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Intraocular pressure (IOP) is the fluid pressure inside the eye. Tonometry is the method eye care professionals use to determine this. IOP is an important aspect in the evaluation of patients at risk of glaucoma. [1] Most tonometers are calibrated to measure pressure in millimeters of mercury .
Ocular hypertension is the presence of elevated fluid pressure inside the eye (intraocular pressure), usually with no optic nerve damage or visual field loss. [1] [2]For most individuals, the normal range of intraocular pressure is between 10 mmHg and 21 mmHg. [3]
The higher the intraocular pressure, the harder it is to push against and indent the cornea. For very high levels of IOP, extra weights can be added to make the plunger push harder. [14] The movement of the plunger is measured using a calibrated scale. [14] The Schiøtz tonometer is the most common device to use this principle.
For eye pressures, a value of 28 hPa (21 mmHg) above atmospheric pressure 1,010 hPa (760 mmHg) is often used, with higher pressures leading to a greater risk. [2] [26] However, some may have high eye pressure for years and never develop damage. [2] Conversely, optic nerve damage may occur with normal pressure, known as normal-tension glaucoma. [27]
The Schiotz tonometer consists of a curved footplate which is placed on the cornea of a supine patient. A weighted plunger attached to the footplate sinks into the cornea. A scale then gives a reading depending on how much the plunger sinks into the cornea, and a conversion table converts the scale reading into IOP measured in mmHg.
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The largest letter on an eye chart often represents an acuity of 6/60 (20/200), the value that is considered "legally blind" in the US. Many individuals with high myopia cannot read the large E without glasses, but can read the 6/6 (20/20) line or 6/4.5 (20/15) line with glasses.