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Background: The aim of this study was to compare the ability of potential vision tests and clinical judgement to predict postoperative visual acuity after uneventful cataract surgery., Methods: Sixty-two subjects (median, 74.5 years) were included in the study. Preoperative measurements included a clinical judgement prediction (based on case history and ocular examination alone), 2 super-illuminated pinhole techniques (distance and near), Potential Acuity Meter and interferometer. Postoperative visual acuity was used as the outcome measure to evaluate the accuracy of the preoperative predictions., Results: Subjects were categorized as follows: (a) moderate cataract (N = 25); (b) moderate cataract and comorbidity (N = 18), and (c) advanced cataract (N = 19). Preoperative predictions within 2 lines of the postoperative visual acuity were as follows (a, b, and c respectively): clinical judgement (92%, 72%, 58%), super-illuminated pinhole distance (96%, 100%, 21%), super-illuminated pinhole near (92%, 78%, 26%), Potential Acuity Meter (72%, 67%, 21%), and interferometer (56%, 61%, 37%)., Conclusions: Based on the preoperative predictions above, none of the potential vision tests was useful compared with the clinical judgement in the advanced cataract group. The super-illuminated pinhole (distance) provided additional information beyond clinical judgement in the moderate cataract subgroup. The Potential Acuity Meter and interferometer were inaccurate even in the presence of moderate cataract, and this and other recent findings suggest they should no longer be considered adequate for potential vision assessment.

Purpose: To determine the number of measurements required to produce a representative mean result for corneal apical radius and asphericity and to examine the repeatability of this mean result., Methods: The Bausch & Lomb Orbscan II corneal topographer was used to take 10 measurements of right eyes of 20 normal individuals. These were used to determine the number of measurements required to obtain a representative result. The apical radius and p-value were derived from the instrument software for the entire surface and also calculated from the raw data for a single meridian., Results: Both apical radius and asphericity stabilized as the number of responses contributing to the mean increased. Repeat measurement for the entire surface of a three-measurement mean result was +/-0.090 mm for apical radius and +/- 0.151 for the p-value. The results for a single meridian, on repeat measurement, will lie within +/- 0.069 mm and +/- 0.051, respectively., Conclusions: Little improvement in stability or repeatability was observed after a three-measurement mean. The error and repeatability of the measurement appear to be better in this investigation when only a single meridian is analyzed. Thus, instrument software might be improved by providing analysis of apical radius and asphericity for a single, selectable meridian.

Purpose: To compare the performance of the Orbscan II topographer with a videokeratoscope for a set of tilted test buttons with known aspheric surface profile characteristics, and for a series of measurements made on normal human corneas., Methods: Measurements of apical radius and p-value were obtained from 12 aspheric test surfaces using the Orbscan II, the EyeSys videokeratoscope, and Form Talysurf analysis. Measurements from the corneas of 18 human subjects were assessed by comparison with data from the EyeSys videokeratoscope. Repeatability of Orbscan measurement was also assessed for both the test surfaces and the human corneas., Results: Measurement of the aspheric surfaces produced small but significant differences between the three instruments. For human corneas, the Orbscan apical radius measure under-read from 0.020 to 0.070 mm, and the p-value measure under-read from 0.011 to 0.085 compared with the EyeSys results., Conclusions: The Orbscan appears to under-read slightly for both apical radius and p-value when compared to both the Talysurf and the EyeSys on both the aspheric surfaces and the corneas. The differences are small but statistically significant. The corneal shape factor provided by the Orbscan instrument display is of limited value.

Aim: To assess the ability of critical flicker frequency (CFF) and optimal reading speed (ORS) to predict the potential vision in patients with cataract with and without ocular comorbidity., Methods: The two novel tests were compared with two well established potential vision tests (PVTs), the potential acuity meter (PAM) and the laser interferometer (LI). Measurements were made preoperatively in 1 eye of 88 subjects using the battery of 4 PVTs. Postoperative measurements were made with the CFF and the ORS. The subjects studied were consecutive cases over a 12-month period who fulfilled the inclusion and exclusion criteria, and agreed to participate in this study., Results: CFF was the PVT most resistant to the presence of cataract. Both CFF and ORS give a similar predictive precision in the presence of cataract and ocular comorbidity, although CFF seems more precise when the cataract is dense., Conclusions: The PAM and the LI showed a limited clinical capability in predicting postoperative visual acuity, particularly with dense opacities. The CFF shows the most promise as a PVT, particularly with dense cataract. Further evaluation is required for both CFF and ORS.

