The non-contact tonometer. Its value and limitations.

A review of the literature and a comparative study against Goldmann applanation tonometers suggest that the non-contact tonometer is reliable for measuring intraocular pressures within the normal range. In addition, the non-contact tonometer eliminates the need for corneal contact and topical anesthesia, thereby avoiding the potential problems of corneal abrasion, spread of infection, and drug reactions. The instrument can be used reliably by paramedical personnel and has particular value in mass screening and possibly in studies of topical antiglaucoma drugs. The non-contact tonometer is less reliable in patients with elevated intraocular pressure, since comparative studies against the Goldmann applanation tonometers have shown poorer correlations in the higher pressure ranges. The instrument is also limited by an abnormal cornea or poor fixation, which may interfere with accurate pressure measurements. Furthermore, the non-contact tonometer is less portable than many tonometers and more expensive than most.