Concordance between the new modular slit-lamp mounted Goldmann applanation tonometer (GAT), conventional slit-lamp mounted GAT, and Perkins tonometer

Indian J Ophthalmol. 2025 Dec 1;73(12):1786-1791. doi: 10.4103/IJO.IJO_2743_24. Epub 2025 Nov 24.

Abstract

Purpose: To evaluate a new device, the Goldmann applanation tonometer (GAT) mounted on a novel handheld 3D-printed modular slit lamp (MSL), and compare it with the gold standard slit-lamp-mounted GAT and the handheld Perkins tonometer.

Methods: One hundred eyes from 100 participants were included in this cross-sectional observational study. The MSL mount was customized for the selected tonometer (Model AT030, Carl Zeiss, India). A Samsung Galaxy S2 mobile phone was used for observing mires and photography during tonometry. One observer measured intraocular pressure (IOP) with slit-lamp GAT, and another observer measured with MSL GAT and Perkins tonometers. The tonometry sequence was slit-lamp GAT, MSL GAT, and Perkins tonometer, with a 5-minute interval between readings.

Results: The median age of participants was 56 years (range: 16-83). The median IOP by slit-lamp GAT was 15 mmHg (range: 9-41). Tonometers were compared in pairs: slit-lamp GAT and Perkins, slit-lamp GAT and MSL GAT, and Perkins and MSL GAT. The pairwise Spearman rank correlations were 0.988, 0.988, and 0.983 (all P < 0.001). The mean differences in IOP (95% limits of agreement) were 0.5 (-0.6 to 1.6), 1.2 (0 to 2.4), and 0.7 (-0.7 to 2.1) mmHg, respectively.

Conclusion: The MSL-mounted GAT provides reliable IOP readings with minor underestimation (within 2 mmHg in 88% of cases), suggesting its potential utility in clinical practice as a portable slit lamp and anterior segment imaging device.

Keywords: 3D-printed tonometry model; Goldmann applanation tonometry; glaucoma screening; hand-held tonometer; intraocular pressure; modular slit lamp; portable tonometer; tonometry innovations.

Publication types

  • Observational Study
  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Equipment Design
  • Female
  • Glaucoma* / diagnosis
  • Glaucoma* / physiopathology
  • Humans
  • Intraocular Pressure* / physiology
  • Male
  • Middle Aged
  • Reproducibility of Results
  • Slit Lamp Microscopy* / instrumentation
  • Slit Lamp*
  • Tonometry, Ocular* / instrumentation
  • Young Adult