Purpose: To determine the usefulness of a battery of potential vision tests (PVTs) including potential acuity meter (PAM), laser interferometer (LI), critical flicker/fusion frequency (CFF), superilluminated pinhole at distance (SPH(d)) and near (SPH(n)), and optimal reading speed (ORS) by their independence of the effects of cataracts and sensitivity to macular disease (MD)., Setting: Department of Optometry, University of Bradford, Bradford and Leeds General Infirmary, Leeds, United Kingdom., Methods: Potential vision test measurements were determined in 76 patients with age-related cataract and no other eye disease, 52 patients with MD and clear ocular media, and 28 patients with normal, healthy eyes., Results: Potential vision tests were independent of the degrading effects of cataract up to a visual acuity (VA) level of 20/200 or worse (CFF), 20/125 (ORS and SPH), and 20/40 (PAM and LI). A high degree of association was found between PVT scores and distance VA in the MD group for SPH(d) (r2 = 0.93), SPH(n) (r2 = 0.89), and PAM (r2 = 0.71). A moderate correlation was found for LI (r2 = 0.55), CFF (r2 = 0.50), and ORS (r2 = 0.45)., Conclusions: Potential acuity meter and LI showed very limited independence to moderate/dense cataracts and inaccurate predictions in patients with MD. Superilluminated pinhole was relatively unaffected by moderate/dense cataract and yet provided accurate predictions in the presence of MD and clear ocular media. Critical flicker/fusion frequency showed the greatest ability to bypass cataracts, although its ability to predict VA in patients with early MD was limited. The ORS was relatively unaffected by moderate/dense cataract, but its poor ability to predict VA in MD may limit its clinical suitability as a PVT.

Purpose: Potential vision testing attempts to predict the visual outcome that might be expected as a result of a cataract operation. This report details the clinical utility of critical flicker frequency (CFF) as a potential vision test (PVT)., Methods: CFF thresholds were determined in 31 subjects with age-related idiopathic cataract and no other eye disease, 19 subjects with macular disease (MD) and clear ocular media, and 24 age-matched control subjects. In addition, the CFF technique was administered before cataract surgery in 52 patients and compared with the information provided by presurgical case history and ocular examination alone (ophthalmological judgment [OJ]) and results from two commonly used PVTs (the retroilluminated pinhole and the potential acuity meter)., Results: CFF thresholds obtained in the nonsurgical cataract group were unrelated to cataract severity and were similar to those in the control group. In contrast, CFF scores were significantly related to visual acuity (VA) in the MD group. In the pre- and postsurgical studies, OJ predicted postoperative VA very well in patients with moderate cataract and normal fundi and better than all the PVTs. OJ performed less well in patients with comorbid eye disease and dense cataracts, when information from the PVTs would probably have been useful. CFF provided the most accurate predictions of postoperative VA in the small sample of patients with dense cataracts., Conclusions: CFF was unaffected by cataract, yet sensitive to MD, and provided useful information about the postoperative visual outcome beyond that obtained through history and ocular examination in patients with dense cataracts.

Purpose: To determine whether critical flicker/fusion (CFF) thresholds fulfill the criteria for a potential vision test (PVT) by being unaffected by media opacity yet affected by retinal disease., Methods: CFF thresholds for three different stimulus sizes (0.5, 1.0, and 1.5 degrees ) were measured in 72 patients (mean age, 78.43 +/- 7.07 years) comprising 31 subjects with media opacity, 21 with macular disease, and 20 with pseudophakia., Results: There were no statistically significant differences between CFF values from the media opacity and the pseudophakia groups for any target size (p > 0.10). However, CFF values were significantly lower in patients with macular disease for all the target sizes (p < 0.05). Analysis of a subset of six subjects with media opacity and seven subjects with macular disease and visual acuity of 20/200 or worse showed the media opacity group still had similar CFF values as the pseudophakia group and had significantly higher CFF than the macular disease group., Conclusions: CFF testing is shown to fulfill the requirements for a PVT and may prove to be particularly useful for patients with dense media opacity.

Purpose: To suggest a tolerance level for the degree of asphericity of aspheric rigid gas-permeable contact lenses and to find a simple method for its verification., Methods: Using existing tolerances for the vertex radius, tolerance limits for eccentricity and p values and were calculated. A keratometer-based method and a method based on sag measurements were used to measure the vertex radius and eccentricity of eight concave progressively aspheric surfaces and six concave ellipsoidal surfaces. The results were compared with a gold standard measurement made using a high-precision mechanical instrument (Form Talysurf)., Results: The suggested tolerance for eccentricity and p value and is +/-0.05. The keratometer method was very accurate and precise at measuring the vertex radius (mean deviation +/- SD from Talysurf results, -0.002 +/- 0.008 mm). The keratometer was more precise than and similar in accuracy to the sag method for measurement of asphericity (mean deviation of keratometer method results from Talysurf results, 0.017 +/- 0.018; mean deviation of sag method results from Talysurf results using five semichords, -0.016 +/- 0.032)., Conclusion: Neither method was precise enough to verify the asphericity within the suggested tolerance. The keratometer can be efficiently used to verify the back vertex radius within its International Organization for Standardization tolerance and the back surface asphericity within an eccentricity/p value tolerance of +/-0.1. The method is poor for progressive aspheres with large edge blending zones. Deriving the eccentricity from sag measurements is a potential alternative if the mathematical description of the surface is known. The limiting factor of this method is the accuracy and precision of individual sag measurements.

