home Tonometer

[ChrisNorthEast]

does anyone measure their own IOP at home? If so what do you use? Any recommendations on where to purchase?

[autumnlass]

A really great question! I was diagnosed with PEX glaucoma last month and I would like to buy a tonometer as well. I think they are very expensive … I read somewhere that the best one was called Icare which retailed at about £2k. 😳 Hope I’m wrong.

[Ritualhazard]

Hi there. Yes, I do have one. They are eye wateringly expensive at a shade over £2K. But…. It’s been a saviour for me. My clinic measured pressures were always in the “normal” range but I have extremely high spikes which no one believed were happening. ~ I was even sent for brain and heart scans because they thought I was having strokes. This is my pressure chart below. The UK retailer is main-line.co.uk/products/ic...

Happy to answer any other questions you may have

Pressure chart

[muddledme in reply to Ritualhazard]

How interesting, my optitian thinks I probably have high spikes too, as things seem to progress despite treatment.

However the problem may be my Preserflo shunts slowly "furring up".

So has your treatment altered since these high spikes were identified ? I wonder how common it is ? Although I suppose that would be largely unknown.

Do the medics welcome your pressure records, or are they sceptical?

I seem to remember reading that some of the home monitoring equipment did not get a good press, but perhaps they have improved.

It would be interesting to know your progress.

Best wishes

[Ritualhazard in reply to muddledme]

Hi. It was my consultant who recommended it. The eye hospital have one you can borrow but there is over a six month wait. My treatment has changed since I brought it in that i am getting treatment. Before, they had no evidence that my pressures were spiking despite the cloudy vision and rainbow haloes so we’re very reluctant to do anything. Taking the conservative approach which I guess is right. Last time I went to the eye hospital ( pre tonometer) I insisted something was done before I left so they added Brimonidine to my other drops. Which reduced the incidence of symptoms but didn’t make them go away completely. Since I’ve had the pressure results I’ve had SLT and I’m going back today to review what happened since then for discussion on next steps. It’s been very powerful for me to take control of my situation and has helped to manage my huge anxiety.

[muddledme in reply to Ritualhazard]

Thank you, I must enquire about a loan scheme, or just a bit more knowledge about home monitoring or phasing in the hospital when I see the specialist glaucoma optician.

Hope you get good results today.

[Peg99 in reply to Ritualhazard]

Hello Ritualhazard,I hope you don't mind me asking but is it the 'new' Icare tonometer you have, the one which allows you to take the IOPs yourself?

I currently use the old Icare tonometer which my Husband has to operate, just as the Optician would. We've been using it for over 10 years and have been very happy with it but as we are getting on a bit, we are thinking that the one I operate myself might be better.

I have normal tension glaucoma, not spikes, and I need to take my pressures every week to make sure they are not too high. A home tonometer certainly beats going to the opticians every week which is what I had to do for many years. Is your tonometer easy to use? Do you know how it compares to Goldman readings please? Do you get any/many false readings or operator errors?

As I say, hope you don't mind the questions.

[Ritualhazard in reply to Peg99]

Hi there. Yes, it’s the one you do yourself. In terms of accuracy I would say it measures one or two mm hg low but it’s generally repeatable within one or two mm. by that I mean if I take a measurement and it’s 24 then another one immediately afterwards it’s 23/24/25. Yesterday I took my pressure just before going to the hospital and it showed 17 in both eyes. Clinic measured pressures were 19. So pretty close - but my pressures do vary a lot so they may just have gone up. It’s as accurate as the one they use in the opticians. I terms of ease of use, I find it easy. I have a friend with normal tension glaucoma and she borrowed it after her trab and she also found it easy to use. Sometimes it gets a bit “funny” but then I change the probe and it’s fine. Overall I’m very happy with it

[Peg99 in reply to Ritualhazard]

Hello Ritualhazard,Thanks for the info, something for me to think about for the near future.

