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Accuracy of Goldmann tonometry in clinical practice
S Sudesh1, M J Moseley, J R Thompson
1Birmingham and Midland Eye Hospital, UK.
Acta Ophthalmologica
|April 1, 1993
Summary
Goldmann applanation tonometry showed significant inter-observer variability in intraocular pressure (IOP) measurements. Training improved IOP readings, but differences of 2-3 mmHg still occurred between tonometrists.
Area of Science:
- Ophthalmology
- Optometry
- Clinical Measurement
Background:
- Goldmann applanation tonometry is a standard method for measuring intraocular pressure (IOP).
- Variability in IOP measurements can impact glaucoma diagnosis and management.
- Understanding observer variability is crucial for reliable clinical practice.
Purpose of the Study:
- To assess the intra- and inter-observer variability of Goldmann applanation tonometry.
- To evaluate the effect of brief revision training on tonometrist performance.
- To quantify the magnitude of measurement differences between observers.
Main Methods:
- Eight hospital tonometrists performed Goldmann applanation tonometry on 16 glaucoma patients.
- Four tonometrists received brief revision training.
- Multiple readings were taken from individual eyes, and measurements were compared between different observers.
Main Results:
- Intraocular pressure (IOP) measurements showed no significant intra-observer variability over four readings.
- A notable decline in IOP was observed when a second tonometrist measured the same eye.
- Approximately 25% of measurements differed by 2 mmHg or more, and 20% by 3 mmHg or more, between observers.
Conclusions:
- Significant inter-observer variability exists in Goldmann applanation tonometry.
- While training may influence readings, substantial measurement differences persist between tonometrists.
- These findings highlight the need for standardized training and quality control in IOP measurement.