The EyeSys videokeratoscope (VK) measurements of the principal corneal meridians of 98 subjects already analysed by Douthwaite et al. [Ophthal. Physiol. Opt. (1999)19:467-474] were re-analysed in order to revise the assessment of asphericity, to derive information on corneal tilt and to assess the degree to which the corneal section approximates to that of a conic section. The range of normality for the revised p-value (asphericity) was from 0.57 to 0.97 for the near horizontal and from 0.56 to 1.08 in the near vertical principal meridians. The approximate corneal tilt angles ranged from -3.95 to +8.13 degrees in the horizontal and from -8.99 to +9.33 degrees in the vertical meridian. A tilted conicoidal surface will display a linear relationship (r = 1) when a scatterplot is drawn of the perpendicular distance squared vs radius squared, after first averaging the two semimeridian results for each VK ring. Analysing the results from the human cornea in the same way allows an assessment of the degree to which the corneal section approximates to that of the conic section.

Purpose: To determine apical radius, surface asphericity, and horizontal visible iris diameters (HVID) in normal subjects and to find out which has the greatest influence on the corneal sagittal depth., Methods: Videokeratoscopic data were analyzed to determine the apical radius and the p-value of the near horizontal principal meridian for 73 right and 77 left eyes. The HVID also were measured., Results: Scatterplots of sagittal depth versus apical radius, p-value, and HVID indicated the strongest association between the sagittal depth and the HVID., Conclusions: Normal variations in corneal asphericity have the least influence whereas normal variations in HVID have the greatest influence in changing the corneal sagittal depth. The most appropriate measurement to take to select the optimum soft contact lens specification may be the HVID.

Purpose: To investigate the use of linear regression analysis performed on the tabular data display of the EyeSys videokeratoscope (VK). When a radius squared vs distance squared scatterplot is produced from aspheric surface data the equivalent conic section can be deduced from the intercept and slope of the linear regression line. Non-linear plots are often produced. Linear regression may then be applied in a number of ways., Method: Topographical data derived from both the EyeSys VK and a computer model of the instrument were analysed by three methods of linear regression. The resultant apical radii, p-values and predicted surface tilts were compared with known values., Results: The three methods predict different surface characteristics whose errors were found to vary depending upon the asphericity of the surface and its tilt., Conclusions: Apical radius is most accurately predicted by linear regression method (1). Both p-value and tilt are best predicted by averaging the radius and position data for corresponding points in each semi-meridian before squaring the resultant points and performing linear regression (method 3).

Aims: To investigate the ability of a telecentric keratometer to describe the asphericity and curvature of convex ellipsoidal surfaces and human corneas., Methods: 22 conicoidal convex surfaces and 30 human corneas were examined by conventional keratometry. Additional keratometric measurements were made when the surface was tilted in the horizontal plane relative to the instrument optical axis. This resulted in a series of radius measurements derived from different regions of the surface. These measurements were used to determine the apical radius and the p value of the horizontal meridian of each surface. The results were compared with those derived from measurements using the EyeSys videokeratoscope and form Talysurf analysis. The method was repeated on 30 human corneas and the results compared with those of a videokeratoscope., Results: For the aspheric buttons, the keratometric and the EyeSys results tended to give higher values for both apical radius and the p values than those of the Talysurf analysis. The best agreement was between the Talysurf and the keratometer where the results were not significantly different. For the human corneas, the apical radii were significantly different comparing the keratometer with the videokeratoscope but the p values were not significantly different., Conclusion: The keratometric method for assessing curvature and asphericity appears to hold promise as a method for quantifying the corneal topography.

The EyeSys videokeratoscope was used to assess the corneal topography in 98 subjects. Scatterplots of distance squared versus radius squared were plotted for the near horizontal and near vertical principal meridians of the two eyes. The regression lines allowed calculation of the surface apical radius and the p-value. The group average apical radius was 7.93 mm (horizontal) and 7.78 mm (vertical). The group average p-value was 0.76 (horizontal) and 0.82 (vertical). Both apical radius and p-value were similar when comparing the two eyes for both the horizontal and the vertical meridians. The two meridians in a single eye, however, had different values for both apical radius and p-value. Male apical radii were longer than those of females but the p-values were the same. There is no apparent association between age and either apical radius or p-value for the subjects used in this study. The asphericity of the cornea does not show any apparent association with corneal curvature in this group of subjects.

