Transpalpebral Tonometry H.v.Below, O.Riemer Common practice for ambulant and stationary ophthalmology Grimma/Sachsen

Tonometry variants optical manuel palpation Schiötz (impression dependent on weight) applanation according to Goldmann air pulse digital and similar impression techniques

Why should you look for new ways to measure intraocular pressure ?? children wounded cornea (erosio, ulcer, etc.) pre-, intra- and postoperative Z.n. Lasik Z.n. perf. KPL e.g. cornea plana keratoconus Z.n. Intact consulting bedridden patients, etc. endocrine orbitopathie developing countries

This new way of measuring was invented 1997 in Russia 173,5 x 25,5 x 19,5 79 gram

Methods 1)bilateral applanation and transpalpebral tonometry, three times measurement 2)Correlation creation of tensio values for normal and glaucoma eyes 3)Gaining experiences with transpalpebral tonometry

What‘s the innovation? F el = m (g) x a (m/s) tonus = F el ________________________ pin surface no anaesthesia no bulbus contact no risk of infection absolute painless mobile low expense simple calibration more harmless then Schiötz m a F

The course of measuring The angle between the patient‘s line of sight and the horizontal should approximately be 45 degrees. As orientation for the 45 degrees you may use the patient‘s finger. The horizontal distance should match the vertical one. Put the tonometer‘s end with his flat side upon the front edge of the upper eyelid‘s gristle, in order that the tonometer‘s end symmetrical axis points straight through the eye‘s center. Let‘s look at an example: The tonometer has been activated and it has been explained to the patient, in which direction she has to look at for the duration of the measuring. The patient‘s head is stabilized by the ophthalmologist‘s free hand. Now the tonometer is put into the right position. The tonometer is softly lowered until the measuring is acoustically signaled. The tonometer can be removed from the patient‘s eyelid and the measured value of the intra-ocular pression is digitally displayed. Here another example from a different angle: The angle between the patient‘s line of sight and the horizontal is 45 degrees, the tonometer is put vertically upon the upper eyelid‘s gristle. After lowering the tonometer, the measuring will be executed and the measured value can be read from the tonometer‘s digital display.

65 patients:42 females, 23males normal eyes:49avg. value Goldm.:13,5+/- 2,5 avg. value. TGD:15,0+/- 3,3 glaucoma eyes:16 avg. value Goldm.:18,3+/- 4,79 avg. value TGD:19,1+/- 6,02 8 POWG 5 steroid secondary glaucoma 1 Lasik, 3 KPL, 1 iritis 2 Phtisis 1 WBG measured in mmHg with standard deviation Patients and results

applanation TGDc mmHg 25 mmHg correlation coefficient r=0.80 in glaucoma eyes P< 0,001 r=0.88 in normal eyes P< 0,001 ResultsResults

strong neck situation while sitting Disadvantages unexperienced may take wrong glaucoma precaution later a technical perfection may be possible a little more inaccurate than applanation measurement sometimes easier while lying cave tarsus pathology, e.g. trachoma? only with learning curve applicably

Svyatoslav Fyodorov An advocator of the new method

An unique way of Transpalpebral tonometry Maybe the tonometer will be soon as common as the thermometer is at home

Conclusion Applicable on children Pre-, intra- and postoperative applicative Realistic values for wounded cornea For consulting purposes it replaces schiötz tonometer More sensitive with endocrine orbitopathy With Lasik not wrongly low With keratoconus not wrongly low More hygenically More painless More economically Also applicable in a practice under water. A new method to detect glaucoma

contact If this presentation should has aroused your interest in the Tonometer TGDc-01 "PRA", and you wish yourselves closer information, or you wish to place an order, then please use the listed contacts below. P.S. Art Design GmbH Kirchstraße Groß-Gerau Tel.: /81422 Fax: /