Ophthalmic device for self-tonometry

Abstract

The ophthalmic instrument for self-tonometry comprises a body housing a measuring device for measuring intraocular pressure in a user's eye and at least one anatomical fixation point for adjusting the distance between the anatomical fixation point and the center of the user's eye. An ocular identification device attached to the body allows identification of the left or right eye being measured using a gyroscope or other sensor.

Description

[Technical field]

[0001] The present invention relates to devices for the self-measurement of intraocular pressure, and in particular to the structure-function relationship between a user and their eye(s). [Background technology]

[0002] Measurement of intraocular pressure (IOP) is important for the assessment of ocular health. Glaucoma is a chronic progressive blinding disease that is monitored by measuring intraocular pressure and treated by lowering intraocular pressure.

[0003] Intraocular pressure is measured using a device called a tonometer. Goldmann tonometry (GAT) remains the reference standard tonometry and involves measuring the force required to flatten the cornea using a prism of known surface area. However, GAT is limited in its use, requiring the injection of anesthetic drops, bulky and expensive equipment, and difficult patient positioning. Additional methods of tonometry have been described, such as US Pat. No. 5,399,433, which uses a non-contact method, where compressed air is sprayed onto the cornea and tissue deformation is then measured.

[0004] Intraocular pressure measurements are most commonly performed in a clinic by a trained healthcare provider. Measurements are taken at single and discrete time points, infrequently, often months apart. However, in reality intraocular pressure has diurnal variations with troughs and peaks. Studies have shown that over 50-75% of IOP peaks occur outside of clinic hours. Thus, a single IOP measurement by tonometry in a clinic does not accurately portray a patient's true IOP profile and subsequent risk of vision loss.

[0005] Thus, there is a need for an ocular pressure measurement device that patients can use to check their own pressure at home to capture IOP data that would otherwise be missed from an in-clinic measurement. The requirements for such a device are unique, as the patient must self-align and stabilize the device for the measurement. In US Pat. No. 5,399,433, an example of such an alignment mechanism is described, using patient visualization of an optical channel. However, alignment alone does not satisfy all design input requirements for successful self-tonometry, which requires additional means for stabilization and eye identification. [Prior art documents] [Patent documents]

[0006] [Patent Document 1] U.S. Pat. No. 5,299,573 [Patent Document 2] U.S. Patent No. 10,058,245 Summary of the Invention

[0007] The present invention provides an ophthalmic instrument that meets the user's needs for successful home tonometry, where alignment, stabilization, and eye identification are all accomplished by the device.

[0008] The ophthalmic instrument includes a measurement device and one or more anatomical fixation points. The measurement device is housed in or on the body of the instrument and is used to measure the intraocular pressure (IOP) of a user's eye. The body is intended to be held and stabilized with both hands and placed on a portion of the user's anatomy for alignment and subsequent measurement. In one embodiment, the body is placed on the user's nose, but it is contemplated that it may be placed on any number of the user's anatomical facial structures, such as the cheek, forehead, eyebrow, or any other orbital bone.

[0009] The anatomical fixation point is a point or area on the body of the instrument that abuts against a part of the user's anatomy, such as the user's nose, cheek, forehead, or eyebrow, and is used to align the user's eye with the measurement device. According to one embodiment, the anatomical fixation point is in the form of an eyecup designed to rest on the user's orbital bone. With a structure similar to binoculars, the distance between the two eyecups can be adjusted to fit the user's interpupillary distance. According to another embodiment, the anatomical fixation point has a horizontal length that can be adjusted by the user and corresponds to a range of distances for aligning the user's eye with the measurement device. More specifically, the distance adjusted by the user between the anatomical fixation point and the center of the user's eye can represent the interpupillary distance. The instrument can be equipped with one or more pads on the outer surface of the body, particularly the anatomical fixation point, to provide comfort when abutting against a part of the user's anatomy.

