{ "id": "ep4x4dxggj", "slug": "rebound-tonometry", "title": "Rebound tonometry", "updated": "2026-10-15", "topic_path": [ { "id": "life", "label": "Life and health", "api_url": "https://www.edgepedia.org/api/v1/topics/life" }, { "id": "life.health", "label": "Human health and medicine", "api_url": "https://www.edgepedia.org/api/v1/topics/life.health" }, { "id": "life.health.clinical", "label": "Clinical assessment and procedures", "api_url": "https://www.edgepedia.org/api/v1/topics/life.health.clinical" }, { "id": "life.health.clinical.clinical-diagnostics", "label": "Diagnosis and clinical assessment", "api_url": "https://www.edgepedia.org/api/v1/topics/life.health.clinical.clinical-diagnostics" }, { "id": "life.health.clinical.clinical-diagnostics.physical-examination-and-clinical-signs", "label": "Physical examination and clinical signs", "api_url": "https://www.edgepedia.org/api/v1/topics/life.health.clinical.clinical-diagnostics.physical-examination-and-clinical-signs" }, { "id": "life.health.clinical.clinical-diagnostics.physical-examination-and-clinical-signs.ophthalmic-and-optic-examination", "label": "Ophthalmic and optic examination", "api_url": "https://www.edgepedia.org/api/v1/topics/life.health.clinical.clinical-diagnostics.physical-examination-and-clinical-signs.ophthalmic-and-optic-examination" } ], "geo": [ { "id": "geo.nongeo.t1946.life.health.clinical.clinical-diagnostics.physical-examination-and-clinical-signs", "label": "Non-geographic · 1946 to 2000: Physical examination and clinical signs", "api_url": "https://www.edgepedia.org/api/v1/geo/geo.nongeo.t1946.life.health.clinical.clinical-diagnostics.physical-examination-and-clinical-signs", "path": [ { "id": "geo.nongeo", "label": "Non-geographic", "api_url": "https://www.edgepedia.org/api/v1/geo/geo.nongeo" }, { "id": "geo.nongeo.t1946", "label": "Non-geographic · 1946 to 2000", "api_url": "https://www.edgepedia.org/api/v1/geo/geo.nongeo.t1946" }, { "id": "geo.nongeo.t1946.life", "label": "Life and health", "api_url": "https://www.edgepedia.org/api/v1/geo/geo.nongeo.t1946.life" }, { "id": "geo.nongeo.t1946.life.health", "label": "Human health and medicine", "api_url": "https://www.edgepedia.org/api/v1/geo/geo.nongeo.t1946.life.health" }, { "id": "geo.nongeo.t1946.life.health.clinical", "label": "Clinical assessment and procedures", "api_url": "https://www.edgepedia.org/api/v1/geo/geo.nongeo.t1946.life.health.clinical" }, { "id": "geo.nongeo.t1946.life.health.clinical.clinical-diagnostics", "label": "Diagnosis and clinical assessment", "api_url": "https://www.edgepedia.org/api/v1/geo/geo.nongeo.t1946.life.health.clinical.clinical-diagnostics" }, { "id": "geo.nongeo.t1946.life.health.clinical.clinical-diagnostics.physical-examination-and-clinical-signs", "label": "Physical examination and clinical signs", "api_url": "https://www.edgepedia.org/api/v1/geo/geo.nongeo.t1946.life.health.clinical.clinical-diagnostics.physical-examination-and-clinical-signs" } ] } ], "excerpt": "Rebound tonometry is a handheld method of measuring intraocular pressure by bouncing a lightweight disposable probe off the cornea, usable in children and by glaucoma patients at home.", "snippet": "Rebound tonometry is a handheld method of measuring intraocular pressure by bouncing a lightweight disposable probe off the cornea, usable in children and by glaucoma patients at home.", "node": "life.health.clinical.clinical-diagnostics.physical-examination-and-clinical-signs.ophthalmic-and-optic-examination", "markdown": "# Rebound tonometry\n\nRebound tonometry is a handheld method for measuring intraocular pressure (IOP) by propelling a lightweight probe against the cornea and analyzing its deceleration and rebound motion. It needs no topical anesthesia or fluorescein, no slit lamp, and a disposable probe, which makes it usable in children without sedation and by patients at home.