title: The effect of poor fixation on computer-assisted topographic corneal analysis. Pseudokeratoconus.
abstract: BACKGROUND
  The effect of changing the alignment of the corneal surface in relation to the plane of the videokeratoscope mires in computer-assisted topographic corneal analysis was evaluated.
  
  
  METHODS
  The corneas of five subjects were analyzed with the visual axis at 0 degrees, 2.5 degrees, 5 degrees, and 10 degrees below the central axis of the videokeratoscope. The relative steepness of the inferior and superior cornea was compared using inferior-superior (I-S) values at each deviation from the central axis. A similar analysis was performed on three aspheric test surfaces with different central curvatures.
  
  
  RESULTS
  The difference in the relative steepness of the inferior and superior cornea was found to increase in proportion to the deviation from alignment with the central axis in both the test subjects and the aspheric test surfaces.
  
  
  CONCLUSIONS
  This change in relative steepness produces a pattern that mimics keratoconus and can be seen at deviations of less than 5 degrees in some patients. The increase in the I-S value was significant at 5 degrees of deviation (P < 0.05). It also was found that this effect increased as the central curvature of the aspheric surfaces increased.
authors.affiliation: Duke University Eye Center, Durham, North Carolina 27710.
authors.forename: R E
authors.initials: RE
authors.lastname: Hubbe
authors.forename: G N
authors.initials: GN
authors.lastname: Foulks
mesh_terms: D003315:Cornea / Q000473:pathology*; D005403:Fixation, Ocular; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007640:Keratoconus / Q000473:pathology* / Q000503:physiopathology