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ULTRA-WIDEFIELD IMAGING, CONTINUED FROM PAGE 2 views of the macula and periphery, as well as a zoom mode for macular angiography. Retina specialists say the technology has greatly affected patient care and treatment in their practices.

“Ultra-widefield angiography certainly has changed and refined the way I care for patients,” says John W.

Kitchens, MD, a retina specialist and partner at Retina

Associates of Kentucky. “I’ve developed a better understanding of the patho genesis of disease, and I can detect and treat disease earlier.”

Says Mathew W. MacCumber, MD, PhD, a private practitioner at Illinois Retina Associates, and associate professor and associate chair for research in the department of ophthalmology at Rush University Medical

Center, “Because of this technology, we can appreciate pathology in the peripheral retina that we couldn’t before. We can image through an undilated pupil or a smaller pupil, which conventional fundus photography doesn’t allow us to do. The technology provides excellent images of the posterior pole, so you don’t need a second camera to look at the macula. You can use it as your primary camera even in a small practice setting.”

Diabetes Care

Ultra-widefield angiography is especially effective in the diagnosis and management of retinal disease associated with diabetes.

“The technology has had the most impact in diagnosing and treating diabetic retinopathy and retinal vein occlusions,” Dr. MacCumber says. “These diseases affect the peripheral retina as well as the posterior pole. Ultrawidefield photography helps us to better appreciate the extent of these diseases in the periphery.”

Thomas Stone, MD, a retina specialist and partner with Dr. Kitchens at Retina Associates of Kentucky, says ultra-widefield angiography, using the Optos P200MA, has changed the way he treats diabetic macular edema.

Before ultra-widefield angiography, he’d initiate treatment with a focal laser. If unsuccessful, he’d administer an intravitreal injection of off-label bevacizumab

COMPANY

Marco

Marco

Marco

Right Medical

Topcon

Medical Systems

Marco

Marco

Marco

Oculus

COMPANY

Canon Medical

Systems

Canon Medical

Systems

Marco

Marco

Marco

Reichert Ophthalmic

Instruments

Right Medical

Right Medical

Right Medical

Right Medical

Shin-Nippon

Shin-Nippon

Shin-Nippon

Shin-Nippon

Figure 2. Ultra-widefield technology has changed the way many retina specialists treat diabetic macular edema, because they’re able to target treatment more precisely to produce better visual outcomes.

MODEL

EPIC

ARTIFICIAL

INTELLIGENCE

FINAL RX

yes

TRS yes

RT-3100 no

Remote Vision

CV-5000

Refraction System no suggested final

Rx provided

MODEL

R-F10

Full Autorefractor

RK-F1 Full-auto

Ref-keratometer

ARK-530A

ARK-560A

3D Wave

Palm AR Handheld

Autorefractor

Palm ARK Handheld

Autorefractor/Keratometer

M3

PARK 1

RK600 Auto Refractor/

Keratometer

Retinomax Series 3

Handheld Autorefractor

Retinomax Series 3

K-Plus Handheld

Autorefractor

Speedy-1 Autorefractor

Speedy-K Autorefractor

ACCUREF 8001

ACCUREF 9001

NVISION-K 5001

Accuref-K 9003D

Tomey USA TR-4000

Tomey USA

Tomey USA

Topcon Medical

Systems

Topcon Medical

Systems

RC-5000

Autorefractor/Keratometer

RT-7000

Autorefractor/Keratometer

RM-8900

Autorefractometer

KR-8900 Auto

Kerato-Refractometer

Topcon Medical

Systems

KR-8000PA Auto

Kerato-Refractometer

Topographer

All claims made by manufacturer

yes yes yes yes

LM/AR

SUBJ/UNAIDED

COMPARISON

yes

ALIGNMENT SYSTEM

fully automated, just press start fully automated, just press start auto align; auto fogging; auto tracking; joystick auto align; joystick; infrared mire alignment; auto fogging auto align; joystick; auto fogging handheld; infrared mire alignment handheld; infrared mire alignment auto align; joystick; infrared mire alignment; auto fogging

Joystick w/automatic measurement joystick handheld-automatic measurement handheld-automatic measurement joystick & automatic measurement joystick & automatic measurement joystick w/automatic measure joystick w/automatic measure joystick w/automatic measure hybrid - automatic 3 dimensional alignment or manual, auto measuring infrared; joystick; mire alignment with dual CCD fully automatic eye-tracking system fully automatic eye-tracking system joystick; infrared measuring joystick w/auto-firing; infrared measuring joystick w/auto-firing; infrared measuring

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SP0709 DIBG-OMD-0630:OMD-OM DIBG 7/2/09 9:51 PM Page 7 yes yes yes yes no no n/a n/a n/a n/a no no yes yes yes no n/a no no no no no no

VISUAL ACUITY

no no no yes no

ADJUSTABLE

CONVERGENCE FOR

NEAR AT VARIABLE

WORKING DISTANCE

yes yes yes n/a yes no no n/a n/a n/a n/a no no no no no no n/a no no no no no no

GLARE TESTING

no no no no no

AUTOMATIC

INPUT OF VA

yes

CHART

LINKAGE

yes yes yes yes yes no yes no yes yes yes no yes yes no yes/std. yes/std.

yes no yes no yes yes yes

KERATOMETER

no yes yes yes yes

R E F R A C T I O N S Y S T E M S

AUTOMATIC

ALIGNMENT W/

PROJECTION

SYSTEM

yes no (not needed) no (not needed) no (not required) yes

ADDITIONAL FEATURES

Compact refraction system; has a footprint of 22 sq. ft.; reduces refraction time; delegation tool; split prism Jackson cross; integrates wavefront data into subjective refraction; adjustable motorized table, color touch screen that can be turned to patient for visual acuity education tool, can be networked into paperless EMR systems.

Compact refraction system used in a tradtional lane; reduces refraction time; delegation tool; split prism

Jackson cross; can be networked into paperless EMR systems.

Wireless & compact refraction system used in a traditional lane; reduces refraction time; can be networked into paperless EMR systems.

Wireless remote control; wireless integration with Right Medical autorefractors and projector.

Programmable for expedited refractions.

Incorporates color-coded cylinder refinement aids; can be integrated w/Topcon autorefractors; auto projectors, VisiChart and M&S Smart System as well as many popular EMR systems; automated patient positioning features with the EXAM-5000 desk system.

A U T O R E F R A C T O R S

ADDITIONAL FEATURES

2.5-mm minimum pupil size required; Dioptric measurement range of -30D to 22D; PD/VD & IOL; RS232C data output.

Simultaneous display of referential retro-illuminated image; 2.5-mm minimum pupil size required; corneal diameter measurement; peripheral K reading; PD/VD & IOL;RS232C data output.

Cataract mark detection; virtual vision comparison; corneal size measurements; Eyetracking system; photopic/scotopic pupil size measurement; measuring range -30D to +25D; interfaces w/EPIC, TRS & Evolution.

Auto tracking/firing/alignment measuring; visual acuity; subjective refinement; corneal size measurement; pupil size measurements; interfaces w/EPIC, TRS & Evolution.

Autorefractor; topographer; wavefront analyzer; OPD; internal OPD; pupillometer; mesopic & photopic pupil displayed; asphericity values (e\Q); XP; Celeron M1.5 GHz Processor; interfaces w/EPIC, TRS & Evolution, the Marco H-D Eye Exam.

Possesses features of tabletop ARs; quick mode; supine mode; interfaces w/EPIC, TRS & Evolution.

Possesses features of tabletop ARKs; quick mode; supine mode; interfaces w/EPIC, TRS & Evolution.

Autorefractor/keratometer; mesopic & photopic pupil measurements; corneal size measurements; noncontact tonometer; softer air puff; adjustable monitor; motorized chin rest; high-speed measurements; interfaces w/EPIC, TRS & Evolution.

Combines a noncontact pachymeter, autorefractor and keratometer into one slim and easy-to-use instrument. 4 scan modes; 2.5 mm minimum pupil size; 5” color LCD monitor, thermal printer; 600 pachymetric points measured; USB connection and can be integrated into EMR. Dimensions: 20” x 10.2” x 21.7”.

Full-color LCD screen, icon-based operating system & built-in printer. 2.3-mm minimum pupil diameter, RS 232C interface & video output terminal. Auto-start function initiates measurements automatically when alignment is achieved. Equipped w/an automatic power save turn off.

Handheld, fully featured. Precise measurements; Super Quick mode for optimal pediatric measurements; 2.5-mm minimum pupil size, retro-illumination to identify cataracts or irregularities in the optical system; melody function assists with small children.

Handheld, fully featured. Precise measurements; Super Quick mode for optimal pediatric measurements; 2.5-mm minimum pupil size, retro-illumination to identify cataracts or irregularities in the optical system; melody function assists with small children; peripheral keratometry measurements; selectable modes for optimal performance.

The fastest measurement times - 0.01 seconds; precise measurements; 2.5-mm minimum pupil size; medical grade retro-illumination; wireless data transfer to Remote Vision auto-phoropter.

The fastest measurement times - 0.01 seconds; precise measurements; 2.5-mm minimum pupil size; medical grade retro illumination; wireless data transfer to Remote Vision; peripheral keratometry measurements; selectable modes for optimal performance.

2.3-mm pupil; lightweight/compact design; automatic measuring function; IOL mode; continuous, quick measurement feature; data output capable; stand or sit 3-position monitor angle; large, easy read color 5.6-inch LCD monitor.

2.3-mm pupil; corneal radius/refraction readings; compact design; IOL mode; distance & near PD measurements; automatic measuring function; continuous measurement feature; data output capable: 3-position montior angle; easy read, color 5.6-inch

LCD monitor; peripheral corneal measurements.

2.3-mm pupil; auto-refraction & auto-K measurement, corneal radius or diopter readouts; near vision testing capable; automatic measuring function; non-accommodating, wide view window technique; IOL mode data output interface large 5.6-inch LCD monitor.

Fully automatic eye-tracking capability, quick and easy auto focusing and measurement function, eye-to-eye tracking is fully automatic, auto “K” measurement, peripheral “K” measurements possible, 7.5 inch Tilt TFT monitor, the new Photo Mode is standard, compact & silent operation, external output via USB port or RS232C.

Automatically calculates interpupillary distance based on patient’s alignment; dual CCD cameras; 0.3-second measurement time; built-in printer.

Full automatic, touch screen operation; calculates pupillary distance; high-speed built-in printer; power chin rest; 0.3-second measurement time or less; provides recommended list of contact lenses.

Full automatic, touch screen operation; cataract & IOL mode; high-resolution color TFT display; 0.3-second measurement time; baseline topographer. Built-in computer & printer.