[0010] An ocular identification device is also attached to the body of the instrument, allowing for the identification of the left or right eye being measured. According to one embodiment, the ocular identification device comprises a gyroscope or other sensor that detects a 180 degree rotation of the body about the Z axis relative to the asymmetry of the body relative to the Y axis. According to another embodiment, the ocular identification device comprises one or more sensors that sense the user relative to the measurement device. The sensor may be, for example, a contact sensor or a proximity sensor. According to certain embodiments, the ophthalmic instrument may comprise both a gyroscope and one or more additional sensors. [Brief description of the drawings]

[0011] [Figure 1] FIG. 1 is a perspective view of an ophthalmic instrument for autotonometry. [Diagram 2] FIG. 1 is a top view of an ophthalmic instrument. [Diagram 3] 1 shows an ophthalmic instrument in use. [Figure 4] 1 shows an ophthalmic instrument in use. [Diagram 5] FIG. 13 is a top view of another embodiment of an ophthalmic instrument for autotonometry. [Figure 6] 1 shows an ophthalmic instrument in use. [Figure 7] FIG. 1 is a diagram of an ophthalmic instrument for autotonometry. [Figure 8a] FIG. 1 is a front view of an ophthalmic instrument for autotonometry showing rotation about the Z axis. [Figure 8b] FIG. 1 is a front view of an ophthalmic instrument for autotonometry showing rotation about the Z axis. [Figure 9] FIG. 13 is a front view of another embodiment of an ophthalmic instrument for autotonometry. [Figure 10] FIG. 13 is a front view of yet another embodiment of an ophthalmic instrument for autotonometry. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0012] An ophthalmic instrument 20 for self-intraocular pressure measurement is shown in Figures 1-10. A user can use the ophthalmic instrument 20 by himself in the comfort of his own home to monitor intraocular pressure (IOP) at any time. The ophthalmic instrument 20 provides ease of use and accurate measurement through proper alignment, stabilization, and eye identification.

[0013] The ophthalmic instrument 20 comprises a body 22 that houses a measuring device 24 and one or more anatomical fixation points 28 located on the body 22 of the instrument 20 that abut a portion of the user's anatomy during use. The anatomical fixation points 28 allow the user to adjust the distance between the anatomical fixation points 28 and the center of the user's eye whose IOP is being measured. The measuring device 24 is positioned inside or on the body 22 of the instrument 20 to measure the IOP of the user's eye. The instrument 20 may be used to measure the IOP of either the right or left eye. An example of a suitable measuring device 24 is a rebound tonometer or a non-contact tonometer.

[0014] In the embodiment shown in Figures 1-4, the ophthalmic instrument 20 comprises two anatomical fixation points 28 in the form of eyecups 30 designed to rest on the orbital bones of a user. The measurement device 24 in this embodiment is placed in the cavity of one eyecup 30a, while the other eyecup 30b is opaque or dark-colored, essentially blocking the vision of the other eye so that the user can focus on the object to be measured. A structure similar to binoculars allows the distance between the two eyecups 30 to be adjusted along the X-axis to match the interpupillary distance of the user, so that both eyecups 30 are aligned with the user's eyes, as visually determined by the user. More specifically, the central portion 32 of the body 22 can connect two tubular structures 34, each having an eyecup 30 at one end. The tubular structures 34 can be hingedly attached to the central portion 32 such that the tubular structures 34 can pivot about the Z-axis to move the tubular structures 34 towards or away from each other. Additionally or alternatively, the tubular structures 34 may be secured to the central portion 32 in a sliding configuration to allow the tubular structures 34 to move towards or away from one another.

