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Medical Forum / Diseases and Disorders / Glaucoma / April 2004Proview accuracy
just got a proview from bausch & lomb. practiced with it a lot and now i am totally comfortable using it. my readings are repeatable, the phosphene is exactly as shown in the proview instructional video, & everything is as instructed. pressure readings are 16 (r) and 18 (l) every time with the proview went to optom today -- pressures were 46 & 45 on the air puff machine. came back to office and measured with proview -- got 16 and 18 again. is it possible that the proview and the air puffer can be so different? On the air puffer I always either jerk my head back or have some other strong involuntary reaction. the machine gave 2 errors today while obtaining my readings. Seems like the air puffer must not be giving good readings... with the new meds, my eyes feel better and vision seems more clear. how could IOP be 45? i conclude the air puff tonometer is not giving good readings Hello I'm an optometrist, and every reading/measurement I make is compared with logic. There is risk of equipment or operator failure in any procedure, so we automatically factor in reliability. My colleague would have panicked at mid-40 IOP's so if you got no major response from them, then you can safely assume that they recognised the error. Personally I would have automatically redone the measurement with an applanation tonometer, which is more controllable and more reliable. BTW there is a software component in these non-contact machines which assesses reliability (many flash if the result is unreliable), so the Optom should have known the truth. I hope this makes you feel more at ease. Cheers Mark > just got a proview from bausch & lomb. practiced with it a lot and now i am > totally comfortable using it. my readings are repeatable, the phosphene is [quoted text clipped - 16 lines] > > i conclude the air puff tonometer is not giving good readings The optom took the readings (mid 40's) as accurate :( > Hello > [quoted text clipped - 37 lines] > > > > i conclude the air puff tonometer is not giving good readings well, yes he did. not sure what that implies about him. > The optom took the readings (mid 40's) as accurate :( > [quoted text clipped - 45 lines] > > > > > > i conclude the air puff tonometer is not giving good readings Mark, thanks for your insights readings from the proview are consistently 15-16 (R) and 16-18 (L) would would you conclude that the true IOP is somewhere below 20 (or probably not above 20)? Dave > Hello > [quoted text clipped - 37 lines] > > > > i conclude the air puff tonometer is not giving good readings Hi Dave I can't conclude anything because 10000km away its not appropriate for me to have a clincal opinion. But I will say this: if this optometrist accepted the mid-40 IOP's as realistic, and did not react accordingly, then I would sincerely suggest you find another optometrist. Or at least another tonometer. Best regards Mark > Mark, thanks for your insights > [quoted text clipped - 52 lines] > > > > > > i conclude the air puff tonometer is not giving good readings > just got a proview from bausch & lomb. practiced with it a lot and now i am > totally comfortable using it. my readings are repeatable, the phosphene is [quoted text clipped - 16 lines] > > i conclude the air puff tonometer is not giving good readings The air puff tonometer is not terribly accurate. Unfortunately, neither is the proview. The most accurate tonometer is the Goldmann applanator used by some optometrists and virtually all ophthalmologists. The major question to be asked is, if you think you may have glaucoma, why are you not seeing an ophthalmologist? If this optometrist was not concerned enough with a pressure over 40 to double check your IOP by applanation or to refer you to a glaucoma specialist, then he shouldn't be seeing patients. --Rick Cohn, MD Glaucoma specialist Winter Park, FL I sincerely agree with you Rick. Optoms are primary care-givers. Whilst I acknowledge that US optoms get involved in more pathology than Australians, my personal view is that my job is to identify those in need of higher-level care and refer appropriately. I expect to be crucified by my colleagues for this attitude (all responses welcome, but please identify yourself) but I never intended to train to be a medical specialist and I do not purport to be one. Cheers Mark > > just got a proview from bausch & lomb. practiced with it a lot and now i am > > totally comfortable using it. my readings are repeatable, the phosphene is [quoted text clipped - 28 lines] > Glaucoma specialist > Winter Park, FL |
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