Accuracy of Goldmann, ocular response analyser, Pascal and TonoPen XL tonometry in keratoconic and normal eyes

Aim: The aim of this study was to evaluate the practicality and accuracy of tonometers used in routine clinical practice for established keratoconus (KC). Methods: This was a prospective study of 118 normal and 76 keratoconic eyes where intraocular pressure (IOP) was measured in random order using the Goldman applanation tonometer (GAT), Pascal dynamic contour tonometer (DCT), Reichert ocular response analyser (ORA) and TonoPen XL tonometer. Corneal hysteresis (CH) and corneal resistance factor (CRF), as calculated by the ORA, were recorded. Central corneal thickness (CCT) was measured using an ultrasound pachymeter. Results: The difference in IOP values between instruments was highly significant in both study groups (p<0.001). All other IOP measures were significantly higher than those for GAT, except for the Goldmann-correlated IOP (average of the two applanation pressure points) (IOPg) as measured by ORA in the control group and the CH-corrected IOP (corneal-compensated IOP value) (IOPcc) measures in the KC group. CCT, CH and CRF were significantly less in the KC group (p<0.001). Apart from the DCT, all techniques tended to measure IOP higher in eyes with thicker corneas. Conclusion: The DCT and the ORA are currently the most appropriate tonometers to use in KC for the measurement of IOPcc. Corneal factors such as CH and CRT may be of more importance than CCT in causing inaccuracies in applanation tonometry techniques.

In-fiber microchannel device filled with a carbon nanotube dispersion for passive mode-lock lasing

Fueled by their high third-order nonlinearity and nonlinear saturable absorption, carbon nanotubes (CNT) are expected to become an integral part of next-generation photonic devices such as all-optical switches and passive mode-locked lasers. However, in order to fulfill this expectation it is necessary to identify a suitable platform that allows the efficient use of the optical properties of CNT. In this paper, we propose and implement a novel device consisting of an optofluidic device filled with a dispersion of CNT. By fabricating a microchannel through the core of a conventional fiber and filling it with a homogeneous solution of CNTs on Dimethylformamide (DMF), a compact, all-fiber saturable absorber is realized. The fabrication of the micro-fluidic channel is a two-step process that involves femtosecond laser micro-fabrication and chemical etching of the laser-modified regions. All-fiber high-energy, passive mode-locked lasing is demonstrated with an output power of 13.5 dBm. The key characteristics of the device are compactness and robustness against optical, mechanical and thermal damage.

Self-contained encrypted image folding

The recently introduced approach for Encrypted Image Folding is generalized to make it self-contained. The goal is achieved by enlarging the folded image so as to embed all the necessary information for the image recovery. The need for extra size is somewhat compensated by considering a transformation with higher folding capacity. Numerical examples show that the size of the resulting cipher image may be significantly smaller than the plain text one. The implementation of the approach is further extended to deal also with color images.

Keratoconus:a review

Keratoconus is the most common primary ectasia. It usually occurs in the second decade of life and affects both genders and all ethnicities. The estimated prevalence in the general population is 54 per 100,000. Ocular signs and symptoms vary depending on disease severity. Early forms normally go unnoticed unless corneal topography is performed. Disease progression is manifested with a loss of visual acuity which cannot be compensated for with spectacles. Corneal thinning frequently precedes ectasia. In moderate and advance cases, a hemosiderin arc or circle line, known as Fleischer's ring, is frequently seen around the cone base. Vogt's striaes, which are fine vertical lines produced by Descemet's membrane compression, is another characteristic sign. Most patients eventually develop corneal scarring. Munson's sign, a V-shape deformation of the lower eyelid in downward position; Rizzuti's sign, a bright reflection from the nasal area of the limbus when light is directed to the limbus temporal area; and breakages in Descemet's membrane causing acute stromal oedema, known as hydrops, are observed in advanced stages. Classifications based on morphology, disease evolution, ocular signs and index-based systems of keratoconus have been proposed. Theories into the genetic, biomechanical and biochemical causes of keratoconus have been suggested. Management varies depending on disease severity. Incipient cases are managed with spectacles, mild to moderate cases with contact lenses and severe cases can be treated with keratoplasty. This article provides a review on the definition, epidemiology, clinical features, classification, histopathology, aetiology and pathogenesis, and management and treatment strategies for keratoconus.

