Routine tonometry led to the recognition of glaucoma in 49 out of 1,210 outpatients over 40 years of age tested in a glaucoma detection program of a teaching hospital. For the determination of ocular tension a local anesthetic must be instilled in each eye. The tonometer, with certain precautions to avoid transfer of infections, is placed directly on each cornea. Additional data were furnished by a water provocative test, a tolazoline test, conventional testing of the central and peripheral visual fields, and the new Harrington-Flocks test. The last-named test measures central visual fields and is adapted to mass screening because it eliminates difficulties about the central fixation point by using brief flashes of ultraviolet radiation to illuminate the test pattern. The detection of defects in the visual field was thus facilitated, but the differences observed between the glaucomatous and nonglaucomatous eyes were more striking in the water provocative and tolazoline tests and in disk examinations than in any of the methods of campimetry.
Horsley ME, Lewis PM, Packer H. GLAUCOMA DETECTION IN AN OUTPATIENT DEPARTMENT. JAMA. 1958;166(11):1265–1269. doi:10.1001/jama.1958.02990110001001
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