Original Research

A comparison of postural and diurnal variations in intraocular pressure using the iCare rebound tonometer and Perkins applanation tonometer in admitted adults in Kenya

Timothy G. Chikasirimobi, Mercy Ndinyo, Maxine N. Ondieki, Isaac Miti, Ndidi J. Ejiochi-Iyoke, Uchechukwu L. Osuagwu, Ferial M. Zeried, Kingsley Agho, Kelechi C. Ogbuehi, Khathutshelo P. Mashige
African Vision and Eye Health | Vol 80, No 1 | a617 | DOI: https://doi.org/10.4102/aveh.v80i1.617 | © 2021 Timothy G. Chikasirimobi, Mercy Ndinyo, Maxine N. Ondieki, Isaac Miti, Ndidi J. Ejiochi-Iyoke, Uchechukwu L. Osuagwu, Ferial M. Zeried, Kingsley Agho, Kelechi C. Ogbuehi, Khathutshelo P. Mashige | This work is licensed under CC Attribution 4.0
Submitted: 19 September 2020 | Published: 17 May 2021

About the author(s)

Timothy G. Chikasirimobi, Faculty of Health Sciences, Masinde Muliro University of Science and Technology, Kakamega County, Kenya
Mercy Ndinyo, Faculty of Health Sciences, Masinde Muliro University of Science and Technology, Kakamega County, Kenya
Maxine N. Ondieki, Faculty of Health Sciences, Masinde Muliro University of Science and Technology, Kakamega County, Kenya
Isaac Miti, Faculty of Health Sciences, Masinde Muliro University of Science and Technology, Kakamega County, Kenya
Ndidi J. Ejiochi-Iyoke, Courts Optical Warehouse, Kingston, Jamaica
Uchechukwu L. Osuagwu, Department Diabetes, Obesity and Metabolism Translational Research Unit, School of Medicine, Western Sydney University, Campbelltown, Australia
Ferial M. Zeried, College of Applied Medical Sciences, Department of Optometry and Vision Science, King Saud University, Riyadh, Saudi Arabia
Kingsley Agho, School of Health Science, Western Sydney University, Campbelltown, Australia
Kelechi C. Ogbuehi, Department of Medicine, Dunedin School of Medicine, Otago University, Dunedin, New Zealand
Khathutshelo P. Mashige, Department of Optometry, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa

Abstract

Background: Elevated intraocular pressure (IOP) remained the most important known risk factor for glaucoma.

Aim: To compare the postural and diurnal IOP variations using the iCare rebound tonometer (RT) and Perkins applanation tonometer (PAT).

Setting: Kakamega County Hospital, Kenya.

Methods: Elevated intraocular pressure measurements were taken by two (masked) examiners with two devices in the morning (06:00–09:00), midday (12:00–15:00) and evening (18:00–21:00), in the sitting followed by supine positions in one randomly selected eye of 24 oculo-visual healthy hospital-admitted patients. Effects of the time of the day and position of the body within and between devices were analysed with the Statistical Package for Social Sciences.

Results: The mean IOP measured by the RT ranged from 6 mmHg to 24 millimetres of mercury (mmHg) in the sitting position and from 10 mmHg to 26 mmHg in the supine position. The mean IOP measured using PAT ranged from 6 mmHg to 21 mmHg in the sitting position and from 8 mmHg to 24 mmHg in the supine position. The IOP measured by both devices significantly varied with position (p < 0.05). Perkins applanation tonometer on average gave a significantly higher IOP (1.7 mmHg [p = 0.003] and 1.3 mmHg [p = 0.034]) at 06:00 compared to that at 12:00 and 18:00, respectively. The IOP readings with the RT were on average 2.2 mmHg and 3.0 mmHg higher at 06:00 compared to that at 12:00 and 18:00, respectively (p < 0.0005).

Conclusion: Significant reductions were observed in postural and diurnal IOPs in the sitting positions and in the afternoon, respectively. Diurnal IOP variations were slightly higher when measured by RT compared to when measured by PAT.


Keywords

diurnal variation; iCare; intraocular pressure; Perkins; posture

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