Comparison of two rebound tonometers in healthy horses

OBJECTIVE: To obtain a reference range for evaluation of intraocular pressure (IOP) in horses using Tonovet Plus(®), to compare the IOP readings obtained with Tonovet(®) and Tonovet Plus(®), and to evaluate the repeatability of readings. ANIMALS STUDIED AND PROCEDURES: Intraocular pressure of 30 client‐owned horses (60 eyes) with no signs of illness or ocular disease was evaluated using Tonovet(®) and Tonovet Plus(®) rebound tonometers. Horses’ mean age was 10.7 (range 6‐17) years. Triplicate measurements were performed without using sedatives or local anesthetics, with minimal restraint. RESULTS: Calculated reference intervals (the CLSI robust method) were 14.4‐27.2 mmHg for Tonovet(®) and 16.0‐26.1 mmHg for Tonovet Plus(®). Mean values (± standard deviation, SD [± coefficient of variation, CV]) obtained with Tonovet Plus(®) (21.6 ± 2.45 mmHg [11.3%]) were on average 0.6 mmHg higher than with Tonovet(®) (21.0 ± 3.14 mmHg [15.0%]), and a negligible statistical difference between the devices was found using the paired sample t test (P = .049). The correlation coefficient for the averaged triplicate measurements was 0.73. The average CV was 4.6% and 4.4% for Tonovet(®) and Tonovet Plus(®), respectively. CONCLUSIONS: The repeatability of measurements was very good with both devices. The readings between the two devices differed statistically significantly, but the correlation was considered good and the variation was numerically small, and thus, the difference was considered clinically irrelevant. When monitoring disease process or treatment response in an individual patient, repeated readings are best performed using a similar device to avoid false interpretation of results.