2-mm minimum pupil size; color LCD display; auto fogging; rotary prism technology; built-in printer; interfaces w/ Topcon auto lensmeter, CV-5000 refraction system, and today’s most popular EMR systems.

2-mm minimum pupil size; central K readings; color LCD display, auto fogging; rotary prism technology; auto-fire mode; built-in printer; corneal pupil diameter measurement; interfaces w/Topcon auto lensmeter, CV-5000 refraction system and today’s most popular EMR systems.

2-mm minimum pupil size; corneal topography standard; peripheral keratometry; optional color-mapping software available; corneal mapping measurements out to 9.2 mm; interfaces w/Topcon auto lensmeter, CV-5000 refraction system and today’s most popular EMR systems; auto fogging; rotary prism Placido ring technology.

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SP0709 DIBG-OMD-0630:OMD-OM DIBG 7/2/09 9:51 PM Page 8

(Avastin, Genentech) or triamcinolone acetonide

(Kenalog, Bristol-Myers Squibb). If this didn’t resolve the edema, he’d consider vitrectomy surgery. “With this new technology, I’m able to look at the peripheral retina,”

Dr. Stone says. “If the patient has significant peripheral nonperfusion, I’ll perform panretinal photocoagulation to the nonperfused areas. This reduces macular edema

(Figure 2). It’s less invasive than vitrectomy and may help prevent vitrectomy in the future.”

Dr. Kitchens says, “If a patient has diffuse edema with poor perfusion, I’ll treat him with an intravitreal injection of off-label bevacizumab. If a patient has diffuse edema with good perfusion, I’ll treat him with an intravitreal corticosteroid and consider focal or grid laser photocoagulation. Before ultra-widefield angiography, my treatment decisions were almost based on trial and error. This new technology enables me to treat patients much more precisely.”

What’s unique about ultra-widefield angiography is that it gives physicians the ability to deliver treatment that’s targeted only to the areas of the retina that need it, therefore sparing healthy tissue.

“You can take digital images of the peripheral retina in a patient with moderate-to-severe proliferative diabetic retinopathy and conclude that he’d benefit precisely from panretinal photocoagulation,” Dr. Stone says. “You can miss an opportunity to make an early diagnosis and a more targeted treatment decision if you use fluorescein angiography with conventional camera systems.”

Dr. Kitchens agrees. “By having the ability to determine more accurately where the problems are in the retina, you can treat the areas that need it and avoid the healthy areas that don’t.”

Says Dr. MacCumber, “I can direct my laser more precisely in diabetes patients who have early proliferative diabetic retinopathy. In some cases, I can avoid performing a complete panretinal photocoagulation treatment, which is something I’ve done routinely in the past when using conventional camera systems.”

COMPANY

Topcon Medical

Systems

Tracey Technologies

Welch Allyn

COMPANY

Marco

Ophthonix Inc.

Topcon Medical

Systems

Tracey

Technologies

COMPANY

Carl Zeiss

Meditec

Carl Zeiss

Meditec

Carl Zeiss

Meditec

Carl Zeiss

Meditec

A Boon in General Ophthalmology

While ultra-widefield imaging has significance in diagnosing and treating retinal disease, it also has important applications in the general ophthalmology practice.

Thomas Henderson, MD, a cataract and refractive surgeon in private practice at Eye Clinic of Austin in

Austin, Texas, uses the Optos P200C primarily to document and monitor pathology. The optometrist in his practice uses ultra-widefield imaging as a basic screening tool for 20% to 30% of healthy, well-vision patients.

“We perform basic screenings for patients who are healthy and for their convenience,” Dr. Henderson says.

“With one ultra-widefield image, you can see most of what you’d see with a full dilated exam. But instead of allocating 30 minutes to dilate a patient, 5 minutes to examine him and then 4 hours for the patient to recover, you spend 2 minutes taking the image and 2 minutes reviewing it with the patient. Plus, it takes 100 views with a direct ophthalmoscope to cover the area you see in one ultra-widefield image. Even then, you couldn’t

Carl Zeiss

Meditec

Carl Zeiss

Meditec

Carl Zeiss

Meditec

Haag-Streit

USA

Haag-Streit

USA

MODEL

KR-9000PW

Wavefront Analyzer iTrace Combo Visual

Function Analyzer

14010

SureSight Autorefractor

MODEL

3D Wave

Z-View

KR-9000PW iTrace Combo

Visual Function

Analyzer

MEASURING

PRINCIPLE

dynamic spatial skiascopy holographic grating

ALIGNMENT SYSTEM

joystick w/auto-firing; infrared measuring auto-align, auto-capture auto-fogging direct view/data acquisition

Hartmann-Shack

Infrared laser ray tracing

MODEL

Humphrey Field

Analyzer IIi

Model 720i

Humphrey Field

Analyzer II-

Model 740i

Humphrey Field

Analyzer II-

Model 745i

Humphrey Field

Analyzer IIi

Model 750i i i

STIMULUS

Goldmann std. proj. size III only;

Heijl-Krakau fixation monitor & video eye monitor

Goldmann std. proj.

size I, II, III, IV, V;

Heijl-Krakau fixation monitor & video eye monitor; gaze tracking

Goldmann std. proj.

size I, II, III, IV, V; Heijl-Krakau fixation monitor & video eye monitor; gaze tracking

Goldmann std. proj. size I, II, III, IV, V; Heijl-Krakau fixation monitor & video eye monitor; head tracking; vertex monitor; gaze tracking frequency doubled sinusoidal gratings

(0.25 cpd; 25 Hz)

Humphrey FDT

Visual Field

Instrument with frequency doubling

Humphrey

Matrix Visual

Field Instrument with frequency doubling

SITA SWAP frequency doubled sinusoidal gratings blue light; Goldmann std. proj. size V stimulus

Octopus 900

BASIC

Octopus 900

PRO

All claims made by manufacturer

100% total fixation control; no fixation losses on printouts; video eye monitor and chin rest sensor; Goldmann standard projection I, II, III, IV, V

METHOD

optical path difference binocular viewing, monocular measurement n/a

Auto-capture with monocular/binocular open-field and Badal

Optometer fixation

AREA OF FIELD

90°

90°

90°

90°

30°

30° n/a

90º in

Goldmann spherical bowl

Same as BASIC + unique auto eye tracking; one system offering standard static white/white + blue/yellow +

Flicker + TRUE Goldmann

Kinetic + low vision + red/white.

90° in

Goldmann spherical bowl.

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VISUAL ACUITY

no no no

NUMBER OF

DATA POINTS

1,440

>10,000 over

6 mm pupil

3,960 corneal

256 rapid sequential points through

2 mm-8 mm pupils

STANDARD TESTS

threshold: 3 central, 1 periph. pattern; 4 screening central,

3 full-field periph. patterns threshold: 4 central,

2 periph. patterns; screening: 5 central screening, 7 full-field/ periph. patterns threshold: 4 central,

2 periph. patterns: screening: 5 central,

7 full-field/periph patterns threshold: 4 central,

2 periph. patterns; screening: 5 central,

7 full-field/periph.

patterns screening: C-20 full threshold: C-20,

N-30

GLARE TESTING

no no no

POINT SPREAD

FUNCTION

yes displayed & printed as convolved image yes

KERATOMETER

yes/std.

yes no true, directly-measured

PSF yes

PRINTER

built-in thermal; can be hooked up to HP

LaserJet built-in thermal; can be hooked up to HP LaserJet built-in thermal; can be hooked up to HP LaserJet n/a

INTERNAL OPD/

LENTICULAR

DIFFERENCE

yes no no built-in thermal; can be hooked up to HP LaserJet

A U T O R E F R A C T O R S

ADDITIONAL FEATURES

Corneal topography standard; color-mapping software; corneal-mapping measurements out to 10 mm; Hartmann-Shack wavefront analysis; Placido ring corneal measurements; 2-mm minimum pupil size; modular transfer function; point spread function.

Integrated ray-tracing aberrometry, corneal topography, auto-refractometry, auto-keratometry, pupillometry in one device; multi-zonal refraction analysis at user-defined zone sizes for assessing photopic and scotopic vision.

Features Wavefront Sensing Technology; less than 5 seconds per eye test time; data acquisition from 14”; child-friendly; battery operated and portable; weighs 2 lbs.; IR data transfer to cordless printer.

WAV E F R O N T A B E R R O M E T E R S

ZERNIKE

OUTPUT

WF Refraction & RMS value on thermal tape. Zernike map displays bar graphs, WF error & RMS values given.

2nd to 6th order

ADDITIONAL FEATURES

Topographer; Wavefront analyzer; OPD; internal OPD; pupillometer; mesopic & photopic pupil displayed; combined w/automated phoropter performs the Marco

H-D Eye Exam; XP; Celeron M1.5 GHz Processor.

The Z-View is designed specifically for dispensing practitioners to prescribe iZon wavefront-guided lenses; wholly contained; ultramodern design; non-Hartmann-

Shack; contemporary design; compact size.

yes yes; including multizonal

Zernike displayed as bar graphs, coefficients, or combined RMS and individual RMS term

Combined autorefraction, corneal mapping and wavefront aberrometer measurements; point spread and modulation transfer functions; Landolt simulation; extensive +22D to -25D refractive measuring range; auto-fogging fixation target; axial & instantaneous power maps; mesopic and photopic measurements.

5-in-1 functionality also includes corneal topography, auto-refraction w/multi-zone analysis for photopic and scotopic conditions, pupillometry and keratometry; binocular open-field fixation; accommodation volume; VFA Summary display; computer independent.

TEST STRATEGIES

threshold: SITA, FastPac; full screen: age ref. strategy; threshold-related; 2-zone,

3-zone & quantify defects threshold: SITA, FastPac; full screen: age ref. strategy; threshold-related; 2-zone,

3-zone & quantify defects threshold: SITA, FastPac; full screen: age ref strategy; threshold-related; 2-zone,

3-zone & quantity defects threshold: SITA, FastPac; full screen: age ref. strategy; threshold-related; 2-zone,

3-zone & quantify defects n/a

P E R I M E T E R S

ADDITIONAL FEATURES

Now with VFI, EasyConnect and HFA-Net Pro standard. Computerized silent projection system; reduces threshold testing by up to 70%; 12 test patterns w/static threshold & screening strategies to 90º; STATPAC2 software compares results w/age-matched normative data; CRT touch screen; wheelchairaccessible table w/built-in printer avail. DICOM Gateway compatible (optional).

Now with VFI, EasyConnect and HFA-Net Pro standard.19 test patterns; user-designed custom testing w/range to 90º; patented gaze-tracking system; built-in 40 GB data storage; compares multiple STATPAC results via print-out;

Goldmann I-V foveal threshold testing; red/blue testing; custom testing avail.; built-in VGA monitor hookup for remote viewing. DICOM Gateway compatible (optional).

