KERATOMETRY

Kerato = cornea
Metry = measurement

Marlya Asri
131810
The ‘keratometry’ or ‘ophthalmometry’ is an
objective method of estimating the corneal
astigmatism by measuring the curvature of central
cornea.
- not of much value in routine refraction for
prescribing glasses;
- of utmost value for prescribing contact lenses and
for calculating the power of intraocular lens to
be implanted.

Principle of keratometer

Keratometer is based on the fact that the anterior surface of the cornea acts as a convex
mirror; so the size of the image produced varies with its curvature. (Inversely proportional)
Therefore, from the size of the image formed by the anterior surface of cornea, the radius
of curvature of cornea can be calculated. The accurate measurement of the image size is
obtained by using the principle of visible doubling
 Normal ranges : 43.00 to 44.00 dioptres
Less than 40.00 or more than 47.00 = unsual
Determines :

1. The curvature – steepness or flatness

2. Refracting power - astigmatism
3. The intergrity of the cornea or tear film

Less number = flattest

High number = steepest
When do we do keratometry?

• Fitting and evaluation for contact lenses

• Determine K readings for IOL power calculation (Pre-op cataract surgery
workup
• Determine the causes of refractive error (corneal/axial)
• Assessing change in corneal shape (keratoconus, corneal scarring or post
op)
How will you calculate the power of
posterior chamber IOL to be implanted?

The power of the IOL to be implanted can be

calculated using keratometry and A-scan ultrasound.
SRK formula commonly employed to calculate IOL
power is as follows:

P = A–2.5L–0.9K

P = IOL power in dioptres,

A = specific constant of the IOL
L = axial length of the eyeball in mm
K = average keratometric reading
Types of keratometers
Two types of keratometers used in practice are

1. Javal- Schiotz model

2. Bausch & Lomb model.

Fig. 25.20 Mires during keratometry with

Bausch and Lomb keratometer
 Focus the eyepiece of the keratometer for the examiner’s eye

Calibration of the machine

• Set the adjustable eyepiece as far counter clockwise as
possible
• Place a white sheet of paper in front of the inrtument’s
objective lens to retroilluminate the reticle
• Turn the eyepiece clockwise until the reticle is first seen in
sharp focus

Ask patient to sit down, place chin on chin rest, aligned the
patient’s outer canthus is aligned with the mark on the
instrument. Cover one eye

Instruct patient
• Keep eyes open wide and blink normally
• Try not to move head or speak
• Look at the reflection of own eye in the keratometer barrel

the patient must be fully informed about the procedure. In keratometry, they should be
assured that nothing will touch the eye and they will be in no discomfort. This is particularly
important as any tendency to squeeze the lids may alter corneal contour.
Examiner :

Look into the keratometer and refine the alignment of the image of the mires
(three circles) on the patient cornea

Focus and adjust so that the reticle is centered in the lower rt hand circle

Locate the axis of the cylinder by lining up two cross by totating the barrel with
axis grip.
To locate the two principal meridians of the pt’s cornea,

Focus the horizontal meridian by turning the horizontal measuring drum until the double
crosses are superimposed.

Then we can measure the vertical meridian by rorating the vertical measuring drum until
the double minuses are superimposed
A common practice is to record the horizontal reading first.
However, some sites will record the flattest meridian first followed by the steepest meridian
and its axis

H V flattest steepest
44.00 @160 / 42.75 @ 070 or 42.75 @ 070 / 44.00 @ 160

Horizontal (180 degree) & Vertical (90 degree)

THANK YOU