Choosing a Tonometer

Deciding whether to monitor your own Eye PressuresReichert 7CR

With self tonometry, the possibility of monitoring eye pressure at home is within every glaucoma patient's reach. And with intraocular pressure as the only current treatable risk factor for glaucoma, those with pre-glaucoma or glaucoma are wise to gather as much data as possible regarding the nature and behavior of their eye pressures. Currently, the practice of monitoring those who are glaucoma suspects (ocular hypertension or OHT) and glaucoma patients entail only receiving routine eye pressure checks at their doctor's office or clinic. It is known by us in the Fiteyes community who test via self tonometry, and by the many studies showing diurnal variations, that eye pressures are far from static (this is even more the case with glaucoma). Therefore, the very infrequent exams that patients are receiving, in our opinion, are completely inadequate in describing the behavior of ocular pressure behavior and variation. This is especially true considering the 'off hours' that doctors don't test the very important night time and morning pressures, and the very important charting of diurnal variation of which Dr. Ritch and others have noted as being a predictor of glaucoma risk (the greater the diurnal variation, the greater the risk factor).

Therefore, for one with glaucoma or OHT, the decision to begin the process of self tonometry can be one of the most important, challenging, and rewarding decisions that a person can make. If a person is still undecided whether self tonometry is a worthwhile decision for them, a review of the Fiteyes home page article Why you should Monitor you IOP is highly suggested because it delves into many of these questions, and expounds on some of the pitfalls, objections and concerns which either a doctor or patient may have with the practice of home monitoring of pressures.

Best Tonometers For Home Use Self-Tonometry

Submitted by dave on Wed, 12/17/2008 - 7:38pm


In my experience the best tonometers for home use (a.k.a., self-tonometry) are the Reichert AT555 and the Tiolat iCare. Of these the Reichert is much easier to use.

Today, miller13 said,

Had  the proview: it never worked :(

I say that's no surprise! Thanks for reporting your experience.

miller13 also asked some questions about which tonometers are suitable for self-tonometry.

Follow up Doctor's Visit

Submitted by dsaito on Mon, 09/01/2008 - 8:50am

I made a visit to a new doctor.  I exercised before I left with my pressures around 13  on the AT555.  The doctor tested my pressure around 22-23.  Wasn't surpising since my pressure always seems to be high when I go to the doctor.  Coming home, tested 19-20 on the AT555. 

He looked at my nerves and didn't like what he saw ("looks like crap" was his exact wording), so he is sending me to a specialist.  He said if he were me, he would get a trab immediately in both eyes. 

I have an appointment with the specialist on Tuesday. 

Grateful for Dave and self-tonometry!

Submitted by Sally on Sat, 06/07/2008 - 8:15pm

Hello Members,

I have had my Reichert AT555 for two days now and taken taken quite a number of readings. Though my IOP does fluctuate, which I did understand is expected, I have seen much lower pressures than I thought I would! My opthalmologist's target pressure for me was 25 on Xalatan. I had frequent pressures of 30+ in his office but much lower numbers in my optometrists office (my friend). During the past two days I have seen only 1 average of 32 in 1 eye, and the majority of the time the IOP is mid 20s or lower (this is off medication). I have been off the Xalatan for the past month. Of course, now that I see my IOP can be even lower than his target of 25, I plan to work on obtaining this on a consistant basis (off medications).

What kind of computer is best for connecting to the AT555 tonometer?

Submitted by dave on Sat, 07/07/2007 - 11:35am

UPDATE: please see new info in this comment: New USB-Serial Port Converter Info in comment-2096

We also have a new software program called FitEyes Insight that makes organizing and understanding your eye pressure data much, much easier!

How to use the Reichert AT555 Properly for Self-Tonometry Research

Submitted by dave on Wed, 07/04/2007 - 4:29pm
  1. You should keep your face close to the tonometer. The best way to do this is to raise the tonometer high enough so that you can sit up straight when measuring your IOP. If you have to bend forward, your chin will tend to be too far away from the tonometer. I have found that having the chin too far away from the tonometer can result in less accurate readings.
  2. Sit up straight.
  3. Breath naturally.

White Coat Ocular Hypertension In One Eye

Submitted by dave on Sun, 06/03/2007 - 3:45pm

White coat hypertension (or white coat syndrome) is a widely recognized blood pressure phenomenon. However, white coat ocular hypertension is not yet recognized by the medical community. One of the first reports of white coat ocular hypertension was published Tuesday, April 24, 2007 here on my blog in an article titled White Coat Syndrome for Eye Pressure.

Today's article represents a follow up to that first report. The purpose of this experiment was to determine if my intraocular pressure is again different when measured in the doctors office compared to when measured at home.

I define white coat ocular hypertension as a situation where patients exhibit elevated eye pressure (intraocular pressure) in the doctor's office but lower eye pressure at home (or in similar situations where they are comfortable). Patients with white coat ocular hypertension will often experience elevated eye pressure under stressful situations other than the physician's office. My data reported below and in the first report of white coat ocular hypertension fit this definition well.

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