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  • Ophthalmic tonometers designed to determine intraocular pressure by measuring the force required to flatten the cornea apex by a fixed amount. These instruments are typically small and reusable instruments and are attached to a slit lamp; the tonometer includes a tip to be applied to the cornea and a manually controlled spring that applies a variable force on the cornea through the tip. The application of the tonometer tip flattens the cornea, producing a thin circular outline that is split into two green semicircles when viewed through the slit lamp oculars; then the force applied is adjusted until both semicircles just overlap and the force value is shown in the instrument scale as pressure (typically in mm Hg). Handheld (electronic penlike devices) and pneumatic applanation tonometers (i.e., pneumatotonomers) are also available. Applanation ophthalmic tonometers (e.g., Goldman and Barraquer types) can measure the amount of force applied; they are intended mainly for assessing ocular hypertension (intraocular pressure between 10 and 24 mm Hg is considered normal), usually to screen patients for glaucoma.
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