Keratograph: Instruction Manual

Keratograph
Instruction Manual
Measurement and Evaluation System for
Corneal Topography
Copyright by G/70500/0803/e
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Instruction Manual Keratograph
0 Foreword
Thank you for the confidence which you have The Keratograph before you belongs to the latest
placed in us by buying this OCULUS product. generation of topographic measuring
With this unit you have made your decision for a instruments. It combines keratometric
modern, highly developed product which has measurement with the measurement of corneal
been manufactured and tested according to the topography. The unit's extreme accuracy of
highest standards of quality. Research and measurement and simplicity in use are the result
development at OCULUS, which always aim at of our careful development.
serving your best interests, can lead to changes Proper use is indispensable for safety in working
in the design and scope of standard equipment. with the unit. Therefore, please familiarize
For this reason the illustrations in this Instruction yourself thoroughly with the contents of this
Manual may differ in some respects from the unit Instruction Manual before using the unit for the
as delivered. first time.
Our company can look back on a history that Should you have questions or need further
stretches more than 100 years into the past. information on your unit, please contact us by
OCULUS today is a middle-sized company telephone or send us a fax message. Our service
whose only focus is to support physicians and team will be happy to help you.
optometrists in their demanding work with a line
of top-quality products for ocular examinations OCULUS Optikgeräte GmbH -
and operations. The Management and Staff
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1 Table of Contents
0 Foreword........................................................................................................................................... 2
1 Table of Contents.............................................................................................................................. 3
2 Scope of Supplies and Optional Accessories ................................................................................... 5
3 Safety Precautions ............................................................................................................................ 7
4 Description of the Unit and its Functions .......................................................................................... 8
5 Appropiate Use / Intended Application.............................................................................................. 8
6 First Use of the Unit .......................................................................................................................... 9
6.1 Installation and Adjustment........................................................................................................ 9
6.2 Directions for Transport and Storage ........................................................................................ 9
7 Directions For Use .......................................................................................................................... 10
7.1 Patient Data Management ....................................................................................................... 10
7.1.1 Selection of a Patient........................................................................................................ 11
7.1.2 Entering a New Patient..................................................................................................... 11
7.1.3 To Start the Examination Program ................................................................................... 12
7.1.4 Deleting / Moving Examination Data ................................................................................ 12
7.1.5 Patient Data...................................................................................................................... 13
7.1.5.1 Rename Patient ............................................................................................................ 13
7.1.5.2 Deleting Patient Data .................................................................................................... 13
7.1.5.3 Exporting Patient Data .................................................................................................. 13
7.1.5.4 Importing Patient Data .................................................................................................. 14
7.1.6 Backup Copies of Data..................................................................................................... 15
7.1.6.1 Backing Up Data ........................................................................................................... 15
7.1.6.2 Data Restoration ........................................................................................................... 15
7.1.6.3 Auto-Backup ................................................................................................................. 16
7.1.7 Changing Settings ............................................................................................................ 16
7.2 The Examination Program ....................................................................................................... 18
7.2.1 How to Carry Out a Measurement.................................................................................... 19
7.2.2 Using Different Types of Display to Evaluate Examination .............................................. 21
7.2.2.1 Overview Display .......................................................................................................... 21
7.2.2.2 Color Map large ............................................................................................................ 23
7.2.2.3 3D Cornea..................................................................................................................... 24
7.2.2.4 Fourier Analysis ............................................................................................................ 25
7.2.2.4.1 Applications of the Fourier Display Mode in Keratokonus....................................... 28
7.2.2.5 Zernike Analysis............................................................................................................ 30
7.2.2.5.1 General.................................................................................................................... 30
7.2.2.5.2 Zernike Analysis Using the Keratograph ................................................................. 32
7.2.2.5.3 Zernike Fit Parameters............................................................................................ 33
7.2.2.5.4 Zernike: Normal Values and Aberration Coefficient ................................................ 34
7.2.2.5.5 Zernike 2D Display Mode ........................................................................................ 34
7.2.2.6 Indices........................................................................................................................... 36
7.2.2.6.1 Vertical Decentration ............................................................................................... 39
7.2.2.7 Refractive Display Mode ............................................................................................... 40
7.2.2.8 Height Data ................................................................................................................... 42
7.2.2.9 Camera Image .............................................................................................................. 45
7.2.2.10 Refractive Compare .................................................................................................. 45
7.2.2.11 Comparing Examinations .......................................................................................... 47
7.2.3 Contact Lens Fitting.......................................................................................................... 48
7.2.3.1 Selecting a Contact Lens .............................................................................................. 49
7.2.3.2 Fluo Image Simulation / [Calc. fluo.] ............................................................................. 50
7.2.3.2.1 Fluo Icon Selection Switches .................................................................................. 51
7.2.3.2.2 Shifting and Rotating the Contact Lens................................................................... 51
7.2.3.2.3 Setting Contact Lens Parameters / [Details] ........................................................... 52
7.2.3.2.4 Changing the Scale of the Fluo Image .................................................................... 53
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7.2.3.2.5 Top Test .................................................................................................................. 53

7.2.3.2.6 Using Hecht Fitting Software / [Hecht CL]............................................................... 54
7.2.3.3 Refraction Module / [Refraction] ................................................................................... 55
7.2.3.3.1 Power Calculation for Toric Lenses......................................................................... 56
7.2.3.3.2 Power Calculation for Soft Lenses .......................................................................... 58
7.2.3.4 Storing and Loading the Fitted Contact Lens................................................................ 58
7.2.4 Pupillometer Software ...................................................................................................... 60
7.2.4.1 Activation of the Pupillometer Software ........................................................................ 60
7.2.4.2 Starting the Pupillometer Software ............................................................................... 61
7.2.4.3 Carrying out an Automatic Pupillometric Measurement................................................ 62
7.2.4.4 Carrying out a Manual Pupillometric Measurement ...................................................... 63
7.2.4.5 Pupillometer Overview Display ..................................................................................... 64
7.2.4.6 Pupillometric Comparison View .................................................................................... 65
7.2.4.7 Pupillometer Camera Image Menu Item ....................................................................... 66
7.2.4.8 Changing the Settings for Pupillometer Camera Exposure .......................................... 67
7.2.5 Changing Settings ............................................................................................................ 68
7.2.5.1 “Change System Settings” Button [System->] .............................................................. 71
7.2.5.2 Contact Lens Database ................................................................................................ 73
7.2.5.3 Input New Contact Lens Types / [Lens geometry ->].................................................... 75
7.2.5.3.1 Creating Contact Lens Geometries (Rigid) ............................................................. 77
7.2.5.3.2 Creating Soft Lens Geometries ............................................................................... 80
7.2.5.3.3 Import and Export of Contact Lens Data................................................................. 81
7.2.6 Measuring the Posterior Surfaces of Contact Lenses ...................................................... 83
7.2.7 Other Functions of the Examination Program .................................................................. 84
7.2.7.1 Loading old Examinations............................................................................................. 84
7.2.7.2 Printout.......................................................................................................................... 84
7.3 The Keratograph Measurement System.................................................................................. 85
7.3.1 Calibrating the Measurement System .............................................................................. 85
7.3.2 Other Functions ................................................................................................................ 86
8 Maintenance ................................................................................................................................... 87
8.1 Care and Cleaning................................................................................................................... 87
8.2 Eliminating Errors or Malfunction............................................................................................. 88
8.2.1 Replacement of Fuses ..................................................................................................... 88
8.2.2 Troubleshooting................................................................................................................ 88
9 Terms of Warranty and Service...................................................................................................... 90
9.1 Terms of Warranty................................................................................................................... 90
9.2 Liability for Malfunction or Damage ......................................................................................... 90
9.3 Manufacturer’s and Service Address....................................................................................... 91
10 Appendix ..................................................................................................................................... 91
10.1 Declaration of Compliance....................................................................................................... 91
10.2 Technical Data......................................................................................................................... 92
10.3 Minimum PC requirements ...................................................................................................... 92
11 Literature ..................................................................................................................................... 93
12 Index............................................................................................................................................ 94
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2 Scope of Supplies and Optional Accessories
Keratograph C (70600):
Keratograph incl. PC 70600

Power supply cable 70600-1/10
Mains cable 05200320
Calibration globe 70500-5/0
Keratograph software diskette
Electrical safety protocol
Directions for use G / 70500
Dust protection hood 60100-5/1
2 2AT fuses 05100210
Chin rest paper 65313
Motherboard manual
Display board manual
Diskette for display board driver
Software package and books
Mouse
Diskette for mouse driver
Mouse pad 027060001062
Optional:
Contact lens holder 70512

Color printer 70520
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Keratograph E (70515):
Keratograph 70515
Power supply cable 70515-1/4
Adapter 70500-7/0
Mains cable 05200320
Serial cable 05202005
Calibration globe 70500-5/0
Keratograph software diskette
Electrical safety protocol
Directions for use G / 70500
Assembly instruction and drilling jig
Dust protection hood 60100-5/1
2 2AT fuses 05100210
x/y table 70517
Interface card TC-200 70522
Installation instructions for interface card I / 70500 /
Optional:
Chin rest 70518

Chin rest paper 65313
Adapter board
PC 70519
Color printer 70520
Contact lens holder 70512
Scope of supplies subject to change due to technical progress.

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3 Safety Precautions
The manufacturer is required by law to inform the socket, have them repaired by our service
user explicitly on the safety aspects of dealing personnel.
with this unit. This chapter contains a summary To disconnect electric plugs from their sockets,
of the most important points to be noted do not pull on the cable, but rather on the plug
regarding technical safety. itself.
Other safety precautions are contained in the text Any auxiliary equipment connected to the analog
of this Instruction Manual and are designated or digital interfaces of this unit must be certified
with the following symbol: as meeting applicable EN and/or IEC-
specifications. In addition, all configurations must
fulfill IEC-Norm No. 601-1 for systems.
Please pay special attention to these directions. Do not connect the Keratograph with non-
medical electrical equipment (e.g. data
Keep this Instruction Manual carefully in a place processing devices) for purposes of creating an
where it is accessible at all times for those using electromedical system if this will result in a safety
the unit. The unit may only be used for its level for the patient which is below that specified
intended purpose as described in this Instruction by IEC-Norm No. 601-1. If permissible levels for
Manual in Point 5 and only by persons whose leakage currents are exceeded due to such
training and practical experience ensure that they connections, appropriate safety measures,
will use the unit properly. including a disconnecting device, must be
Before the unit is operated for the first time, an present.
introductory training in its use must be carried out
by us or an authorized dealer. Do not use the units contained in the Standard
Equipment List
Please operate the unit only with original parts • in places where there is danger of explosion,
and accessories delivered by us and in a • in the presence of combustible anesthetics or
technically flawless condition. Do not attempt to volatile solvents such as alcohol, benzine or
use it if it is damaged, but rather contact your the like.
supplier.
Do not store or use the unit in damp rooms.
Please abide by accident prevention laws where Avoid placing the unit near dripping, or splashing
applicable. water, and make certain that no liquids can enter
the unit. For this reason, please do not place any
The unit may be used in medical areas only if containers of liquid on top of the unit, and also
they are equipped according to VDE 0107 norms take care when cleaning the unit with a damp
or the equivalent (Association of German cloth that no liquid gets into the unit.
Electrotechnical Engineers).
Always disconnect the electric plugs of the Do not cover the air vents.
Keratograph and all units connected to it, e.g.,
the PC and the printer, from their power sources Note: This unit is a high-quality technical
before carrying out maintenance or cleaning product. To ensure that it performs flawlessly
work. and safely, we recommend having the unit
inspected by our service personnel every two
Do not exert main force to connect electrical years. Should any problem arise which you
plugs and sockets. If it is not possible to connect cannot solve with the enclosed "Troubleshooting"
them, check whether the plug is correct for the list (Section 8.2.2), please label the unit "Out of
socket. If you find damage in either a plug or a Order" and contact our service department.
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4 Description of the Unit and its Functions
The OCULUS Keratograph belongs to the most This virtual image is captured by a precision lens
modern generation of precision topographic and a tandem-arranged CCD camera.
measuring instruments. It combines keratometric
and topographic measuring methods in a single All distortions found in the radii of curvature of
unit. the examinee's eye thus become available for
use by the measuring process.
Measurement of the corneal surface is carried
out through a system of rings which are reflected The analog image is then processed by the
at the cornea. The resulting data are evaluated measuring unit for evaluation, i.e. it is made
by the computer. available to the PC in digitized and compressed
form for further processing.
Technical Principle: After receiving appropriate data from a screen

diagram, the PC uses this information to develop
A illumination system with a special reflector a topographic image of the cornea.
illuminates a transparent calotte or "skullcap"
with concentric circles from behind. It then shows the measurement results on the
screen not only in color but also in the form of a
The image of this "cap" is reflected from the diagram and a 3-dimensional image.
examinee's eye, which is opposite to it.
5 Appropiate Use / Intended Application
The OCULUS Keratograph is a measuring ophthalmologists, for hospital departments,

instrument which is intended for eye opticians and optometrists. It may be used only
examinations and only for the uses described in at locations specifically designated for it or when
this Instruction Manual. attached to an examination unit.
The unit is used for measuring corneal The OCULUS Keratograph may be used only
topography and has been designed for use in with original parts and accessories delivered by
fitting contact lenses. us and in a technically flawless condition.
It may therefore be used only by persons who Electric power must be supplied by the special
have been instructed in its use and whose power pack (cf. the electrical equipment
professional training, knowledge, and practical specifications). Other types of connection are not
experience ensure that they will work with the permissible.
unit appropriately.
Please also observe the safety precautions
The OCULUS Keratograph has been designed described above!
for use in the examination rooms of practicing
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6 First Use of the Unit
6.1 Installation and Adjustment
Prior to first use, the wiring and connections of OCULUS. The Keratograph is an optical unit and
the OCULUS Keratograph examination area to should therefore be handled with care. Please do
the mains should be carried out by our service not expose it to jars, impacts, dirt or high
personnel or by a trained person authorized by temperatures.
6.2 Directions for Transport and Storage
Should you transport the unit to another location, Please give the unit time to acclimatize to its new
please do so very carefully. surroundings before using it for the first time.
Avoid the vicinity of heating units and humidity
both during use of the instrument and when it is The conditions set by IEC-Norm No. 601-1 for
stored. transport and storage are:
Check the unit for damage after each relocation. Ambient temperature: -40°C to +70°C
Under no circumstances should you put a Relative Humidity: 10 % to 100%
damaged unit into operation; rather, please get in including condensation
contact with our service department. Air pressure: 500 hPa ... 1060hPa
(7.3 psi ... 15.3 psi)
The optic components in the unit may become
covered by condensation if you store the unit in a These levels apply for a period of 15 weeks at
cold room or in a vehicle during the cold part of most if the unit is kept in an appropriate case.
the year or if there are wide changes from cold to
warm in the ambient temperature.
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7 Directions For Use
First turn on the PC, then the Start the patient data management system by
Keratograph. clicking with the mouse or pressing any key.
After being turned on, the PC loads the operating

system and then displays the OCULUS Logo.
7.1 Patient Data Management
To start the examination program, simply select The following screen display is used for this
a patient name or enter a new patient name in purpose:
the data management system.
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7.1.1 Selection of a Patient
All previously examined patients are listed In addition, the patient can also be searched for
alphabetically at the left. via his ID-number. (For this purpose, however,
If there are more patients than can be displayed the "Last name" field must be empty.)
on the screen, the list can be scrolled up or down
with the help of the Windows slide bar. If the patient name is found in the list, it is
In order to find the desired patient in the list transferred into the "Patient" boxes by clicking
quickly, it is helpful to type the name of the the name in the list, and any previous
patient in the "Patient" boxes (at the upper left). examinations of the patient are simultaneously
As you enter each letter, the nearest listed in the "Previous Examinations" window (at
corresponding name is found and displayed in the lower right).
the list.
7.1.2 Entering a New Patient
In order to enter a new patient into the patient An ID-number of the patient can be entered but
data management system, the [Clear] button is not necessary.
should be activated in order to erase patient data If the screen button [File] is now activated, the
from the "Patient" boxes. Then the full last name, following message appears:
first name and date of birth must be entered in "Patient data does not exist!"
the "Patient" boxes (at the upper left). "File new patient?". Activating the button
[File patient] causes the patient to be entered
into the patient data base.
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7.1.3 To Start the Examination Program
After having chosen a patient the examination By double clicking on a patient’s name the
program (cf.7.2, page 18) can be started by examination program is also started.
clicking of the [Keratograph] button. If, besides Furthermore it is possible to start the
that, an examination is clicked on in the examination program by double clicking on a
examination window, this is loaded in the „previous examination“, and this examination is
examination program automatically. then loaded in the examination program
automatically.
7.1.4 Deleting / Moving Examination Data
Two screen buttons are found below the

"Previous Examinations" list. The functions which
they activate always affect the last examination
clicked:
[Delete Exam.]
This function permits the deletion of individual
examinations from the patient data management
system. After activating the screen button, the
user is asked again whether this examination
should in fact be deleted.
[Move Exam.]
If the wrong patient name was inadvertently
selected in the "Patient list" during an
examination, the examination results can
subsequently be allocated to the correct patient
as follows:
Activate the screen button [Move Exam.] in the

patient data management system window. The
patient list then appears.
Now the correct patient can be selected in this
list (with the scroll bar and by clicking on the
correct line).
Once the correct patient name has been found

and selected, the corresponding examination
data are now allocated to it by activating the
screen button [Move Examination].
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7.1.5 Patient Data
7.1.5.1 Rename Patient
Patient data can subsequently be changed by

activating the screen button [Rename Pat.]
(below the list of patients).
The patient data can be corrected in the

