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Extra resources for Becker-Shaffer’s diagnosis and therapy of the glaucomas.
One approach has used resonance applanation tonometry measuring the sonic resonance of the eye when a continuous force over a fixed area is applied. 173 Infrared spectroscopic measurements correlate with IOP as measured by manometry in pig eyes. A newer approach has been to build a miniature pressure sensor that can reside inside the eye; one such device is part of an intraocular lens. The development of a device which can easily monitor IOP over a 24-hour period or longer would greatly aid our understanding of aqueous humor dynamics and glaucoma.
After each use, the tonometer plunger and footplate should be rinsed with water, followed by alcohol, and then wiped dry with lintfree material. It is important to prevent foreign material from drying within the footplate because this affects the movement of the plunger. The most common ‘foreign material’ that finds its way onto the plunger tip is fluid from the patient’s tear film. The instrument can be sterilized with ultraviolet radiation, steam, ethylene oxide, or a variety of solutions that have been indicated for the Goldmann prism.
198 Except for age and positive family history, these correlations did not hold for actual glaucoma. It is unclear whether the rise in IOP with age represents an increase for all individuals or a greater skewness of the data – that is, a greater minority of the people having higher pressure while the majority show no change. 205 This suggests that some differences in IOP exist between different age groups that can not be explained by chronologic aging. 194,208,209 In part, this difference appears to be racial or genetic.