Rigid corneal lenses were designed for 36 subjects using the software available with the EyeSys Corneal Analysis System 2000 (software version 2.00W) and a program from the textbook 'Contact lens Optics and Lens Design' Both alignment and apical clearance designs were investigated. It was found that the EyeSys lenses produced tear layer thickness and axial edge clearance values that were excessive in some cases, especially for flatter corneas. In the case of an alignment mode of fitting, the designs were relatively steep in the back optic zone and flat in the periphery when compared with designs derived from the textbook.

Purpose: To investigate whether the apparent corneal asymmetry in the EyeSys videokeratoscope (VK EyeSys Laboratories, Houston, TX) image is a result of the cornea being tilted in relation to the instrument and to examine the possibility of deducing this tilt from a single captured image., Methods: Videokeratoscopic images were captured with and without a front surface conicoidal contact lens (experiment 1). An image was captured with central fixation followed by image capture with fixation 10 degrees off center. These two images were used to calculate the angle of tilt with central fixation. The approximate tilt of the cornea derived from a single captured image was determined by the use of a mathematical model applied to some of the ring images (experiment 2). Twenty-four subjects were used in each of the above experiments., Results: The mean tilt for the first group of subjects with the contact lens on the cornea was 2.8 degrees, whereas the tilt for the cornea alone was 3.2 degrees (experiment 1). The corneal tilt for the second group of subjects was 3.3 degrees, and the approximate tilt derived from a single captured VK image, using the equation, was 3.2 degrees (experiment 2)., Conclusions: The similarity of the tilt angle with and without the contact lens in place suggests that the apparent asymmetry seen in the VK images of human corneas may be largely an artifact arising from corneal tilt and not nasal/temporal asymmetry. The agreement of the corneal tilt derived from two VK images and the approximate tilt derived from a single image indicates that the latter may offer a quick and convenient way to determine the fixation adjustment required to eliminate corneal tilt.

Background: Various studies have compared the accuracy and repeatability of autokeratometers and videokeratoscopes using calibrated convex surfaces. We investigate the agreement between the Topcon KR-3500 autokeratometer and the EyeSys videokeratoscope on human corneas and calibrated convex surfaces., Methods: Measurements were obtained from 30 convex ellipsoidal buttons and 20 right eyes of 20 young normal human subjects. Vertex radius and p-values were compared for the two instruments., Results: The two instruments showed excellent agreement on convex buttons. The human data showed no such relationship. For vertex radius, a good level of agreement was obtained only for surfaces whose p-values were near unity. Repeatability was also calculated and was shown to be better with the Topcon autokeratometer than with the EyeSys videokeratoscope. Editing the EyeSys data to encompass the same corneal area as that of the Topcon improved its repeatability, although it did not reach the level of the Topcon autokeratometer., Conclusions: The Topcon autokeratometer and the EyeSys videokeratoscope showed reasonable agreement for surface topography on convex conicoidal plastic test buttons but not for human corneas. Alterations in the data-capture mechanisms of videokeratoscopes could improve their ability to accurately image paraboloidal surfaces.

Purpose: This study investigated the topographic corneal thickness in four groups of Hong Kong Chinese., Methods: The corneal thickness was determined with an ultrasound pachometer mounted on a X-Y plate. A head rest was used to reduce further any movement from the subject during the measurement. After the central cornea was measured, the peripheral cornea was determined on nasal, temporal, superior, and inferior regions, 2 and 5 mm from the corneal center., Results: The corneal thickness was not significantly different between the right and left eyes. For the right eye, there was no significant thickness difference for the four quadrants at a midperipheral and peripheral region, respectively. There was a general thinning of the corneal thickness at all regions from aging but no difference between the genders., Conclusion: The corneal thickness in our subjects was similar to that in other studies. The mean central corneal thickness varied from 541.7 (m to 560.8 microm, dependent on age. This study provides some information for the future studies of Chinese corneal thickness.

Background: The method of using an optical spherometer and a lens thickness gauge, in combination with a pillar and collar, has previously been shown to be repeatable and accurate (to 0.01 mm) in measuring the edge lift of rigid monocurve lenses., Purpose: This paper goes on to validate the technique for measurements taken on edge-finished multicurve rigid lenses., Methods: The axial edge lift (AEL) of a series of multicurve rigid lenses having known values of AEL was measured using an optical spherometer, a thickness gauge, and contact lens V gauge in a similar way as was described in the companion paper., Results: The results show that as long as a correction factor of 0.01 mm is applied, as found in the previous paper, the technique will allow satisfactory verification of the edge lift., Conclusions: The technique is accurate and reproducible, even in multicurve lens designs, provided that a calibrating correction factor of 0.01 mm is applied to account for methodological error. It will also indirectly allow the accuracy of manufacture of the peripheral curves and diameters of any rigid contact lens to be verified.

