ARCHETYPE Intraocular pressure test (openEHR-EHR-OBSERVATION.intraocular_pressure.v0)

ARCHETYPE IDopenEHR-EHR-OBSERVATION.intraocular_pressure.v0
ConceptIntraocular pressure test
DescriptionThe measurement of intraocular pressure, most commonly using a tonometry device.
UseUse to record one or more intraocular pressure measurements as part of a single assessment, including contextual factors. Measurements are recorded as separate events for each eye. Where test conditions differ, each measurement under a distinct set of conditions is recorded as an additional event. Where measurements are performed at different times within the same assessment, each time-point is also recorded as a separate event. The CLUSTER.exclusion_exam archetype can be nested within the 'Test not done' SLOT to optionally record that the intraocular pressure was not performed.
PurposeTo record one or more intraocular pressure measurements as part of a single assessment.
ReferencesGlaucoma Procedure Data Set [Internet]. Royal College of Ophthalmologists, London. May 2024 [cited 2026 Jan 22]. Available from: https://www.rcophth.ac.uk/wp-content/uploads/2024/05/Glaucoma-Procedure-Data-Set.pdf

Lamparter, J., & Hoffmann, E. M. (2009). Measuring intraocular pressure by different methods. Der Ophthalmologe, 106(8), 676-682. DOI 10.1007/s00347-009-1971-8
Copyright© openEHR Foundation
AuthorsAuthor name: Gustavo M Bacelar-Silva
Organisation: Faculty of Medicine - University of Porto
Email: mail@gustavobacelar.com
Date originally authored: 2012-06-05
Other Details LanguageAuthor name: Gustavo M Bacelar-Silva
Organisation: Faculty of Medicine - University of Porto
Email: mail@gustavobacelar.com
Date originally authored: 2012-06-05
Other Details (Language Independent)
  • Licence: This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/4.0/.
  • Custodian Organisation: openEHR Foundation
  • References: Glaucoma Procedure Data Set [Internet]. Royal College of Ophthalmologists, London. May 2024 [cited 2026 Jan 22]. Available from: https://www.rcophth.ac.uk/wp-content/uploads/2024/05/Glaucoma-Procedure-Data-Set.pdf Lamparter, J., & Hoffmann, E. M. (2009). Measuring intraocular pressure by different methods. Der Ophthalmologe, 106(8), 676-682. DOI 10.1007/s00347-009-1971-8
  • Current Contact: Lars Fuhrmann, lars.fuhrmann@dog.org
  • Original Namespace: org.openehr
  • Original Publisher: openEHR Foundation
  • Custodian Namespace: org.openehr
  • MD5-CAM-1.0.1: 7D6651084A77D85037D5E284333A4290
  • Build Uid: 1af3a371-4f89-43c6-8695-1971a0f0cc3a
  • Ip Acknowledgements: This artefact includes content from SNOMED Clinical Terms® (SNOMED CT®) which is copyrighted material of the International Health Terminology Standards Development Organisation (IHTSDO). Where an implementation of this artefact makes use of SNOMED CT content, the implementer must have the appropriate SNOMED CT Affiliate license - for more information contact https://www.snomed.org/snomed-ct/get-snomed or info@snomed.org.
  • Revision: 0.0.1-alpha
KeywordsIOP, tonometry, glaucoma, eye, pressure, tension, ocular, GAT, intraocular, hypertension, hypotony
Lifecyclein_development
UID1570d6f6-b0b7-4f28-b050-2dbff9d2d863
Language useden
Citeable Identifier1013.1.1369
Revision Number0.0.1-alpha
events
Any eventAny event: Default, unspecified point in time or interval event which may be explicitly defined in a template or at run-time.
data
Eye examinedEye examined: Identification of the eye under examination.
  • Left eye [The left eye was examined.]
    [SNOMED-CT::1290031003]
  • Right eye [The right eye was examined.]
    [SNOMED-CT::1290032005]
PressurePressure: The intraocular pressure of the identified eye, measured using the method specified 'Tonometry type'.
For devices that only output one pressure value per measurement, this element is used. For devices that output multiple pressure values per measurement, this element is used for the output that did not undergo a correction step or is correlated with an uncorrected method by design. Use the 'Corrected pressure' and 'Correction type' elements for outputs that have been corrected for factors such as corneal thickness or biomechanics. Where typical device output is based on integration of multiple measurement cycles, the final device output should be recorded in this data element. If not all cycles can be completed, this element can still be used to record the average of successful cycles, but note this as a confounding factor.
Property: Pressure
Units: 0.0..<1000.0 mmHg
Limit decimal places: 1
Tonometry typeTonometry type: Type of tonometry used to measure the intraocular pressure.
Coding with a terminology is recommended. Free text entry should only be permitted if no appropriate coded value is available. Where additional detail, such as a tonometer device name ist needed, the use of the Tonometer details SLOT is recommended.
Choice of:
  •  Coded Text
    • Goldmann [Measured using a Goldmann applanation tonometer.]
