Corneal Topography

Corneal topography
• In nature, there are 2 types of cornea

shapes, prolate and oblate. ... A prolate
cornea is steeper centrally while an
oblate cornea is flatter centrally
• Corneal topography, also known
as photokeratoscopy or videokeratography,
is a non-invasive medical
imaging technique for mapping the surface
curvature of the cornea, the outer structure
of the eye.
Corneal topography
• Corneal topography provides us with a detailed
description of various curvature and shape
characteristics of the cornea.
• This information is very helpful for the illustration of
corneal astigmatism, detection of corneal pathologies
and perfection of contact lens fitting
keratometry
Keratoscopy
Placido disc
• Topographers can be small-cone or large-cone Placido disc systems or
slit-scanning devices.
• Placido disc systems project a series of concentric rings of light on the
anterior corneal surface.
• The corneal shape or curvature is directly measured in diopters of
curvature along thousands of points on the rings
• Small-cone Placido disc topographers project more rings on the
cornea and have a shorter working distance than large-cone Placido
disc topographers. These systems supply a great deal of measurement
points
Principle
Assessing the reflection of a concentric set of black
and white rings from the convex anterior surface of
the cornea.
The projected concentric rings are referred to as
"mires."
The shape of the corneal surface can be inferred by
inspection of these mires.
Photokeratoscopy
• The photokeratoscope combines the principles
found in keratometer and placido disc.
• A development of keratoscopy, corneal topography extends the
measurement range from the four points a few millimeters apart
that is offered by keratometry to a grid of thousands of points
covering the entire cornea.
• The procedure is carried out in seconds and is completely painless.
• The three-dimensional map is therefore a
valuable aid to the examining ophthalmologist or
optometrist and can assist in the diagnosis and
treatment of a number of conditions; in planning
refractive surgery such as LASIK and evaluation
of its results; or in assessing the fit of contact
lenses.
• The patient is seated facing the device, which is raised to eye
level. One design consists of a bowl containing an illuminated
pattern, such as a series of concentric rings.
• In either type, light is focused on the anterior surface of the
patient's cornea and reflected back to a digital camera at the
device.
• The topology of the cornea is revealed by the shape taken by
the reflected pattern.
• A computer provides the necessary analysis, typically
determining the position and height of several thousand
points across the cornea.
• The topographical map can be represented in a number of
graphical formats, such as a sagittal map, which color-codes
the steepness of curvature according to its dioptric value.
Advantages
• Quick, safe, non-invasive and painless
• Provides detailed images and sub-surface of your eyes
• Provides instant, direct imaging of the form and structure of eye
tissue
• Image resolution is extremely high quality
• No patient prep required
Videokeratoscopy
• Computer assisted videokeratoscopy (VCK) is a latest

technology.
• It uses the thousands of data points representing the corneal
curvature which are located by the topographer, interpreted
and displayed as a colour coded map of the corneal surface.
Technologies
-Curvature or placido ring imaging
-Grid projection
Procedure
• As the rings or grid are projected on to the corneal
surface, the video camera capture the images, which
are then digitalized and sent to the computer for
analysis.
• Colour coded maps are used to interpret the structure
of cornea.
• Cool colours(green, blue) represent flatter area.
• Warm colours(red, orange) represent steeper area.
(A symmetric bow tie is normal,
regular corneal astigmatism.
Slit-scanning devices
• Slit-scanning or elevation devices directly measure the elevation of
both the anterior and posterior cornea.
• These devices process elevation data along several points on the
anterior and posterior corneal surfaces. This data is then converted
into anterior and posterior curvature in diopters as well as corneal
thickness or pachymetry in microns.
• Examples of elevation devices are the Orbscan (Bausch & Lomb),
Pentacam (Oculus) and Visante OCT (Carl Zeiss Meditec)
Maps
• Axial Map
• Tangential Map
• Refractive Power Map
• Elevation Map
Thank you

Corneal Topography

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Corneal topography

• In nature, there are 2 types of cornea

• Computer assisted videokeratoscopy (VCK) is a latest

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