home eye pressure monitoring

Are handheld or portable tonometers appropriate for home eye pressure monitoring?

Submitted by dave on Thu, 04/22/2010 - 12:29pm

In any tonometer (based on today's technology), you can have some, but not all of, the following:

  • ease of use
  • accuracy (reliability and validity of data)
  • low cost
  • portability

handheld portable tonometerPeople tend to give a priority to portability and low cost. New products aimed at this feature set have recently been announced. Does it make sense to utilize those devices for self-tonometry?

We have to agree that any trade off that doesn't include reliability and validity of IOP data invalidates the whole endeavor of self-tonometry. Not only is it meaningless to do it if the data is not of sufficient quality upon which to make important decisions, but it could actually be detrimental to do self-tonometry in that case.

With today's technologies, portability entails user-alignment (in the context of self-tonometry). Proper user-alignment to produce a valid measurement, by definition, depends upon user skill as well as various specific conditions of each measurement. User-alignment, regardless of the tonometer, is difficult! (User-alignment is defined as the operator of the tonometer having to align the tonometer with the eye manually. Alignment is a very precise process requiring a steady hand, good eyesight, training and practice.)

Therefore, the requirement of user-alignment conflicts with the requirement of reliability and validity of IOP data. We cannot guarantee reliability and validity of IOP data when variable user skills are required to produce that data.

If any decent ophthalmologist or scientist (or intelligent thinker) considers a set of IOP data, they must consider how the data was obtained. If patient skill played a critical role in producing that data, as it does when user-alignment is required, the clear thinking person will immediately discount that data. Therefore, the self-tonometrist's efforts may not produce much of value.

Is there a specialist that will allow me to self monitor my eye pressure?

Submitted by Anonymous (not verified) on Sat, 09/12/2009 - 9:41am

glaucoma specialist Hi,

I emailed you awhile ago about self-tonometry and am again interested after reading these messages here on FitEyes.com.

I have mixed gluacoma: some optic nerve cupping on both eyes. My doctor keeps recommending surgery in my left eye, but I do not want to go with that option yet.

Is there a specialist you know of in [my city] that will allow me to self monitor my eye pressure?

Self-tonometry in glaucoma management--past, present and future

Submitted by Anonymous (not verified) on Tue, 09/01/2009 - 9:00pm

Glaucoma is the leading cause of irreversible blindness in the world. Diagnosis and management of glaucoma is significantly associated with intraocular pressure, but contemporary office-based measurements are not sufficient to discover diurnal changes and spikes, nor do they demonstrate the effect of medication and compliance. Patient-directed self-tonometry can be taken throughout the day and is therefore the subject of much discussion and research. In this article we review the history of self-tonometry devices and present technologies for the future.
Surv Ophthalmol. 2009 Jul-Aug;54(4):450-62.
Liang SY, Lee GA, Shields D.
City Eye Centre, Brisbane, Queensland, Australia.

weight lifting question for glaucoma patient

Submitted by Anonymous (not verified) on Wed, 08/05/2009 - 6:52pm

weight liftingHi,
I just found your blog -- it is quite interesting. I have pigmentary glaucoma diagnosed ten years ago.

I read your posts on weight lifting. I understand that the bench press was implicated for some as correlated with an IOP spike. My question is... what about an INCLINE or STANDING press, where the head is well above horizontal? Does that also cause an IOP rise or not?

Thank you,

Accurate home tonometers

Submitted by Anonymous (not verified) on Wed, 08/05/2009 - 6:52pm

I just found your blog -- it is quite interesting. I have pigmentary glaucoma diagnosed ten years ago.

Here is my second question: Are there any accurate HOME tonometers out there that don't cost a fortune?

Thank you,

Meeting To Discuss Non-medical Management of Eye Pressure and Self-Tonometry

Submitted by dave on Sat, 05/30/2009 - 1:59pm

This year the World Glaucoma Congress (WGC) is taking place in the United States (Boston, MA) from July 8th to 11th. Dr. Ritch will be there, as will Marcel and I.

I believe all of you know, or know of, Dr. Ritch. Marcel is a key founder of the International Society for Self-Tonometry (ISST), of which Dr. Ritch is Honorary Chairman. Marcel is a driving force behind getting me and several other self-tonometrists together in Boston.

New tonometers designed for self-tonometry coming soon

Submitted by dave on Wed, 05/13/2009 - 3:45pm

Next month will see the introduction of an exciting new tonometer designed specifically for self-tonometry. I like what I have seen so far. After the product is released we plan to evaluate it and, of course, we will keep you informed via FitEyes.com.


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