Reichert’s seventh generation non-contact tonometer at first appears big. Measuring 19.75 in x 10.5 in x 14 in, it certainly encompasses more space than a goldmann applanation device. That said, what’s inside this machine gives it multiple advantages over traditional IOP monitors.
As in previous generations, anesthetic drops are not required for measurements to be taken. The force and sound of the air puff have been decreased, and the measurement process has become completely automated. After the patient rests his/her forehead against the upper bar, the technician asks the patient to fixate on the central target (these instructions are even listed on the monitor for the examiner to read). Once the measure icon is depressed, alignment of the cornea and measurement are entirely performed by the machine within seconds. Intraocular pressure is listed on the screen and can be either printed by the device or, via USB port, transmitted to a computer.
Figure 1: The Reichert 7 Auto Tonometer; Patient view, Operator view
In practice, the tonometer performed outstanding. Technicians who had never used an NCT before were quick to learn the device and found it “extremely easy to use”. Patients and staff who had previously had NCT performed indeed found the air puff to be “less irritating” and “overall comfortable” compared to previous experiences. The tonometer offers both 1 and 3 puff measurements, but to test reliability we performed multiple one puff measurements on the same patients and found the results to be 100% consistent. While three puff measurements were less comfortable than 1 puff measurements, those patients surveyed stated that they would rather have the NCT to check their pressure if it meant they would not need to have anesthetic drops administered.
Figure 2: The Reichert 7 Auto Tonometer in Use
This brings up an important issue for today’s practicing ophthalmologist. As we are looking to increase office productivity and improve patient experiences, “drop-free” eye exams for general ophthalmology may be a possibility. With devices such as non-mydriatic fundus cameras, small pupil slit lamp lenses, and non-contact tonometry, this seems a very viable option.
Overall, this is a fantastic machine that offers almost the all bells and whistles possible. While its USB port is a welcome addition for those physicians now using EMR, it is unfortunate that the developers did not build in wireless networking. For that reason, and that reason alone, I cannot give the device a perfect 10/10 but 9.5/10.
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