What is Tonometry: Working Principle, Purpose, best Procedure22, Results

Tonometry

Today we will discuss about tonometer in which we will mainly discuss important points like – What is Tonometry, How does tonometry work, Working principle of tonometry, What are the types of tonometry, etc.

What is Tonometry ?

Tonometer is an eye test that helps detect changes in eye pressure.

The most common type of tonometer test is called the “Goldman application tonometry test”.

For quite some time, it has been considered the international standard for measuring eye pressure. It involves the use of a flat-tipped probe that is pressed gently against the surface of your eye. There are several other methods for testing eye pressure.

This procedure involves the use of an alternative type also known as non-contact tonometer. Also included are Tono-pen and EyeCare tonometer. These tests are generally considered less effective than Goldman application tonometry.

When using non-contact tonometry, air pressure is applied to your eye using an instrument that slightly flattens the cornea. This blows a puff of air over the cornea which measures the pressure in your eye. If it shows abnormal results, the ophthalmologist can usually perform other tests to confirm your diagnosis.

What is Tonometry

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A tono-pen is a handheld device similar in size to a large marker. The ophthalmologist may touch this instrument to your eye to measure pressure.

An eyecare tonometer is also a handheld device that gently taps the front of the eye to obtain a pressure reading.

Tonometry is usually a quick and simple test that checks the pressure inside your eyes. Seeing an ophthalmologist can help see if you are at risk for glaucoma.

Glaucoma is a distinct disease in which the optic nerve becomes progressively damaged over time, resulting in loss of vision. In general, this disease is often associated with increased eye pressure. Identifying this increased eye pressure and trying to reduce it is the only known way to prevent glaucoma blindness. Early screening helps protect your vision and slow vision loss.

What is tonometry used for ?

Your doctor uses ocular tonometry to see if you are at risk for glaucoma. It is often observed that in people with glaucoma, the fluid flowing inside their eye either builds up too fast or flows too slowly, causing pressure inside their eye. The increased eye pressure eventually affects the optic nerve and causes vision loss.

Who needs a tonometry test?

Your eyes are filled with various fluids that keep them healthy. New fluid is constantly being created and old fluid is expelled. But if this drainage system becomes plugged, fluid can build up, increasing the pressure inside your eyes.

Sometimes an injury or trauma to the eye causes increased pressure. When your eye heals, everything goes back to normal. But some people have a drainage system that doesn’t work the way it should.

The high pressure that builds up inside your eye can damage your optic nerve, which normally sends images from your eyes to your brain. It can cause glaucoma.

Your eye doctor may refer you for a Goldman applanation tonometry test if they suspect you may be at risk for glaucoma.

According to the AAO, you may be at increased risk of glaucoma if you:

What is Tonometry

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1. Being over 40 years old.
2. Being Black, Hispanic or Asian.
3. Glaucoma may have a genetic trait.
4. Farsightedness or nearsightedness.
5. Others are chronic eye conditions.
6. Eye injury in the past.
7. Having diabetes
8. Having high blood pressure
9. Having poor blood circulation.
10. Long-term use of corticosteroid drugs.

Your doctor may also test your eye pressure if you are experiencing these-like symptoms.

1. Gradual loss of peripheral vision.
2. Having tunnel vision
3. Severe pain in the eyes.
4. blurred vision
5. reddening of the eye
All these symptoms can be symptoms of glaucoma.

What happens during a tonometry test?

Before doing the Goldman tonometry test, your doctor will put numbing drops in your eye so that you can’t feel anything.

When your eye becomes numb, the doctor may stick a small strip of paper that has an orange tint to the surface of your eye, causing it to become scarred. It also helps in increasing the accuracy of the test.

Your doctor will then place a machine called a “slit-lamp” in front of you. They will ask you to rest your chin and forehead on a support provided, then move the lamp towards your eye until the tip of the tonometer probe touches your cornea.

This by slightly flattening the cornea, the tonometer detects the pressure in your eye. Your eye doctor will adjust the tension until they get an appropriate reading. Because your eye is numb, you will not feel any pain during this procedure.

