Purpose of the Air Puff Test in an Eye Exam

The "air puff test" is a slang term for non-contact tonometry (NCT), a test used during an eye exam to measure the pressure inside your eye. The air puff test gives your eye doctor an eye pressure reading known as intraocular pressure (IOP), which helps detect glaucoma. 

"Puff tonometry" is a good screening test for eye doctors, but can sometimes overestimate pressures. This test is not as accurate as traditional tonometry, but is very sensitive in picking up pressure problems. Many people prefer the air puff test, as no contact is made with the eye. The puff of air you will feel is not painful.

A man for being tested for glaucoma
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Measuring Eye Pressure

Direct tonometry on the surface of the eye is a more accurate measurement of eye pressure. However, this type of testing requires a skilled technician to perform it correctly. Before the test is performed, a technician will numb the eye with an anesthetic. During the exam, a sensor is placed gently on the surface of the eye, giving a very accurate reading of IOP.

The air puff test emits a gentle puff of air onto the eye, then measures the time it takes for the air to flatten a small area of the cornea and return to the instrument. Your eye doctor may use either one depending on circumstances.

Elevated Eye Pressure

So what if the air puff test results in a high reading? Elevated IOP is sometimes referred to as ocular hypertension. Elevated eye pressure does not automatically signal glaucoma, but it puts you at risk for developing the disease. Your eye doctor will want to check your eye pressure at every visit, to make sure other signs of glaucoma do not develop.

Glaucoma is a serious eye disease that may result in vision loss if not treated early. Because the condition does not produce obvious symptoms, an air puff test is sometimes the only way for a doctor to detect it. However, a sudden increase in eye pressure, particularly in the case of acute angle-closure glaucoma, may produce other symptoms including blurred vision, halos around lights, severe eye pain, and nausea.

Angle-closure glaucoma is rare but serious. Unless treated quickly, the condition could result in blindness. If you experience the above symptoms, seek medical attention immediately for evaluation. 

What You Should Know

The air puff test is advantageous to traditional tonometry in that it can be performed with less skill and can be done by a technician. Also, it does not touch the eye, so there is no concern with contamination. Furthermore, no eye drops are needed before the test.

Some clinicians feel that the air puff test is not as accurate as a traditional tonometer that actually touches the eye. Depending upon your risk, family history, other factors and what you are seeing your eye doctor for that day, your eye doc may choose one test over the other. Make sure to discuss this with your eye doctor especially if you have risk or family history of glaucoma.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Yilmaz I, Altan C, Aygit ED, et al. Comparison of three methods of tonometry in normal subjects: Goldmann applanation tonometer, non-contact airpuff tonometer, and Tono-Pen XLClin Ophthalmol. 2014;8:1069–1074. doi:10.2147/opth.s6391

  2. American Academy of Ophthalmology. What is ocular hypertension?

  3. Glaucoma Research Foundation. Symptoms of angle-closure glaucoma.

By Troy Bedinghaus, OD
Troy L. Bedinghaus, OD, board-certified optometric physician, owns Lakewood Family Eye Care in Florida. He is an active member of the American Optometric Association.