Influence of Age, Race, and Corneal Factors on Intraocular Pressure Measurements with Goldmann, Pascal, and Ocular...

To evaluate the influence of age, race, and corneal factors on intraocular pressure (IOP) measurements using Goldmann applanation tonometry (GAT), Pascal dynamic contour tonometry (DCT), and the ocular response analyzer (ORA), and to assess their correlation and agreement.

A cross-sectional study included 231 eyes from 125 healthy individuals. Race was self-reported based on Brazilian Institute of Geography and Statistics criteria. Following anamnesis and ophthalmological examination, ultrasonic pachymetry, corneal curvature, and astigmatism measurements were performed. IOP was measured in random order with GAT, DCT, and ORA by a single examiner. Corneal hysteresis (CH) and corneal resistance factor (CRF) were also assessed.

Age had no significant effect on tonometry readings. Race influenced only GAT measurements, with differences between mixed-race and Black (p = 0.03) and mixed-race and Asian individuals (p = 0.01). Central corneal thickness significantly affected GAT (p = 0.001) and ORA Goldmann-correlated IOP (p < 0.001). Corneal curvature influenced GAT (p = 0.007) and DCT (p = 0.001). CH significantly influenced only the corneal-compensated ORA measurement (p < 0.001). CRF affected GAT, DCT, and ORA Goldmann-related IOP readings (p < 0.001). Tonometry methods showed moderate to strong correlation (r = 0.63-0.86; p < 0.001), but only moderate agreement.

Age did not impact IOP measurements. Race influenced only GAT readings. Corneal properties variably affected all tonometry methods. Although the devices showed strong correlation, the agreement was moderate, highlighting the importance of considering corneal factors and device selection when evaluating IOP.

The study shows that corneal features can affect IOP readings, especially with Goldmann tonometry. Age did not affect the results, and race had a small effect on Goldmann only. Devices correlated strongly but were not interchangeable due to wide limits of agreement. This means eye doctors should consider the type of device and corneal factors when checking IOP.

Doi L, Oshima A, Hossaka S, et al. Influence of Age, Race, and Corneal Factors on Intraocular Pressure Measurements with Goldmann, Pascal, and Ocular Response Analyzer. J Curr Glaucoma Pract 2025;19(4):168-174.