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Shiotz Tonometer - Updated

The Schiøtz tonometer was the first reasonably accurate device for measuring intraocular pressure (IOP) trans-corneally, introduced in 1905. It uses different fixed weights that indent the cornea, and the amount of indentation corresponds to a measurement on a scale. Higher scale readings indicate lower IOP due to greater resistance from the sclera. Friedenwald's formula uses measurements from two different weights to estimate the IOP based on a coefficient of ocular rigidity. The procedure involves taking repeated measurements with increasing weight until consistent readings are obtained to determine the IOP in mmHg.

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170 views8 pages

Shiotz Tonometer - Updated

The Schiøtz tonometer was the first reasonably accurate device for measuring intraocular pressure (IOP) trans-corneally, introduced in 1905. It uses different fixed weights that indent the cornea, and the amount of indentation corresponds to a measurement on a scale. Higher scale readings indicate lower IOP due to greater resistance from the sclera. Friedenwald's formula uses measurements from two different weights to estimate the IOP based on a coefficient of ocular rigidity. The procedure involves taking repeated measurements with increasing weight until consistent readings are obtained to determine the IOP in mmHg.

Uploaded by

RAHIL
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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SHIOTZ TONOMETER

SCHIØTZ TONOMETER
• First reasonably accurate trans- corneal indentation tonometer in 1905

USES OF SCHIØTZ TONOMETER


• It is used for continuous measurement of IOP
• It is used in experiment, research work on animal eyes
• Advantages:
• Easy to use, simplicity, low price
• Disadvantages:
• Gives false reading when used in eyes in abnormal scleral rigidity
• False low levels of IOP with low scleral rigidity seen in high myopes and following ocular surgery
PARTS OF SCHIÖTZ TONOMETER :
• Handle: to hold the instrument in vertical position on the
cornea
• Foot plate: rests on the cornea
• Plunger: moves freely within a shaft in the foot plate
• Bent lever: short arm rests on the upper end of the plunger
and a long arm which acts as a pointer needle
• The degree to which the plunger indents the cornea is
indicated by the movement of this needle on a scale
• Weights: 5.5 g weight is permanently fixed to the plunger,
which can be increased to 7.5 and 10gm.
INDENTATION OF CORNEA :

Base plate of
tonometer rests
on cornea.

Plunger of
tonometer
indents the
cornea
PRINCIPLE
• The weight of tonometer on the eye increases the actual IOP (Po) to a higher
level (Pt)
• The change in pressure from Po to Pt is an expression of the resistance of the
eye (scleral rigidity) to the displacement of fluid

P(t) = P(o) + E
• IOP with Tonometer in position
• Pt = Actual IOP Po + Scleral Rigidity E
• Because the tonometer actually measures Pt , it is necessary to estimate Po for
each scale reading & weight
FRIEDENWALD’S FORMULA
• In 1940s, Friedenwald gave a mathematical formula
• Formula has a single numerical constant -
• the coefficient of ocular rigidity (K), which is roughly an expression of the distensibility of the eye
• Average value is 0.025
• He developed a nomogram for estimating K on the basis of two tonometric readings with different
weights

Log Pt2 / Pt1 = K ( V2 – V1 )


• Pt1 & V1 represent the tonometric pressure & volume of the indentation caused by the bar in the
determination made with the first weight
• Pt2 and V2 represent the respective values as obtained with the second weight
• More the plunger indents the cornea, higher the scale reading and lower the IOP
• Each scale unit represents 0.05 mm protrusion of the plunger
PROCEDURE
• Patient should be anasthetised with 4% lignocaine
• In supine position
• Fixation target just overhead
• Examiner separates the lids
• Lower tonometer plate to rest on cornea plunger is free to move vertically
• Scale reading is measured
• 5.5 gm weight is initially used
• If scale reading is 4 or less - additional weight is added to plunger
• IOP measurement is repeated until 3 consecutive readings agree within 0.5 scale
units
• Conversion table is used to derive IOP in mmHg from scale reading and plunger
weight.
THANK YOU

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