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

Name: Intraocular pressure
License: http://creativecommons.org/licenses/by-sa/4.0/

ARCHETYPE ID	openEHR-EHR-OBSERVATION.intraocular_pressure.v0
Concept	Intraocular pressure
Description	The local measurement of intraocular pressure, most commonly using a tonometry device.
Use	Use to record the measurement of intraocular pressure in a single eye per event. Record the details of each test of each eye using separate events. The CLUSTER.exclusion_exam archetype can be nested within the 'Measurement not done' SLOT to optionally record explicit details about the measurement not being performed. When intraocular pressure in an eye is measured multiple times using methods that use different data elements for the result, such as noncontact tonometry and palpation, do not record both in one event. Use separate events instead.
Purpose	To record one or multiple intraocular pressure measurements of the eyes of an individual.
References	IHE Eye Care Domain. General Eye Evaluation (GEE) [Internet]. IHE; 2012. Available from: http://www.ihe.net/Technical_Framework/upload/IHE_EyeCare_Supp_GEE_Rev1-1_TI_2012-06-29.pdf Royal College of Opthalmologists. Cataract National Dataset for Adults [Internet]. 2011. Available from: http://www.rcophth.ac.uk/page.asp?section=583&sectionTitle=Cataract+National+Data+Set+for+Adults CfH, UK. Do Once & Share - Glaucoma [Internet]. [cited 2012 Sep 26]. Available from: http://www.doasglaucoma.org/ DICOM Supplement 30 [Internet]. [cited 2012 Sep 26]. Available from: http://medical.nema.org/ Lamparter, J., & Hoffmann, E. M. (2009). Messung des Augeninnendrucks (Tonometrie) mit unterschiedlichen Verfahren. Der Ophthalmologe, 106(8), 676-682. Vantomme M, Pourjavan S, Detry-Morel M. The range of the waveform score of the ocular response analyzer (ora) in healthy subjects. Bull Soc Belge Ophtalmol. 2013;(322):91–7. Haag-Streit. INSTRUCTIONS FOR USE Applanation tonometer AT 900® / AT 870 [Internet]. Haag-Streit; [cited 2025 Oct 6]. Available from: https://haag-streit.com/2%20Products/General%20diagnostics/Tonometers/Tonometer%20AT%20900/Instructions%20for%20use/1500%207006000%2004270_IFU_AT_900_01_en_web.pdf Liu P, Wang F, Song Y, Wang M, Zhang X. Current situation and progress of drugs for reducing intraocular pressure. Ther Adv Chronic Dis. 2022 Dec 2;13:20406223221140392. doi: 10.1177/20406223221140392. PMID: 36479139; PMCID: PMC9720821.
Copyright	© openEHR Foundation
Authors	Author 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	Author name: Gustavo M Bacelar-Silva Organisation: Faculty of Medicine - University of Porto Email: mail@gustavobacelar.com Date originally authored: 2012-06-05
OtherDetails 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=IHE Eye Care Domain. General Eye Evaluation (GEE) [Internet]. IHE; 2012. Available from: http://www.ihe.net/Technical_Framework/upload/IHE_EyeCare_Supp_GEE_Rev1-1_TI_2012-06-29.pdf Royal College of Opthalmologists. Cataract National Dataset for Adults [Internet]. 2011. Available from: http://www.rcophth.ac.uk/page.asp?section=583§ionTitle=Cataract+National+Data+Set+for+Adults CfH, UK. Do Once & Share - Glaucoma [Internet]. [cited 2012 Sep 26]. Available from: http://www.doasglaucoma.org/ DICOM Supplement 30 [Internet]. [cited 2012 Sep 26]. Available from: http://medical.nema.org/ Lamparter, J., & Hoffmann, E. M. (2009). Messung des Augeninnendrucks (Tonometrie) mit unterschiedlichen Verfahren. Der Ophthalmologe, 106(8), 676-682. Vantomme M, Pourjavan S, Detry-Morel M. The range of the waveform score of the ocular response analyzer (ora) in healthy subjects. Bull Soc Belge Ophtalmol. 2013;(322):91–7. Haag-Streit. INSTRUCTIONS FOR USE Applanation tonometer AT 900® / AT 870 [Internet]. Haag-Streit; [cited 2025 Oct 6]. Available from: https://haag-streit.com/2%20Products/General%20diagnostics/Tonometers/Tonometer%20AT%20900/Instructions%20for%20use/1500%207006000%2004270_IFU_AT_900_01_en_web.pdf Liu P, Wang F, Song Y, Wang M, Zhang X. Current situation and progress of drugs for reducing intraocular pressure. Ther Adv Chronic Dis. 2022 Dec 2;13:20406223221140392. doi: 10.1177/20406223221140392. PMID: 36479139; PMCID: PMC9720821., 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=63886942838F51F8639C396D82081467, build_uid=cdb4c9ca-bb2d-429d-bb36-c3ff09b9ead1, 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}
Keywords	IOP, tonometry, glaucoma, eye, eye pressure
Lifecycle	in_development
UID	1570d6f6-b0b7-4f28-b050-2dbff9d2d863
Language used	en
Citeable Identifier	1013.1.1369
Revision Number	0.0.1-alpha
