Misplaced Pages

This article has multiple issues. Please help improve it or discuss these issues on the talk page. (Learn how and when to remove these messages) This article may need to be rewritten to comply with Misplaced Pages's quality standards. You can help. The talk page may contain suggestions. (April 2023) This article is written like a personal reflection, personal essay, or argumentative essay that states a Misplaced Pages editor's personal feelings or presents an original argument about a topic. Please help improve it by rewriting it in an encyclopedic style. (April 2023) (Learn how and when to remove this message) This article may be too technical for most readers to understand. Please help improve it to make it understandable to non-experts, without removing the technical details. (April 2023) (Learn how and when to remove this message) This article provides insufficient context for those unfamiliar with the subject. Please help improve the article by providing more context for the reader. (April 2023) (Learn how and when to remove this message) (Learn how and when to remove this message)

Armand Imbert (1850-1922) and Adolf Fick (1829-1901) both demonstrated, independently of each other, that in ocular tonometry the tension of the wall can be neutralized when the application of the tonometer produces a flat surface instead of a convex one, and the reading of the tonometer (P) then equals (T) the IOP," whence all forces cancel each other.

This principle was used by Hans Goldmann (1899–1991) who referred to it as the Imbert-Fick "law", thus giving his newly marketed tonometer (with the help of the Haag-Streit Company) a quasi-scientific basis; it is mentioned in the ophthalmic and optometric literature, but not in any books of physics. According to Goldmann, "The law states that the pressure in a sphere filled with liquid and surrounded by an infinitely thin membrane is measured by the counterpressure which just flattens the membrane." "The law presupposes that the membrane is without thickness and without rigidity...practically without any extensibility."

A sphere formed from an inelastic membrane and filled with incompressible liquid cannot be indented or applanated even when the pressure inside is zero, because a sphere contains the maximum volume with the minimum surface area. Any deformation necessarily increases surface area, which is impossible if the membrane is inelastic.

The physical basis of tonometry is Newton's third law of motion: "If you press an eyeball with an object, the object is also pressed by the eyeball."

The law is this:

Intraocular pressure = Contact force/Area of contact

The law assumes that the cornea is infinitely thin, perfectly elastic, and perfectly flexible. None of these assumptions are accurate. The cornea is a membrane that has thickness and offers resistance when pressed. Therefore, in Goldmann tonometry, readings are normally taken when an area of 3.06mm diameter has been flattened. At this point the opposing forces of corneal rigidity and the tear film are roughly approximate in a normal cornea and cancel each other out allowing the pressure in the eye to be inferred from the force applied.

See also

• Eye examination
• Optometry

Notes

1. Goldmann H. "Applanation Tonometry". Transactions Second Glaucoma Conference. New York, Josiah Macy, Jr Foundation. 1957.
2. Koster W. "Beiträge zur Tonometrie und Manometrie des Auges". Graefe's Arch. Ophthalmol. 1895; 41: 113-158.
3. Markiewitz HH. "The so-called Imbert-Fick Law". AMA Arch. Ophthalmol. 1960; 64: 189/159.
4. Whitacre, MM, Stein, R. (1993) "Sources of error with use of Goldmann-type tonometers". Surv. Ophthalmol. 38,1-30
5. Anders Eklund, Per Hallberg, Christina Lindén, and Olof A. Lindahl. (2003) "An Applanation Resonator Sensor for Measuring Intraocular Pressure Using Combined Continuous Force and Area Measurement". Invest. Ophthalmol. Vis. Sci. 2003 Jul;44(7):3017-24.
6. The Glaucoma Book, Paul N. Schacknow, John R. Samples, p.79. Springer, 2010. ISBN 978-0-387-76699-7.

• Pressure
• Ophthalmology