[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC6047858/) Because IOP measured a few times per year in the clinic misses much of a patient's daily variation, home self-tonometry with these devices can change treatment decisions; in one study, basing judgments on home-measured mean and maximum IOP avoided undertreatment in almost half of the included patients.[2](https://journals.lww.com/sjop/fulltext/2024/10000/home_icare___what_we_already_know.2.aspx)\n\n| Key fact | Detail |\n|---|---|\n| What is measured | IOP, inferred from the inverse of the probe's deceleration time on corneal impact[3](https://www.ovid.com/jnls/glaucomajournal/fulltext/10.1097/ijg.0b013e318285fefd~rebound-tonometer-ideal-tonometer-for-measurement-of) |\n| Probe | 26.5 mg single-use metal probe with a round plastic tip, impacting at 0.25–0.35 m/s[4](https://bjo.bmj.com/content/90/7/833) |\n| Measurement sequence | 6 readings in about 2 seconds; highest and lowest discarded, average of the remaining 4 displayed[5](https://www.nice.org.uk/advice/mib57/chapter/Technology-overview) |\n| Anesthesia and calibration | No topical anesthesia; no routine maintenance or calibration (probe base and batteries replaced every 12 months)[5](https://www.nice.org.uk/advice/mib57/chapter/Technology-overview) |\n| Device cost | Icare TA01i reported at £2,195 excluding VAT in the 2016 NICE technology overview[5](https://www.nice.org.uk/advice/mib57/chapter/Technology-overview) • [5](https://www.nice.org.uk/advice/mib57/chapter/technology-overview) |\n| Agreement with Goldmann | Mean differences from −0.28 to +1.5 mmHg across studies; limits of agreement typically within roughly ±4 mmHg but wider at high IOP and in children[6](https://journals.lww.com/glaucomajournal/fulltext/2025/06000/reliability_of_self_monitoring_of_intraocular.5.aspx) • [7](https://onlinelibrary.wiley.com/doi/10.1111/j.1475-1313.2008.00571.x) |\n| Corneal limits | Manufacturer recommends use only for central corneal thickness 500–600 µm and astigmatism up to 3 diopters[2](https://journals.lww.com/sjop/fulltext/2024/10000/home_icare___what_we_already_know.2.aspx) |\n\n## How it works\n\nThe tonometer contains a pair of coaxial coils: a driving solenoid that propels a lightweight magnetized probe toward the cornea, and a sensing coil that monitors its motion.[3](https://www.ovid.com/jnls/glaucomajournal/fulltext/10.1097/ijg.0b013e318285fefd~rebound-tonometer-ideal-tonometer-for-measurement-of) An electronic timer sends a 30-millisecond current pulse to the solenoid; the resulting magnetic field repels the permanent magnet in the probe and drives it forward.[8](https://doi.org/10.1034/j.1600-0420.2000.078002142.x) After the pulse, the moving magnet induces a voltage in the sensing coil, and this voltage is proportional to the probe's speed; the voltage changes sign when the probe strikes the eye and rebounds.[8](https://doi.org/10.1034/j.1600-0420.2000.078002142.x)\n\nThe quantity most closely correlated with IOP is the inverse of the deceleration time, \\( \\text{deceleration time}^{-1} \\). Deceleration depends on the hardness of the surface struck: the higher the IOP, the faster the probe decelerates and the shorter the contact time, and the device converts this into an IOP value.[3](https://www.ovid.com/jnls/glaucomajournal/fulltext/10.1097/ijg.0b013e318285fefd~rebound-tonometer-ideal-tonometer-for-measurement-of) The iCare probe is a 26.5 mg single-use metal shaft with a round plastic tip (radius 0.9 mm), accelerated to 0.25–0.35 m/s at impact.[4](https://bjo.bmj.com/content/90/7/833) A veterinary variant, the iFalcon Tonovet, instead applies a nonlinear model based on Hertz contact theory, incorporating contact stiffness and impact energy into the IOP calculation.[9](https://pmc.ncbi.nlm.nih.gov/articles/PMC12749333/)\n\n## How it is done\n\nThe practitioner holds the probe tip 4–8 mm from the cornea (3–7 mm for the Icare PRO), perpendicular to the center of the cornea.