"Change Patient Data" window, which then
appears (at the upper right).
Activating the [Update] button puts the changes

into effect.
7.1.5.2 Deleting Patient Data
Patient data can be deleted with the screen Caution! ⇒ Double confirmation is required
button [Delete Pat.]. before the data are actually deleted, since here
not only all examinations of the patient but also
the patient data are removed from the patient
data management system.
7.1.5.3 Exporting Patient Data
This function makes it possible to transfer

patients and examination data from the host PC
to other data storage media (e.g. disks).
After activation of the screen button [Export] a

window appears which consists of two areas.
The upper area describes the data set which is to
be exported, the lower is used to determine the
storage medium which will receive it.
Enter the disk drive to which the data set is to be
transferred in the "Directory" box under "Data
medium dest.:" (e.g.: "A:\" if diskettes are to be
used).
A subdirectory can also be entered (example:
A:\February\).
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"Data Set" "Memory Available"

Use this field to select whether all examinations The two items of information concerning memory
of the patient are to be exported or only one. storage space show how much memory space is
If only one examination is to be exported, select required and how much is available on the
it in the Previous Examinations List before storage medium which will receive it.
activating [Export].
"Including CCD Images" The data set is transferred by activating the

Moreover, the camera images can be extracted [Export] screen button, whereas [Cancel]
from the data set so that less memory storage terminates the function without a transfer of data.
space is required without camera images.
7.1.5.4 Importing Patient Data
(e.g. from a floppy to the hard disk or to a A patient list shows which patients are present
directory of the PC). on the data storage medium. In addition, the
examinations of a patient are shown after that
Activate [Import] to start this function. patient has been selected.
"Directory" If only a single examination is to be imported,

Enter the drive letter here and - if there is one - click that examination in the "Existing
the sub-directory of the source from which the examinations" list.
import is to take place.
The import is started with the screen button
[Import data].
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7.1.6 Backup Copies of Data
7.1.6.1 Backing Up Data
The [Backup] button opens the "Backup" • "Changed and New Data Only"
window, which consists of two areas: Only those data are copied which have
changed or been newly created since the last
Save and Restore backup.
These areas are used to specify the directory in • "Including CCD Images"
which backup-copies of data are to be created or This function can be turned off to reduce
from which data are to be called to the screen. memory requirements. This is useful for data
For example, this is "F:\" in the case of an backup to floppies.
external drive with exchangeable data storage
media (removable hard disks). Note: ⇒ Backup of data can take a long time,
The backup can take place according to different depending on the volume of data; therefore it is
criteria: best to use this function when the PC (and the
Keratograph) will not be needed for a while.
• "Save All Data"
Copies are made of all examinations and Activate [Save] in order to start the data backup.
patient data.
7.1.6.2 Data Restoration
The restoration of already stored data can • "Add Examination Data"

likewise be carried out according to different This function adds the examination data of
criteria: the data storage medium to the already
existing examination data of the patient.
• "Delete Existing Data First"
This function removes all presently stored [Restore] Uploads data from the backup
examination data of a patient before restoring medium into the system.
it to the backup data storage medium. After
restoration, therefore, only those
examinations will be present which have been
restored on the backup data storage medium.
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7.1.6.3 Auto-Backup
It is also possible to save data via an automatic This function is activated in the menu "Change
backup. In this case a backup copy of the new Settings".
examination data is always made at the end of This function should only be used if an additional
the examination program. drive with an exchangeable data storage medium
is present.
7.1.7 Changing Settings
After the [Settings] screen button has been acti- • Automatic Backup
vated, the menu "Change Settings" appears. This box can be used to turn on the auto-
Here the patient data management system can matic backup function. (Click the "Enable"
be modified according to your specific wishes: checkbox).
• Language The backup directory into which data are to
Is used to select the language (German, be saved must be preset. This directory is
English, French or Italian) in which the also used as backup directory for the normal
program is to be displayed. backup function.
Moreover, It is possible to determine whether
• Date Format camera images are also to be saved during
Is used to set the date display. The following automatic backup or not.
formats can be selected:
Day/Month/Year (DMY),
Month/Day/Year (MDY),
or Year/Month/Day (YMD),
as well as the sign separating month, day,
and year.
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• Sort by The [Use] button confirms the setting for the

The patient list can be sorted according to duration of the present session of the program.
either patient names or ID-numbers. Thereafter, however, the previous settings are
(If you plan to use names to find patients, it is reloaded each time the program is restarted.
helpful to sort the list by names.)
If you plan to use ID-numbers to call patient
data to the screen, the sorting list should be The setting just made can be made permanent
sorted accordingly. with the [Save] button. The setting will then be
loaded each time the program is started again.
• Date
This field is used to change the system time
and date. The [Cancel] button rejects the changes just
made and exits from the function.
• Import / Export
This is used to name the drive and, if
necessary, the sub-directory from which
information is to be imported or to which
exports are to be sent.
• Keyboard
If you select “simulated”, an additional
button labelled [Keyboard] appears next to
the field for entering the patient’s name.
Activating this button produces a virtual
keyboard as an alternative means of entering
the patient’s name.
• Keyboard size
Here you can select the size of the virtual
keyboard.
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7.2 The Examination Program
To start the examination program, first select a • Lens Fitting

patient from the list and confirm this with the Starts a program for fitting contact lenses to
[Keratograph] button (cf. 7.1 page 10). the corneal surface which has already been
measured.
After the "Keratograph" examination program is
started, the patient data (at the upper left) and a • Settings
menu bar containing information for controlling Here different program settings can be made.
the program are displayed. The following main
menu headings are seen in the menu bar: • Miscellaneous
Different program functions can be selected
• Patient from this menu.
This ends the examination program and
brings the user back to the patient data
management system.
• Examination
• Print
Calls former examination results to the screen
Prints out the screen contents of the moment
and carries out new examinations.
at the printer.
• Display
Is used to select different forms of displaying
examination results.
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7.2.1 How to Carry Out a Measurement
• Adjust the height of the table so that the The question now appears: "Which eye shall be
combination forehead and chin rest holds the examined?". Answer it with [Right] or [Left] in
patient’s head comfortably but firmly. order to start the examination.
• Adjust the chin rest so that the patient’s eyes • The actual camera image now appears on the
are approximately at the level of the black ring left side of the screen. Align the Keratograph
of the combination chin and forehead rest. with the help of the x/y table so that the
patient’s eye appears in the middle of the
• Inform the patient that he is now required to camera image (rough adjustment). Then
keep his eyes fixed on the yellow fixation LED adjust the distance between the Keratograph
of the Keratograph (in the center of the and the patient's eye so that the camera
Placido system). image is as sharply focused as possible.
• Start the examination program (cf. 7.2, page Provided that the Keratograph is nearly in
18) and select the function “New releasing position, the Keratograph then
Examination (Eye)” from the “Examination” automatically measures the distance to the
menu. patient's eye and shows it graphically next to the
camera image.
Page 20
This graphical display gives a side view and a top Now the geometric surface of the cornea and the
view of the measuring process and also shows local radii of curvature are calculated from the
the direction in which the unit can be moved in reflection image of the Placido system, stored
order to arrive at releasing position (fine automatically, and presented on the screen in the
adjustment). form of an overview display.
Measurement is carried out automatically if the Note: ⇒ The user can first familiarize himself
Keratograph is in releasing position. For this, with this procedure by carrying out the measuring
however, it is first necessary to give the go- process a few times with the glass globe which is
ahead for measurement. delivered with the unit.
Before this go-ahead for measurement is given, Note: ⇒ The patient’s nose and forehead may
the patient should be asked to open his eye wide cast shadows on the ring system. These areas
so that as large a region of the corneal surface are then inaccessible for measurement, making
will be measured as possible. interpolation necessary (black dots or white
The go-ahead is carried out by pressing the areas in the color topographic image, see also
space bar of the PC keyboard. 7.2.2.2 page 23).
Overshadowing of the ring system can be
Note: ⇒ If the measurement system does not minimized by placing the patient’s head in the
release (for example in the presence of a very chin-and-forehead rest in such a way that his
pronounced keratoconus), measurement can be nose is as far away from the Keratograph as
forced by pressing the RETURN key on the PC possible (turn head, measure more from the
keyboard. side). However, it is essential that the patient still
keeps his eyes fixed on the yellow fixation LED.
After measurement has been activated the
image is transferred in digital form to the PC and
displayed. Then the processing of the image
begins automatically.
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7.2.2 Using Different Types of Display to Evaluate Examination
7.2.2.1 Overview Display
Overview Display combines several different • Colored Topographic Image

evaluation displays and thus provides a quick (at the upper right). Different colors are
survey of the corneal topography which has been allocated to the local radii of curvature which
measured. have been measured; these are displayed in
position-dependent form. This form of display
The following display fields are provided: gives the most accurate impression of the
curvature profile of the measured cornea.
• Patient Data Here, too, the pupil edge is presented as a
(at the upper left). black and white line.
• Reduced Camera Image • Color Bar

of the measurement (middle left). The ring At the right margin of the overview display is a
edges (red/blue) determined during image list of the radii of curvature to which the colors
processing and the iris and pupil (black/white) correspond. The three fields below the color
are also shown in order that the measurement bar describe the radii of curvature more
can be checked. The pupil center is shown as precisely:
a black/white cross. The distance between The first field shows the unit of curvature
the center of the topographic corneal map (millimeters or diopters) as well as the
and the pupil center (fixation difference) is increment (e.g. 0.25 D) in the case of the
shown as numerical value in the lens fitting "relative" color bar (see below).
software (cf. 7.2.2.11 page 47).
Page 22
The next field shows whether the radii are • Field for Comments
sagittal or tangential. The last field shows the At the top edge of the camera image is a
type of color scale, i.e. "absolute" or "relative" place for adding comments. For this purpose,
(cf. 0 page 60). click on the top edge of the camera image with
the mouse pointer. Then a window appears
• Keratometer Data (at the lower left) saying “Change info text“, in which you can
Both major meridians are ascertained on the enter your comment or change one already
3 mm ring of the cornea; by definition, these entered. Clicking the [OK] button closes the
always lie at an angle of 90° to each other. window again, whereupon the comment
The position of the major meridians is seen in appears in the camera image.
the small diagram in the right part of the field. This comment is also shown when the
The curvature profile on these major examinations are loaded (cf. 7.2.7.1 page 84).
meridians from the center to the perimeter of
the field appears in the middle of the diagram. • Manual Measuring Function
In addition, the usual keratometer values This function allows you to measure the
appear in the screen at the left side of the distance between two arbitrary points in the
diagram, camera image:
Rh: Horizontal radius of curvature in the Clicking anywhere in the camera image (left
center of the cornea. mouse button) automatically turns the mouse
Rv: Vertical radius of curvature in the pointer into a cross. By keeping the mouse
center of the cornea. button depressed you can now position this
Ast: Astigmatism in the center of the cross in the camera image with precision. After
cornea. letting go of the mouse button to mark a point of
Axs: Axis of the astigmatism your choice you can position the cross once
Ecc: Mean eccentricity of the cornea more. In addition to the cross the system now
Øcor: Diameter of cornea (iris) shows the distance to the first point and a
AA: Analysed Area. Gives the area of the “rubber band” connecting line between the two.
corneal surface actually measured (as Press the left mouse button once more to quit
opposed to merely interpolated) as a the function. To delete measurement arrows
percentage of the entire measuring generated in this way, reselect “
field. Display/Overview ”.
• Numeric Display of Peak Values

(at the lower right) permits a rapid numeric
analysis of corneal topography.
The maximum and minimum radii of
curvature of several rings on the cornea
(diameters of 3mm, 5 mm and 7 mm) are
ascertained. These extreme values are
displayed in position-dependent fashion, so
that the magnitude of astigmatism and its
angle position are easily discernible.
Maximum curvature values are shown in red,
minimum curvature values in blue.
Note: ⇒ The major meridians are displayed if
4 peak values are not present on a ring.
• Finding Curvature Values

Clicking any location in the colored
topographic image causes the curvature
values for that location to appear above the
mouse pointer. Curvature corresponds to the
parameters in the color bar (mm/D, Sag/Tan,
Rel/Abs).
Page 23
7.2.2.2 Color Map large
This form of presentation permits an interactive • Zone diameter: The diameter of the circle (in
evaluation of color topographic images. For this mm), on which the measuring point is set.
purpose the image is presented enlarged (right). • Meridian: The meridian on which the point
The pupil edge is shown as a black and white lies.
line. • Color: The color which is allocated to the
In the case of an incomplete measurement the curvature.
interpolated areas are shown as black dots or
white areas (depending on whether the If two marked areas are present, the difference
completed image or the original image is being between the two points is shown (at lower left):
used, cf. 0 page 69). • Difference between radii of curvature in
mm (Reference 1 - Reference 2).
Using the right and left mouse button you can • Difference between refractive powers in
mark two different points in the topographic diopters (Reference 1 - Reference 2).
image: • Distance between two points.
left mouse button: measuring point 1,
right mouse button: measuring point 2. Note: ⇒ Activating the [GRID] button permits
The numerical data of the marked point on the better orientation in the topographic image by
cornea then appear in the display field (at the making it possible to superimpose a scalar
lower left): system of polar coordinates over the color
These data are: display (and delete this afterwards).
• Radius of curvature in mm. In addition, the [NUM] button can be used to turn
• Optical power of the already determined on and off a numeric display of many curvature
curvature (in diopters). values in the topographic image.
Page 24
7.2.2.3 3D Cornea
The 3D image of the corneal surface presents a carried out, then the image of the cornea is
striking view of the curvature profile of the shown in motion.
measured cornea. This is particularly helpful in The [Wide Narrow] slide bar adjusts the extent
showing the patient the geometric relationships of the movement; the other slide bar [Slow Fast]
of the corneal surface. adjusts the speed of presentation.
The animation process is stopped by clicking
The display can be rotated to any desired with the mouse.
position by means of the "Rotation" buttons (at
the lower right). The [0] screen button re-rotates The display of the cornea image can also be
the display back to its original position. changed as follows:
The image of the cornea can also be shown in The display of curvature can be intensified or
motion in order to improve the 3D-effect. attenuated with the [Exaggerate] slide bar.
The exaggerated display permits better
When the [Tilt] or [Turn] buttons are activated, a recognition (e.g. of mild astigmatism).
calculation of the animation process is first
Page 25
The type of presentation can also be changed by

means of the following four screen buttons: • Curvature
[Color], [Red/Green], [Realistic], [Curvature] The local height of the image displayed (i.e.
the 3rd dimension) corresponds to the level of
• Color the curvature. The image resulting from this
The display is presented in the form of a illustrates the curvature profile quite well,
filled-out contour model. The color of the since any differences in curvature which may
surface designates the local radius of be present in the measured cornea (e.g. in
curvature of each location. astigmatism or keratoconus) make a stronger
• Red/Green visual impression than in the realistic display,
The display is presented in the form of a wire- especially if the intensity is set to "Maximum".
frame representation. When wearing red- However, the display does not correspond to
green spectacles the viewer sees a true 3- the actual contours of the surface (e.g. a
dimensional view of the display. globe appears as a flat surface, since
• Realistic curvature is everywhere the same.)
The actual geometric form of the corneal
surface is displayed, if the slide bar Note: ⇒ The different forms of presentation can
[Exaggerate] is moved completely to the left, be used simultaneously, e.g. it is possible to
what means the exaggeration function is display a left-rotating, intensified image of
disabled. Moving the slide bar to any other curvature in red / green and in movement.
position causes an exaggeration of the
elevation between the cornea and a reference
body (ellipsoid of revolution). This simplifies
the identification of e.g. Astigmatism,
Keratoconus,...
7.2.2.4 Fourier Analysis
Named after the French physicist Jean Baptiste sine waves), the period of the third harmonic is a
Joseph Fourier (1768-1830), this mathematical third as long as that of the first (giving three sine
method permits decomposition of any periodical waves) etc. Summing up all the constituent wave
function in terms of trigonometric sine and cosine components gives the original function (Fourier
functions (Fourier analysis). The fundamental synthesis).
wave, known as the first harmonic, is a sine
wave whose period is equal to that of the wave
being analyzed. The period of the second
harmonic is half that of the first (thus giving two
Periodic function to be analyzed Decomposition into two sine waves and one
cosine wave
Page 26
The Keratograph performs a Fourier analysis on and the optical vertex of the cornea.
the topographic image by breaking it down into It is important to note that this function yields
its individual components as described above relative, not absolute values, since its arithmetic
(To start the Fourier analysis select “Fourier mean is zero.
analysis” under the menu bar function “Display”). The minimum and maximum values of each
The first step is to divide the image into individual radius are shown as white (minimum) and black
concentric rings. Then the curvature on each ring (maximum) circles. This makes it possible to
is decomposed into separate sine and cosine infer the position of the axis of decentration for
waves by means of Fourier transformation. The each of the zones. In a normal cornea maximum
resulting components of all rings are regrouped decentration rarely exceeds 0.45 mm for
and displayed in separate images showing, sagittal curvature (1.88 for tangential
respectively, zero order, first order, second order curvature).
components etc. Some interesting characteristics
are found when the individual wave components
are studied in isolation from each other in this • Regular astigmatism
manner:
The second-order
wave represents
• Spherical equivalent a regular sine
wave of double
This image frequency,
consists solely of meaning that it
the zero order achieves two
wave component minima and two
in the form of the maxima over a
arithmetic mean of radius ring. This
all radii of each function also
individual ring. yields only relative
This value can values.
also be interpreted The axis position for each zone is represented by
as the spherical red and blue circles. In addition, central and
component of the peripheral astigmatism are indicated by red and
radii of each ring. blue lines. A red line signifies a steep meridian,
Assuming the cornea to have the shape of an while a blue line signifies a flat meridian.
ellipsoid of revolution, the spherical component Keratoconus is often associated with a rotation of
permits an approximate calculation of the the astigmatic axis from the center to the
eccentricity of the cornea. In a normal eye periphery, resulting in impressive whirl patterns.
corneal eccentricity ranges below 0.85.
Experience has shown that the magnitude and
axis position of central astigmatism obtained by
• Decentration Fourier analysis are in closer agreement with
subjective refraction than are the central radii
The first-order measured by an integrated Keratograph. This is
wave is a regular due to the fact that any decentration or major
sine wave which corneal aberration (e.g. trefoil or four-lobed
achieves a mini- defect) influences the amplitude and axis
mum and a maxi- position in keratometer measurements.
mum over a given
radius ring. It
serves as a mea-
sure of the tilt
between the opti-
cal axis of the
videokeratoscope
Page 27
• Irregularities • Combining irregularities and spherical

equivalent
All remaining
wave components Combining the
add up to give the irregular and the
irregularities of the spherical compo-
corneal ring under nents often makes
measurement, it easier to detect
again expressed three or four-lobed
as relative values. defects than would
In a normal a display of
cornea the irregular compo-
arithmetic mean of nents alone.
all irregularities is
less than 0.030
mm for sagittal curvature (0.141 for tangential
curvature). An inverse relationship obtains
between the degree of irregularity and the best
corrected visual acuity. Fourier indices
The “Irregularities” field contains only wave
components that cannot be corrected by means Calculations based on the individual components
of a sphere, cylinder or prism. If these are large, yield indices which permit a quick numerical
the patient will only achieve good visual acuity characterization of the corneal surface:
with rigid contact lenses.
Combining Fourier components
One option is to display the “Decentration“ and