[0015] 3 and 4 each show the ophthalmic instrument 20 in use, with the user 36 holding the body 22 and stabilizing it using both hands, with the two anatomical fixation points 28 abutting the user's orbital bone for alignment and subsequent measurement. The embodiment with two eyecups 30 provides substantial stability of the ophthalmic instrument 20 during use. In fact, the two eyecup embodiment provides several additional advantages. For example, one of the eyecups 30a can be equipped with the measurement device 24, while the other eyecup 30b can be equipped with an opaque cover or other non-functional eye-facing surface. The non-functional eye-facing surface masks the opposite eye, making it easier for the user 36 to focus on the alignment crosshairs of the measurement eye without having to strain by closing one eyelid. Closing one eyelid has been shown to create an artificially high IOP in the measurement eye. Furthermore, having two eyecups 30 allows the user to fully align the measurement device 24 with the pupil, both grossly and finely. Additionally, having two eyecups 30 provides a binocular sense of symmetry and visual style, making it easier for a user 36 to understand how to use the ophthalmic instrument 20.

[0016] Figure 4 shows the ophthalmic instrument 20 in an inverted position relative to Figure 3. In Figure 3, a user 36 is holding the ophthalmic instrument 20 with the first eyecup 30a housing the measurement device 24 aligned with the user's right eye to measure the IOP of the user's right eye. In Figure 4, the user 36 has rotated the ophthalmic instrument 20 about the Z axis and is holding the ophthalmic instrument 20 with the first eyecup 30a aligned with the user's left eye to measure the IOP of the user's left eye.

[0017] In the embodiment shown in Figures 5-8, the ophthalmic instrument 20 includes a single anatomical fixation point 28 having a horizontal length 38 corresponding to a range of distances for aligning the user's eye with the measurement device 24, as adjusted by the user 36.

[0018] FIG. 6 shows the ophthalmic instrument 20 in use, with the user 36 holding the body 22 and stabilizing it using both hands, with the anatomical fixation point 28 abutting a portion of the user's anatomy, in this case the user's nose, for alignment and subsequent measurement. The anatomical fixation point 28 may also be designed to abut, for example, the user's cheek, forehead, or eyebrow, or any combination of these areas. The anatomical fixation point 28 has a horizontal length 38, as adjusted by the user 36, corresponding to a range of distances for aligning the user's eye with the measurement device 24. More specifically, while holding the instrument 20 as shown in FIG. 6, with the anatomical fixation point 28 in contact with the user's nose or other anatomical structure, the user 36 can move the body 22 of the instrument 20 left and right along the X-axis until the user's eye is aligned with the measurement device 24, which the user 36 can visually detect. For example, an anatomical fixation point 28 having a length 38 of 20 mm may cover an interpupillary distance (from the center of the cornea to the bridge of the nose) of about 55 mm to 75 mm, such that a person with an interpupillary distance of 55 mm would set the appliance 20 at one end of the anatomical fixation point 28, while a person with an interpupillary distance of 75 mm would set the appliance 20 at the opposite end of the anatomical fixation point 28. According to certain embodiments, the anatomical fixation point 28 may have a horizontal length 38 of about 10 mm to about 50 mm, or about 20 mm to about 40 mm, or about 25 mm to about 35 mm.

[0019] Any device for nose-stabilized ocular measurements requires a mechanism to accommodate the distance between the nasal fixation point 28 and the center of the user's eye, or a distance known as the monocular interpupillary distance (PD). This distance can vary widely between populations. According to certain embodiments, the anatomical fixation point 28 can include a pad 40, such as a nose pad, designed to rest the body 22 on the user's nose or other targeted anatomical area. The pad 40 provides comfort and also serves as an alignment indicator to help the user 36 properly position the body 22 relative to the user's nose or other targeted anatomical area. According to certain embodiments, the pad 40 can be a color different from the color of the body 22 to allow the user 36 to easily find the pad 40. Additionally or alternatively, the pad 40 can have a slightly sticky or rough texture or other texture different from the texture of the body 22, which is also designed to allow the user 36 to easily identify the pad 40 for proper placement. The pad 40 may be formed from foam, silicone, or any other medical grade polymeric material and may be adhered to the anatomical fixation point 28 on the body 22 with an adhesive or other suitable attachment means. When the body 22 of the instrument 20 is stabilized in the user's hands, the anatomical fixation point 28 requires an appropriate horizontal length 38 of the pad 40 to accommodate a range of monocular interpupillary distances (FIG. 5). The horizontal length 38 of the pad 40 may generally be essentially the same as the horizontal length 38 of the anatomical fixation point 28. This horizontal degree of freedom allows the user 36 to align the eye with the measurement device 24 by sliding the body 22 side to side along the pad 40 to accommodate the monocular PD of the measured eye. However, even if alignment of one eye with the measurement device 24 is achieved, the measurement alone does not allow identification of which eye is being measured.

