[Clinical and experimental evaluation of the so-called Tono-Pen tonometer]

The measuring accuracy and reliability of the new Tono-Pen tonometer, which works on the Mackay-Marg principle, were tested on isolated human and pigs' bulbi and on 24 patients. On isolated pigs' bulbi the Tono-Pen indicated the true pressure, whereas the pressures measured on isolated human bulbi were too high and the range of scatter was wider. On patients' eyes the values obtained with the Tono-Pen correlated well with those measured with the hand applanation tonometer (r = 0.92), although the values measured with the Tono-Pen again higher (mean 4.5 mm Hg). As indicated by autocorrelation of repeated measurements, the Tono-Pen appears to be mainly responsible for the difference between the two instruments. The standard deviation of the autocorrelation of the Tono-Pen values was 4.5 mm Hg, that of the hand applanation tonometer only 1.2 mm Hg. The considerable standard deviation of the Tono-Pen measurements may be due to the structure of the human cornea, and in particular Bowman's membrane. The reproducibility of Tono-Pen measurements is too low for it to be recommended for ophthalmological diagnosis.