      [SNOMED-CT::389152008 | Goldmann applanation tonometry]
    • Perkins [Measured using a Perkins applanation tonometer.]
      [SNOMED-CT::389151001 | Perkins applanation tonometry]
    • Tono-Pen [Measured using a handheld applanation tonometer relying on the MacKay-Marg principle, such as a Tono-Pen.]
    • Rebound [Measured using a rebound tonometer, such as an iCare® device.]
      [SNOMED-CT::1286870002]
    • Dynamic Contour [Measured using a Dynamic Contour tonometer, such as a PASCAL® device.]
      [SNOMED-CT::1286902005]
    • Transpalpebral [Measured using tonometer that is held against the eyelid, such as the TGDc-01 device.]
    • Non-contact [Measured using a tonometer that does not make contact with the globe or eyelid, typically using a jet of air (air-puff). Not to be confused with pneumatonometry.]
      [SNOMED-CT::389150000 | Non-contact tonometry]
    • Implanted pressure sensor [Measured using a pressure sensor implanted in the eye.]
    • Goldmann-correlated non-contact (IOPg) [Measured using non contact tonometer that explicitely outputs a goldman-corellated pressure was used to perform the test. Examples include the Ocular Response Analyzer® or 7CR® devices.]
    • Pneumatonometer [A pneumatonometer, which is a contact-based method, was used to perform the test. Not to be confused with NCT devices.]
      [SNOMED-CT::252804008 | Pneumatic tonometry]
    • Schiøtz [A Schiøtz indentation tonometer was used to perform the test.]
      [SNOMED-CT::389149000 | Schiotz tonometry]
  •  Text
Tonometer detailsTonometer details: Structured details about the tonometry device used to measure the intraocular pressure.
Include:
openEHR-EHR-CLUSTER.device.v1 and specialisations
Corrected pressureCorrected pressure: An adjusted intraocular pressure value derived from the measured 'Pressure' and using the method specified in 'Correction type', to more closely approximate the true pressure of the identified eye.
Property: Pressure
Units: 0.0..<1000.0 mmHg
Limit decimal places: 1
Correction typeCorrection type: The type of correction applied to the measured 'Pressure' to calculate the 'Corrected pressure' value.
Coding with a terminology is recommended. Free text entry should only be permitted if no appropriate coded value is available. Note that terms such as ccIOP and bIOP are based on the names of output variables, which may be shared by different devices that do not share identical methods. Where these are used, it is recommended to specify the device name or model in the tonometer details CLUSTER.
Choice of:
  •  Coded Text
    • Corneal compensated intraocular pressure (IOPcc) [The pressure result was compensated for corneal parameters. Produced by devices such as the Reichert ORA® or 7CR® tonometers.]
    • Biomechanically corrected intraocular pressure (bIOP) [The pressure was corrected for parameters of corneal biomechanics. Produced by devices such as the Corvis ST® tonometer.]
    • Corrected for central corneal thickness [The pressure was corrected for central corneal thickness (CCT).]
  •  Text
Palpation findingPalpation finding: Semi-quantitative description of the softness or hardness of the eye based on palpation with the examiners fingers.
Coding with a terminology is recommended. Free text entry should only be permitted if no appropriate coded value is available.
Choice of:
  •  Coded Text
    • Unpressurized [The eyeball appears to lack any internal pressure.]
    • Softer than normal [The pressure is approximated to be below the normal range, but some pressure is present.]
    • Normal [The pressure is approximated to be within the normal range (10-21mmHg).]
    • Harder than normal [The pressure is approximated to be above the normal range, but not very hard or rock-hard.]
    • Very hard [The pressure appears to be extremely elevated, sometimes referred to as a rock-hard eye.]
  •  Text
Inspection findingInspection finding: Record of presence or absence of visible signs of a total lack of internal pressure of the examined eye.
Typically reserved for rare situations where physical interaction with the globe is inadvisable, such as physically aggressive individuals or when an open globe injury is strongly suspected. Coding with a terminology is recommended. Free text entry should only be permitted if no appropriate coded value is available.
Choice of:
  •  Coded Text
    • The eye shows signs of being unpressurized. [Based on visual examination, there are signs of a total loss of intraocular pressure. For instance, the eye may have lost its round shape in the setting of significant trauma.]
    • The eye shows no signs of being unpressurized. [Based on visual examination, there are no signs of a total loss of intraocular pressure.]
    • Uncertain [Based on visual examination, it is uncertain if there are signs of a total loss of intraocular pressure.]
  •  Text
Clinical interpretationClinical interpretation: Single word, phrase or brief description that represents the clinical meaning and significance of the findings.
This element may be used flexibly to support the recording of clinical interpretation. A single instance may be used to record a brief narrative summary of the findings. Alternatively, one or more instances may be used to represent coded interpretations. A combination of both approaches may also be used, with the narrative description recorded in one instance alongside one or more coded interpretations in separate instances.
Test not doneTest not done: Details to explicitly record that this test was not performed.