[0020] The ophthalmic instrument 20 also includes an ocular identification device. According to one or more embodiments, the ocular identification device includes a gyroscope or other sensor that detects a 180 degree rotation of the body 22 about the Z axis when the ophthalmic instrument 20 is inverted or flipped over. Since the human face is approximately symmetrical about the Y axis, ocular identification can be achieved by integration of an asymmetry of the body 22 of the instrument 20 with respect to the Y axis, while maintaining functional symmetry with respect to the X axis (FIG. 7) and incorporating a gyroscope or other sensor housed within the body 22, in combination with an alignment and stability mechanism. The embodiment shown in FIGS. 1-4 also has an asymmetry with respect to the Y axis, with one eyecup 30a housing the measuring device 24 and the other eyecup 30b lacking a measuring device. The eyecup 30b lacking a measuring device may have a non-functional eye-facing surface, which may be, for example, an opaque surface. Since the gyroscope or other sensor is housed within the body 22, it is not shown in the figures. The term "functional" as used herein indicates that while not all features of the body 22 itself need be precisely symmetrical with respect to the X-axis, some symmetrical features of the ophthalmic instrument 20, such as the eyecups 30a, 30b or pads 40 and the measurement device 24, are integral to functionality because of their symmetry. More specifically, features such as the measurement device 24 and the eyecups 30a, 30b or pads 40 function equally well in both the original configuration of the ophthalmic instrument 20 as well as in an inverted or inside-out configuration.

[0021] The asymmetry of the ophthalmic instrument 20 with respect to the Y-axis allows for measuring the right or left eye by rotating the body 22 of the instrument 20 about its Z-axis (FIGS. 8a and 8b) and then sliding the body 22 horizontally to align the eye with the measuring device 24. The ophthalmic instrument 20 maintains the adjusted interpupillary distance when the body 22 is flipped over, corresponding to the vertical symmetry of the user's face. Also, according to certain embodiments, the functional X-axis symmetry of the ophthalmic instrument 20 allows the user to utilize the same pad 40 in a vertically flipped arrangement to restitch the body 22 after rotation and slide the body 22 again along the horizontal to align with the appropriate monocular interpupillary distance of the next eye to be measured, as accommodated by the length of the pad. As shown in FIG. 8a, when the body 22 is ready to be aligned with the right eye of the user, the first edge 42 of the pad 40 is on top and the second edge 44 of the pad 40 is on bottom, and when rotated 180 degrees about the Z axis, as shown in FIG. 8b, when the body 22 is ready to be aligned with the left eye of the user, the first edge 42 of the pad 40 is on bottom and the second edge 44 of the pad 40 is on top. The body 22 can be equipped with two measurement buttons to allow for right hand measurements in both left and right eye orientations of the instrument 20. The first measurement button 46a may be located on the top surface of the body 22 on the right side of the body 22 when the instrument 20 is in the right eye orientation, and the second measurement button 46b may be located on the bottom surface of the body 22 on the left side of the body 22 when the instrument 20 is in the right eye orientation, such that the second measurement button 46b ends up on the top surface of the body 22 on the right side of the body 22 when the instrument 20 is rotated 180 degrees about the Z axis. The incorporation of a gyroscope or other sensor establishes a vertical reference axis for the ophthalmic instrument 20 paired with the lateral direction of the eye, and a rotation of the body 22 about the Z axis with subsequent reversal of the gyroscope reference axis indicates which eye is being measured. For example, the gyroscope may be connected to an electronic display panel 48 located on the body that indicates the left or right eye. The same electronic display panel 48 may also be connected to the measurement device 24 to show the pressure data. Alternatively, the pressure data may be shown on a different electronic display panel 48 than the right or left eye indicator.

