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Table of Contents
SHORT COMMUNICATION
Year : 2021  |  Volume : 3  |  Issue : 1  |  Page : 22

Pupilopleic: A new auxiliary device to perform refraction in irregular corneas


1 Department of Ophthalmology, Universidad del Bosque y Universidad Nacional, Bucaramanga, Colombia
2 Department of Ophthalmology, Clinica Oftalmologica Integral, Bucaramanga, Colombia
3 Department of Ophthalmology, Oftalmólogo Fundacíon Santa fe Bogota, Bucaramanga, Colombia

Date of Submission13-Oct-2020
Date of Acceptance24-Mar-2021
Date of Web Publication13-Jul-2021

Correspondence Address:
Dr. Eduardo Arenas Archila
Calle 100 – 20 Cons 701, Bogota
Colombia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/pajo.pajo_56_20

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How to cite this article:
Archila EA, Nino A, Ramirez MF. Pupilopleic: A new auxiliary device to perform refraction in irregular corneas. Pan Am J Ophthalmol 2021;3:22

How to cite this URL:
Archila EA, Nino A, Ramirez MF. Pupilopleic: A new auxiliary device to perform refraction in irregular corneas. Pan Am J Ophthalmol [serial online] 2021 [cited 2021 Oct 19];3:22. Available from: https://www.thepajo.org/text.asp?2021/3/1/22/321298



Retinoscopy is the manual method that determines the refractive power of the eye and it is based on the reflection of a light stimulus hitting the posterior pole of the patient's eye, returning to the eye of the examiner. When properly performed, retinoscopy is considered of good value of the real objective refraction, and it is the main principle of the computerized autorefractors.

The cornea is more elliptical than spherical, with an aspheric curvature that flattens toward the periphery. Due to the cornea's geometric characteristics, rays refracted from an area close to the center will form a focal point, while the peripheral rays give rise to aberrations.

The crystalline is a thick aspheric parabolic lens with different refraction indexes in the nucleus and in the periphery. In the lens, the rays refracted in the central area will be focused directly and the peripheral area will also give rise to aspheric aberrations. In normal conditions, the pupil filters the aberrant rays, but if the pupils are large, as happened under cycloplegia mydriasis, this type of control is lost.

We describe herein a device to facilitate retinoscopy in patients with dilated pupils in eyes with different types of irregularities of the corneal surface or of the lens. We designed a special plastic trial lens to be mounted on the phoropter or in the trial lens frame to facilitate the retinoscopic evaluation of refractive errors. This plastic trial lens device has a hole in the center, bigger than the stenopeic hole. We named it Pupilopeic [Figure 1].
Figure 1: The plastic trial lens device

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The difference between the two is that the stenopeic has been designed to concentrate the fovea's rays, neutralizing mild refractive errors in the refraction. The pupilopeic facilitates retinoscopy and avoids central aberrations in those cases with corneal changes under dilated pupils. After several trial apertures, we concluded that the best diameter to facilitate better retinoscopy refraction was 3.3 mm.

We found that the pupilopeic device is easy to build and use in cases with irregular corneas such as keratoconus or eyes submitted to corneal surgery or with scars. Most of those cases present topographic irregularities and only with the pupilopeic, it was possible to define a more regular image in the retinoscopic maneuver, allowing for a better final refraction evaluation. We believe pupilopeic should be added to all refractive equipment, even those based on the retinoscopic reflex and with computerized analysis.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.




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