[frankthebank in reply to Ritualhazard]

Hi thanks for the post, does this require additional products to be bought like probes? As I gather these can be costly because they are one use? Thanks

[Ritualhazard in reply to frankthebank]

Hi. Yes they do need probes. At £70 for 50it adds up if you take your pressures twice a day as I do. However, and I’m not recommending this, just sharing what I do. I have a little pot of 100% alcohol that I dip the probes In after I’ve used them. I gently remove them from the tonometer with tweezers, dip the end, then pop it back in the plastic case it came in. That way they usually last three to four days. I checked with a paramedic friend who said it should be fine. But, and I reiterate, I’m just sharing what I do and not recommending it at all to anyone else

[frankthebank in reply to Ritualhazard]

Ok great thanks Ritual appreciate the reply

[Dmfan1 in reply to Ritualhazard]

Hi there ritualhazard, where did you get your tonometer from and is it easy to read and use please?

[Helen_GlaucomaUK Administrator]

Hi All

Yes, the Icare tonometer seems to be the best one but at a huge cost. For people who have stable glaucoma, it isn't really necessary. Intraocular ocular pressure (IOP) normally fluctuates during the day but for people whose IOP could be spiking high during the day, monitoring during the day can be helpful.

My question in the first instance to my eye specialist would be, do they do any on loan? I don't think that this is common practice but I did hear from someone where this was possible. It may even have been a research trial that was taking place.

It is always advised that if you do purchase one, that you inform your eye specialist and are given instructions and shown how to use it properly. This will prevent inaccurate readings.

Phasing can also be done within the hospital. This is where you attend the eye clinic from morning to late afternoon and throughout the day, your IOP is measured. This is only suggested when thought necessary.

[muddledme in reply to Helen_GlaucomaUK]

Thank you , very helpful information.

[AlfredV]

I wonder to what extent the old mechanical ones are practicable? Some would say that it is not doable because you can't administer anaesthetic at home, but for a number of years now I've been having my pressures taken with the standard goldmann tonometer (the blue light one they press on your eye), without anaesthetic. It surprises some ophthalmologists when I request it, but it doesn't hurt, it's just a bit uncomfortable.

[Peg99]

Hello ChrisNorthEast,I have a tonometer at home, an ICare tonometer but mine is an older model where someone else has to take the readings for me (my Husband in my case). I have had it for over 10 years and it has been extremely reliable and accurate in all that time. My current Consultant is happy with it and takes my readings seriously. Yes it was very expensive but given the length of time I've had it, and the good it has done, it's been worth it.

I got it as I was having to have my pressures taken every week for many years, and going to the optician at £5 a time was not only time consuming but quite expensive (I did it for nearly 20 years). Then my Optician at the time showed me his ICare Tonometer and suggested I might like to buy one for myself. My Consultant thought it was a good idea so I went ahead and my Optician showed my Husband how to use it.

As Ritualhazard has said, the supplier in the UK is Main-line and I think they are only available from them. I happened to be talking to them last month and they said that if I wanted to buy a new Tonometer they would probably take my old one in part exchange. I mention this because, although the website doesn't say so, it might be possible to buy a refurbished tonometer which might be cheaper.

As to other tonometers, I have looked around but haven't found any that are accepted by the eye professionals in the UK. A quick Google will tell you that various versions of the Tono Pen are popular in the USA but they don't seem to have taken off here and Opticians I have asked about them haven't been keen.

It is a big thing to buy your own Tonometer and you have to be sure that you actually need it for the long term. If the need is there, the peace of mind they can bring cannot be measured and I certainly don't regret buying mine.

[Quiet_Lin]

Only last week I contacted Main-Line about the iCare Home 2. Currently, the price is £2,046.00 including VAT and Carriage.

In addition the probes, which need changing after every reading, cost £84.00 for a box of 50 including VAT and Carriage,

If you can claim VAT exemption, that knocks a chunk off.

Also, sometimes the probes crop up cheaper on Ebay. I saw 100 for £70 offered.

They also say "The warranty is 24 months. The manufacturer does recommend a service every one - two years, the same as all of the other iCare devices, this would be carried out by our trained engineers at Mainline Birmingham and is a chargeable service."

Main-Line also say they have no second-hand devices available.

I will ask Moorfields before going ahead.

Kind regards everyone.