“Irregularities“ components separately, as
described above. However, it is also possible to
add the spherical equivalent to each of these
components. Use the “Settings” menu to add or
remove the spherical equivalent. (see 0 page
70).
• Spherical RMin: minimal radius of curvature
of the spherical component
• Combining decentration and spherical • Spher. Eccentricity: corneal eccentricity
equivalent calculated from the spherical component.
This must not be confused with the
Adding the spheri- eccentricity at 30°, which is determined
cal equivalent to according to the sagittal radii method.
the decentration • Max. Decentration: maximum value and
component often position of decentration in the “Decentration”
provides an intui- diagram
tive display of the • Astigma. central: curvature difference and
conus position, axis position of regular, central astigmatism
allowing the apex • Astigma. peripheral: curvature difference
to be more readily and axis position of regular, peripheral
discerned than in astigmatism
the original image.
• Irregularities: mean of all deviations in the
“Irregularities” diagram
Note ð Pathological values are highlighted in
red as a matter of course.
Page 28
Color bars: using the relative color bar (+/-) because they
represent additive components of the original
The “Fourier Analysis“ display uses two color image.
bars with identical color increments. The left
color bar (Org.) corresponds to the overview However, if “Spherical equivalent” is added to
display, while the right color bar has a relative either “Irregularities” or “Decentration”, then the
(+/-) scale. At the bottom right of every resulting maps will refer to the left color bar
topographic map is an indication of the color bar (Org.) (see also 0 page 70).
being used.
Curvature values can be queried in any
The original color bar (left) is only used in the topographic image by clicking onto the location of
“Original” and the “Spherical equivalent" maps. interest (left mouse button). This causes the
The “Decentration", “Regular astigmatism” and curvature value at that location to be displayed
“Irregularities" maps can only be represented above the mouse pointer.
7.2.2.4.1 Applications of the Fourier Display Mode in Keratokonus
In keratoconus one finds the following deviations “Spherical equ.”

from the image generated by a normal eye, each The minimal radius of curvature is steeper and
of which may be more or less pronounced normally less than 6.93 mm for sagittal
depending on the stage of the disease. curvature (6.87 for tangential curvature), while
eccentricity may exceed 0.85. However, both
parameters are subject to considerable variation
and may not be used as indices in isolation from
each other.
Page 29
“Decentration + spher.” “Irregularities”, resp., Irregularities +

spherical equivalent”
The direction of
decentration is In keratoconi of various degrees of severity one
usually vertical or often encounters maps with more or less clear-
approximately ver- cut three or four-leafed shapes. These are
tical (as opposed indicative of higher-order corneal aberrations,
to horizontal or ap- referred to in the context of Zernike polynomials
proximately hori- as trefoil or four-lobed defect. Combining these
zontal in the irregularities with the spherical equivalent often
healthy eye) and renders them more distinct.
depends on the
apex position of
the cone, which is
represented very
clearly in the combined presentation mode.
The degree of decentration is usually greater
than in the normal eye, exceeding 0.45 mm.
However, this parameter too is subject to
variation and not to be used as an index.
“Regular astigmatism”
Whereas in
astigmatism the
axis runs in a
straight line, in
keratoconus it not
infrequently
undergoes a
rotation from the
center to the Trefoil images (irregularities)
periphery, thus
taking on a spiral
appearance.
Three and four-leafed shape (irregularities plus

spherical component)
Page 30
7.2.2.5 Zernike Analysis
7.2.2.5.1 General
Zernike polynomials are normally used to The Dutch physicist and Nobel Prize winner Frits
describe wavefronts. The diagram below shows Zernike (1888-1966, inventor of the contrasting
a parallel wavefront passing through a refractive phase microscope) succeeded in mathematically
surface L. representing the deviations of a real wavefront
from an ideal one by means of a sum of
polynomials. Each polynomial is named
according to the image defects it represents (e.g.
astigmatism, comatic effect or spherical
aberration). Zernike polynomials are also known
as circular polynomials because they refer to a
circle with radius 1 and are expressed in terms of
polar coordinates.
Mathematically speaking, each Zernike

polynomial is characterized by a power series in
Every light ray consists of a sinusoidal oscillation. the radial variable, ρ, and a Fourier-like series in
Locations of equal phase within the total array of the angular variable, θ. In its general form,
sinusoidal oscillations form planar wavefronts Z n,±m, n gives the degree of the polynomial in
perpendicular to the direction of propagation on the radial variable, while m gives the frequency of
the refractive surface (green). Here the incident the angle θ per 360°. Polynomials with an even n
wavefronts, which are oriented parallel to each and m=0 are always rotationally symmetrical,
other, are deformed, in the ideal case resulting in while all others are dependent on the angle.
spherical waves which meet precisely in the
focus F (in the diagram above the wavefronts are The first Zernike polynomials bear the following
shown as red concentric circular arcs around F). designations:
This ideal case is virtually never encountered in Z 0,0 height constant, average height of
practice because real wavefronts show surface
deviations from a perfect spherical wave after Z 1,±1 tilt (+1 in x-direction, -1 in y-direction)
passing through the refractive surface (difference Z 2,0 focus, resp., surface in the shape of a
area represented by gray squares in the second conic section
Z 2,±2 astigmatism
Z 3,±1 coma
Z 3,±3 trefoil
Z 4,0 spherical aberration
Z 4, ±2
th
higher (4 ) order astigmatism
Z 4, ±4 four-lobed defect
Z 5, ±1
th
higher (5 )order coma
Z 5, ±3
th
higher (5 ) order trefoil
Z 5, ±5 five-lobed defect
Z 6,0 higher (6th) order spherical aberration
diagram). The smaller this deviation or aberration
Z 6, ±2
th
higher (6 ) order astigmatism
is, the higher is the quality of the refractive
Z 6, ±4
th
system, be it a telescope, a microscope, the higher (6 ) order four-lobed defect
cornea or the entirety of refractive media Z 6, ±6 six-lobed defect
comprised by the human eye.
The exact mathematical formula of each Zernike
polynomials are stored in the file:
C:\TOPO\ZERNEKE.TXT
Page 31
angular Overview of the most important

frequency Zernike polynomials
m
Z 4, ±4 four-lobed defect
Z 3,±3 trefoil
Z 2,±2 astigmatism Z 4, ±2 fourth-order astigmatism
Z 1,±1 tilt Z 3,±1 coma
Z 2,0 focus Z 4,0 spherical aberration

degree n
Page 32
7.2.2.5.2 Zernike Analysis Using the Keratograph
The Keratograph performs a Zernike analysis on To start the Zernike analysis select “Zernike
measured height data. It calculates for each analysis” under the menu bar function “Display”.
Zernike polynomial a coefficient which describes After the calculation of all Zernike coefficients
the contribution of that polynomial to the height has been carried out, the following display
data. appears:
On the left side there appears a three- Polynomials can be individually activated or
dimensional image representing all Zernike deactivated by clicking the corresponding check
polynomials that have been activated. This boxes.
display is scaled automatically when it is
generated. It can also be rotated manually using Activating or deactivating Zernike polynomials
the buttons in the “Position” field. Clicking the immediately causes the 3D image to be redrawn.
“Rotate” button causes the 3D image to rotate The new image is not scaled automatically in this
continuously until a new task is activated. case but is shown in same scale as the previous
The color bar on the left shows which color image. This makes it easier to assess the effects
corresponds to which height value. that individual polynomials have on the image. By
clicking the “Scale” button the image may be
The Zernike coefficients are listed on the right. A displayed in a scale optimal for it. In addition, the
scroll bar permits scrolling the list up and down in scale may be manually adjusted using the
the case of more than 14 coefficients. “Exaggerate” slider control.
Page 33
At the top right is a field titled “Zernike of Z 2,2 and Z 2,-2. A more intuitive approach
Coefficients” which provides the option of results from a combination of the two
viewing the Zernike coefficients in the “Z polynomials and, instead of separate sine and
Separate” or the “|Z| Vectors” display mode. cosine terms, the computation of the length and
Normally one Zernike component consists of two angle of the resulting vector. The length of the
polynomials (e.g. Z 2,2 and Z 2,-2 for the vector gives the component’s contribution to the
astigmatic component). These two terms only total aberration, while the angle can be seen in
differ by a trigonometric component (Z 2,2 the 3D image.
contains a cosine function and Z 2,-2 a sine
function): The “All Off” and “All On” buttons at the top right
z2,2(r,phi) =Z2,2*SQR(6) * ( 1*r^2 ) * COS(2*phi) serve to activated, resp., deactivate all Zernike
z2,-2(r,phi)=Z2,-2* SQR(6) * ( 1*r^2 ) * SIN(2*phi) polynomials. A good way to display a single
The two terms of the astigmatic component have polynomial is to click “All Off” and then activate
a phase difference of 45°, as one can infer from desired polynomial. A good way to remove
the “Z Separate” mode. The angle resulting individual polynomials from the original
from the combined polynomial, however, is representation is to first click “All On” and then
determined by the ratio between the coefficients deactivate those polynomials to be removed.
7.2.2.5.3 Zernike Fit Parameters
If we take into account the corneal refractive

index, a cornea with optimal image forming
properties must theoretically have the shape of
an ellipsoid with a numerical eccentricity of 0.75
and therefore a reference body of this shape is
the obvious choice. Rotationally symmetric
There are various parameters (“Zernike Fit polynomials can then be interpreted as
Parameters”) that may be set before carrying out deviations from this ideal shape.
a Zernike analysis (“Zernike fit“). One of these The current settings of the Zernike parameters
parameters is the maximum degree (n). This (reference body, maximum degree, maximum
parameter determines how many Zernike diameter) are shown at the top in the field titled
polynomials are used and hence how much “Zernike-Fit-Parameters”. Clicking the
computing time is required. Furthermore, it is “Change” button opens a menu for changing the
possible to specify up to what diameter the Zernike fit parameters.
measured corneal data are to be included in the
Zernike analysis (∅∅ max). In addition, one has
the option of specifying whether the height data
should be converted directly to Zernike
coefficients or whether the difference of the
height data to a reference body should be used
as the basis for the conversion. This reference
shape can be a sphere, an ellipsoid with an
average eccentricity equal to that of the
measurement or an ellipsoid with an eccentricity
of 0.75. The reference body is always rotationally Click “Calculate new” to confirm the new
symmetric, and its shape influences only the settings and perform a recalculation.
rotationally symmetric polynomials (Z 0,0 / Z 2,0 / The current settings (i.e. the Zernike fit
Z 4,0 ...). The central radius of the reference parameters and the selection of polynomials to
body is always taken as the mean central radius be activated or deactivated) can be saved by
of the measurement. In the absence of a clicking “Save settings”. Once stored, these
reference body, the greatest contribution to the settings are loaded automatically the next time
shape of the cornea is made by the Z 2,0 compo- the “Zernike Analysis” menu is activated. To load
nent (paraboloid), since this component has the the stored settings while the program is running,
greatest resemblance to the shape of the cornea. click “Load settings”.
Page 34
Two additional check terms are fitted as accurately as possible to the

boxes are to be found measured height data. The more polynomials
at the top of the field on that are used, the more closely the calculated
the lower right titled data approximate the measured height data;
“Reference Shape” and “Diff.”. The first, “Refer- however, the fit will never be perfect. Adding
ence Shape”, specifies that the height data of a these residual differences to the Zernike
reference body are to be added to the polynomial polynomials gives an indication of the magnitude
data. This provides a realistic image of the cor- of the discrepancy in relation to the polynomials.
nea in the case where a reference body is used. The mathematical standard deviation of the
original height data with respect to the Zernike
“Diff.” adds to the calculated height data their polynomials is also calculated and shown as a
deviation from the measured data. In calculating numerical value in the “Diff” line.
the Zernike coefficients the selected polynomial
7.2.2.5.4 Zernike: Normal Values and Aberration Coefficient
A set of absolute values of Zernike coefficients The function of calculating an aberration

corresponding to the norm are stored in the coefficient and highlighting abnormal values in
Keratograph. Abnormal absolute values are red is only available if the following Zernike fit
therefore shown in red in the coefficients list. In parameters are used:
addition, the Keratograph calculates an aber- • reference body: ellipsoid ecc. =0.75
ration coefficient from the Zernike coefficients. If • max. degree: n=8
there is no abnormal Zernike coefficient, the • ∅max: 8mm constant
aberration coefficient will be equal to 0.0. Values These are the parameter settings relevant to the
exceeding 1.0 are an indication that the corneal normal values.
surface contains untypical wave components
which may be the cause of impaired vision.
7.2.2.5.5 Zernike 2D Display Mode

Page 35
The “Display” field (near the middle of the standard. To achieve that the Zernike
display) permits switching from the 3D to a 2D polynomials different from the standard appear
height display mode. While the 3D display gives right in the menu window in red colour, the
a very graphic representation of height data, it is setting “|Z| Vectors” must be used.
not as convenient when it comes to determining
the exact height at certain positions on the In this way keratoconi can be made visible even
cornea. The 2D display enables you to determine in their early stages. In addition, this feature
the height of any desired point on the cornea by makes it easier to recognize the apex position of
simply clicking on it with the left mouse button. a keratonconus. As can be seen from the three
maps below, the conventional display mode
In addition, the software determines the highest using sagittal radii is prone to errors in
point (apex) which is then shown as a black representing the apex position. A clearer
cross in the picture. The height of this point representation is achieved with the Zernike 2D
(Max:) is shown along with its position (X-Pos: display or with fluo image simulation, since these
and Y-Pos:). This height value quantifies the techniques are based on height data.
degree of a keratoconus. The more the
keratoconus progresses, the bigger is gets this In higher keratoconus stages the x/y position of a
height usually. The most appropriate way to keratoconus apex shifts usually in the direction
calculate the cone height is to switch on the temporal/down.
reference body (with the eccentricity of 0.75) and
all Zernike-polynomials, except of the lower
orders (Z 0,0 / Z 1,1 / Z 2,0 / Z 2,2), as a
Conventional map based on Zernike 2D map Simulated fluo image

sagittal radii
Page 36
7.2.2.6 Indices
This menu uses the measured surface data to Furthermore, a classification of the cornea is
calculate various indices. Corneal indices permit made (e.g. stage 2 keratokonus).
the large number of measurement data The Keratograph uses the following data for
generated by the Keratograph to be reduced to a index calculation: curvature data, height data and
small number of characteristic values which Fourier analysis as well as Zernike analysis
permit statements regarding the shape of the output. This comprehensive use of all relevant
corneal surface to be made. corneal data permits early identification of a wide
variety of abnormalities.
The index menu is titled with the usual patient The individual indices are shown in the middle
information bar, supplemented in this case by the top left of the display. They are designated as
fields “Pat-ID” and “Infotext”: follows:
Pat-ID: gives the patient’s ID-number that has

been entered into the patient data
administration software.
Infotext: shows any information that has been
entered into the field for comments in
the overview display. (for “field for
comments” see 7.2.2.1 page 21)
Page 37
ISV = Index of Surface Variance. Gives the The instrument compares the measured values
deviation of individual corneal radii from with the mean values and standard deviations of
the mean value. Elevated in all types of a normal population. Measured values which
irregularity of the corneal surface (scars, exceed the standard deviation by a factor of
astigmatism, deformities caused by more than 2.5 are classified as abnormal and
contact lenses, keratokonus etc.). highlighted in yellow. Pathological values, i.e.
IVA = Index of Vertical Asymmetry. Gives the values that exceed the standard deviation by a
degree of symmetry of the corneal radii factor of more than 3, are highlighted in red.
with respect to the horizontal meridian as Clicking in the “Indices” field causes a window
axis of reflection. Elevated in cases of to appear containing explanations of the index
oblique axes of astigmatism, in kerato- abbreviations (ISV, IVA,...).
conus or in limbal ectasias.
KI = Keratoconus-Index. Elevated especially Index limit values:
in keratoconus
CKI = Center Keratoconus-Index. Elevated Index Abnormal pathological (red)
especially in central keratoconus. (yellow)
RMin = Gives the smallest radius of curvature in ISV Õ37 Õ41
the entire field of measurement. Elevated IVA Õ0,28 Õ0,32
in keratokonus.
KI >1.07 >1.07
IHA = Index of Height Asymmetry. Gives the
degree of symmetry of height data with
CKI Õ1,03 Õ1,03
respect to the horizontal meridian as axis Rmin <6,71 <6,71
of reflection. Analogous to IVA, though IHA Õ19 >21
sometimes more sensitive. IHD Õ0,014 >0,016
IHD = Index of Height Decentration. ABR Õ1 Õ1
Calculated from a Fourier analysis of
height values this index gives the degree The “Progress of Indices” field (below) lists the
of decentration in vertical direction. indices from all examinations performed up to
Elevated in keratokonus. the present on each eye. In this way indices from
ABR = Aberration coefficient. Calculated from old and new examinations can be readily
Zernike analysis output. If there are no compared for each eye. If more than four
abnormal corneal aberrations, ABR is examinations have been performed per eye, the
0.0, otherwise ABR becomes 1.0 or program will provide a Windows slider control for
greater, depending on the degree of selecting those to be displayed. The currently
aberration. loaded measurement is highlighted with a blue
KKS = Keratokonus Stage. Based on frame. Note ð Examinations listed in the
topometric measurements, this index “Progress of Indices” field can be loaded
follows the clinical findings of Amsler’s directly by double clicking.
classical staging schema.
AA = Analyzed Area. Gives the area of the
corneal surface actually measured (as
opposed to merely interpolated) as a
percentage of the entire measuring field.
Page 38
A graphic representation of adapted as far

