Intro To Goldmann Tonometry - Part 2

Question 1

How is IOP created?

Answer 1

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

Question 2

When is IOP performed?

Answer 2

In every examination of the human eye

Question 3

Name multiple different times when you will see a patient where there is not a need to check the IOP

Answer 3

1) contact lens follow up for proper fitting of a contact lens
2) when a patient comes in with complaints and you need to recheck their spectacle RX
3) corneal abrasion or foreign body in the cornea
4) any time you are seeing a patient for a refractive follow up
- child who’s changing and needs checked every few months
- doing VT

Question 4

What is commonly referred to as the “gold standard” of IOP measurement?

Answer 4

Goldmann tonometry

Question 5

What is one reason you would consider an IOP be taken by Non-Contact Tonometry (air puff) to be more accurate than Goldmann tonometry?

Answer 5

Post refractive surgical patients (ex: LASIK)

Question 6

What type of tonometer could be the future gold standard for measuring IOP?

Answer 6

Biomechanics - The Pascal Dynamic Contour Tonometer (DCT)

Question 7

How does The Pascal Dynamic Contour Tonometer (DCT) measure the IOP?

Answer 7

It is digital, and it uses the principle of contour matching instead of applanation to measure IOP

Question 8

If your patient has a thicker cornea, what type of result do you expect to get?

Answer 8

You’ll get a higher reading than what it actually is

Question 9

If your patient has a thinner cornea, what type of result do you expect to get?

Answer 9

You’ll get a lower reading than what it actually is

Question 10

What do you want to have the patient do before you put the tonometer or pachymeter on the eye?

Answer 10

Have the patient blink constantly right up to the moment you put them on the eye

Question 11

What will happen to the cornea if the patient does not blink a lot right before you take the IOP?

Answer 11

After 15 seconds or sooner on dry eye patients, the cornea will dry and become significantly thinner, which alters your readings significantly

Question 12

What is a Gaussian image?

Answer 12

One that changes/moves and can give hypnotic effects (ex: iPad, computer, phone)

Question 13

If the mires are too thin, what do you do?

Answer 13

Add more dye (NaFL or Flouress)

Question 14

If the mires are too thick, what do you do?

Answer 14

Have the pt sit back and blink a few times and then wait 10-15 seconds for the dye to clear