Effect of central corneal thickness on intraocular pressure with the rebound tonometer and the applanation tonometer in normal dogs

Objective To evaluate the effect of central corneal thickness (CCT) on the measurement of intraocular pressure (IOP) with the rebound (TonoVet^®) and applanation (TonoPen XL^®) tonometers in beagle dogs. Animal studied Both eyes of 60 clinically normal dogs were used. Procedures The IOP was measured by the TonoVet^®, followed by the TonoPen XL^® in half of the dogs, while the other half was measured in the reverse order. All CCT measurements were performed 10 min after the use of the second tonometer. Results The mean IOP value measured by the TonoVet^® (16.9 ± 3.7 mmHg) was significantly higher than the TonoPen XL^® (11.6 ± 2.7 mmHg; P < 0.001). The IOP values obtained by both tonometers were correlated in the regression analysis (γ² = 0.4393, P < 0.001). Bland–Altman analysis showed that the lower and upper limits of agreement between the two devices were ?0.1 and +10.8 mmHg, respectively. The mean CCT was 549.7 ± 51.0 μm. There was a correlation between the IOP values obtained by the two tonometers and CCT readings in the regression analysis (TonoVet^® : P = 0.002, TonoPen XL^® : P = 0.035). The regression equation demonstrated that for every 100 μm increase in CCT, there was an elevation of 1 and 2 mmHg in IOP measured by the TonoPen XL^® and TonoVet^®, respectively. Conclusions The IOP obtained by the TonoVet^® and TonoPen XL^® would be affected by variations in the CCT. Therefore, the CCT should be considered when interpreting IOP values measured by tonometers in dogs.     

Evaluation of the Perkins handheld applanation tonometer in horses and cattle

The objective of this study was to evaluate and validate the accuracy of the Perkins handheld applanation tonometer for measuring intraocular pressure (IOP) in horses and cattle. Both eyes of 10 adult horses and cattle were evaluated in a postmortem study. The eyes from 10 clinically normal adult horses and cattle were also examined after bilateral auriculopalpebral nerve block and topical anesthesia for an in vivo study. IOP was measured postmortem using direct manometry (measured with an aneroid manometer) and tonometry (measured with a Perkins handheld applanation tonometer). The correlation coefficients (r²) for the data from the postmortem manometry and Perkins tonometer study were 0.866 for horses and 0.864 for cattle. In the in vivo study, IOP in horses was 25.1 ± 2.9 mmHg (range 19.0~30.0 mmHg) as measured by manometry and 23.4 ± 3.2 mmHg (range 18.6~28.4 mmHg) according to tonometry. In cattle, IOP was found to be 19.7 ± 1.2 mmHg (range 18.0~22.0 mmHg) by manometry and 18.8 ± 1.7 mmHg (range 15.9~20.8 mmHg) by tonometry. There was a strong correlation between the IOP values obtained by direct ocular manometry and the tonometer in both horses and cattle. Our results demonstrate that the Perkins handheld tonometer could be an additional tool for accurately measuring IOP in equine and bovine eyes.     

Evaluation of a rebound tonometer (Tonovet®) in clinically normal cat eyes

Objective  To determine the accuracy of and to establish reference values for a rebound tonometer (Tonovet^®) in normal feline eyes, to compare it with an applanation tonometer (Tonopen Vet^®) and to evaluate the effect of topical anesthesia on rebound tonometry.
Procedures  Six enucleated eyes were used to compare both tonometers with direct manometry. Intraocular pressure (IOP) was measured in 100 cats to establish reference values for rebound tonometry. Of these, 22 cats were used to compare rebound tonometry with and without topical anesthesia and 33 cats to compare the rebound and applanation tonometers. All evaluated eyes were free of ocular disease.
Results  Both tonometers correlated well with direct manometry. The best agreement with the rebound tonometer was achieved between 25–50 mmHg. The applanation tonometer was accurate at pressures between 0 and 30 mmHg. The mean IOP in clinically normal cats was 20.74 mmHg with the rebound tonometer and 18.4 mmHg with the applanation tonometer. Topical anesthesia did not significantly affect rebound tonometry.
Conclusions  As the rebound tonometer correlated well with direct manometry in the clinically important pressure range and was well tolerated by cats, it appears suitable for glaucoma diagnosis. The mean IOP obtained with the rebound tonometer was 2–3 mmHg higher than that measured with the applanation tonometer. This difference is within clinically acceptable limits, but indicates that the same type of tonometer should be used in follow-up examinations in a given cat.     

