Intro To Goldmann Tonometry

Question 1

How is IOP created?

Answer 1

By the inflow and outflow of aqueous in the anterior chamber of the eye

Question 2

How does glaucoma occur (very simple terms)?

Answer 2

Either not draining like it should, or aqueous production was turned up

Question 3

When is IOP performed?

Answer 3

ALWAYS in EVERY examination of the human eye (except for CL follow-up)

Question 4

Normal average IOP

Answer 4

8-12

Question 5

At what pressure do we get a little worried about IOP getting a little high?

Answer 5

Greater than 23

Question 6

What can steroids do to the IOP?

Answer 6

They may cause a significant and damaging increase in IOP

Question 7

Why is post-op IOP measured?

Answer 7

To make sure the inflammation from the surgical trauma has not caused a pressure spike

Question 8

What’s the average number of drops of Pred Forte 1.0% that it takes before the the average patient will experience a pressure spike?

Answer 8

248

Question 9

What’s known as the “Gold Standard” of IOP measurement?

Answer 9

Goldmann tonometry

Question 10

What is the instrument of choice to measure IOP in patients with any IOP disorders?

Answer 10

Goldmann tonometry

Question 11

What is the instrument of choice to measure IOP in patients who have previously had LASIK?

Answer 11

NCT (or air puff) because the cornea is already thinned, and it will be hard to read the correct results using Goldmann tonometry

Question 12

In what units is the IOP measured in?

Answer 12

Millimeters of mercury (mmHg)

-these are diurnal variations in pressures

Question 13

What color light do you use when you are practicing Goldmann tonometry?

Answer 13

Cobalt blue

Question 14

What height and width of the beam do you use when you are practicing Goldmann tonometry?

Answer 14

Max height and max width of the beam

Question 15

What angle of illumination do you use when you are practicing Goldmann tonometry?

Answer 15

Wide angle of illumination

Question 16

Which way do you turn the dial on the Goldmann tonometer in order to increase the force?

Answer 16

Clockwise

Question 17

Which way do you turn the dial on the Goldmann tonometer in order to decrease the force?

Answer 17

Counterclockwise

Question 18

What do you do if your semi-circles on the Goldmann tonometer are too thin?

Answer 18

Instill another drop of NaFl stain or Flouress into the patient’s eye(s). Then test the patient’s IOP.

Question 19

What do you do if your semi-circles on the Goldmann tonometer are too thick?

Answer 19

Wait about 10-15 seconds and have the patient blink a few times. Then test the patient’s IOP.

Question 20

If the puncta are clear, what can happen when you use the NaFL dye?

Answer 20

Some NaFL will drain into the nasal passages and can even go down the back of the throat. No reason to warn the patient. If they bring it up, just assure them that it will clear and there is no reason to be alarmed.

Question 21

What happens if NaFL gets on clothes?

Answer 21

It will cause a permanent stain. If this happens to your patient’s clothes, offer to replace the garment.

Question 22

What happens if you use too much NaFL dye and overflow the tear lake and punctual drainage capacity?

Answer 22

It will run down the patient’s face. It will stain the skin, and not wash off, but will usually go away within a day or two.