[5](https://www.nice.org.uk/advice/mib57/chapter/Technology-overview) One measurement sequence acquires six readings in quick succession, each individual contact lasting within 0.1 s; the whole sequence takes about 2 seconds.[5](https://www.nice.org.uk/advice/mib57/chapter/Technology-overview) • [10](https://bmjopen.bmj.com/content/3/4/e001788) The device discards the highest and lowest values and displays the average of the remaining four, together with a quality indication.[5](https://www.nice.org.uk/advice/mib57/chapter/Technology-overview) • [11](https://www.icare-world.com/us/icare-the-original-developer-of-the-rebound-tonometer/) A built-in inclination sensor detects probe errors or wrong positioning and rejects unreliable readings.[12](https://www.nature.com/articles/srep42067) No topical anesthesia or slit lamp is required, and the probe is disposable.[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC6047858/)\n\n## Origin\n\nThe method was reported by Antti Ilmari Kontiola in \"A new induction-based impact method for measuring intraocular pressure,\" published in Acta Ophthalmologica Scandinavica in 2000.[8](https://doi.org/10.1034/j.1600-0420.2000.078002142.x) The underlying idea, deducing eye hardness from the impact and rebound of a probe, had earlier precursors, and the 2000 paper describes the induction-based implementation in which impact duration or maximum deceleration is measured with the probe handheld about 3–10 mm from the eye.[8](https://doi.org/10.1034/j.1600-0420.2000.078002142.x) The scheme is a probe propelled at a set velocity whose sudden velocity reduction and rebound on striking the eye or closed eyelid is converted to IOP by electronics.[13](https://patents.google.com/patent/WO1996006560A1/en) The device was commercialized as the Icare TA01i, released in 2003 by Tiolat Oy (now Icare Finland Oy), Helsinki.[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC6047858/) The United States Food and Drug Administration granted 510(k) clearance to the iCare tonometer in 2007 and to the iCare HOME self-tonometer in 2017.[14](https://eyewiki.aao.org/Home_Tonometry)\n\n## Variants\n\nEarly rebound models included the Icare TA01i, which the 2016 NICE briefing reported as expected to be discontinued in 2017, with the functionally similar Icare ic100 as its successor[5](https://www.nice.org.uk/advice/mib57/chapter/technology-overview), Icare PRO, and Icare HOME (previously Icare ONE); later rebound models include the Icare HOME2 and Icare IC200.[5](https://www.nice.org.uk/advice/mib57/chapter/Technology-overview) The Icare PRO, launched in 2010, added an inclination sensor enabling supine measurement.[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC6047858/) The Icare ic100, an updated TA01i, has been available since 2016.[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC6047858/) The Icare HOME, released in 2014 for self-tonometry, displays no IOP on the device; data are transferred to a computer with Icare LINK software and stored with time, date, eye identification, and per-measurement quality.[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC6047858/) The newer iCare HOME2 adds a small display showing the measured IOP, sensors that automatically recognize the tested eye and head position, and a colored LED guiding positioning with a quality score per measurement.[6](https://journals.lww.com/glaucomajournal/fulltext/2025/06000/reliability_of_self_monitoring_of_intraocular.5.aspx) The Icare IC200 permits measurement in the supine position with 200° of positional freedom.[15](https://link.springer.com/article/10.1186/s40662-021-00249-z) Outside human clinics, the iFalcon, iCare TonoVet Plus, and Reichert Tono-Vera Vet serve veterinary practice, and the lower-cost SUOER SW-500 is aimed at budget users.