Abstract
PurposeTo compare the effectiveness of transpalpebral scleral tonometry (TPST) and corneal pneumotonometry in children, and assess the discomfort level when measuring intraocular pressure (IOP) by these methods.MethodsTPST using EASYTON tonometer (Russia) and pneumotonometry using Reichert 7 Non-contact AutoTonometer (USA) have been sequentially performed on 84 eyes (42 children aged 5–14, ave. 9.3 ± 2.7), including 64 myopic eyes (-0.5 to 6.75D), 18 hyperopic eyes (+ 0.75 to + 3.75D), and 2 emmetropic eyes. We assessed tolerance to the procedure on a five-point scale using a questionnaire which listed several criteria: discomfort, presence of pain, fear or anxiety during the procedure, the child's resistance to measurement.ResultsEASYTON tonometry demonstrated repeatability of IOP indicators when measuring the same eye three times sequentially and almost the same IOP level in paired eyes of isometropic children. Pneumotonometry reveals a greater individual data variability and a more pronounced asymmetry of the paired eyes’ indicators. IOP measured using the TPST was 18.3 ± 2.3 mmHg across the whole group, 18.2 ± 2.3 mmHg in myopic, and 18.5 ± 2.3 mmHg in hyperopic children. With pneumotonometry, the corresponding indicators were 17.1 ± 3.9 mmHg, 16.9 ± 3.8 mmHg, and 18.2 ± 4.0 mmHg. The average score for the TPST (4.64 ± 0.60 points) was significantly higher than that for pneumotonometry (3.85 ± 0.90 points) (p < 0.05).ConclusionsTPST provides broader possibilities for IOP control in pediatric practice, yielding more reliable and accurate results than pneumotonometry, eliminating the influence of corneal thickness and irregularity on the measurement result, and ensuring a calmer behavior and more comfort of children during the procedure.
Highlights
Registering intraocular pressure (IOP) in adults and children is an essential element of ophthalmological diagnosis and monitoring of eye diseases
The purpose of this work was a comparative study of effectiveness of use of transpalpebral scleral tonometry with EASYTON tonometer and corneal pneumotonometry in children, as well as a point assessment of the child’s discomfort level when measuring IOP by these methods
A comparative analysis of the obtained data demonstrated that the IOP values measured for the same eyes of the same children using an EASYTON tonometer turned out to be slightly higher than with pneumotonometry (p = 0.02)
Summary
Registering intraocular pressure (IOP) in adults and children is an essential element of ophthalmological diagnosis and monitoring of eye diseases. While there is a large variety of ocular tonometry methods for adult patients, the range of methods for measuring IOP in children is significantly limited [1, 2]. This is accounted for by the fact that instrumental measurement of IOP is a complicated and sometimes even impracticable procedure due to the children’s negative attitude, fear, or even refusal to be examined, as well as the fact that the child’s restlessness during the measurement (in particular, blepharospasm, tension of extraocular muscles, etc.) leads to unreliability of the data obtained [3,4,5]. Ophthalmologists and optometrists prefer to use non-contact corneal pneumotonometry for outpatient IOP screening in children as it is the most accessible and feasible procedure under dispensary observation
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