Is the iCare HOME tonometer effective for monitoring treatment changes recommended by my glaucoma specialist?
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3.3 years ago
@member_31

My glaucoma specialist is recommending a change in eye drops. I will see him again in three months. I don't believe a single visit in three months will provide sufficient information to determine how the new eye drops are performing at reducing my intraocular pressure. I would like to get a home tonometer.

I would like to know if there is evidence I can show to my doctor that this home tonometer will be effective at monitoring my IOP.

icare-tonometer self-tonometry tonometer glaucoma • 1.5k views
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Entering edit mode
3.3 years ago
david 4.3k
@david_fe

published online 31 May 2021 in the journal Ophthalmology Glaucoma. https://doi.org/10.1016/j.ogla.2021.05.007

FitEyes Summary

  • Yes, based on more than a 15 years of self-tonometry experience within the FitEyes community, the iCare HOME tonometer is a good choice.

  • The authors of the study below demonstrate the ability of the iCare HOME tonometry device to self-assess therapy-related changes in IOP that were comparable with IOP changes detected by Goldmann applanation tonometry (GAT) for over 90% of eyes. This will make your glaucoma specialist comfortable. However, always keep the following perspective in mind: Is Goldmann Applanation Tonometer (GAT) the Gold Standard? | Ask FitEyes.

  • Among eyes where Goldmann applanation tonometry (GAT) failed to show a treatment effect, 71.4% showed IOP changes with the iCare HOME IOP measurement four times per day. This indicates that self-tonometry provides useful information that GAT can miss. FitEyes believes self IOP monitoring is superior to relying solely upon your ophthalmologist's in-office measurements.

  • The authors concluded that the iCare HOME tonometer is user friendly and will provide useful data regarding the reduction of IOP after treatment changes with self-measurements a few times a day.

  • You can rent an iCare HOME tonometer at Tonometers - Enlivened Online Dispensary Tonometer Rentals

Abstract

Objective

To assess whether iCare HOME rebound tonometry can detect therapy-related changes during self-monitoring of intraocular pressure (IOP).

Design

Prospective clinical trial.

Subjects, Participants, and/or Controls

43 eyes (n=27 subjects) with open angle glaucoma or ocular hypertension were enrolled during standard-of-care clinic visits. Participants were grouped into control eyes managed on stable therapy (n=18 eyes), or therapy change eyes undergoing selective laser trabeculoplasty (SLT, n=8 eyes), initiating topical therapy (n=8 eyes), or adding a second medication to existing monotherapy (n=9 eyes).

Methods, Intervention, or Testing

Subjects recorded IOP four times daily (before breakfast, before lunch, before dinner, before bed) for one week using iCare HOME tonometry. Upon tonometer return, subjects underwent SLT or new medication start; an additional week of iCare HOME measurements was collected after 4-6 weeks. Control subjects recorded an additional week of measurements after six weeks. Measurements were grouped into four time periods (5-10am, 10am-3pm, 3-5pm, 8pm-1am). Goldmann applanation tonometry (GAT) was performed at each study visit for comparison.

Main Outcome Measures

Detection of therapy response defined as an IOP reduction of ≥20%.

Results

For eyes which demonstrated a therapy response by GAT (n=11), iCare HOME detected a therapy response in 90.9% of eyes in ≥1 time period and 45.5% of eyes in all four time periods. In eyes without a GAT-measured therapy response (n=14), iCare HOME detected a response for 71.4% (n=10) of eyes in ≥1 time period and for 7.1% of eyes (n=1) at all four time periods. In treatment eyes, intraday and interday average minimum and maximum IOP, as well as interday IOP range, were significantly reduced after therapy without a significant change in intraday IOP range. Control group eyes did not demonstrate a significant change in average IOP minimum, maximum, or range between study weeks.

Conclusions

Home tonometry with iCare HOME reliably detects therapy-related IOP changes in patients with glaucoma and ocular hypertension. Treatment responses correlated well with in-office GAT and may detect treatment responses missed by GAT. IOP measurements via home tonometry provide additional clinical information regarding intraday and interday IOP fluctuation beyond standard of care, in office GAT measurements. The iCare HOME is a valuable tool to monitor therapeutic efficacy in patients with glaucoma.

Keywords

  • glaucoma
  • ocular hypertension
  • home tonometry
  • rebound tonometry
  • intraocular pressure
  • therapy change
  • iCare Home

Links

The Utility of iCare HOME Tonometry for Detection of Therapy-Related Intraocular Pressure Changes in Glaucoma and Ocular Hypertension - ScienceDirect

iCare HOME Tonometry for Detection of Therapy-Related IOP Changes in Glaucoma and Ocular Hypertension | PracticeUpdate

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