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Ophthalmic Physiol Opt. 2009 Nov;29(6):648-51. doi: 10.1111/j.1475-1313.2009.00680.x.

Goldmann tonometry versus the Tono-Pen XL for intraocular pressure measurement: an evaluation of the potential impact on clinical decision making in glaucoma.

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1
Department of Ophthalmology, Southern General Hospital, Glasgow, Scotland. zia.carrim@doctors.org.uk

Abstract

AIM:

To assess the validity of the Tono-Pen XL as an alternative to the Goldmann applanation tonometer (GAT) for the measurement of intraocular pressure (IOP) in patients with ocular hypertension (OHT) and glaucoma.

METHODS:

Over a 3 month period, patients with OHT or glaucoma attending a general clinic had IOP measurements taken using the Tono-Pen XL and the GAT. Tono-Pen measurements were taken by suitably trained nursing staff, while Goldmann tonometry was performed by the examining ophthalmologist.

RESULTS:

There were 124 eyes of 62 patients in this study. Overall, mean IOP was 18.3 +/- 4.8 mmHg using GAT and 18.8 +/- 5.5 mmHg using the Tono-Pen. Using the Bland-Altman method, the upper and lower limits of agreement between the two devices were +10.6 mmHg and -9.6 mmHg, respectively. Significant over- and under-estimates of IOP were noted in 10 (16%) patients.

CONCLUSION:

Our findings suggest that the Tono-Pen XL cannot be used as a substitute for GAT in the management of patients with glaucoma or OHT.

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