[9](https://pmc.ncbi.nlm.nih.gov/articles/PMC12749333/) • [16](https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1269332/full)\n\n## Applications\n\n**Screening.** In a normal population, the ICare differed from Goldmann by less than 3 mmHg in more than 80% of cases, supporting its use as a screening tool where Goldmann applanation tonometry is not applicable or not recommended.[17](https://link.springer.com/article/10.1111/j.1475-1313.2005.00327.x)\n\n**Pediatrics.** Rebound tonometry was the preferred method for 70% of children with glaucoma, and a normal reading is likely accurate and may spare the child an examination under anesthesia; however, differences of 10 mmHg from Goldmann were not uncommon in this population.[10](https://bmjopen.bmj.com/content/3/4/e001788)\n\n**Home monitoring.** Glaucoma patients self-measuring with Icare HOME five times per day for a week achieved a mean difference of 0.15 ± 0.65 mmHg against ophthalmologist-measured Goldmann.[12](https://www.nature.com/articles/srep42067) Certification for home use requires patient and provider readings within 5 mmHg of each other and a patient reading range of 7 mmHg or less.[5](https://www.nice.org.uk/advice/mib57/chapter/Technology-overview) In a 2025 study, only 4 of 110 patients could not obtain more than 50% reliable readings.[6](https://journals.lww.com/glaucomajournal/fulltext/2025/06000/reliability_of_self_monitoring_of_intraocular.5.aspx)\n\n**Postural and veterinary use.** Because IOP is higher supine than sitting, supine-capable models matter for diurnal profiling.[18](https://www.dovepress.com/supine-and-sitting-intraocular-pressure-measurements-using-icare-home2-peer-reviewed-fulltext-article-OPTH) In veterinary ophthalmology, rebound tonometers are widely adopted because they need no corneal anesthesia and suit small animals; in rabbits with manometer-regulated IOP of 11–86 mmHg, three devices agreed closely with each other (\\( R^{2} \\) 0.95–0.98).[9](https://pmc.ncbi.nlm.nih.gov/articles/PMC12749333/)\n\n## Limitations and alternatives\n\n**Agreement with Goldmann varies by device generation and IOP level.** Early iCare studies found small overestimation: +1.0 (SD 2.17) mmHg in 101 eyes with 95% Bland-Altman limits of −3.2 to +5.2 mmHg,[4](https://bjo.bmj.com/content/90/7/833) and +1.5 ± 3 mmHg in a nurse-led glaucoma unit, where the difference would have changed therapy or follow-up in 18% of patients.[7](https://onlinelibrary.wiley.com/doi/10.1111/j.1475-1313.2008.00571.x) Newer devices tend to read lower: a meta-analysis of 6 studies (672 eyes) found a pooled Icare PRO minus Goldmann difference of −0.14 mmHg (95% CI −0.43 to 0.15), but with strong heterogeneity (\\( I^{2} = 77\\% \\)).[19](https://doi.org/10.1177/1120672119866067) In 145 glaucomatous eyes, IcarePRO and IC200 read significantly lower than Goldmann, especially at higher IOP.[15](https://link.springer.com/article/10.1186/s40662-021-00249-z) Against non-contact tonometry, both methods showed similar limits of agreement with Goldmann, and neither fulfilled ISO 8612 requirements in that study.[20](https://onlinelibrary.wiley.com/doi/10.1111/j.1755-3768.2009.01774.x)\n\n**IOP-level dependence.** Rebound readings run about 2–3 mmHg higher than Goldmann in the normal 10–21 mmHg range, and up to 8–10 mmHg higher at IOPs of 60–70 mmHg; Bland-Altman slopes confirm increasing overestimation as IOP rises.[3](https://www.ovid.com/jnls/glaucomajournal/fulltext/10.1097/ijg.0b013e318285fefd~rebound-tonometer-ideal-tonometer-for-measurement-of) • [20](https://onlinelibrary.wiley.com/doi/10.1111/j.1755-3768.2009.01774.x) In children, limits of agreement widen from (−8.6, 3.9) mmHg below 21 mmHg to (−21.08, 10.04) mmHg above it.[10](https://bmjopen.bmj.com/content/3/4/e001788) Conversely, newer devices may overestimate at low IOP and underestimate at high IOP, although the pattern varies by device and study.