Measurement of Intraocular Pressure in the Emergency Department – An Educational Quality Improvement Project

Abstract

Background: Primary care physicians are facing both increasing volume and complexity of ocular presentations. The tonometer, a device used to measure intraocular pressure, is a useful component of the eye examination which can aid in the differentiation of serious ocular pathologies. Objectives: Primary aim was to achieve 100% of the ED care providers being trained on how to use the department’s tonometer. Secondary aims were to subjectively improve ED staff’s successful tonometer set up and the interpretation of the IOP readings. Methods: This educational quality improvement project shares how an Emergency Department District General Hospital has trained its physicians to both correctly utilise the tonometer and interpret its results. Results: Three cycles of improvements have shown a significant improvement in successful tonometer set up and interpretation within a high percentage of working physicians. Conclusions: This project has contributed to more thorough general eye assessments; supported decisions to allow safe discharge; and developed more comprehensive referrals. This educational report reflects a simple and replicable strategy to improve primary eye care triage and services