Comparison of the rebound tonometer (TonoVet) with the applanation tonometer (TonoPen XL) in normal Eurasian Eagle owls (Bubo bubo)

OBJECTIVE: To examine the feasibility and accuracy of a handheld rebound tonometer, TonoVet, and to compare the intraocular pressure (IOP) readings of the TonoVet with those of an applanation tonometer, TonoPen XL, in normal Eurasian Eagle owls. ANIMALS STUDIED: Ten clinically normal Eurasian Eagle owls (20 eyes). PROCEDURES: Complete ocular examinations, using slit-lamp biomicroscopy and indirect ophthalmoscopy, were conducted on each raptor. The IOP was measured bilaterally using a rebound tonometer followed by a topical anesthetic agent after 1 min. The TonoPen XL tonometer was applied in both eyes 30 s following topical anesthesia. RESULTS: The mean +/- SD IOP obtained by rebound tonometer was 10.45 +/- 1.64 mmHg (range 7-14 mmHg), and by applanation tonometer was 9.35 +/- 1.81 mmHg (range 6-12 mmHg). There was a significant difference (P = 0.001) in the IOP obtained from both tonometers. The linear regression equation describing the relationship between both devices was y = 0.669x + 4.194 (x = TonoPen XL and y = TonoVet). The determination coefficient (r(2)) was r(2) = 0.550. CONCLUSIONS: The results suggest that readings from the rebound tonometer significantly overestimated those from the applanation tonometer and that the rebound tonometer was tolerated well because of the rapid and minimal stress-inducing method of tonometry in the Eurasian Eagle owls, even without topical anesthesia. Further studies comparing TonoVet with manometric measurements may be necessary to employ rebound tonometer for routine clinical use in Eurasian Eagle owls.     

Comparison of the rebound tonometer (ICare) to the applanation tonometer (Tonopen XL) in normotensive dogs

OBJECTIVE: To compare intraocular pressure (IOP) measurements obtained by recently introduced rebound tonometer (ICare) and the well-known applanation tonometer Tonopen XL in normal canine eyes. METHODS: In a prospective, randomized, single-center study, IOP measurements by ICare and Tonopen XL tonometers were compared in 160 nonpathologic canine eyes (80 dogs). Complete slit-lamp biomicroscopy and indirect ophthalmoscopy were performed on each dog. Rebound tonometry was performed first and immediately after topical anesthetic drops were instilled in both eyes. One minute after the application of the topical anesthetic, applanation tonometry was performed in both eyes. The intraocular pressures obtained by use of both techniques were compared by statistical analysis. RESULTS: The mean IOP readings were 9.158 mmHg (SD 3.471 mmHg) for the ICare tonometer (x) and 11.053 mmHg (SD 3.451 mmHg) for the Tonopen XL readings (y). The mean difference in intraocular pressures (-1.905 mmHg) was within clinically acceptable limits. The correlation coefficient (r2) of the relationship within both tonometers was r2=0.7477. The corresponding linear regression between the tonometers readings was y=0.6662x+4.942. CONCLUSIONS: Intraocular pressures obtained with the ICare rebound tonometer were concordant with the IOP readings obtained by applanation Tonopen XL, but ICare values were significantly (P<0.0001) lower. Rebound tonometry could be an appropriate tonometry method for routine clinical use after its calibration for canine eyes.     