[6](https://journals.lww.com/glaucomajournal/fulltext/2025/06000/reliability_of_self_monitoring_of_intraocular.5.aspx)\n\n**Corneal factors.** Central corneal thickness influences rebound readings as it does Goldmann,[4](https://bjo.bmj.com/content/90/7/833) with overestimation in thick corneas and underestimation in thin ones;[20](https://onlinelibrary.wiley.com/doi/10.1111/j.1755-3768.2009.01774.x) the Icare Pro requires its own formula for CCT correction.[21](https://iovs.arvojournals.org/article.aspx?articleid=2189731) The manufacturer recommends iCare HOME use only for CCT between 500 and 600 µm and astigmatism up to 3 diopters.[2](https://journals.lww.com/sjop/fulltext/2024/10000/home_icare___what_we_already_know.2.aspx) Higher astigmatism affects Goldmann more than rebound.[22](https://journals.sagepub.com/doi/10.1177/1120672120921380) Commentators also note possible effects from medicated eye drops, \"stiff\" corneas associated with diabetes, and myopia.[5](https://www.nice.org.uk/advice/mib57/chapter/Technology-overview)\n\n**Recent evidence.** A 2024 PRISMA review found iCare HOME moderately to accurately matched to Goldmann, with a median underestimation of 1 mmHg and self-tonometry success rates of 67.5–100% (median 82.5%).[2](https://journals.lww.com/sjop/fulltext/2024/10000/home_icare___what_we_already_know.2.aspx) The iCare HOME2's 95% limits of agreement (mean difference −0.28 ± 1.57 mmHg; LoA −3.36 to 2.79 mmHg) were 50% narrower than previously reported for the earlier HOME.[6](https://journals.lww.com/glaucomajournal/fulltext/2025/06000/reliability_of_self_monitoring_of_intraocular.5.aspx) The SUOER SW-500 correlated well with Goldmann (r = 0.89 right eye) but underestimated IOP by 2.96 mmHg in eyes with IOP ≥21 mmHg.[16](https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1269332/full)\n\n## References\n\n1. [Icare® rebound tonometers: review of their characteristics and ease of use](https://pmc.ncbi.nlm.nih.gov/articles/PMC6047858/)\n2. [Home iCare – What we already know (Saudi Journal of Ophthalmology, 2024 systematic literature review)](https://journals.lww.com/sjop/fulltext/2024/10000/home_icare___what_we_already_know.2.aspx)\n3. [Rebound Tonometer: Ideal Tonometer for Measurement of Intraocular Pressure? (Journal of Glaucoma)](https://www.ovid.com/jnls/glaucomajournal/fulltext/10.1097/ijg.0b013e318285fefd~rebound-tonometer-ideal-tonometer-for-measurement-of)\n4. [Comparison of rebound tonometry with Goldmann applanation tonometry and correlation with central corneal thickness (Iliev et al., Br J Ophthalmol 2006)](https://bjo.bmj.com/content/90/7/833)\n5. [Technology overview | Icare rebound tonometer to measure intraocular pressure | NICE MIB57](https://www.nice.org.uk/advice/mib57/chapter/Technology-overview)\n6. [Reliability of Self-Monitoring of Intraocular Pressure With iCare Home2 Rebound Tonometry (Journal of Glaucoma, 2025; Romano et al.)](https://journals.lww.com/glaucomajournal/fulltext/2025/06000/reliability_of_self_monitoring_of_intraocular.5.aspx)\n7. [Comparison of rebound and applanation tonometry in the management of patients treated for glaucoma or ocular hypertension (Ophthalmic Physiol Opt 2008)](https://onlinelibrary.wiley.com/doi/10.1111/j.1475-1313.2008.00571.x)\n8. [Antti Ilmari Kontiola (2000). A new induction‐based impact method for measuring intraocular pressure. Acta Ophthalmologica Scandinavica.](https://doi.org/10.1034/j.1600-0420.2000.078002142.x)\n9. [Comparison of three rebound tonometers in rabbits](https://pmc.ncbi.nlm.nih.gov/articles/PMC12749333/)\n10. [Comparison of handheld rebound tonometry with Goldmann applanation tonometry in children with glaucoma: a cohort study (BMJ Open)](https://bmjopen.bmj.com/content/3/4/e001788)\n11. [The original developer of the rebound tonometer - iCare (manufacturer page)](https://www.icare-world.com/us/icare-the-original-developer-of-the-rebound-tonometer/)\n12. [Agreement of patient-measured