When I first learned how to do Goldmann, I was so scared because I thought I was going to hurt my patients. I was dreading checking pressures, especially on patients who couldn’t keep their eyes open. On my last rotation I learned a trick that has made me get much better at checking pressures (even on those blinkers!).
1.Have your patient look down and get the tonometer tip really close to their eye.
2.Grab the upper lashes and pin them onto the upper orbital rim.
3.Have the patient look straight or give them a fixation point before having her or him look down.
4.Check your pressure!
I haven’t had to hold onto their bottom lid after I started doing this, but if you have to, use your thumb of the same hand (hand that you are holding upper lid) and pin it onto lower orbital rim.
With a little practice, you’ll be able to check those pressures quickly and efficiently!