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March 1987

Is Applanation Tonometry a Risk Factor for Transmission of Creutzfeldt-Jakob Disease?

Arch Ophthalmol. 1987;105(3):314. doi:10.1001/archopht.1987.01060030028007

To the Editor.  —Creutzfeldt-Jakob disease is characterized by dementia, myoclonus, ataxia, spasticity, and inexorable neurologic decline. Death usually occurs within one year. The condition can be transmitted by a small subviral agent from neural tissue and has apparently been transferred with donor corneal material during keratoplasty.1 Creutzfeldt-Jakob disease is of special importance to ophthalmologists because patients may present themselves with vision-related complaints long before the diagnosis is considered and at a stage when the diagnosis cannot be made with certainty. These complaints, which include visual field loss, visual blurring, metamorphopsia, and reading difficulties, commonly lead to an examination of the eyes, and applanation tonometry is often performed in the responsible evaluation of such cases. We are concerned that this procedure may represent a small but significant risk for the transmission of Creutzfeldt-Jakob disease and that, owing to the gravity of the illness once it is acquired, this risk cannot