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Corneal Pachymetry
Corneal pachymetry is the process of measuring the thickness of the cornea. A pachymeter is a medical device used to measure the thickness of the eye's cornea. It is used to perform corneal pachymetry prior to refractive surgery, for Keratoconus screening, LRI surgery and is useful in screening for patients suspected of developing glaucoma among other uses. Process It can be done using either ultrasonic or optical methods . The contact methods, such as ultrasound and optical such as confocal microscopy (CONFOSCAN), or noncontact methods such as optical biometry with a single Scheimpflug camera (such as SIRIUS or PENTACAM), or a Dual Scheimpflug camera (such as GALILEI), or Optical Coherence Tomography (OCT, such as Visante) and online Optical Coherence Pachymetry (OCP, such as ORBSCAN). Corneal Pachymetry is essential prior to a refractive surgery procedure for ensuring sufficient corneal thickness to prevent abnormal bulging of the cornea, a side effect known as ectasia. Pa ...
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Cornea
The cornea is the transparency (optics), transparent front part of the eyeball which covers the Iris (anatomy), iris, pupil, and Anterior chamber of eyeball, anterior chamber. Along with the anterior chamber and Lens (anatomy), lens, the cornea Refraction, refracts light, accounting for approximately two-thirds of the eye's total optical power. In humans, the refractive power of the cornea is approximately 43 dioptres. The cornea can be reshaped by surgical procedures such as LASIK. While the cornea contributes most of the eye's focusing power, its Focus (optics), focus is fixed. Accommodation (eye), Accommodation (the refocusing of light to better view near objects) is accomplished by changing the geometry of the lens. Medical terms related to the cornea often start with the prefix "''wikt:kerat-, kerat-''" from the Ancient Greek, Greek word κέρας, ''horn''. Structure The cornea has myelinated, unmyelinated nerve endings sensitive to touch, temperature and chemicals; a to ...
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Medical Device
A medical device is any device intended to be used for medical purposes. Significant potential for hazards are inherent when using a device for medical purposes and thus medical devices must be proved safe and effective with reasonable assurance before regulating governments allow marketing of the device in their country. As a general rule, as the associated risk of the device increases the amount of testing required to establish safety and efficacy also increases. Further, as associated risk increases the potential benefit to the patient must also increase. Discovery of what would be considered a medical device by modern standards dates as far back as in Baluchistan where Neolithic dentists used flint-tipped drills and bowstrings. Study of Archaeology, archeology and Roman medical literature also indicate that many types of medical devices were in widespread use during the time of ancient Rome. In the United States it was not until the Federal Food, Drug, and Cosmetic Act ( ...
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Human Eye
The human eye is a sensory organ in the visual system that reacts to light, visible light allowing eyesight. Other functions include maintaining the circadian rhythm, and Balance (ability), keeping balance. The eye can be considered as a living optics, optical device. It is approximately spherical in shape, with its outer layers, such as the outermost, white part of the eye (the sclera) and one of its inner layers (the pigmented choroid) keeping the eye essentially stray light, light tight except on the eye's optic axis. In order, along the optic axis, the optical components consist of a first lens (the cornea, cornea—the clear part of the eye) that accounts for most of the optical power of the eye and accomplishes most of the Focus (optics), focusing of light from the outside world; then an aperture (the pupil) in a Diaphragm (optics), diaphragm (the Iris (anatomy), iris—the coloured part of the eye) that controls the amount of light entering the interior of the eye; then an ...
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Refractive Surgery
Refractive surgery is an optional eye surgery used to improve the refractive state of the eye and decrease or eliminate dependency on glasses or contact lenses. This can include various methods of surgical remodeling of the cornea ( keratomileusis), lens implantation or lens replacement. The most common methods today use excimer lasers to reshape the curvature of the cornea. Refractive eye surgeries are used to treat common vision disorders such as myopia, hyperopia, presbyopia and astigmatism. History The first theoretical work on the potential of refractive surgery was published in 1885 by Hjalmar August Schiøtz, an ophthalmologist from Norway. In 1930, the Japanese ophthalmologist Tsutomu Sato made the first attempts at performing this kind of surgery, hoping to correct the vision of military pilots. His approach was to make radial cuts in the cornea, correcting effects by up to 6 diopters. The procedure unfortunately produced a high rate of corneal degeneration, ...
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Keratoconus
Keratoconus is an eye disorder in which the cornea, the transparent front part of the eye, gradually thins and bulges outward into a cone shape. This causes distorted vision, including blurry vision, double vision, increased nearsightedness, irregular astigmatism, and light sensitivity, which can reduce Quality of life (healthcare), quality of life. Both eyes are usually affected. The cause is not fully understood but likely involves a combination of heredity, genetic, environmental, and hormonal factors. Having a parent, sibling, or child with keratoconus increases risk significantly. Environmental risk factors include frequent eye rubbing and atopy, allergies. Diagnosis is typically made with corneal topography, which maps the shape of the cornea and reveals characteristic changes. In early stages, vision is often corrected with glasses or soft contact lenses. As the condition progresses, rigid or scleral contact lenses may be needed. In 2016, the FDA approved corneal col ...