All	Archetype [runtimeNameConstraintForConceptName=null, archetypeConceptBinding=[LOINC::56844-4 \| Intraocular pressure of Eye], archetypeConceptDescription=The local measurement of intraocular pressure, most commonly using a tonometry device., archetypeConceptComment=null, otherContributors=Ian McNicoll, freshEHR Informatics, UK Ian Rodrigues, Guy's and St Thomas' NHS Foundation Trust, UK Lars Fuhrmann, Deutsche Ophthalmologische Gesellschaft (DOG), Germany Ariel Ong, University College London, UK Heather Leslie, Atomica Informatics, Australia Silje Ljosland Bakke, Helse Vest IKT AS, Norway Aitor Eguzkitza, UPNA (Public University of Navarre) - CHN (Complejo Hospitalario de Navarra), Spain, originalLanguage=en, translators= Norwegian Bokmål: Silje Ljosland Bakke, Helse Vest IKT AS, silje.ljosland.bakke@helse-vest-ikt.no , subjectOfData=unconstrained, archetypeTranslationTree=null, topLevelToAshis={items=[], contacts=[], state=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/state[at0007]/items[at0117], code=at0117, itemType=ELEMENT, level=4, text=Pupil state, description=The state of the individual's pupils during the measurement., comment=Note this is not an examination of the pupil, but an assertion on its state., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0121::Normal [The pupil is in its natural physiological state without pharmacological intervention or pathological changes.] at0122::Medically induced mydriasis [The pupil was dilated due to prior administration of mydriatic agents.] at0118::Medically induced miosis [The pupil was constricted due to prior administration of miotic agents.] at0120::Pathological pupil state [The pupil was in an unphysiological state due to disease, trauma, or structural abnormalities.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/state[at0007]/items[at0109], code=at0109, itemType=ELEMENT, level=4, text=Position, description=The position of the individual at the time of measurement., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0110::Standing [Standing at the time of the intraocular pressure measurement.] [SNOMED-CT::10904000 \| Orthostatic body position] at0111::Sitting [Sitting at the time of the intraocular pressure measurement.] [SNOMED-CT::33586001 \| Sitting position] at0112::Lying in supine position [Lying in supine position (face up) at the time of the intraocular pressure measurement.] [SNOMED-CT::40199007 \| Supine body position] at0113::Lying in prone position [Lying in prone position (face down) at the time of the intraocular pressure measurement.] [SNOMED-CT::1240000 \| Prone body position] at0114::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] at0115::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] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/state[at0007]/items[at0127], code=at0127, itemType=ELEMENT, level=4, text=Anaesthesia state, description=An assertion on the anesthesia of the individual during the measurement., comment=The detail of the anaesthesia procedure and specific medication used is to be recorded in other archetypes., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0128::General anesthesia [The patient was under general anaesthesia during the measurement.] [SNOMED-CT::420653000 \| Under general anesthesia] at0129::Sedation [The patient was under sedation during the measurement.] [SNOMED-CT::17971005 \| Sedated] at0130::No anesthesia [The patient was not under anaesthesia during the measurement.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/state[at0007]/items[at0074], code=at0074, itemType=ELEMENT, level=4, text=Confounding factors, description=Description of any incidental factors related to the state of the subject which may affect clinical interpretation of the measurement., comment=Examples: blepharospasm, reduced cooperation, measurement interrupted, difficulty holding lid open., uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/state[at0007]/items[at0134], code=at0134, itemType=ELEMENT, level=4, text=Medication regimen exposure, description=An assertion about the exposure to the planned medication regimen in the time period prior to the intraocular pressure measurement., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0135::Complete regimen exposure (presumed) [The measured eye had presumably been exposed to IOP-lowering drugs as planned before this measurement.] at0136::Incomplete regimen exposure (presumed) [The measured eye had presumably been incompletely exposed to IOP-lowering drugs compared to the treatment plan before this measurement.] at0137::Uncertain regimen exposure. [It is uncertain if or how the measured eye had been exposed to the IOP-lowering drug regimen.] at0138::No IOP lowering drugs [The measured eye has not been exposed to IOP-lowering drugs in a way that affects the current measurement.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/state[at0007]/items[at0132], code=at0132, itemType=ELEMENT, level=4, text=Number of topical pressure lowering medication classes, description=The number of topical pressure-lowering medication classes thought to be affecting this eye's pressure at measurement., comment=Commonly called 'number of medications'. Combination drops count by their components (e.g., prostaglandin analogue + beta-blocker = 2 classes). May differ between the eyes. See Liu et al in references for an overview of pharmacological classes. , uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/state[at0007]/items[at0133], code=at0133, itemType=ELEMENT, level=4, text=Number of systemic pressure lowering medication classes, description=The number of systemic pressure-lowering medication classes thought to intentionally affect this eye's pressure at measurement., comment=Typical examples include carbonic anhydrase inhibitors, mannitol or glycerol. Note that substances like betablockers are commonly used systemically, but rarely with the intention of lowering the intraocular pressure. Such incidental use for another indication is not counted. See Liu et al in references