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. … With clear
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
massaging effects.
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
< .001).
“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.