Tonometers

Re: Tonometers

plantagenet — Thu, 19 Apr 2012 10:17:00 GMT

[quote user="Mark Hedberg"]cleaned thoroughly between use[/quote]

Absolutely true - as commented, it is a beautiful and clever device and so needs to be treated with respect. I book the animal in for a relaxed, longer consult.

Re: Tonometers

Mark Hedberg — Thu, 19 Apr 2012 08:59:09 GMT

[quote user="Anthony Todd"]

[quote user="plantagenet"]Schiotz tonometer[/quote]

We have 4; never been used, after nearly 10 years; one vet tried on GA cat once. Is there a knack and/or some detailed instructions anywhere. Is it possible to use them in a conscious animal?

I do realise the importance of IO pressure though.

They are a really beautiful looking device, worth the money just to look at one.

[/quote]

Schiotz's are useful; you do need that proxymetacaine though! Also must be held vertically during use and cleaned thoroughly between use, otherwise the weight gets sticky and that's why the little metal sensor gets frozen.

Once you put in proxymetacaine into the eye, wait a minute for the numbness to kick in - it's not instant.

Re: Tonometers

plantagenet — Thu, 19 Apr 2012 08:40:44 GMT

[quote user="Anthony Todd"] Is there a knack and/or some detailed instructions anywhere.[/quote]

The instructions were in the packet!

There even seems to be a clip on youtube

Conscious seems ok almost all the time but an extra pair of hands helps, bit fiddly but quite quick.

Re: Tonometers

Anthony Todd — Thu, 19 Apr 2012 08:38:25 GMT

[quote user="plantagenet"]Schiotz tonometer[/quote]

We have 4; never been used, after nearly 10 years; one vet tried on GA cat once. Is there a knack and/or some detailed instructions anywhere. Is it possible to use them in a conscious animal?

I do realise the importance of IO pressure though.

They are a really beautiful looking device, worth the money just to look at one.

Re: Tonometers

Robert Lowe — Wed, 18 Apr 2012 22:59:38 GMT

Absolutely agree that the investment is worthwhile and you have a number of options. I would recommend trying the Tonopen and the TonoVet before buying as you may find one easier than the other.

[quote user="David Mills"]

Great investment; and glaucoma, despite what specialists/cert holders tell you IS a condition treatable in first opinion practice - limited number of causes, even more limited number of treatments. As, I would say, are most ophthalmology conditions.

[/quote]

You need to listen to some different specialists then. Absolutely it is treatable in general practice. If you can make a diagnosis of the cause of the glaucoma, treat the underlying pathology (the list of differentials is a long as my arm), discuss with the client the full range of surgical and medical treatment options, monitor progression of the disease (of which IOP is just a component) etc. Perfectly doable in practice but probably takes some humility to do it effectively.

If you think that it is a limited number of cases with even more limited treatment then you need to expand your horizons

Re: Tonometers

Evelyn Barbour-Hill — Wed, 18 Apr 2012 18:57:40 GMT

[quote user="plantagenet"]some of the kit I took with me when I locummed.[/quote]

Oops.

Perhaps you had better rephrase that!

Re: Tonometers

plantagenet — Wed, 18 Apr 2012 18:51:56 GMT

Schiotz tonometer - very cheap <£100 and quite reliable. I've had mine for about 15y - some of the kit I took with me when I locummed.

Re: Tonometers

Gareth C. — Tue, 17 Apr 2012 13:17:39 GMT

sounds like you enjoy ophthalmology and you should def get a tonometer. I use a tonopen and they are vv easy to use. Charge it out, say £10 each time, and it'll pay for itself quite easily. Evaluation of iop is essential.

Re: Tonometers

Claire Fisher — Sun, 08 Apr 2012 12:01:04 GMT

We have a Tonovet - I found it a bit fiddly to use at first but use it reasonably regularly now.

Our local referral opthalmologist has a loaner Tonopen which wouldn't be much use in the middle of the night but at least if the client can't afford referral it means pressure can be measured. Maybe try one on loan first?

Re: Tonometers

David Mills — Sun, 08 Apr 2012 00:07:54 GMT

Re: Tonometers

Richard Huddart — Sat, 07 Apr 2012 21:52:39 GMT

I think a Tonopen or similar is a worthwhile investment. I know they are expensive and hard to justify but if you use it for lots of red eyes it's surprising how many times you can be reassured that an eye is NOT glaucoma, and how often you get low intra ocular pressures. How many practices must have a beautiful Scholtz tonometer (forgive the spelling) lying around not being used - must be one of the most un-used bits of kit ever! We got our tonometer mainly because we got lots of out-of-hours calls from a Dandie Dinmont terrier breeder who was paranoid (justifiably) about acute glaucoma requiring urgent treatment. But we use it quite a lot on other animals and I think it's paid for itself. There are many things we purchase which we really need which do not give an instant profit (ultrasound scanners, x-ray processors, etc) and this is another one in my view.