Title: To study the role of Non-contact Tonometry for measurement of intraocular pressure in patients attending ophthalmology outpatient department

Authors: Dr Sakshi Sahni, Dr Nalini Birpuri

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i9.126

Abstract

Introduction

The intraocular pressure is the fluid pressure inside the eye. It is the result of a dynamic balance between aqueous humour formation and outflow, which are nearly equal under normal conditions. Normal intraocular pressure varies between 10.5 to 20.5 mmHg with a mean pressure of 15.5 ±2.57mmhg (leydecker 1958). Intraocular pressure has an important role in case of detection of glaucoma, one of the most important cause of blindness worldwide. Ocular hypertension is associated with an increased risk of developing glaucoma and reducing intraocular pressure has shown to lessen progressive loss of visual field.

Accurate and precise measurement of intraocular pressure is, therefore, fundamental to the management of glaucoma. Three types of tonometer are used clinically viz. Indentation, Applanation and Non Contact Tonometer. Schiotz, in 1905 developed prototype of indentation tonometer. The concept of applanation tonometry is based on Imbert Ficks law which states that pressure inside a sphere (P) is equal to the force (F) required to flatten its surface divided by the area of flattening (A) . P=W/A.

Goldmann in 1954 modernised this tonometer and currently it is the most popular and accurate tonometer. This device is mounted on a slit lamp bio microscope. The standard Goldmann tonometer falls somewhat short in the regard due to its requirement for a slit lamp (non portability), topical anaesthesia, fluorescein and an ophthalmologist.

Bernard Grolman (1950) invented Non Contact Tonometer based on principle of applanation tonometer. Routine screening for glaucoma began with NCT.

References

  1. Schiotz HA. The Intraocular pressure In: Duke Elder S(ed). System of Ophthalmology, The Physiology of the Eye and of the Vision.1968. Henry Kimpton, London. Vol IV. pp.233-34.
  2. Forbes M, Pico, Grolman B. A non-contact tonometer. Description and clinical evaluation. Archive of ophthalmology 1974; 91:134-40.
  3. Choi WJ, Kim JW, Tchah H, Jin YH, Kim YJ. Non-Contact tonometry; an ideal method for mass screening. Korean J Ophthalmol 1990; 4 : 30-33.
  4. Tonnu PA, Ho T, Sharma K,White E, Bunce C ,Heath DG. A comparison of four methods of tonometry: method agreement and interobserver variability. Br J Ophthalmol 2005; 89 : 847-50.
  5. Ogbuehi KC. Assessment of the accuracy and reliability of the Topcon CT80 non-contact tonometer. Clin Exp Optom 2006; 89 : 310-14.
  6. Salim S, Linn DJ, Echols2 JR, Netland PA. Comparison of intraocular pressure measurement with the portable PT100 non-contact tonometry with the Goldmann applanation tonometery. Clinical Ophthalmology 2009; 3 : 341-44.
  7. Rao BS. Clinical evaluation of the non-contact tonometer and comparison with Goldmann applanation tonometer. Indian J Ophthalmology1984; 32 : 432-34.
  8. AlMubrad TM. Performance of the PT100 Non-contact tonometer in healthy eyes. Clinical Ophthalmology 2011; 5:661-66.
  9. Augsburger A, Terry JE. Non-contact and Mackay-Marg tonometry:comparison in patients ages 7 to 85 years. Am J Optom Physiol Opt 1977; 54:31-34.
  10. Fick. Examination of the Eye In: Duke Elder S(ed) System of Ophthalmology, The Foundations of Ophthalmology : 1968 Henry Kimpton, London. Vol VII.pp.348-49.
  11. Examination of the Eye In: Duke Elder S(ed). System of Ophthalmology, The Foundations of Ophthalmology. 1968. Henry Kimpton, London. Vol VII.pp.348-49.
  12. Hansen MK. Clinical comparison of the XPERT Non contact tonometer and conventional Goldmann applanation tonometer. Acta Ophthalmol Scand 1995; 73 : 176-80.
  13. Popovich KS, Shields MB. A comparison of IOP measurements with the XPERT NCT and GAT. J Glaucoma 1997; 6: 44-46.
  14. Stamper, Robert L. A history of intraocular pressure and its measurement. Optometry and Vision Science 2011; 88E 16-28.
  15. Shields MB. The non contact tonometer: Its value and limitations. Surv ophthalmol 1980; 23 : 211.
  16. Wittenberg S. A clinical evaluation of the non-contact tonometer. J Am Optom Assoc 1977; 48 : 196-206.

Corresponding Author

Dr Sakshi Sahni

Department of Ophthalmology, GMC Jammu, India