ARVO 2016 Annual Meeting Abstracts 540 IOP Measurement Thursday, May 05, 2016 11:00 AM–12:45 PM Exhibit/Poster Hall Poster Session Program #/Board # Range: 6430–6472/D0150–D0192 Organizing Section: Glaucoma Program Number: 6430 Poster Board Number: D0150 Presentation Time: 11:00 AM–12:45 PM Intraocular pressure measurement in the emergency department is inconsistently documented and significantly varies from ophthalmologist IOP Akhilesh S. Pathipati1, Edward Wood3, Carson K. Lam3, Christopher S. Sales2, Darius M. Moshfeghi3. 1Stanford University School of Medicine, Stanford, CA; 2Opthalmic Consultants of Boston, Boston, MA; 3Ophthalmology, Stanford University School of Medicine, Byers Eye Institute, Palo Alto, CA. Purpose: Intraocular pressure (IOP) is a critical sign in the workup of any emergent ophthalmic complaint, but few studies have evaluated the measurement of IOP in the emergency department (ED). We performed a prospective, comparative study to assess the documentation and accuracy of IOP measured by ED providers. Methods: The study included 64 subjects who presented to the Stanford Hospital ED for whom an ophthalmology consult was requested. Per standard practice at the hospital, we asked ED providers to measure IOP for any patient with an ophthalmic complaint. Values were benchmarked against IOP measured by the consulting ophthalmologist. Ophthalmologist IOP was used as the gold standard because it is the measurement that is ultimately used to make decisions regarding ophthalmologic care at Stanford Hospital. Both ED providers and ophthalmologists used a Tono-pen tonometer to measure IOP. Results: The ED documented IOP on 16 patients (32 eyes) out of the 64 patients (128 eyes) enrolled in the study (25%). A numeric measurement was recorded for 23 eyes, with 9 measurements recorded in patient charts as “normal.” Ophthalmologists documented IOP for all 128 eyes. Numeric values measured in the ED varied from ophthalmology by an average of 4.30 +/- 4.39 mmHg (p = 0.0179; Power > 0.99 at alpha 0.05). Conclusions: IOP is inconsistently documented and is often inaccurately measured in the ED. The ED did not record IOP for a large majority of patients presenting with eye complaints (75%). When they did, measurements were significantly different than those of consulting ophthalmologists. Both of these factors limit the ability of ophthalmologists to triage opthalmic emergencies and make recommendations regarding care before they see the patient. Future studies should evaluate why IOP is poorly documented and whether non-ophthalmic providers can more accurately measure IOP with automated tonometers that minimize the role of operator skill. Doing so may help standardize and improve ED ophthalmologic care. Commercial Relationships: Akhilesh S. Pathipati, None; Edward Wood, None; Carson K. Lam, None; Christopher S. Sales, None; Darius M. Moshfeghi, None Program Number: 6431 Poster Board Number: D0151 Presentation Time: 11:00 AM–12:45 PM The effect of the lateral decubitus position on intraocular pressure in normal volunteers Hiroaki Kanno, Akira Sawada, Tetsuya Yamamoto. Ophthalmology, Gifu University Graduate School of Medicine, Gifu, Japan. Purpose: To explore the intraocular pressure (IOP) differences between right and left lateral decubitus positions (LDPs), and to examine the time course of IOP after keeping the posture in healthy subjects.

Methods: In 21 normal volunteers, the IOP was measured in the sitting position (SP) and the LDPs with an Icare rebound tonometer (Icare). In the first experiment, the IOPs in the right and left LDPs, and the SP were measured each 5 minutes after assuming these postures. In the second setting, after IOP measurement in the SP, the IOPs in the left LDP were measured 1,3,5,10,15 and 20 minute(s) after assuming this posture. Results: The mean age was 31.1 ± 2.3 years, and men included 14. The IOP with the Icare in the SP was 13.7 ± 2.9 mmHg in the right eye and 13.9 ± 3.3 mmHg in the left eye (P=0.380). Both in the right and left LDPs, the IOPs in both dependent and non-dependent eyes increased compared to them in the SP (each P