intraocular pressure using rebound tonometry with Goldmann applanation tonometry (GAT) in glaucoma patients (Scientific Reports 2017)](https://www.nature.com/articles/srep42067)\n13. [WO1996006560A1 - A method and a device for measuring intraocular pressure](https://patents.google.com/patent/WO1996006560A1/en)\n14. [Home Tonometry - EyeWiki (American Academy of Ophthalmology)](https://eyewiki.aao.org/Home_Tonometry)\n15. [Evaluation of rebound tonometer iCare IC200 as compared with IcarePRO and Goldmann applanation tonometer in patients with glaucoma (Eye and Vision 2021)](https://link.springer.com/article/10.1186/s40662-021-00249-z)\n16. [A comparison of intraocular pressure measurement using SUOER SW-500 rebound tonometer and conventional reusable Goldmann prisms (Frontiers in Medicine, 2024)](https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1269332/full)\n17. [Comparison of the ICare rebound tonometer with the Goldmann tonometer in a normal population (Fernandes et al., Ophthalmic Physiol Opt 2005)](https://link.springer.com/article/10.1111/j.1475-1313.2005.00327.x)\n18. [Supine and sitting intraocular pressure measurements using iCare HOME2 (Dove Medical Press)](https://www.dovepress.com/supine-and-sitting-intraocular-pressure-measurements-using-icare-home2-peer-reviewed-fulltext-article-OPTH)\n19. [Meta-analysis of the concordance of Icare PRO–based rebound and Goldmann applanation tonometry in glaucoma patients (Rödter et al., Eur J Ophthalmol 2019/2020; mirror copy)](https://doi.org/10.1177/1120672119866067)\n20. [Performance of the rebound, noncontact and Goldmann applanation tonometers in routine clinical practice (Acta Ophthalmologica)](https://onlinelibrary.wiley.com/doi/10.1111/j.1755-3768.2009.01774.x)\n21. [Comparison of Three Intraocular Pressure Measurement Methods Including Biomechanical Properties of the Cornea (IOVS)](https://iovs.arvojournals.org/article.aspx?articleid=2189731)\n22. [Icare versus Goldmann in a randomised middle-aged population: the influence of central corneal thickness and refractive errors (Eur J Ophthalmol 2020)](https://journals.sagepub.com/doi/10.1177/1120672120921380)\n\n---\n*Topic: Encyclopedia › Life and health › Human health and medicine › Clinical assessment and procedures › Diagnosis and clinical assessment › Physical examination and clinical signs › Ophthalmic and optic examination*\n\n*Initially written Sep 29, 2026 · Reviewed: Sep 30, 2026 · Edited: Sep 30, 2026; Oct 15, 2026 · Last review: Sep 30, 2026*\n\n*Copyright 2026 EdgeChat AI, a subsidiary of Biostate AI.*\n\nLicense: Edgepedia Community License 1.0, https://www.edgepedia.org/edgepedia/license\n", "same_as": [], "url": "https://www.edgepedia.org/rebound-tonometry", "markdown_url": "https://www.edgepedia.org/rebound-tonometry.md", "license": { "name": "Edgepedia Community License 1.0", "url": "https://www.edgepedia.org/edgepedia/license", "summary": "Free with credit, commercial use included. AI training is open to everyone. For other uses, organizations over USD 100M in revenue or 100M monthly users license separately.", "spdx": "LicenseRef-Edgepedia-Community-1.0" }, "credit": "\"Rebound tonometry\", Edgepedia (EdgeChat), https://www.edgepedia.org/rebound-tonometry. Edgepedia Community License 1.0.", "credit_md": "\"[Rebound tonometry](https://www.edgepedia.org/rebound-tonometry)\", Edgepedia (EdgeChat), [https://www.edgepedia.org/rebound-tonometry](https://www.edgepedia.org/rebound-tonometry). [Edgepedia Community License 1.0](https://www.edgepedia.org/edgepedia/license).", "credit_html": "\"Rebound tonometry\", Edgepedia (EdgeChat), https://www.edgepedia.org/rebound-tonometry. Edgepedia Community License 1.0.", "speakable": "Rebound tonometry is a handheld method of measuring intraocular pressure by bouncing a lightweight disposable probe off the cornea, usable in children and by glaucoma patients at home." }