There is a widespread belief among the medical profession including some ophthalmologists that the determination of ocular tension by palpation through the lids offers a fairly reliable estimation of the level of intraocular pressure for the diagnosis of glaucoma. Numerous patients with failing vision are seen with irreparable glaucomatous damage to the optic nerve because of undiagnosed glaucoma. Most of these patients have open-angle or chronic simple glaucoma because the insidious nature of the disease had given them no warning. A significant number have lost visual field progressively because someone missed the diagnosis by relying on the tactile method of estimating ocular tension. The normal intraocular pressure ranges up to about 27 mm. Hg as measured with the Schiøtz tonometer. In untreated cases of chronic simple glaucoma (openangle) the tension usually runs higher than this. Although pressures in this condition may range up to 60 mm. Hg as measured with
McDonald JE, Caygill WM. THE UNRELIABILITY OF TACTILE TENSION. JAMA. 1957;165(9):1131–1133. doi:10.1001/jama.1957.72980270001010
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