corneal eccentricity at 30° for as possible to
each of the semi-meridians is Amsler’s and
shown in the middle top right. Muckenhirn’s
The axis positions of the central stages.
radii are taken into account in Note ð However, one should always bear in
this diagram. The red axis mind that this assessment by the Keratograph
represents the steeper meridian software is entirely based on topography and is
and the blue axis the flatter one. not to be regarded as a basis for a clinical
Here too, values highlighted in diagnosis. Besides staging, the software is
red are indicative of pathological capable of producing comments in this field such
values. The mean eccentricity values for the two as “severely deformed cornea”, “status following
principal sections are shown below the corneal surgery” or “pellucid marginal
eccentricity diagram. degeneration”, whenever it encounters topo-
graphic features indicative of such conditions.
The large diagram at the top right titled
Curvature contains a representation of the Clicking on the field titled “Keratoconus Level
sagittal or tangential radii (see 0 Page 69 on how Topogr.” produces a table showing the clinical
to change between the two). signs associated with each of the five
keratoconus stages developed for the
In the very center is a field titled “Keratoconus Keratograph. It must be stressed again at this
Level Topogr.”. Based on a combination of point that a diagnosis of a keratconus (especially
several indices this output field characterizes the in incipient cases) without taking into
stage of development of the keratoconus in consideration all relevant clinical information is
question. Besides classification into any of liable to be wrong, as similar pictures may also
stages 1-4, it may also show the attribute result from irregularities of the lacrimal film or
“possible” in cases of suspected incipient kerato- cornea or from fixation problems.
conus. The present classification has been
Page 39
7.2.2.6.1 Vertical Decentration
The large map at the top left shows vertical In normal and astigmatic eyes as well as in near-
decentration calculated according to a Fourier central keratoconus this display mode yields
analysis of height data. Combining the spherical perfectly closed rings. In the transition to
component with the vertical decentration keratoconus the rings gradually open up due to
component (both generated from height data) the concomitant decentration, finally taking on
makes it possible to depict the development and the shape of an inverted omega in the center.
different degrees of severity of keratokonus.
Example:
Normal eye Astigmatic eye
Possible KK Possible KK Incipient KK Incipient KK
Stage 1 KK Stage 1-2 KK Stage 2 KK
Stage 2-3 KK Stage 3 KK Stage 3-4 KK Stage 4 KK

Page 40
7.2.2.7 Refractive Display Mode
The refractive display mode permits an In the refractive map (bottom left ) the diopter
assessment of the optical effect of the corneal values are greater at the periphery because the
surface. For this purpose it uses focal distances focal distance at the periphery (f2, f3) differs from
rather than curvature values. These focal that at the center (f1) (spherical aberration).
distances are calculated according to Snell’s law
(light-ray tracking), and spherical aberrations
have therefore already been taken into account.
Focal distances are always given in terms of
diopters.
The difference between this and the conventional

curvature display method becomes apparent
when one considers the topographic images they
produce of a sphere: f1 f2 f3
The curvature map (“Original”, at the top right)

will only show one color, since the curvature of a
sphere is everywhere the same.
Page 41
Clicking in either of the topographic maps causes The refraction at the corneal vertex (CVD=0) is
the curvature value and the refractive value at automatically calculated from the spectacle
that point to be displayed. power values and is likewise displayed
numerically.
The data field (at the very bottom) contains the
following parameters: Before changing spectacle power values of an
• Rh: central horizontal curvature radius (in mm earlier examination (i.e. when the examination
and diopters) and its axis position date differs from the current date) the system
• Rv: central vertical curvature radius (in mm asks “Change the stored spectacle power
and diopters) and its axis position values?”, to prevent inadvertent changing of
• Astig: astigmatism in the center (in diopters) stored values
• Ecc: mean corneal eccentricity
• Pupil: diameter in mm When to use the refraction display mode:
• Iris: diameter in mm This display mode is particularly suitable for
• Apex: radius in mm and dpt studying measurements before and after excimer
• Ø, h: measure absolute height difference laser treatment because it provides the following
information in a single window:
The “Spectacle power“ field at the bottom right is • normal topographic map (original)
used for entering (and saving) the patient’s • refractive topographic map
refractive values: • central radii in diopters
• Sph: spherical equivalent • pupil diameter in mm
• Cyl: cylinder (always negative) • refractive values of the patient at the time of
• Axis of the cylinder measurement
• CVD: corneal vertex distance
Measurement of absolute height difference apex. The height on the horizontal meridian of
To measure absolute height difference means to astigmatism is calculated on the basis of a
measure the difference in height between the weighted average: (2 x temp. + 1x nasal)/3.
apex and a point on a variable diameter around Height (in terms of µm) is determined at a
variable diameter (mm) around the apex. The
Page 42
diameter of the zone can be changed by obtained can be used for fitting Ortho-K lenses.
pressing the plus or minus key. Values thus
7.2.2.8 Height Data
This display mode uses the internal three-

dimensional height model of the cornea Absolute height
generated by the measurement.
pA plane
The use of height data offers the following
advantages: cornea
• Height data give a more accurate

representation of the true shape of the
corneal surface. They can be used directly Absolute height, PA, (in a meridian section) is the
for fluo image simulation as well as for difference in height between a local point on the
calculating the posterior surface of contact corneal surface and a plane which makes
lenses. Comparison with the fluo image of a contact with the cornea in its center.
contact lens shows that the use of height
data for locating the position of the apex in
keratoconus gives far more accurate results Difference in height between cornea
than one would expect from a display method and reference body
based on sagittal and tangential radii
• Height data contain a variety of information, pD
which, however, only becomes accessible
through further calculations. cornea
• Height data can serve to define standards reference
independent of the type of instrument being shape
used.
• Height data are relatively insusceptible to The difference in height, PD, between cornea and
fixation artifacts, thus lessening the reference body, may either be positive or
probability of pseudokeratoconus occurring. negative:
• Height data can serve as a starting point for negative: measurement below reference body,
analyzing various aberrations of the corneal positive: measurement above reference body.
surface by means of Zernike polynomials.
Furthermore they can be used for In the Height Map menu (see Figure on next
keratoconus quantification page) the map at the top right shows the corneal
surface in the normal display mode based on
• Height data make it possible to determine
sagittal or tangential radii.
how of the cornea would theoretically have to
be removed in order to produce the desired
The map at the bottom right shows the
reference surface from cornea as originally
topography of a rotationally symmetric
measured.
reference body, the shape of which can be
defined using the “r” and “Ecc” fields above the
Height data can be shown either in absolute or in topographic map. The height data map is
relative terms (in the latter case as differences in updated automatically after every change to the
height between measurement and reference reference body.
surface): For example, if “Ecc” is set to 0, the reference
becomes a sphere.
If “r” is set to 0, the map will show absolute
height data.
Page 43
If the “rm” button is active, as in the default button displays a polar coordinate system
setting, the reference body is calculated from the showing local height data. This permits an
mean central curvature radius and an eccentricity assessment of the fit of spheroaspherical or
0.1 greater than that of the cornea. These quadrant lenses of known apex depth.
parameters are ideal for displaying normal or
astigmatic corneas, and they are frequently used The "Height Map" window is bordered by two
in manual topometry programs. Activating the color bars. The right color bar corresponds to
“rf” button causes the reference body to be that of the overview display and represents
calculated using the flat central curvature radius curvature values (mm or D). The left color bar
and an eccentricity 0.1 greater than that of the contains height data, classifying deviations from
cornea. This setting is especially suitable for the reference body into 10 µm intervals. Clicking
cases of keratoconus, as the position of the apex with the left mouse button permits the user to
is displayed immediately. change the resolution for better readability.
The large map on the left is a graphic Clicking with the left mouse button in any of the
representation of height data shown in terms of color maps causes the curvature or height value
differences in height between the measuring at that location to be displayed in all of the maps.
point (cornea) and the reference body. The
figures at the bottom left give the simulated
ophthalmometric values including axis position
and mean eccentricity at 30°. Clicking the “Num”
Page 44
Applications of the height display method

fluo images show that images based on height
The conventional method of imaging keratoconi data yield more accurate results. The conus
by means of sagittal or tangential radii is prone to apex is always located at the end of the loop-like
artificial distortion. For example, it not bulge of the contour lines. In the fluo image the
infrequently leads to an inaccurate location of the apex is located somewhat closer to the loop due
apex position. Clinical findings in conjunction with to the tilt of the lens on the eye.
Right eye Left eye
Representation based on
sagittal radii
The hour-glass shape in the center

is an artifact inherent to the display
method. In the right eye the apex
appears to be located inferior and
nasal, while in the left eye it
appears to be located inferior.
tangential radii
Same problem as with sagittal

radii; nevertheless, often yields
more intuitive results.
height data
In both eyes the apex position

appears to be located temporal
towards the lower pupillary margin.
This is in agreement with clinical
findings (ophthalmoscopy in
regressive light) and the fluo
image.
Simulated fluo image
Right eye: lens contact in the

apical area temporal and inferior to
the pupillary margin as well as
nasal and superior. Left eye: lens
contact around the temporal/
inferior temporal pupillary margin
as well as nasal between 9 and 10
o´clock.
Page 45
7.2.2.9 Camera Image
The camera image of the measurement is The [Pupil / Iris] button additionally enables you
displayed in original size. to mark the edge of the iris and pupil in order to
The ring edges determined during image check the measurement of the cornea diameter.
processing can be sketched in (and deleted The magnifying function serves to enlarge
again afterward) with the [Rings] button. This details. This is done by clicking in the image with
permits exact control of the image processing as the left mouse button, whereupon the area
well as a specific evaluation of the reflection of around the mouse pointer appears enlarged in
the Placido system. the bottom right-hand corner of the display.
Use the right mouse button to deactivate the
magnifying function.
7.2.2.10 Refractive Compare

The comparative representation serves to depict been loaded the refractive difference between
changes in corneal refractivity such as can be the two is automatically calculated and shown in
caused by wearing Ortho-K lenses (or through the large map on the left. This map is generated
refractive surgery). by subtracting the second map from the first.
Thus the patient´s change in refractivity is
Map 1 on the top right gives a refractive shown.
representation of the current measurement (see Underneath the refractive difference map is a
Chapter 7.2.2.7). You have the option of loading diagram showing a section through the refractive
a second refractive measurement in map 2 difference.
below. When this second measurement has
Page 46
This diagram shows the prevailing value of the The scale can be changed by clicking with the
axis position. X-axis: diameter around the apex left mouse button on the color bar. In this way it
in mm. Y-axis: diopter value. It is possible to is possible to depict refractivity in smaller or
change the axis of the section. larger diopter intervals.
Example: At 173,4° (or 354,4°) is an interrupted
blue line in the picture „Refractive Difference“. By • Apex
clicking on this line with the left mouse button a In the corner on the bottom left of the pictures 1
continuous line appears. This can be made to and 2 the refractivity at the apex of the two
rotate, and the values of the axis position in the current refractive measurements is given.
lower diagram are changed accordingly.
• Astigmatism
• NUM In the corner of the buttom right of the picture 1
Clicking on the NUM key causes the refractive and 2 the astigmatism of the two current
difference map to be divided into several zones. refractive measurements is given in diopters.
The mean refractive difference is calculated from
the points measured within that zone ans is • Principal sections
displayed in its center. This value gives the The position of the two principal sections cn be
average refractive difference for the entire zone inferred from the small diagram in the top right-
rather than of a single point. hand corners. These are per definition always
perpendicular to each other.
• Color bar
The color bar on the left of the refractive
difference map gives a color scale of refractivity
in diopters.
Page 47
7.2.2.11 Comparing Examinations
This type of display makes it possible to compare differences among the various topographies.
different examinations of a patient with each This is then displayed in the field at lower left.
other in order to evaluate the trend which the (For this at least two topographic displays must
cornea is developing. It also serves the purpose be loaded.)
of checking treatments with the excimer laser.
In the "Map" activation box you can select which
Up to four examinations of a patient can be of the examinations should be subtracted from
compared with each other. each other.
The first topographic display corresponds to the The result, i.e. the difference, is displayed in
examination which is loaded at the moment. color coding. The mm values belonging to it are
In order to call other topographic displays to the listed on the left margin (cf. 0 page 60).
screen, first click on one of the empty heading
areas. This opens the Examinations List, from Curvature values can be ascertained in any
which the display of another examination can topographic display as follows: Clicking any
now be called to the screen. The selection is location in the topographic display causes the
made according to date, clock hour, and right or curvature values for that location to appear
left eye. above the mouse pointer. A comparison display
shows the comparative value.
It is possible to calculate a differential diagram of
two images as a means of determining
Page 48
7.2.3 Contact Lens Fitting
The measurement of corneal geometry is of Contact lens fitting is started by calling the "Lens
great assistance to the user during contact lens fitting" (cf. 7.2 page 18) menu to the screen
fitting. after the examination.
Without burdening the patient, it permits the The screen then shows two data areas:
insertion of a contact lens and the inspection of
the contact lens fit to be simulated on the
computer screen.
Left: Data of cornea Right: Data of contact lens
The area Data of cornea shows the table of The curve of corneal eccentricity on the major
Eccentricity and the usual keratometric values: meridians is listed above the keratometer data in
the form of numbers from the inside to the
Rh: Horizontal radius of curvature in the outside.
center A mean of eccentricity is calculated and
Rv: Vertical radius of curvature in the displayed for each peripheral angle. The central
center radii of the individual meridians are displayed at
Rm: Mean radius of curvature in the center the left column.
Astigm.: Corneal astigmatism in the center
Axis: Axis position of the flat meriadian These data give the contact lens adjuster a good
∅ Cor: Diameter of the iris or the cornea idea of the shape of the cornea from the center
Ecc: Mean eccentricity of the cornea to the periphery.
Fix.dif: Fixation difference. Distance between
pupil center and center of topographic Eccentricity values at 30° are used to calculate
corneal map. the average eccentricity.
The circle diagram at the right of the data shows The contact lens to be fitted is selected by
the position of the major meridians. means of the “Contact Lens Fitting” data fields
(see next page).
Page 49
7.2.3.1 Selecting a Contact Lens
The geometric data of the cornea serve to

calculate suggestions for all available contact
lens types; these are then entered into the list of
suggestions.
The list at the very top specifies contact lens

geometries which most closely correspond to the
measured cornea. The list of suggestions thus
provides a ranking list of suggestions for lens
fitting. Suggestions for soft contact lenses always
appear at the bottom of the list (independent of
quality of fit). The contact lens parameters
referring to the first suggestion are automatically
displayed in the corresponding data fields:
• Manufacturer
• Lens type
• Central radius
• Eccentricity
•
nd
Toricity (2 central radius)
• Diameter
Now either the parameters can be changed

individually, or another suggestion for a contact
lens can be transferred to the data fields by The following buttons are available for fitting
clicking the corresponding line in the list of contact lenses:
suggestions.
[Calc. fluo.] starts the calculation of a fluo image
However, it is only possible to change contact simulation (see next page).
lens parameters if the lens type of the selected [Hecht CL] starts a special contact lens fitting
manufacturer is available with these parameters. software of the Hecht company (cf. 7.2.3.2.6
Otherwise the program will select a lens most page 54).
similar to the one specified. Clicking the [+] and [Details] enables you to process additional
[-] buttons thus always produces the next contact lens parameters (cf. 7.2.3.2.3 page 52).
possible value (e.g.: diameter 9.20 → 9.60). [Print] prints the image as is.
[Quit] ends the contact lens fitting routine.
After a change of lens type in the “Lens” or
“Manufacturer” field the best possible The field titled “Display” allows to change the
suggestion for that lens type is first displayed. “data of cornea” field (top left). Eccentricity,
sagittal curvature, top test or fluo icon can be
To enter a user-defined contact lens, set the chosen.
“Manufacturer” field to “Mathematic” (topmost
field). After this all parameters can be set The “Position” field shows the position (shift
individually, regardless of whether the desired and rotation) of the contact lens on the cornea.
lens is available or not. (cf. 7.2.3.2.2 page 51)
If toric lenses are to be used, the program will

