New ways to measure intraocular pressure.

PURPOSE OF REVIEW: In the last 10 years, several new means to measure intraocular pressure have emerged. This review covers recent findings concerning four new technologies: the ocular response analyzer, dynamic contour tonometry, rebound tonometry and the Proview phosphene tonometer.

RECENT FINDINGS: The ocular response analyzer provides measurements of corneal biomechanics, including corneal hysteresis. Intraocular pressure readings from the ocular response analyzer have correlated well with Goldmann applanation tonometry and seem to be independent of corneal thickness in nonglaucoma patients; however, further studies are needed to determine whether this is true in glaucoma patients. Dynamic contour tonometry also appears to give pressure readings that are independent of corneal thickness. Rebound tonometry is convenient, can be used without topical anesthesia and appears to correlate well with Goldmann tonometry; however, pressure readings from rebound tonometry are not independent of corneal properties. Use of the Proview phosphene tonometer appears to decrease patient anxiety regarding their glaucoma; however, studies have not been supportive of its accuracy.

SUMMARY: Dynamic contour tonometry provides intraocular pressure readings that are less dependent on corneal properties than Goldmann applanation tonometry. Rebound tonometry appears to correlate well with Goldmann tonometry and can be used without topical anesthesia.