The relationship between measurement method and corneal structure on apparent intraocular pressure in glaucoma and ocular hypertension

Purpose: To analyse the relationship between measured intraocular pressure (IOP) and central corneal thickness (CCT), corneal hysteresis (CH) and corneal resistance factor (CRF) in ocular hypertension (OHT), primary open-angle (POAG) and normal tension glaucoma (NTG) eyes using multiple tonometry devices. Methods: Right eyes of patients diagnosed with OHT (n=47), normal tension glaucoma (n=17) and POAG (n=50) were assessed, IOP was measured in random order with four devices: Goldmann applanation tonometry (GAT); Pascal(R) dynamic contour tonometer (DCT); Reichert(R) ocular response analyser (ORA); and Tono-Pen(R) XL. CCT was then measured using a hand-held ultrasonic pachymeter. CH and CRF were derived from the air pressure to corneal reflectance relationship of the ORA data. Results: Compared to the GAT, the Tonopen and ORA Goldmann equivalent (IOPg) and corneal compensated (IOPcc) measured higher IOP readings (F=19.351, p<0.001), particularly in NTG (F=12.604, p<0.001). DCT was closest to Goldmann IOP and had the lowest variance. CCT was significantly different (F=8.305, p<0.001) between the 3 conditions as was CH (F=6.854, p=0.002) and CRF (F=19.653, p<0.001). IOPcc measures were not affected by CCT. The DCT was generally not affected by corneal biomechanical factors. Conclusion: This study suggests that as the true pressure of the eye cannot be determined non-invasively, measurements from any tonometer should be interpreted with care, particularly when alterations in the corneal tissue are suspected.

The effect of flying and low humidity on the admittance of the tympanic membrane and middle ear system

Many passengers experience discomfort during flight because of the effect of low humidity on the skin, eyes, throat, and nose. In this physiological study, we have investigated whether flight and low humidity also affect the tympanic membrane. From previous studies, a decrease in admittance of the tympanic membrane through drying might be expected to affect the buffering capacity of the middle ear and to disrupt automatic pressure regulation. This investigation involved an observational study onboard an aircraft combined with experiments in an environmental chamber, where the humidity could be controlled but could not be made to be as low as during flight. For the flight study, there was a linear relationship between the peak compensated static admittance of the tympanic membrane and relative humidity with a constant of proportionality of 0.00315 mmho/% relative humidity. The low humidity at cruise altitude (minimum 22.7 %) was associated with a mean decrease in admittance of about 20 % compared with measures in the airport. From the chamber study, we further found that a mean decrease in relative humidity of 23.4 % led to a significant decrease in mean admittance by 0.11 mmho [F(1,8) = 18.95, P = 0.002], a decrease of 9.4 %. The order of magnitude for the effect of humidity was similar for the flight and environmental chamber studies. We conclude that admittance changes during flight were likely to have been caused by the low humidity in the aircraft cabin and that these changes may affect the automatic pressure regulation of the middle ear during descent. © 2013 Association for Research in Otolaryngology.

Astigmatism and vision:should all astigmatism always be corrected?

As technology and medical devices improve, there is much interest in when and how astigmatism should be corrected with refractive surgery. Astigmatism can be corrected by most forms of refractive surgery, such as using excimer lasers algorithms to ablate the cornea to compensate for the magnitude of refractive error in different meridians. Correction of astigmatism at the time of cataract surgery is well developed and can be achieved through incision placement, relaxing incisions and toric intraocular lens (IOL) implantation. This was less of an issue in the past when there was a lower expectation to be spectacle independent after cataract surgery, in which case the residual refractive error, including astigmatism, could be compensated for with spectacle lenses. The issue of whether presurgical astigmatism should be corrected can be considered separately depending on whether a patient has residual accommodation, and the type of refractive surgery under consideration. We have previously reported on the visual impact of full correction of astigmatism, rather than just correcting the mean spherical equivalent. Correction of astigmatism as low as 1.00 dioptres significantly improves objective and subjective measures of functional vision in prepresbyopes at distance and near.

High-resolution, wavelength-division-multiplexed in-fibre Bragg grating sensor system

A novel wavelength-division-multiplexed in-fibre Bragg grating sensor system combined with high resolution drift-compensated interferometric wavelength-shift detection is described. This crosstalk-free system is based on the use of an interferometric wavelength scanner and a low resolution spectrometer. A four element system is demonstrated for temperature measurement, and a resolution of ±0.1°C has been achieved.

