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
Pazos M, Traverso CE, Viswanathan A; European Glaucoma Society; Guidelines Task Force; Guidelines Writers, Authors and Contributors; Guidelines Internal Reviewers; Experts by Experience group (patients’ panel); Team of Clinica oculistica of the university of Genoa for medical editing and graphics; External Reviews; EGS Executive Committee; Board of The EGS Foundation. European Glaucoma Society - Terminology and guidelines for glaucoma, 6th Edition. Br J Ophthalmol. 2025 Sep 8;109(Suppl 1):1-212. doi: 10.1136/bjophthalmol-2025-egsguidelines. PMID: 41026937.
Organisation: Faculty of Medicine - University of Porto
Email: mail@gustavobacelar.com
Date originally authored: 2012-06-05
Organisation: Faculty of Medicine - University of Porto
Email: mail@gustavobacelar.com
Date originally authored: 2012-06-05
- 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 Pazos M, Traverso CE, Viswanathan A; European Glaucoma Society; Guidelines Task Force; Guidelines Writers, Authors and Contributors; Guidelines Internal Reviewers; Experts by Experience group (patients’ panel); Team of Clinica oculistica of the university of Genoa for medical editing and graphics; External Reviews; EGS Executive Committee; Board of The EGS Foundation. European Glaucoma Society - Terminology and guidelines for glaucoma, 6th Edition. Br J Ophthalmol. 2025 Sep 8;109(Suppl 1):1-212. doi: 10.1136/bjophthalmol-2025-egsguidelines. PMID: 41026937.
- 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: A864D0C1C8D397A42B4338EA5111667B
- Build Uid: a408cb26-1d76-4e57-8842-27d94a248791
- 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
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
Coding with a terminology is recommended. Free text entry should only be permitted if no appropriate coded value is available.
Choice of:
- Coded Text
- Standing [Standing at the time of the intraocular pressure measurement.]
[SNOMED-CT::10904000 | Orthostatic body position] - Sitting [Sitting at the time of the intraocular pressure measurement.]
[SNOMED-CT::33586001 | Sitting position] - Lying in supine position [Lying in supine position (face up) at the time of the intraocular pressure measurement.]
[SNOMED-CT::40199007 | Supine body position] - Lying in prone position [Lying in prone position (face down) at the time of the intraocular pressure measurement.]
[SNOMED-CT::1240000 | Prone body position] - Lying in left lateral decubitus position [Lying on the left hand side at the time of the intraocular pressure measurement.]
[SNOMED-CT::102536004 | Left lateral decubitus position] - Lying in right lateral decubitus position [Lying on the right hand side at the time of the intraocular pressure measurement.]
[SNOMED-CT::102535000 | Right lateral decubitus position]
- Standing [Standing at the time of the intraocular pressure measurement.]
- Text
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 anaesthesia] - 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
For example: 'blepharospasm', 'reduced cooperation', 'measurement interrupted', and 'difficulty holding lid open'.
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_
openEHR-EHR-CLUSTER.clinical_
- Left eye [The left eye was examined.]
[SNOMED-CT::1290031003 | Structure of left eye proper] - Right eye [The right eye was examined.]
[SNOMED-CT::1290032005 | Structure of right eye proper]
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
Coding with a terminology is recommended. Free text entry should only be permitted if no appropriate coded value is available. It is recommended to specify the device name and/or model in the 'Medical device' archetype nested in the 'Tonometer details' SLOT in this archetype. Note that 'Transpalpebral' refers to the use of a transpalpebral tonometer, not palpation through the eyelid.
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 | Rebound tonometry] - Dynamic Contour [Measured using a Dynamic Contour tonometer, such as a PASCAL® device.]
[SNOMED-CT::1286902005 | Dynamic contour tonometry] - 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 a non-contact tonometer with an output that is explicitly specified as being Goldmann-correlated. Examples include the Ocular Response Analyzer® (ORA) 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]
- Goldmann [Measured using a Goldmann applanation tonometer.]
- Text
Include:
openEHR-EHR-CLUSTER.device.v1 and specialisations
Property: Pressure
Units: 0.0..<1000.0 mmHg
Limit decimal places: 1
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. It is recommended to specify the device name and/or model in the 'Medical device' archetype nested in the 'Tonometer details' SLOT in this archetype.
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
Typically reserved for situations where measurement with a tonometer is not possible or reliable. 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
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
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. Examples: "Above target pressure", "elevated", "hypotonic".
Include:
openEHR-EHR-CLUSTER.exclusion_
For example: local information requirements; or additional metadata to align with FHIR.
Include:
All not explicitly excluded archetypes
Vebjørn Arntzen, Oslo universitetssykehus HF, Norway
Silje Ljosland Bakke, Helse Vest IKT AS, Norway (openEHR Norway 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
Corina Ehrne, INNOFORCE Est., Liechtenstein
Manel Fernández Bonet, Consorci Sanitari Integral, Spain
Tim Freisenich, University, Germany
Lars Fuhrmann, German Society of Ophthalmology, Germany (openEHR Editor)
Ciprian Gerstenberger, HN IKT, Norway
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
Stefan Lang, Universitätsklinikum Brandenburg an der Havel, Germany
Heather Leslie, Atomica Informatics, Australia (openEHR Editor)
Ramil Lising, University of the Philippines, Philippines
Ian McNicoll, freshEHR Clinical Informatics, United Kingdom
Olha Nikolaieva, University Hospital Basel, Switzerland
Mona Nordvik, Haukeland Universitetssykehus, Norway
Bjørn Næss, DIPS ASA, Norway
Ariel Ong, Moorfields Eye Hospital, United Kingdom
Marta Pazos, Hospital Clínic de Barcelona, Spain
Rishi Ramessur, Moorfields Eye Hospital, United Kingdom
Christian Richter, Dr. Richter & Dr. Richter PartG, Germany
Ian Rodrigues, St Thomas' Hospital, United Kingdom
Ruben Rognmo, Helse Nord IKT, Norway
Marc Schargus, Asklepios Eye Hospital North Hamburg, Germany
Wolfgang Schultz, MedicalCommunications GmbH, Germany
Anne Stahl, adesso, Germany
John Tore Valand, Helse Vest IKT, Norway
Marte Vassli Gullesen, HNIKT, Norway
Ines Žabkar, Better, Slovenia