Sir,
Measuring the intraocular pressure (IOP) is crucial in the assessment of paediatric glaucoma. Although Goldman tonometry (GT) is the gold standard for measuring IOP in adults, its lack of portability makes it unpractical in children.
We aimed to assess the preference of choice of instrument (Tonopen (TT), Perkins (PT), Airpuff (AT), and iCARE tonometers (iT)) for measuring IOP in children among UK paediatric ophthalmologists (POs). To the best of our knowledge, this is the first survey examining the practice of paediatric IOP measurement.
Case report
A questionnaire was sent to 939 consultant ophthalmologists in the UK. Of them, 658 (70%) returned the survey and 98 (15%) identified themselves as PO.
All POs had GT available in their units and 99% had a Tonopen or Perkins. Less than 50% had an Airpuff and less than 15% had an iCARE tonometer. POs were subdivided into eight groups (G1–G8) depending on which instruments (TT, PT, AT, iT) they had available in their units. The availability of instrument permutations was divided as follows: G1 (GT, TT, AT, PT, and iT); G2 (GT, TT, AT, and iT), G3 (GT, TT, AT, and PT), G4 (GT, AT, PT, and iT), G5 (GT, TT, PT, and iT), G6 (GT, TT, and AT), G7 (GT, TT, and PT), and G8 (GT, AT, and PT).
For children more than 10 years, the Goldman was the method of choice. For children under 10 years the Tonopen was the instrument of choice; however where an iCARE tonometer was available to PO, it was preferred over the Tonopen.
Comment
The iCARE tonometer does not appear to be widely available in the UK yet of the units that had access to it, it was the instrument of choice in measuring IOP in children. Wider acceptance of this instrument may be of benefit in managing paediatric glaucoma and a study to evaluate any discrepancy in IOP measurement in children with the instrument may also be of benefit.