[0022] According to another embodiment shown in FIG. 9, the eye identification device comprises at least two sensors 50a, 50b associated with anatomical fixed points 28a, 28b, respectively. As used herein, the term "sensor" refers to a sensor capable of detecting and responding to a signal or stimulus, such as proximity, contact, movement, rotation, temperature, sound, etc. The measurement device 24 may be centrally located along the X-axis of the body 22, with the first anatomical fixed point 28a and the first sensor 50a located on one side of the measurement device 24, and the second anatomical fixed point 28b and the second sensor 50b located on a second side of the measurement device 24 opposite the first side. Pads 40, such as nose pads, may also be fixed to each of the anatomical fixed points 28a, 28b. As in the previous embodiment, the body 22 of the instrument 20 is intended to be held with both hands and placed on either the right nose pad 40a or the left nose pad 40b to measure the user's left or right eye, respectively. Both pads 40a, 40b are of an appropriate length for the measurement device 24 to accommodate a wide range of monocular PDs, as adjusted by the user.

[0023] The sensors 50a, 50b are placed at or near each anatomical fixed point 28a, 28b to sense when the body 22 of the device 20 is placed on the user's anatomy. The sensors 50a, 50b may be contact sensors, proximity sensors, or other suitable sensors. For example, when the body 22 of the device 20 is placed on the user's nose against the left nose pad 40b, a contact sensor above or below the left nose pad 40b detects contact, which indicates a measurement of the user's right eye. Conversely, when the body 22 of the device 20 is placed on the user's nose against the right nose pad 40a, a contact sensor above or below the right nose pad 40a detects contact, which indicates a measurement of the user's left eye. As another example, when the body 22 of the device 20 is placed on the user's nose against the left nose pad 40b, a proximity sensor located near the left nose pad 40b detects the presence of the body 22, which indicates a measurement of the user's right eye. Conversely, when the body 22 of the device 20 is placed on the user's nose against the right nose pad 40a, a proximity sensor located near the right nose pad 40a detects the presence of the body 22, which indicates a measurement of the user's left eye. As mentioned above, the anatomical fixation points 28a, 28b may be designed to abut the user's nose, cheeks, forehead, or eyebrows, or any combination of these areas. The sensors 50a, 50b in this embodiment may also be used in combination with the gyroscope embodiment.

[0024] The embodiment shown in FIG. 10 is similar to the embodiment shown in FIG. 9, but has a slidable measuring device 52. More specifically, the instrument 20 shown in FIG. 10 has two anatomical fixation points 28a, 28b designed to abut a portion of the user's anatomy that allows the user to adjust the distance between the anatomical fixation points and the center of the first eye and / or second eye of the user 36. The embodiment shown in FIG. 10 also comprises at least one anatomical fixation point 28a arranged on one side of the slidable measuring device 52 and at least one anatomical fixation point 28b arranged on the other side of the slidable measuring device 52, the slidable measuring device 52 having a horizontal movement distance 54 corresponding to a range of distances for horizontal alignment of the first eye and / or second eye of the user relative to the slidable measuring device 52, as adjusted by the user. For example, the instrument 20 may be in the form of a headset having two of the anatomical fixed points 28a, 28b designed to rest against the user's forehead and two of the anatomical fixed points 28c, 28d designed to rest against the user's cheek. Similar to the horizontal length 38 of the anatomical fixed points 28 described above, the horizontal movement distance 54 may be from about 40 mm to about 95 mm, or from about 45 mm to about 90 mm, or from about 50 mm to about 85 mm. The eye identification device includes a sensor 50, whereby as the slidable measuring device 52 moves horizontally, the sensor 50 senses the slidable measuring device 52 relative to the user 36, allowing for identification of the left or right eye being measured. The sensor 50 may include, for example, one or more sensing circuits. The sensing circuits may be configured to sense the position of the slidable measuring device 52 to allow for identification of the left or right eye being measured. Alternatively, the sensor 50 may include one or more contact sensors, as described above. One or more pads 40 may also be disposed on an exterior surface of the body 22 at at least one of the anatomical fixed points 28a, 28b, 28c, 28d. The distance adjusted by the user 36 may represent the interpupillary distance. Alternatively, the horizontal travel distance 54 of the slidable measuring device 52 may represent the interpupillary distance.The slidable measuring device 52 may be the same type of measuring device 24 described above, such as a rebound tonometer or a non-contact tonometer, but is capable of sliding along the X-axis.