Purpose: The clinical importance of the edge lift of rigid contact lenses is often neglected, possibly due to previous difficulties in its measurement. A new method of measuring axial edge lift (AEL) and radial edge lift (REL) using standard contact lens verification equipment, such as an optical spherometer, a thickness gauge, and contact lens V gauge, is described., Methods: The technique was validated for trueness (accuracy) and precision (repeatability) by measuring the edge lift of a number of monocurve lenses, manufactured both with and without a normal edge finish., Results: Edge lift was measured to an accuracy of 0.01 mm., Conclusions: As long as a mean of eight independent measurements of back optic zone radius (BOZR), sagitta, and one measurement of center thickness are taken, the pillar and collar technique is capable of producing accurate and repeatable measurements of the edge lift of a rigid contact lens.

We measured the central corneal thickness and the applanation intraocular pressure (IOP) on 45 Hong Kong Chinese. There was no obvious relationship between these two parameters, as different from other literatures. It could be due to either a limited number of subjects with a high IOP level (only six subjects with IOP > or = 22 mmHg), or Chinese has a thicker central cornea in general. The mean central cornea of our subjects was thicker (566 +/- 36 microns) than some previous findings. Thirty subjects had their intraocular pressure further increased by adopting a 40 degrees head-down posture. Their IOP and topographic corneal thickness were measured again. There was no significant change in the central corneal thickness even though the IOP was elevated by 11.7 mmHg. However the nasal cornea demonstrated a thinning effect (by some 18 microns) during the IOP elevation but it returned to the pre-inverted level after returning to a sitting posture for 5 min. Further investigation with more corneal regions being measured would be valuable to evaluate the in vivo effect of IOP elevation from glaucoma attack on corneal thickness.

Purpose: Previous studies have found that the intraocular pressure (IOP) variation from postural change is due to the obstruction of aqueous outflow by an increase in episcleral venous pressure. This study investigated if any shift of anterior lens position from postural variation would be another contributing factor., Methods: Thirty-three Chinese subjects were recruited with their IOP and anterior chamber depth (ACD) measured in the sitting, supine, and prone postures. The IOP was measured using a Pulsair 2000 noncontact tonometer and ACD with a Nidek US-2000 EchoScan unit., Results: The highest IOP was obtained in the prone position and this value was significantly different from the IOP obtained in other postures, whereas there was no significant difference in ACD., Conclusions: Because no significant variation in ACD was demonstrated, the prone and supine IOP variation could be due to something other than the change in lens position. However, a higher IOP in the prone position rather than in the supine position also suggests that it is not merely the episcleral venous pressure causing the IOP change. Investigation of the entire iris profile at different postures would be more informative in future studies.

The posterior corneal p-value and apical radius of 60 Hong Kong Chinese were assessed. The values were derived based on the information of the anterior corneal topography and the corneal thickness in different regions. The mean posterior corneal apical radius along the horizontal meridian was 6.51 mm (SD +/- 0.40 mm) and the p-value was 0.34 (SD +/- 0.38). The apical radius is greater while the p-value is smaller than a previous study using a similar principle. This may indicate a flatter posterior cornea and greater peripheral flattening in Hong Kong Chinese. No significant difference between the nasal and temporal corneal thickness, nasal and temporal posterior p-value and apical radius was demonstrated. The right and left eyes were also similar in different ocular parameters apart from a smaller anterior corneal p-value on the right eye (R eye: 0.70 +/- 0.13; L eye: 0.67 +/- 0.12), but the difference may not be significant clinically. The method used here is simple and the generation of posterior corneal topography is informative.

The central posterior corneal radius was measured by assessing the first and second Purkinje images produced from a modified keratometer. This method was initially assessed by measuring five PMMA lens buttons with back surface radii from 6.2 mm to 7.0 mm. It was reasonably accurate when compared with the measurements made using a conventional radiuscope. The technique was found to be repeatable for human subjects measured on three separate occasions. The mean central posterior corneal radii from a group of 30 Hong Kong Chinese were 6.64 mm (SE 0.05 mm) and 6.39 mm (SE 0.05 mm) along the horizontal and vertical meridians respectively. These results are similar to previous studies using a similar technique. The posterior corneal radii were found to be similar for right and left eyes and there were no gender differences.

Twenty-three optometry students with normal corneal condition were recruited. The intraocular pressure and central corneal curvature of the right eye were measured in a sitting and a 30 degrees head-down posture. The mean (standard deviation) IOPs before and during posture change were 15.6 (2.4) mmHg and 22.1 (2.3) mmHg respectively. This 6.5 mmHg mean rise in IOP was found to be statistically significant which is similar to the results from previous studies. The mean changes in radius of corneal curvature and the orientation of the axis of the vertical principal meridian were 0.02 mm (SD 0.025 mm) and 2.4 degrees (SD 10.4 degrees) respectively. No significant variation was demonstrated on these keratometric results due to the 30 degrees head-down posture. The maximum change in radius of curvature was only 0.055 mm for one subject. Perhaps this amount of pressure rise was not sufficient enough to distort the corneal surface centrally. Another possibility could be an even distribution of the elevated pressure around the cornea, or the distribution of pressure is not even but could not be revealed by a conventional keratometer.