Now with VFI, EasyConnect and HFA-Net Pro standard. Includes all features of

740i; STATPAC for blue/yellow perimetry. DICOM Gateway compatible (optional).

Now with VFI, EasyConnect and HFA-Net Pro standard. Model 750i includes all of the previous features plus head tracking; automatic vertex monitoring; automatic pupil measurement; std. blue/yellow testing; kinetic testing and keyboard; all models upgradable. DICOM Gateway compatible (optional).

45-second screening; 4-minute threshold; 19 lbs.; easy to use; age-related normative database.

screening: N-30,24-2 threshold: N-30-F,

24-2 FDT, 30-2 FDT

Macula: 10-2, Macula

Threshold (4°) threshold; single field analysis report external 8.5 x 11 color printer n/a screening: MOBS threshold: Zest, MOBS

24-2

Fast screen <45 seconds; 20GB HD; CD RW drive; floppy drive; external keyboard; small footprint; statistical analysis w/age-related normative database; serial field, video eye monitoring; no eye patch needed; no trial lens needed out to ± 3.00D; ambient light testing.

Available as a licensed option on all HFA II & II-i models; 745-750; blue-yellow threshold testing in 3 to 6 minutes per eye. Makes blue-yellow testing a clinically practical tool for early detection of glaucoma. Improved reproducibility; larger dynamic range & higher sensitivity than other SWAP tests.

Automatic pupil measurement; automated lens holder; stimuli presentations are adaptive to patient responses; easily upgraded to 900 PRO series; wheelchair- accessible table provided; easily integrated with electronic medical records.

diagnostic thresholds for glaucoma & macula; linear

32 & macula threshold; low vision; neurological; diabetes blepharoptosis; multiple screening tests, including glaucoma & 130 point screenings

Same as BASIC + unique custom testing allows you to build what you want where you want it.

Perimeter controlled by

PC/monitor & ink jet printer (all provided);

EyeSuite Lite Software provided for long-term storage & data analysis; easily networked; viewing stations - no charge. EZ to read 7 in 1 printout.

Same as BASIC +

Full 3-level EyeSuite software provided for long-term storage and data analysis.

TOP (tendency oriented perimetry) for thresholds in just over 2.5 minutes per eye; dynamic; normal - all age related; 1 and 2 level screening tests with supra-threshold

Same as BASIC Same as BASIC

JULY 2009

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SP0709 DIBG-OMD-0630:OMD-OM DIBG 7/2/09 9:52 PM Page 10

COMPANY

Haag-Streit

USA

MODEL

Octopus 300

BASIC

STIMULUS

100% total fixation control no fixation losses on printouts; video eye monitor and forehead rest sensor; Goldmann standard projection III, V; operates in diffused room lighting

AREA OF FIELD

30º direct projection; far distance correction only needed.

Haag-Streit

USA

Haag-Streit

USA

Haag-Streit

USA

Kowa

Optimed Inc.

Octopus 300

PRO

Goldmann

Kinetic

EyeSuite

Software

Analysis program

AP-5000C

Same as BASIC + unique auto eye tracking; one system offering standardized static white/white + blue/yellow + Flicker + low vision

True Goldmann I thru V + 1-4/a-e.

Control speed of 0 (static) or

2/3/4/5/10 degree per second or free form

EyeSuite Lite;

EyeSuite Advanced;

EyeSuite Pro

Goldmann std. proj. size

II-V, Heijl-Krakau Eye fixation monitor

Same as BASIC

Software package to 900 Basic (option)

& Pro (standard).

Archive perimetry data with single field analysis.

80º

Figure 3. Ophthalmologists use ultra-widefield imaging to find and document abnormalities, such as wet AMD (shown here), that might identify certain patients as being poor candidates for cataract and refractive surgery.

cover the same area with the direct ophthalmoscope — even in a dilated eye.”

Moreover, ultra-widefield imaging plays an important role in anterior segment patient care. The technology doesn’t allow doctors to examine the anatomy of the anterior segment, such as the crystalline lens or cornea, but it enables them to use it in presurgical and postsurgical applications in cataract and refractive surgery patients.

“Ultra-widefield imaging is a competent way of detecting presurgical risk factors and postsurgical complications because you can view nearly the whole retina,”

Mr. Anderson says. “For example, if a patient had peripheral retinal breaks, you’d want to know this before cataract surgery. If the patient doesn’t have retinal breaks, you’d want to know if he developed them after surgery. The Optos technology enables you to image the majority of the retina and even see through cataracts.”

Peyton Neatrour, MD, a cataract and refractive surgeon at Beach Eye Care/Neatrour Eye Institute in

Virginia Beach, Va., says he uses the Optos P200C to find and document abnormalities that would identify certain patients as being poor candidates for cataract and refractive surgery. “Ultra-widefield imaging enables me to image and document pathology in the retina that may limit a patient’s return of vision following cataract surgery. It also gives me a more targeted prognosis of a patient’s visual outcomes post cataract surgery,” he says.

In potential cataract surgery patients, he looks for retinal pathology such as macular holes, AMD, epiretinal membrane and macular puckering. “The ability of the technology to detect subtle choroidal nevi with the green filtered view is impressive as well,” he adds.

Dr. Neatrour also uses the technology for presurgical evaluations in LASIK, CK, ICL and PRK candidates.

“Patients who have myopia greater than –5 are at a higher risk for peripheral retinal pathology. Using ultra-

Sightpath

Medical

Oculus Inc.

Oculus Inc.

Oculus Inc.

Foresee PHP

Centerfield II

Twinfield

Easyfield

OPTOPOL

Technology S.A.

(distributed by Canon

Medical Systems)

PTS 1000

Dot deviation signal flashed over macular Ioci

Goldmann size II; Heijl-Krakau

& central fixation; video eye monitor; static white-onwhite & blue-on-yellow; auto kinetic

Goldmann size I–III; Heijl-Krakau

& central fixation; video eye monitor; static white-on-white, blue-on-yellow & red-on-white; auto & manual kinetic

Goldmann size III; Heijl-Krakau

& central fixation; video eye monitor; static whiteon-white

Goldmann size I-V white, blue, red, green

Central visual field - 14º

70°

90°

30°

100º (160 with fixation shift horizontally)

Paradigm Medical

Industries Inc.

Dicon Inc.

Paradigm Medical

Industries Inc.

Dicon Inc.

Paradigm Medical

Industries Inc.

Dicon Inc.

Paradigm Medical

Industries Inc.

Dicon Inc.

Woodlyn/Medmont M700

TKS 5000 autoperimeter

LD 400 autoperimeter

FieldLink

Automated

Perimetry

System

LD 700 static w/kinetic fixation; Heijl-Krakau fixation monitor static w/kinetic fixation; Heijl-Krakau fixation monitor.

static w/kinetic fixation; Heijl-Krakau fixation monitor.

Goldmann size III;

Heijl-Krakau; red LED fixation targets, static

Goldmann Size III - pale green rear projection LED

(red macula stimulus optional)

15 points x 3dB steps /

45 points x 1dB steps - video fixation monitoring feature

30°

80º

±90°

±60°

±60°

All claims made by manufacturer

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JULY 2009

SP0709 DIBG-OMD-0630:OMD-OM DIBG 7/2/09 9:52 PM Page 11

STANDARD TESTS

Diagnostic thresholds for glaucoma and macula; linear 32 threshold; low vision; multiple screening tests, including 30 second per eye; 1 minute per eye

Same as BASIC + custom testing to build muliple examinations

Build ANY kinetic test needed & save to library for perfectly repeated tests every time

EyeSuite Lite standard on

900 Basic & 300 basic;

EyeSuite Lite, Advanced & Pro standard on 900 & 300 Pro

25 test programs including threshold: Center 1 & 2, macula, periphery & meridian; screening: standard or precision; isopter:

Goldmann & automatic perimeter is combined

Central visual field test for

CNV determination.

30°; 10° macula; 30°course;

36°–70°; 70°; 0°– 36°; sgl. pts. -36°; sgl. pts.-70°;

36° sectors; 10-2; 24-2;

30-2 quick screen all of the above plus indiv. test pts.; central

& entire field

PRINTER

No outdated processor built in; easy to read 7-in-1 printout; auto print and/or export to our EyeSuite Lite/Advanced/Pro

(available) to your own

PC for long-term storage

& data analysis; easily networked; no add’l charges for viewing stations.

Same as BASIC + all 3 levels of EyeSuite

(Lite/Advanced/Pro) are provided.

n/a n/a

External PC connected

External color inkjet optional optional

TEST STRATEGIES

TOP (Tendency Oriented Perimetry) for thresholds in just over 2.5

minutes per eye; dynamic; normal

- all age related; 1 and 2 level screening tests with supra-threshold

Same as BASIC

Manual or automated Goldmann

Kinetic; use of automated, guided or free vectors n/a threshold: IQAC aged reference screening 2,3,4 zone & quantify defects

10-2; 24-2; 30-2; preprogrammed quick tests

Accurate threshold, Intelligent advanced threshold, screening and quick 3-zone

10°, 30° & 60° field patterns;

13 programs std.

10°, 30° & 60° field patterns;

13 programs std.

10°, 30° & 60° field patterns;

13 programs std.

built-in

Printout manager with predefined printout styles

Inkjet std.; color printer support w/

Fieldview.

Inkjet std.; color printer support w/

Adv. FieldView.

Inkjet std.; color printer support w/

FieldView.

optional printer screening 30°, central field, suprathreshold, full

& fast threshold central 30º, full 50°, peripheral 30º - 50º, macula 10º, glaucoma 22º/50º, neurological 50º, quickscan 22º/30º, use any printer via PC driving 50º/80º, binocular 30º/40º, binocular driving test 160º, spatially adaptive test 50º; customize any test or build your own

P E R I M E T E R S

ADDITIONAL FEATURES

Automatic pupil measurement; stimuli presentations are adaptive to patient responses; easily upgraded to 300 PRO series; wheelchair-accessible table

(either compact or universal sized) available; easily integrated with electronic medical records using available EyeSuite Software package.

Same as BASIC

Quantification of kinetic isoptors for easy comparison; field correction based on reaction time of patients response; zoom function to plot selected areas that can be used in combination with static perimetry.

Easily networked w/no extra charges for viewing stations; easily integrated w/electronic medical records. Archive perimetry data w/single-field analysis-lite

+ cluster trend analysis structure function graph + pro superposition images/fields. New cluster and polar graphs.

