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Year : 1983  |  Volume : 31  |  Issue : 6  |  Page : 713

Differential tonometry in myopia

Sarojini Devi Eye Hospital Institute of Ophthalmology, Hyderabad, India

Correspondence Address:
H Prabhakara Reddy
Sarojini Devi Eye Hospital, Institute of Ophthalmology, Hyderabad
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Source of Support: None, Conflict of Interest: None

PMID: 6676249

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How to cite this article:
Reddy H P, Jayanthi K. Differential tonometry in myopia. Indian J Ophthalmol 1983;31:713

How to cite this URL:
Reddy H P, Jayanthi K. Differential tonometry in myopia. Indian J Ophthalmol [serial online] 1983 [cited 2023 Dec 10];31:713. Available from: https://journals.lww.com/ijo/pages/default.aspx/text.asp?1983/31/6/713/29307

In performing tonometry, we endeavour to determine the Intra-Ocular-pressure as close to the steady level i.e Po as possible. All to­nometers in use today work on the principle of applying a force to the eye and measuring the deformation produced. Since tonometry in­volves the application of a force to the eye it is inevitably accompanied by a rise of 1.O.P. It is this articifially elevated pressure, usually termed pt, which is measured directly by the tonometer. The pressure which is of clinical in­terest, however, is the pressure Po which existed in the undisturbed eye before the to­nometer was applied. It is important to recog­nise that for indentation tonometers like Schiotz tonometer, the difference between Po & Pt is large. Nevertheless the most frequently used tonometer worldwide is the Schiotz inde­ntation tonometer despite clear evidence that the problem of ocular rigidity involved in inde­ntation tonometry cause misleading results in the individual eye. (Hetland-Erisan 1966, Smith 1967, Leydhecker 1973). When the ocu­lar rigidity differs slightly from normal, the error in deducing the true IOP Po may be neg­ligible, but in a small proportion of eyes, the rigidity may be so far removed from normal that the error becomes clinically significant. It will he remembered that the general effect is that the Schiotz tonometer tends to over-esti­mate the Po in eyes of high rigidity and to under-estimate Po in eyes of low rigidity.

In order, to overcome this defect. Frieden­wald proposed the so-called method of "DIFFERENTIAL TONOMETRY" in which a reading is taken with one weight on the Plunger and then a second reading' in taken with a different weight. By referring the nomogram Po and Ocular rigidity can be de­termined.

In general the problem of making a diag­nosis of glaucoma in a pt. with myopia pre­sents unusual difficulties. The low ocular rigid­ity in many of these eyes result in Schiotz read­ings within normal limits. Their true status is revealed by applanation tonometry. However because of the simplicity of the Technique and the cheapness and Portability of the Instru­ment Schiotz tonometer is still most frequently used all over. Differntial Tonometry used cor­rectly can provide information which is morevaluable clinically than that given by a single reading with the schiotz Tonometer.

In this study,we compared the I.O.P. read­ings obtained by Differential Tonometry and Goldmanns tonometer in cases of Myopia. Results are compared and Advantages and disadvantages of Differential tonometer, and Goldmann tonometer are Highlighted.


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