Define tonometry. Answer - Indirect estimation of IOP from determination of
resistance of the globe to deformation by an applied force
Why do we measure IOP? Answer - - component of CEE
- provide baseline data for future comparison
- *association btwn IOP & glaucoma*
Explain the physiology of IOP Answer - - pressure within eyeball is secondary
to production & drainage of aqueous fluid
- regulation of aqueous production & drainage allows for control of IOP
- aqueous secreted from ciliary processes
Where does aqueous drain from? Answer - 80-90% through TM
10-20% through uveoscleral outflow
Why is Goldmann performed after slit lamp and before dilation? Answer - -
anesthetic softens cornea and applanation slightly distorts cornea & blurs
vision
- soft cornea allows for better penetration of dilating agents
, How does the applanating probe work in a Goldmann tonometer? Answer -
contacts cornea and flattens (applanates) circular area of cornea
fluorescein stained tear layer forced away from cornea and around the area of
applanation--> yellow-green ring
prisms double the image
Why should you avoid pushing the tono probe arm back too forcefully when
inserting into holder? Answer - calibration could be affected
Describe the tonometry probe orientation Answer - 0 deg or 180 deg should
be aligned at which hash (for most pts)
adjust to red hash if corneal astig > 3D
On the tono measuring drum, 1g equals how many mmHg? Each hash equals
how many mmHg? Answer - 1 g= 10 mmHg
each hash= 2 mmHg
Where do you preset the measuring drum on the tonometer? Answer - 8-12
mmHg
What do you soak the tono prob in and for how long? Answer - 10 min in 3%
H2O2
What can happen if you do not properly rinse your tono probe after soaking?
Answer - large chemical burn with epithelial defect (pt shouldn't suffer long
term effects)
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