Tonometers—which one should I use?

Abstract

Although several factors are known to play a role in the development and progression of glaucoma, intraocular pressure (IOP) remains the only modifiable risk factor. Medical and surgical treatments for glaucoma both aim to reduce IOP to minimize disease progression. Tonometry is therefore an essential element of the ophthalmological exam. There are several types of tonometers available currently. These range from well-established instruments that have been in clinical use for decades to new devices, which are the result of recent technological advances. The various instruments have advantages and disadvantages that affect their suitability for a given setting, purpose, and patient population. In this review, we aim to describe the most commonly available tonometers today along with their advantages, disadvantages, and applicability.

Correlation between corneal thickness, keratometry, age, and differential pressure difference in healthy eyes

“…NCT is more affected by CCT than the GAT, which may be justified by the corneal viscoelastic property, where the rate of impingement of force affects the stiffness 47 .…”

Current concepts of cerebrospinal fluid dynamics and the translaminar cribrosa pressure gradient: a paradigm of optic disk disease

“…Other methods to measure IOP include indentation tonometry, rebound tonometry, pneumotonometry, and a variety of newer methods, each of which have advantages and disadvantages. 8 At the present time, there is no means to directly measure the orbital CSF pressure. ICP is typically measured by a lumbar puncture (LP).…”

Corrected Intraocular Pressure Variability with Central Corneal Thickness Measurement

“…12 Other studies in the literature reported other factors related to corneal biomechanical parameters also could affect IOP measurements. [13][14][15][16] A thinner CCT has been reported to represent a significant risk in patients diagnosed with primary openangle glaucoma; moreover, patients having thinner CCT were found to have more advanced pathology and a severe glaucomatous defect. 5,17 Ultrasound pachymetry has been a universally accepted tool for measuring CCT, being highly reproducible and consistent.…”