indicate the orientation of the flat meridian with Note ð In the case of soft lenses, the “Ecc.”
field shows “Soft” and the [Calc. fluo.] button is
the symbol . This symbol always appears next
disabled, since fluo image simulation is not
to the input field for the larger radius.
possible for soft lenses.
Page 50
7.2.3.2 Fluo Image Simulation / [Calc. fluo.]
Activating the [Calc. fluo.] key causes a fluo After the first fluo image simulation a field titled
image simulation to be carried out. Here the “CL power” appears at the bottom right. Here
following parameters are calculated: the power values of the contact lens can be
calculated as a function of the patient’s spectacle
• Distance of major meridians to the contact power and the type of lens. Activate the [CL
lens (at the lower left). power] button to start this “CL Power
This display permits a good evaluation of the Calculation”-Module (cf. 7.2.3.3 page 55).
adjustment, since the curve profile makes it
easy to see whether the adjustment has been As the fluo image overwrites the keratometer
flat, steep or parallel. The curve bends up- data, these are now displayed at the bottom left.
wards if adjustment is flat, downwards if it is
steep, and runs horizontally in the case of The “Display” field enables you to select the
parallel adjustment. information to be displayed in the fluo image field
(top left):
• Fluo image simulation of the contact lens • the eccentricity table
on the eye (for different peripheral angles)
Here the program calculates distances be-
• a table of sagittal radii
tween lens and cornea over the entire area of
(for different peripheral angles)
the contact lens and presents the results in
• the Top Test (cf. 7.2.3.2.5 page 53)
different shades of green. The meaning of the
various shades can be inferred from the • or the fluo image simulation
green color bar. Above the fluo image is a
description of the contact lens used for the To print the current presentation, click [Print].
simulation.
Page 51
7.2.3.2.1 Fluo Icon Selection Switches
Every new fluo image generates a selection

button in the form of a miniaturized fluo image.
These fluo icons are listed in the right margin of
the main fluo image.
Clicking on one of these fluo icons with the left

mouse button causes the corresponding fluo
image to be reloaded along with the calculated
diagrams and all contact lens parameters used
for the simulation calculation (manufacturer, lens,
central radius, eccentricity,...). In addition, all
previously processed refractive data are
reloaded.
This function permits rapid switching between

different lens fit simulations.
To delete a fluo image, click on it with the right
When the eighth fluo image is generated, the top mouse button. Answering the subsequent
one is removed and the whole icon row moves question “Delete Fluo icon?” with [Delete]
one up to make room for the new icon at the removes the fluo icon and causes the icons
bottom. below to move one up.
7.2.3.2.2 Shifting and Rotating the Contact Lens
Shifting Rotating
Clicking the contact lens in the fluo image at any To rotate a toric contact lens click near the white
point enables you shift the lens within the allowed markers with the mouse pointer. This causes the
area while you keep the left mouse button de- rotation axis of the lens to be marked red. Now
pressed (red contour). Letting go of the mouse rotate the axis position of the contact lens while
button automatically produces a question: “Move keeping the mouse button depressed. Next
contact lens?“. Click the [Move] button to have appears the question “Rotate contact lens?“
the fluo image simulation recalculated and which you can confirm with [Rotate] to start the
displayed for the new position of the contact lens. recalculation.
Page 52
The position of the contact lens is shown in the Definition of inclination angle
“Position” field: -90°
R/L: positive stands for right, negative for left, The inclination angle is -
U/D: positive for up and negative for down, the angle between the
Incl.: inclination angle of the contact lens. horizontal plane and the Incl.
markers of the contact
The change of position resulting from the lens (e.g. -5°). 0°
movement (shifting/rotation) of the contact lens is The sign does not
continuously tracked in this field. coincide with that of the +
axis (Rf).
+90°
7.2.3.2.3 Setting Contact Lens Parameters / [Details]
Clicking the [Details] button opens up a menu

for setting additional contact lens parameters.
The menu is positioned such that the
manufacturer and lens type still remain visible.
Contact lens parameters are classified as

pertaining either to the Basis curve or the
Periphery. Changing parameters of the
periphery only makes sense if the
“Manufacturer” field has been set to
“Mathematic” because the peripheral geometry
of normal lenses is fixed.
For an explanation of parameters of the
periphery see also 7.2.5.3.1 page 78.
The calculated tilt of the lens is displayed in the

“Tilt” field.
Any shift or rotation (inclination) of the contact
lens is shown numerically in the “Position” field
(see top of this page).
The symbol indicates the orientation of the flat
meridian.
[Quit] exits the [Details] function and leads back

to “Contact lens fitting”.
Page 53
7.2.3.2.4 Changing the Scale of the Fluo Image
To change the scale of the fluo image, click on Changing the scale can be helpful in cases of,
the green color bar in the left margin of the fluo for example, marked keratoconus, as a larger
image. maximum value (e.g. 300 µm) makes it possible
This produces a window in which you can to assess distance curves involving large
change the maximum value of the scale. The distances (i.e. in cases of poor lens fit).
default value is 100 (µm). If a different scale has Changes of scale are automatically followed by a
been selected, this is indicated by the remark recalculation of the fluo image.
“!!Scale!!” next to the scale.
7.2.3.2.5 Top Test
The “Display” field in the Contact lens fitting

window can be switched to “Top Test“:
p = k • (1 + c1 • k )
h2
where: k=
2 • r0
p
p =arrow height
h =zone height
h r0 =central radius
r0
This presentation mode lists the individual eccentricity at 30° (Ecc) and the flattening
meridian angles (Mer.), the central radius of the constant (c1).
meridian (r0), the coaxial radius at 30° (rs), the In conjunction with the central radius r0 the
degree of flattening, i.e. the difference between flattering constant c1 permits a mathematical
central and coaxial radius (rs-r0), the resultant description of the corneal paraboloid.
Page 54
7.2.3.2.6 Using Hecht Fitting Software / [Hecht CL]
A special lens fitting program is available from Now a lens can be selected in the Hecht
the Hecht company for fitting Hecht contact software.
lenses. This program calculates suggestions for This done, click the [Fluo. image] button to exit
contact lenses on the basis of measurements of the Hecht software. The OCULUS software will
corneal geometry and in accordance with the then run another fluo image simulation.
fitting rules of the Hecht company. Closing the window directly circumvents a
renewed calculation of the fluo image.
This software is accessible via the [Hecht CL]
button (see Figure on page 49).
Note ð To change the geometric data of a Furthermore the Hecht company offers a lens
Hecht lens you always first have to click the fitting software “Hecht Expert”. With this the
[Hecht CL] button. For this reason selecting a contact lens geometry can be defined more
contact lens in the Hecht software deactivates detailed.
the relevant input fields in the OCULUS software.
This is to ensure that a contact lens in the Hecht
software can be altered by none other than the
Hecht software. The input fields are reactivated
as soon as you enter a new contact lens
suggestion or select a different manufacturer.
Page 55
7.2.3.3 Refraction Module / [Refraction]
The refraction module permits a calculation of basis of the corneal vertex distance (CVD) and
the required refraction of the contact lens as a displayed in the column “CVD=0”.
function of spectacle power and lens type. It also If power values have already been entered, these
enables you to compare different lens types (e.g. will be adopted directly (cf. 7.2.2.7 “Refractive
toric or bitoric) with respect to their corrective Display Mode” page 40).
effect.
Clicking the [Suggestion] button starts the
It is advisable to complete the selection of the calculation of a suggestion for a contact lens with
posterior surface of the contact lens (i.e. the fluo due consideration to the power values, the
image simulation) before starting the power curvature of the cornea and the selected
calculation program via the [CL power] button posterior surface of the contact lens. This
(cf. Figure at page 50). The reason for this is that suggestion (e.g. Sph: 6.25 D) is then transferred
changes to the curvature of the posterior surface to the “Test lens” field where it can
necessitate additional corrective effects of the subsequently be edited manually. Each change
contact lens. of a value is automatically followed by a
calculation and presentation of the “Expected
The content of the “Test lens” field of the power remaining power” The expected remaining power
calculation module varies according to the corresponds to the overrefraction which would be
selected lens type. necessary if the contact lens were placed on the
The following are available: eye. The test lens should therefore be so
• Test lens, rotationally symmetrical selected as to minimize the expected remaining
• Test lens, toric power.
• Test lens, soft
Note ⇒ The “Expected remaining power“ is not
The first entry you have to make in the a measured but rather a calculated value which
“Spectacle power“ field are the patient’s power takes as many ocular and contact lens
values. Be sure always to enter the cylinder value parameters into account as possible (though not
with a negative sign. The spectacle power value all). This value should therefore be compared
is converted into corneal vertex power on the with the measured overrefraction found after the
selection of a contact lens.
Page 56
The Refraction Module contains the following values and thus remains available for later
fields: occasions.
• Spectacle power • Cornea

Entry of power values and automatic This field displays the keratometric values of
calculation of corneal vertex refraction the cornea measured by means of the
(CVD=0). Keratograph:
r0 (mm): central radii
• Test lens Cor.Ast.: corneal astigmatism (central)
Selection of contact lens parameters: Axis (Rf): axis of the flat meridian
The curvature of the posterior surface of the
contact lens has been measured by means of • Remaining power (expected)
the fluo image and is therefore only displayed This field shows the “Expected remaining
here. This curvature can only be changed power” described above.
through contact lens fitting (fluo image
simulation). Clicking the [Back] button exits the power
calculation module and transfers the new values
• Comment to the “Power calculation” field of the contact
Here the user can enter any text he desires. lens fitting dialog box.
The text is saved together with the power
7.2.3.3.1 Power Calculation for Toric Lenses
Further contact lens parameters can be entered Any change in inclination automatically leads to a
in the “Test lens toric” field: recalculation of the fluo image after exiting the
power calculation module ( [Back] button).
Incl.: Here you can change the inclination
(rotation) of the contact lens (cf. page 52). n: The refractive index n of the contact lens
Initially the inclination is such that the flat material determines the degree of induced
meridian of the posterior surface of the contact astigmatism in toric lenses, and hence their toric
lens corresponds to that of the cornea. This is effect. This is why the contact lens material or
where to correct the rotation of the lens in the the refractive index has to be specified.
event that the two flat meridians do not coincide.
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Note ⇒ The refractive index always has to be normally be caused by the posterior surface
entered manually (i.e. in the case of toric lenses). is here compensated by a cylindrical
It is not stored along with the other contact lens component in the anterior surface. With the
parameters in the contact lens database. induced astigmatism neutralized by the
shape of its anterior surface, this type of
To the right of the “n” field is a selection field for contact lens corrects corneal astigmatism as
specifying the name of the material; n is then a spherical contact lens does, while at the
adjusted accordingly. (The file “C:\TOPO\N- same time offering the advantage of a better
MAT.TXT“ contains a list of material names and fit by virtue of its toric posterior surface.
their corresponding refractive indices. The user Due to the neutralization of any induced
can extend this file with a text editor, e.g. astigmatism the corrective effect of this
WordPad.) contact lens does not depend on its rotation
(inclination).
However, as in the case of toric lenses, this
lens type does not allow for additional
cylindrical correction.
As the refractive index is irrelevant in the
case of bitoric compensated lenses, the “n”
field and the material selection field are both
deactivated.
• Bitoric
Bitoric lenses are toric on their anterior as
Any of three different types of toric lenses can be well as their posterior surface. The axis
selected in the “Test lens toric“ field: position of the two surfaces are independent
of one another, making it possible to first
• Toric determine the torus of the posterior surface
The posterior surface of this contact lens is solely for the purpose of a proper fit and then
toric (better fit), whereas the anterior surface derive the required torus and axis position of
is spherical. the front surface from the overrefraction.
Due to the difference in refractive power Bitoric contact lenses have to be calculated
between the contact lens material and tear by the manufacturer, and the “Sph (D):”
fluid, the toric posterior surface causes an field is therefore deactivated.
artificial, or induced, astigmatism.
Depending on the patient’s power values, After selecting the desired contact lens type it is
this effect can be advantageous in certain advisable to first click the [Suggestion] button in
cases. order to obtain an optimal test lens for the
Due to its spherical anterior surface this type selected lens type.
of lens does not allow for additional
cylindrical correction. Note ⇒ Clicking the [Suggestion] button does
not permit you to change the type of contact lens.
• Bitoric compensated This function makes no suggestions as to the
This lens type has a toric posterior surface type of contact lens, but rather determines the
as well as a toric anterior surface. optimal test lens for a manually preselected lens
The induced astigmatism which would type.
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7.2.3.3.2 Power Calculation for Soft Lenses
Calculating contact lens power is simpler in the soft” field. The expected remaining power for
case of soft lenses because of the absence of a this contact lens is calculated using the axis
tear lens. Here the power calculation module first position of the patient’s spectacle power.
calculates corneal vertex refraction (CVD=0) and
transfers the rounded result to the “Test lens
7.2.3.4 Storing and Loading the Fitted Contact Lens
After fitting the contact lens, click the [Quit] data always refers to the contact lens which is
button to end the fitting routine (cf. Figure at currently loaded.
page 49). If you click [No Storage], then no contact lens is
The program then asks whether or not you want stored.
it to store the selected contact lens and refraction If you click [Store], then the contact lens as well
data. At the same time it displays the contact as refraction data are stored.
lens and parameters in question on the screen. Clicking [Back] allows you to continue fitting the
The proposal to store contact lens (and power) contact lens or to select a different contact lens.
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Loading fitted contact lenses:

Stored refraction and contact lens data are The fluo image is not stored along with the other
automatically loaded together with the data and should therefore first be calculated by
examination data (cf. 7.2.7.1 page 84). clicking the [Calc. fluo.] button and assessed.
The refraction data are likewise only displayed
After starting the “Contact lens fitting” routine once the fluo image has been calculated.
the program transfers the loaded contact lens
data into their respective fields (in the contact If you make no changes to any contact lens or
lens fitting dialog box). The content of the data refraction parameters, you will not encounter any
fields is therefore not merely a suggestion but questions when exiting the contact lens fitting
constitutes a properly fitted contact lens, and routine ([Quit] button). However, if you change a
there is consequently no blue highlighting of parameter, you will be asked, for example, the
contact lenses in the suggestion list. following question:
Now you can choose whether to store the new

contact lens parameters or keep the old ones.
Seite 60
Gebrauchsanweisung Keratograph
7.2.4 Pupillometer Software
The Keratograph, in addition to its other An optional pupillometric function is available in

functions, permits a pupillometric analysis to be the Keratograph from software versions 1.55 and
carried out, resp., pupillograms to be made. upward. Pupillometric retrofitting may be carried
For this purpose, the size of the pupil is (during a out for all Keratograph 2 types (year of
given time period) continuously measured and manufacture approx. 1998 or later). The
then represented as a function of time. During Keratograph software provides information on
the measurement the pupil is illuminated with the model type (type 1 or type 2)
infrared light, permitting the determination of the (“Settings“/”System“/”Device Type“).
size of the pupil even when in a state of dark
adaptation. In addition, the Keratograph provides The Pupillometer software is started through the
the means of activating, resp., deactivating two menu item “Examination/Pupillometer.“ In the
states of glare of differing stimulus levels for the event that this menu item is absent, it is
purpose of determining the reaction of the pupil necessary to activate the Pupillometer software.
to glare. It is moreover possible to compare the
reactions of the pupils of the left and right eyes
and to compute difference curves from the
results.
7.2.4.1 Activation of the Pupillometer Software
The Pupillometer software is protected by a Before Pupillometer measurements can be made

product key. An individual “Releasing Code” is it is necessary to activate the Pupillometer
required for the activation of the software for software. This does not apply to pupillometer
each Keratograph probe (The Pupillometer examinations contained in already installed
software on a PC is not automatically activated software (e.g., trial versions).
during installation of the Keratograph software).
Proper communication of the Keratograph with The first step in activation is the loading of the
the PC (indicated, e.g., by the ability to carry out examination software. After this has been done
a topographic measurement) is a prerequisite for the following window is opened:
activating the Pupillometer software, since
otherwise the Keratograph’s “Device Code“
cannot be read in.
Next, the following four letters must be entered, LUSP

all in lower case, i.e. without the Shift key:
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Subsequently the activation menu is displayed:
The individual device code is displayed in this

menu. To activate the Pupillometer software the
corresponding releasing code must be entered
and the OK button clicked.
After entering a valid Pupillometer releasing code
the software may be loaded (“Examination /
Pupillometer“).
Customers may obtain the requisite releasing

code from OCULUS by providing the device
code. Those customers who have purchased the
Keratograph together with Pupillometer software
have received a sheet which lists the serial
number, the device code and the releasing code.
7.2.4.2 Starting the Pupillometer Software
Loading the Pupillometer software is done by Pupillometer“. When this has been carried out
selecting the menu item “Examination / the following window is opened:
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The current camera image appears in real time function of two switches is selecting the eye to be
on the left-hand side. Now, with the aid of the measured.
cross hair, the Keratograph is adjusted so that
the image of the patient’s eye under investigation Four different programs are available:
appears in the center of the camera image. • Pupillogram: 0.2s of glare, followed by a
Vertical or horizontal displacements are 9.8s pause (repeated five times)
immediately visible in the camera image. • Anisocoria test: 5s of glare, followed by a
Adjustment of distance is carried out by means 15s pause (repeated three times)
of image focus. The Keratograph should be • No glare
adjusted so that the camera image is as sharp as • Manual
possible. To facilitate the focus adjustment, a
blue bar appears to the right of the camera In the case of “Pupillogram“, “Anisocoria test“
image. The longer this bar, the more in focus is and “No glare,“ the programs function
the image. Thus the distance should be adjusted automatically. This is not the case for the
so that this blue bar is as long as possible. “manual” program: here the degree of glare is
not adjusted automatically; it must be set in the
Various switches for the relevant program are Pupillometer program by means of various
located on the right side of the screen. The time buttons. The pupillometric measurement
development of the degree of glare is stored in process begins when one of these program
one program. Each switch appears twice, once switches has been activated.
for the right eye and once for the left eye. The
programs are identical for both eyes. The only
7.2.4.3 Carrying out an Automatic Pupillometric Measurement

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The measurement process begins immediately degree of glare at various time periods may be
after a program (in this case the pupillogram found. The row “Glare“ shows the state of the
program) has been started. As before, the real- ring illumination (Placido system), with red
time camera image appears on the left. The indicating ON and grey OFF. “Min. Gl.“ shows
camera image is analyzed in constant time the state of the inner ring only, which may be
intervals and, together with the pupil rim used to achieve a mild glare.
determined by the measurement – marked in
red – is displayed on the right-hand side. Each The measurement process is automatically
successfully analyzed camera image yields a ended when the right side of the diagram has
pupil diameter value, as well as x,y values that been reached. It is possible to terminate the
specify the location of the center of the pupil measurement process prematurely by clicking on
relative to the center of the camera. These the “End“ button. Before the measurement is
values, together with time elapsed since the terminated a camera image is automatically
beginning of the measurement, are displayed to made and stored together with the measured
the right of the blue focus bar and are data.
continuously updated.
Following the end of the measurement, the
These values (initially without the x,y screen view switches to the Pupillometer
coordinates) are shown in the diagram at the overview display.
bottom of the screen, in which additionally the
7.2.4.4 Carrying out a Manual Pupillometric Measurement

