J Korean Ophthalmol Soc.  2014 Jul;55(7):1049-1055.

Comparison of Intraocular Pressures According to Position Using Icare Rebound Tonometer

• Kim HJ
• Yi K

Abstract

PURPOSE
To evaluate changes in intraocular pressure (IOP) according to position using a portable rebound tonometer.
METHODS
We measured the IOP values of 20 healthy volunteers (40 eyes) in the sitting, supine, right lateral decubitus and left decubitus positions with a portable rebound tonometer, and then analyzed using the Wilcoxon signed rank test. IOP in sitting position was also measured with a non-contact tonometer and a Goldmann applanation tonometer, and analyzed with Kruskal-Wallis test and Spearman correlation analysis. Agreement among the 3 tonometers was calculated using the Bland-Altman method.
RESULTS
The IOP measured with rebound tonometer in the supine position was significantly higher than in the sitting position (p = 0.002). However, there was no significant difference in IOP between the supine and decubitus positions. In the decubitus position, there was no significant difference in IOP between the dependent and non-dependent eyes. IOP measurement using the rebound tonometer showed positive correlation with that of the noncontact and Goldmann applanation tonometers.
CONCLUSIONS
In normal subjects, IOP measurement obtained with a rebound tonometer in the supine position was significantly higher than in the sitting position, but there was no significant difference in IOP between the supine and decubitus positions. A rebound tonometer may be useful for patients whose intraocular pressure measurement with Goldmann applanation tonometer or non-contact tonometer is impossible. When using a portable rebound tonometer in bed-ridden or pediatric patients, we should pay attention to the interpretation of IOP in the supine position.

Keyword

Decubitus position; Icare PRO rebound tonometer; Supine position

MeSH Terms

Healthy Volunteers
Humans
Intraocular Pressure*
Iron-Dextran Complex*
Supine Position
Iron-Dextran Complex

Figure

• 

  Figure 1. Comparison of intraocular pressures according to body position with rebound tonometer (*p < 0.05, Wilcoxon signed rank test).

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  Figure 2. Comparison of intraocular pressure (IOP) measured with non-contact tonometer and Icare rebound tonometer (r = 0.636, p = 0.000). IOP = intraocular pressure; RB = Icare rebound tonometer; NCT = non-contact tonometer.

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  Figure 3. Comparison of intraocular pressure measured with Goldmann applanation tonometer and Icare rebound tonometer (r = 0.662, p = 0.000). IOP = intraocular pressure; RB = Icare rebound tonometer; GAT = Goldmann applanation tonomter.

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  Figure 4. Bland-Altman plot. The differences between IOP measured by RB and NCT are plotted against the mean of the two measurements. IOP = intraocular pressure; RB = rebound tonometer; NCT = non-contact tonometer; SD = standard deviation.

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  Figure 5. Bland-Altman plot. The differences between IOP measured by RB and GAT are plotted against the mean of the two measurements. IOP = intraocular pressure; RB = rebound tonometer; GAT = Goldmann applanation tonomter; SD = standard deviation.

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