okay so I'm going to do a test that checks the eye pressure.
This is the Icare tonometer.
We don't require any eye drops to numb the front of the eye it just very gently flicks
the cornea, front surface of the eye.
I'm going to take six readings to get an average so if you're ready I'm going to be resting
against the forehead, keep looking into the distance, keep both eyes open and breathe
normally
very good we have a reading of 18mil of mercury there.
let's just check the left
Now for the left keep looking straight ahead as you were, both open, a little closer
and that's six, we have a reading of 18 mil of mercury in the left thank you.
The test that was just performed was Icare tonometry.
The Icare comes
in this case here
foam cushioned inlay.
It protects the device there
lovely foam there
and inside the case we have the handheld, portable,
battery operated, Icare tonometer.
The batteries
are housed in the base here
adjustable head support there for the patient.
Keeps the device nice and steady when performing the test
we load our tonometer probe in there, turn the device on, gives us a little beep
and another.
And it asks us to load the tonometer probe.
We load it.
Press the button.
It magnetizes, stays nicely attached and as you saw we just perform tonometry with the
Icare taking six readings per eye.
Takes the average for the readings.
So with the Icare there is no anaesthetic required for the patient, they hardly feel
the contact, there's no puff of air with this test, just a quick durable device easy to
perform and no calibration required for the ICare there
Now here is a case containing the tonometer probes
just there you can see
they are single use, must be disposed of
When finished we use a fresh one
for each patient
and if you are feeling generous
you can record the patient's intraocular pressure on one of these little recording sheets
and give them a copy.
I also want to note the date and time that tonometry was performed, so that is the Icare
tonometer and all the accessories.
Okay so I'm going to check the pressures of the eyes using the Perkins tonometer.
yYu're not going to feel the probe make contact so keep looking into the distance at one point
keep both eyes open and breathe normally.
Rest there thank you
We have 18 mil of Mercury.
Okay and for the left keep looking straight ahead for me
there we go
That's done thank you.
We have 17 mil of mercury in the left.
The second eye pressure test you saw performed there was Perkins tonometry.
Like the Icare it comes in one of these protective portable cases
so they are excellent for using on domiciliary visits just like the Icare
with this test we have to use anaesthetic in the patient eyes
just looking inside we have the protective
foam to keep the Perkins nice and safe
if we take the Perkins out
it makes lots of clicking noises
here you have your headrest for support for the patient, for keeping the device as steady
as possible
we can adjust the headrest to the desired location and then just lock it in place by
turning the dial here and just turn it on for you
you see the Cobalt blue light LEDs there
this is where we load the tonometer head and the practitioner looks through there, it is
the viewing portal, for lining up the Myers during the test
here is your pressure reading dial, adjust it by moving this here
and wherever we land tells us the pressure reading.
Batteries are housed in the base here
in a nutshell that is the Perkins tonometer
we can either use a reusable tonometer heads or disposable one.
Here is a reusable one so we disinfect the head between patients
okay and we pop this in here
have to line up
like so to keep the mires at the correct orientation
and for anesthetic you may want to consider something like lidocaine.
Fluorescein already contained.
If you're using anaesthetic without the dye then you need to pop some fluorescein in it
separately
that will start on 16.
it's the head
against the eye, observe the mires, align the mires accordingly
it is the Perkins tonometer there a form of a applanation tonometry
okay so I'm just going to do a test that checks the pressure of the eye so you've got your
anaesthetic in that numbs the front.
The probe gently touches the eye for just for a few seconds.
So what I want you to do is keep both eyes open at all times, keep looking at one point
straight ahead and breathe normally
just going to rest against the cornea
very good, try not to blink for me, hold it, there we go
just turn the dial there get the reading
okay
just the other one, keep looking straight just at one point
just rest against the eye there, good
hold it there
okay sit back and relax for me.
Okay keep looking at my right ear, I just want to check the integrity
of the cornea here since I've touched the eye with the tonometer probe
take a blink for me
there doesn't appear to be any staining there, let's just have a look at the left
just looking towards my left ear
good that's all clear.
You can sit back for me
The tonometry test you saw performed on the patient there was Goldmann planation tonometry,
known as the gold standard, performed by all ophthalmologists when you're seen in the eye
clinic, Here is the Goldman
applanation tonometer.
So this is used in conjunction with the slit lamp so it's not really a portable device
like the Perkins and the Icare.
So you have the base of the tonometer here and you just fix this onto the plate that
is housed on the slit lamp
pressure reading dial here
you can see we've already got the tonometer probe lined up and ready to go in the holder
here.
So again we have to use anaesthetic in the patient eyes.
give it at least 20 to 30 seconds to numb the cornea.
Okay this is housed on the slit lamp, we ask the patient to keep both eyes ope,n look at
one point in the distance, breathe normally
and we use the blue light from the slit lamp which excites the dye allowing us to visualize
the mires and we bring it close to the eye
this won't be as steady as the slit lamp but we bring it close, we ask the patient to blink,
and then we rest very delicately on the epithelial surface look through the slit lamp and align
the mires
and come back, ask the patient to relax
and then we take the reading off the scale here.
So that is the Goldman tonometer there
thank you