Scribd
Upload
5K views27 pages

Tonometry

Tonometry is used to measure intraocular pressure. There are two main types: indentation and applanation. Indentation tonometry includes the Schiotz tonometer. Applanation tonometry includes Goldmann, Perkins, pneumatic, and air-puff techniques. The Goldmann tonometer is considered the gold standard but requires a slit lamp. The Perkins and Tono-Pen are handheld applanation devices. Pneumatic tonometry uses a pressure transducer while air-puff is non-contact. Accuracy varies between techniques.

Uploaded by

Tika
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
5K views27 pages

Tonometry

Tonometry is used to measure intraocular pressure. There are two main types: indentation and applanation. Indentation tonometry includes the Schiotz tonometer. Applanation tonometry includes Goldmann, Perkins, pneumatic, and air-puff techniques. The Goldmann tonometer is considered the gold standard but requires a slit lamp. The Perkins and Tono-Pen are handheld applanation devices. Pneumatic tonometry uses a pressure transducer while air-puff is non-contact. Accuracy varies between techniques.

Uploaded by

Tika
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
You are on page 1/ 27

TONOMETRY

TONOMETRY
• Tonometry is the procedure performed to
determine the intraocular pressure (IOP).
CLASSIFICATION
TONOMETRY

DIRECT INDIRECT

Indentation Applanation Manometer


APPLANATION

Contact Non-contact

Goldmann Perkins Air-puff Pulse air


INDENTATION
TONOMETER

•It is based on fundamental fact that plunger


will indent a soft eye more than hard eye.
•The indentation tonometer in current use is
that of Schiotz .
•It was devised in 1905 and continued to
refine it through 1927.
PROCEDURE
 Patient should be anaesthetising with 4%
lignocaine or 0.5% proparacaine.
 with the patient in supine position, looking up at a
fixation target while examiners separates the lids and
lower the tonometer plate to rest on the cornea so
that plunger is free to move.
 The 5.5gm weight is initially used.
 If the scale reading is 4 or less , additional
weight is added.
ADVANTAGES
•Simple Technique
•Elegant design
•Portable
•No need for slit lamp or power supply
•Reasonably priced
•Widely used tonometer
Applanation
tonometers
• Goldman tonometer
• Perkins applanation tonometer
• Pneumatic tonometer
• Tono pen
Goldmann
tonometry
• The concept was introduced by goldmann in
1954
• It is based on IMBERT FICK LAW
• It states that the pressure inside an ideal
sphere (P) is equal to force (F) required to
flatten(A)
• P=F/A
Cont…
• Most popular and accurate tonometer.
• It consists of double prism mounted on slit
lamp.
• The prism applanates the cornea in an
area of
3.06 mm diameter.
Techniqu
e
• Topical anesthesia
• Staining tear film with fluorescein.
• The cornea and biprisms are illuminated with
cobalt blue light.
• Biprism just touches the apex of cornea.
• At this point two fluorescent semicircles are
viewed through prism.
• Applanation force against cornea is adjusted
until inner edges of two semicircles just
touches.
Potential errors

Patient related
• Thin cornea
• Thick cornea
• Astigmatism
• Irregular cornea
Technical
• Tonometer out of calibration
• Repeated tonometry
• Pressing on the eyelids or globe
• Squeezing of the eyelids
Advantage
•
s
Highly accurate
• Do not requires supine position
• portable
Disadvantages
• Not portable
• costly
• reading error if scares on cornea
Perkins
Tonometer
• It uses the same biprism as the Goldmann
applanation.
• The light source is powered by battery.
• The readings are consistent and compared
quite well with the Goldmann applanation.
Perkins
Tonometer
Perkins –
• Handheld
• Horizontal as well as vertical
• Infants, children, recumbent patients
Advantage
s
• Portable
• Does not requires electricity

Disadvantage
• It requires supine position
• Costly
Pneumatic
tonometer
• Cornea is applanated by touching apex
by silastic diaphragm covering sensing
nozzle.
• It is connected to central chamber containing
pressurized air.
• There is pneumatic to electronic transducer.
• It converts the air pressure to recording on
paper strip and IOP is red.
Pneumatic
tonometer
Tono
•Thispen
is handheld Mackay Marg type tonometer It is a computerised
pocket tonometer
•It converts IOP into electric waves
Cont…
• The wave form is internally analyzed by a
microprocessor.
• Three to six estimations of the pressure are
then averaged.
• The instrument is 18 cm in length and weighs
60 g.
NON-CONTACT TYPE

• Air puff tonometer :- In this central part of


cornea is flattened by a jet of air . This
tonometer is very good for mass screening as
there is no danger of cross infection and
local anaesthetic is not required.
• Pulse air tonometer :- It is a non-contact
tonometer that can be used with the patient
in any position.

You might also like