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Goldmann applanation tonometry without fluorescein

D C Bright, J W Potter, D C Allen

    American Journal of Optometry and Physiological Optics
    |December 1, 1981
    PubMed
    Summary
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    Performing Goldmann applanation tonometry without fluorescein leads to lower intraocular pressure readings. These inaccuracies increase with higher pressures, potentially misrepresenting glaucoma risk.

    Area of Science:

    • Ophthalmology
    • Optometry
    • Clinical Measurement

    Background:

    • Goldmann applanation tonometry is a standard method for measuring intraocular pressure (IOP).
    • Recent discussions have explored the possibility of performing this procedure without fluorescein dye.

    Purpose of the Study:

    • To evaluate the clinical efficacy and accuracy of Goldmann applanation tonometry performed without fluorescein.
    • To compare IOP measurements obtained with and without fluorescein dye.

    Main Methods:

    • A randomized study involving 100 consecutive patients.
    • Applanation tonometry was performed on each patient both with (Fluress) and without (Ophthetic only) fluorescein.
    • A predetermined randomization schedule ensured unbiased comparison.

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    Main Results:

    • A significant average difference of 7.01 mm Hg was observed between readings with and without fluorescein.
    • Tonometry readings were consistently lower when fluorescein was omitted.
    • Regression analysis revealed that the discrepancy in readings increased proportionally with elevated intraocular pressure.

    Conclusions:

    • Omitting fluorescein during Goldmann applanation tonometry results in underestimated IOP measurements.
    • Measurement errors are exacerbated at higher intraocular pressures, posing a risk for accurate glaucoma assessment.
    • The clinical utility of Goldmann applanation tonometry without fluorescein is questionable, particularly for high-risk patients.