Aims: This study examined the occurrence, magnitude, and the consequences of a possible tilt between the corneal surface and optical axis of the EyeSys videokeratoscope., Methods: Initially, a theoretical model was developed to calculate the angle of tilt. The predictions of the model were verified empirically using a convex conicoid surface and were found to predict the tilt to within 0.5 degree of the actual tilt. The likely effects of the tilt on the corneal power were also examined. The angle of tilt was then measured on the human cornea and the effect of neutralising the tilt on the videokeratoscopic data display was observed., Results: The angle of tilt was found to lie between 1 degree and 6 degrees in a temporal direction., Conclusion: When the corneal tilt on the human subjects was neutralised, then a reduction in the nasal/temporal asymmetry was observed.

The purpose of this report is to assess the accuracy of the TMS-1 videokeratoscope (Computed Anatomy Inc.) by using convex ellipsoidal surfaces. The ellipsoids were calibrated using Form Talysurf analysis, which allowed for subsequent calculation of the vertex radius and p value. The videokeratoscope was used to examine the same ellipsoids. The data provided by the instrument software were used to plot a graph of r2 verses y2, where r is the measured radius at y, the distance from the corneal point being measured to the optical axis of the instrument. The intercept on the ordinate of this graph gives the vertex radius, and the slope give the p value. The results arising from the Talysurf and the TMS-1 techniques were compared. The TMS-1 videokeratoscope gave readings for the vertex radius that were generally higher than those of the Talysurf analysis. The vertex radius was up to 0.09 mm greater. The p value results were similar by the two methods for p values of approximately 0.8; however, the TMS-1 results were higher, and the discrepancy increased as the p value approached that of a paraboloid. Although the videokeratoscope may be useful in comparative studies of the cornea, there must be some doubt about the absolute values displayed as the surface becomes increasingly aspheric.

A corneal topography study was carried out on Hong Kong Chinese subjects using a modified keratometer. The Chinese corneal topography measured by this modified keratometer was similar to other studies using the Wesley-Jessen Photo Electronic Keratoscopy (PEK) System 2000. The mean p-values along the horizontal meridian and the vertical meridian were 0.82 and 0.87, respectively. A negative correlation was found between the p-value and the central corneal radius along the horizontal meridian which may indicate that a steeper central cornea will have a greater p-value. However, the correlation coefficient of 0.56 was not too certain for this conclusion to be drawn. A difference of 0.04 was found between the horizontal p-value and the vertical p-value, which may be a result of the tight lid tension along the vertical meridian. This modified keratometer can be considered as an inexpensive instrument for the study of corneal topography.

Aims/background: This study was carried out to assess the accuracy of the EyeSys videokeratoscope by using convex ellipsoidal surfaces of known form., Methods: PMMA convex ellipsoidal buttons were calibrated using Form Talysurf analysis which allowed subsequent calculation of the vertex radius and p value of the surface. The EyeSys videokeratoscope was used to examine the same ellipsoids. The tabular data provided by the instrument software were used to plot a graph of r2 versus y2 where r is the measured radius at y, the distance from the corneal point being measured to the surface vertex. The intercept on the ordinate of this graph gives the vertex radius and the slope the p value. The results arising from the Talysurf and the EyeSys techniques were compared., Results: The EyeSys videokeratoscope gave readings for both vertex radius and p value that were higher than those of the Talysurf analysis. The vertex radius was around 0.1 mm greater. The p value results were similar by the two methods for p values around unity but the EyeSys results were higher and the discrepancy increased as the p value approached that of a paraboloid., Conclusions: Although the videokeratoscope may be useful in comparative studies of the cornea, there must be some doubt about the absolute values displayed. The disagreement is sufficiently large to suggest that the instrument may not be accurate enough for contact lens fitting purposes.

The purpose of this research was to determine if the conventional keratometer measures tangential or sagittal radius. A Bausch and Lomb keratometer was modified to enable an assessment of vertex radius and p-value to be made on convex conicoidal buttons of known surface form. Calculation of these two parameters was achieved assuming that the keratometer was measuring tangential radius and then repeated assuming a sagittal measurement. The resulting values could then be compared with those obtained by Form Talysurf analysis and by the use of an autokeratometer designed to measure sagittal radius. There was good agreement between the three instruments when the modified Bausch and Lomb keratometer was assumed to measure sagittal radius. We conclude that the Bausch and Lomb keratometer makes a radius measurement closer to the sagittal than the tangential radius of a conicoid of revolution.

