1. TONOMETRY
TONOGRAPHY
Dr Frank FAMOSE
DVM, CES Ophtalmologie
Ekaterinburg May 2010
Intra-Ocular Pressure (IOP)
1

2. Hypertension : increase of IOP
Hypotension : Decrease of IOP
2

3. IOP evaluation : manometry
3

4. Direct evaluation of IOP
Principles
Utilisation Difficulties
PIO evalutation
►Direct : manometry
►Indirect : tonometry
Tension of ocular globe = pressure
4

5. Digital tonometry
FingerFinger
EyeEye
Indentation tonometry
Tonometer’sTonometer’s
plugplug IndentationIndentation
PressurePressure
EyeEye
Ex : Schi•tz tonometer
5

6. Aplanation tonometry
PlugPlug
Resistance to
deformationdeformation
P = f/A
EyeEye
PressurePressure
Ex : Maklakoff, Mackay MargMarg
Mackay--
Tonopen, Tonovet
Results and variations
Technical
Species
skills
Pupillary
Anesthesia
dilatation
6

7. Red Eye
Corneal
Glaucoma
oedema
IndicationsIndications
Lens
Mydriasis
luxation
Ocular
trauma
7

8. 8

9. 9

10. Practical realisation
►Digital Tonometry
10

11. Practical realisation
►Schiötz tonometry :
instrument
Practical realisation
►Schiötz tonometry :
animal restraint
11

12. Practical realisation
►Schiötz tonometry : measurements
Practical realisation
►Schiötz tonometry : how to get good results?
12

13. Variation factors
Globe
Restraint Cornea
movements
Calibration Cleaning
Practical realisation
►Tonopen : instrument
13

14. Practical realisation
►Tonopen : animal restraint
Practical realisation
►Tonopen : measurements
14

15. Variation factors
Normal
Restraint Calibration
values
Measure Instrument
quality management
Practical realisation
►Tonovet : instrument
15

16. Practical realisation
►Tonovet :
animal restraint
How to choose your tonometer ?
Quality ?
Indirect Scheduled
costing ? use ?
Financial
Simplicity ?
outcomes ?
16

17. Quality ?
Tonopen/Tonovet
Schi€tz Tonometer
Digital tonometry
Just an example…
Overweights Tonopen Schiotz
Price 2500 250
Direct cost/use 10 1
Other costs 0.5 0.5
Nurse cost 0.6 3
Vet cost 0.8 4
Total cost 11.9 8.5
If double use 6.9 8.0
17

18. Tonography
Principle
Calculation
Practical use
of « C »
Examination
Indications
Protocol
Conclusion
Essential evaluation
Equipement necessary
Easy to use
18