A simulator for Goldmann Applanation Tonometry: a novel approach to training

Abstract BACKGROUND: Goldmann Applanation Tonometry (GAT) is the gold standard technique for measuring intraocular pressure (IOP) and an essential skill required early in clinical ophthalmic practice. Medical students, residents, and ophthalmic technicians often practice on real-life patients or courageous volunteers, increasing the chance of possible cross infections, corneal abrasions, and incorrect IOP measurements. The Goldmann Applanation Tonometry Simulator (GatSim) is a novel online application aimed to act as an adjunct to standard GAT training. METHODS: A website was created using HTML and JavaScript ES6, tested on Google Chrome version 104, and hosted on GitHub. The user interface was designed to provide experiential learning via opportunities to practice the technical components of GAT including tonometer and mires positioning, real-time feedback, and new patient selection. The simulation was tested by our research team to ensure that it appropriately mimicked GAT in the user interface. RESULTS: We developed a web application which simulates GAT. The latest version can be found at gatsim.com. Beginner operators can now gain initial experience on our model before seeing patients, a safety measure which may mitigate potential adverse events and improve overall outcomes. CONCLUSIONS: GatSim is the world’s first online Goldmann Applanation Tonometry simulator. Its utility is impactful, allowing students to learn the mechanics of GAT via an easy-to-use online application while also demonstrating the power of simulation in education. We hope such technology can help develop GAT trainee skill sets, minimize potential complications in the performance of GAT, and provide inspiration for future developments of online simulators.