Topographic axial curvature map
.Primary instrument for the sleep meridian
.Supporting instrument for the power difference
.Confirms regular ,symmetrical astigmatism
0.074D± 46.16 D @107
D@17 ±0.055D 48.19
D@17 ±1.5 2.03
Autokeratometry
.Primary instrument for the power difference
.Supporting instrument for the sleep meridian
.Multiple devices with Barrett integrated Ks
Aberration Profile
Quantitative representation of corneal ●
.Aberrations(Zernike pyramid)
Extremely useful for understanding the ●
.reason for a reduction in visual quality
2ndorder aberrations correspond to a ●
.Patient’s spectacle correction
3ed and 4thorder aberrations elevated
.With KCN Following refractive surgery
Mandatory pre-operative screen for ●
.Premium IOL candidates
An impotent part of revaluating all ●
.Patients with prior refractive surgery
Aberration
.Profile
Quantitative representation of corneal ●
.Aberrations(Zernike pyramid)
Extremely useful for understanding the ●
.reason for a reduction in visual quality
2ndorder aberrations correspond to a ●
.Patient’s spectacle correction
3ed and 4thorder aberrations elevated
.With KCN Following refractive surgery
Simulated Keratometry
A topographer simulating a standard▪
.keratometer
May not completely correlate with the▪
,Outcomes of common autokeratometry
.Especially for the low stigmata
A useful screen for the identification of▪
.irregular and /or asymmetric astigmatism
Helpful for contact lens fitting showing the▪
.Intermediate and marginal curvatures
Rings image
A reflected contour map of the▪
.Corneal surface
Contour lines demonstrate areas▪
.Of steepening and flattening
Abroad overview of the anterior▪
.Corneal surface
Useful for keratoconus, corneal▪
.Scarring prior refractive surgery
Based on sophisticated▪
.Vdeokeratographic imaging
Irregularity Map
Displays areas of anterior corneal surface▪
Irregularity
Uses best fit toric surface as the▪
Reference in an attempt to eliminate
.toricity from the map display
Displays elevation differences that●
Cannot be accounted for with a best fit
.toric reference
Similar to an elevation map ,except the▪
reference is a best fit toric surface
.Rather than a best fit sphere surface
Elevation Map
Displays corneal height and is often▪
.Used for CL fitting
Referenced against theoretical best fit▪
.Sphere placed on the corneal surface
Elevation data is derived from corneal▪
.Curvature data using an algorithm
Shows areas corresponding to▪
Depressions elevations that are
.Above/below the best fit sphere
.Red=Above BFS. Blue=Below BFS▪
Tangential Curvature Map
Calculates measured data points at a 90▪
.Tangent to the corneal surface
Correctly assumes that all refracted light▪
.Does not fall on a central reference axis
A detailed representation of the corneal▪
Surface. Smaller patterns .Useful for
Understanding the size and the shape of
.Unusual areas (e.g.; cone in KERATOCONUS)
Sensitive to local irregularities of the▪
Corneal surface and generally better for
Showing transitions incurvature than an
Axial curvature map. Typically has less
Axial Map Numerical View
Discrete calculated corneal powers▪
Displayed across the anterior surface
Quantitative and qualitative aid for▪
.Judging corneal power distribution
Can be used by 3re party software for▪
.Other types of analysis
Mostly used for an objective analysis of▪
the anterior corneal surface
.Red=steep Blue=flat▪
Axial Curvature Map
Useful for the characterization of the
Astigmatism type(irregular),alignment
.and location (WTR))asymmetric(
Axial Curvature Map
Most commonly used topographic map▪
.Feature …aka: power, or sagittal map
Limitation: Assumes that all refracted light
Displays an average of scaled values with
.smoothing .Some detail may be lost
Preferred clinically because it relates●
.corneal shape to corneal power
Often used to characterize the astigmatism●
Type (irregular),alignment .(asymmetric)
.And location (WTR vs. ATR vs. oblique)
Initial Instrument Setup
For an Ophthalmology Clinic
Axial Curvature
What other popular ophthalmic instruments use
?Technology dating back to the 19th century
.Most optical biometers
Micheleson-1881
.Reflective keratometry
Helmholtz-1851
Technology Base-The Placido disk
The Portuguese ophthalmologist Antonio:1880
.Placido painted alternating black and white rings on flat disk
1950s:Westey –Jensen used a curved bowl to
.Improve measurement accuracy in the periphery
1990s:Gersten/NYE€E Infirmary
The image reflected by the tear film describes
.Anterior corneal contour lines
These contour lines can be converted into corneal
.Curvature using a mathematical model
The result is a 3-dimensional map of the corneal
.Surface
●Modern topographers use VKG € fast computers to
.Capture and rapidly process corneal images
…Placido topography can be used for
.Surface elevation, irregularity and curvature
Refractive data (sphere,cylinder&axis)
.Regional pachymerty
Anterior corneal aberration profile
.Identifying the location of the corneal apex
.Posterior corneal power mapping
.Keratoconus screening Accurate diagnosis
.Multifocal IOL screening
.Sophisticated image simulation
