Updated hand-held tonometer enhances clinical experience

Reviewed by Jane T. Shuman, MSM, COT, COE, OCS, CMSS, OSC

A newly released hand-held tonometer model (Icare ic100, Icare U.S.A.) features several design upgrades while retaining the rebound technology for measuring IOP that was at the core of the earlier model.

“The rebound technology has proven to be very good, so that’s one thing we did not want to change,” said Holly Swain, OD, product manager, Icare U.S.A. “We added features that should make IOP measurement even easier and more accurate.”

Responding to comments from customers, the company focused on improving the interface design and ergonomics of the tonometer. The navigation system, with its improved menus and large, color screen, makes the instrument more user-friendly. The device has an automated measuring sequence, which takes a series of six measurements with a single touch of a button.

Other enhancements help operators align the instrument even more accurately, which in turn gives more precise results, Dr. Swain said.

For example, the tonometer has a built-in intelligent position assistant that uses red and green lights on the probe base to help users place the instrument in the correct position.

In designing the device, the company also upgraded features, such as the error codes. Now, instead of displaying numerical codes that users have to memorize, the instrument gives a brief textual explanation, such as telling operators they are too near or too far from the patient. All of these changes help operators obtain consistent, repeatable, IOP measurements.

“What I really like about [it] is a technician can be very easily trained to use this device, while still taking time to train them on the Goldmann tonometer if that is what the practice requires,” said Jane T. Shuman, MSM, COT, COE, OCS, CMSS, OSC, president of Eyetechs Inc. In her role, she trains technicians and evaluates practice efficiencies.

“The newer version lets users know they are perfectly perpendicular to the cornea and if they are too close or too far from the eye, so they get perfect positioning on their own after they’ve been shown how to use it,” she said.

The updated tonometer is suitable for all patients but should be especially useful in helping practices screen groups previously not seen by technicians, such as pediatric and corneal patients, Shuman said.

“Many corneal physicians want to examine the virgin cornea before the IOP is taken, but because the [device] doesn’t require any drops, it is not going to affect the appearance of the cornea,” she explained. “This means the technician doesn’t have to go back in to the patient after the examination, and that the physician doesn’t need to do it him or herself.”

The tonometer also may be advantageous with immediate postoperative patients, since some corneal surgeons do not want the cornea affected until after they’ve examined it.

Pediatric patients

Pediatric patients

As for children, clinicians are sometimes reluctant to measure the IOP of their very young patients with the Goldmann tonometer because of the challenges of correctly positioning them and administering drops.

The rapidity of the measurement with the new instrumentjust a momentary contact with a lightweight probe-and the dropless technique solve those issues.

“The original version of the tonometer was really pretty good, but [the company] has certainly made it more foolproof,” Shuman said. “There are some physicians who will only trust the Goldmann, but for the general ophthalmologist this is a really good screening tool that can then be repeated with the Goldmann if they find something unexpected or have a patient who is a glaucoma suspect or diagnosed with glaucoma.”

Jane T. Shuman, MSM, COT, COE, OCS, CMSS, OSC

E: jshuman@eyetechs.com

Shuman is president of Eyetechs Inc.

Holly Swain, OD

E: holly.swain@icare-usa.com

Dr. Swain is product manager at Icare U.S.A.