Précis: Automated gonioscopy provided good-quality images of the anterior chamber angle. There was a short learning curve for operators, and the examination was well tolerated by patients. Patients expressed a preference for automated gonioscopy compared with traditional gonioscopy. Purpose: The purpose of this study was to assess the feasibility of using a desktop automated gonioscopy camera in glaucoma clinics by examining patient tolerability, ease of use, and image quality and comparing patient preference compared with traditional gonioscopy. Patients and Methods: A prospective study was conducted in a university hospital clinic. Traditional gonioscopy was performed followed by imaging of the iridocorneal angle (ICA) using the Nidek GS-1 camera by 2 glaucoma specialists. Participants were asked to rate the comfort of automated gonioscopy and which method they preferred. The clinicians graded the ease of acquisition for each patient, and the image quality was reviewed by a grader. Results: Forty-three eyes of 25 participants were included. Sixty-eight percent of participants viewed automated gonioscopy as “extremely comfortable,” and the remainder reported it “comfortable”. Forty percent preferred automated gonioscopy compared with traditional gonioscopy, while 52% were equivocal. Clinicians scored 32% of participants as “somewhat difficult” to the image. In 46% of eyes, good-quality photographs were obtained for 360 degrees of the ICA. Only 1 eye had no parts of the ICA clearly visible. Seventy-four percent of eyes had at least half of the ICA clearly visible in all 4 quadrants. Conclusion: Automated gonioscopy provided good-quality images of the ICA for most patients. It was often not possible to image the entire 360 degrees at the first attempt, but the examination was comfortable for patients, and only 8% preferred traditional gonioscopy to the automated photographic examination.
Background/Objectives Intraocular pressure (IOP) is the primary modifiable risk factor in the progression of glaucoma. The ICare HOME is a self-tonometer which empowers patients to measure their own IOP and allows a more complete picture of diurnal IOP. This project aims to determine the feasibility of teaching patients to perform self-tonometry remotely using a remote video link. Subjects/Methods This prospective study involved 12 patients with glaucoma attending an outpatient ophthalmology clinic. Participants were provided with a rebound tonometer (Icare HOME) and instructions to attend remote teaching from home. An optometrist conducted a 30 min live video training session via NearMe with each patient. Following training, participants were asked to measure their own IOP, observed remotely by the optometrist. Successful participants were asked to take a series of home IOP measurements over 48 h. Questionnaires were used to evaluate perceptions on home tonometry and remote training. Results Participants had an average age of 60.1 ± 15.5 years. 58% (7 of 12) were female. 83% (10 of 12) obtained successful diurnal measurements at home. All participants were happy with remote teaching, and none would have preferred training to be conducted face-to-face. All participants were interested in continuing home IOP monitoring. Conclusions Most patients were able to perform home tonometry successfully when taught remotely, with a success rate similar to previously reported rates for face-to-face teaching using the same device. Most participants were receptive to using video calling as a platform for teaching home tonometry.
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