| Popis: |
Tonometry is still an essential component of diagnostic testing in glaucoma. Functional and morphological investigations can provide very detailed information about the extent of glaucomatous damage. They are useful in the early detection of glaucoma damage; when damage is manifest, they are useful in estimating the rate of progression in follow-up studies. In contrast, tonometric procedures are much less perfect and sensitive and provide no information at all about the extent of glaucoma damage. However, they often provide the first evidence that glaucoma may be present at all and they are the decisive parameter in controlling surgical or medical treatment to reduce pressure, as the reduction in intraocular pressure (IOD) is still the most common approach in treating glaucoma - in spite of our awareness of numerous other risk factors for glaucoma. There is no reason to doubt that reducing IOD is an effective therapy in many forms of glaucoma, as this has been demonstrated in numerous large epidemiological studies. Tonometric procedures have become more precise in recent years. Goldmann applanation tonometry (GAT) and pneumatonometry are widely used. There are also some areas for which the rarer forms of tonometry can be recommended. Procedures for quasi-continuous pressure measurements and, in the future, these may replace the current approach of measuring IOD at discrete time points. There are a variety of snares in clinical practice, which may lead to misinterpretation and wrong therapeutic decisions, so that these must be repeatedly emphasised. |
