By Prof. Dr. Jörg Draeger (auth.)
We in ophthalmology are lucky for you to degree quantitatively many features of ocular morphology and visible functionality. those measurements are both target (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 element of corneal body structure and pathology which has up to now escaped cautious and trustworthy measurements is corneal sensitivity. prior makes an attempt were really crude and will be in comparison to measuring intraocular strain through electronic compression. Professor Draeger has for the decade and a part directed his awareness to the query of esthesiometry of the cornea. He has a present for developing and devising new inventive ocular tools. His hand-held tonometer is a ideal instance. He has now utilized the main of this tool to the hot digital optical esthesiometer. in lots of guides he has pronounced on his first effects utilizing this contemporary strategy to research corneal body structure and overview sure pathologic stipulations. during this monograph Professor Draeger has accumulated all of his fabric and reviews on his lengthy adventure. The usefulness of this device is simply commencing to be preferred. it's noticeable that this new measuring machine may also help us within the becoming of touch lenses, comparing herpes simplex infections of the cornea, stick with the postoperative process sufferers with a penetrating keratoplasty, etc.
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Extra resources for Corneal Sensitivity: Measurement and Clinical Importance
We accept as sensation response only the answer by the patient and not the lid reflex which is difficult to differentiate from the physiologic blinking. Fig. 30. The head of the patient rests against a neck suppOrt, the esthesiometer is in the correct position to perform measurements During the considered: measurement the following points have to be 1. Touching of the lids and the lashes has to be avoided as this could lead to erroneous results. 2. A tremor of the examiner's hand and of the instrument or eye movements by the patient will lead to a shearing of the test object on the cornea and therefore to erroneous values.
Thus, it is yet impossible to measure exactly whether a strong stimulus produces pain in a shorter period of time than a weak one. In all subjects a stimulus stronger than 30 times the threshold needs about a second to produce pain. And even a stimulus near the threshold causes pain after 1 to 2 seconds of application. Two explanations seem to be possible: 1. Temporal summation in only one kind of nervous endings or channels makes the sensation turn from touch to pain. 2. There are at least two kinds of sensory endings in the cornea, one for touch and one for pain.
A duration of five to ten years and 3. a duration of more then ten years. We attempted to use the severity of a diabetic retinopathy as the yardstick of a microangiopathy in the eye. We therefore classified the fundus picture of our patients in the following way: 1. Thirty-three patients had no diabetic retinopathy. 2. A diabetic retinopathy was found in 45 patients (these were all patients with adult onset diabetes). In order to evaluate the possible influence of the mode of therapy, we distingushed two groups of treatment: 1.