[0025] The description and figures contained herein show specific embodiments to teach those skilled in the art how to make and use the best options. For the purpose of teaching the principles of the invention, some conventional aspects have been simplified or omitted. Those skilled in the art will appreciate variations from these embodiments that fall within the scope of the invention. Those skilled in the art will also appreciate that the features described above can be combined in various ways to form multiple embodiments. As a result, the present invention is not limited to the specific embodiments described above, but only by the claims and their equivalents.

Claims

1. 1. An ophthalmic device for self-tonometry, comprising: a) a body having functional symmetry about an X-axis and asymmetry about a Y-axis, such that a 180 degree rotation of said body about a Z-axis allows a user to measure the right or left eye; b) a measuring device disposed in or on the body, the measuring device measuring intraocular pressure in a first eye and / or a second eye of the user; and c) at least one anatomical fixation point that allows a user to adjust a distance between the at least one anatomical fixation point and a center of the first eye and / or the second eye of the user, the at least one anatomical fixation point abutting a portion of the user's anatomical structure and corresponding to a range of distances for aligning the first eye or the second eye of the user to the measurement device as adjusted by the user; d) an eye identification device attached to the body, the eye identification device comprising a sensor that detects 180 degree rotation of the body about the Z axis relative to the Y axis asymmetry of the body, enabling identification of the left or right eye being measured.

2. 2. The ophthalmic apparatus of claim 1, comprising two of the at least one anatomical fixation point, each of the two anatomical fixation points being in the form of an eyecup designed to abut an orbital bone of the user.

3. 3. The ophthalmic apparatus of claim 2, wherein the measurement device is disposed within a cavity of a first one of the eyecups, and a second one of the eyecups comprises an eye-facing surface that obstructs the user's vision.

4. 2. The ophthalmic apparatus of claim 1, wherein the at least one anatomical fixed point abuts at least one of the group consisting of the user's nose, the user's cheek, the user's forehead, and the user's eyebrow.

5. The ophthalmic device of claim 1 , further comprising a pad disposed on an exterior surface of the body in alignment with the at least one anatomical fixation point.

6. The ophthalmic apparatus of claim 1 , wherein the at least one anatomical fixation point comprises a horizontal length corresponding to a range of interpupillary distances.

7. The ophthalmic apparatus of claim 1 , wherein the user adjusted distance represents an interpupillary distance.

8. 2. The ophthalmic device of claim 1, wherein the at least one anatomical fixation point comprises a contact sensor configured to sense when the anatomical fixation point of the body abuts against a portion of the user's anatomy.