Page 64
In contrast to the automatic version of the Both types of glare may be arbitrarily controlled
program, the manual version allows the degree in the case of a manual pupillometric
of glare to be set manually. The switches “Glare“ measurement.
and “Min. Gl.“ are used for this purpose. “Glare“
sets the entire ring system to ON or OFF. “Min. Following the termination of the measurement
Gl.“ is used to activate or deactivate the inner process the screen view changes to the
ring of the ring system. The degree of stimulus Pupillometer overview display.
provided by “Min. Gl.“ is therefore considerably
less than that of “Glare.”
7.2.4.5 Pupillometer Overview Display
At the left a data field may be found in which The data field entry “pupil diameter“ (upper left)
certain information relevant to the measurement contains information of a general nature: The
is listed. The camera image stored during the minimum and maximum values of the measured
measurement is shown at the right. In the pupil diameter are shown. In addition, the mean
diagram at the bottom there are also two white and standard deviation are computed and
pointers which can be shifted after clicking on displayed. Note that these values are significant
them with the mouse. When this is done the primarily in the case where the measurement is
values in the data field are updated. The pupil carried out without glare (measurement of
diameter at any given time may be displayed with pupillary athetosis).
the help of these pointers.
Page 65
The data fields also contain measurement values • Pupil (camera image)
corresponding to the two white pointers. A pupil This switch allows the red line in the camera
measurement value consists of: image (right) marking the pupil rim to be
• Pupil diameter in mm switched on and off.
• Time (relative to the beginning of the • Slope
measurement) in seconds This switch allows the display of the speed
• X-position of the pupil center (relative to the as a line slope in the diagram (below). This is
center of the camera) in mm represented as a connecting line between
• Y-position of the pupil center (relative to the the two measured values of pupil curve. The
center of the camera) in mm slope of this connecting line corresponds to
the speed at which the pupil diameter
The differences corresponding to the two changes.
pointers are also shown in the diagram. In
particular the Activating the x-position, resp., y-position curves
• Time difference in seconds allows recognition of any shift in the position of
• Speed in mm per seconds. the patient’s eye.
The speed at which the pupil alters are
calculated by dividing the change in the pupil The camera image (right) has a magnification
diameter by the time differential. This value feature: clicking on the camera image causes a
represents the mean speed of changes in the detail to be magnified.
pupil between both pointers.
The scaling of the y-coordinate in the diagram
The “Display“ entry of the data field contains five (below) may be changed by clicking on the y-
different switches. axis. When this is done, a dialog box opens in
• Pupil curve which scaling values of 4mm, 6mm, 8mm or
Displays the pupil curve in the diagram 10mm may be selected.
(bottom).
• X-pos A field for remarks is displayed in the patient field
Displays the curve of the x-position of the (top right). This text may be edited by clicking on
pupil center in the diagram (bottom). it. The default value for the text is the name of
the program (“Pupillogram“ or “Anisocoria test“ ).
• Y-pos
However, in the case of the program values “No
Displays the curve of the y-position of the
glare“ or “Manual“ the value “Pupillometry“ is
pupil center in the diagram (bottom).
used.
7.2.4.6 Pupillometric Comparison View
A “Compare Examinations“ item is available in In this case too there appear white pointers
the Pupillometer “Display” menu. When this has which can be clicked on and shifted. This shift
been selected, a second examination may be takes effect in all three diagrams simultaneously
loaded by activating the drop-down list to the and causes the displayed values of the pupil
right of the label “Examination B“ and selecting diameter to be automatically updated in the
the desired examination. appropriate diagram. The following conventions
After the second examination has been loaded are used in the overview diagram: The left
both examinations together with their difference pointer is referred to as Pointer 1 and the right
curves are displayed. pointer as Pointer 2.
Page 66
The comparison view is especially well-suited for comparison view and a difference curve is
recognition of anisocoria (unequal size of the calculated and displayed.
pupils). For this purpose one should first carry
out the automatic program “Anisocoria test.“ The scaling of the y-axis may also be changed in
Following this, the results of the examinations of comparison view by clicking on the y-axis.
the left and right eyes are displayed in
7.2.4.7 Pupillometer Camera Image Menu Item
The Display Menu of the Pupillometer contains This displays an enlarged picture of the recorded
an additional menu item titled “Camera Image.“ camera image (taken with infrared illumination).
Page 67
7.2.4.8 Changing the Settings for Pupillometer Camera Exposure
The infrared exposure of the Keratograph Whenever possible the “normal“ setting should
changes on an individual basis. This requires be chosen. In the event that “High“ or “Maximum“
that the software be adaptable to various is selected then, for technical reasons, when ring
exposures. illumination is used in the measurement (“Glare“)
the illumination must be turned off for a short
Changes in the exposure may only be made in period. This results in a flickering of the ring
the overview mode or in the case when a illumination when glare is activated. However this
Pupillometer examination has been loaded. is not the case for low glare (inner ring).
Before any changes can be made, it is necessary
to enter the letters Since changes made in the exposure are
“ l u s P “ (lower case “l“ “u“ and “s“ and upper permanently stored it is only necessary to carry
case “P“). out the changes in the settings once. Note that
the degree of exposure has no effect on the
When this has been service life of the camera since only the
done a dialog box is exposure time is changed.
opened which contains
check boxes permitting
three different Pupillo-
meter exposure levels to
be selected.
• Normal
• High
• Maximum
Page 68
7.2.5 Changing Settings
The examination program allows the user to The relative color scales can be displayed in
adapt working procedures to his own three different increments (cf. table below).
preferences. This is carried out in the "Change
Settings" menu. Relative Unit of Curvature
Diopter Millimeter
The following points can be adjusted: Fine 0.25 D 0.05 mm
Medium 0.5 D 0.10 mm
• Display units Coarse 1.0 D 0.20 mm
The measured curvature of the cornea can be
given either as the radius of curvature in mm The absolute color bar has a resolution of
or as the equivalent of curvature in diopters. 0.10 mm in the central area. The increment is
The conversion is carried out according to the 0.2 mm below 6.6 mm, and 3 mm above 10.5
following formula: mm.
The diopter is selected as the unit of
D=
(1,3375 − 1)mm • D curvature, the curvature values are converted
r into diopters, but the colors on the absolute
color scale do not change.
• Color scale stepping:
Different formats are possible for the color
scale. The scale can be absolute or relative.
When the scale is absolute, each radius of
curvature always has the same color. A
relative color scale is automatically scaled;
the center of the scale corresponds to the
mean curvature of the corneal surface.
Page 69
• Curvature radius The “Curvature radius” button refers to all

modes of curvature presentation, e.g.
Here you can determine whether to have the
-color topographic image,
sagittal or the tangential curvature displayed.
-3D image,
The tangential curvature is the curvature of
-diagrams of the Overview Display,
the cornea at the measuring point.
-Fourier analysis,
-etc.,...
Tangential Curvature
It does not refer to
rT1 -keratometric data,

-color presentations of refraction,
rT0 -height data,
-contact lens fitting.
• Presentation
Here you can choose whether the diagram is
shown as a complete picture (the not
measured parts are interpolated and marked
with black dots) or as an original picture (not
The sagittal curvature is equivalent to the measured parts are white).
distance between the measuring point and the
point where the perpendicular to the tangent at • Color table
the measuring point intersects with the axis. In addition to the “Internal” color table used
by OCULUS you can also use an “External”
color table. This enables you to adapt colors
to other topographs for better comparison of
Sagittale Curvature examinations. The external color table is
stored in the file C:\TOPO\TOPO.COL. Here
. 64 shades of color can be defined with their
rS1 RGB values.
. rS0
• Central Radii:
Use this button to select whether central radii
(rh/rv) are to appear in mm or diopters in the
Overview Display.
• Date Format:
Is used to set the date display. The following
In the tangential presentation mode irregularities formats can be selected:
in corneal geometry appear more pronounced. Day/Month/Year (DMY),
Month/Day/Year (MDY),
In the sagittal presentation mode the curvature or Year/Month/Day (YMD),
value depends on the slope at the measuring as well as the sign separating month, day,
point; furthermore, the position of the optical axis and year.
comes into play. The sagittal presentation mode
is more representative of the influence of the
cornea on the patient’s visual acuity.
Page 70
• Language: If a setting is changed, any related values in the

The language which the program uses for examination displayed at the moment auto-
output can be selected from among German, matically change to match.
English, French and Italian.
The [System ->] button permits you define the
• 3D-Image interface for communicating with the Keratograph
This screen button is used to adapt the red- (cf. 7.2.5.1 page 71).
green 3D image to the viewing spectacles
which are used. The [Contact lens ->] button leads to the
Red-Green: Red glass left, green glass right. configuration menu of the contact lens database
Green-Red: Green glass left, red glass right. (cf. 7.2.5.2 page 73).
• Release (default) The [Use] button causes the setting which has
This field determines whether the automatic been made to be used for the rest of the present
release of the function "Start New program session; however, the setting previously
Examination" first is locked or released. stored in the computer's memory is again
activated the next time the program is started.
• Print
Printout can take place in black-and-white or Pressing the [Save] button stores the new
in color. Printout corresponds to the contents setting in the computer’s memory, so that this
of the screen if "Color" is selected; on the setting will be activated in future every time the
other hand, the background remains white in program is started.
a black-and-white printout (this saves ink and
speeds the printout). The [Cancel] screen button rejects any changes
just made and exits from this function.
• Fourier maps
Allows to add the spherical equivalent to the The version number of the examination software
decentration map or to the irregularities map is shown at the bottom right.
that are shown in the Fourier analysis (see
7.2.2.4 page 25).
Page 71
7.2.5.1 “Change System Settings” Button [System->]
Here you can set the speed of data transmission • Data package size
and select a communication port. From software version 1.38 upwards, data
transmission is secured by an error correction
function. This is necessary because “Pentium
2” PCs do not guarantee reliable data
transmission, especially if Windows 98 is
being used.
To permit error correction the system
transmits data in packages that can be resent
in the event of an error. This means that
errors reduce the speed of data transmission.
Data package size can be set within a range
from 30 to 3000. The following should be
• Mode considered in this respect:
The measuring head only responds if the - The larger the package size the lower is the
“Online” mode has been selected. Setting frequency with which data packages are
the mode to “Demo mode” permits you to tested. This means that data transmission
use the software without the Keratograph. in large packages is comparatively faster
when there are few errors.
• Device type - The smaller the package size the fewer
Here the device type of the Keratograph has data have to be resent in the event of an
to be specified. Keratograph 2 is identifiable error. This means that data transmission in
by the fact that its inner ring blinks twice when small packages is comparatively faster
you switch the device on. when there are many errors.
The “Other” function allows you to select
• Data transmission any desired package size between 30 and
With a suitable PC card the speed of data 3000 by entering the corresponding number.
transmission can be set to 460,800 bauds.
The default setting for communication ports The [Start Keratograph ->] and
COM1 and COM2 is 115,200 bauds. [Test Communication ->] buttons correspond in
function to the main menu item
• Boot mode “Miscellaneous” (cf. 7.3.2 page 86).
“Handshake”: When booting in this mode,
the system waits for confirmation after each Clicking the [Port detect ->] button starts a
byte and then immediately sends the next. function for automatic selection of an interface
“Synchron (NT)”: In this mode the system for Keratograph 2. For this purpose you need an
waits for a fixed time interval after each “OCULUS COM Port Detector”. Plug the detector
confirmation before sending the next byte. into the desired interface of your PC, then click
This mode slows down the booting procedure the [Port detect ->] button. If the interface has
(10 seconds instead of 6), but it enhances been properly installed in the Windows system
transmission reliability. As the system is only control, you will now be able to find it. The
booted once after switching on the system will then automatically determine and
Keratograph it is only the initial program start display the baud rate, COM port and boot mode
that is slowed down (provided the for this interface.
Keratograph is not switched off inbetween). However, the system only tests interfaces COM1
This setting is always required under to COM6. It will not detect higher COM port
Windows NT. numbers (COM7, COM8,...).
Page 72
After detecting the interface the system will ask To try to find the port address you can now click
“Use detected port settings?” (see Figure the [Search Port Address] button. The system
above). Click [Use] to adopt the detected will then search the usual COM port addresses
settings. for the “OCULUS COM Port Detector”.
If no valid COM port is found, this will produce Detected ports can be recognized by the answer
the following message: given. A number (e.g. 128, see Figure below)
means that a functioning port address has been
found. For proper configuration of the interface
you can now install the port in the Windows
system control.
Page 73
7.2.5.2 Contact Lens Database
The Keratograph has a contact lens database Manufacturers are listed in the order in which
containing posterior surface geometries for they were confirmed. The next manufacturer to
contact lens fitting. receive confirmation is always added at the end
of the list.
Here you yourself can decide which type of
contact lens you wish to use for fitting. The succession of manufacturers in the box on
Use the "Choose contact lens" menu for this the right determines the priority of contact lens
purpose. To activate this function, use the recommendations. If the geometric data are
[Contact Lens ->] button in the "Settings" similar, then the contact lenses of the
menu (cf. 0 page 70). manufacturer who is higher in the list are
preferable.
All contact lens manufacturers whose names are
stored in the PC are listed in the "Manufacturer"
box at the left. Note ⇒ To create a list with your own priorities,
Manufacturers used for fitting are listed in the first deactivate all manufacturers and then
"Used manufacturers " box at the right. reactivate them in the desired order.
Activating or deactivating a manufacturer in the

left box removes or adds that manufacturer's
name in the right-hand box.
Page 74
Clicking a manufacturer type in the "Used [Cancel] returns to the previous window without
Manufacturers " box displays next to the box a confirming the changes.
list of all of that manufacturer's contact lenses for
which data are available. Specific lens types of Use the "Edit Lens Data" box to expand the
that manufacturer can then be excluded or contact lens database.
included, or the priorities of the manufacturer's Two buttons are available for this purpose:
lens types can be revised in the list.
[Lens geometry ->] starts a software module for
The "Use Hecht fitting software" button turns inputting new contact lens geometries (cf. next
the [Hecht CL] button on and off during contact page).
lens fitting.
[Import / Export ->] permits new geometric data
[Save] ratifies the contact lens approval which to be loaded from or saved to a diskette (cf.
was just given. 7.2.5.3.3 page 81).
[Use] uses these settings only for the current

session.
Page 75
7.2.5.3 Input New Contact Lens Types / [Lens geometry ->]
This window is used to display and add to the It is also possible to create a new lens type
geometries of contact lenses which have already [New lens type],
been stored.
or to delete an existing lens type including the
After selection of a manufacturer and lens type contact lens data [Delete lens type],
(in the "Lens Type" box), all contact lenses of
that type are listed. The full and abbreviated or to change the name of a lens type [Change
designations of the manufacturer and lens type name].
are also displayed.
Page 76
• New lens type: • Change name:

Clicking the [New lens type] button causes The name of a contact lens type and/or
the following window to appear: manufacturer (together with the
abbreviations) can be changed by means of
the [Change name] button. A new input box
is displayed for this purpose. The changes
are implemented by clicking the [Change]
box after new data have been entered.
Individual lenses can also be modified after they

have been selected in the list. Use the [Change]
Now the name of the manufacturer and the button to change the data of a lens and the
lens type can be either entered or selected [Delete] button to delete a selected lens.
from the list if they are already in the
computer’s memory. The corresponding
abbreviations must also be entered. Two programs are available for creating serial
Abbreviations are used in the list of contact lens data.
recommendations for contact lens fitting The [Add lenses] button is used to create rigid
because only limited space is available here. lens geometries (cf. Next page).
Once all designations have been entered, the The [Add soft lenses] button is used to create
new lens type is created by clicking [New]. soft lens geometries (cf. 7.2.5.3.2 page 80).
The new lens type now apears in the main
display window, but contact lens data are not
yet present. The [Save + Quit] button stores changes made
and returns to the "Confirm Contact Lens"
display.
• Delete lens type: The [Cancel] button rejects all changes and
The selected contact lens type can be deleted likewise returns to the "Choose Contact Lens"
together with its contact lens data by clicking display.
the [Delete lens type] button. The
manufacturer’s name is also deleted if this is
the last lens type which is listed for that
manufacturer.
Page 77
7.2.5.3.1 Creating Contact Lens Geometries (Rigid)
Clicking the [Add lenses] button opens the

following input menu:
A new series of contact lenses can be created by 1. Base curve parameters

entering the geometric data of the contact lens • r0: Central radius of contact lens curvature
series with minimum / maximum values and (steepest meridian of toric lenses)
increments. The following data must be defined: • dr0: Curvature differences of main meridians
at the center (i.e. of toric lenses; this value = 0
in the event of rotationally symetrical lenses).
• Ecc:Eccentricity of the contact lens (i.e.
aspheric lenses; this value = 0 in the event of
spheric lenses).
• ∅ : Total diameter of the contact lens.
Example:
Spheric Toric Lens Aspheric

