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Goldmann Applanation Tonometry Free of the Slitlamp

Bruce E. Cohan, MD; Zvi Flanders, MS; Andrew C. Pearch, MSE; M. Anthony Schork, PhD
Arch Ophthalmol. 2010;128(5):628-631. doi:10.1001/archophthalmol.2010.55.
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A prototype device was developed for using the Goldmann applanation tonometer (GAT) without a slitlamp to make it potentially practical to measure intraocular pressure (IOP) away from the clinic. Inexpensive consumer video components and a small flashlight replaced the microscope and illuminator of the slitlamp in a device that was assembled to use a standard, unmodified GAT. The device was evaluated for IOP measurement by volunteer measurer-subjects, who had no experience using the GAT, on each other and also by volunteers on themselves (self-tonometry). In a single, short training session with the prototype, the naive volunteers learned to measure IOP with the GAT. Other naive volunteers made IOP measurements on themselves with the prototype that were comparable in reliability with those obtained with the prototype by a professional measurer.

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The prototype device and self-tonometry. A, Cartoon of a generic prototype instrument for the Goldmann applanation tonometer free of a slitlamp with each generic component color coded: head-chin rest and joystick mechanism = gray, supports for illumination and imaging = blue, illuminator = light blue, video monitors = green, video camera = red, and standard, unmodified Goldmann applanation tonometer = black. B and C, Self-tonometry: measurement of the right eye while viewing with the left eye (B); measurement of the left eye while viewing with the right eye (C). (For caregiver tonometry, the video monitor is turned 180° to face the caregiver.) LCD indicates liquid crystal display; CCD, charge-coupled device.

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Goldmann applanation tonometry free of the slitlamp. Arch Ophthalmol 2010;128(5):628-31.
Home tonometry for management of pediatric glaucoma. Am J Ophthalmol 2011;152(3):470-478.e2.

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