Following its introduction 60 years ago, Goldmann applanation tonometry (GAT) quickly became the reference standard for the clinical estimation of intraocular pressure (IOP) owing to the device’s simplicity, easy-to-understand principles of operation, reproducibility, and easy integration into the slit-lamp examination. In the article introducing their device, Goldmann and Schmidt1 pointed out that IOP estimates would be wrong if central corneal thickness (CCT) varied much from what they believed to be the mean CCT of 500 µm. A series of small studies validated that prediction in the 1970s,2 but the interaction between CCT and IOP was mostly ignored by clinicians until the Ocular Hypertension Treatment Study showed in 2002 that CCT plays an important role in tonometry, glaucoma diagnosis, and risk assessment.3,4
Brandt JD. Stop “Adjusting” Intraocular Pressure Measurements. JAMA Ophthalmol. 2017;135(6):608–609. doi:10.1001/jamaophthalmol.2017.1035
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