Empowering Patients, Easing Workflows: The Case for Home Tonometry

A Clinic-First Look at Integrating Home Tonometry Into Glaucoma Workflows

This webinar, presented by Dr. Manjool Shah and Ashley Felloney of MyEyes, addresses a practical question that many glaucoma practices face: how do you add 24-hour diurnal IOP monitoring to an already overloaded clinic schedule without creating new burdens for staff? The answer, as demonstrated through Dr. Shah's case studies and Ashley Felloney's walkthrough of the MyEyes concierge model, is that the operational lift is handled almost entirely outside the clinic. The provider prescribes, the MyEyes team executes, and a polished report arrives in time for the follow-up visit.

The Workflow Gap That Home Tonometry Fills

Dr. Shah opens by framing the core problem: clinicians make high-stakes treatment decisions — medication changes, laser referrals, surgical interventions — based on a handful of spot-check IOP readings that cover, at best, eight hours of a 24-hour cycle. Even the most diligent scheduling of morning, afternoon, and late-day visits cannot capture the 3:00 to 6:00 a.m. window where many glaucoma patients experience their most significant pressure spikes. In-office diurnal curves are resource-intensive, requiring patients to sit in the clinic for hours, and still miss the nocturnal period entirely. The iCare HOME2, deployed through a rental model with full concierge support, generates hundreds of data points over one to two weeks without consuming any chair time or tech bandwidth.

How the MyEyes Concierge Model Works in Practice

Ashley Felloney details the end-to-end process that eliminates friction for both the clinic and the patient. The prescribing provider submits a prescription through the MyEyes website, which takes minutes. From that point, MyEyes handles everything: the device ships within 24 hours; a Patient Ambassador — who has glaucoma herself and uses the iCare HOME2 personally — calls the patient the day after delivery to conduct onboarding. Most training sessions are completed over the phone, without video, and MyEyes reports a 97% success rate in getting patients up and running, including older and less technologically comfortable individuals. During the rental period, the concierge team is available for troubleshooting. When the rental ends, the patient drops the device in a prepaid return box, MyEyes downloads the data, and a formatted report is sent to the prescribing provider.

Diagnose, Compare, and Purchase: Matching the Plan to the Clinical Question

Ashley Felloney explains the three program tiers that clinics can slot into different points in their triage and treatment workflows. The Diagnose rental is a single one- to two-week monitoring period designed for the initial clinical question: what is this patient's true diurnal IOP profile? The Compare rental bundles two monitoring periods — one before and one after an intervention such as SLT, canaloplasty, MIGS, or a medication adjustment — with up to a year between the two rentals. This creates a genuine A/B comparison that documents procedure efficacy with objective data. For patients who want ongoing long-term monitoring, the device is available for purchase. Payment plans, HSA and FSA eligibility, and growing insurance reimbursement — MyEyes is a preferred vendor with United — reduce financial barriers. The MyEyes team supports patients through the insurance documentation process, providing all necessary codes and answering questions.

Case Evidence: When Remote Data Changes the Surgical Plan

Dr. Shah presents four cases from his own practice at the University of Michigan's Kellogg Eye Center that illustrate how home tonometry data directly altered clinical management. In the most striking example, a young patient under 30 on maximum topical therapy presented with in-office pressures consistently in the low to mid-teens, yet his OCT continued to progress. HOME2 data revealed pressures spiking to the high 20s and low 30s every morning between 3:00 and 6:00 a.m. — a pattern completely invisible to the clinic. This data provided the confidence to recommend canal surgery rather than continuing to add drops to a regimen that appeared controlled by daytime standards. In another case, a patient referred with presumed glaucoma showed stable, sub-normal pressures throughout the full 24-hour cycle with symmetrical curves between eyes, redirecting the workup away from glaucoma surgery and toward a vascular etiology identified by retinal imaging. Neither of these outcomes would have been possible with office-based tonometry alone.

Pre- and Post-Procedure Comparison Without Adding Visits

The Compare rental is particularly valuable for busy practices because it documents treatment efficacy without requiring additional in-office visits. Dr. Shah demonstrated this with a patient who underwent repeat SLT: the pre-treatment HOME2 curve showed morning spikes into the low 20s with a standard deviation around three, while the post-treatment curve showed reduced peaks and a standard deviation closer to two. This apples-to-apples comparison confirmed that the laser had both lowered peak IOP and stabilized the diurnal curve. For practices managing high surgical volumes, the Compare rental provides objective outcome data that supports documentation for payers and reassures co-managing optometrists — all without adding chair time.

Addressing the Workforce Gap With Remote Monitoring

Dr. Shah closes with a demographic reality: glaucoma prevalence is rising while the specialist workforce is shrinking. Practices cannot absorb more frequent monitoring visits. Remote IOP monitoring with the iCare HOME2, supported by a concierge team that handles logistics, training, and reporting, allows clinicians to extend their diagnostic reach without expanding staff or clinic hours. The model parallels the shift in diabetes management from quarterly fasting glucose checks to continuous glucose monitoring — more data, captured in the patient's real-world environment, enabling more personalized and proactive treatment decisions. For clinic administrators and practice managers evaluating operational efficiency, the key point is that the MyEyes service model was designed to be additive to clinical insight without being additive to clinical workload.

Institutional Adoption and Patient Satisfaction

Ashley Felloney notes that MyEyes has served over 2,200 patients with a 95% customer satisfaction score. The service is trusted by academic centers including Harvard, Duke, NYU, and the University of Michigan's Kellogg Eye Center. Dr. Shah adds unsolicited praise from his own patients about the MyEyes onboarding experience, underscoring that the concierge model not only removes operational burden from the clinic but also generates patient goodwill and engagement with their own disease management. For practices considering adoption, the infrastructure and track record are already established.