Circadian rhythm of intraocular pressure in cats

OBJECTIVE: To evaluate the rhythm of intraocular pressure (IOP) in healthy domestic cats with no evidence of ocular disease and to analyze the influence of photoperiod, age, gender and ocular diseases on diurnal-nocturnal variations of cat IOP. ANIMALS: All animals were Domestic Short-haired cats; 30 were without systemic or ocular diseases, classified as follows: 12 male intact adult cats, five intact adult female, five adult spayed female, and eight male cats; the latter were less than 1 year of age. In addition, five adult cats with uveitis and three adult cats with secondary glaucoma were included. PROCEDURE: IOP was assessed with a Tono-Pen XL at 3-h intervals over a 24-h period in 12 healthy adult male cats kept under a photoperiod of 12-h light/12-h darkness for 2 weeks. Eight animals from the same group were then kept under constant darkness for 48 h, and IOP was measured at 3-h intervals for the following 24 h. In addition, IOP was assessed at 3 p.m. and 9 p.m. in five intact females, five spayed females, and in eight young cats, as well as in five adult cats with uveitis and three glaucomatous cats. RESULTS: Consistent, daily variations in IOP were observed in animals exposed to a light-dark cycle, with maximal values during the night. In cats exposed to constant darkness, maximal values of IOP were observed at subjective night. Differences of IOP values between 3 p.m. and 9 p.m. (diurnal-nocturnal variations) persisted in intact females, spayed females, and young animals, as well as in uveitic and glaucomatous eyes. CONCLUSIONS: The present results indicate a daily rhythm of cat IOP, which appears to persist in constant darkness, suggesting some level of endogenous circadian control. In addition, daily variations of cat IOP seem to be independent of gender, age, or ocular diseases (particularly uveitis and glaucoma).     

Activated coagulation times in normal cats and dogs using MAX-ACTTM tubes

Objective  To establish reference values for activated coagulation time (ACT) in normal cats and dogs, by visual assessment of clot formation using the MAX-ACT^TM tube.
Subjects  We recruited 43 cats and 50 dogs for the study; 11 cats and 4 dogs were excluded from the statistical analysis because of abnormalities on clinical examination or laboratory testing including anaemia, prolonged prothrombin time (PT) or activated partial thromboplastin time (APTT), or insufficient plasma volume for comprehensive laboratory coagulation testing.
Procedure  Blood samples were collected via direct venipuncture for MAX-ACT, packed cell volume/total solids, manual platelet estimation and PT/APTT measurement. Blood (0.5 mL) was mixed gently in the MAX-ACT tube at 37°C for 30 s, then assessed for clot formation every 5 to 10 s by tipping the tube gently on its side and monitoring for magnet movement. The endpoint was defined as the magnet lodging in the clot. The technique was tested with 10 dogs by collecting two blood samples from the same needle insertion and running a MAX-ACT on each simultaneously.
Results  In normal cats the mean MAX-ACT was 66 s (range 55–85 s). In normal dogs the mean was 71 s (range 55–80 s). There was no statistical difference between the first and second samples collected from the same needle insertion.
Conclusions and Clinical Relevance  In both cats and dogs, a MAX-ACT result >85 s should be considered abnormal and further coagulation testing should be performed. Additionally, failure to discard the first few drops of the sample does not appear to significantly affect results.     

Evaluation of intraocular and partial CO2 pressure in dogs anesthetized with propofol

The effects of propofol on intraocular pressure (IOP) and end tidal CO₂ (ETCO₂) were studied because an elevation in the latter may alter IOP. Twenty dogs were divided into two groups (G1 and G2). G1 dogs were induced with 10 mg/kg (IV) of propofol followed by a 0.4 mg/kg/min continuous infusion of the same agent diluted in a 0.2% dextrose solution for 1 h. G(CAPS) 2 dogs served as the control group, where only dextrose solution was administered, under the same time intervals as in G1. Applanation tonometry (Tono-Pen) was used to determine IOP and ETCO₂ as a method to determine partial CO₂ pressure. Measurements were taken every 15 min for 1 h, with M1 occurring immediately before IV administration. IOP and ETCO₂ were not statistically significant in either groups. Based on the results, it may be concluded that propofol does not alter IOP and ETCO₂.     