Include:
openEHR-EHR-CLUSTER.exclusion_exam.v1 and specialisations
CommentComment: Additional narrative about the measurement, not captured in other fields.
state
Pupil statePupil state: Statement describing the condition of the individual's pupils during the measurement.
The physical examination of the eye will be recorded using the CLUSTER.exam-eye family of archetypes. Use the 'Clinical evidence' archetype nested within the 'Additional details' SLOT to record structured details about relevant eye examination findings. Coding with a terminology is recommended. Free text entry should only be permitted if no appropriate coded value is available.
Choice of:
  •  Coded Text
    • Normal [The pupil is in its natural physiological state without pharmacological intervention or pathological changes.]
    • Medically induced mydriasis [The pupil was dilated due to prior administration of mydriatic agents.]
    • Medically induced miosis [The pupil was constricted due to prior administration of miotic agents.]
    • Pathological pupil state [The pupil was in an unphysiological state due to disease, trauma, or structural abnormalities.]
  •  Text
Body positionBody position: Statement about the body position of the individual at the time of measurement.
Coding with a terminology is recommended. Free text entry should only be permitted if no appropriate coded value is available.
Choice of:
Anaesthesia stateAnaesthesia state: Statement about the use of anaesthesia during the measurement.
Details of the anaesthesia procedure and the specific medications used should be recorded using separate archetypes. Coding with a terminology is recommended. Free text entry should only be permitted if no appropriate coded value is available.
Choice of:
  •  Coded Text
    • No anaesthesia [The patient was not under anaesthesia during the measurement.]
    • Sedation [The patient was under sedation during the measurement.]
      [SNOMED-CT::17971005 | Sedated]
    • General anaesthesia [The patient was under general anaesthesia during the measurement.]
      [SNOMED-CT::420653000 | Under general anesthesia]
    • Topical anaesthesia [The patient's eye was anaesthetised by a topical agent during the measurement.]
    • Periocular injection [The patient's eye was anaesthetised by a periocular injection during the measurement.]
  •  Text
Confounding factorsConfounding factors: Description of any incidental factors related to the state of the subject which may affect clinical interpretation of the measurement.
For example: 'blepharospasm', 'reduced cooperation', 'measurement interrupted', and 'difficulty holding lid open'.
Additional detailsAdditional details: Structured elements about specific factors related to the state of the subject which may affect clinical interpretation of the measurement.
The scope of structured content appropriate for nesting within this SLOT includes, but is not limited to: Quality or reliability indicators generated by the device, such as the ORA Waveform Score, iCare measurement quality indicator, or Tono-Pen statistical confidence indicator; and clinical evidence relevant to interpretation of the pressure measurement, such as central corneal thickness or detailed physical examination findings relevant to the measurement, such as pupillary state at the time of measurement.
Include:
openEHR-EHR-CLUSTER.intraocular_pressure_test_reliability_indicator.v0 or
openEHR-EHR-CLUSTER.clinical_evidence.v1
protocol
ExtensionExtension: Additional information required to extend the model with local content or to align with other reference models or formalisms.
For example: local information requirements; or additional metadata to align with FHIR.
Include:
All not explicitly excluded archetypes
Other contributorsSilje Ljosland Bakke, Helse Vest IKT AS, Norway (openEHR Editor)
Robert Bendau, Asklepios Eye Hospital North Hamburg, Germany
Michael Boland, Mass Eye and Ear, United States
Victoria de Juan, Alcon, Spain
Christopher Dicke, DOG, Germany
Aitor Eguzkitza, UPNA (Public University of Navarre) - CHN (Complejo Hospitalario de Navarra), Spain
Lars Fuhrmann, German Society of Ophthalmology, Germany (openEHR Editor)
Carsten Grohmann, University Medical Center Hamburg-Eppendorf, Germany
Bettina Hohberger, Department of Ophthalmology, University of Erlangen, FAU, Germany
Severin Kohler, Berlin Institute of Health, Germany
Simon König, Augenklinik Unimedizin Mainz, Germany
Heather Leslie, Atomica Informatics, Australia (openEHR Editor)
Ian McNicoll, freshEHR Clinical Informatics, United Kingdom
Olha Nikolaieva, University Hospital Basel, Switzerland
Ariel Ong, Moorfields Eye Hospital, United Kingdom
Rishi Ramessur, Moorfields Eye Hospital, United Kingdom
Christian Richter, Dr. Richter & Dr. Richter PartG, Germany
Ian Rodrigues, St Thomas' Hospital, United Kingdom
Marc Schargus, Asklepios Eye Hospital North Hamburg, Germany
Wolfgang Schultz, Wolfgang Schultz, Germany
Anne Stahl, adesso, Germany
Norwegian Review Summary, Norwegian Public Hospitals, Norway
Ines Žabkar, Better, Slovenia
Translators
  • Norwegian Bokmål: Silje Ljosland Bakke, Helse Vest IKT AS, silje.ljosland.bakke@helse-vest-ikt.no