PurposeTo compare intraocular pressure (IOP) measurements, taken using Perkins applanation tonometry (PAT) and Goldmann applanation tonometry (GAT).Methods100 eyes of 100 patients underwent Perkins and Goldmann applanation tonometry, with a randomized order of modality, performed by a masked observer. The right eye was measured, for all subjects, and the data used in statistical analysis. The comparability of results given by the two instruments was evaluated using the Bland–Altman method.ResultsIOP measurements for 100 eyes were obtained (range: 10–44 mmHg). The mean GAT reading was 21.63 mmHg, with standard deviation (SD) 5.69 mmHg. The mean PAT reading was 21.40 mmHg, with SD 5.67 mmHg. The mean difference between readings from Goldmann versus Perkins tonometry was 0.22 mmHg (SD: 0.44 mmHg). The limits of agreement were calculated to be −0.64–+1.08 mmHg (1.96 SD either side of the bias).ConclusionThe Perkins applanation tonometer yields IOP measurements that are closely comparable with GAT. Therefore, PAT may be used in routine clinical practice, as part of the implementation of national guidelines, or preferred practice patterns, for glaucoma and ocular hypertension.

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Certain associations such as between cylindromas and apocrine cystadenoma are expected, as they are sweat gland proliferations. Similarly, basal cell and squamous cell carcinomas are malignant proliferations of keratinocytes and have similar histogenesis. However, most collision tumours occur by chance, and are not derived from similar cell lines nor share pathogenic mechanisms.The coexistence of two or more neoplasms in a single cutaneous specimen is unusual and can be diagnostically misleading if only one of the two is discovered. Biopsy reports must always be questioned in the light of the clinical history and examination. Unless histopathological diagnoses are considered alongside the clinical appearance of the original lesion, which may be altered by surgery, the anomaly may not be questioned.It is essential therefore that new lesions be photographically documented prior to any intervention. This will aid in the patient's future management particularly in situations where the patient is reviewed by a different clinician at subsequent visits. This objective tool is especially important in cases where the clinical appearance does not correlate well with histological findings. Performing a large incisional biopsy will also maximize the chance of identifying multiple lesions.