Visual Pathway —
Training activity: 8

Details

Take measurements of intraocular pressure in a patient

Type

Developmental training activity (DTA)

Evidence requirements

Evidence the activity has been undertaken by the trainee​.

Reflection on the activity at one or more time points after the event including learning from the activity and/or areas of the trainees practice for development.

An action plan to implement learning and/or to address skills or knowledge gaps identified.

Reflective practice guidance

The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.

Before action

• What essential knowledge do you need before taking intraocular pressure measurements, such as different tonometry techniques, factors influencing IOP, and normal ranges?
• Consider the specific skills you hope to develop by taking intraocular pressure measurements. For example, what practical skills in using the tonometer and ensuring accurate readings are you aiming for?
  • Reflect on your current understanding of intraocular pressure measurement.
  • What aspects of the procedure or interpretation are you particularly interested in learning practically?
• Discuss this training activity with your training officer to understand the specific tonometry techniques used in your department and any relevant safety protocols.
  • Consider potential challenges you might encounter, such as patient anxiety or difficulty with the procedure.
  • How can you prepare to communicate effectively with patients and ensure their comfort?
  • Reflect on your confidence level in performing this practical skill. What steps can you take to prepare and approach the task?

In action

• Pay attention to your actions as you prepare the equipment and the patient for intraocular pressure (IOP) measurement.
  • What type of tonometer are you using and why? How are you ensuring patient comfort and cooperation?
  • What decisions are you making during the measurement process to ensure accuracy and safety?
  • Are you adjusting your technique based on the patient’s reaction?
  • How are you documenting the IOP measurement, including the time, method, and any relevant observations?
  • What aspects of taking IOP measurements feel intuitive? What aspects require more conscious attention to technique and potential sources of error?
• How effective is your technique in obtaining a reliable and accurate IOP measurement?
  • What challenges are you facing during the measurement (e.g., patient anxiety, corneal abnormalities, difficulty with fixation)?
  • What are you learning about factors that can influence IOP measurements as you perform the procedure?
  • How does this activity connect to your understanding of the anatomy and physiology related to intraocular pressure?
• If you are encountering difficulties in obtaining a reliable measurement, are there alternative techniques or approaches you could consider?
  • What support or guidance might you need in the moment if you obtain an unexpected IOP reading or are unsure about the accuracy of your measurement?
  • Are you adhering to infection control protocols and ensuring patient safety during the procedure?

On action

• What type of tonometer did you use to measure intraocular pressure (IOP)?
  • What were the key steps involved in preparing the patient and performing the measurement?
  • What readings did you obtain for the patient’s IOP?
  • Did you encounter any challenges in obtaining a reliable measurement?
  • How did the patient react to the procedure?
  • What did you document following the IOP measurement?
• What skills or knowledge related to measuring IOP did you develop or improve?
  • What factors can influence IOP measurements?
  • Were there any unexpected readings or difficulties?
  • What did you learn from these?
  • How does measuring IOP contribute to the overall assessment of a patient’s eye health?
• What areas for continued development have you identified in measuring IOP?
  • How will you ensure accuracy and patient comfort when performing this procedure in the future?
  • What further training or resources might be beneficial to enhance your skills in tonometry?
  • What specific actions will you take to reinforce your learning about IOP measurement?

Beyond action

• Reflect on your experiences of taking intraocular pressure (IOP) measurements.
  • Has your understanding of the principles of tonometry, potential sources of error, and the significance of IOP readings deepened since these initial experiences?
  • Compare your technique for measuring IOP during this training activity with your current practice. What aspects of your technique, such as patient positioning, probe handling, or recording, have you refined?
  • Review your reflections from this training activity alongside other reflections related to anterior segment examination or glaucoma assessment. What broader understanding of managing intraocular pressure and associated conditions have you developed? What are your future learning objectives in this area?
  • Have you discussed challenging IOP measurements or variations in technique with experienced colleagues? Did these discussions offer valuable insights or alternative approaches?
• Understand that accurately measuring IOP is a fundamental skill in ophthalmology.
  • How has this training activity contributed to your overall competence in conducting a comprehensive eye examination and identifying potential ocular hypertension or glaucoma?
    • How might this experience support you in explaining the importance of IOP measurement to patients?
    • How have you applied the skills and knowledge gained from this training activity in subsequent IOP measurements?
    • Have you become more confident in your technique and in recognising factors that might influence readings? How has this influenced your wider approach to assessing and monitoring patients at risk of glaucoma?
• Identify the transferable skills developed through this training activity, such as manual dexterity in using instruments, attention to detail in recording measurements, and effective communication with patients to ensure cooperation.
  • Outline specific steps for the ongoing development of your proficiency in taking and interpreting IOP measurements, building upon the foundation laid by this training activity.

Relevant learning outcomes

#	Outcome
# 3	Outcome Measure intraocular pressure.
# 5	Outcome Employ effective communication with a range of individuals, including the patient and the multidisciplinary team.
# 7	Outcome Produce clear, concise and accurate documentation in line with local standards and legislation.