The Proview Pressure Monitor
The do-it-yourself option.
BY GLARA YI, O.D., CHRISTOPHER J. QUINN, O.D., F.A.A.O.

Diurnal intraocular pressure (IOP) variations can increase the challenge of managing glaucoma. Bausch & Lomb recently introduced the Proview Eye pressure monitor to help in this regard.

The Proview is the first at-home self-monitoring kit that allows patients to measure their own IOP. The device, invented by Bernard Fresco, O.D., is pencil-shaped and tipped with a small, flat probe. An internal spring is loaded onto a pressure scale inside the device. The patient applies the device to the eye through a half-closed upper lid and applies pressure (through the device) until he sees a pressure phosphene. (A phosphene is the perception of light that's produced with the application of mechanical pressure on the globe.)

The appearance of the phosphene is directly related to the IOP and is measured by the marked scale on the instrument.

The Proview produces a phosphene that looks like a dark circle surrounded by a bright halo. Patients can check their IOP any time of the day from the convenience of their own home and create a log of measurements. This eliminates the need for an examination at your office and may provide valuable diagnostic and management information about diurnal IOP fluctuations.

As with any new task, a learning curve is associated with using the Proview device. When introducing it into your practice, select patients carefully to be certain they will comply with using the instrument and recording their measurements, and to make sure they understand how to use it accurately.

Medicare doesn't cover the Proview device, but training in its use is billable.

Although some reports have found that 90% of IOP measurements were within +/- 3 mm Hg with the Proview device as compared to Goldmann tonometry, Goldmann tonometry will remain the gold standard for IOP measurement. However, the Proview will provide you with additional information and allow the patient to become a participant in his own glaucoma management.

References available upon request.