News Which Tonometer is Right For My Practice?

Goldmann Applanation Tonometry (GAT) is widely regarded as the gold standard for measuring intraocular pressure (IOP), but there are many alternate tonometers on the market that may be a better fit for your staff and your patients. 

While GAT remains a crucial tool in ophthalmology due to its reliability and precision when performed correctly, it does come with several challenges:

1. Learning Curve: GAT requires significant training and experience to perform accurately. This can be particularly challenging for technicians and other non-ophthalmologists 
2. Patient Cooperation: Accurate measurements depend on patient cooperation. Patients must remain still and keep their eyes open, which can be difficult for some 
3. Corneal Properties: Variations in corneal thickness and curvature can affect the accuracy of GAT measurements. Thicker or thinner corneas can lead to overestimation or underestimation of IOP 
4. Use of Anesthetic: GAT requires the application of topical anesthetic, which can be uncomfortable for patients and may cause temporary irritation 
5. Environmental Factors: Factors such as lighting conditions and the cleanliness of the tonometer tip can impact the accuracy of readings 
6. Time-Consuming: The process of aligning the tonometer and obtaining a reading can be cumbersome and inefficient compared to newer, automated devices 

There are some modern devices that represent significant advancements in technology, each offering unique features to improve the accuracy, efficiency, and comfort of IOP measurements and glaucoma screening.

Ocular Response Analyzer

The Ocular Response Analyzer (ORA) from Reichert is a sophisticated instrument that measures corneal biomechanical properties along with IOP. Advantages of ORA include:

1. Corneal Hysteresis Measurement: ORA is the only device that measures corneal hysteresis, a key predictor of glaucoma progression.

2. Corneal Compensated IOP (IOPcc): This measurement is less affected by corneal properties and provides a more accurate assessment of glaucoma risk, without needing a manual CCT adjustment by the operator.

3. Advanced Bi-Directional Applanation System: This system enables precise measurement of corneal hysteresis and IOPcc, while measuring in real-time to ensure the most gentle air puff possible.

4. Ease of Use: The built-in eye tracking software and automated positioning make the ORA user-friendly. There is no joystick or manual alignment required.  Your practice may save time by eliminating the need for anesthetic drops, or high-level disinfection of components.

Tono-Pen AVIA

The Tono-Pen AVIA is a handheld tonometer designed for measuring intraocular pressure (IOP) with ease and precision. Tono-Pen AVIA boasts advantages such as:

1. Calibration-Free: The Tono-Pen AVIA does not require calibration, making it always ready for use 
2. Quick-Tap Measurement Mode: This feature allows for faster IOP measurements, often in as few as two taps 
3. Ergonomic Design: Its award-winning design ensures comfort for both the operator and the patient 
4. Statistical Confidence Indicator: This feature provides more reliable readings by indicating the confidence level of each measurement 
5. Minimized Cross-Contamination: The use of sanitized Ocu-Film® Tip Covers reduces the risk of patient cross-contamination

Tono-Vera Tonometer

The Tono-Vera Tonometer is another advanced device for measuring IOP, featuring innovative technology to enhance accuracy and ease of use. Its advantages include:

1. ActiView™ Positioning System: This patented system guides the user to the apex of the cornea, ensuring precise measurements 
2. Gentle Rebound Technology: This technology eliminates the need for topical anesthetic, making the process more comfortable for patients 
3. Objective and Repeatable Results:  Tono-Vera provides consistent and reliable IOP readings and automatically measures when aligned, reducing the possibility of user error or interpretation of results
4. In the clinic or on the go:  Boasting an interchangeable battery pack offering AA or rechargeable lithium ion battery options, Tono-Vera has you covered whether you are on the road or in the clinic charging between patients.