Skip to main content

Advertisement

Log in

Comparison of intraocular tonometry using three different non-invasive tonometers in children

  • Pediatrics
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Background

In childhood glaucoma, the correct determination of intraocular pressure (IOP) is crucial in clinical decision-making. We therefore investigated how intraocular tonometry readings correlate with readings from commonly used tonometers.

Methods

IOP was measured unilaterally in 20 children suffering from congenital (n = 7) or secondary glaucoma (n = 13), 10 minutes after the induction of general anaesthesia. The children were aged from 1 month to 17 years (mean age 4.3 years, median age 1.3 years). Non-invasive applanation (Tono-Pen XL, Perkins tonometer) and indentation tonometry (Schiötz tonometer) were performed in random order prior to intraocular tonometry with a 26-gauge needle connected to a pressure sensor. Linear regression analysis and the coefficients of variance (CV) were used to compare the data obtained from the various tonometers.

Results

Compared with intraocular pressure, the CV was 10% for the Tono-Pen XL, 17% for the Schiötz, and 19% for the Perkins tonometer. The coefficient of determination (r2) was 0.74 for Tono-Pen XL, 0.60 for Schiötz and 0.78 for Perkins tonometry. The IOP values obtained with the Tono-Pen XL scattered homogeneously around the intraocular IOP, while the Perkins and Schiötz tonometers underestimated intraocular measured IOP.

Conclusion

Of the three tonometers evaluated in this series of paediatric glaucoma patients, the Tono-Pen XL most closely reflected true IOP.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Amaral WO, Teixeira RM, Alencar LM, Cronemberger S, Calixto N (2006) Central and peripheral corneal thickness: influence on the iop measurement by Tonopen. Arq Bras Oftalmol 69:41–45

    Article  PubMed  Google Scholar 

  2. Bhan A, Browning AC, Shah S, Hamilton R, Dave D, Dua HS (2002) Effect of Corneal Thickness on Intraocular Pressure Measurements with the Pneumotonometer, Goldmann Applanation Tonometer, and Tono-Pen. Invest Ophthalmol Vis Sci 43:1389–1392

    PubMed  Google Scholar 

  3. Blumberg D, Congdon N, Jampel H, Gilbert D, Elliott R, Rivers R, Munoz B, Quigley H (2007) The effects of sevoflurane and ketamine on intraocular pressure in children during examination under anesthesia. Am J Ophthalmol 143:494–499

    Article  PubMed  CAS  Google Scholar 

  4. Bordon AF, Katsumi O, Hirose T (1995) Tonometry in pediatric patients: a comparative study among Tono-pen, Perkins, and Schiötz tonometers. J Pediatr Ophthalmol Strabismus 32:373–377

    PubMed  CAS  Google Scholar 

  5. Deuter CM, Schlote T, Hahn GA, Bende T, Derse M (2002) Messung des Augeninnendrucks mit dem Tono-Pen im Vergleich zum Applanations-tonometer nach Goldmann - eine klinische Studie an 100 Augen. Klin Monatsbl Augenheilkd 219:138–142

    Article  PubMed  Google Scholar 

  6. Dietlein TS, Jacobi PC, Krieglstein GK (1996) Klinische Diskrepanz zwischen Schiötz- und Perkins-Tonometrie beim kindlichen Glaukom. Klin Monatsbl Augenheilkd 209:299–303

    PubMed  CAS  Google Scholar 

  7. Dohadwala AA, Munger R, Damji KF (1998) Positive correlation between Tono-Pen intraocular pressure and central corneal thickness. Ophthalmology 105:1849–1854

    Article  PubMed  CAS  Google Scholar 

  8. Eisenberg DL, Sherman BG, McKeown CA, Schuman JS (1998) Tonometry in adults and children. A manometric evaluation of pneumatonometry, applanation, and TonoPen in vitro and in vivo. Ophthalmology 105:1173–1181

    Article  PubMed  CAS  Google Scholar 

  9. Feltgen N, Leifert D, Funk J (2001) Correlation between central corneal thickness, applanation tonometry, and direct intracameral IOP readings. Br J Ophthalmol 85:85–87

    Article  PubMed  CAS  Google Scholar 

  10. Friedenwald JS (1937) Contribution to the theory and practice of tonometry. Am J Ophthalmol 20:985–1024

    Google Scholar 

  11. Goldmann H, Schmidt T (1957) Über Applanationstonometrie. Ophthalmologica 134:221–242

    Article  PubMed  CAS  Google Scholar 

  12. Horowitz GS, Byles J, Lee J, D’Este C (2004) Comparison of the Tono-Pen and Goldmann tonometer for measuring intraocular pressure in patients with glaucoma. Clin Experiment Ophthalmol 32:584–589