A mathematical equation was derived to calculate the corneal p-value based on the central and peripheral corneal radii and the corresponding semichord diameters. The calculation was simplified by a computer program written using GWBASIC. The accuracy of corneal p-value generated from this program was checked with Douthwaite's modified keratometer with good correlation. This program could be used to find out the corneal p-value and apical radius ro for any topographic keratometer which only provides central and peripheral radii without any information of the p-value and apical radius.

The conventional rigid-lens fitting method uses fluorescein to assess the tear layer beneath a trial lens on the corneal surface. A more advanced technique, which uses a computer program to determine the back surface specifications of a contact lens from a pre-set tear layer thickness, has been studied. No significant difference was found in terms of corneal physiological changes between the conventionally determined contact lenses and computer-determined contact lenses after a three-month wearing period. The results suggest that there is little difference in the two methods of fitting. However, the computer determined method was found to be more efficient in terms of chair time, and also can aid inexperienced rigid lens practitioners to select the appropriate lens back surface curves.

By subdividing a lens design into simpler units it is possible to evaluate its mass and locate its centre of mass (the centroid). The constituent subcomponents form plane sections of the sphere, or, in the case of aspheric lenses, sections of a conicoid. The theory of lens analysis in terms of the conicoidal (and spherical) frustrum is discussed and a BASIC computer program is presented to perform the calculations for spherical multicurve contact lenses.

The clinician involved in cataract assessment is often faced with a deterioration in visual performance which may or may not be totally attributable to the cataract. Neural changes may occur concurrently and contribute toward the reduced performance. This paper reviews the methods which attempt to discriminate between changes due to cataract development and changes produced by neural degeneration. New techniques have been developed with more emphasis on quantitative rather than qualitative assessment. These techniques are discussed critically with particular reference to their ability to distinguish between the contributions of optical and neural change. This has particular application in predicting the visual outcome after cataract surgery.

The effect of induced fixation disparity produced by negative lenses and base-in prisms on the pattern visually evoked potential (VEP) was investigated. Monocular and binocular pattern reversal VEP were recorded through the negative lenses and base-in prisms using a 9.5 min arc check size. The results suggest that the mean binocular amplitude was 27% larger than the mean monocular amplitude which indicates partial summation in the absence of negative lenses or base-in prisms. A reduction of the binocular VEP amplitude appears to arise in the presence of fixation disparity induced by both the negative lenses and base-in prisms. Both the prisms and the negative lenses had no appreciable effect on the monocular VEP amplitude.

Although the curvature of the general cornea's two principal meridians can be acceptably modelled (within limits) by ellipses, this is insufficient to delineate the overall corneal surface. Applying different assumptions in either case, two corneal models are advanced which interpolate x, y, z points over the whole corneal surface, dependent only on the specifications of the plane curves of the principal meridians.

To study the effect of voluntary concentration on the visual evoked potential (VEP) with monocular and binocular rivalry stimulation, pattern reversal VEPs were recorded using 5.5 min arc and 50 min arc check sizes. Subjects viewed the VEP stimulus with the left eye and a light emitting diode (LED) with the right eye. They were asked to concentrate on either the VEP stimulus or the LED. The two targets were arranged so that the left eye remained accurately focused on, and directed to, the centre of the VEP stimulus throughout the recordings. The binocular VEP wave became attenuated when the subject concentrated on the LED. The wave was reduced to around two-thirds of the amplitude present when concentrating on the VEP stimulus. This reduction in the VEP amplitude is considered to be due to a binocular interaction because there was a lack of amplitude attenuation when the experiment was repeated with monocular conditions. The results also suggest that the wave is smaller when the non-dominant eye receives the VEP stimulus compared with that when the dominant eye is stimulated by the VEP target.

A keratometer with a standard and a large mire was used to estimate the corneal apical radius and p value. A computer program used this information to determine an optimum fitting contact lens. A fitting set was used independently to determine the optimum contact lens by conventional clinical assessment. The two approaches were in broad agreement, but the computerized approach was quicker. However, calculations revealed that in this group of subjects standard keratometry provides a good estimate of the equivalent sphere which is used to determine the optimum back optic zone radius in the computerized approach.

The influence of neutral density (ND) filters on the pattern visually evoked response (VER) was investigated as a function of check size. Monocular and binocular transient pattern reversal VER's were recorded through three ND filters (0.6, 1.0, and 2.6 log units) before 1 eye on 55 adult subjects using 5.5 min arc and 50 min arc check sizes. The 5.5 min arc check produced responses which suggest that partial binocular summation is present in the absence of ND filters but disappears as the filter density increases. In the case of the 50 min arc check size the presence of binocular summation is less certain and a 1.0 log unit ND filter produces binocular inhibition which may be due to latency differences between the two eyes. Eye dominancy appears to have no effect on these results.

