At-home device reveals diurnal IOP to enhance glaucoma management

Elise Brisco, OD, FAAO, of Hollywood Vision Center, in Los Angeles, says she recently lost some vision OD post-cataract surgery. The reason: The surgeon didn’t know she was a steroid responder, and the surgeon didn’t monitor her post-op IOP.Determined to preserve her vision after her OS cataract surgery in 2022, she says she learned of and used the icare HOME. The handheld, patient-operated self-tonometer enables IOP acquisition outside normal practice hours and delivers the measurements to the OD for review. Its latest version, the icare HOME2, recently became available. (See icare-world.com/us/product/icare-home2/ .)

Here, Dr. Brisco, Randall Thomas, OD, MPH, FAAO, of Concord, NC, and Murray Fingeret, OD, FAAO, of SUNY College of Optometry, in New York, discuss their experience with at-home IOP monitoring.

PATIENT BENEFITS

• Full IOP profile. “The icare HOME2 tonometer allows for a more definitive understanding of a patient’s IOP profile, enabling enhanced management decisions,” explains Dr. Thomas.
• Intuitive utilization. The icare HOME2 has a smart light guide and an interactive display screen to facilitate IOP acquisition, offers Dr. Fingeret. Additionally, ODs can refer patients to an instructional video, which can be accessed at https://youtu.be/-adL6jI5LMU .
  “The video goes step-by-step, so it works well in training patients on precisely how to use it,” he notes.
• Comfort. The device measures IOP non-invasively in two ways:
  (1) Its design enables patients to use it while they are sitting, reclined or completely flat.
  (2) Dr. Thomas says the icare HOME2 doesn’t require anesthetic, as patients have reported “not feeling anything” when it’s obtaining measurements.
• Convenience. Dr. Brisco says using at-home monitoring precludes glaucoma patients from constant early morning IOP checks with their doctor.
  “This can be a hassle, especially for glaucoma patients who don’t have easy access to transportation,” she explains.
  She adds that eye doctors and third-party lenders can rent and/or lease either device, which is typically not covered by insurance, to patients.

PRACTICE BENEFITS

• Comprehensive care. “Using this device ensures optometrists are being thorough in their care,” explains Dr. Thomas. “Patients don’t successfully sue doctors who provide optimal care.”
• Patient compliance. Dr. Brisco says at-home monitoring can increase the likelihood of patient compliance with their anti-glaucoma drops because the IOP measurements illustrate the fact that glaucoma really is the silent thief of sight.
• High-tech reputation. “Having this device shows patients that the optometrist provides cutting-edge care, and that’s what patients desire in any doctor,” explains Dr. Fingeret.
• Practice revenue. Dr. Brisco points out that ODs can see patients via telehealth appointments to discuss the IOP measurements and what that means for their disease management.
  “Insurance covers these visits, and patients don’t mind paying for the convenience of not having to travel to the practice for such visits” she explains.

THAT OTHER EYE

So, what happened to Dr. Brisco’s left eye? She says she “fastidiously” checked her IOP multiple times a day using at-home monitoring, which resulted in her doctor first decreasing and then replacing steroids with NSAIDS post cataract surgery.

“I believe that device helped preserve my vision in my left eye,” she says. OM