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5.1 How pressure is measured
The applanation tonometer functions according to the 'Goldmann method';
measurement of the pressure required to maintain a uniform applanation of the
surface of the cornea.
The readings obtained are based on the assumption that a cornea with a 'normal'
thickness is being measured (a different corneal thickness leads to changes in the
measured IOP). A 'normal' corneal thickness is considered to fall within the range of
530 to 560 Micrometers.
If wrong measuring results are suspected, please conduct a functional verification in
accordance with the 'Maintenance' section.
5.2 Prepare the prism for use
The prism tip should be prepared for use by following the manufacturer's
instructions
Tonosafe prism tips and the prism holder have the same mass as the Haag-Streit
Goldmann prism. Conversion of results is not required.
To insert the prism into the prism holder;
1. Lean the tonometer back until the prism holder moves forward
2. Gently pinch together the Tonogrip (cone arm securing buttons) on either side
to hold the prism holder in position
3. With the cone arm buttons pressed and the prism holder out, the prism may
be pushed into place.
5.3 Preparing the patient
Ensure the patient is relaxed before starting the procedure. They should have a normal
heart rate and should be in the correct (e.g. seated, supine) position >5 mins before
taking the reading.
Both eyes must always be anaesthetised (e.g. 2-3 drops each of an
anaesthetic within half a minute) to reduce movements of the lids
during examination.
Place a fluorescein paper strip near the external canthus in the lower conjunctiva sac.
After a few seconds the lacrimal fluid is sufficiently coloured and the paper can be
removed.
Alternatively, combined anaesthetic fluorescein eye drops can be used.
When using drops, a solution of sodium fluorescein 0.25% to 0.5% is advisable.
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