Monocular and binocular transient visually evoked responses (VER) were recorded on 50 adult subjects using a pattern reversal stimulus (check size 5.5 min arc). The peak-to-trough amplitude of the VER wave was measured and compared with the subjective visual acuity (Landolt C). The binocular amplitude enhancement over the monocular amplitude was around 26% across the acuity range studied, whereas the mean binocular subjective visual acuity improvement was around 11.3%, but this varied from 1% at the high acuity end to 17% at the low acuity end of the range.

A technique is described for predicting visual acuity in adult humans by using the visually evoked response (VER). This involves using a pattern-reversal checkerboard with a small check size (5.5. min arc) as the stimulus, and measuring the peak-to-trough amplitude of the VER wave arising from it. The technique is therefore both rapid and convenient. The pattern-reversal rate was varied in order to assess the influence of the temporal modulation on the VER waves. The results suggest that a rapid pattern reversal rate produces a VER which displays a reduced association with spatial processing.

A technique is proposed which allows assessment of the anterior chamber depth with a standard table slit-lamp without any extra attachments. A final approximation is made which suggests that a 1 degree change in the angle between the observation and illumination systems of the slit lamp when the end point is reached indicates a change in anterior chamber depth of 0.1 mm.

The amplitude repeatability of pattern reversal visual evoked response using a 5.5 and 40' arc check was investigated in twelve subjects with each subject recording ten 64 sweep runs. The variability by visual inspection or by analysis of variance suggests that a single run will provide a representative amplitude for a 40' arc check whereas the 5.5' check will require more runs merged together before the amplitude is stable. The larger spread of error encountered with the 40' arc check may point to a visual component contributing to more amplitude variability. The possibility of making some assessment of the level of noise present during recording is discussed.

A pattern reversal stimulus (check size 5.5 min arc) was used to elicit visually evoked responses (VER's). The peak to trough amplitude of the VER wave was measured and compared to the subjective visual acuity (Landolt C) in 30 subjects. The recordings were made at 3, 6, and 12 pattern reversals per s. The correlation coefficients are reasonably high (r = 0.81) for both the 3 and 6 reversal rates with a considerably lower correlation coefficient (r = 0.54) for the 12 reversals per s stimulus. Repeatability measurements on a further 6 subjects taken over a 5-week period produced an amplitude coefficient of variation of 13% for the 6 subjects with the 3 reversals per s stimulus.

Pattern reversal visually evoked responses (VER's) at a frequency of 7 Hz were recorded from 10 subjects. Peak-to-trough amplitudes were measured at centrally fixated field sizes from 1 to 8 degrees for check sizes from 2.5 to 30 min. Check size for maximum amplitude decreased as field size was reduced. The amplitude--check size relation was not necessarily linear across its full range. When using an extrapolation technique for estimating visual acuity, a curvilinear regression may be more appropriate than the assumption of a linear regression.

The relationship between corneal curvature measured by classical keratometry and refractive error raises the question of a possible systematic relationship between refractive error and the degree of corneal asphericity. A recomputation and analysis of previously published data leads to the conclusion that the different refractive groups have similar values of the parameter 'p' and differ only in the apical radius of the cornea.

The critical flicker frequency and the Pulfrich stereophenomenon were both used to investigate the long term effects on temporal resolution and visual latency of wearing a tinted lens in front of one eye for a period of five days. The results obtained from three subjects showed that in every case the critical flicker frequency was depressed by the tinted lens and displayed no adaptive recovery, but the Pulfrich effect displayed a reduction of apparent depth in the median plane indicating the presence of an adaptive recovery. It is postulated that the CFF indicates that the physiological transmission of the visual signal is unaltered over the the five days and the Pulfrich adaptation occurs due to an alteration of the interpretation of the unchanged visual response. That is, the adaptation is a perceptual rather than a physiological one.

The pattern reversal visually evoked response (VER) was recorded using a small check size stimulus. Subjects viewed the VER stimulus with the left eye and a light emitting diode (LED) with the right eye. They were asked to concentrate on either the VER stimulus or the LED. The two targets were arranged so that the left eye remained accurately focused on, and directed to, the center of the VER stimulus throughout the recordings. The VER wave became attenuated when the subject concentrated on the LED. The wave was reduced to around two-thirds of the amplitude present when concentrating on the VER stimulus.

The ability of the evoked potential to predict conventional visual acuity, as measured with a Landolt C test, was investigated for subjects with normal acuities. Both peak-to-trough and Fourier-analysed amplitudes were used. The extrapolation technique assumed curvilinear regression and produced correlations no better than did a method employing amplitude measurements of a single check size of 5.5 min arc (r = 0.67). Assessment of Landolt C acuity by subjective use of the evoked potential stimulus was unable to produce a higher correlation.