    Article  PubMed  Google Scholar 

  13. Kniestedt C, Nee M, Stamper RL (2005) Accuracy of dynamic contour tonometry compared with applanation tonometry in human cadaver eyes of different hydration states. Graefes Arch Clin Exp Ophthalmol 243:359–366

    Article  PubMed  Google Scholar 

  14. Kohlhaas M, Boehm AG, Spoerl E, Pursten A, Grein HJ, Pillunat LE (2006) Effect of central corneal thickness, corneal curvature, and axial length on applanation tonometry. Arch Ophthalmol 124:471–476

    Article  PubMed  Google Scholar 

  15. Krieglstein G, Langham ME (1975) Influence of body position on the intraocular pressure of normal and glaucomatous eyes. Ophthalmologica 171:132–145

    PubMed  CAS  Google Scholar 

  16. Lam DS, Leung DY, Chiu TY, Fan DS, Cheung EY, Wong TY, Lai JS, Tham CC (2004) Pressure phosphene self-tonometry: a comparison with Goldmann tonometry in glaucoma patients. Invest Ophthalmol Vis Sci 45:3131–3136

    Article  PubMed  Google Scholar 

  17. Lee GA, Khaw PT, Ficker LA, Shah P (2002) The corneal thickness and intraocular pressure story: where are we now? Clin Experiment Ophthalmol 30:334–337

    Article  PubMed  Google Scholar 

  18. Levy J, Lifshitz T, Rosen S, Tessler Z, Biedner BZ (2005) Is the tono-pen accurate for measuring intraocular pressure in young children with congenital glaucoma? J AAPOS 9:321–325

    Article  PubMed  Google Scholar 

  19. Liu J, Roberts CJ (2005) Influence of corneal biomechanical properties on intraocular pressure measurement: quantitative analysis. J Cataract Refract Surg 31:146–155

    Article  PubMed  Google Scholar 

  20. Madjlessi F, Marx W, Reinhard T, Althaus C, Sundmacher R (2000) Impressions- und Applanationstonometrie bei pathologischen Hornhäuten im Vergleich mit der intraokularen Nadeldruckmessung. Ophthalmologe 97:478–481

    Article  PubMed  CAS  Google Scholar 

  21. Marx W, Madjlessi F, Reinhard T, Althaus C, Sundmacher R (1999) Mehr als vier Jahre Erfahrung mit der elektronischen, intraokularen Nadel-Druckmessung bei irregulären Hornhäuten. Ophthalmologe 96:498–502

    Article  PubMed  CAS  Google Scholar 

  22. Mirakhur RK, Elliott P, Shepherd WF, McGalliard JN (1990) Comparison of the effects of isoflurane and halothane on intraocular pressure. Acta Anaesthesiol Scand 34:282–285

    PubMed  CAS  Google Scholar 

  23. Mirakhur RK, Shepherd WF, Darrah WC (1987) Propofol or thiopentone: effects on intraocular pressure associated with induction of anaesthesia and tracheal intubation (facilitated with suxamethonium). Br J Anaesth 59:431–436

    Article  PubMed  CAS  Google Scholar 

  24. Nagdeve NG, Yaddanapudi S, Pandav SS (2006) The effect of different doses of ketamine on intraocular pressure in anesthetized children. J Pediatr Ophthalmol Strabismus 43:219–223

    PubMed  CAS  Google Scholar 

  25. Rootman DS, Insler MS, Thompson HW, Parelman J, Poland D, Unterman SR (1988) Accuracy and precision of the Tono-Pen in measuring intraocular pressure after keratoplasty and epikeratophakia and in scarred corneas. Arch Ophthalmol 106:1697–1700

    PubMed  CAS  Google Scholar 

  26. Schiötz H (1905) Ein neuer Tonometer. Arch Augenheilkunde 52:410–424

    Google Scholar 

Download references

Acknowledgement

The authors would like to thank the operating theatre staff and Mr. Graner, both of the University Eye Hospital of Freiburg, for excellent technical assistence.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Julia Lasseck.

Additional information

The authors are fully responsible for all primary data. We permit Graefes Archive for Clinical and Experimental Ophthalmology to review our data.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lasseck, J., Jehle, T., Feltgen, N. et al. Comparison of intraocular tonometry using three different non-invasive tonometers in children. Graefes Arch Clin Exp Ophthalmol 246, 1463–1466 (2008). https://doi.org/10.1007/s00417-008-0863-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-008-0863-y

Keywords

Navigation