P69 Intra-ocular pressure measurement in eye casualty: Which is the Fairest of Them All?

A survey completed by junior doctors who routinely run eye casualty clinics identified Goldmann applanation tonometry (GAT) as the single most time-consuming element of a standard consultation. IOP can be measured with a range of devices in the eye clinic. By identifying the most accurate and time efficient method we can save time in consultations as well as provide better outcomes for the patient. Purpose To compare four tonometry techniques: Goldmann applanation tonometer(GAT), Non-contact tonometer(NCT), Tonopen(TP) and Icare tonometer(ICT) to determine the most accurate and efficient method. Method 20 subjects presenting in the casualty eye clinic were used in the study ranging between 36-75 years. Once undergoing routine ophthalmic examination from the same clinician, IOP was recorded with all devices. Three readings were taken before calculating an average value and time taken for each device for each patient. No patients were excluded from the study. Results The average IOP with GAT, NCT, TP and ICT was 8.5 ± 2.7, 10.3 ± 4.2, 8.6 ± 3.1, and 8.4 ± 4.5 mmHg, respectively. The average time taken with GAT, NCT, TP and ICT was 56, 132, 38 and 23 seconds, respectively. There was no significant difference in IOP measured by GAT and TP and ICT however, NCT (10.3 mm Hg, P < 0.01) measured significantly higher IOPs compared to GAT. Conclusion When compared to Goldmann applanation tonometer, Icare was the most accurate and efficient method. While Tonopen was fairly accurate some patients were unable to tolerate it. NCT was significantly slower compared to other devices.