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Limbal Relaxing Incisions
Limbal relaxing incisions (LRI) are a refractive surgical procedure to correct minor astigmatism in the eye. Incisions part way through the cornea are made at one side or at opposite edges of the cornea, following the curve of the iris, causing a slight flattening of the cornea in that area. Because the incisions are outside of the field of view, they do not cause glare and other visual effects that result from other corneal surgeries like radial keratotomy. LRI have become the most common technique to correct astigmatism as part of cataract surgery. They are simpler and less expensive than laser surgery such as LASIK LASIK or Lasik (; "laser-assisted in situ keratomileusis"), commonly referred to as laser eye surgery or laser vision correction, is a type of refractive surgery for the correction of myopia, hyperopia, and astigmatism. LASIK surgery is p ... or photorefractive keratectomy and avoid the precise placement requirements of toric IOLs. Good results do not r ...
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Glaucoma
Glaucoma is a group of eye diseases that can lead to damage of the optic nerve. The optic nerve transmits visual information from the eye to the brain. Glaucoma may cause vision loss if left untreated. It has been called the "silent thief of sight" because the loss of vision usually occurs slowly over a long period of time. A major risk factor for glaucoma is increased pressure within the eye, known as Intraocular pressure, intraocular pressure (IOP). It is associated with old age, a family history of glaucoma, and certain medical conditions or the use of some medications. The word ''glaucoma'' comes from the Ancient Greek word (), meaning 'gleaming, blue-green, gray'. Of the different types of glaucoma, the most common are called open-angle glaucoma and closed-angle glaucoma. Inside the eye, a liquid called Aqueous humour, aqueous humor helps to maintain shape and provides nutrients. The aqueous humor normally drains through the trabecular meshwork. In open-angle glaucoma, ...
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Ultrasound
Ultrasound is sound with frequency, frequencies greater than 20 Hertz, kilohertz. This frequency is the approximate upper audible hearing range, limit of human hearing in healthy young adults. The physical principles of acoustic waves apply to any frequency range, including ultrasound. Ultrasonic devices operate with frequencies from 20 kHz up to several gigahertz. Ultrasound is used in many different fields. Ultrasonic devices are used to detect objects and measure distances. Ultrasound imaging or sonography is often used in medicine. In the nondestructive testing of products and structures, ultrasound is used to detect invisible flaws. Industrially, ultrasound is used for cleaning, mixing, and accelerating chemical processes. Animals such as bats and porpoises use ultrasound for locating prey and obstacles. History Acoustics, the science of sound, starts as far back as Pythagoras in the 6th century BC, who wrote on the mathematical properties of String instrument ...
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Corneal Waveform (CWF)
Corneal pachymetry is the process of measuring the thickness of the cornea. A pachymeter is a medical device used to measure the thickness of the eye's cornea. It is used to perform corneal pachymetry prior to refractive surgery, for Keratoconus screening, LRI surgery and is useful in screening for patients suspected of developing glaucoma among other uses. Process It can be done using either ultrasonic or optical methods . The contact methods, such as ultrasound and optical such as confocal microscopy (CONFOSCAN), or noncontact methods such as optical biometry with a single Scheimpflug camera (such as SIRIUS or PENTACAM), or a Dual Scheimpflug camera (such as GALILEI), or Optical Coherence Tomography (OCT, such as Visante) and online Optical Coherence Pachymetry (OCP, such as ORBSCAN). Corneal Pachymetry is essential prior to a refractive surgery procedure for ensuring sufficient corneal thickness to prevent abnormal bulging of the cornea, a side effect known as ectasia. Pach ...
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Astigmatism
Astigmatism is a type of refractive error due to rotational asymmetry in the eye's refractive power. The lens and cornea of an eye without astigmatism are nearly spherical, with only a single radius of curvature, and any refractive errors present can be corrected with simple glasses. In an eye with astigmatism, either the lens or the cornea is slightly egg-shaped, with higher curvature in one direction than the other. This gives distorted or blurred vision at any distance and requires corrective lenses that apply different optical powers at different rotational angles. Astigmatism can lead to symptoms that include eyestrain, headaches, and trouble driving at night. Astigmatism often is present at birth, but can change or develop later in life. If it occurs in early life and is left untreated, it may result in amblyopia. The cause of astigmatism is unclear, although it is believed to be partly related to genetic factors. The underlying mechanism involves an irregular c ...
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Intraocular Pressure
Intraocular pressure (IOP) is the fluid pressure inside the eye. Tonometry is the method eye care professionals use to determine this. IOP is an important aspect in the evaluation of patients at risk of glaucoma. Most tonometers are calibrated to measure pressure in millimeters of mercury (mmHg). Physiology Intraocular pressure is determined by the production and drainage of aqueous humour by the ciliary body and its drainage via the trabecular meshwork and uveoscleral outflow. The reason for this is because the vitreous humour in the posterior segment has a relatively fixed volume and thus does not affect intraocular pressure regulation. An important quantitative relationship (Goldmann's equation) is as follows: :P_o = \frac + P_v Where: * P_o is the IOP in millimeters of mercury (mmHg) * F the rate of aqueous humour formation in microliters per minute (μL/min) * U the resorption of aqueous humour through the uveoscleral route (μL/min) * C is the facility of outflow in mic ...
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