In ocular fundus perimetry, the visual field is examined w/an ocular fundus image displayed on screen. System offers capability to overlap ocular fundus image

& perimetry result so physician can better understand the retinal function.

n/a

3 suprathreshold; new CLIP threshold; fast threshold; 1 full threshold 4/2; qdrnts; sgl. pts.; user-defined

3 suprathreshold; new CLIP threshold; fast threshold; 1 full threshold 4/2; qdrnts; sgl. pts.; user-defined

3 suprathreshold; fast threshold; full threshold 4/2; qdrnts; sgl. pts.

Kinetic, screening, threshold,

3-zone, fast threshold, BSV (binocular single vision), flicker (critical fusion frequency), blue on yellow (SWAP),

BDT (Binocular Drivers Test), advanced

- reduced field option

- neurological defects option threshold-related suprathreshold screening; quantify missed pts.; full threshold; HT threshold-related suprathreshold screening; quantify missed pts.; full threshold; HT threshold-related suprathreshold screening; quantify missed pts.; full threshold; HT threshold-related suprathreshold; full threshold; fast threshold central threshold,

Medmont Flicker Perimetry

Normative database; easy to interpret report w/mapping, change-over-time analysis & reliability indices.

Portable; compares exams; stats pkg.; progressive display; combo stats & kinetic display; color display; exam indep. of room light; free software upgrd.; adj. test pt. duration & intervals; 30-cm radius bowl; Goldmann std.; measures pupil size; trial lens holder.

Compares exams; stats pkg.; progressive display; combo stats & kinetic disp.; color of room light; free software upgrade; adj. test pt. duration & intervals; 30-cm radius bowl; Goldmann std.; measures pupil size; trial lens holder.

Less than 12 lbs; portable; stats pkg.; CCD camera; moveable headrest & cone/bowl; color LCD display; stores 40,000 exams; screening rslts. 50–70 secs.; 30-cm radius bowl; free software upgrds.; exam indep. of room light; measures pupil size.; trial lens holder; two models; built-in console/computer; can use newer model w/own PC or laptop.

Eye monitoring by means of built-in video camera. Advanced auto-detection of eye position. Automatic pupil diameter measurement. Automatically controlled chin-rest enables you to set proper patient’s position precisely and easily. Printout manager with predefined printout styles. Network capabilities (remote database, networked review stations). Direct database back-up. Special ventilation system is used to keep fresh air throughout examination inside stimulation bowl.

Supported by Adv. FieldView Omega Analysis software; disk storage; FieldLink upgradable; voice recognition; voice prompts.

Half the size of TKS 5000 w/full-field capability; fits on rotating table; supported by

FieldView Analysis software; disk storage; voice management; voice prompts;

Advanced FieldView w/Fieldview download to PC.

Includes FieldView Omega Analysis software; FieldLink communications software; laptop computer; deluxe table; voice recognition; voice prompts; Advanced

FieldView.

11 lbs., compact, easy to use; connects to any PC or purchase w/touch screen controller; full database for patient management, output range 540-590nm, alignment controls for patient comfort.

Instrument is controlled via PC, which allows for easy networking in your office and integration with your EMR or PM software. Software allows you to view exams in 2D or 3D, in color or greyscale, overlay retinal images over visual field exams (optional).

Utilizes previous exams from patients to reduce test time and gives detailed regression reports or patient history. Customize printouts for your need.

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COMPANY

Carl Zeiss

Meditec

MODEL

ATLAS

Model 9000

RESOLUTION

0.01D; submicron

PROCESSING

TIME

less than

1 second

NUMBER

OF RINGS

22

Carl Zeiss

Meditec

EyeQuip

EyeQuip

Figure 4. With ultra-widefield imaging, physicians can pinpoint glaucoma indicators, such as defects in the retinal nerve fiber layer

(shown here), which are linked to an early indication of glaucoma risk.

They can view optic discs on screen side by side to find asymmetries

— one of the biggest risk factors in determining a glaucoma suspect.

widefield technology provides a thorough view of their eyes, which complements the dilated indirect exam,” he says.

Utility in Glaucoma

Physicians also use ultra-widefield imaging to more accurately diagnose and manage glaucoma. Doctors can get a clear view of the optic nerve, measure it and examine it in both eyes side by side. In addition, clinicians can measure the ISNT rule and examine the remaining fundus to determine if any retinal pathology exists well into the periphery that might be affecting the optic nerve.

These views help confirm whether or not a patient is a glaucoma suspect. “Our technology enables you to pinpoint glaucoma indicators, such as defects in the superior arcade and breaks in the retinal nerve fiber layer, which are linked to an early indication of glaucoma risk,”

Mr. Anderson says. “Looking at the optic discs on screen side by side is the fastest way to find asymmetry, which is one of the biggest risk factors in determining a glaucoma suspect. You can zoom in on the discs so they take up 90% of the screen.”

According to Dr. Neatrour, ultra-widefield imaging enables him to see the optic nerve more clearly and document damage that occurs over time due to glaucoma progression (Figure 4).

Pictures Worth a Million Words

Because of the clarity of the digital images that show the posterior segment in great detail, doctors have the ability to educate patients about their eyes and eye disease like never before.

“Patients are blown away by the images,” Dr.

Henderson says. “You can paint a picture with your words and sometimes patients will understand. You can draw a picture with your pen, and patients may understand a little better,” he says. “But when you take a picture of their eyes and show them exactly what’s going on, there’s no doubt they understand what’s right or wrong with their eyes. This helps me forge a better therapeutic bond with my patients. I can’t emphasize strongly

Oculus Inc.

Oculus Inc.

Oculus Inc.

EyeSys

Vison, Inc.

EyeSys

Vison, Inc.

Haag-Streit

Marco

Nidek Inc.

Nidek Inc.

Oculus Inc.

Keratograph

Pentacam

Pentacam HR

(High Resolution)

Shin-Nippon

Tomey USA

CT-1000

TMS-4

Topcon Medical

Systems

Topcon Medical

Systems

KR-8000PA

KR-9000PW

Tracey

Technologies iTrace Combo

Visual Functional

Analyzer

Woodlyn/Medmont E300

Visante omni

(linking ATLAS with Visante OCT)

Piccolo

Topographer

Scout

Topographer

0.01D; submicron

< 1 micron

< 1 micron

System 3000 high res

Vista Portable

CT

CTK-922

3D Wave high res

± 0.10

high res

OPD-Scan II, Optical

Path Difference Diag.

System, ARK-10000

Magellan

Mapper

Easygraph high res high res;

± .03 mm

± 0.20D

seconds 22

(ATLAS

Placido), OCT pachymetry

< 3 seconds 28

28 < 3 seconds; depends on computer computer dependent computer dependent instant

0.4 seconds

0.4 seconds

< 1 second

1 second

40

25

22

19 vertical;

23 horizontal

19 vertical;

23 horizontal

60

22; high-res

CCD camera

± 0.10D

± 0.25D

1 second max. 2 seconds

22; high-res

CCD camera no rings;

Scheimpflug camera

+/- 0.1D

1 second no rings;

Scheimpflug camera

High res

± 1.25D

800 x 600 pixels n/a n/a

.01 diopter/1µ

< 2 seconds, depends on CPU

3 seconds n/a n/a instant

20

25 & 31

10

11

25

High resolution none/instant 32

All claims made by manufacturer

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SP0709 DIBG-OMD-0630:OMD-OM DIBG 7/2/09 9:54 PM Page 13

NUMBER OF

DATA POINTS

thousands thousands

7,168 measured

75,000 analyzed

7,168 measured

75,000 analyzed up to 14,400

9,000

22,000

6,480

6,480 or more

21,600

22,000

<10 mm

<10 mm

125 mm

70 mm

80 mm

75 mm

75 mm

1.5 mm

40 mm

22,000

25,000 true elevation pts.

138,000 true elevation pts.

6,344

8,000

3,600

3,960

9,000

15,000 measured points

6 mm

70 mm

85 mm

85 mm

20 mm

30 mm

WORKING

DISTANCE

70 mm

47 mm

80 mm

80 mm

80 mm

FOCUSING

MECHANISM

Joystick with patented

Cone of Focus ™ alignment system and Smart Capture ™

Technology

V-Trac ™

Registration System patented infrared vertex detector patented infrared vertex detector

3 camera apex detection with auto-capture image sequence through focus auto-capture joystick

XYZ axis fully automatic alignment

XYZ axis fully automatic alignment

XYZ joystick w/autooffset correction automatic focusing; manual override automatic focusing; manual override automatic focusing; manual override automatic focusing; manual override joystick w/automatic measurement joystick automatic alignment w/manual override automatic alignment w/manual overdrive laser vertex joystick with progressive auto capture and 4 simultaneous captures so you never have to repeat the test

C O R N E A L T O P O G R A P H E R S

ADDITIONAL FEATURES

Proven Placido disk technology and Arc-Step Algorithm for submicron elevation accuracy. Zernike corneal wavefront analysis for aspheric IOL selection, image simulation of higher order corneal aberrations, invisible ring illumination for patient comfort; auto pupillometry (scoptopic & photopic) and white to white (HVID) measurement. PathFinder II Corneal Analysis Software screens for 5 different corneal conditions with >92% accuracy. MasterFit II CL fitting module. Small footprint, integrated Win XP computer with

DVD-ROM/ethernet/USB.

Only combined Placido + OCT system for anterior and posterior corneal topography including the Holladay Report; complete anterior segment imaging with full pachymetry map, anterior chamber angle and diameter measurements, corneal flap thickness measurement; Refractive Tools Software for surgical planning; Irido-Corneal Tools Software to quantify angle anatomy;

Topography Link Software compatible with ZEISS ATLAS Models 993, 995, and 9000.

Corneal wavefront mapping clearly displays corneal spherical aberration and low and high order aberrations that can be removed from the map individually; slit lamp or table top mount; use your laptop or desktop computer; Exclusive Wave

Contact Lens Design Software included.

Std. corneal wavefront mapping clearly displays low & high-order aberrations that can be removed from the map individually; opt. IR pupillometry; three interchangeable opt. IR pupillometry; three interchangeable Scout models; portable w/battery; slit lamp mounted or table-based w/a permanent headrest; use your laptop or desktop computer; exclusive Wave Contact Lens software designs custom RGP & soft lenses .

New desktop topographer/pupillometer. Solid state USB 2.0 digital design, patented high-resolution, 3-camera technology and patented multi-resolution, adaptable ring placido. Many options include corneal wavefront high-order aberration map,

Holladay diagnostics, etc.

Newly updated for 2008. Portable, fast and easy-to-use, solid state USB 2.0 digital design, no moving parts, automatic exam acquisition, map options include corneal wavefront high order aberration map, Holladay diagnostics, etc.

