[4247163]
During the intraocular pressure test, the goldmann applanation tonometer measuring prism tip was applied to bilateral eyes to assess the intraocular pressures. Following this assay, the patient began to complain of discomfort and blurred vision in both eyes. After an examination of the patient's eye, it was determined the patient sustained circumferential cornea irritations, which lined up directly with the tonometer measuring prism tip used in the intraocular pressure test. Upon review of the event and examination of the equipment, it was noted that the tonometer measuring prism tip used on the patient and several other tonometer tips appear to have cracking and erosion of the applanation tip which comes in contact with the eye. The staff has been cleaning the tips with the manufacturer's recommended cleaners (sodium hydrochlorite and hydrogen peroxide), yet the tips continue to be damaged during the cleaning process. Due this event and the quantity of damaged tonometer measuring prisms, despite following the manufacturer's cleaning instructions, we are now using disposable measuring prisms.
Patient Sequence No: 1, Text Type: D, B5