Abstract • When estimating intraocular pressure in patients who are uncooperative or who have central corneal disturbances, the physician may find it either impractical or undesirable to place the small tip of a portable electronic applanation tonometer (Tono-Pen) over the central cornea. To gauge better the usefulness of Tono-Pen readings obtained from various locations, we compared such readings measured through the central cornea, midperipheral cornea, limbal cornea, and sclera of 15 cannulated eye bank eyes. Mean Tono-Pen readings from the midperipheral and clear limbal cornea did not differ significantly from central corneal readings over a 10—to 35—Hg range of intraocular pressures and were within ±2.4 mm Hg of mean central corneal readings. Mean readings taken from the sclera, however, were 8.8 to 17.0 mm Hg higher than mean central corneal readings over the 10— to 40—mm Hg range. We concluded that multiple noncentral corneal readings with the Tono-Pen provided a useful approximation of intraocular pressure, whereas scleral readings did not. References 1. Minckler DS, Baerveldt G, Heuer DK, Quillen-Thomas B, Walonker AF, Weiner J. Clinical evaluation of the Oculab Tono-Pen . Am J Ophthalmol . 1987;104:168-173. 2. Kao SF, Lichter PR, Bergstrom TJ, Rowe S, Musch DC. Clinical comparison of the Oculab Tono-Pen to the Goldmann applanation tonometer . Ophthalmology . 1987;94:1541-1544.Crossref 3. Boothe WA, Lee DA, Panek WC, Pettit TH. The Tono-Pen: a manometric and clinical study . Arch Ophthalmol . 1988;106:1214-1217.Crossref 4. Frenkel RE, Young JH, Shin DH. Comparison of the Tono-Pen to the Goldmann applanation tonometer . Arch Ophthalmol . 1988;106:751-753. 5. Stamper RL, Gardner ID, Bron AJ. Evaluation of a new, portable tonometer with digital display . Ophthalmology . 1987;94( (suppl) ):133.Crossref 6. Kooner K, Cooksey J, Barron J, Zimmerman T. Goldmann tonometry vs. Oculab Tono-Pen . Invest Ophthalmol Vis Sci . 1988;29( (suppl) ):61. Abstract. 7. Farrar, SM, Miller KN, Shields MB, Stoup CM. An evaluation of the Tono-Pen for the measurement of diurnal intraocular pressure . Am J Ophthalmol . 1989;107:411-416. 8. Rootman DS, Insler MS, Thompson HW, Parelman J, Poland D, Unterman SR. Accuracy and precision of the Tono-Pen in measuring intraocular pressure after keratoplasty and epikeratophakia and in scarred corneas . Arch Ophthalmol . 1988;106:1697-1700.Crossref 9. Higginbotham EJ. Clinical evaluation of the Oculab Tono-Pen . Am J Ophthalmol . 1988;105:101. 10. Hines MW, Jost BF, Fogelman KL. Oculab Tono-Pen, Goldmann applanation tonometry, and pneumatic tonometry for intraocular pressure assessment in gas-filled eyes . Am J Ophthalmol . 1988;106:174-179. 11. Hessemer V, Rössler R, Jacobi KW. Comparison of intraocular pressure measurements with the Oculab Tono-Pen vs. manometry in humans shortly after death . Am J Ophthalmol . 1987;105:678-682. 12. Lim JI, Blair NP, Higginbotham EJ, Farber MD, Shaw WE, Garretson BR. Assessment of intraocular pressure in gas-containing eyes . Arch Ophthalmol . 1990;108:684-688.Crossref 13. Mendelsohn AD, Forster RK, Mendelsohn SL, et al. Comparative tonometric measurements of eyebank eyes . Cornea . 1987;6:219-225.Crossref 14. Khan JA, LaGreca BA. Tono-Pen estimation of intraocular pressure through bandage contact lenses . Am J Ophthalmol . 1989;108:422-425. 15. Panek WC, Boothe WA, Lee DA, Zemplenyi E, Pettit TH. Intraocular pressure measurement with the Tono-Pen through soft contact lenses . Am J Ophthalmol . 1990;109:62-65. 16. Moses RA, Arnzen RJ. Instantaneous tonometry . Arch Ophthalmol . 1983;101:249-252.Crossref 17. Holladay JT, Allison ME, Prager TC. Goldmann applanation tonometry in patients with regular corneal astigmatism . Am J Ophthalmol . 1983;96:90-93. 18. Armaly MF, Rubin ML. Accomodation and applanation tonometry . Arch Ophthalmol . 1961;65:415-423.Crossref 19. Lichter PR, Bergstrom TJ. Premature ventricular systole detection by applanation tonometry . Am J Ophthalmol . 1983;81:797-803. 20. Wilke K. Intraocular pressure measurement on various parts of the cornea . Acta Ophthalmol . 1971;49:545-551.Crossref
Archives of Ophthalmology – American Medical Association
Published: Oct 1, 1991
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