Retrospective Audit of Goldmann Applanation Tonometry Measurements in a Consultant-Led Glaucoma Clinic

Debra Gleeson AssocDipAppSc(Orth) 1
Meri Vukicevic BOrth PGDipHlthResMeth PhD 2
Michael Jamieson MBBS BMedSc FRANZCO 1

1 The Royal Victorian Eye and Ear Hospital, Melbourne, Australia
2 Discipline of Orthoptics, School of Allied Health, La Trobe University, Melbourne Australia

Goldmann applanation tonometry is the gold standard for measuring intraocular pressure by indenting or flattening the corneal apex. Accuracy in performing Goldmann applanation tonometry is of high importance as changes to glaucoma treatment are often made based on this measurement. Clinical audits of Goldmann applanation tonometry are crucial for identifying variance within clinics and ensuring quality control. This study reports the finding of three routine clinical audits on a consultant-led glaucoma clinic, comparing measurements taken by orthoptists and medically trained ophthalmologists or registrars. Sixty-six percent of tonometry readings were within acceptable range (±2mmHg) at Audit 1 and this improved to 71% at Audit 3 (p = 0.03). Many factors affect applanation tonometry measurement and the findings of this audit suggest that hands-on training of orthoptic clinicians would be useful to ensure best practice in the technique and thereby reduce the number of erroneous measurements.