for an overview of pharmacological classes. This is not expected to differ between the eyes. , uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=, extendedValues=null]], capabilities=[], relationships=[], context=[], description=[], ism_transition=[], identities=[], target=[], credentials=[], other_participations=[], data=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0057], code=at0057, itemType=ELEMENT, level=4, text=Eye examined, description=Identification of the eye under examination., comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0058::Left eye [The left eye was examined.] [SNOMED-CT::1290031003] at0059::Right eye [The right eye was examined.] [SNOMED-CT::1290032005] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0042], code=at0042, itemType=ELEMENT, level=4, text=Pressure, description=Intraocular pressure, as measured by the type of tonometry described in the 'Tonometry type' element., comment=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., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_QUANTITY, bindings=null, values=Property: Pressure Units: 0.0..1000.0 mmHg Limit decimal places: 1, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0046], code=at0046, itemType=ELEMENT, level=4, text=Tonometry type, description=Type of tonometry used to measure the intraocular pressure., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0047::Goldmann [A Goldmann applanation tonometer was used to perform the test.] [SNOMED-CT::389152008 \| Goldmann applanation tonometry] at0048::Perkins [A Perkins tonometer was used to perform the test.] [SNOMED-CT::389151001 \| Perkins applanation tonometry] at0049::Tono-Pen [A Tono-Pen applanation tonometer was used to perform the test.] at0050::Rebound [A rebound tonometer, such as an iCare® device, was used to perform the test.] [SNOMED-CT::1286870002] at0051::Dynamic Contour [A Dynamic Contour Tonometer, such as a PASCAL® device was used to perform the test.] [SNOMED-CT::1286902005] at0053::Transpalpebral [A tonometer that measures through the eyelid, such as the TGDc-01, was used to perform the test.] at0066::Non-contact [A non-contact tonometer was used to perform the test.] [SNOMED-CT::389150000 \| Non-contact tonometry] at0095::Implanted pressure sensor [An implanted pressure sensor was used to perform the test.] at0096::Goldmann-correlated ocular response analysis [An Ocular Response Analyzer® was used to perform the test, with the goldmann-correlated (IOPg) output.] [SNOMED-CT::1286913008] at0099::Pneumatotonometer [A pneumatotonometer was used to perform the test.] [SNOMED-CT::252804008 \| Pneumatic tonometry] at0100::Schiøtz [A Schiøtz tonometer was used to perform the test.] [SNOMED-CT::389149000 \| Schiotz tonometry] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0081], code=at0081, itemType=ELEMENT, level=4, text=Corrected pressure, description=Corrected value for intraocular pressure., comment=For devices that output multiple pressure values, this element should be used for the values that take additional parameters into account for a correction of the raw pressure value. The method of correction used is specified in the 'correction type' element., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_QUANTITY, bindings=null, values=Property: Pressure Units: 0.0..1000.0 mmHg Limit decimal places: 1, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0082], code=at0082, itemType=ELEMENT, level=4, text=Correction type, description=The type of correction applied to produce the 'Corrected pressure' value., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0090::Corneal-compensated ocular response analysis [The corneal-compensated intraocular pressure as measured by the Ocular Response Analyzer.] at0091::Biomechanically corrected noncontact tonometry [The biomechanically corrected intraocular pressure as measured by the Corvis ST scheimpflug noncontact tonometer.] at0092::Corrected for central corneal thickness [The pressure was corrected for central corneal thickness (CCT).] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0093], code=at0093, itemType=SLOT, level=4, text=Citation of central corneal thickness used for correction, description=A SLOT to cite the central corneal thickness measurement that was used as a basis for the correction., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:* openEHR-EHR-CLUSTER.citation.v0, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0083], code=at0083, itemType=ELEMENT, level=4, text=Palpation finding, description=Semi-quantitative description of the softness or hardness of the eye based on palpation with the examiners fingers., comment=Palpation of unpressurised eyes., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0085::Unpressurized [The eyeball appears to lack any internal pressure.] at0086::Softer than normal [The pressure is approximated to be below the normal range, but some pressure is present.] at0087::Normal [The pressure is approximated to be within the normal range (10-21mmHg).] at0088::Harder than normal [The pressure is approximated to be above the normal range, but not very hard or rock-hard.] at0089::Very hard [The pressure appears to be extremely elevated, sometimes referred to as a rock-hard eye.