Durgesh Kumar Sinha

Abstract

Purpose: Measurement of intraocular pressure (IOP) is basic investigation in a general ophthalmic workup. We attempt to determine the agreement in the measurement of IOP obtained by Goldman applanation tonometer, Perkin’s applanation tonometer, Non-contact tonometer in patients attending general ophthalmology OPD in a tertiary care centre in South India and its use in a community ophthalmology setting Materials and Methods: A cross-sectional analytical study in which IOP was measured in patients using the three tonometers. Central corneal thickness (CCT) was measured using Ultrasonic pachymetry. Bland Altman analysis was done to evaluate the agreement between instruments. Results: 800 eyes of 400 patients were included in the study. By Bland Altman method, Perkin’s tonometer was found to have better correlation to IOP obtained by Goldman applanation tonometer. Perkin’s tonometer was found to be most accurate when CCT was in the range of 501–550 microns and noncontact tonometer was found to be least accurate when CCT was greater than 600 microns. On comparing correlation at different age groups, both the methods had better correlation at Conclusion: Both the tonometers showed a significant correlation with the gold standard technique GAT over a range of IOP and CCT with the Perkin’s tonometer better than the NCT. This study proves that Perkin’s tonometer can be recommended as a reliable screening tool in community outreach ophthalmology services. The twin advantages of portability and availability make the Perkin’s tonometer a popular choice among ophthalmology trainees and optometrists in a developing country like India.   Keywords: Intraocular pressure, Glaucoma, GAT, Perkin'S Tonometer, NCT

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Abstract

Purpose: To evaluate ocular manifestations in primary severe hypertension. Materials and Methods: A retrospective chart review of 100 eyes of 50 patients in age group 45-60 years diagnosed with primary severe hypertension (systolic blood pressure [SBP] ? 180 mm Hg and diastolic blood pressure [DBP] ? 110 mm of Hg) in a tertiary hospital in 6 months from December 2018 to May 2019. Vision with evaluated with Snellen’s chart, fundus was examined with IDO, DO, +90D, +20 D lens and OCT was done. Results: Mean age were found to be 51 years ±9.8 under treatment for essential hypertension. Fundus findings included Arteriolar Narrowing (both Focal and Generalized arteriolar Narrowing), Hard Exudates, Cotton Wool Patches, Flame Shaped Haemorrhages, Optic disc edema, Disc haemorrhages. OCT findings included Macular Oedema, Irregular reflection, Sub Retinal Fluid, Inner Retinal Fluid, Hyper Reflective Dots. Conclusion: This study can be used as an early diagnostic tool in hypertension. Severe hypertension may lead to may exudative changes. With Arteriolar Narrowing and Hyperreflective Dots within retina as the most common findings. Awareness should be spread regarding ophthalmological examination among patients so that timely measures can be initiated to stop the progression of disease.   Keywords: Ocular Manifestation, Hypertension

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