Corneal Abrasion due to Applanation Tonometry. Clinical Audit to Reduce the Incidence of Corneal Abrasions After Applanation Tonometry

JOURNAL TITLE: Highlights of Ophthalmology

1. Chaitali Patel
2. Sonal Sisodia
3. Samir Bhavsar
Publishing Year
Author Affiliations
    1. Ophthalmologist, Shree Krishna Hospital and Pramukhswami Medical College, India
    1. Ophthalmologist, Department of Ophthalmology, Pramukhswami Medical College and Shree Krishna Hospital, Bhaikaka University, Karamsad, Anand Gujarat, India
    1. Ophthalmologist, Pramukhswami Medical College, And Shree Krishna Hospital, Bhaikaka University Karamsad, Anand Gujarat, India
  • Article keywords
    Clinical audit, re-audit, Applanation tonometer, Corneal abrasion


    Aim: To decrease the rate of corneal abrasions after measuring intraocular pressure (IOP) by applanation tonometry. Method: Intraocular pressure measurement is a routine procedure, mainly in patients above the age of 40 years, known patients of glaucoma and glaucoma suspects. In a teaching institute like ours, this procedure is commonly carried out by the second and third year residents, using a Goldman applanation tonometer. In our institute it had come to our notice that after this procedure, quite a few patients had complaints of pain and foreign body sensation, suspected to be due to the iatrogenically created corneal abrasions. Thus, to minimize the incidence of corneal abrasions, clinical audit was carried out. Audit was done on 50 patients (100) eyes. The data was analyzed using Microsoft excel. A sensitization of the residents was carried out, to improve the technique. After few months re-audit was done on another 39 patients (78 eyes). Result: Data compilation was done and analyzed. In audit, around 29% of patients reported with corneal abrasion against a set target of 0%, and the result significantly improved to 13% after the entire process of re-audit. Conclusion: Measurement of IOP by applanation tonometry can be a significant factor in the cause of corneal abrasion, especially when done by residents. This may cause patient discomfort as well as serious corneal complications, thus endangering vision. Clinical Significance: Audit provided a scope in the improvement of the procedure of Applanation Tonometry, thus leading to better patient safety and satisfaction.

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