MEASUREMENTS OF OPTICAL

CONSTANTS OF THE EYE

Aastha Parekh
 POINTS TO COVER

• Corneal curvature and thickness

• Curvature of the lens and ophthalmophakometry
• Axial and axis of the eye
 CORNEAL CURVATURE

• Cornea = kerat
• Measurement = metry
• Measurement of the anterior surface of the cornea is called Keratometry
 USES OF KERATOMETRY

• Measurement of corneal astigmatism

• Radius of curvature of cornea – helps in contact lens fitting
• Assess the integrity of the tear film
• Detection of irregular astigmatism – keratoconus/pterygium/corneal scarring
 PRINCIPLE

• Anterior corneal surface acts as a Convex Mirror

PRINCIPLE
PRINCIPLE
 WHAT DOES IT MEASURE?

• Radius of curvature of the cornea from where the power can be calculated
• D = n2 – n1/r where, n2 = index of keratometry (1.3375)
n1 = index of air (1.00)
r = radius of curvature
• D = 1.3375 - 1.00 / r (m)
= 0.3375 / r(m)
= 337.5 / r (mm)
 DESIGN – OBSERVATION SYSTEM

• Observation system comprises of astronomical telescope and doubling system

 DOUBLING SYSTEM

• The eye makes miniature involuntary movements during fixation

• Image formed by the anterior corneal surface also moves
• Doubling system uses 2 prisms – Base up and base out
• This deviated the image into two – Vertical and horizontal
• Images are 90 degrees to each other
 TYPES OF DOUBLING

• Fixed Doubling • Variable Doubling

- Bausch and Lomb, Topcon
- Fixed: Object height and doubling device
distance
- Variable: Image size and mire separation
- Haag Striet and Javal Schiotz
- Fixed: Image size and mire separation
- Variable: Object height and doubling
device distance
DESIGN – ILLUMINATION SYSTEM
 TYPES OF KERATOMETER

• One position Keratometer • Two position Keratometer

- Double images are produced side by side - Requires rotation about the axis to
as well as 90 degrees from each other measure each of the principle meridians
- Principle meridians are assumed to be at
right angles to each other
BAUSCH AND LOMB KERATOMETER
 TARGET

• Target Size = 64 mm
• Target Distance = 75 mm
 CALIBRATION

• Should be done regularly to ensure the

accuracy of ‘K’ readings
• Done with steel balls of known
curvature
 PROCEDURE

• Adjust as per patients comfortable seating

• Fixation target
• Focus mires
• Rotate drum for aligning the + and – mires
• Note the readings
 CORNEAL THICKNESS

• Non-invasive process of measuring the thickness of the cornea

• Central Corneal Thickness (CCT)
• Pachymetry
 USES OF PACHYMETRY

• Helps to assess the function of the corneal endothelium

• Corneal refractive surgery or Corneal transplant
• Glaucoma suspects
• Bullous keratopathy
• Corneal oedema
• Fuchs' endothelial dystrophy
• Keratoconus screening
 NORMAL VALUES

• Normal corneal thickness: It ranges from 0.7 to 0.9 mm at the limbus and
varies between 0.49 mm and 0.56 mm at the centre
• Abnormal Results Abnormally thick or thin measurements may indicate -
corneal thinning, corneal oedema, Lower or higher than suspected intraocular
pressure
• Corneal configuration in new-borns is similar to that of the adult cornea.
• It has been found that cornea on day one is significantly thicker and decreases
in thickness as the child grows older.
• The superior peripheral cornea is thinnest in new-born
 TECHNIQUES

ULTRASONIC OPTICAL ALTERNATE

• Pentacam
• Conventional ultrasonic • Manual
pachymetry • Specular Microscopy • Pachycam
• Ultrasound biomicroscopy • Optical Coherence Tomography • Ocular Response Analyser
(UBM)
• Confocal Microscopy
• Laser Doppler Interferometry
• Scanning slit technology
ULTRASONIC METERS
OPTICAL PACHYMETERS
ALTERNATIVES
 CURVATURE OF LENS AND
OPHTHALMOPHAKOMETRY

• Phakometry is used for accurate measurements of the dioptric power of the

human lens important for studying ocular development and refractive error
• A Scan provides information about the length of the eye to calculate the power
of the intraocular lens power.
• Average axial length of the eyes is about 23 mm. For every 1mm axial length
difference, we can anticipate a 3 D difference in refractive error
 A SCAN

• A scan ultrasound biometry commonly referred to as an A Scan is

routine type of diagnostic test used in optometry or ophthalmology
• Thin parallel sound bean is emitted from the probe tip with an echo
bouncing back into the probe tip as the sound beam strikes each
interface.
• An interface is the junction between any two media of different
densities and velocities
1. Anterior corneal surface
2. Aqueous – Anterior lens
3. Posterior lens – Anterior vitreous
4. Posterior Vitreous – Retinal surface
5. Choroid – Anterior Sclera
 ULTRASOUND PRINCIPLES

• Sound is defined as a vibratory disturbance within a solid or liquid that travels

in a wave pattern.
• When the sound frequency is between 20 hertz (Hz) and 20,000 Hz, the sound
is audible to the human ear.
• Most A-scan and B-scan probes use a frequency of approximately 10 million
Hz (10 MHz) that is predesigned by the manufacturer
 METHODS

• Contact:
1. Applanation Method
2. Hand held Method
• Immersion
 APPLANATION METHOD

• An ultrasound probe is placed directly on the cornea attached with slit lamp
HAND HELD METHOD
 IMMERSION METHOD

• Immersion technique requires the use of a Prager Scleral Shell and saline
• Avoids corneal compression
• Eyes measured with the immersion method are on average 0.1-0.3 mm longer
 FORMULAE

• Theoretical - Binkhorest formula

• Regression – Sanders, Retzlaff and Kraft ( SRK1, SRK11, SRKT)
THANK YOU!