Seep’ Gaiage Gpisianty Program Procedues and Gadelnes Reference Gude KERATOMETER ey rere Section 11 ~ Ophthaimometry Moridian aa B “7 ‘Eyepiece EP. Drum Horizontal Drum Focusing knob Lock Chin Rest ‘Adjusting Knob Hott E Elevation ob coContact Lens Dispensing 1 2.4 Theory Workbook Unit 02: Instrumentation Module: 2.1: Keratometer Parts of the Keratometer and Their Functions Label | Name Description and Function of Part of Part A Chin Rest | Turning this knob allows the chin rest © to be adjusted up Adjusting | and down to properly position the patient's head. Knob B Meridian | Twisting this collar allows alignment of the plus sign Axis horizontal bars (also the minus signs) to determine the Drum meridian axis on corneas with astigmatism. Cc Chin Rest | The patient places chin here throughout measurement (see A). D_ | Lock Turning this knob clockwise secures the instrument body in place once the desired position, vertically (see E) and horizontally has been achieved. E Height With the lock (D) released, turning this knob raises or Elevation | lowers the instrument body to align with the patient's Knob cornea and position the black cross,Contact Lens Dispensing 1 2.5 Theory Workbook Unit 02: Instrumentation Module: 2.1: Keratometer Label |Name _| Description and Function of Part of Part E.P. | Eyepiece |The operator views the mires through this ocular; must be calibrated to operator's eye prior to taking measurements (see procedure). F | Focusing | Turning this knob moves the body of the instrument forward Knob or back, enabling operator to focus the mires. G | Head Rest | Turning this knob varies the tilt of the forehead rest bar Adjustme | (see H.R.); may not be available on some models (e.g. nt Knob | Inami). H_ | Occluder | This disk is swung into position in front of the eye NOT | being measured in order to present a plain field of view, enhancing fixation. H.R. | Head Rest | Support bar where patient steadies the forehead during measurement (see G). J | Vertical | The reference point which indicates the meridian axis of the Scale vertical curvature reading. IndicatorContact Lens Dispensing 1 2.6 Theory Workbook Unit 02: Instrumentation Module: 2.1: Keratometer Label | Name Description and Function of Part of Part K | Canthus | Indicates the correct vertical position of the instrument Marker when aligned with the lateral canthus of the patient. Z Horizontal | One of two reference points which indicate the meridian axis Scale of the horizontal curvature reading. Indicator M “Horizont | Rotation adjusts the position of the plus signs which, when al” Drum | aligned, indicate the curvature of the cornea along the more horizontal meridian; reading is taken from the scale calibrated in diopters (some also have mm of radius). N “Vertical” | Rotation adjusts the position of the minus signs which, Drum when aligned, indicate the curvature of the cornea along the more vertical meridian; reading is taken from the scale calibrated in diopters (some also have mm of radius). s Meridian | Displays 180E protractor in 5E'increments for reading Axis Scale | meridian axis positions (see B, ) and L).BwNe SET UP OF KERATOMETER Disinfect the chin rest and forehead rest of the Keratometer Ask patient to remove eyeglasses or contact lenses Focus the eyepiece by turning clockwise as far as you can counter clockwise Place a piece of paper in front of the instrument and focus the eyepiece until the reticle is in focus by turning the eyepiece clockwise ‘Adjust the patients chair and the instrument to a comfortable position for both the patient and the examiner. Unlock the instrument controls Instruct the patient to place his chin in the chin rest and forehead against the headrest. Raise or lower the chin rest until the canthus marker is even with the patients outer canthus Adjust the headrest to be slightly above the patients eyebrow.STEP BY STEP PROCEDURE 1. From the outside of the instrument align the barrel with the patients right eye by raising or lowering the instrument and by moving it to the left or right until a reflection of the mires is seen on the patients cornea 2. Instruct the patient to look at the reflection of their eye inside the Keratometer 3. Look into the keratometer and refine the alignment of the image of the mires 4, Focus the mires and adjust the instrument so that the reticle is centered in the lower right mire 5. Lock the instrument in place. This is necessary on to keep the instrument from moving around 6. Adjust the horizontal and vertical power wheels until the mires are close ( you should have only 3 mires). 7. To locate the two principle meridians of the patients cornea rotate the horizontal wheel until the horizontal spurs are consistant( beside each other} 8. Adjust the horizontal wheel until the horizontal spurs cross over or overlap to create one 9. Adjust the vertical wheel until the vertical mires overlap If there is corneal astigmatism matching the mires in both meridians together will not be possible without rotating the drum to change the axis 10. During this procedure you will have to realign and focus the mires to keep the reticle in the center of the bottom right mire 11. The quality of the mires will indicate the integrity of the cornea 12. Repeat this procedure with the left eye