Reproducibility and tolerability of the ICare rebound tonometer in school children

PURPOSE: To establish the intraobserver and interobserver reliability of the rebound tonometer (RBT) in healthy schoolchildren and to test patient tolerance in an unanesthetized eye. SUBJECTS AND METHODS: To examine the reproducibility of the RBT, 2 experienced ophthalmologists undertook 3 consecutive intraocular pressure (IOP) measurements with the RBT without an anesthetic in 304 eyes of 152 healthy schoolchildren. Any pain or discomfort experienced by the children was recorded. Intraobserver and interobserver reliabilities were established by calculating correlation coefficients (r). RESULTS: Of the 152 patients, 78 (51.3%) were males and 74 (48.7%) were females. The mean patient age was 11.2+/-2.6 years (range: 7 to 15 y). Mean IOP values obtained by examiners 1 and 2 were 16.48+/-2.82 mm Hg and 17.27+/-3.27 mm Hg for the right eyes and 17.15+/-3.36 mm Hg and 17.06+/-3.21 mm Hg for the left eyes. Intraobserver correlation coefficients for examiner 1 were 0.970 for the right eyes and 0.974 for the left eyes. For examiner 2, intraobserver correlation coefficients were 0.963 for the right eyes and 0.970 for the left eyes. The interobserver correlation coefficients were 0.798 for the right eyes and 0.858 for the left eyes (all P<0.0001). With the RBT, 98.6% of the subjects felt no pain and/or discomfort. CONCLUSIONS: Measurement of IOP with the RBT is a highly reproducible method in schoolchildren showing high intraobserver and interobserver correlation and it seems to be very comfortable when performing IOP measurements in schoolchildren without an anesthetic.