In-fibre Bragg grating temperature sensor system for medical applications

A novel quasidistributed in-flber Bragg grating (FBG) temperature sensor system has been developed for temperature profiling in vivo in the human body for medical applications, e.g., hyperthermia treatment. This paper provides the operating principle of FBG temperature sensors and then the design of the sensor head. High-resolution detection of the wavelength-shifts induced by temperature changes are achieved using drift-compensated interferometric detection while the return signals from the FBG sensor array are demultiplexed with a simple monochromator which offers crosstalk-free wavelength-division-multiplexing (WDM). A "strain-free" probe is designed by enclosing the FBG sensor array in a protection sleeve. A four FBG sensor system is demonstrated and the experimental results are in good agreement with those obtained by traditional electrical thermocouple sensors. A resolution of 0.1°C and an accuracy of ±0.2°C over a temperature range of 30-60°C have been achieved, which meet established medical requirements.

40 Gbit/s dispersion managed soliton transmission over 1160 km in standard fibre with 75 km span length

In dispersion managed high bit rate systems, the importance of correctly choosing the pulse launch position is investigated. Using this technique, error free transmission has been achieved of a 40 Gbit/s 231-1 nonlinear RZ PRBS over 1160 km in a dispersion compensated standard fiber propagation experiment with a 75 km standard fiber span.

Soliton transmission at 10 Gbit/s over 2022 km of standard fibre with dispersion compensation

We present experimental results of 10 Gbit/s, 20 ps soliton data transmission over standard fibre, dispersion compensated to 0.5 ps/nm/km. Acceptable Q values were measured to a distance of 2022 km.

Blank beam fabrication of regenerated type IA gratings

We demonstrate an idealized method for the fabrication of regenerated type IA fibre Bragg gratings using commonly available apparatus. We use this technique to show that gratings written in the same fibre with the same period may have central wavelengths which are 14.4 nm apart and have an + 11.5% and - 1.2% difference in temperature and strain coefficients, respectively. We use these results to show that temperature compensated dual grating sensor heads, of an arbitrary length, may be quickly and consistently manufactured. © 2004 IOP Publishing Ltd.

Influence of downstream processing on the breakage of whey protein precipitates

Whey proteins may be fractionated by isoelectric precipitation followed by centrifugal recovery of the precipitate phase. Transport and processing of protein precipitates may alter the precipitate particle properties, which may affect how they behave in subsequent processes. For example, the transport of precipitate solution through pumps, pipes and valves and into a centrifugal separator may cause changes in particle size and density, which may affect the performance of the separator. This work investigates the effect of fluid flow intensity, flow geometry and exposure time on the breakage of whey protein precipitates: Computational fluid dynamics (CFD) was used to quantify the flow intensity in different geometries. Flow geometry can have a critical impact on particle breakage. Sharp geometrical transitions induce large increases in turbulence that can result in substantial particle breakage. As protein precipitate particles break, they tend to form denser more compact structures. The reduction in particle size and increase in compaction is due to breakage. This makes the particles become more resistant to further breakage as particle compactness increases. The effect of flow intensity on particle breakage is coupled to exposure time, with greater exposure time producing more breakage. However, it is expected that the particles will attain an equilibrium particle size and density after prolonged exposure in a constant flow field where no further breakage will occur with exposure time. © 2005 Institution of Chemical Engineers.

Fluctuations and correlations in sandpiles and interfaces with boundary pinning

Interfaces are studied in an inhomogeneous critical state where boundary pinning is compensated with a ramped force. Sandpiles driven off the self-organized critical point provide an example of this ensemble in the Edwards-Wilkinson (EW) model of kinetic roughening. A crossover from quenched to thermal noise violates spatial and temporal translational invariances. The bulk temporal correlation functions have the effective exponents β1D∼0.88±0.03 and β2D∼0.52±0.05, while at the boundaries βb,1D/2D∼0.47±0.05. The bulk β1D is shown to be reproduced in a randomly kicked thermal EW model.

Fluctuations and correlations in sandpiles and interfaces with boundary pinning

Interfaces are studied in an inhomogeneous critical state where boundary pinning is compensated with a ramped force. Sandpiles driven off the self-organized critical point provide an example of this ensemble in the Edwards-Wilkinson (EW) model of kinetic roughening. A crossover from quenched to thermal noise violates spatial and temporal translational invariances. The bulk temporal correlation functions have the effective exponents β1D∼0.88±0.03 and β2D∼0.52±0.05, while at the boundaries βb,1D/2D∼0.47±0.05. The bulk β1D is shown to be reproduced in a randomly kicked thermal EW model.