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    Method of Extending The Range of The Keratometer

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    Danielle Sangalang
    This document describes a device that extends the range of the keratometer from 52D to 68D. It attaches an illuminated mire to the front of the keratometer, bringing it closer to the cornea. This records the curvature over a larger corneal area than the standard keratometer. Calibration using steel balls found the device multiplies the true radius by 1.332 on average. It extends the keratometer's ability to measure severely steep corneas like those with keratoconus.

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    Method of Extending The Range of The Keratometer

    Uploaded by

    Danielle Sangalang
    650 views3 pages
    This document describes a device that extends the range of the keratometer from 52D to 68D. It attaches an illuminated mire to the front of the keratometer, bringing it closer to the cornea. This records the curvature over a larger corneal area than the standard keratometer. Calibration using steel balls found the device multiplies the true radius by 1.332 on average. It extends the keratometer's ability to measure severely steep corneas like those with keratoconus.

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    Method of Extending the Range of the Keratometer

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    This document describes a device that extends the range of the keratometer from 52D to 68D. It attaches an illuminated mire to the front of the keratometer, bringing it closer to the cornea. This records the curvature over a larger corneal area than the standard keratometer. Calibration using steel balls found the device multiplies the true radius by 1.332 on average. It extends the keratometer's ability to measure severely steep corneas like those with keratoconus.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    650 views3 pages

    Method of Extending The Range of The Keratometer

    Uploaded by

    Danielle Sangalang
    This document describes a device that extends the range of the keratometer from 52D to 68D. It attaches an illuminated mire to the front of the keratometer, bringing it closer to the cornea. This records the curvature over a larger corneal area than the standard keratometer. Calibration using steel balls found the device multiplies the true radius by 1.332 on average. It extends the keratometer's ability to measure severely steep corneas like those with keratoconus.

    Copyright:

    © All Rights Reserved
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    of 3

    VOL. 68, NO.

    5 NOTES, CASES, INSTRUMENTS 931

    METHOD OF EXTENDING THE ner, and yields a figure for corneal curvature
    RANGE OF THE KERATOMETER which represents a larger area for steeper
    corneas than the auxiliary lens method.
    DAVID MILLER, M.D.
    ADOLPH HOLMBERG METHOD
    JOAN EXFORD, O.D.
    This device essentially decreases the dis­
    AND
    tance between the mires and the subject's
    MIRIAM BOYD, O.D.
    cornea by attaching a self-illuminated mire
    Boston, Massachusetts to the front of the keratometer. The new
    In patients with keratoconus, the 52- mires, which are the same size as those of
    dioptric limit of the keratometer often falls the keratometer (64 mm), are attached to a
    short of the patient's corneal refractive plastic cylinder (19.5 mm thick) by a re­
    power. tainer ring. The back of the cylinder is shaped
    Use of a +2.25 lens over the sighting ap­ so that it fits into the recess covering the ex­
    erture of the instrument and the use of a isting mires.
    correction factor increase the range of the The new mire, a transparent positive of
    instrument to 68D.2 However, this method the actual mire (somewhat like a photo­
    measures the curvature over a relatively graphic slide), is illuminated by four G.E.
    small central area in steep corneas. No. 2157D bulbs placed inside the plastic
    The device to be described extends the cylinder (figs. 1-A, 1-B and 2 ) . In one ex­
    range of the keratometer in a different man- periment, the plastic cylinder (with the new
    mire) was fitted over the front of the kera­
    tometer and readings were taken on five cali­
    From the Cornea Service, Massachusetts Eye and brated steel balls.
    Ear Infirmary. This work was supported by
    USPHS Grant NB-05691 from the National Insti­ A factor was developed so that a reading
    tute of Neurological Diseases and Blindness. from the keratometer drum could be con­
    Reprint requests to David Miller, M.D., Massa­
    chusetts Eye and Ear Infirmary, 243 Charles verted to the true curvature of a steep cor­
    Street, Boston, Massachusetts 02114. nea.

    Fig. 1 (Miller, Holmberg, Exford and Boyd). (A) Front of conventional keratometer, showing the
    fires. (B) Auxiliary mires, attached to the front of the keratometer.
    932 AMERICAN JOURNAL OF OPHTHALMOLOGY NOVEMBER, 1969

    in diopters by 4/3, would thus give the true


    corneal reading with the auxiliary mire in
    place.
    The present modification gives a new
    range to the keratometer of from 48D to
    68D.
    The keratometer with auxiliary mire has
    been used on human corneas and found to be
    easily readable in a darkened room.