Comparison of a rebound and an applanation tonometer for measuring intraocular pressure in normal rabbits

Objective To compare intraocular pressure (IOP) measurements made on healthy adult rabbits without the effect of tranquilizers using the new applanation tonometer, Tono‐Pen Avia^®, and the rebound tonometer Tonovet^®. Methods Intraocular pressure was measured throughout the day (6:00, 9:00, 12:00, 15:00, and 18:00 h) in 38 adult New Zealand White rabbits (76 eyes). The animals were 20 males and 18 females, with a mean weight of 3.5 kg and an average age of 6 months. A complete ocular exam (including Schirmer tear test, fluorescein staining, slit‐lamp biomicroscopy, and direct ophthalmoscopy) was performed on all animals at the beginning of the trial. Rebound tonometry was performed, and after 10 min, anesthetic drops were instilled and applanation tonometry was carried out. IOP values obtained using the two techniques were analyzed statistically. Results The mean IOP was 9.51 ± 2.62 mmHg with Tonovet^®, and 15.44 ± 2.16 mmHg with the Tono‐Pen Avia^®. Significant differences between measurements with the two tonometers were observed (P < 0.001). The linear regression equation describing the relationship between the two tonometers was y = 0.4923x + 10.754 (y = Tonovet^® and x = Tono‐Pen Avia^®). High IOPs were recorded in the early measurements (6:00), but the average IOPs from both devices were statistically similar throughout the day (P = 0.086). The correlation coefficient was r² = 0.357. No significant difference in IOP regarding gender was observed. Conclusion The Tono‐Pen Avia^® recorded higher levels of IOP compared with the Tonovet^®. Early in the day, the IOP of rabbits was higher than later in the day, regardless of the tonometer used.     

The effects of ketamine‐midazolam anesthesia on intraocular pressure in clinically normal dogs

Objective To determine the effects of intravenous ketamine‐midazolam anesthesia on intraocular pressure (IOP) in ocular normotensive dogs. Animals Thirteen adult mixed‐breed dogs. Procedures Dogs were randomly assigned to treatment (n = 7) and control (n = 6) groups. Dogs in the treatment group received intravenous ketamine 15 mg/kg and midazolam 0.2 mg/kg and dogs in the control group received intravenous saline. The time of intravenous drug injection was recorded (T₀). Measurements of IOP were then repeated 5 min (T₅) and 20 min (T₂₀) following the intravenous administration of ketamine‐midazolam combination and saline in both groups. Results Measurements showed normal IOP values in both groups. The mean ± SD baseline IOP values for treatment and control groups were 13.00 ± 1.47 and 10.33 ± 2.20, respectively. For baseline IOP values, there was no significant difference between treatment and control groups (P = 0.162). In the treatment group, the subsequent post‐treatment mean ± SD values were 15.64 ± 2.17 (5 min), and 14.92 ± 1.98 (20 min). There was no evidence of statistical difference between baseline values and post‐treatment values after treatment with ketamine‐midazolam (P₅ = 0.139; P₂₀ = 0.442). In control eyes, the mean ± SD values at 5 and 20 min were 10.41 ± 2.01 and 10.16 ± 1.69, respectively. There was no significant difference between baseline values and post‐treatment values in control group (P₅ = 1.000; P₂₀ = 1.000). Conclusion Ketamine‐midazolam combination has no clinically significant effect on IOP in the dog.     

