L5 - Baseline Measurements + Keratometry Flashcards

1
Q

Baseline measurements

A
Pupillary Distance 
HVID and VVID (palpebral aperture)
Pupil diameter (minimum, habitual, maximum) 
Blink rate 
Lid tension 
Lid angle 
Corneoscleral profile (CSP)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Small and large VVID (palpebral aperture)

A

Small <9mm

Large >11mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Photopic and Mesopic pupil

A

Photopic 3-4mm

Mesopic 4-5mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Blink rate

A

10-12 per minute

1 blink per 5-6 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Normal lid angle

A

1/5 of cornea covered by upper lid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

High lower lid position

A

Lower lid covers significant part of cornea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Small and Large palpebral aperture

A

Small - both lids cover cornea

Large - neither lids cover cornea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Keratometry equation

A

Rn = (2ay’) / (y-y’)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Keratometry - distorted mires/ no stable coincidence mires

A

Corneal scars
Dry eye
Patient didn’t blink (high tear film evaporation)
Unstable tear film

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Keratometry- mires incomplete

A

Eyes not open wide enough, cable Infront of mires

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Keratometry - very small radius

A

Patient not fixated properly (measured too far outside)

Opposite eye not covered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Keratometry - central radius (flat cornea and normal range)

A

Flat cornea = r>8.2mm

Normal range = 7.4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Cornealscleral profile (CSP) and CL fit

A

Flatter the sclera in comparison to the cornea, flatter the CL needs to be

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

The difference between central radii…

A

Indicates toricity of the cornea (resulting in corneal astigmatism)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Spherical cornea, small CA, normal CA, high CA, very high CA

A
Spherical cornea = ∆r = 0.0mm
Small CA = ∆r<0.1mm
Normal CA = 0.1<∆r<0.3mm
High CA = ∆r>0.3mm
Very high CA = ∆r>0.4mm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Total Astigmatism (TA)

A

The sum of Corneal and Internal Astigmatism (CA+IA)

17
Q

Internal Astigmatism (IA) occurs due to…

A

Occurs due to posterior lens surface of the cornea and tilting or shape of the crystalline lens or refractive index change of optical components

18
Q

Corneal Astigmatism (CA)

A

When cornea has unequal curvature or diaptic power of the anterior lens surface

19
Q

TA = IA + CA within a range of…

A

∆A (IA - CA) of 20degrees

20
Q

Power meridian

Axis meridian

A

Power meridian is the meridian of greatest power (r(mm)@(degrees))

Axis meridian is the meridian of least optical power (cyl(D)x(degrees))

21
Q

TA < IA contact lens suggestion

A

SCL

22
Q

TA > IA contact lens suggestion

A

RGP

23
Q

How to calculate CA

A

Find the difference between the mm of the meridians in Keratometry
0.05mm=0.25D
Difference between meridians in D = CA

24
Q

With the rule astigmatism

A

Steepest meridian (lowest mm) is on 90degrees

25
Q

Against the rule astigmatism

A

Steepest meridian (lowest mm) is on 180 degrees

26
Q

If the prescription doesn’t coincide with CA…

A

Then there is lenticular astigmatism

27
Q

Assessment of corneal shape

A

Keratometry
Corneal topographer
Orbscan
Pentacam