Pinakin Davey, DO, PhD: Novel Methods for Testing IOP

While advances in technology are constantly driving medicine forward, ophthalmologists and optometrists often find themselves performing the same method of testing for decades upon decades. Pinakin Davey, DO, PhD, professor and director of research at Western University, presented a study he led at the 2019 Annual Meeting of the Association for Research in Vision and Ophthalmology that examined the accuracy and use of a handheld tonometer, called the LifeTouch tonometer, to measure intraocular pressure(IOP) in patients.

Davey stated that eye care professionals are usually the only ones able to perform a test to determine IOP and a device such as this could allow more health care providers with the ability to perform such tests.

MD Magazine®: Why is it important to find new ways to test IOP and what are the advantages of the device in your study?

Davey: Intraocular pressure measurements are a standard measurement that is performed in every eye examination. It’s particularly glaucoma patients that are at risk for damage permanent damage due to elevation of intraocular pressure or individuals that have treatments that is performed on their eye to lower the pressure, we monitor and measure intraocular pressure. However, intraocular pressure has suffered because we are not able to measure IOP that commonly between visits of a patient, as well as non-ophthalmic professionals cannot perform this measurement. For example, you could go to a pharmacy and get your blood pressure evaluated, you could go to a primary care physician get your blood pressure evaluated, your blood sugar evaluated, but you will not be able to get your eye pressure evaluated. Emergency care rooms are not able to evaluate eye pressures either.

So, when you have an emergency situation where the pressure of the eye is very elevated or non-ophthalmic professionals are not able to tell you whether that was the problem with your eye. So, if you can come up with a device that can be very repeatable, very reliable, and can be utilized by multiple professionals of healthcare that are not necessarily eye care certified or trained will be fantastic.

One device that I've been working with as a collaborator and the inventor of the device, John Maggiano. His principles can be democratized IOP measurement so with that goal in mind and making the signal all digital, that machine learning classifiers and artificial intelligence can identify if there's a problem with the eye was the underlying principles of this. So, taking a small piece of electric material we can measure the force applied to the eye very accurately, and mind you this is a very little tiny amount of force that is needed, and the duration of contact to the eye is also very, very small — 0.1seconds. So, it's a very light touch to the eye and you can actually measure the force applied, as well as, you can actually measure the flattening of the of the eye and you can calculate intraocular pressure very accurately.

So, this is in its early prototype development, it is patented, and we're hoping that we will be able to come up with a device that any professional medical professional can actually use this to measure IOP.

MD Mag: Why is developing new and more accurate testing so imperative going forward?

All we have when we have devices, and there are loads of devices in eye care both of ophthalmology, optometry, any eye care we have loads of gadgets. They are the center to our eye examination. Improving them constantly is very crucial. Otherwise, if you do the same thing isn't that the definition of madness? Doing the same thing over and over again and expecting different results. We have not figured out what causes some of these diseases that we have known for over two centuries and yet we haven't fixed the disease and part of the problem is lack of technology.

Technology actually improves, even though we may have looked at artificial intelligence 20 years ago, the technology has improved much more now that we'll be able to get closer to the solution to the problem and so I think it's very important as scientists we keep moving forward in the right direction and keep pushing ourselves to come up with independent novel biomarkers that can tell us about disease states more accurately.