Corneal Topographic

Patterns
By Afaf Johar
Corneal Topography
• Corneal topography is a computerized test that maps the curve of
your cornea. It can show problems with your eye's surface, like
swelling or scarring, or conditions such as astigmatism. You might
have it before you get surgery, a cornea transplant, or a contact lens
fitting.
Uses
• Refractive surgery
• Keratoconnus
• Post surgery astigmatism
• Effect of corneal and ocular surface disorders: Disorders such as
pterygium
• Other uses : Contact lens fitting etc
History
• Classification of corneal topography patterns based on the study by
Rabinowitz et al in 1996..
• (1) Round,
• (2) Oval,
• (3) Superior Steepening,
• (4) Inferior steepening,
• (5) Irregular,
• (6) Symmetric bowtie with skewed radial axis,
• (7) Asymmetric bowtie with inferior steepening,
• (8) Asymmetric bowtie with superior steepening
• (9) Asymmetric bowtie with skewed radial axis
• (10) Symmetric bowtie.
• (11) Horse shoe shape
• (12) Triple pattern
• (13) Mixed pattern
Symmetric bowtie

Asymmetric bowtie
Prolate
The cornea appears to have
increased dioptric power
(steeper) centrally than at the
periphery.
Prolate symmetric bowtie
Prolate asymmetric bowtie
Oblate
A cornea of decreased power
(flatter) centrally than
peripherally.
Oblate symmetric bowtie
Oblate asymmetric bowtie
With the Rule astigmatism
Against the rule Astigmatsim
Regular Astigmatism
• Regular astigmatism is usually presented topographically by a bow tie
pattern that can be symmetrical or asymmetrical. Any pattern
presenting with an angle α between the axis of the two halves of the
bow tie of less than 20° , was defined as regular astigmatic.
• Regular symmetrical astigmatism
• Regular asymmetrical astigmatism
Irregular Astigmatism Pattern
• If the two steepest semimeridia were at an angle α to each other
which was greater than 20°, this astigmatism was defined as irregular.
This is represented topographically as a “bi-oblique” bow tie pattern.
Symetric with skewed radial axis Asymetric with skewed radial axis
Mixed Pattern
Features of both oblate and
prolate shape are present at
different corneal areas.
Triple
pattern: characteristically,
three distinct areas of radial
steepening were identifiable
Horseshoe” pattern: in this
configuration, a C-shaped
area of increased corneal
power could be identified at
the graft host interface