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Size does matter: what is the corneo-limbal diameter?

Jan Pg Bergmanson¹, Jesus G Martinez¹

¹Texas Eye Research and Technology Center, University of Houston College of Optometry, Houston, Texas, USA.

Clinical & Experimental Optometry

|September 5, 2017

Summary

Accurate corneal and limbal dimensions are crucial for scleral lens fitting. Current measurements are outdated and inaccurate, necessitating new protocols for precise corneo-limbal diameter determination.

Keywords:

corneal diameter corneo-limbal diameter horizontal visible iris diameter limbal width scleral lens

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Area of Science:

Ophthalmology
Optometry
Biomedical Engineering

Background:

Accurate corneal and limbal dimensions are critical for fitting modern scleral lenses.
Existing published corneal diameter values are based on outdated, imprecise, and inconsistently defined measurements.
The widely cited average corneal diameter (11.7 x 10.6 mm) is derived from historical data and not direct measurement.

Purpose of the Study:

To review and critically assess available literature on corneal and limbal dimensions.
To highlight the limitations of current measurement techniques and definitions in ophthalmic literature.
To emphasize the need for standardized and accurate methods for determining corneo-limbal diameters.

Main Methods:

Systematic review of existing scientific literature concerning corneal and limbal measurements.
Analysis of measurement methodologies, definitions, and their historical context.
Evaluation of the accuracy and limitations of current ophthalmic instrumentation for these measurements.

Main Results:

Published corneal diameter values lack clear definitions and are often based on indirect or historical data.
Horizontal visible iris diameter measurements underestimate the true corneo-limbal diameter by excluding limbal width.
Current ophthalmic instrumentation may lack the necessary resolution and definition for precise corneo-limbal measurements.

Conclusions:

The limbal width remains structurally undefined and inaccurately measured in current literature.
There is a significant need for developing new protocols to accurately measure corneal and limbal dimensions.
More precise measurements are predicted to show that optimal scleral lens fitting requires diameters of 16.0 mm or larger.