4. Measurement of the
Intra-Ocular Pressure
• Normal IOP: 12-22 mmHg
• Raised IOP can lead to damage of
OPTIC NERVE leading to loss of vision (GLAUCOMA)
7. • Sterilize
• Anaesthetise
• Record
Start with 5.5 gm Weight but if the
reading is <3, add weight to make it
7.5gm/10gm
Because with Schiotz tonom. the
Greatest accuracy is attained if the
deflection is b/w 3-4.
13. Goldmann tonometer
Most popular & accurate
Double prism mounted on a standard slit-lamp
Double prisms
• Applanates the cornea with a diameter of 3.06 mm
19. • The Pulse Air Tonometer releases air over a range of pressures at your eye. At
the same time, an infrared beam of light is shone off your cornea.
• When the cornea flattens out under the pressure of the air, the beam of light
reflects at a different angle.
• When this occurs, the device records the pressure of the air that was required,
measured in millimetres (mm) of mercury (Hg)
23. GONIOSCOPY
● Technique of biomicroscopic examination of angle of
anterior chamber is known as Gonioscopy.
● Device used is Goniolens.
Indirect Direct
provides mirror image provides direct view of of angle.
Angle.
e.g. Goldmann goniolens. e.g. Koeppe goniolens
24. ANGLE STRUCTURES
• As seen behind forward are:
1) Root of iris
2) Ciliary band
3)Scleral spur
4)Trabecular meshwork and Schlemm's canal.
5) Schwalbe's line.
27. PRINCIPLE
It is impossible to visualize angle of anterior chamber by direct examination
due to two reasons i.e. opacity of corneoscleral junction and total internal
reflection of light emitted from angle structures through anterior surface of
cornea.
Hence goniolens is used to divert beam of light to make examination of
angle possible.
Procedure
Patient is seated upright on slit lamp.
A drop of methylcellulose is placed in concavity of goniolens.
With patient looking up one edge of lens is positioned on lower fornix.
Upper eyelid is lifted elevated and patient is instructed to look straight
ahead.
The lens is rotated into position against eye.
28.
29.
30. Applications of Gonioscopy
1) Classification of Glaucoma.
2) Localization of foreign bodies, abnormal blood vessels or tumours in angle.
3) Demonstration of peripheral anterior synechiae(PAS) extent and hence planning of glaucoma
surgery.
4) Surgical aid direct goniolens is used during goniotomy.