Tonometry 3%

Question 1

What principle is the application tonometry based on?

Answer 1

Imbert-Fick Principle

Question 2

What is the Imbert-Fick principle?

Answer 2

The pressure inside a thin-walled sphere=the force necessary to flatten its surface divided by the area of flattening.

Question 3

What is the formula for Imbert-Fick Prinicplr?

Answer 3

P=F/A

P= Pressure
F=Force
A=Area

Question 4

In applanation tonometry pressure is determined by the amount of weight required to flatten the cornea _____mm

Answer 4

3.06mm

Question 5

______and ______are factored into formula for Goldmann applanation principle.

Answer 5

K rigidity
Surface tension

Question 6

Tip of Goldmann is designed to minimize ______pull from tear film and _____push from K.

Answer 6

Inward
Outward

Question 7

This form of tonometry is very accurate, has minimal effect from repeats measurements.

Answer 7

Goldmann

Question 8

Goldmann applanation principle formula is based on _______mcm thick K

Answer 8

550

Question 9

_________used for thinner and thicker K’s

Answer 9

Namograms

Question 10

What are the advantages of Goldmann?

Answer 10

Most accurate, reproducible

Question 11

What is the most accurate tonometry test?

Answer 11

Goldmann

Question 12

What are the disadvantages to Goldmann?

Answer 12

Requires training, subjective to breath holding, tight collars, and pressure on the globe, not portable, requires anesthetic, poor technique can cause K injury

Question 13

The following products/procedures for disinfection will _________the tip causing it to _______: alcohol, Acetone, UV radiation, Sterilization, immersion in fluid for more than 1 hour, storing at temp greater than 60C

Answer 13

Degrade
Fail

Question 14

What do you clean the tip of Goldmann with?

Answer 14

Hydrogen peroxide

Question 15

Never leave the Goldmann tip in hydrogen peroxide for more than _______minutes

Answer 15

10

Question 16

70% Isopropyl Alcohol will _____the probes of Goldmann and if not _____properly can cause marked pain and anterior uveitis.

Answer 16

Destroy
Dried

Question 17

A side view of the Tonometry probe-set the axis to _____degrees.

Answer 17

180

Question 18

*If pt has_______cyl position the probe on Goldmann with the red line at the corresponding minus cyl axis of K astig

Answer 18

Greater than or equal to 3D

Question 19

Where should the drum be set when starting Goldmann?

Answer 19

at 10

Question 20

Each mark on the drum of Goldman tip represents…..

Answer 20

2 mm Hg

Question 21

When doing Goldmann the light source should be place at what degree?

Answer 21

60-65 degrees

Question 22

When doing Goldmann what should the light setting be?

Answer 22

Use wide open diffuse illumination, bright illumination, the cobalt blue filter and 10 or 12x magnification

Question 23

When doing Goldmann you should approach the cornea with your _______

Answer 23

naked eye

Question 24

When doing Goldmann you should look through the ______when you are almost on the cornea.

Answer 24

oculars

Question 25

What are the steps in doing Goldmann once you have got it lined up, lights and magnification adjusted and you are now looking through the oculars?

Answer 25

Judge mire thickness, Adjust alignment of mires horizontally and vertically, check for proper forward pressure on the eye "the sweet spot", measure IOP.

Question 26

*In Goldmann, If mires are too thick what should you do?

Answer 26

Have pt blot closed eyes with tissue

Question 27

In Goldmann if mires are too thin what should you do?

Answer 27

Add more dye.

Question 28

In Goldmann, if mires are too_______ the pressure will be overestimated.

Answer 28

Fat

Question 29

In Goldmann, If the mires are too ______ the IOP will be underestimated.

Answer 29

thin

Question 30

What should you do if mires are too thick when doing Goldmann?

Answer 30

Pull the slit lamp back, dry off the end of the prism tip , have pt blot closed eyes, start over.

Question 31

*What is the likely cause of mires being too fat when doing Goldmann?

Answer 31

lashes in contact with the probe, too much Fluress ore excessive tearing

Question 32

How should you hold lids when doing Goldmann?

Answer 32

By pressing on the orbital rim, do not put pressure on the globe itself.

Question 33

What is the usual variation in IOP over a 24 hour period?

Answer 33

3-5 mmHg

Question 34

*What time of day is the highest IOP reading?

Answer 34

Approx 6am

Question 35

Pressure spikes that are ____ are diagnostic.

Answer 35

>5mmHg

Question 36

What should you do for your CL pt to do if you have done Goldmann?

Answer 36

Soft: Irrigate eyes with sterile irrigating solution to remove all fluorescein. Advise pt not to wear their CL for at least 1 hour, lenses will absorb Fluorescein turning them yellow. Hard: Advise pt not to wear their lenses as long as they normally would. Topical anesthetics soften K epithelium makin an abrasion more likely.