Effects of topical 0.5% tropicamide on intraocular pressure in normal cats

The objective of the study was to determine the effect of topical 0.5% tropicamide on intraocular pressure (IOP) in normotensive feline eyes. IOP was measured bilaterally in 70 clinically healthy cats and gonioscopy (and goniophotography) was performed. Thereafter, 50 cats were treated unilaterally with one drop of 0.5% tropicamide. The contralateral, left eye served as a control. In the placebo group consisting of 20 cats, one drop of physiologic saline solution was administered to the right eye. In all cats, IOP of both eyes was measured 30, 60 and 90 min after topical administration. After unilateral tropicamide application, IOP increased significantly both in the right and in the left eye. Maximum average IOP increase was observed at the control measurement performed 90 min after treatment, with an elevation of 3.8 +/- 4.2 mmHg in the right eye and 3.5 +/- 3.6 mmHg in the left eye. Maximum IOP increase after treatment was 18.0 mmHg in the treated eye and 17.0 mmHg in the left eye. Measurements made at 60 min after treatment revealed a significantly higher increase in IOP in the right eye as compared to the left eye (P60 < 0.05), whereas the differences between right and left eye in IOP increase were not significant at 30 and 90 min after mydriatic application (P30 = 0.123; P90 = 0.305). Although tropicamide-induced mydriasis was observed in the treated eye, the contralateral eye did not show any changes in pupillary function at any time. With increasing age of the cats, IOP increase was found to be more moderate, whereas the gender of the cats did not have any significant influence on IOP changes. In the 20 cats in the placebo group, no significant changes in IOP were observed. We conclude that topical 0.5% tropicamide causes a significant elevation of IOP in the treated and untreated eye in normal cats.     

Validation of the TonoVet® rebound tonometer in normal and glaucomatous cats

Objective  To validate intraocular pressure (IOP) readings obtained in cats with the TonoVet^® tonometer. Animals studied  IOP readings obtained with the TonoVet^® were compared to IOP readings determined by manometry and by the Tono‐Pen XL^? in 1 normal cat and two glaucomatous cats. TonoVet^® and Tono‐Pen XL^? readings were also compared in a further six normal and nine glaucomatous cats. Procedures  The anterior chambers of both eyes of three anesthetized cats were cannulated and IOP was varied manometrically, first increasing from 5 to 70 mmHg in 5 mmHg increments, then decreasing from 70 to 10 mmHg in 10 mmHg decrements. At each point, two observers obtained three readings each from both eyes, with both the TonoVet^® and Tono‐Pen XL^?. IOP was measured weekly for 8 weeks with both tonometers in six normal and nine glaucomatous unsedated cats. Data were analyzed by linear regression. Comparisons between tonometers and observers were made by paired student t‐test. Results  The TonoVet^® was significantly more accurate than the Tono‐Pen XL^? (P = 0.001), correlating much more strongly with manometric IOP. In the clinical setting, the Tono‐Pen XL^? underestimated IOP when compared with the TonoVet^®. Conclusions  Both the TonoVet^® and Tono‐Pen XL^? provide reproducible IOP measurements in cats; however, the TonoVet^® provides readings much closer to the true IOP than the Tono‐Pen XL^?. The TonoVet^® is superior in accuracy to the Tono‐Pen XL^? for the detection of ocular hypertension and/or glaucoma in cats in a clinical setting.     

Effects of metaraminol bitartrate on intraocular pressure in dogs under halothane anesthesia

The effects of metaraminol bitartrate on intraocular pressure (IOP) were studied in dogs anesthetized with halothane. Forty-five healthy, adult, mixed-breed dogs, of both sexes, were divided into three groups of 15 dogs each (GI, GII and GIII) and maintained under general anesthesia with halothane after tranquilization with levomepromazine and induction with thiopental. Saline (0.9%) was administered intravenously (IV) to GI through continuous infusion, at a velocity of 0.125 mL kg⁻¹ min⁻¹. GII and GIII received metaraminol 0.004% IV, at a dose of 5 μg kg⁻¹ min⁻¹, at 0.125 mL kg⁻¹ min⁻¹ and at a dose of 2 μg kg⁻¹ min⁻¹, at 0.06 mL kg⁻¹ min⁻¹, respectively. IOP was measured by applanation tonometry (Tono-Pen) before and during anesthesia. Results showed that IOP decreased in GI, increased in GII, and remained at basal levels in GIII. Continuous infusion of metaraminol at 2 μg kg min⁻¹ maintained IOP at pretest levels, while infusion at 5 μg kg⁻¹ min⁻¹ produced an elevation of IOP.     

