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LETTER TO THE EDITOR |
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Year : 2014 | Volume
: 62
| Issue : 7 | Page : 832 |
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Using the rebound tonometer to measure intraocular pressure in an anesthetized patient
Jitendra Jethani
Department of Pediatric Ophthalmology and Strabismus, Dr. Thakorbhai V Patel Eye Institute, Vadodara, Gujarat, India
Date of Web Publication | 13-Aug-2014 |
Correspondence Address: Jitendra Jethani Pediatric Ophthalmology and Strabismus Clinic, Dr. Thakorbhai V Patel Eye Institute, Haribhakti Complex, Salatwada, Vadodara - 390 001, Gujarat India
Source of Support: None, Conflict of Interest: None | Check |
DOI: 10.4103/0301-4738.138185
How to cite this article: Jethani J. Using the rebound tonometer to measure intraocular pressure in an anesthetized patient. Indian J Ophthalmol 2014;62:832 |
Dear Editor,
iCare tonometer, a rebound tonometer, is designed to measure intraocular pressure ("IOP") with minimal need for topical anesthesia. [1] The iCare tonometer has been used in children and home screening. [2] However, because the probe of the tonometer is gravity-dependent, it cannot be used validly in an individual who is in a supine position, as the probe, due to gravity, falls and does not rebound [Figure 1]a and b]. We describe a technique to measure IOP with the iCare tonometer in the supine position. This would be helpful in examination under anesthesia children and patients who can sit upright.
The Technique | | |
Placing an anesthetized person in an upright position carries the risk of the tongue blocking the airway, causing hypoxia. This particular risk can be avoided when patients are placed on their side. The technique is as follows: The patient is laid on one side, and the tonometer appropriately tilted to that side (as shown in the Video 1 and [Figure 1]c). The pressure can then be measured. The particular modification is safe for children taken for examination under anesthesia and gives a quick and reliable multiple readings. A similar technique has been used for ND YAG capsulotomy in children under general anesthesia. [3] It also doesn't require a higher end equipment (the iCare pro), which is expensive compared to the I care model.
References | | |
1. | Suman S, Agrawal A, Pal VK, Pratap VB. Rebound tonometer: Ideal tonometer for measurement of accurate intraocular pressure. J Glaucoma 2013. [Epub ahead of print]. |
2. | Hsiao YC, Dzau JR, Flemmons MS, Asrani S, Jones S, Freedman SF. Home assessment of diurnal intraocular pressure in healthy children using the Icare rebound tonometer. J AAPOS 2012;16:58-60. |
3. | Chen JA, Fredrick DR. Novel technique for Nd: YAG posterior capsulotomy in pediatric patients. J Pediatr Ophthalmol Strabismus 2010;47:41-2. |
[Figure 1]
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