Min: Max: Step Min: Max: Step Min: Max: Step
r0 7.20 9.60 0.10 7.20 9.60 0.10 7.20 9.60 0.10
dr0 0.00 0.00 0.00 0.30 1.00 0.10 0.00 0.00 0.00
Ecc 0.00 0.00 0.00 0.00 0.00 0.00 0.40 1.00 0.10
ø 9.30 10.30 0.50 9.30 10.30 0.50 9.30 10.30 0.50
Page 78
2. The Periphery
r2
r1
r0
b2 b1
The periphery of contact lenses must also be If the curvature of the zones is not constant but
entered after the base parameters have been depends on the central radius, it can be defined
defined. Two peripheral zones, each with 3 by using the formula: r1=r0*A+B. The
parameters, can be entered: parameters A and B can be entered after this
formula has been clicked.
• b1: Width of Zone 1:
• r1: Curvature of Zone 1 For example, the user can define the curvature
• dr1: Differences in curvature of the main of a marginal zone as being invariably 0.8 mm
meridians (for toric lenses) greater than the central radius (A=1 / B=0.8), or
invariably 1.5 times the central radius (A=1.5 /
• b2: Width of Zone 2 B=0).
• r2: Curvature of Zone 2
• dr2: Differences in curvature of the main If toric lenses are to be defined, the
meridians (for toric lenses) "dr1=dr0*r1/r0" / "dr2=dr0*r2/r0" button should
be clicked. This copies the relationships of the
These parameters are used to define bevelled central radii to the periphery.
lenses and those with more than one curvature.
The value b2 must be specified as zero if the
If the curvature of a zone remains constant second zone is not used; however, the remaining
throughout the entire series, it can be entered parameters must have the same settings as
after clicking the "r1 = constant" or "r2 = those of Zone 1. The value b1 may not be set to
constant" buttons. zero.
Page 79
• Example: Bevelled lens with symmetrical axes of rotation (0.8 mm greater than the central
radii)
b1 = constant b1=0.25
r1=r0*A+B A=1.00 B=0.80
dr1 = constant
dr1=0
r2=r0*A+B A=1.00 B=0.80
dr2 = constant
dr2=0
• Example: Bevelled lens with symmetrical axes of rotation (1.5 times central radius)
r1=r0*A+B A=1.50 B=0.00
dr1 = constant
dr1=0
r2=r0*A+B A=1.50 B=0.00
dr2 = constant
dr2=0
• Example: 3-curve lens
r1=r0*A+B A=1.20 B=0.00
dr1 = constant
dr1=0
r2=r0*A+B A=1.50 B=0.00
dr2 = constant
dr2=0
• Example: Toric lens with bevel
r1=r0*A+B A=1.50 B=0.00
dr1=dr0*r1/r0
r2=r0*A+B A=1.50 B=0.00
dr2 = constant
dr2=0
If the [Generate new lenses] button is clicked, [Quit] cancels the function without creating a
the previously defined series of contact lens data series.
is created and the function is ended.
More than one series can be created for a single
lens type.
Page 80
7.2.5.3.2 Creating Soft Lens Geometries
Clicking the [Add soft lenses] button (cf. 7.2.5.3

page 75) causes the following display to appear:
The generation of soft lens geometries

corresponds to that of rigid geometric data,
except that fewer parameters must be given.
Page 81
7.2.5.3.3 Import and Export of Contact Lens Data
The following display appears after a diskette button in the "Choose Contact Lens" menu (cf.
has been inserted and the [Import / Export ->] 7.2.5.2 page 73) has been clicked:
Two lists are now displayed: • Export

Before contact lens types are exported to a
The list at the left shows contact lens types which diskette, the desired types of contact lens
are already stored in the PC; that on the right data already stored in the PC must be marked
shows those which are stored on the diskette. (left column).
Several contact lens types in these lists can be Then the [-> Export ->] button must be
marked for Export or Import. clicked. The contact lens data are then copied
to the diskette.
The following question appears if one or more

contact lens types are already stored on the
diskette:
Page 82
• "External", "Free?"
The following answers are possible: The "External:" box shows the path where
the contact lenses are stored (A:\).
[Yes] Overwrite this lens type. Any subdirectories of the diskette can also be
[No] Do not overwrite this lens type. specified here, and a backup copy of the
[All] Overwrite all lens types on the contact lens database can be created by
diskette without a warning entering "C:\".
message after they are selected. Use the [Free?] button to again call data from
[Cancel] Cancel the function. the diskette (after insertion of a different
diskette) or to determine how much storage
Note: ⇒ If more data are exported than the space is still free on the diskette.
diskette can hold, you will be asked to insert
another diskette when the previous one is full. Changes on the diskette are always carried out
immediately.
• Import However, changes in the PC database become
To call contact lens data from a diskette, you effective only after the [Save + Quit] button is
must first mark them at the right and then activated.
activate the No changes are carried out in the PC-database if
[<- Import <-] button. The rest of the process the [Cancel] button is clicked.
is identical to that of the Export function.
• Marking • Update
The marking functions are activated with the Proceed as follows in order to update the
"Mark" box at the right of the diskette’s "Lens contact lens database from a diskette:
Type" list:
- Select the "Choose Contact Lens"
[All] Mark all contact lens types in function (cf. 7.2.5.2 page 73).
the list. - Insert a diskette.
[Compare] Compare both lists and mark - Click [Import / Export ->]
only those contact lens types - Click [Compare]
which are still missing. - Click [<- Import <-]
[None] Do not mark any contact lens - Click [Save and Quit]
type.
The new contact lens data are immediately
The "Mark" box at the left functions in called and confirmed.
precisely the same way, but affects contact
lenses which are already stored in the PC.
Marked contact lens types can be deleted
from either list with the [Delete] button.
Page 83
7.2.6 Measuring the Posterior Surfaces of Contact Lenses
Immobilization arm
Fully mounted
contact lens holder
Contact lens holder
Fastening clip
The measurement of posterior contact lens Hold the contact lens between your thumb and
surfaces is like the measurement of corneas, index finger and lay it carefully on the water
with the difference that the contact lens to be surface of the contact lens holder. Then unscrew
measured must be mounted in a contact lens the adjustment screw until the contact lens is
holder. firmly seated in the holder.
For this purpose the fastening clip has to be
stuck onto the immobilization arm before making Note: ⇒ In doing so, make sure that no bubbles
the first measurement. Then the contact lens form under the contact lens and that the
holder can be mounted onto the fastening clip. posterior surface to be measured remains free of
The contact lens holder must first be filled with water.
water: Unscrew the cap nut, pour in water, and
screw the cap nut back in, making sure to The immobilization arm (with calibration globe)
capture as little air inside as possible. must now be screwed onto the chin rest. Then
Hold the contact lens holder with the adjustment the contact lens holder can be set on the
screw head downwards and screw the immobilization arm. The immobilization arm must
adjustment screw farther into the holder until the be aligned in such a way that the optical axes of
upper part of the contact lens holder is the contact lens and the Keratograph are
completely moistened with water. Now unscrew generally aligned with each other.
the adjustment screw outward again until the To use the software for measuring posterior
surface of the water assumes a slightly concave surfaces you first need to set the “C-Lens
shape. measuring” switch in the “Settings” menu of
the examination software to “On”. The menu bar
will now display a new menu titled “Lens Check”
which contains the calling instruction “Back
surface”
Now you can start the examination software to
measure the contact lens. For this purpose
Adjustment screw select menu item “Lens Check” / “Back sur-
Cap Nut
face”. This produces the question: “Measure-
The posterior surface of the contact lens must be ment of contact lenses. Of which eye is this
dry when measured. The lens must therefore be contact lens ?”. The measuring routine will start
dried off first with a soft cloth and cleaned. In after you make your selection (right/left).
particular, the concave inner surface should be The measuring procedure is the same as that for
free of moisture, dust particles, and fingerprints. eye measurement: set focus sharp, align Kerato-
graph, trigger measurement.
Page 84
The software now calculates the curvature can be used with corneal surfaces are also
values of the contact lens and displays the available here (3D-display, Fourier analysis,...)
results on the screen. All display options which
7.2.7 Other Functions of the Examination Program
7.2.7.1 Loading old Examinations
Examinations of any patient which are already

stored in the computer's memory can be
reloaded into the "Examinations" menu with the
help of the "Load old Examination" function (cf.
7.2 page 18).
Selection is then carried out via the list of
displayed examinations. Click on the desired
examination and confirm with [OK] (By double-
clicking an examination with the mouse pointer it
will also be loaded).
The examination list shows the date, time, eye

and comments (cf. 7.2.2.1 page 21), if any.
7.2.7.2 Printout
The "Print" menu function permits the screen If the “Print” switch is set to “B/W“ (see 0, page
contents of the moment to be printed out at the 70), the otherwise gray screen background
printer, so that any displays which are available appears white; this speeds up the printing
for selection can also be printed out. process and saves printing ink.
The user can go on working with the program
during printout, since the printout runs "in the
background".
Page 85
7.3 The Keratograph Measurement System
7.3.1 Calibrating the Measurement System
To ensure that measurements are as exact as • Clean the globe well before calibration (e.g.
possible, the Keratograph must be calibrated with alcohol).
before the first examination of a patient and • Fasten the immobilization arm on the
thereafter approximately once a month. combination chin and forehead rest.
• Carry out a measurement using the
The calibration globe (r=8,000mm) which is calibration (cf. 7.2.1 page 19).
included in delivery makes this step • Activate the function "Save Calibration
uncomplicated and rapid. However, the Table" in the "Miscellaneous" menu after
Keratograph should be turned on approximately performing the measurement.
15 minutes before the calibration measurement. • Answer the question "Save Calibration
The calibration globe which is included in delivery Table?" with [OK].
as shown in the illustration.
The system is now recalibrated.
Note: ⇒ If the following error message appears:

Calibration globe "Measurement was not complete!", then the
align in parallel globe should again be carefully cleaned and a
new measurement carried out.
Page 86
7.3.2 Other Functions
The following service functions are contained in The bottom line shows the current
the "Miscellaneous" menu: communication status:
- Communication OK
• Start Keratograph: Error correction rarely required, data
The Keratograph must be restarted if transmission secure.
communication between the Keratograph and
the PC is impaired. This function must be - Problems with communication
activated for this purpose. Errors frequent, but correction has so far
The message then appears: always been successful.
"Switch On Keratograph" - Big problems with communication
The Keratograph is restarted by first turning it
off and then on again. Then the message Errors very frequent and not always
must be confirmed [OK] in order to start the rectifiable despite multiple attempts at
data transfer from the PC to the Keratograph. correction. You are urged to use smaller
(This function is also activated in the package sizes.
background whenever the examination Use the [Quit] button to end the
program is used for the first time.) communication test.
• Test Communication: • Set Shutter:

This function tests the communication Here it is possible to set the exposure time of
between the PC and the Keratograph. the electronic CCD camera of the
If Keratograph 2 is being used, the function Keratograph.
determines the error status of the PC. In this
case it shows the number of corrected data • Set Ports:
packages and the number of transmitted This function makes it possible to turn on and
data. From these values it derives the error off the illumination of the rings, the
rate (error per minute) and determines and Keratometer test marks, the infrared
displays the recommended size of data illumination, and the aperture ring.
packages. In addition, the camera image is
displayed to permit control of the data stream.
Page 87
8 Maintenance
8.1 Care and Cleaning
Always disconnect the main plug

before cleaning the unit!
The Housing Ring calotte
Do not use aggressive cleaners containing The ring calotte is a precision-made part and
chlorine, solvents, abrasives, or powerful should not be subjected to pressure. Its surface
chemicals! is easily scratched.
It is best to clean the outer surface of the
housing with a soft cloth and an antistatic For this reason please clean the surface of the
cleaner. ring calotte with particular care. Use a lint-free,
The outer surfaces can also be wiped with a dry cloth, but make absolutely sure that no dust
damp cloth. In this case, please wipe away gets into the small bore holes.
residues using a mixture of equal parts of alcohol
and distilled water to which a splash of a If necessary, the unit can also be cleaned
standard commercial dishwashing liquid has carefully with a very slightly dampened cloth.
been added.
Page 88
8.2 Eliminating Errors or Malfunction
8.2.1 Replacement of Fuses
Disconnect the main plug before Use only the fuse type given on the
replacing the fuses! type plate for replacement.
The two electrical fuses of the unit are located in To replace the drawer, push it back into its
a small fuse compartment which is integrated mounting until the tab of the drawer again snaps
into the main input connector. into place.
To open the compartment, press the tab on the
top and pull out the drawer.
8.2.2 Troubleshooting
Never connect or disconnect a cable • If the fixation LED is off, the Keratograph
while the PC or the Keratograph are presumably still has no voltage. Switch the
turned on! PC and Keratograph off again and check
whether the cable between Keratograph and
If a problem occurs which you cannot solve power supply is properly connected.
with the following directions, please label the Caution! This cable may not be connected
unit "Out of Order" and get in touch with our or disconnected while the Keratograph is
service department. on, as this can destroy the camera of the
Keratograph!
Problem: The PC shows the following message
after the examination software is started: "No • If the fixation LED is on, then the switches
communication with Keratograph" have probably been actuated in the wrong
order:
• For Keratograph C (i.e. with built-in PC and - Switch the PC and Keratograph off at
power unit): their power switches.
Please check whether both switches are - Wait 5 seconds.
turned on. If not, switch them on and restart - Switch on the PC and then the
your PC. Keratograph.
- Start the examination software.
• For devices with external power unit:
Please check whether the control lamp of the If "No communication with Keratograph" is
power unit is on. If not, apply voltage to the still displayed, then the order of succession in
power unit and switch it on. turning on the units was not the problem.
Inspect the fixation LED in the center of the ring Check the settings of the serial interface:
calotte (bring your eyes very close to the unit for • Start the examination software and answer
this purpose): the error message "No communication
with Keratograph" by pressing the [OK]
button.
Page 89
• Select "Settings" / [System] and check the Problem: The measurement software does
system settings (cf. 7.2.5.1 page 71): not start
If you are using a serial turbo-interface board,
then the transfer rate should be 460,800 Start the examination software.
bauds and the correct port is COM3 Select "Examination" / "New Examination
(OCULUS recommendation). (Eye)".
If you are using a standard serial interface If the software shows only an image of the
board, the transfer rate should be 115,200 examination procedure but the examination
bauds and the correct port is COM1 procedure itself does not start, the software is set
(recommendation). to Demo-Mode.
If you have changed the settings, these must be In order to set it to the normal procedure, enter
stored in the computer's memory by pressing the the "Settings" menu and activate "[System]"
[Save] button (before you exit from the "Settings" (cf. 0 page 70) in order to enter the data
menu). transmission field. “Mode” must be set to
“online” there. Then press the [Save] button in
Check to see whether the port which you have order to exit from the "Settings" menu.
selected in the "Settings" menu is free in the PC Turn off the PC and the Keratograph’s electric
and is connected with the Keratograph's electric power supply and restart the system.
power supply.
Problem: The results of measurement do not
In order to check whether the communication is meet expectations
now functioning properly, you must first exit from
the examination software and the patient data The system must be recalibrated.
management system software. Then turn off the Calibration of the Keratograph is stored in the
PC and the Keratograph's electric power supply PC’s memory. If you exchange the PC you must
and restart both of them. likewise recalibrate the system (cf. 7.3.1 page
85).
Page 90
9 Terms of Warranty and Service
9.1 Terms of Warranty
In purchasing this unit you have acquired an These warranty services are valid only if the bill
OCULUS quality product. of sale with the date of purchase is included.
If manipulations of the unit are undertaken by
The unit was built with care, using high-quality non-authorized persons, all warranty claims are
materials and modern production techniques. cancelled, since considerable danger to the user
and the patient can arise from incorrect changes
Warranty is granted according to legislative and maintenance.
regulations on this system, beginning from the
date of delivery. This warranty includes all In case of damage during shipment, please
defects and malfunctions caused by materials or lodge a complaint with the shipping company
construction. immediately thereafter and have them confirm
the damage on the bill of lading, in order that the
Not included in this warranty are malfunctions damage can be correctly processed and
and defects due to improper use and outside repaired.
influences.
Our terms of business and delivery apply in the
However, should you have reason for justified version which is valid on the date of purchase.
complaints within the warranty period, they will be
repaired without charge.
9.2 Liability for Malfunction or Damage
OCULUS considers itself responsible for the requested to provide a certification of the type
safety, reliability and serviceability of the unit only and extent of their repair work, including details
if the unit is used in accordance with this on changes made in the ratings or the capacities
Instruction Manual. The unit contains no parts of the unit if required. The certification must bear
which require maintenance or repair by the user. the date on which the work was carried out as
No liability whatever is possible on the part of well as the name of the service company and
OCULUS if assembly work, additions to the unit, must be signed.
readjustments, maintenance work, alterations, or If desired, OCULUS will provide authorized
repairs are carried out on the unit by non- persons with circuit diagrams, replacement parts
authorized persons or if the unit is improperly lists, additional descriptions, and adjustment
cared for or handled. instructions for this purpose.
Use only original parts from OCULUS for repairs.
If the above-mentioned work is carried out by
authorized persons, these persons must be
Page 91
9.3 Manufacturer’s and Service Address
Additional information is available from our

service department or from our authorized
representatives.
Manufacturer’s and Service Addresses:
Germany:
OCULUS Optikgeräte GmbH

Münchholzhäuser Straße 29
D 35582 Wetzlar
Tel.: +49 641 / 2005-0
Fax: +49 641 / 2005-255
Email: sales@oculus.de
www.oculus.de
USA:
OCULUS Inc.
P.O. Box 1007
th
18902 NE 150 St.
Woodinville, WA 98072-1007
Tel.: 425-867-1800
Fax.: 425-867-1881
E-Mail: oculusincusa@msn.com
10 Appendix
10.1 Declaration of Compliance
We hereby declare as sole proprietor that this

product complies with the following norms or
normative documents:
IEC 601 - 1
IEC 601 - 1 - 2
according to the directives of Guideline No.