Keratometer built-in; contact lens software; 3-D image; keratoconus detection; Fourier and Zernike analysis.

Diopter range is on Ct. 10 to 100D out to 11 mm; includes: axial, tangential, refractive & elevation maps; ARK; wavefront analyzer; OPD; internal OPD; pupillometer; mesopic & photopic pupil displayed; XP; Celeron M1.5 GHzProcessor.

Diopter range is on Ct.10 to 100D out to 11 mm; includes: axial, tangential, refractive & elevation maps; objective autorefraction & wavefront analysis technology via dynamic skiascopy; wavefront maps include: OPD, Zernike polynomial graphs, total wavefront aberration & wavefront higher-order aberration.

Klyce Corneal Navigator Screening Program aiding in the detection of nine corneal conditions; Corneal Aberrometry Software;

NAVIS EMR included.

Exclusive “REAL” keratometer built in; image data transferred digitally to computer; Windows-compatible software;

3-D; overview image; Fourier analysis; height & refractive maps std.; keratoconus detection software;

Zernike analysis software & contact lens fitting software opt.; contact lens software includes 35,000 lens database & fluor. image-simulation; ortho-k software also available.

Exclusive “REAL” keratometer built in; image data transferred digitally to computer; Windows-compatible software; 3-D; overview image; Fourier analysis; height & refractive maps std; keratoconus detection software & Zernike analysis software; contact lens software includes 35,000 lens database & fluor. image simulation; refractive comparison software for corneal refractive therapy; opt. pupillometry software avail.

The Pentacam is a rotating Scheimpflug camera system; anterior & posterior corneal topography; anterior segment/chamber analysis; calculates chamber angle in degrees, camera chamber volume, diameter & height; creates moveable 3-D model; images anterior & posterior corneal surfaces, iris & the lens; quantifies & diplays crystalline lens opacifications; measures

IOL vault distance from any eye surface; detects optimal focus for anterior chamber imaging, Holladay Report with Equivalent K

Readings for better IOL Calculation; 1 year free software upgrades.

The Pentacam HR is a rotating Scheimpflug camera system; anterior & posterior corneal topography; anterior segment/chamber analysis; calculates chamber angle in degrees, camera chamber volume, diameter & height; creates moveable 3D model; images anterior & posterior corneal surfaces, iris & the lens; quantifies & displays crystalline lens opacifications; measures IOL vault distance from any eye surface; detects optimal focus for anterior chamber imaging, Holladay Report with Equivalent K

Readings for better IOL Calculation; 1 year free software upgrades.

Joystick alignment w/automatic measurement; compact design; user-friendly; easily updated software; axial, tangential, elevation, refractive, multiple, 3-D maps; comparison maps; small cone/larger measuring zone; contact lens fitting software with fluoro image stimulation.

Provides spherical equivalent, regular astigmatism, asymmetry & higher-order alignment; provides refractive information w/3-mm &

6-mm diameter range; keratoconus screening; Klyce statistics; enhanced height & height change maps; contact lens software included.

Tri-functional autorefractor/keratometer w/corneal mapping & contact lens fluorescein simulation fitting program; interfaces w/Topcon computerized lensmeters and CV-5000 vision tester.

Combined autorefraction; corneal mapping & wavefront aberrometer measurements.

5-in-1 functionality including ray tracing wavefront aberrometry, multi-zone auto refraction, auto-keratometry, pupillometry; topography enabled by EyeSys Vision; provides corneal spherical aberration measurement for

IOL selection; measures lenticular aberrations; keratoconus screening; asphericity index; computer-independent.

Instrument is controlled via PC, which allows for easy networking in your office and integration with your EMR or PM software.

Software allows you to view exams in 2D or 3D. Fully automatic image capture keeps patient testing both fast and simple.

Images are captured automatically with a simple built-in alignment system. Simply position the instrument, guided by the intuitive 3D focusing target, and let the software do the rest.

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SP0709 DIBG-OMD-0630:OMD-OM DIBG 7/3/09 12:40 AM Page 14

Figure 5. The 3D Wrap modeling capability feature of the Optomap

P200C imaging system creates a 3-D model of patients’ eyes, enabling doctors to illustrate the details of IOL placement in cataract and refractive surgery candidates. Doctors can simulate the insertion of different types of lenses, while explaining the benefits of monofocal and multifocal IOLs.

enough how much this technology reinforces the doctorpatient relationship.”

Dr. Stone has had and continues to have similar experiences. “Patients are fascinated with the technology.

They can see their eyes in a way they’ve never seen them before,” he says. “When I show patients before and after treatment photos, their reactions are positive. I give them confidence about how I take care of them, and it means a lot to them.”

Ultra-widefield imaging provides a big wow factor for patients, Dr. Neatrour says. He often uses the 3D

Wrap Patient Orientation tool that creates a 3-D model of patients’ eyes with the Optomap image in the correct position. The feature provides a virtual tour of patients’ eyes to educate them about the anatomy of the eye. “The virtual tour takes patients through the cornea, pupil, the crystalline lens to the back of the eye. This helps them to understand how their condition is affecting their vision.”

Another feature of the 3D Wrap is the modeling capability (Figure 5) that allows doctors to illustrate the details of IOL placement in cataract and refractive surgery patients. “Within this model, doctors can simulate the insertion of different types of lenses, while explaining the benefits of monofocal and multifocal

IOLs. This is shown on screen in a very graphic and easy-to-understand manner. It’s very exciting for patients,” Mr. Anderson says.

Affordable, Profitable Investment

Despite the many invaluable features of the Optos ultra-widefield digital imaging systems, the technology is affordable for retina specialists and general ophthalmologists who have small, medium or large practices.

Unlike some of the more common financing options, such as monthly lease agreements or upfront cash purchases that manufacturers offer physicians to implement new technology, Optos provides an operating lease program called Access Technology NOW (ATN), which cov-

NAME

Accutome

Accutome

DGH Technology Inc.

DGH Technology Inc.

DGH Technology Inc.

Haag-Streit USA

Micro Medical

Devices

Micro Medical

Devices

Paradigm Medical

Industries, Inc.

Dicon Inc.

Paradigm Medical

Industries, Inc.

Dicon Inc.

Reichert Ophthalmic

Instruments

P-2500 P/A

Reichert Ophthalmic

Instruments

Reichert Ophthalmic

Instruments

Sonomed Inc.

Sonomed Inc.

Tomey USA

Tomey USA

ATP Auto

NCT/

Pachymeter

IOPac

Standard

IOPac

Advanced

300AP

300P

SP-100

SP-3000

MODEL

AccuPach VI

PachPen

DGH-55

Pachmate

DGH-550

Pachette 2

DGH-555

Pachette 3

OLCR

P2000

FastPach

P2000

Pachymeter

P-2200

TYPE

desktop handheld handheld desktop desktop slit lamp mounted handheld handheld desktop desktop desktop handheld handheld desktop desktop handheld compact/ desktop

COMPANY

Heine

Heine

Heine

Heine

Heine

Keeler Instruments

Keeler Instruments

Keeler Instruments

Keeler Instruments

Keeler Instruments

MODEL

SIGMA 150

SIGMA 150 K

SIGMA 150 KC

OMEGA 500

OMEGA 200

All Pupil II

Wired

All Pupil II

Wireless

Fison Wired

Spectra Plus

LED

Vantage Plus

Bulb Wired

All claims made by manufacturer

headmount headmount headmount headmount headmount with exclusive headband dimmer control headmount with exclusive headband dimmer control headmount exclusive sport frame red, light blue blue, black headmount with exclusive headband dimmer control

7 oz.

7 oz.

3.25 lbs./

1.4 kg.

3.25 lbs./

1.4 kg

1.17 lbs.

8.8 lbs.

WEIGHT

3.1 lbs.

3 oz.

3.6 oz.

4 lbs.

1.4 lbs.

please call

8 oz.

RANGE

300µ to 999µ

300µ to 999µ

200µ to 1100µ, flap option 95µ to 1100µ

200µ to 1100µ, flap option 95µ to 1100µ

200µ to 1100µ flap option 95µ to 1100µ please call

90µ to 1200µ

8 oz.

3.6 lbs.

90µ to 1200µ

200µ to 1200µ

3.6 lbs.

30 lbs.

120µ to 1200µ tonometer:

0 to 60 mm Hg pachymeter:

200µ to 999µ

300 - 1000 microns

300 - 1000 microns

100µ to 1000µ

100-1000µ

150-1200µ

3 ranges: 150-

350µ, 399-1000µ

& 900-1500µ

TYPE

S-Frame Spectacle

SPOT SIZE

small & large small & large small & large small, medium

& large small, medium

& large small; medium; large small; medium; large large large

Intelligent optics: small, medium, large

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SP0709 DIBG-OMD-0630:OMD-OM DIBG 7/3/09 12:41 AM Page 15

FILTERS

integrated red free; cobalt, yellow and diffuser available integrated red free; cobalt, yellow and diffuser available integrated red free; cobalt, yellow and diffuser available integrated red free, cobalt, yellow and diffuser integrated red free and cobalt; yellow available as substitution built-in UV/safety filter; red free; diffuser built-in UV/safety filter; red-free; diffuser safety filter; red-free; cobalt blue red-free; cobalt blue built-in UV/safety filter, red-free, cobalt blue diffuser no yes yes yes yes no yes yes yes yes yes yes yes

BUILT-IN IOP

CALCULATOR

yes yes no yes yes no yes yes yes yes yes

PORTABILITY

yes yes no yes yes yes yes yes yes yes

POWER

SOURCE

universal lithium battery two AAA batteries

A/C two AA batteries please call dual rechargeable batteries dual rechargeable batteries

A/C

A/C

100V to 240V

5V dc 300mA

5V dc 300mA

A/C

A/C lithium rechargeable battery

100 to 240V

P A C H Y M E T E R S

ADDITIONAL FEATURES

Voice output; gentle touch probe; easy-to-use touch screen; new Digital Signal Analysis for accuracy.

Ergonomically designed to fit comfortably in hand; gentle touch probe; can store & average nine measurements; new Digital Signal Analysis for accuracy.

Carrying case; extra charger; extra batteries included; bilateral mode; totally portable.

Carrying case; extra charger; extra batteries included; bilateral mode; totally portable.

Carrying case; extra charger; extra batteries included; bilateral mode; totally portable.

1µ, real-time continuous readouts; PC, laptop, printer & ethernet.

Easy one-touch operation; auto data capture; advanced pattern batteries recognition; automatic IOP adjustment; corneal waveform display; hi-res color LCD and touch screen controls; wireless print; upgradeable to AP2000 (A-scan and pachymeter); ADA; 200+ patient scans on single charge.

