![]() Like its predecessor, the Icare PRO uses a probe attached to a magnetic solenoid probe to rebound off the cornea. A newer Icare rebound tonometer, the Icare PRO (Icare), which can be used in both the upright and the horizontal positions for IOP measurement, is commercially available in Europe but has not yet been approved by the Food and Drug Administration in the United States. It has been well received in the pediatric population and has been demonstrated to give reproducible results, to correlate fairly well with Goldmann applanation tonometry (GAT), and to decrease the number of examinations requiring anesthesia.Īlthough the original Icare rebound tonometer is commercially available and has been approved by the Food and Drug Administration for use in the United States, this device can be used only when the patient is in an upright position. The Icare (Icare Finland, Helinski, Finland) is a portable handheld rebound tonometer that does not require the use of topical anesthetic. The clinical introduction of rebound tonometry has positively impacted the management of pediatric glaucoma. When accurate IOP measurement in infants and young children with known or suspected glaucoma cannot be accomplished in the clinic, examination under anesthesia may be required. Measurement of intraocular pressure (IOP) is critical in the management of pediatric glaucoma. However, the increase, which is less than 1 mm Hg, seems clinically insignificant and is unlikely to alter glaucoma management in children. IOP rises when a child changes position from sitting to supine when measured by the Icare PRO or the Tono-Pen. In children, Icare PRO tonometry correlates well with GAT in the sitting position, and with the Tono-Pen in both the sitting and supine positions. The mean supine IOP for the Icare PRO and Tono-Pen were 18.4 ± 4.5 and 18.8 ± 4.2 mm Hg, respectively. Mean seated IOP for GAT, Icare PRO and Tono-Pen were 16.4 ± 4.2, 17.5 ± 3.5, and 18.0 ± 3.9 mm Hg, respectively. The subjects were then placed in the supine position for 5 minutes, and tonometry using the Icare PRO and the Tono-Pen was obtained, in the same order used when they were the sitting position.Įnrolled were 47 children (94 eyes). Goldmann applanation tonometry (GAT) was then performed by a clinician masked to the previous measurements. Subjects underwent tonometry in both eyes while upright (sitting), after instillation of topical anesthetic, with either the Icare PRO or the Tono-Pen first, and then the second instrument (order randomized). To explore the effect of body position (sitting vs supine) on intraocular pressure (IOP) in children, as assessed by the Icare PRO and the Tono-Pen.Ĭhildren with known or suspected glaucoma and those without glaucoma were recruited from the Duke Eye Center pediatric clinic.
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