Abstract
The essential technique of Goldmann tonometry is thought to have a risk of nosocomial infection, and thus there has been pressure to use single-use tonometer tips or slower and more-costly methods of disinfection for reusable tips. Here we review the evidence of infection from tonometry and the evidence behind different disinfection methods. The only infection reported to be transmitted by tonometry is adenoviral epidemic keratoconjunctivitis, which is also transmitted without tonometry and is a relatively low-morbidity infection. More serious eye infections or systemic infections have never been reported to be attributed to tonometry or eye examination. The most popular, affordable, quick and sustainable method of disinfection, using alcohol swabs to wipe the tip, is the only economically justifiable method.