Automatic IOP adjustment; corneal waveform technology batteries (A-scan of cornea); choice of 20 or 50 MHz probe; corneal mapping;

FemtoScan flap measurement mode; patient database integrated desktop software; wireless sync/print, hi-res LCD touch screen controls; LRI software.

Pachymeter system w/LCD monitor; 20 MHz P-probe, probe holder; calibration cylinder; foot switch; A/C adapter; built-in thermal printer.

A-scan pachymeter combination; portable & sleek; 10 MHz A-scan probe & 20 MHz P-probe large LED Display w/auto gain control, 8 axial readings; 6 IOL calculations; built-in thermal printer.

Fully integrated tonometer/pachymeter combining the measurement of IOP & CCT in one instrument; designed in response to numerous clinical studies; presents measurements on simple-to-read color display; automatically computes adjusted IOP value w/out additional data entry.

One-touch measurement; automatically averages readings; built-in calibration; platform based on Palm Powered technology; straight or 45° angled probe.

Glaucoma Risk Calculator derived from the OHTS study. One-touch measurement; storage for up to 1,000 patients; refractive model for accurate measurements in multiple zones; infrared printing; color; backlit screen, straight or 45° angled probe.

A-scan & pachymeter in one unit; small footprint, portable w/touch-screen user interface; built-in probe sensitivity test & auto calibration check; straight or 45°.

Small footprint, portable, w/touchscreen user interface; built-in probe sensitivity test & automatic calibration check; straight or 45° angled

20 MHz probe.

Handheld with built-in printer; IOP calculations and network ready; simple to use and highly accurate; user programmable nomograms.

Color touch screen; tone-assisted measurement & auto-averaging up to 20 readings per location; results of 10 discreet points or up to 25 map points can be displayed, stored or printed.

POWER SOURCE

mPACK lithium ion portable power source wired to stand, desktop, wall-mount and mPACK portable power source wired to stand, desktop, wall-mount and mPACK portable power source wired to stand, wall-mount, and mPACK portable power source or unplugged wireless with mobile transformer or wall charger wired to stand, desktop, wall-mount and mPACK portable power source

3 options in 1: Smart Pack Convertible

(mobile, wall or desk) or Wall Pack standard wireless; lithium ion battery; comes with two batteries desk or wall-mountable transformer lithium ion battery

3 options in 1: Smart Pack

Convertible (mobile, wall or desk) or Wall Pack

PORTABILITY

yes with mPACK portable power source yes with mPACK portable power source yes with mPACK portable power source yes with mPACK portable power source or unplugged wireless yes with mPACK portable power source

B I N O C U L A R I N D I R E C T S

ADDITIONAL FEATURES

Mounted to lightweight, fully adjustable S-Frame — weighs a mere 5.2 oz. Variable pupil scope (for optimized views in pupils 10mm-2mm); carbon fiber frame for durability. Xenon halogen bulb offers a CRI Rating of 98.5 for accurate color rendering. 100% dust-proof.

Guaranteed for life.

Variable pupil scope (for optimized views in pupils 10mm-2mm); carbon fiber frame for durability. Xenon halogen bulb offers a CRI Rating of 98.5 for accurate color rendering.

100% dust-proof. Guaranteed for life.

Variable pupil scope (for optimized views in pupils 10mm-2mm); carbon fiber frame for durability. Xenon halogen bulb offers a CRI Rating of 98.5 for accurate color rendering.

100% dust-proof. Guaranteed for life.

Variable pupil scope (for optimized views in pupils 10mm-2mm); aluminum chassis mounting for all optical components for durability. All features fully integrated.

Xenon halogen bulb offers a CRI Rating of 98.5 for accurate color rendering.

100% dust-proof guaranteed.

The choice for teaching and operating rooms. Integrated teaching mirrors on the left and right. Variable pupil scope (for optimized views in pupils 8mm-1.2mm); aluminum chassis mounting for all optical components for durability.

Lightweight; less than 500 grams; easy to use; brightest; PD range 47 mm-75 mm.

yes/Smart Pack

Lightweight; less than 500 grams; easy to use; brightest; PD range 47 mm-75 mm.

yes, wireless lithium ion battery no yes, lithium ion battery yes/Smart Pack

LED illumination: 10,000 hours of use. 6 hours of on time. PD range 48 mm-76 mm.

IOS Optics w/single step spot & convergence for maximum 3D steropsis; Hi-Mag Retina

Lens to enhance visualization of the fundus; PD range 52 mm-76 mm.

JULY 2009

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SP0709 DIBG-OMD-0630:OMD-OM DIBG 7/2/09 9:56 PM Page 16 ers basic screenings, advanced imaging procedures and/or fundus photography and fluorescein angiography.

The company offers each ATN model with a monthly lease plan that includes service, upgrades and a pay-perprocedure payment plan. “Our most popular financing option is the operating lease model,” says Thomas G.

Daniells, global vice president of marketing at Optos.

“The doctor pays for the Optomap service on a per-procedure pricing basis, so there’s no capital outlay.”

Once physicians introduce the technology, they soon realize its profit potential. However, slight differences exist between retina and general ophthalmology practices when it comes to profitability and sources of revenue.

Retina. The primary source of revenue from the use of ultra-widefield imaging in retina practices comes from medically necessary reimbursable procedures, such as fundus photography and fluorescein angiography. “The financial benefit comes from the incremental use of the technology,” Mr. Daniells says.

At Retina Associates of Kentucky, Drs. Kitchens and

Stone perform approximately 27 fundus photography and 47 fluorescein angiography procedures per month, generating around $130,000 a year. Dr. Stone says that while high-quality patient care is the chief reason for implementing ultra-widefield technology, the system has increased revenue for certain procedures.

“Since we’ve had this technology, I’ve performed

30% more medically necessary fluorescein angiography exams and probably about 10% to 20% more Optomap fluorescein angiography-driven laser surgeries,” he says.

General ophthalmology. Revenue from the use of this technology in general ophthalmology practices comes from reimbursable procedures for diagnosing and monitoring retinal pathology and glaucoma, as well as from annual basic screenings that patients pay for out of pocket. This is the case in Dr. Henderson’s practice. He performs approximately 86 fundus photography procedures and 80 basic screenings per month, averaging

$109,000 a year.

“I do anywhere from two to 10 ultra-widefield imaging exams a day, so most busy comprehensive ophthalmologists will find this technology to be profitable and practice building,” Dr. Henderson says.

Basic screenings are an important revenue stream for general ophthalmology practices, Mr. Daniells says.

“Because basic screenings are done annually, physicians can compare images year after year,” he adds. “If you can do 100 or more of these procedures and charge $50 to $100 a patient per month, you can bring in an additional $5,000 to $10,000 per month. Many practices can bring in an extra $100,000 per year.”

Dr. Neatrour says his practice, which has three locations, expects to perform approximately 394 basic screenings per month, or 4,728 per year, and 297 fundus photography procedures per month, or 3,568 per year.

As a result, projected annual revenue from the machine is $460,880.

“We believe the Optos technology provides a 4-to-1 return on investment to the practice,” Dr. Neatrour says.

“It’s such an incredible technology for you and the patient. You’ll ask yourself why you didn’t introduce it sooner.”

OM

Clarity Medical

Systems

Escalon Digital

Solutions

COMPANY

Canon Medical

Systems

Canon Medical

Systems

Carl Zeiss

Meditec

Carl Zeiss

Meditec

Carl Zeiss

Meditec

Carl Zeiss

Meditec

Carl Zeiss

Meditec

Clarity Medical

Systems

COMPANY

Keeler Instruments

Keeler Instruments

Keeler Instruments

Keeler Instruments

Keeler Instruments

Keeler Instruments

Kowa/Neitz

Kowa/Neitz

Kowa/Neitz

Welch Allyn

Welch Allyn

All claims made by manufacturer

MODEL

Vantage Plus

Bulb Wireless

Standard

Vantage Plus

Bulb Wireless

Slimline

Vantage Plus

LED Wired

Vantage Plus

LED Wireless

Standard

Vantage Plus

LED Wireless

Slimline

Vantage Plus

LED Digital

IO-Alpha

IO-H

IO-TV

12500

Binocular

Indirect

12500-D

Binocular

Indirect

TYPE

headmount with exclusive headband dimmer control headmount with exclusive headband dimmer control headmount with exclusive headband dimmer control headmount with exclusive headband dimmer control headmount with exclusive headband dimmer control headmount with

USB interface small pupil

BIO video BIO; small pupil headmount headmount

MODEL

CR-1

Mark II

CF-1

FF450 Plus

VISUCAM

VISUCAM

VISUCAM

PRO NM

NM/FA

NM/FA FAF

VISUPAC Digital

Imaging and Archive

Management System

RetCam 3

TYPE

non-mydriatic digital fundus camera mydriatic digital fundus camera full-feature fundus camera for color, red free, FA, autofluorescence, and ICG.

Designed for digital interface.

non-mydriatic digital fundus camera for color and red free non-mydriatic digital fundus camera for color, red free and FA non-mydriatic digital fundus camera for color, red free, FA, autofluorescence and ICG digital imaging and archive system digital: premature infant, children & adult anterior chamber

FIELD

OF VIEW

45°

50°

50°, 30°, 20°

45°, 30°

45°, 30°

45°, 30°

50°, 30°, 20°

30º, 80º, 120º,

130º

RetCam Shuttle

E5 digital: premature infant, children & adult anterior chamber digital conversion of mydriatic fundus camera

30º, 80º, 120º

130º any small; medium; large small; medium; large small; medium; large

SPOT SIZE

Intelligent optics: small, medium, large

Intelligent optics: small, medium, large

Intelligent optics: small, medium, large

Intelligent optics: small, medium, large

Intelligent optics: small, medium, large

Intelligent optics: small, medium, large small (19 mm); med. (50 mm); large (80 mm) medium

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FILTERS

built-in UV/safety filter, red-free, cobalt blue diffuser built-in UV/safety filter, red-free, cobalt blue diffuser built-in UV/safety filter, red-free, cobalt blue diffuser built-in UV/safety filter, red-free; cobalt blue diffuser built-in UV/safety filter, red-free, cobalt blue diffuser built-in UV/safety filter, red-free, cobalt blue diffuser

UV; blue; red-free blue; red-free

UV; blue; red-free cobalt blue or yellow; red-free diffuser; cobalt blue or yellow; red-free

POWER SOURCE

standard wireless; lithium ion battery; comes with two batteries slimline wireless - lithium polymer battery; comes with two batteries

3 options in 1: Smart Pack

Convertible (mobile, wall or desk) or Wall Pack standard wireless lithium ion battery; comes with two batteries slimline wireless lithium polymer battery; comes with two batteries wireless slimline polymer battery; comes with two batteries opt. cordless rechargeable battery pack; carrying case opt. cordless rechargeable battery pack; carrying case requires AC power source for

CCD camera; carrying case portable power pack; wall- or desk-mount portable power pack; wall- or desk-mount

PORTABILITY

yes, w/wireless lithium ion battery yes, w/wireless lithium polymer battery yes/Smart Pack yes/wireless lithium ion battery yes/wireless lithium polymer battery yes/first digital ophthalmoscope with USB interface

AC power wall- or desk-mount; portable, rechargeable battery

AC power wall- or desk-mount; portable, rechargeable battery

AC power wall- or desk-mount; portable, rechargeable battery yes

B I N O C U L A R I N D I R E C T S

ADDITIONAL FEATURES

IOS Optics w/single step spot & convergence for maximum 3D steropsis; hi-mag retinal lens to enhance visualization of fundus; PD range 52 mm-76 mm.

