Home Tonometry in Glaucoma: Physician and Patient Perspectives on Indications, Benefits, and Barriers to Wider Implementation
Jeffrey Liu, Sarah Rose Smale, Zara Saleem, Michael Paul Snyder, Sharon Fridovich FreedmanPurpose:
To assess physician and patient perspectives on home tonometry (HT) in glaucoma and understand its impact on glaucoma care, as well as barriers to its broader clinical integration.
Methods:
Separate surveys were sent to ophthalmologists and patients: one distributed by the American Glaucoma Society to its members, and the other through MyEyes™ to its patient clients. Physician surveys included training background, prescribing practices, and attitudes toward HT, while patient surveys included glaucoma history, HT use, and attitudes toward HT. Surveys incorporated mirrored questions to compare perspectives between HT prescribers and non-prescribers, and between physicians and patients, comparing frequency distributions and Likert-scale scores.
Results:
Among 158 ophthalmologists, 59% reported prescribing HT, most often for patients with moderate to severe glaucoma. HT data influenced clinical management in 85% of prescribers and increased treatment confidence in 92%. Compared to HT prescribers, non-prescribers more frequently cited device inaccuracy and low patient proficiency as reasons not to prescribe HT (
Conclusions:
HT was generally valued by physicians and patients, increasing physician confidence and positively influencing patient well-being. Broader integration remains limited by patient financial barriers and physician skepticism about device reliability and patient proficiency. Further research on outcomes of HT use versus non-use may help address these limitations.
Précis:
Glaucoma physician and patient perspectives on home tonometry revealed benefits such as improved physician treatment confidence and reduced patient anxiety, while highlighting cost, device accuracy concerns, and patient proficiency as potential barriers to broader integration.