The utility of home tonometry for peri-interventional decision-making in glaucoma surgery: Case series

Abstract

Purpose: To describe twelve cases in which home intraocular pressure (IOP) monitoring complimented clinical decision-making in glaucoma management.

Observations: Home IOP monitoring elucidated peaks and amplitudes of variation that were not captured by in-clinic IOP measurements during the pre- or post-interventional period.

Conclusions & importance: Home monitoring can establish pre-treatment IOP patterns that are not evident during in-clinic measurements. Home monitoring can also demonstrate response to treatment more quickly than in-clinic monitoring, and provide more information about nyctohemoral fluctuations than is ascertained by in-clinic tonometry.

Keywords: Diurnal intraocular pressure; Glaucoma surgery; Home monitoring; Intraocular pressure fluctuation; Telemedicine.

Fig. 1

Solid dots represent iCare HOME intraocular pressure (IOP) measurements. Open red circles indicate in-clinic IOP measurements (Goldmann applanation tonometry). Procedural interventions included (*) ab-interno canaloplasty/Hydrus surgery in both eyes, (†)intracameral bimatoprost insertion in both eyes. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)

Fig. 2

Solid dots represent iCare HOME intraocular pressure (IOP) measurements. Open red circles indicate in-clinic IOP measurements (Goldmann applanation tonometry). Procedural interventions included (*) ab-interno canaloplasty/Hydrus surgery in both eyes, (†) Preserflo surgery in the right eye. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)

Fig. 3

A) 24-2 Humphrey Visual Field obtained prior to trabeculectomy. B) Solid dots represent iCare HOME intraocular pressure (IOP) measurements. Open red circles indicate in-clinic IOP measurements (Goldmann applanation tonometry). Procedural intervention included (*) trabeculectomy in the right eye. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)

Fig. 4

Solid dots represent iCare HOME intraocular pressure (IOP) measurements. Open red circles indicate in-clinic IOP measurements (Goldmann applanation tonometry). Procedural intervention included (*) XEN gel stent in the left eye. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)

Fig. 5

Solid dots represent iCare HOME intraocular pressure (IOP) measurements. Open red circles indicate in-clinic IOP measurements (Goldmann applanation tonometry). Procedural intervention included (*) XEN gel stent in the left eye. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)

Fig. 6

Solid dots represent iCare HOME intraocular pressure (IOP) measurements. Open red circles indicate in-clinic IOP measurements (Goldmann applanation tonometry). Procedural interventions included (*) XEN gel stent in the right eye (†) phacoemulsification and viscocanalostomy in the left eye. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)

Fig. 7

Solid dots represent iCare HOME intraocular pressure (IOP) measurements. Open red circles indicate in-clinic IOP measurements (Goldmann applanation tonometry). Procedural intervention included (*) XEN gel stent in the left eye. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)

Fig. 8

Solid dots represent iCare HOME intraocular pressure (IOP) measurements. Open red circles indicate in-clinic IOP measurements (Goldmann applanation tonometry). Procedural intervention included (*) 180-degree selective laser trabeculoplasty in the right eye. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)

Fig. 9

Solid dots represent iCare HOME intraocular pressure (IOP) measurements. Open red circles indicate in-clinic IOP measurements (Goldmann applanation tonometry). Procedural interventions included (*) 360-degree selective laser trabeculoplasty in both eyes. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)

Fig. 10

Solid dots represent iCare HOME intraocular pressure (IOP) measurements. Open red circles indicate in-clinic IOP measurements (Goldmann applanation tonometry). Procedural interventions included (*) phacoemulsification and Baerveldt implant in the right eye. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)

Fig. 11

Solid dots represent iCare HOME intraocular pressure (IOP) measurements. Open red circles indicate in-clinic IOP measurements (Goldmann applanation tonometry). Interventions included (*) initiation of latanoprost in both eyes. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)

Fig. 12

Solid dots represent iCare HOME intraocular pressure (IOP) measurements. Open red circles indicate in-clinic IOP measurements (Goldmann applanation tonometry). Intervention included (*) initiation of oral acetazolamide. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)