93/42/EWG for Medical Products.
Diploma’d Engineer Rainer Kirchhübel
Managing Director
OCULUS Optikgeräte GmbH
Page 92
10.2 Technical Data

Measuring device:
Measurement range 3 to 38 mm
9 to 99 D
Accuracy ±0,1 D
Reproducibility ±0,1 D
Number of Rings 22
Working distance 80 mm
Number of data points evaluated 22,000
Dimensions (HxWxD) 420 x 260 x 170 mm
Weight 2.3 kg
Power pack:
Main connection 100 - 240 V AC, 50 - 60 Hz

Power consumption 100 W
Fuses 2 x T 2 A - 250 V
Classification according to IEC Norm No. 601 - 1
Type of protection against electric shock: Safety class 1

Degree of protection against electric shock: Type B
Degree of waterproofing IP 20
Operating conditions:
Temperature +10°C to +40° C

Humidity 30% to 75%
Air pressure 700 hPa to 1060 hPa
Transport- and storage conditions

(acc. to IEC 601-1)
Ambient temperature - 40° C to +70° C

Relative humidity 10% to 100%
including condensation
Air pressure 500 hPa to 1060 hPa
10.3 Minimum PC requirements
CPU: Pentium 100

Operating system: Windows 3.1, 95, 98 (for Keratograph 2 also Windows NT)
On-board memory: 16 MB RAM
Graphic card: 1 MB (VGA)
Page 93
11 Literature
1. „Augenärztliche Kontaktlinsenanpassung“, 16. Kontaktlinsen; Verlag Optische Fachver-

Enke Verlag 1991, Dr. Ernst Bürki öffentlichung GmbH Heidelberg 1991; Heinz
2. NOJ 10/2001 52-55 (Part 1), 11/2001 52-54 Baron; page 565-604
(Part 2); 12/2001 52-57 (Part 3) "Neue 17. die Kontaktlinse 3/95; "Spaltbild-Topo-
Möglichkeiten der Hornhautdiagnostik mit graphie"; Christian Krüsi; page 28-31
Hilfe der Videokeratometrie"; Dr. Ernst Bürki 18. die Kontaktlinse 3/95; "Automatische Kom-
3. Ophthalmology Volume 6, Number 8, August pensation von Defokussierungsfehlern bei
1999; "Corneal Topography"; American Aca- der Video-Topometrie"; T. Oltrup, M.
demy of Ophthalmology; page 1628-1638 Matallana, T. Bende, B. Jean; page 23-27
4. Optic und Vision 7/8; "Blick nach vorn"; page 19. DOZ 11/94; "Zur Entfernungsabhängigkeit
42-45 von Keratoskopen"; Karl-Heinz Wilms; page
5. die Kontaktlinse 6/2000; "Kontaktlinsen- 104-111
anpassung nach penetrierender Kerato- 20. NOJ 8/1973; "Überlegungen zur Topometrie
plastik"; Fritz Fischl; page 20-24 von Cornea und Kontaktlinse"; Karl-Heinz
6. Optometrie 1/1997; "Klassische Ophthal- Wilms; page 569-571
mometrie und Videokeratometer"; Dipl.-Ing. 21. die Kontaktlinse 5/97; "Automatische Kerato-
(FH) Augenoptik Stefanie Dittmer und Prof. meter - Sichere Auswahl der ersten Probe-
Dr. Bernd Lingelbach FH Aalen Fachbereich linse?"; Sibylle Rochel und Ulrike
Augenoptik; page 6-17 Westendorff; page 9-18
7. die Kontaktlinse; Sonderdruck Januar/ 22. Invest. Ophthalmol. Vis. Sci. (1994), 35,(6):
Februar 1999; "Zuverlässigkeit von automa- 2749-2757, Automated Keratoconus Screen-
tischen Keratometern für die Kontaktlinsen- ing with Corneal Topography Analysis,
anpassung"; Manuel Fraatz Maeda N/Klyce SD/Smolek MK/ Thompson
8. die Kontaktlinse 12/99; "Video-Keratometrie - HW
ein Werkzeug für den Hobby-Anpasser?"; 23. Klin. Mbl. Augenheilk. (1999), 214: 372-377,
Gunther Oesker; page 4-12 Topographiegestützte Berechnung der
9. Contact Letter 07/99 Hecht-company; Keratoconus-Dimensionen, Langenbucher
"Keratograph und erste Messlinse" A/Gusek-Schneider GCh/Kus MM/Seitz B
10. Contact Letter 04/98 Hecht company; "Die 24. Ophthal. Physiol. Opt. (1995),Fourier Ana-
Verwendbarkeit des Oculus Keratographen lysis of Videokeratographic Data, 15: 171-
für die praktische Contactlinsenanpassung" 185, Hjortdal JØ/Erdmann L/Bek T
11. NOJ 6/1998; "Die Verwendbarkeit des 25. DOZ. 1997, 52(4): 92-96 (Part 1) und 52(5):
Oculus Keratographen für die praktische 104-107 (Part 2), Cornea: Abbildungseigen-
Contactlinsenanpassung"; Dipl.-Ing. (FH) schaften und Topometrie, Löffler
Augenoptik Anja Seiwert und Dipl.-Ing. (FH) G/Lingelbach B/Lingelbach E
Augenoptik Sigrid Neumann; page 52-58 26. Optometry Vis. Science (1997), 74(11): 963-
12. Diplomarbeit an der Fachhochschule Aalen 969, Cone Dimensions in Keratoconus using
Fachbereich Augenoptik 28.02.1998; "Die Zernike polynomials, Schwiegerling J
Verwendbarkeit des Oculus Keratographen 27. Optom. Vis. Sci. (1997), 74: 906-916, Using
für die praktische Contactlinsenanpassung"; Corneal Height Maps and Polynomial De-
Dipl.-Ing. (FH) Augenoptik Anja Seiwert composition to Determine Corneal Aber-
13. Augenärztliche Untersuchungsmethoden; rations, Schwiegerling J/Greivenkamp JE
Enke Verlag 1995; Wolfgang Straub, Peter 28. Optom. Vis. Sci. (1996), 73: 721-728,
Kroll, Hans Joachim Küchle; "Topographie Keratoconus Detection Based on Video-
der Hornhaut" von Werner Förster; page keratoscopic Height Data, Schwiegerling
248-254 J/Greivenkamp JE
14. Z. prakt. Augenheilkd. 20:61-64 (1999); 29. J. Opt. Soc. Am. (1995), 12: 2105-2113,
"Kontaktlinsenanpassung – Videokerato- Representation of Videokeratographic Height
graphie"; Prof. Dr. Bernd Lingelbach Data with Zernike Polynomials,
15. Z. prakt. Augenheilkd. 20:157-164 (1999); Schwiegerling J/Greivenkamp JE/Miller JM
"Zernike-Polynome"; Prof. Dr. Bernd
Lingelbach
Page 94
12 Index
Contact Lens Fitting.......................................... 48

A
Contact Lens Holder......................................... 83
AA..................................................................... 37 Contact Lens Suggestions................................ 49
aberration ......................................................... 30 Contact Lens Type, Add ................................... 75
ABR .................................................................. 37 Contact Lens Type, Delete ......................... 75, 76
Absolute Color Scale........................................ 68 Contact Lens, Bitoric ........................................ 57
absolute height difference ................................ 41 Contact Lens, Bitoric Compensated................. 57
Activation of the Pupillometer software ............ 60 Contact Lens, Export ........................................ 81
Add new Contact Lens Type ............................ 75 Contact Lens, Generate New ........................... 79
Amsler’s stages................................................ 38 Contact Lens, Import ........................................ 81
Animation ......................................................... 24 Contact Lens, Rotating ..................................... 51
Anisocoria test.................................................. 66 Contact Lens, Shifting ...................................... 51
Anisocoria Test ................................................ 62 Contact Lens, Soft............................................ 49
Apex ........................................................... 41, 46 Contact Lens, Toric .................................... 49, 57
apex position .............................................. 35, 44 cornea, diameter ........................................ 22, 41
Astigma. central ............................................... 27 corneal vertex distance..................................... 41
Astigma. peripheral .......................................... 27 Corneal Vertex Distance................................... 55
astigmatism ...................................................... 30 Corneal Vertex Power ...................................... 55
astigmatism, regular......................................... 26 Curvature Radii................................................. 69
Automatic Backup ............................................ 16 Curvature Tangtial ............................................ 69
Curvature, Sagittale.......................................... 69
B
D
Backup ............................................................. 15
Backup, Automatic ........................................... 16 Data package size ............................................ 71
Base Curve....................................................... 77 Data transmission............................................. 71
Base Curve Parameters................................... 77 Data, Backup .................................................... 15
Bitoric ............................................................... 57 Data, Restore ................................................... 15
Bitoric Compensated Contact Lens.................. 57 Date Format ............................................... 16, 69
Bitoric Contact Lens ......................................... 57 Date, actual ...................................................... 17
Boot Mode ........................................................ 71 decentration...................................................... 26
decentration, vertical ........................................ 39
C Declaration of Compliance ............................... 91
Calibration Globe.............................................. 85 Delete Examination .......................................... 12
Calibration the Measurement System .............. 85 Delete Patient Data .......................................... 13
Camera exposure, Pupillometry....................... 67 Demo Mode ...................................................... 71
Camera Image ................................................. 45 Details............................................................... 52
Carry out a measurement ................................ 19 Detect Port........................................................ 71
Central Radii..................................................... 69 Device code...................................................... 60
CKI ................................................................... 37 Diopter .............................................................. 68
Color Bar .................................................... 21, 68 display mode, refractive.................................... 40
Color Map large................................................ 23 Display of Peak Values..................................... 22
Color Scale....................................................... 68 Display units ..................................................... 68
Color Scale, Absolute....................................... 68 Display, 3D ....................................................... 24
Color Scale, Relative........................................ 68 Display, Different Types of ............................... 21
coma ................................................................ 30 Display, Overview ............................................. 21
Communication ................................................ 71 E
Communication, No.......................................... 88
Comparing Examinations ................................. 47 Eccentricity, Table ............................................ 50
Complete Picture.............................................. 69 English........................................................ 16, 70
COM-Port ......................................................... 71 Error Correction ................................................ 71
COM-Port Detector .......................................... 71 Exaggerate ....................................................... 24
Contact Lens Database.................................... 73 Examination Program ....................................... 18
Page 95
Examination, Compare..................................... 47 IVA.................................................................... 37

Examination, Delete ......................................... 12
K
Examination, Load ........................................... 84
Examination, Move........................................... 12 Keratograph 1/2................................................ 71
Examination, Print ............................................ 84 keratokonus.............................. 28, 35, 36, 39, 44
Expected Remaining Power ............................. 55 Keratometer Data ............................................. 22
Export Contact Lens Data ................................ 81 KI.... .................................................................. 37
Export Patient Data .......................................... 13 KKS .................................................................. 37
External Color Table ........................................ 69
Eye, Choose..................................................... 19 L
Eye, Measure ................................................... 19 Language.................................................... 16, 70
F Liability.............................................................. 90
Literatur ............................................................ 93
Field for Comments.......................................... 22 Load Examination............................................. 84
Fitting Suggestions........................................... 49 Loading Fitted Contact Lenses......................... 59
fix. dif................................................................ 48
fixation difference ....................................... 21, 48 M
Flattering Constant ........................................... 53 Measurement using the Mouse Pointer............ 22
Fluo Icon........................................................... 51 Measurement, Force ........................................ 20
Fluo Icon, Delete .............................................. 51 Measurement, Release .................................... 20
Fluo Image Simulation ..................................... 50 Millimeter .......................................................... 68
Fluo Image, Scale of ........................................ 53 Minimum PC requirements............................... 92
focal distances ................................................. 40 Move Examination ............................................ 12
Force Measurement ......................................... 20
Fourier analysis ................................................ 25 N
Fourier indices.................................................. 27 n, Refraction Index ........................................... 56
G Name, Rename ................................................ 13
New Measurement ........................................... 19
Go-ahead for measurement............................. 20 New Patient ...................................................... 11
H O
Hecht Fitting Software................................ 54, 74 Ortho-K ....................................................... 42, 45
height data........................................................ 42 Overview Display.............................................. 21
height difference............................................... 42
heights.............................................................. 42 P
heights, absolute .............................................. 42 Pat-ID ............................................................... 36
I Patient Data Management................................ 10
Patient Data, Delete ......................................... 13
ID-number .................................................. 11, 17 Patient Data, Export ......................................... 13
IHA ................................................................... 37 Patient Data, Import.......................................... 14
IHD ................................................................... 37 Patient Data, Sorting ........................................ 16
Immobilization Arm........................................... 83 Patient, new...................................................... 11
Import Contact Lens Data ................................ 81 Patient, Rename............................................... 13
Import Patient Data .......................................... 14 pellucid marginal degeneration......................... 38
Inclination ................................................... 52, 56 Periphery .................................................... 52, 78
indices .............................................................. 36 Port Detect........................................................ 71
indices, Fourier................................................. 27 Posterior Surface Measurement....................... 83
infotext.............................................................. 36 Power Calculation for Soft Lenses ................... 58
Internal Color Table.......................................... 69 Power Calculation for Toric Lenses.................. 56
Interpolation.......................................... 20, 23, 69 Print Examination ............................................. 84
Iris..................................................................... 45 Print, Contact Lens Fitting ................................ 50
iris diameter...................................................... 41 Printout Color/Black-and-white ......................... 70
iris, diameter............................................... 22, 41 progress of indices ........................................... 37
irregularities...................................................... 27 Pupil.................................................................. 45
ISV.................................................................... 37 pupil center ................................................. 21, 48
Page 96
pupil diameter................................................... 41 spectacle power................................................ 41

Pupillogram ...................................................... 62 Spectacle Power............................................... 55
Pupillography.................................................... 60 spher. eccentricity............................................. 27
Pupillometer ..................................................... 60 spherical aberration .......................................... 30
Pupillometer software....................................... 60 spherical equivalent.......................................... 26
Pupillometry...................................................... 60 standard deviation ............................................ 37
Storing Fitted Contact Lens .............................. 58
R
Synchron (NT) .................................................. 71
reference body ................................................. 42 System.............................................................. 71
Referenzkörper ................................................ 33
T
Refraction Index n ............................................ 56
Refraction Module ............................................ 55 Tangential Curvature ........................................ 69
Refraction Power Calculation ........................... 55 Technical Data.................................................. 92
Refraction Values ............................................. 55 Time, actual...................................................... 17
Refractive Compare ......................................... 45 Top Test ........................................................... 53
refractive display mode .................................... 40 Topographische Klassierung............................ 38
refractive values ............................................... 41 Toric Contact Lens ........................................... 57
regular astigmatism.......................................... 26 Toric Contact Lenses ....................................... 49
Relative Color Scale......................................... 68 Transmission, Data .......................................... 71
Release (default).............................................. 70 trefoil................................................................. 29
Releasing code................................................. 60 Troubleshooting................................................ 88
Releasing Measurement .................................. 20
U
Remaining Power, Expected............................ 55
Rename Patient ............................................... 13 Units, Display.................................................... 68
Restore............................................................. 15
retinoscopy ....................................................... 38 V
Ring Edges....................................................... 45 Version, Software ............................................. 70
RMin ........................................................... 27, 37 vertical decentration ......................................... 39
Rotating Contact Lenses .................................. 51
W
S
Warranty........................................................... 90
Saggital, Table ................................................. 50 wavefront .......................................................... 30
Sagittale Curvature........................................... 69
Serial Interface ................................................. 71 Z
Shifting Contact Lenses ................................... 51 Z Separate........................................................ 33
Shutter, Set ...................................................... 86 Z Vectors .......................................................... 33
sine wave ......................................................... 25 Zernike analysis................................................ 30
Soft Lenses ...................................................... 80 Zernike polynomials.......................................... 30
Softlenses ........................................................ 49 Zernike-Fit-Parameter ...................................... 33
Software version............................................... 70
Sorting Patient Data ......................................... 16

Keratograph: Instruction Manual

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Keratograph

7.2.3.2.5 Top Test .................................................................................................................. 53

2 Scope of Supplies and Optional Accessories

Keratograph incl. PC 70600

Contact lens holder 70512

Chin rest 70518

Scope of supplies subject to change due to technical progress.

4 Description of the Unit and its Functions

Technical Principle: After receiving appropriate data from a screen

5 Appropiate Use / Intended Application

The OCULUS Keratograph is a measuring ophthalmologists, for hospital departments,

6 First Use of the Unit

6.1 Installation and Adjustment

6.2 Directions for Transport and Storage

7 Directions For Use

After being turned on, the PC loads the operating

7.1 Patient Data Management

7.1.1 Selection of a Patient

7.1.2 Entering a New Patient

7.1.3 To Start the Examination Program

7.1.4 Deleting / Moving Examination Data

Two screen buttons are found below the

Activate the screen button [Move Exam.] in the

Once the correct patient name has been found

7.1.5 Patient Data

7.1.5.1 Rename Patient

Patient data can subsequently be changed by

The patient data can be corrected in the

Activating the [Update] button puts the changes

7.1.5.2 Deleting Patient Data

7.1.5.3 Exporting Patient Data

This function makes it possible to transfer

After activation of the screen button [Export] a

"Data Set" "Memory Available"

"Including CCD Images" The data set is transferred by activating the

7.1.5.4 Importing Patient Data

"Directory" If only a single examination is to be imported,

7.1.6 Backup Copies of Data

7.1.6.1 Backing Up Data

7.1.6.2 Data Restoration

The restoration of already stored data can • "Add Examination Data"

7.1.7 Changing Settings

• Sort by The [Use] button confirms the setting for the

7.2 The Examination Program

To start the examination program, first select a • Lens Fitting

7.2.1 How to Carry Out a Measurement

7.2.2 Using Different Types of Display to Evaluate Examination

7.2.2.1 Overview Display

Overview Display combines several different • Colored Topographic Image

• Reduced Camera Image • Color Bar

• Numeric Display of Peak Values

• Finding Curvature Values

7.2.2.2 Color Map large

The type of presentation can also be changed by

7.2.2.4 Fourier Analysis

• Irregularities • Combining irregularities and spherical

Combining Fourier components

One option is to display the “Decentration“ and

7.2.2.4.1 Applications of the Fourier Display Mode in Keratokonus