By Prof. Dr. Jörg Draeger (auth.)
We in ophthalmology are lucky which will degree quantitatively many elements of ocular morphology and visible functionality. those measurements are both aim (e. g. electroretinography, tonometry, electromyography, visually evoked responses, etc.) or subjective and psychophysical (e. g. visible acuity, visible fields, colour imaginative and prescient, etc.). One point of corneal body structure and pathology which has to this point escaped cautious and trustworthy measurements is corneal sensitivity. past makes an attempt were quite crude and will be in comparison to measuring intraocular strain by way of electronic compression. Professor Draeger has for the decade and a part directed his recognition to the query of esthesiometry of the cornea. He has a present for developing and devising new creative ocular tools. His hand-held tonometer is a ideal instance. He has now utilized the primary of this software to the recent digital optical esthesiometer. in lots of courses he has suggested on his first effects utilizing this contemporary strategy to learn corneal body structure and evaluation convinced pathologic stipulations. during this monograph Professor Draeger has accrued all of his fabric and reviews on his lengthy event. The usefulness of this device is simply starting to be favored. it truly is noticeable that this new measuring gadget can help us within the becoming of touch lenses, comparing herpes simplex infections of the cornea, stick to the postoperative process sufferers with a penetrating keratoplasty, etc.
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Extra resources for Corneal Sensitivity: Measurement and Clinical Importance
Direct the test body toward the desired area of impact; 2. maintain the correct distance of the instrument so that the impact of the test object will occur during the phase of slow advancement. 3. The test object will encounter the cornea vertically to its surface avoiding any shearing forces or shearing movements; 4. control exactly the time of impact (Fig. 30). The other hand of the physician can gently keep the patient's lids apart in order to avoid the test body touching the lashes. The patient has to look into a desired direction in order to obtain a measurement on a specific area (if necessary, with the help of a fixation point in the examining room).
In the vertical meridian the deviation is usually upward and significant is only the erroneous localization of a stimulus in the center of the cornea. ::::::- --:::::::::-- -- // ~/ ~ Fig. 40. Localization of a stimulus. The symbols without any variance signify the actual cite of the stimulus. The symbol with spread represent average values which the subject indicated as the site of excitation 54 The Localization of a Stimulus on Cornea and Conjunctiva The localization of stimuli is more accurate in the temporal and nasal canthi than in the cornea.
85 8 270120 3,1 435460 87 179 850 83 58 45 57094 32 1 Fig. 39. Distribution of thresholds in a small conjunctival area sensitivity may be due to a variable impedence by the epithelium or other tissues (compare also v. Frey and Strughold, 1926). Schirmer (1963) reported that the threshold for tangential stimuli exerted with his spring esthesiometer on the cornea were lower than when the test body was approached from in front. Schirmer believes that this phenomenon is due to movement specific receptors.