**Question:** Increased intraocular tension can be diagnosed by

A. Pachymetry
B. Tonometry
C. Slit lamp examination
D. Fundoscopy

**Correct Answer:** B. Tonometry

**Core Concept:**
Intraocular tension refers to the pressure inside the eye, which plays a crucial role in maintaining the structural integrity of the eye and influencing visual acuity. Glaucoma is a group of eye diseases characterized by damage to the optic nerve and associated visual field defects. Increased intraocular tension is a hallmark feature of glaucoma and is used as a diagnostic tool.

**Why the Correct Answer is Right:**
Tonometry is the process of measuring intraocular tension. The Goldmann applanation tonometer is a widely used tonometer that directly measures intraocular tension by applying a small force on the cornea and recording the resistance offered by the cornea. This method is considered reliable and accurate in detecting increased intraocular tension, which is a key diagnostic feature of glaucoma.

**Why Each Wrong Option is Incorrect:**

A. Pachymetry: This term refers to the measurement of corneal thickness, which is an unrelated process to intraocular tension measurement and is not used for glaucoma diagnosis.

B. Slit lamp examination: While a slit lamp examination allows for visualization of the anterior segment anatomy, it is not a direct method to measure intraocular tension and is not sufficient for diagnosing increased tension.

C. Fundoscopy: Fundoscopy is a procedure involving the examination of the fundus (the back part of the eye), which is essential for diagnosing retinal disorders. It does not directly measure intraocular tension and is not sufficient for diagnosing increased tension.

**Clinical Pearl:**

Increased intraocular tension should always be accompanied by clinical signs and symptoms such as visual field defects, optic nerve head changes, and retinal nerve fiber layer thinning. A comprehensive eye examination involving tonometry, slit lamp examination, and fundoscopy is crucial for an accurate diagnosis of glaucoma.

**Explanation of the Core Concept:**

Intraocular tension plays a vital role in maintaining the structural integrity of the eye and is directly related to visual acuity. An elevated intraocular tension is a significant risk factor for optic nerve damage, leading to visual field defects and potential blindness if left untreated. Tonometry is a reliable method to measure intraocular tension and is an essential component in diagnosing glaucoma.

**Clinical Pearls:**

1. Tonometry is a non-invasive method that indirectly measures the resistance offered by the cornea when a small force is applied.
2. In addition to intraocular tension measurement, a comprehensive eye examination includes slit lamp examination and fundoscopy to diagnose glaucoma accurately.
3. Increased intraocular tension can lead to optic nerve damage and visual field defects, which may progress to blindness if left untreated.

**Clinical Pearls:**

1. Glaucoma is a group of disorders characterized by optic nerve damage resulting from elevated intraocular tension.
2. Tonometry is