Measuring intraocular pressure

@article{Okafor2015MeasuringIP,
  title={Measuring intraocular pressure},
  author={Kingsley C. Okafor and James D. Brandt},
  journal={Current Opinion in Ophthalmology},
  year={2015},
  volume={26},
  pages={103–109}
}
Purpose of review Tonometry is undergoing a long-overdue renaissance. Goldmann applanation tonometry (GAT) is 50-year-old technology. Although GAT is considered a ‘reference standard’, it has many limitations and confounders. This review compares GAT to some of the newer technologies that have recently been commercialized or are in development. Recent findings Dynamic contour tonometry is fairly cornea-independent, but requires technical skill to carry out. Rebound tonometry requires no… 

When gold standards change: time to move on from Goldmann tonometry?

The English ophthalmologist Richard Banister was one of the first to report palpable hardness of the normal-appearing eye in 1622, and GAT is the currently accepted ‘gold standard’ and approximates IOP by measuring the force needed to flatten a fixed area at the corneal apex.

How to Measure Intraocular Pressure: An Updated Review of Various Tonometers

The authors review the various devices currently in use for the measurement of intraocular pressure (IOP), highlighting the main advantages and limits of the various tools.

Rebound tonometry versus Goldmann tonometry in school children: feasibility and agreement of intraocular pressure measurements.

IOP measurement is feasible in a greater number of children with RBT, and the examination was faster than that for GAT, and RBT tended to overestimate the IOP.

Comparison of intraocular pressure measured by ocular response analyzer and Goldmann applanation tonometer after corneal refractive surgery: a systematic review and meta-analysis

IOPcc, which is less dependent on CCT, may be more close to the true IOP after corneal refractive surgery compared with IOPg and IOPGAT, and the recovery of IOPcc after corNEal surfaceRefractive surgery may beMore stable than that after lamellar refractive Surgery.

Intraocular Pressure in Ophthalmological Practice

Although there were statistically significant differences between values measured by various NCT devices, these differences have no significant clinical relevance and resulted in the use of the Ocular Response Analyser to measure IOP in suspicious cases.

Comparison of intraocular pressure measurements using Goldmann tonometer, I-care pro, Tonopen XL, and Schiotz tonometer in patients after Descemet stripping endothelial keratoplasty

IOP measurements in post-DSEK patients showed good agreement between GAT and either Tonopen XL or I-care pro, and IOP difference between devices were not dependent on central corneal thickness.

The Clinical Interpretation of Changes in Intraocular Pressure Measurements Using Goldmann Applanation Tonometry: A Review

Clinical applicable guidelines for differentiating true change from test-retest variability (TRV) in IOP measurements using Goldmann applanation tonometry (IOPG) are determined by quantitatively summarizing the published evidence from 18 studies.

Comparison Of Intraocular Pressure (IOP) Measured By Non-Contact (Air–Puff) Tonometer Compared With Goldmann Applanation Tonometer

There is a good consistency between the non-contact Air-Puff tonometer and GAT, which produces IOP measurements which are similar & consistent to that of gold standard GAT.

Comparison between different tonometers following intrastromal corneal ring segments implantation

IOP measurements taken by air puff tonometer were significantly lower than those taken by GAT and ORA-IOPcc and these differences were not constant across the pressure range but increased as the pressure values determined using GATand ORA increased.

Measuring Intraocular Pressure in Patients With Keratoconus With and Without Intrastromal Corneal Ring Segments

All 5 tonometers provided reliable IOP readings in the keratoconic eyes regardless of the presence of corneal ring segments, and iCare Pro readings were most consistent with GAT, whereas ORA readings were least consistent with this reference standard.
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References

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Dynamic contour tonometry for post-LASIK intraocular pressure measurements.

The Dynamic contour tonometer appears to be suitable, reliable, and easy to use for IOP measurements after LASIK surgery, and post-operative results with the contour Tonometer agree well with preoperative figures.

Comparison of handheld rebound tonometry with Goldmann applanation tonometry in children with glaucoma: a cohort study

There is poor agreement between RBT and GAT in children with glaucoma and high RBT readings should prompt the practitioner to use another standard method of IOP measurement if possible, or consider the RBT measurement in the context of clinical findings before referring the child to a specialist clinic or considering EUA.

Transpalpebral measurement of intraocular pressure using the Diaton tonometer versus standard Goldmann applanation tonometry

Diaton cannot recommend Diaton as a substitute or alternative method for GAT for diagnosis and follow-up of patients with abnormal IOPs, but it may be helpful as a screening tool, especially for subjects whose age is between 20 and 50 years and for healthy subjects.

Repeatability and Reproducibility for Intraocular Pressure Measurement by Dynamic Contour, Ocular Response Analyzer, and Goldmann Applanation Tonometry

This result, in conjunction with the finding that variability was not different between eyes, examiners, or measurement sets, suggests that DCT and ORA are reliable enough to be clinically useful.

Accuracy of Goldmann, ocular response analyser, Pascal and TonoPen XL tonometry in keratoconic and normal eyes

The DCT and the ORA are currently the most appropriate tonometers to use in KC for the measurement of IOPcc, and corneal factors such as CH and CRT may be of more importance than CCT in causing inaccuracies in applanation tonometry techniques.

Comparison of the Utility of Pascal Dynamic Contour Tonometry With Goldmann Applanation Tonometry in Routine Clinical Practice

Pascal tonometry was found significantly more time consuming and difficult than Goldmann tonometry in routine practice, and both types of tonometry were well tolerated by patients.

Correlation between central corneal thickness, applanation tonometry, and direct intracameral IOP readings

There is no systematic error of applanation tonometry with increasing CCT, and therefore it is inadequate to recalculate IOP based on regression formula of Applanatory IOP versus CCT compared with direct intracameral manometry.

The influence of central corneal thickness and age on intraocular pressure measured by pneumotonometry, non-contact tonometry, the Tono-Pen XL, and Goldmann applanation tonometry

IOP measurement by all four methods is affected by CCT, with the NCT affected significantly more than the GAT, and subject age has a differential effect on the IOP measurements made by the Gat and OBF compared to the Tono-Pen.
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