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0123], code=at0123, itemType=ELEMENT, level=4, text=Inspection finding, description=Record of presence or absence of visible signs of a total lack of internal pressure of the examined eye., comment=Typically reserved for rare situations where physical interaction with the globe is inadviseable, such as physically aggressive individuals or when an open globe injury is strongly suspected., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0124::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.] at0125::The eye shows no signs of being unpressurized. [Based on visual examination, there are no signs of a total loss of intraocular pressure.] at0126::Uncertain [Based on visual examination, it is uncertain if there are signs of a total loss of intraocular pressure.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0094], code=at0094, itemType=ELEMENT, level=4, text=Waveform score, description=Waveform score produced by the Ocular Response Analyzer device., comment=Higher values indicate higher reliability., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_QUANTITY, bindings=null, values=Property: null Units: 0.0..10.0 arb. unit, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0061], code=at0061, itemType=ELEMENT, level=4, text=Clinical interpretation, description=Single word, phrase or brief description that represents the clinical meaning and significance of the findings., comment=null, uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0078], code=at0078, itemType=SLOT, level=4, text=Test not done, description=Details to explicitly record that this test was not performed., comment=null, uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include: openEHR-EHR-CLUSTER.exclusion_exam.v1 and specialisations, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0063], code=at0063, itemType=ELEMENT, level=4, text=Comment, description=Additional narrative about the measurement, not captured in other fields., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null]], content=[], source=[], events=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002], code=at0002, itemType=EVENT, level=2, text=Any event, description=Default, unspecified point in time or interval event which may be explicitly defined in a template or at run-time., comment=null, uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=EVENT, bindings=null, values=null, extendedValues=null]], provider=[], protocol=[ResourceSimplifiedHierarchyItem [path=/protocol[at0068]/items[at0079], code=at0079, itemType=SLOT, level=2, text=Extension, description=Additional information required to extend the model with local content or to align with other reference models or formalisms., comment=For example: local information requirements; or additional metadata to align with FHIR., uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include: All not explicitly excluded archetypes, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0068]/items[at0055], code=at0055, itemType=SLOT, level=2, text=Device details, description=Details about the tonometry device used to measure intraocular pressure., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include: openEHR-EHR-CLUSTER.device.v1 and specialisations, extendedValues=null]], details=[], activities=[]}, topLevelItems={data=ResourceSimplifiedHierarchyItem [path=ROOT_/data[at0001]/events[at0002]/data[at0003], code=at0003, itemType=ITEM_TREE, level=2, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=0..1, cardinalityText=optional, subCardinalityFormal=0.., subCardinalityText=Minimum of 0 items (Cardinality: 0.., unordered), dataType=ITEM_TREE, bindings=null, values=null, extendedValues=null], state=ResourceSimplifiedHierarchyItem [path=ROOT_/data[at0001]/events[at0002]/state[at0007], code=at0007, itemType=ITEM_TREE, level=2, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=0..1, cardinalityText=optional, subCardinalityFormal=0.., subCardinalityText=Minimum of 0 items (Cardinality: 0.., unordered), dataType=ITEM_TREE, bindings=null, values=null, extendedValues=null], protocol=ResourceSimplifiedHierarchyItem [path=ROOT_/protocol[at0068], code=at0068, itemType=ITEM_TREE, level=0, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=0..1, cardinalityText=optional, subCardinalityFormal=0.., subCardinalityText=Minimum of 0 items (Cardinality: 0.., unordered), dataType=ITEM_TREE, bindings=null, values=null, extendedValues=null]}, addHierarchyItemsTo=protocol, currentHierarchyItemsForAdding=[ResourceSimplifiedHierarchyItem [path=/protocol[at0068]/items[at0079], code=at0079, itemType=SLOT, level=2, text=Extension, description=Additional information required to extend the model with local content or to align with other reference models or formalisms., comment=For example: local information requirements; or additional metadata to align with FHIR., uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:* All not explicitly excluded archetypes, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0068]/items[at0055], code=at0055, itemType=SLOT, level=2, text=Device details, description=Details about the tonometry device used to measure intraocular pressure., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include: openEHR-EHR-CLUSTER.device.v1 and specialisations, extendedValues=null]], minIndents={}, termBindingRetrievalErrorMessage=null]