9. The ophthalmic instrument of claim 1 , wherein the sensor is a gyroscope.

10. 1. An ophthalmic device for self-tonometry, comprising: a) a main body; b) at least two anatomical fixation points that allow a user to adjust a distance between an anatomical fixation point and a center of a first eye and / or a second eye of the user, the at least two anatomical fixation points abutting a portion of an anatomical structure of the user; c) a measuring device disposed in or on said body, the measuring device measuring intraocular pressure in a first eye and / or a second eye of a user with a first anatomical fixation point disposed on a first side of said measuring device and a second anatomical fixation point disposed on a second side of said measuring device; d) an ophthalmic instrument comprising an ocular identification device attached to the body, the ocular identification device comprising a sensor such that when the body is fixed to the user via one of the anatomical fixation points, the sensor senses the user relative to the measurement device and enables identification of the left or right eye being measured.

11. The ophthalmic apparatus of claim 10 , wherein the at least two anatomical fixation points comprise two eyecups designed to abut against the user's orbital bones.

12. 12. The ophthalmic apparatus of claim 11, wherein the measurement device is disposed within a cavity of a first one of the eyecups, and a second one of the eyecups comprises an eye-facing surface that obstructs the user's vision.

13. 11. The ophthalmic apparatus of claim 10, wherein the at least two anatomical fixed points each abut at least one of the group consisting of the user's nose, the user's cheek, the user's forehead, and the user's eyebrow.

14. 11. The ophthalmic apparatus of claim 10, wherein each of the anatomical fixation points has a length corresponding to a range of distances for horizontal alignment of the user's first eye and / or second eye relative to the measurement device, as adjusted by the user.

15. The ophthalmic instrument of claim 10 , wherein the sensor comprises one or more contact sensors.

16. 16. The ophthalmic instrument of claim 15, wherein the one or more contact sensors are configured to sense fixation to at least one of the anatomical fixation points to enable identification of a left or right eye being measured.

17. The ophthalmic instrument of claim 10 , wherein the sensor comprises one or more proximity sensors.

18. The ophthalmic apparatus of claim 17 , wherein the one or more proximity sensors are configured to sense a left or right eye being measured.

19. The ophthalmic device of claim 10 , further comprising a pad disposed on an exterior surface of the body so as to be aligned with at least one of the anatomical fixation points.

20. 1. An ophthalmic device for self-tonometry, comprising: a) a main body; b) at least two anatomical fixation points that allow a user to adjust a distance between the anatomical fixation points and a center of the first eye and / or the second eye of the user, the at least two anatomical fixation points abutting a portion of the user's anatomical structure; c) a measuring device disposed in or on said body, for measuring intraocular pressure of a first eye and / or a second eye of a user with at least one anatomical fixation point disposed on a first side of said measuring device and at least one anatomical fixation point disposed on a second side of said measuring device, said measuring device having a horizontal movement distance to correspond to a range of distances for horizontal alignment of said first eye and / or second eye of said user to said measuring device as adjusted by said user; d) an ophthalmic instrument comprising an ophthalmic identification device attached to the body, the ophthalmic identification device comprising a sensor whereby as the measuring device moves horizontally, the sensor senses the measuring device relative to the user, enabling identification of the left or right eye being measured.

21. 21. The ophthalmic apparatus of claim 20, wherein one of the anatomical fixed points abuts at least one of the group consisting of the user's nose, the user's forehead, the user's cheek, and the user's eyebrow.

22. 21. The ophthalmic apparatus of claim 20, wherein the sensor comprises one or more sensing circuits configured to sense a measurement device position to enable identification of a left or right eye being measured.

23. The ophthalmic apparatus of claim 20 , wherein the sensor comprises one or more contact sensors.

24. 24. The ophthalmic apparatus of claim 23, wherein the one or more contact sensors are configured to sense contact at a location that identifies the left or right eye being measured.

25. The ophthalmic device of claim 20 , further comprising a pad disposed on an exterior surface of the body over at least one of the anatomical fixation points.

26. 21. The ophthalmic apparatus of claim 20, wherein the user adjusted distance represents an interpupillary distance.

27. 21. The ophthalmic instrument of claim 20, wherein the distance traveled by the measuring device represents the interpupillary distance.

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