IOS Optics w/single step spot & convergence for maximum 3D steropsis; hi-mag retinal lens to enhance visualization of fundus; PD range 52 mm-76 mm.

LED illumination:10,000 hours of use; 17 hours of on time; IOS Optics w/single step spot & convergence for maximum 3D steropsis; hi-mag retinal lens to enhance visualization of fundus; PD range 52 mm-76 mm

LED illumination: 10,000 hours of use; 11 hours of on time; IOS optics with single step spot & convergence of maximum 3D steropsis, hi-mag retinal lens to enhance visualization of fundus. PD range 52 mm-76 mm.

LED illumination: 10,000 hours of use; 6 hours of on time; IOS optics with single step spot & convergence of maximum 3D steropsis, hi-mag retinal lens to enhance visualization of fundus. PD range 52 mm-76 mm.

First digital binocular indirect system. Not old analog. Utilize Vantage Plus LED Digital

Wireless in your office, operating room, and teaching facility or anywhere you want to capture digital images.

Continuously adjustable observation angle; teaching mirror; video capability.

Lightweight; halogen illumination.

Color CCD camera; continuous NTSC output.

yes (w/portable power source)

Video-aligned optics for crystal clear views; lightweight comfort; true small pupil capability; UV/IR filter; 100 hrs. lamp life; widest PD range (49 mm to 74 mm), leather padded headband.

Diffuser filter expands illuminated area; video-aligned optics; for crystal clear views; lightweight comfort; true small pupil capability; widest PD range

(49 mm to 79 mm); leather-padded headband.

ANGIO-

GRAPHY

no yes yes no yes yes yes

FA option no yes

R E T I N A L C A M E R A S

NUMBER/TYPE

OF PORTS

digital digital

2 USB 2.0;

1 primary;

1 Ethernet port n/a

FLASH

STIMULUS

n/a n/a

VIDEO

CAPACITY

n/a n/a

2 main interface ports;

4 digital, video and/or film cameras possible simultaneously internal digital sensor;

USB and ethernet ports internal digital sensor;

USB and ethernet ports internal digital sensor;

USB and ethernet ports

360 W/s

Max yes

Xenon flash lamp; 16 steps no

Xenon flash lamp; 20 steps depending on mode

Xenon flash lamp; 24 steps depending on mode no no

4 digital sensors available; n/a

USB and ethernet ports no flash 2 USB 2.0;

1 primary;

1 Ethernet port import, store

& play video yes no flash n/a yes n/a

ADDITIONAL FEATURES

Full 45-degree retinal images, 2x magnification, 1/4 flash intensinty of the CR-1, illuminated operation panel, Swivel,

5.7” LCD monitor, single joystick operation, 15.1 MP EOS digital SLR camera back, optional imageSPECTRUM software and DICOM software.

Small-diameter mode; color photography; red free photography; fluorescein angiography (FA); proprietary control software outputs retinal imaging information into optional imageSPECTRUM software; 10.1 MP EOS digital

SLR camera back; 2X magnification and DICOM software.

High resolution Zeiss optics. Each angle of view has its own “telescope” lens to optimize image quality at all three magnifications; upper camera port optimized for digital interface.

All-integrated design with onboard database system. Auto-flash, auto-focus, 3.3mm small pupil mode, various preset internal fixation points and stereo capture mode. Large LCD monitor for patient management; alignment, capture and review. Network ready and DICOM conform. Telemedicine ready.

All-integrated design with onboard database system. Auto-flash, auto-focus, 3.3mm small pupil mode, various preset internal fixation points and stereo capture mode. Large LCD monitor for patient management; alignment, capture and review. Network ready and DICOM conform. Telemedicine ready.

All-integrated design with onboard database system. Auto-flash, auto-focus, 3.3mm small pupil mode, external fixation and stereo capture mode. Large LCD monitor for patient management; alignment, capture and review. Network ready and

DICOM conform. Telemedicine ready.

Relational database for complete image management, documentation, progression viewing and image enhancement.

Integrated report generator. Attaches to VISUPAC STAR network, integrates with other ZEISS instrument modalities.

Network ready and DICOM conform.

Fully integrated imaging system that delivers the next generation of ophthalmic visualization, photo documentation and ease of use with a new user interface, redesigned cart and ergonomic hand piece. This advanced system incorporates

DICOM compatibility and image annotation feature. Brilliant, full-color images can be captured for immediate assessment of the retina and anterior chamber; digital images can also be sent electronically to the ophthalmologist for immediate evaluation and longitudinal tracking over time. The RetCam 3 Digital Imaging System makes it possible to facilitate ophthalmic care in the hospital NICU, PICU and operating room.

RetCam Shuttle enables ophthalmic imaging with a convenient, mobile system that can be easily maneuvered into tight spaces and transported to affiliate hospitals. The Shuttle system enables on-site or remote documentation of the pediatric retina and pediatric or adult anterior chamber. Network capability allows transfer of images to any networked system or to a physician for remote evaluation.

Digital imaging for most mydriatic fundus camera; 5 MP CCR sensor; calibrated measurement tools; Auto Eye-Map montage feature; DICOM-compliant; integrates with PACS and OphthaVision AXIS for side-by-side review of images from different modalities.

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CONTINUED FROM PAGE 5

Figure 1. VuMax-II from Sonomed she’s an anterior segment, cornea and external disease specialist. She and Dr. Masket use the UBM Plus

(Accutome, Malvern, Pa.) for many treatments, including anterior segment reconstruction and IOL exchange.

“The UBM reveals the position of the optic, haptics and relationship to the iris, posterior chamber and ciliary body. This helps pre- and postoperatively in patients with malpositioned IOLs requiring exchange,”

Dr. Fram says. “The UBM also may be an excellent tool for evaluating pseudo-accommodating lenses and clarifying the anatomical reasons for phenomena, such as negative dysphotopsia, after uneventful cataract surgery.”

Comparing UBMs

In addition to comparing UBM features side by side

(See “What Are Your Choices?” on page 24-S), practitioners may consider the qualities that manufacturers say differentiate their devices.

Cheng-ning Chang, principal software engineer for

Accutome, explains, “The UBM Plus design is totally different from other UBMs. Like Accutome’s B-Scan

Plus, the UBM Plus is a fully USB device. All of the ultrasound parts except the display are inside the probe.”

Jim O’Connor, marketing manager at Accutome adds, “We developed a self-contained UBM probe. A doctor or tech hooks it to a laptop and it’s ready to go.”

OIS

COMPANY

AMA Optics Inc.

COMPANY

Escalon Digital

Solutions

Escalon Digital

Solutions

Escalon Digital

Solutions

Kowa

Optimed Inc.

Kowa

Optimed Inc.

Kowa

Optimed Inc.

Kowa

Optimed Inc.

Marco

Nidek Inc.

OIS

OIS

OIS

Topcon Medical

Systems

Topcon Medical

Systems

Topcon Medical

Systems

Visual

Pathways Inc.

Visual

Pathways Inc.

Visual

Pathways Inc.

MODEL

E6 Single

E6 Dual

E11

Genesis D

Handheld Fundus

Camera nonMyd 7

Fundus Camera nonMyd

Alpha-D III

Retinal Camera

ARIS 70

ARIS RSVP

TYPE

digital conversion of mydriatic fundus camera digital conversion of mydriatic fundus camera digital conversion of mydriatic fundus camera joystick w/autofiring and infrared measuring compact; tabletop; nonmydriatic color compact; tabletop; nonmydriatic color

VX-10

Two-in-One

Fundus Camera

RTA-5

Retinal Thickness

Analyzer with Digital

Fundus Imaging compact tabletop; mydriatic; nonmydriatic color/FA digital composite

AFC-210/230

Pro Photographer

Winstation

Essential

Winstation

Retina

Winstation

5000

Winstation

11K

TRC-NW8

TRC-NW300 table top, non-mydriatic digital conversion of mydriatic fundus camera digital conversion of mydriatic fundus camera digital conversion of mydriatic fundus camera digital conversion of mydriatic fundus nonmydriatic nonmydriatic

TRC-50DX/

TRC-50DX ICG

ARIS 110 digital/film mydriatic digital; autostereo; non & mydriatic retinal imaging system (4.0 mm pupil for

“semi-auto” mode) digital; autostereo; non & mydriatic retinal imaging

Remote Stereo Viewing

Platform

FIELD

OF VIEW

any any mydriatic:

50°/25°

72x60°

45° any any any

MODEL DESIGN

Retinal Acuity Meter-RAM Handheld, stand alone

All claims made by manufacturer

any

30° horizontal nonmydriatic

45°/20˚ nonmydriatic

45°/30˚ any

45°

45°

20°; 35°; 50° twenty-six

30º fields=120º on retina eleven 30º fields=80º n/a

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SP0709 DIBG-OMD-0630:OMD-OM DIBG 7/3/09 12:41 AM Page 19 yes no no yes yes yes yes no no yes no yes yes yes yes no n/a

ANGIO-

GRAPHY

yes

NUMBER/TYPE

OF PORTS

n/a yes n/a

ILLUMINATION

High illumination

Convergent light n/a n/a

1 primary port; USB 2.0

digital interface

1 primary port; 1-6.1

mega pixel camera back w/USB 2.0 digital interface

1 primary port; 1 USB

2.0 digital interface n/a n/a n/a

2 primary ports;

Upper = digital interface/35 mm/

Polaroid digital

2 USB

1 RGB n/a n/a n/a n/a

1 std: digital CCD digital CCD built-in

2 std: 35 mm or digital CCD

4 USB; RS232; ethernet; printer; sound card

4 USB; RS232; ethernet; printer; sound card n/a n/a

6 W/s to 27 W/s n/a yes

3.3 W/s to 13 W/s yes

12 W/s to 300 W/s

35 W/s to 40 W/s no

35 W/s to 40 W/s no n/a n/a

OPTICS

CCFT

FLASH

STIMULUS

n/a n/a n/a n/a

1 W/s to 25 W/s n/a n/a n/a

VIDEO

CAPACITY

n/a n/a n/a no still; digital only no still; digital only no still; digital only no still; digital only yes yes n/a n/a n/a

R E T I N A L C A M E R A S

ADDITIONAL FEATURES

Digital imaging for most mydriatic fundus camera; 6 MP CCR sensor for excellent image quality in a single cameraback; calibrated measurement tools; Auto Eye-Map montage feature; DICOM-compliant; integrates with PACS and OphthaVision AXIS for side-by-side review of images from different modalities.

