TONOMETRY ACTUAL EXAM 2024|VERIFIED EXAM QUESTIONS WITH CORRECT DETAILED ANSWERS ALL GRADED A+|LATEST UPDATE |GUARANTEED SUCCESS
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TONOMETRY
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TONOMETRY
TONOMETRY ACTUAL EXAM 2024|VERIFIED EXAM QUESTIONS WITH CORRECT DETAILED ANSWERS ALL GRADED A+|LATEST UPDATE |GUARANTEED SUCCESS
Define tonometry. - ANSWER-Indirect estimation of IOP from determination of resistance of the globe to deformation by an applied force
Why do we measure IOP? - ANS...
TONOMETRY ACTUAL EXAM
2024|VERIFIED EXAM QUESTIONS
WITH CORRECT DETAILED ANSWERS
ALL GRADED A+|LATEST UPDATE 2024-
2025|GUARANTEED SUCCESS
Define tonometry. - ANSWER-✅Indirect estimation of IOP from determination of
resistance of the globe to deformation by an applied force
Why do we measure IOP? - ANSWER-✅- component of CEE
- provide baseline data for future comparison
- *association btwn IOP & glaucoma*
Explain the physiology of IOP - ANSWER-✅- pressure within eyeball is secondary to
production & drainage of aqueous fluid
- regulation of aqueous production & drainage allows for control of IOP
- aqueous secreted from ciliary processes
Where does aqueous drain from? - ANSWER-✅80-90% through TM
10-20% through uveoscleral outflow
Why is Goldmann performed after slit lamp and before dilation? - ANSWER-✅-
anesthetic softens cornea and applanation slightly distorts cornea & blurs vision
- soft cornea allows for better penetration of dilating agents
How does the applanating probe work in a Goldmann tonometer? - ANSWER-
✅contacts cornea and flattens (applanates) circular area of cornea
fluorescein stained tear layer forced away from cornea and around the area of
applanation--> yellow-green ring
prisms double the image
Why should you avoid pushing the tono probe arm back too forcefully when
inserting into holder? - ANSWER-✅calibration could be affected
,Describe the tonometry probe orientation - ANSWER-✅0 deg or 180 deg should be
aligned at which hash (for most pts)
adjust to red hash if corneal astig > 3D
On the tono measuring drum, 1g equals how many mmHg? Each hash equals how
many mmHg? - ANSWER-✅1 g= 10 mmHg
each hash= 2 mmHg
Where do you preset the measuring drum on the tonometer? - ANSWER-✅8-12
mmHg
What do you soak the tono prob in and for how long? - ANSWER-✅10 min in 3%
H2O2
What can happen if you do not properly rinse your tono probe after soaking? -
ANSWER-✅large chemical burn with epithelial defect (pt shouldn't suffer long term
effects)
What is Tonosafe? - ANSWER-✅disposable tonometer prism; reduces risk of cross
infection btwn patients, but very expensive
What DPAs does Goldmann Tonometry require? - ANSWER-✅*sodium fluorescein*
in combo with an *anesthetic*
What is the most common DPA used for Goldmann tono? What are other DPAs used?
- ANSWER-✅Most common: Fluress (benoxinate/NaFl)
Others:
Fluorocaine (proparacaine/NaFl)
Separate drops of proparacaine & NaFl strip
(NaFl allow for measurement, anesthetic is for pt comfort)
What is the purpose of the sodium fluorescein dye during tono? - ANSWER-
✅defines mire pattern
vital dye staining (penetrates any breaks in cell-cell junctions of epithelial cells prior
to and after tono)
What should be included in patient education? - ANSWER-✅- what test being
performed
- purpose of procedure
- what to expect during procedure
- informed consent
- explain diagnostic agents are administered & potential side-effects
- informed consent for drops
, What is the recommended limit of anesthetic drops? - ANSWER-✅2 drops per half
hour (softens cornea)
What do you do if the fluorescein drains but the anesthetic is still effective? -
ANSWER-✅Instill NaFl strip
Describe the Goldmann illumination and slit lamp set up. - ANSWER-✅*45-60 deg*
angle of illumination
Low mag: *6.3x or 10x*
*max illumination*
- max beam of width and height
- no 10% grey filter
- max setting on rheostat
cobalt blue filter
When do you stop moving the probe towards the pt's eye when looking outside
oculars? - ANSWER-✅2-3 mm from apex of cornea
How can ghost mires aid in applanation? - ANSWER-✅know you're well-centered if
ghost probes aren't centered
What are the requirements for mire alignment? - ANSWER-✅- mire size not too thin
or thick
- mire position centered horizontally & vertically
- End point: inside edge of semicircles JUST touch
(top mire size = bottom mire size)
What do you record if you are between measurements on the drum?? - ANSWER-
✅round up
Explain IOP meaurements. - ANSWER-✅no specific 'safe' number
varies between pt's
pt's history plays a role
10-21 mmHg often quoted as avg range
What are IOP measurements outside normal limits? - ANSWER-✅< 6-8mmHg
> 22mmHg
Asymmetry of >/= 3mmHg between eyes
What do you include for IOP documentation? - ANSWER-✅- DPAs administered &
when
- IOP measurement & time of reading
- tono method (G [Goldmann], NCT, Tonopen, Tactile)
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