An applanation tonometer with a replaceable prism for contacting a cornea has emitter and detector ports arranged opposite each other on opposite sides of a longitudinal axis, with the ports aimed at about 45° to the longitudinal axis. Light from an emitter then passes through the emitter port and crosses the prism axis to be incident and reflected from an emitter-reflecting surface of the prism and become incident on the applanation surface. Light reflected from the applanation surface is incident on and reflected from a detector-reflecting surface opposite and parallel with the emitter-reflecting surface to proceed across the prism axis to the detector port. Such an arrangement produces reliable applanation signals and varies the spacial intensity of light reflected from the applanation surface so that the tonometer can automatically distinguish between concentric and eccentric contact of the applanation surface with a cornea.
