There may be alternatives to
Goldmann tonometry for measuring
IOP in children, according to a study.
Although the Goldmann tonometer remains the gold standard of IOP
measurement, it may not be applied to all children.
instruction and proper guidance, the pressure phosphene tonometer can be
considered in selected children, the study authors said.
In a prospective comparative study, IOP was measured with three
different measuring tools in 100 eyes of 50 children aged 5 years to 14 years.
IOP readings were obtained with a pressure phosphene tonometer (Proview eye
pressure monitor, Bausch + Lomb), a non-contact pulse air tonometer (XPERT NCT
Plus, Leica) and a Goldmann tonometer (900.4.4, Haag-Streit). Goldmann
tonometer measurements were obtained last to avoid a decrease in IOP due to
Mean IOP measurements were comparable for all devices tested: 15.9 mm Hg
with the Goldmann tonometer, 16 mm Hg with the pressure phosphene tonometer and
15.7 mm Hg with the non-contact tonometer. The mean difference between readings
was 2.9 mm Hg for the pressure phosphene and Goldmann tonometers and 2.1 mm Hg
for the non-contact and Goldmann tonometers.
On a comfort scale of 1 to 5, with 5 indicating the most discomfort, the
children rated the pressure phosphene tonometer at 0.6, compared with ratings
of 2 for the non-contact tonometer and 2.3 for the Goldmann tonometer (P
Although the pressure phosphene tonometer was less accurate than
the non-contact tonometer compared with Goldmann tonometer, it gave a
reasonably close estimate and had a high specificity of raised IOP. In
addition, measurement by the pressure phosphene tonometer is most acceptable to
children, the authors said.