Optometric Management Tip # 132   -   Wednesday, July 28, 2004
Non-contact tonometers... they get no respect

There are a few topics that optometrists are pretty divided on, even passionate about, and air puff tonometry is one of those. Lots of ODs use non-contact tonometers (NCT) on a daily basis in practice, but a huge segment thinks the devices are not worthy. I’m in the camp that thinks they have a lot of value, so much so that I’ll present the topic as a tip worth considering to colleagues who don’t have one. I think NCTs have received an undeserved bad rap in many circles. I’ve heard them referred to as boat anchors. I say take another look at them.

First, let me acknowledge that Goldmann applanation is the standard that all tonometers are compared with, and it is the preferred instrument to diagnose and treat glaucoma with. All my exam rooms are equipped with applanation tonometers on the slit lamp, and we perform the test many times per day. But there is a big advantage to delegating routine tonometry to qualified technicians as a pre-test, and NCT is the easiest way to do that. NCTs are not intended to replace Goldmann in a practice, but to be used with Goldmann.

Here are some common myths about air puff tonometers. See if you believed any of these, and see if I can change your mind.

Best wishes for continued success,

Neil B. Gailmard, OD, MBA, FAAO
Chief Optometric Editor, Optometric Management