Using Bruckner's test for gross keratometry screening.

Bruckner's test[1] was done using indirect ophthalmoscopy at a distance of 50 cm in a 12-year-old boy presenting with corneal opacity [Fig. 1a] and localized area of brightness [Fig. 1c and d] along the opacity was seen suggesting some change in refractive power of the local milieu as compared to rest of the cornea. Pentacam (OCULUS, Arlington, WA) confirmed the localized area of steepness [Fig. 1b]. I thus propose the use of Bruckner's test as a quick method of gross screening of corneal topography as any gross localized change in keratometry would change local optics giving us differential glow in that area.

Figure 1

(a) Corneal opacity in a 12-year-old child, no other symptoms; (b) Pentacam (refractive keratometry map) showing high keratometry values localized superiorly; (c) photo through left eyepiece of indirect ophthalmoscope showing bright area (arrow); and (d) photo through right eyepiece of indirect ophthalmoscope showing bright area (arrow)

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