Originally published at Association Of Optometrists (AOP).
Optometrist, Ashish Chokshi, outlined how his practice has supported patients to monitor IOP at home using pioneering technology.
Optometrist, Ashish Chokshi, described how his practice has embraced technology that enables patients to monitor their intraocular pressure (IOP) at home during his presentation at 100% Optical (1–3 March, ExCeL London).
The practice director and optometry lead for medical retina at Moorfields Eye Hospital outlined how patients have the option of taking out the iCare HOME2 on loan so they can monitor their IOP while away from practice.
Chokshi explained that the device is a handheld rebound tonometer which incorporates technology to assist the correct positioning of the tonometer. His Fulham optometry practice, Diopter Eye Clinic, has been loaning two devices to patients for the past two and a half years.
The device takes six readings at a distance of 5mm from the cornea, automatically eliminating the highest and lowest readings.
Chokshi highlighted that if a reliable reading is not obtained, an error message is displayed and the patient is encouraged to take another reading.
He added that the device can be linked to a patient’s smartphone, with potential for the IOP readings to be uploaded and shared remotely with the practice.
“If pressures are high, then we can bring the patient back into the practice quickly,” Chokshi said.
Chokshi provides a 30 to 50-minute onboarding session to patients to set them up on the system and teach them how to use the device.
Chokshi observed that while the onboarding session is not essential, he prefers to ensure that patients are fully confident using the device before they take it home, and that measurements can be obtained during the loan period.
Written guidance is also provided, outlining what to do in case the IOPs are abnormally high or low.
Chokshi explained that the device works by propelling a disposable probe towards the cornea.
The higher a patient’s IOP is, the quicker it will reach the cornea and rebound back into the tonometer.
Chokshi observed that the iCare HOME2 is helpful in gaining greater insight about IOP variation over the course of the day and night.
He noted that those patients who are at risk of developing glaucoma, or at risk of further progression in glaucoma, would benefit the most from the technology – as the true maximum IOP can be mapped.
Chokshi shared that, in particular, the HOME2 can provide important IOP information to manage those who have certain types of glaucoma, such as normal tension glaucoma, or pigment dispersion, to help decide the target IOP.
He has also found the device to be useful in obtaining an accurate IOP profile among patients who have already received treatment, such as topical therapy or selective laser trabeculoplasty (SLT), to help guide their management.
“What we have found with SLT, is that the full effect is often found three to six months post-op,” Chokshi shared.
He noted that the device costs upwards of £1000 so patient selection is key in order to minimise the risk of non-return.
Chokshi added that thorough training in using the device helps to reduce the risk of accidental damage.
