Cling film as a barrier against CJD in Goldmann‐type applanation tonometry

Davies, Leon N.; Bartlett, Hannah; Dunne, Mark

doi:10.1046/j.1475-1313.2003.00161.x

Cited by 7 publications

(9 citation statements)

References 28 publications

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“…Both the ICARE and the Tonopen XL have disposable tips. This could be an advantage in situations involving a high risk of cross barrier infection (Davies et al. , 2004).…”

Section: Discussionmentioning

confidence: 99%

Three portable tonometers, the TGDc‐01, the ICARE and the Tonopen XL, compared with each other and with Goldmann applanation tonometry*

Jagt

Jansonius

2005

Ophthalmic Physiologic Optic

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Three portable tonometers, the TGDc-01, the ICARE and the Tonopen XL, were compared with each other and to Goldmann applanation tonometry in a large group of healthy subjects and patients with ocular hypertension or glaucoma (n = 103). Measurements performed with the ICARE and the Tonopen XL were in good agreement with that of the Goldmann tonometer. Intraocular pressure (IOP) values measured with the TGDc-01 were significantly lower and showed more variability. The 95% limits of agreement (portable tonometer - Goldmann) were -17 to +10 mmHg for the TGDc-01, -6 to +7 mmHg for the ICARE and -6 to +8 mmHg for the Tonopen. Corneal thickness could not explain the differences between an IOP measured with the portable tonometers and an IOP measured with the Goldmann tonometer. Patient comfort was slightly higher for ICARE when compared with the Tonopen.

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“…Both the ICARE and the Tonopen XL have disposable tips. This could be an advantage in situations involving a high risk of cross barrier infection (Davies et al. , 2004).…”

Section: Discussionmentioning

confidence: 99%

Three portable tonometers, the TGDc‐01, the ICARE and the Tonopen XL, compared with each other and with Goldmann applanation tonometry*

Jagt

Jansonius

2005

Ophthalmic Physiologic Optic

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“…The Goldmann tonometer is currently the clinical gold standard for measuring IOP (Gilchrist 1996) and has been described elsewhere (Moses 1958). Disposable Tonosafe ® probes were used for all Goldmann measurements as repeated use of the original probe would otherwise require sterilization procedures that would be too time‐consuming for the purposes of this study, a protocol adopted in a previous investigation (Davies et al 2004).…”

Section: Methodsmentioning

confidence: 99%

“…Without looking at the tonometer scale, one optometrist (LND) rotated the dial of the tonometer so that the inner aspects of the two fluorescein mires just touched. As IOP fluctuates during the cardiac pulse cycle, the measurement was taken at the mid‐cycle point (Davies et al 2004). Further, the tonometer scale was read by a second optometrist (HB) to eliminate examiner bias (Lotti et al 1999; Davies et al 2004).…”

Section: Methodsmentioning

confidence: 99%

Clinical evaluation of rebound tonometer

Davies

Bartlett

Mallen

et al. 2006

Acta Ophthalmologica Scandinavica

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103

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ABSTRACT.Purpose: To evaluate the reliability and repeatability of intraocular pressure (IOP) measurements using a new rebound tonometer. Methods: Intraocular pressure was measured in 42 healthy human eyes of subjects aged 18-30 years (mean ± standard deviation [SD] 21.5 ± 3.2 years) using the ICare Rebound and Goldmann tonometers in two separate sessions. Results: Intraocular pressure measurements were found to read slightly, but not significantly, higher with the ICare tonometer compared with the Goldmann instrument in both sessions (first session: mean bias ± SD + 0.50 ± 2.33 mmHg; second session: mean bias ± SD + 0.52 ± 1.92 mmHg). Limits of agreement between repeated readings were ± 5.11 mmHg for measurements taken with the ICare tonometer, compared with ± 3.15 mmHg for measurements taken with the Goldmann method. Conclusion: Measurement of IOP in normal, healthy subjects using the ICare rebound tonometer produced a small, statistically insignificant, positive bias when compared with the Goldmann tonometer. Intersessional repeatability of IOP taken with the ICare is poorer than that of IOP taken with the Goldmann tonometer, but is comparable with that of other non-Goldman-type tonometers currently available.

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“…We note that disposable protective covers and disposable tonometer tips, which essentially eliminate any risk associated with contact tonometry, are available but are not yet commonly used [24–26]. The British Royal College of Ophthalmologists in a document dated May 2004, evidently no longer available on line, recommended that contact tonometry equipment be wiped and disinfected after each use.…”

Section: Discussionmentioning

confidence: 99%

Ocular Tonometry and Sporadic Creutzfeldt - Jakob disease (sCJD): A Confirmatory Case-Control Study

Davanipour

Sobel

Ziogas

et al. 2014

BJMMR

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AimsTo evaluate the hypothesis that sporadic Creutzfeldt-Jakob disease (sCJD) may be transmitted through ocular tonometry.BackgroundThe infectious agent of sCJD may be present in the cornea prior to clinical symptoms. Cornea infectiousness has been documented by cornea transplants in guinea pigs and humans. sCJD is resistant to complete inactivity by conventional sterilization techniques. Thus contact tonometry equipment is not disinfected sufficiently to kill sCJD. We previously hypothesized that contact tonometry is a sCJD risk factor.Study DesignPopulation-based case-control study.Place and Duration of StudyDepartment of Neurology, School of Medicine, Loma Linda University, Loma Linda, CA, USA; 4 years.MethodologyAn 11-state case-control study of pathologically confirmed definite sCJD cases, individually matched controls, and a sample of control surrogates was conducted. Ocular tonometry histories were obtained from case-surrogates, controls, and a sample of control-surrogates.ResultsThe odds ratio (OR) for ever vs never having had an ocular tonometry test was statistically significant for matched and unmatched analyses for 15 through 3 years prior to disease onset, using both control self-responses and control surrogates: ORs were ∞ and 19.4 with 1-sided P-values <0.0001 and 0.003 and ORs=∞ and 11.1 with 1-sided P-values <0.003 and 0.02, respectively. ORs increased as the number of tonometry tests increased during this age period: trend test, 2-sided P-value < 0.0001. For ≥5 vs <5 tonometry tests, the OR was 5.8 (unmatched) and 3.7 (matched), 2-sided P-value<0.00005. Respondents generally could not specify the type of tonometry. There was no indication of increased tonometry testing among cases within 2 years of disease onset.ConclusionsThe a priori hypothesis was supported. Contact tonometry, preferred by ophthalmologists, may be capable of transmitting sCJD. Consideration should be given to using disposable instrument covers after each use. The use the disposable covers or non-contact tonometry is preferable in the absence of effective disinfectant processes at this time.

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Cling film as a barrier against CJD in Goldmann‐type applanation tonometry

Abstract: Even if the above findings are found to be acceptable, given the known intra-subject variations of this type of tonometry (+/-4 mmHg), ethical and legal considerations relating to the barrier properties of cling film are likely to prevent its routine use by optometrists.

Cited by 7 publications

References 28 publications

Three portable tonometers, the TGDc‐01, the ICARE and the Tonopen XL, compared with each other and with Goldmann applanation tonometry*

Three portable tonometers, the TGDc‐01, the ICARE and the Tonopen XL, compared with each other and with Goldmann applanation tonometry*

Clinical evaluation of rebound tonometer

Ocular Tonometry and Sporadic Creutzfeldt - Jakob disease (sCJD): A Confirmatory Case-Control Study

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