To the Editor.
—The report by Pogrebniak and Sugar1 in the November 1988 issue of the Archives pointed out the potential corneal toxicity from hydrogen peroxide soaked tonometer tips. Fortunately, that case showed clearing of the cornea within 2 days. I recently encountered a more severe corneal burn from a tonometer tip that had been cleaned with a 3% solution of hydrogen peroxide. In this case, hydrogen peroxide had been applied to the tonometer tip 30 minutes before using it on a patient. Because of the fear of viral transmission, the peroxide had not been irrigated. The tip was moist at the time the pressure was taken. The patient noted blurred vision and pain following the examination.By the next day, the patient had a perfect "O-shaped" opacity in the anterior stroma that was identical in size to the tip of the applanation tonometer. The opacity was displaced slightly
Levenson JE. Corneal Damage From Improperly Cleaned Tonometer Tips. Arch Ophthalmol. 1989;107(8):1117. doi:10.1001/archopht.1989.01070020183011