Is the air puff test accurate?

[socurious123]

I'm a 23 year old guy, I posted on here 3 years ago (Dr John Hagan might remember).It started 3 years ago at a annual eye check up, my eye-pressure on a puff-test measured 21-22. This sparked a 3 year chain of ''worrying over glaucoma''. I then preceded to a retinal specialist whos 'assistant' with a puff-test (99% sure it was a 'tono-pen puff tester), which measured 27-27! This made my heart sink and a month later I went to a Glaucoma specialist who on a Goldmann measured both eyes at 16-17, and then nearly two years later (corona-virus extended my re-test), I once again measured 16-17, and all through those two years ever 3-4 months I went to a optometrist (a friend/referra  of the glaucoma specialist) who on a machine (not a goldmann but not a hand held tester?) measured around 16-18 every time.

I was given the all clear after numerous test and two thorough glaucoma specialist exams plus the constant reassurance from the friend/referral optometrist. There has always always been one thing I never asked and I wish I did, so here I am. My cornea thickness is 600-615+ in both my eyes, which I was told is why I got a ''inaccurate measurement'' from the very beggining and ''if they had a goldmann I would of never have been in that spiral of test. Now to my question I hope to god I can figure out, even if my eye pressure takes 4-5 off the 'cornea conversion', why did that assistant ever measure 27? Did I squeeze, was I stressed? How come that one time it measured so high - it's still regarded as around 23 if the conversion strips it, but still? out of every single test, only that one ever hit over 20+?. Is it safe to say the puff test can throw the measurements way way off? I know this sounds so silly backtracking, this was all cleared nearly a year ago now... I just wish I had asked what it meant as in the doctors minds I was ''all fine'' but as a 23 year old patient, I got no clue what I'm honestly being told so it just concerns me..

[John C Hagan III, MD, FACS, FAAO]

Nice to hear from  you again and that things turned out well.  Our practice has never used the air tonometer. If was made for techs and other people that did not want, or were not allowed to put in drops (for example large public screenings). The tonopen does not use air. We use it only for people that are severe squeezers or who have orthopedic problems that make it impossible to do the Goldman tonometer.     As to the other part of your question I can't answer. Maybe the tech was having a bad day, or not a very good tech, or maybe you squeezed or flinched.  Not the firs time I have heard that story and other episodes similar to your are posted here.