Although rare (if the procedure is performed correctly), a patient may sustain a corneal abrasion while having Goldmann tonometry. Such patients should be managed in accordance with The College of Optometrists clinical Management Guidelines.
For the majority of patients who sustain an abrasion through tonometry, a preservative-free topical lubricant (e.g. Celluvisc 1%), and review the next day, should be sufficient management. It is important that the patient is reassured that while the eye might be quite sore, the problem is not serious.
It is not advisable to give topical antibiotics in this situation, as the risk of infection is very low. Due to increasing resistance to antibiotics, use of antibiotics without the presence of infection is not advised in this situation. For more information visit Antibiotic Guardian.
In the case of a large abrasion, or an abrasion which is not healing. You may wish to refer to eye casualty for management.
If a patient has sustained an abrasion through tonometry, it is important as part of ‘Duty of Candour’ that you explain what has happened. If you have obtained valid consent, the patient should already understand that corneal abrasion was a potential risk of having tonometry.
