A handheld open-field infant keratometer (an american ophthalmological society thesis).

PURPOSE To design and evaluate a new infant keratometer that incorporates an unobstructed view of the infant with both eyes (open-field design). METHODS The design of the open-field infant keratometer is presented, and details of its construction are given. The design incorporates a single-ring keratoscope for measurement of corneal astigmatism over a 4-mm region of the cornea and includes a rectangular grid target concentric within the ring to allow for the study of higher-order aberrations of the eye. In order to calibrate the lens and imaging system, a novel telecentric test object was constructed and used. The system was bench calibrated against steel ball bearings of known dimensions and evaluated for accuracy while being used in handheld mode in a group of 16 adult cooperative subjects. It was then evaluated for testability in a group of 10 infants and toddlers. RESULTS Results indicate that while the device achieved the goal of creating an open-field instrument containing a single-ring keratoscope with a concentric grid array for the study of higher-order aberrations, additional work is required to establish better control of the vertex distance. CONCLUSION The handheld open-field infant keratometer demonstrates testability suitable for the study of infant corneal astigmatism. Use of collimated light sources in future iterations of the design must be incorporated in order to achieve the accuracy required for clinical investigation.