Tonometry is generally a safe procedure. However, there may be a very small risk of scratching your cornea when the tonometer touches your eye. However, even if this happens, your eye will normally heal on its own in a few days.

How does tonometry work?

Tonometry measures the pressure in your eye by flattening your cornea. The more force that is needed to flatten your cornea, the higher the intraocular pressure. People with high intraocular pressure may be more likely to develop glaucoma. Tonometry can detect this problem early so that your ophthalmologist can create an effective treatment plan.

What is Tonometry

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Working principle of tonometry

Manometry uses intracameral cannulation, which is the only method that accurately measures the true IOP inside the eye. Because of its invasive technique, it cannot be used in a clinical setting. Transpalpebral tonometry does not elongate or indent the cornea. Thus, it removes impurities related to scarring, edema, curvature or biomechanical properties of the cornea and sclera.

What are the types of tonometry tests and how do they measure eye pressure?

Your doctor may perform several different types of tonometry tests. Your doctor will determine which evaluation will be most appropriate for your needs. Some of the most common types of tonometry include:

Non-contact tonometry: Also known as air-puff tonometry, this test uses puffs of air to flatten your cornea. Non-contact tonometry is not the most accurate way to measure the pressure inside your eye. It is usually used as a simple screening tool and is the easiest way to test children.

Goldmann applanation tonometry

Goldmann tonometry:- During this diagnostic evaluation your doctor uses a small probe to flatten your cornea. Then they use a slit lamp to examine your eye. Applanation tonometry is a highly precise technique and is often performed after high intraocular pressure has been detected by air-puff tonometry.

Applanation tonometry
This applanation tonometer is used to measure the intraocular pressure of your eye. Isoco is measured in millimeters of mercury (mmHg) and is determined by the amount of force that is needed to flatten, or subnet, a coherent area of ​​the cornea. A topical anesthetic is used because of the need for contact.

Electronic indentation tonometry: This type of tonometry test is performed to measure intraocular pressure, it uses an electronic device. Your doctor places a small instrument directly on your cornea and the test results are viewed on a computer screen.

Non contact tonometry

The non contact tonometry flattens the cornea by a jet of air, which is why there is no direct contact between the device and the surface of the eye. That is why it is called non-contact tonometry. This primarily avoids the need to sterilize equipment but a recent study showed that air puffs produce a tear film aerosol that may contain potentially infectious material. 81 The force of an air jet increases exponentially and linearly with time. The device also emits a collimated beam of light that is reflected from the central cornea and then received by a photocell. When an area of ​​the cornea with a diameter of 3.6 mm is flattened, the reflected light at the photocell is maximized. The time required to produce peak reflection is directly related to the force of the air jet and thus counterbalanced to IOP.

Tonometry test

Tonometry is used to measure the pressure inside the eye. This test is used to check for glaucoma. It is also used to measure how well glaucoma treatment is working.

Advantages of Tonometer

1. Ease of running
2. having an elegant design.
3. Anodized scale mount that is highly resistant to sterilizing wear
Independence of the sources of the present.
4. Delivered in smart padded metal cases, easy to carry

Disadvantages of Tonometer

1. General anesthesia is required.
2. not practical way for humans
3. The introduction of the needle leads to the blood aqueous barrier and the release of prostaglandins that alter IOP.

How much does a tonometer cost

Usually the price of tonometer ranges from $ 70 to $ 3200, this price varies by country and region.

What is a normal tonometer reading?

A normal result means whether the patient’s eye pressure is within the normal range. Usually the normal eye pressure range is 10 to 21 mm Hg. Sometimes the thickness of your cornea can affect the measurement. Normal eye readings with thick corneas are high, and normal eyes with thin corneas have low readings

What can cause increased eye pressure?

One of these reasons is when the aqueous humor in the eye does not drain properly and fluid keeps accumulating inside the eye. In this, eye drops may be prescribed to reduce and control IOP. Another reason can be side effects of some medicines like steroids.