A Comparative Study of Intraocular Pressure Measurement by Different Tonometer in Patients Attending Tertiary Care Hospital

Jump To References Section

Authors

  • PG Resident, Department of Ophthalmology, Dr. Vasantrao Pawar Medical College, Hospital & Research Centre, Nashik - 422003, Maharashtra ,IN
  • Associate Professor, Department of Ophthalmology, Dr. Vasantrao Pawar Medical College, Hospital & Research Centre, Nashik - 422003, Maharashtra ,IN
  • Professor, Department of Ophthalmology, Dr. Vasantrao Pawar Medical College, Hospital & Research Centre, Nashik - 422003, Maharashtra ,IN

DOI:

https://doi.org/10.18311/mvpjms/2019/v6i2/18283

Keywords:

Goldmann Applanation Tonometer, Perkins Tonometer, Schiotz Indentation Tonometer, Screening Tool
Perkins Tonometer

Abstract

Background and Objectives: Raised intraocular pressure is a well-known causative risk factor for the development of glaucoma. It is also the only component of glaucoma that is amenable to medical or surgical intervention, provided it is detected early enough. The measurement of intraocular pressure has evolved over time with the advent of a myriad of newer tonometers – one such being the non-contact tonometer. This study has been embarked upon with the objective of comparing the non-contact tonometer with the gold standard. Goldmann applanation tonometer versus the Schiotz tonometer, one of the most popularly used tonometers in the developing world. It also aims to establish the value of the non-contact tonometer as a screening tool. Materials and Methods: 200 purposively selected patients were subjected to three methods of tonometry; Goldmann applanation tonometry, Perkins Tonometry and Schiotz indentation tonometry (with the 5.5g, 7.5g and 10g weights); on both eyes. Three recordings were obtained with each method and the arithmetic mean taken as the intraocular pressure. The data was statistically analyzed using the intra-class correlation coefficient. Results: The non-contact tonometer showed excellent agreement with the Goldmann applanation tonometer compared to the Schiotz tonometer which showed only a fair agreement. Interestingly, the left eyes showed better agreement on noncontact tonometry than the right eyes, a phenomenon we attribute to apprehension of the patients on their first experience with the air puff. The non-contact tonometer also scored high as an effective screening tool. Conclusion: The non-contact tonometer compares favorably with the Goldmann applanation tonometer and can be reliably used as a screening tool. However, in view of the varying degrees of comparison between the two eyes, its role in monitoring glaucomatous eyes needs to be further evaluated.

Downloads

Published

2020-05-07

Issue

Section

Original Research Article

 

References

Foster PJ, Buhrmann R, Quigley HA, Johnson GJ. The definition and classification of glaucoma in prevalence surveys. Br. J. Ophthalmol 2002; 86:238–42. https://doi.org/10.1136/bjo.86.2.238.

Quigley HA, Broman AT. The number of people with glaucoma worldwide in 2010 and 2020. Br. J. Ophthalmol. 2006; 90:262–7. https://doi.org/10.1136/bjo.2005.081224.

Pascolini D, Mariotti SP. Global estimates of visual impairment: 2010. Br. J. Ophthalmol. 2012; 96:614–8.

https://doi.org/10.1136/bjophthalmol-2011-300539.

Maheshwari R, S Choudhari N, Deep Singh M. Tonometry and Care of Tonometers. J. Curr. Glaucoma Pract. 2012; 6(3): 124–130. https://doi.org/10.5005/jp-journals-10008-1119.

Bland MJ, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986; 1(8476):307–310. https://doi.org/10.1016/S0140-6736(86)90837-8.

Tonnu PA, Ho T, Sharma K, White E, Bunce C, GarwayHeath D. A comparison of four methods of tonometry: method agreement and interobserver variability. Br. J. Ophthalmol 2005; 89:847–50. https://doi.org/10.1136/bjo.2004.056614

Parker VA, Herrtage J, Sarkies NJ. Clinical comparison of the Keeler Pulsair 3000 with Goldmann applanation tonometry. Br. J. Ophthalmol. 2001; 85(11):1303–1304. https://doi.org/10.1136/bjo.85.11.1303.

Vandewalle E, Vandenbroeck S, Stalmans I, Zeyen T. Comparison of ICare, dynamic contour tonometer, and ocular response analyzer with Goldmann applanation tonometer in patients with glaucoma. Eur. J. Ophthalmol. 2009; 19(5): 783–789. https://doi.org/10.1177/112067210901900516.

ChandrakumarBalaratnasingam, William H. Morgan, Louise Bass, Stephen J. Cringle, Dao-Yi Yu; Time-Dependent Effects of Elevated Intraocular Pressure on Optic Nerve Head Axonal Transport and Cytoskeleton Proteins. Invest. Ophthalmol. Vis. Sci. 2008; 49(3):986–999. doi: 10.1167/ iovs.07-1090. https://doi.org/10.1167/iovs.07-1090.

Patel H, Gilmartin B, Cubbidge RP, Logan NS. In vivo measurement of regional variation in anterior scleral resistance to Schiotz indentation. Ophthalmic Physiol. Opt. 2011; 31:437–43. https://doi.org/10.1111/j.14751313.2011.00840.x.

Nagarajan S, Velayutham V, Ezhumalai G. Comparative evaluation of applanation and indentation tonometers in a community ophthalmology setting in Southern India. Saudi J. Ophthalmol. 2016; 30(2):83–87. https://doi.org/10.1016/j.sjopt.2015.11.002.

Jackson CRS. Schiotz tonometers – an assessment of their usefulness. Brit. J. Ophthal. 1965; 49:478. Krieglstein GK, Waller WK. Goldmann applanation versus handapplanation and https://doi.org/10.1136/bjo.49.9.478.

Schiötz indentation tonometry. Albrecht Von Graefes Arch. Klin. Exp. Ophthalmol. 1975; 194(1):6-11. https://doi.org/10.1007/BF00408271.