Armand Imbert (1850–1922) and Adolf Fick (1829–1901) both demonstrated, independently of each other, that in ocular tonometry the tension of the wall can be neutralized when the application of the tonometer produces a flat surface instead of a convex one, and the reading of the tonometer (P) then equals (T) the IOP," whence all forces cancel each other. __TOC__ History This principle was used by Hans Goldmann (1899–1991) who referred to it as the Imbert-Fick "law", thus giving his newly marketed tonometer (with the help of the Haag-Streit Company) a quasi-scientific basis; it is mentioned in the ophthalmic and optometric literature, but not in any books of physics. According to Goldmann,Goldmann H. "Applanation Tonometry". Transactions Second Glaucoma Conference. New York, Josiah Macy, Jr Foundation. 1957. "The law states that the pressure in a sphere filled with liquid and surrounded by an infinitely thin membrane is measured by the counterpressure which just flattens the membrane." "The law presupposes that the membrane is without thickness and without rigidity...practically without any extensibility."
A sphere formed from an inelastic membrane and filled with incompressible liquid cannot be indented or applanated even when the pressure inside is zero, because a sphere contains the maximum volume with the minimum surface area.Koster W. "Beiträge zur Tonometrie und Manometrie des Auges". Graefe's Arch. Ophthalmol. 1895; 41: 113–158.Markiewitz HH. "The so-called Imbert-Fick Law". AMA Arch. Ophthalmol. 1960; 64: 189/159. Any deformation necessarily increases surface area, which is impossible if the membrane is inelastic.
The physical basis of tonometry is Newton's third law of motion: "If you press an eyeball with an object, the object is also pressed by the eyeball."
The law is this: Intraocular pressure = Contact force/Area of contact
The law assumes that the cornea is infinitely thin, perfectly elastic, and perfectly flexible.Whitacre, MM, Stein, R. (1993) "Sources of error with use of Goldmann-type tonometers". Surv. Ophthalmol. 38,1–30 None of these assumptions are accurate. The cornea is a membrane that has thickness and offers resistance when pressed.Anders Eklund, Per Hallberg, Christina Lindén, and Olof A. Lindahl. (2003) "An Applanation Resonator Sensor for Measuring Intraocular Pressure Using Combined Continuous Force and Area Measurement". Invest. Ophthalmol. Vis. Sci. 2003 Jul;44(7):3017-24. Therefore, in Goldmann tonometry, readings are normally taken when an area of 3.06mm diameter has been flattened. At this point the opposing forces of corneal rigidity and the tear film are roughly approximate in a normal cornea and cancel each other out allowing the pressure in the eye to be inferred from the force applied.The Glaucoma Book, Paul N. Schacknow, John R. Samples, p.79. Springer, 2010. .
See also Eye examination Optometry
Notes