Intraocular pressure measurement

RE: Intraocular pressure measurement

ChrisBVSc — Thu, 19 Oct 2017 17:29:24 GMT

[quote user="David Mills"]

[quote user="ChrisBVSc"]

[quote user="David Mills"]

Question. When is IOP measurement truly necessary?

Given 99% of anterior lens luxations end up with enucleation, and make up the majority of glaucoma cases, and the obvious clinical signs... Big outlay for a piece of kit to tell you what a clinical exam normally will.

[/quote]

Ideally in any unexplained red, painful or cloudy eye, even if it's just to rule out high IOP as it's not something you want to miss. Also if it's low then that can aid a diagnosis of uveitis. In my personal experience in general practice, the majority of glaucoma cases have been either primary disease or secondary to chronic uveitis rather than secondary to lens luxation.

Basically as long as clients are willing to pay for it, you can potentially gain some very important & useful information at very little risk. I've had several recent cases where it's been essential to the diagnosis & management, so wouldn't be without it now.

[/quote]

Thank goodness for published literature then rather than personal experience. Primary disease as in...?

Essential - poppycock. Ask yourself, how did it change your treatment options?

Have you audited your glaucoma cases to see the causes and outcome?

[/quote]

Well that's a bit of a standoff-ish reply, but anyway..

Personal experience with caseload - yes, but my point was there are more situations than just anterior lens luxation in which measuring IOP is useful. Surely I don't need to argue this point any further? Without measuring IOP I wouldn't have been able to make a diagnosis.

Primary disease.. goniodysgenesis in an English Springer Spaniel a good enough example?

How did tonometry change my treatment options? Well, I knew IOP was significantly raised, which funnily enough allowed me to decide on appropriate medical management & facilitated discussions about referral assessment for gonioscopy +/- surgical management of glaucoma. I was even able to monitor response to treatment!

Have I audited my glaucoma cases? Not "officially" no, but I informally keep track of what I've seen, what was done, and what happened. However I make plenty of use of published literature in my approach to diagnosis & management of these cases.

I will now bow out before this becomes a massive tangent, & allow a return to the discussion of tonometry fees while I go & give the Tonovet a clean

RE: Intraocular pressure measurement

David Mills — Thu, 19 Oct 2017 16:43:27 GMT

[quote user="ChrisBVSc"]

[quote user="David Mills"]

Question. When is IOP measurement truly necessary?

[/quote]

Thank goodness for published literature then rather than personal experience. Primary disease as in...?

Essential - poppycock. Ask yourself, how did it change your treatment options?

Have you audited your glaucoma cases to see the causes and outcome?

RE: Intraocular pressure measurement

ChrisBVSc — Thu, 19 Oct 2017 16:35:09 GMT

[quote user="David Mills"]

Question. When is IOP measurement truly necessary?

[/quote]

RE: Intraocular pressure measurement

David Mills — Thu, 19 Oct 2017 16:22:48 GMT

Question. When is IOP measurement truly necessary?

RE: Intraocular pressure measurement

ChrisBVSc — Thu, 19 Oct 2017 16:20:39 GMT

Our current fee is £24 for tonometry (in addition to the consult or re-ex fee).

Martin - we charge for blood pressure, around £28 last time I checked.

Please note I don't set the prices!

RE: Intraocular pressure measurement

Martin Atkinson — Thu, 19 Oct 2017 14:20:20 GMT

Slight tangent but does anyone else charge for taking blood pressure with a doppler kit? We charge £10 a time.

RE: Intraocular pressure measurement

ebedford — Wed, 18 Oct 2017 21:37:09 GMT

£20 first time, £15 follow up, which I think really encourages follow up use to monitor the condition so it gets used a lot more than if it costs £50 a time. We have a tonovet and it's not a faff at all.

RE: Intraocular pressure measurement

Rob Loxley — Wed, 18 Oct 2017 19:49:44 GMT

[quote user="Martin Atkinson"]

[quote user="robloxley"]

If you charged £15 and did one a week then you'd pay off the gross capital cost over 3 years and any extra use / beyond 3 years is extra.

[/quote]Did you know that when Tesco open a new superstore they will have paid off the capital investment in 9 months. We are clearly under-charging if we are aiming at 3 years, I don't know were that figure came from but it is pretty old fashioned. I would want to have paid for any capital investment in a year.

[/quote]

Then charge £45 and use it once a week?

RE: Intraocular pressure measurement

Martin Atkinson — Wed, 18 Oct 2017 17:00:46 GMT

[quote user="robloxley"]

If you charged £15 and did one a week then you'd pay off the gross capital cost over 3 years and any extra use / beyond 3 years is extra.

RE: Intraocular pressure measurement

Beats — Wed, 18 Oct 2017 07:22:25 GMT

[quote user="robloxley"]If you ... did one a week then[/quote]

do you use it once a week?

i use my schiotz tonometer (more faff to use i appreciate) about once every couple of months at best.

when i worked in a clinic with a tonopen/tonovet don't remember it getting any more frequent use.

RE: Intraocular pressure measurement

Rob Loxley — Tue, 17 Oct 2017 22:43:17 GMT

If you charged £15 and did one a week then you'd pay off the gross capital cost over 3 years and any extra use / beyond 3 years is extra.