    TABLE 1
    CALIBRATION OF KERATOMETER EXTENSION
    USING PRECISION STEEL BALLS
    Fig. 2 (Miller, Holmberg, Exford and Boyd).
    Auxiliary mires, with wires leading from the light Keratometer Reading Ratio
    bulbs enclosed in the mire to a fuse box and switch. with New Mire Keratom­
    Radius of eter
    Steel Reading
    RESULTS Ball Diopters Radius to Real
    Radius
    The mean ratio of keratometer reading to
    real radius was 1.332 (table 1). The stan­ 5.15 49.00 6.89 1.338
    5.55 45.50 7.42 1.337
    dard deviation was 0.00054. 5.95 42.75 7.90 1.328
    Multiplying the radius of curvature by 6.35 39.87 8.46 1.331
    6.75 37.75 8.94 1.324
    3/4, or multiplying the keratometer reading

    ORIGINAL NEW
    MIRE MIRE

    CORNEA
    CORNEAL AREA
    64 mm INCLUDED WITH
    ORIGINAL MIRE

    Fig. 3 (Miller, Holmberg, Exford and Boyd). Optical ray diagram, illustrating the area of cornea
    yielding the reflected image from the original keratometer mires (situated 75 mm from the cornea) as
    compared to the area encompassed with the new mires (situated 55.5 mm from the cornea).
    VOL. 68, NO. 5 NOTES, CASES, INSTRUMENTS 933

    DISCUSSION 68D cornea would have a 3-mm zone repre­


    The principle of the keratometer assumes sented.
    that the cornea is a convex mirror. The rela­ SUMMARY
    tionship between the image, object and radius The range of the keratometer has been
    of a mirror is h' = — hr J /2d — r when extended to 68D by attaching a device which
    moves the mires closer to the patient and re­
    h = size of object (mire) = 64 mm in
    cords the curvature from a larger portion of
    B & L keratometer
    the cornea than does the conventional kera­
    h' = size of image (determined by dou­
    tometer.
    bling device in keratometer)
    r = radius of curvature of cornea REFERENCES
    d = distance between object and image 1. Linksz, A. : Physiology of the Eye. New
    York, Grune and Stratton, 1950, v. 1, p. 118.
    (75 mm in keratometer) 2. Gordon, S. : Extended Range Keratometry.
    Rochester, Contact Lens Guild, Inc., 1967, p. 1.
    The conventional keratometer holds h
    (mire size) and d (distance between object
    and image) constant. By determining h'
    (image size), the operator finds r (corneal
    radius of curvature). In the case of most
    AUTODISLOCATION OF A LENS
    ophthalmometers, h' is determined by using
    IN CONGENITAL RUBELLA
    a doubling device. Since we wanted to use ALBERT HORNBLASS, M.D.
    the same doubling device for the present AND
    modification, we determined its limits. For a NED REINSTEIN, M.D.
    cornea with a refractive power of 38D, the Brooklyn, New York
    image size was 4.26 mm and for a cornea of
    The oculodigital phenomenon 1 · 2 is that act
    52D, the image size was 2.88 mm. Knowing
    whereby a person elicits a retinal phosphene
    the range of the image sizes for the instru­
    by exerting pressure on the globe with his
    ment tells us the range of the doubling de­
    finger. We have studied an eight-year-old
    vice. Any change in d (such as in our modi­
    boy with the rubella syndrome who caused
    fication) had to keep within the range of the
    the rupture and dislocation of his catarac-
    doubling device.
    tous lens by the oculodigital phenomenon.
    The present device changes from 75 mm We believe that this is the first reported case
    to 55.5 mm, yet keeps h 64 mm, and stays of autodislocation of the lens resulting from
    within the set range of h' (that is, 2.88 mm this action. In addition, this child demon­
    to 4.26 mm). Under these conditions the strated gestures previously unreported in
    new range of the keratometer becomes 48D visually deprived individuals.
    to68D.
    An added feature of this keratometer ex­ CASE REPORT
    tension in contrast to the use of auxiliary T. G, an eight-year-old Negro boy, weighed four
    lenses is the enlarged area of corneal surface pounds, six ounces at birth after a 40-week gesta-
    represented by the measurement (fig. 3 ) . From the Division of Ophthalmology, Depart­
    Using the conventional keratometer, a read­ ment of Surgery, Downstate Medical Center, State
    ing of 44D represents the curvature of a University of New York. This study was supported
    by USPHS Grant 5T1NBS11S-12 from the Na­
    3.27-mm corneal zone. If one measured a tional Institute of Neurological Diseases and Blind­
    steep cornea of 68D using an auxiliary ness.
    +2.25 lens, a corneal zone of only 2.32 mm Reprint requests to Albert Hornblass, M.D., Di­
    vision of Ophthalmology, Downstate Medical Cen­
    in diameter would be represented. However, ter, State University of New York, 450 Clarkson
    using the modification already described, a Avenue, Brooklyn, New York 11203.

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