Effects of systemic administration of 0.5% tropicamide on intraocular pressure, pupillary diameter, blood pressure, and heart rate in normal cats

OBJECTIVE: The objective of the study was to determine the effects of systemic 0.5% tropicamide on intraocular pressure (IOP), pupillary diameter (PD), blood pressure, and heart rate (HR) in normal felines with normotensive eyes. PROCEDURES: Intraocular pressure, PD, systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP), and HR were measured in 18 clinically healthy cats. Each of the previously mentioned parameters was measured every 30 min during the trial period. At T(60), each cat was treated with one to two drops of 0.5% tropicamide ophthalmic solution placed on the dorsal aspect of the tongue. Changes in SBP, DBP, MBP, and HR were evaluated using one-way repeated measures analysis of variance, with time as the repeated factor. IOP and PD were evaluated using two-way repeated measures analysis of variance, with time and side (OD vs. OS) as the repeated factors. P values less than or equal to 0.05 were considered statistically significant. RESULTS: After lingual tropicamide administration, the mean PD at T(60) was 3.53 mm OD and 3.53 mm OS. The mean PD at T(90) was 6.36 mm OD and 6.31 mm OS. The mean PD at T(120) was 8.25 mm OD and 8.19 mm OS. This change in PD from T(60), T(90), and T(120) was statistically significant, demonstrating a linear increase in PD over time after tropicamide application on the tongue (P<0.0001). There was no statistically significant difference in PD when comparing the right to the left pupils (P=0.10). The mean IOP at T(60) was 14 mmHg OD and 12.94 mmHg OS. The mean IOP at T(90) was 14.5 mmHg OD and 14.23 mmHg OS. The mean IOP at T(120) was 14.94 mmHg OD and 14.89 mmHg OS. This change in IOP from T(60), T(90), and T(120) was statistically significant, demonstrating a linear increase in IOP over time after tropicamide application on the tongue (P=0.034). There was no statistically significant difference in IOP when comparing the right eye to the left eye (P=0.28). There were no statistically significant differences in SBP, DBP, MBP, and HR values over time for the duration of the study. CONCLUSIONS: We conclude that although lingual application of tropicamide appears to result in systemic absorption, causing significant pupillary dilation and elevations in IOP, systemic effects on SBP, DBP, MBP, and HR were not observed.     

Distribution of intraocular pressure in dogs

Intraocular pressure (IOP) was measured by four different applanation tonometers in normal dogs. By MacKay-Marg tonometry in 391 dogs (772 eyes) the mean ± SD IOP was 18.8 ± 5.5 mmHg (range 8–52 mmHg). Using Tono-Pen XL tonometry in 421 dogs (823 eyes) the mean IOP was 19.2 ± 5.9 mmHg, and the range was 4.42 mmHg. With MMAC-II tonometry in 80 dogs (158 eyes), the mean IOP was 15.7 ± 2.8 mmHg with a range of 10–30 mmHg. By pneumatonograph tonometry in 135 dogs (255 eyes), the mean IOP was 22.9 ± 6.1 mmHg and the range was 10–47 mmHg. In this study 53 breeds were represented. Of those breeds with six animals or more, no significant differences were detected in IOP between breeds ( P > 0.353) or sex ( P > 0.270). There was a significant decline of 2–4 mmHg ( P > 0.0001) in IOP as age increased from less than 2 years to greater than 6 years of age. This trend was present with all of the four tonometers. There were no significant differences between the MacKay-Marg and TonoPen-XL tonometers ( P > 0.198), but significant differences with the MMAC-II ( P > 0.001) and pneumatonograph ( P > 0.001) tonometers existed compared to the first two instruments. Based on this study and the literature, the mean IOP for the normal dog is 19.0 mmHg with a range of 11 (5%) and 29 (95%) mmHg.