Purpose To compare agreement of intraocular pressure (IOP) measurements using Goldmann applanation tonometry (GAT) and Goldmann correlated intraocular pressure generated (IOPg) by the Reichert ocular response analyser (ORA). Methods Consecutive patients presenting for glaucoma evaluation underwent ORA assessment followed by examination including GAT. For each ORA assessment, measurements were taken until a waveform score (WS) of 6.5 was obtained or until five measurements were obtained per eye. The relationship between GAT and IOPg and the influence of the WS upon this relationship was evaluated. A Bland-Altman plot and linear regression were used to determine agreement between GAT and IOPg. Results A total of 518 eyes of 260 patients were included in the final analysis. Increasing WS was found to predict a smaller difference between GAT and IOPg (b ¼ À0.2, Pp0.001). Selecting the highest WS among ORA assessments of each eye, WS continued to predict concordance between GAT and IOPg (b ¼ À0.2, P ¼ 0.006). The mean IOP difference between methods was 0.1 mm Hg (±0.3), which was found to be statistically insignificant (P ¼ 0.391). This relationship between GAT and IOPg was successfully validated using a second distinct data set of 100 eyes. GAT and IOPg measurements varied by 2 mm Hg or less in 53.9% of eyes and 5 mm Hg or less in 92.3% of eyes. Conclusion In clinical practice IOPg is strongly related to GAT. Although higher WS is indicative of greater IOPg/GAT concordance, its influence is minimal. This study does not support the use of a specific WS cutoff to determine quality of an IOPg measurement.

. Purpose:  To determine whether differences in corneal hysteresis (CH) and central corneal thickness (CCT) between black, Hispanic and white subjects exist independently of one another. Methods:  Retrospective, cross‐sectional data were reviewed for 807 eyes of 410 patients consecutively evaluated for glaucoma. Included patients had open angles, at least one reliable 24‐2 perimetric examination and no evidence of nonglaucomatous vision loss. Patients underwent CH measurement with the ocular response analyzer followed by CCT measurement and full ocular examination. Patients were asked to self‐classify their race or ethnicity. Statistical analyses were performed to identify characteristics that varied between black, Hispanic and white subjects and to explain this variation. Results:  Of the 270 patients (511 eyes) included, 84 were black, 96 Hispanic and 90 white. There were no significant differences in diagnosis, sex, age, intraocular pressure or glaucoma severity between races/ethnicities (p ≥ 0.16). Blacks were found to have lower CCT (529.3 μm) and CH (8.7 mmHg) compared to Hispanics (544.7 μm, p = 0.008; 9.4 mmHg, p = 0.007) and whites (549.9 μm, p < 0.001; 9.8 mmHg, p < 0.001). On multivariable analysis, inter‐racial/ethnic differences in CCT were not found to exist independent of CH (p ≥ 0.10), whereas the significant intergroup variation in CH remained after adjustment for CCT and other covariates (p ≤ 0.005). Conclusions:  Variation in CCT between races/ethnicities does not exist independent of CH. However, significant intergroup variation in CH is present independent of CCT. This finding suggests that CH may be a preferable measurement to evaluate intergroup differences in corneal properties and their relationship to open‐angle glaucoma.

In patients under evaluation and treatment for glaucoma, CH was more closely related to visual field MD than to structural markers of glaucoma damage as measured by SD-OCT.