1. Mar 04,2019

Consider This Step When Using Telemedicine to Screen for Glaucoma

Measuring IOP using hand held rebound tonometer increases accuracy, according to study

There is additional evidence that measuring intraocular pressure (IOP) during telemedicine eye screening improves the likelihood of an accurate glaucoma diagnosis. A recent study involving >900 individuals screened via a telemedicine encounter showed that a higher IOP detected during the screen increased the chances of such a diagnosis.

The participants were high-risk patients who were screened for glaucoma via telemedicine by one of seven primary care practices. The initial visit consisted of fundus photography, evaluating family history of glaucoma, and measuring IOP using a hand-held rebound tonometer. Participants with certain findings, including IOP >21 mm Hg, were asked to undergo a second visit; 347 participated in that second visit. Among the results:

  • ~2 in every 10 patients had IOP >21 mm Hg
  • Of those, 13 patients had IOP >30 mm Hg, and 2 patients exceeded 40 mm Hg
  • Of all who were examined a second time, 11% had glaucoma, and 7% had ocular hypertension.
  • Patients with suspicious nerve findings and elevated IOP were nearly 5 times more likely to be diagnosed with glaucoma.
  • Those with suspicious discs and IOP ≤21 mm Hg were twice as likely to be diagnosed.

Hark L, Myers J, Pasquale L, et al. Philadelphia Telemedicine Glaucoma Detection and Follow-up Study. [Published online ahead of print February 11, 2019. Journal of Glaucoma. doi: 10.1097/IJG.0000000000001207.