TELEMATIC ASSISTED SELFTONOMETRY

G. Michelson and M. Groh

Department of Ophthalmology, University of Erlangen, Germany

Background: Glaucoma is one of the most common causes of blindness in the Western world. For white persons, the cumulative probability of open angle glaucoma is 4.2%. At 20-years’ follow-up, the cumulative probability of glaucoma-related blindness in at least one eye was estimated to be 27%, and for both eyes, it was estimated to be 9%. One major risk factor is the increased intraocular pressure.

Purpose: To describe a new method for telematic control of the intraocular pressure.

Method: Patients measured the intraocular pressure several times a day with a portable device (Ocuton S, EPSA, Saalfeld, Germany). The resulting measurement values were then entered into a portable digital assistant (3Com's PalmPilot). At a later time these values were transmitted by a modem to the central MedStage server (Siemens, Erlangen). In case of increased levels of the intraocular pressure an e-mail was automatically sent to the eye doctor. To him the pressure curve inclusive a statistical analysis was displayed in an easily readable chart by the communication software MedStage (Siemens, Erlangen). If necessary the eye doctor was able to sent an e-mail to his patient directly from the Website of the pressure curve. N=15 patients with glaucoma were continuously examined.

Results: Selftonometry with telematic control of intraocular pressure enabled a continuous evaluation of the patient by the eye doctor. Intraocular pressure curves over weeks and months were a novel parameter evaluating patients with glaucoma. This approach offered the advantage to control the treatment remotely and to optimize his workflow. Advantages for the patient were that the measurements were easily done at home under normal conditions, and that he gains independence by controlling when the measurement and data transmission will be performed.

Conclusion: The telematic control of the intraocular pressure is a cost-effective procedure enabling the very early diagnosis of pathologically increased values of the intraocular pressure. The system runs by the patient in telematic communication with the eye doctor.