Digital imaging for most mydriatic fundus camera; Dual 6MP CCR sensors dedicated for color and monochromatic to provide the highest quality color images and angiograms; calibrated measurement tools; Auto Eye-Map montage feature; DICOM-compliant; integrates with PACS and OphthaVision AXIS for side-by-side review of images from different modalities.

Digital imaging for most mydriatic fundus camera; 11 MP CCR sensor for specialized settings; calibrated measurement tools; Auto Eye-Map montage feature; DICOM-compliant; integrates with PACS and OphthaVision AXIS for side-by-side review of images from different modalities.

Compact flash memory; LCD monitor for picture review; color mydriatic photography; indirect lens holder accessory; VK-2 digital imaging system; EMR connectivity; DICOM; JPG and BMP export for telemedicine; connection to portable notebook computer as well as desktop.

LCD monitor for alignment and focusing; small-pupil mode; preset flash exposures; nonmydriatic color photography; camera has internal working distance and focusing dots; with VK-2 digital imaging system; EMR connectivity; DICOM;

JPG and BMP export for telemedicine; offers connections for both portable notebook and desktop computers.

LCD monitor for alignment and focusing; small-pupil mode; preset flash exposures; color photography; nonmydriatic color photography; fluorescein angiography (FA) photography; red-free photography; camera has internal working distance and focusing dots; VK-2 digital imaging system; EMR connectivity; DICOM; JPS and

BMP export for telemedicine. Ideal for telemedicine applications as it offers connections to both portable notebook and desktop computers.

LCD monitor for alignment and focusing; small-pupil mode; preset flash exposures; color photography; nonmydriatic color photography; fluorescein angiography (FA) photography; red-free photography; camera has internal working distance and focusing dots; VK-2 digital imaging system; EMR connectivity; DICOM; JPG and BMP export for telemedicine.

Versatile and modular imaging system offers a wide range of comprehensive diagnostic testing for early detection and effective monitoring of diabetic retinopathy, AMD, other retinal pathologies, and glaucoma. Capabilities include: retina & disc imaging with individual slit-analysis, quantified topography and 3D disc topography, thickness analysis and RNFL thickness measurement, objective progression analysis with automated image registration for consistent comparative analysis, Dynamic 3-D anatomy imager across full scan area with video presentation capture, and a wellness screening program. Upgrades include: Remote RTA viewer stations and extended customer support programs.

12.8 megapixels for detection of diabetic retinopathy, auto-focus & auto alignment on y-axis or x-y-z axis.

Small-pupil mode, stereo mode, montage capability.

Designed to meet the needs of general ophthalmologists by delivering a good quality image ideal for primary documentation purposes through the use of its 3.2 megapixel sensor. Using OIS Symphony, images can be enhanced and reviewed side by side with imported ophthalmic diagnostic reports produced by other devices in the clinic. Single- click integration with different EMR systems can be provided.

With its 5.3 megapixel sensor, it’s designed to meet the needs of retina specialists who require excellent image quality with more detail for a higher level of diagnostic ability than general ophthalmologists require. Using OIS Symphony, images can be enhanced and reviewed side by side with imported ophthalmic diagnostic reports produced by other devices in the clinic. Single click integration with different EMR systems can be provided.

With its 35-mm, 6-megapixel CCD, it’s designed to meet the needs of more demanding retina specialists who require the best image quality available. Using OIS Symphony, images can be enhanced and reviewed side by side with imported ophthalmic diagnostic reports produced by other devices in the clinic. Single-click integration with different EMR systems can be provided.

With its 35-mm, 11-megapixel CCD, it’s designed for research & teaching institutions that demand the most detailed images on the market today. Using OIS Symphony, images can be enhanced and reviewed side by side with imported ophthalmic diagnostic reports produced by other devices in the clinic. Single-click integration with different EMR systems can be provided.

Color fundus with unique red-free imaging. High quality 10.1 megapixel images with Nikon digital camera. Auto focus, auto capture, auto small pupil detector, stereo mode, and Auto Mosaic and EyeRoute ®

™ . Can be combined with Topcon’s IMAGEnet ™ Lite

Systems for image management and networking. Compatible with today’s most popular EMR systems.

8 megapixel built-in capture device; auto focus, auto exposure and auto shoot; direct printout to digital printer; can be combined with Topcon’s IMAGEnet ™ Lite and EyeRoute ® Systems for image management and networking. Compatible with today’s most popular EMR systems.

Digital-ready; can accept a variety of photo devices; Color fundus, red-free & fluorescein filters. Autofluorescence & ICG filters also included on TRC-50DX ICG. Touch-screen control panel; 21 flash settings; small pupil mode; can be connected to

Topcon’s IMAGEnet system.

Fully automated; pupil-tracking; exposure & focus; telecentric optics; Constant Base Stereo; filter selection for IR, red 1, red 2, red-free & color images; BichromaticImage Navigation; optional glaucoma detection & evaluation S/W internet ready.

New automatic glaucoma detection & evaluation (GDE) software module available as option, featuring Constant

Base Stereo™.

Fully automated; pupil-tracking; exposure & focus; telecentric optics; new automatic glaucoma detection, evaluation (GDE) software module available as option, featuring Constant Base Stereo; filter selection for IR, red 1, red 2, red-free and color images; BichromaticImage Navigation; optional glaucoma detection & evaluation S/W internet ready.

Includes PC, monitor, ArisWare software; stereo emitter & two pair viewing glasses for hands-free stereo viewing of ARIS™ stereo images.

CALIBRATION COMPONENTS

Automatic Meter, Carrier Frames

Pinhole Clip, Occluder

R E T I N A L A C U I T Y M E T E R

SPECIAL FEATURES

The RAM uses bright, calibrated illumination, exact distance & 1-mm pinhole apertures to accurately measure retinal acuity; assesses macular function & forecasts postoperative vision.

Prevents unnecessary surgeries & reduces unexpected poor outcomes. Reproducible & easy.

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SP0709 DIBG-OMD-0630:OMD-OM DIBG 7/2/09 9:57 PM Page 20

COMPANY

Bioptigen, Inc.

MODEL

HHP SDOCT,

Adult Human

TYPE OF LASER

840 nm SLD, standard or broadband

FIELD

OF VIEW

2° x 2°-60° x 60°

Bioptigen, Inc.

HHP SDOCT,

Pediatric

840 nm SLD, standard or broadband

2° x 2°-70° x 70°

Bioptigen, Inc. HHP SDOCT,

Preclinical

840 nm SLD, standard or broadband

0.4° x 0.4°-50° x 50°

Figure 2. UBM Plus from Accutome

The self-contained probe design offers economic advantages, as well as portability, according to Mr.

Chang. “We ensure that your hardware isn’t falling behind,” he says. “If you watch the PCs on the market, you know that every 6 months, the capacity doubles and the price drops. Because the UBM Plus (Figure 2) system simply includes software and a plug-in probe for your computer, you can upgrade your laptop, desktop or monitor relatively inexpensively any time you like, and you won’t need to replace your entire UBM system.”

Barry Durante, president of Sonomed, explains what sets apart his company’s VuMax-II. “With proprietary image-enhancing software, the VuMax-II provides the highest image quality available for the widest range of applications, and the software capabilities and user interface are unmatched in the industry,” he says.

“Doctors can clearly visualize structures that, until now, they’d only seen in textbooks or in the anatomy lab.”

At Quantel, national sales manager Kenneth

Dickerson explains the advantages of the Aviso UBM.

“Quantel offers true 25 MHz and 50 MHz linear scanning probes,” he explains. “The display is unparalleled, and you can readily resize onscreen, not just to one or two fixed magnifications. Doctors are impressed with the DICOM-compatible resolution of the Aviso and with the ClearScan cover (ESI, Inc., Plymouth, Minn.), which provides improved ease and comfort when examining the side of the eye.”

Finally, Mark Zamorski, marketing specialist at

Reichert, Inc., Depew, N.Y., highlights the flexibility of the Reflex UBM (Figure 3). “The Reichert Reflex is truly compact, requiring no added hardware to conduct or review an exam, and the space-saving instrument allows doctors to perform procedures in their offices they previously sent elsewhere,” he says. “Users can put the Reflex on the table stand, mount it flush on a wall, or use a multiposition monitor mount. This flexibility means the unit fits into any practice, and the touch screen permits easy navigation of the Reflex’s intuitive software.”

Gaining Momentum

The use of UBMs is increasingly common among doctors who need to see behind the iris. They’re usually

Carl Zeiss

Meditec

Cirrus HD-OCT 840 nm superluminescent diode

36º x 30º

Carl Zeiss

Meditec

Carl Zeiss

Meditec

GDx

Stratus OCT

Heidelberg

Engineering

Inc.

Heidelberg

Engineering

Inc.

Heidelberg

Engineering

Inc.

Heidelberg

Engineering

Inc.

Heidelberg

Engineering

Inc.

Heidelberg

Engineering

Inc.

Heidelberg

Engineering

Inc.

Heidelberg

Engineering

Inc.

Marco

HRT3 with

Glaucoma

Module

HRT3 with

Retina Module

HRT3 with

Cornea Module

Spectralis

Spectralis

Spectralis

Spectralis

Spectralis

®

®

®

®

®

HRA + OCT

OCT

OCT

HRA

PLUS

FA+OCT

Opko

Instrumentation

RTA 5

Retinal

Thickness

Analyzer w/Digital

Fundus Imaging

Spectral OCT/SLO portable scanning laser polarimeter

20º x 20º

820 nm 26º vertical superluminescent x 20.5º diode horizontal

15° x 15° Confocal scanning laser ophthalmoscope;

670 nm diode laser

Confocal scanning laser ophthalmoscope;

670 nm diode laser

Confocal scanning laser ophthalmoscope;

670 nm diode laser

820 nm diode laser;

870 nm SLD

15° x 15°

400 µm x 400 µm

30º, 20º, 15º

820 nm diode laser;

870 nm SLD

488 nm OPS laser;

790 nm diode laser;

820 nm diode laser

488 nm OPS laser;

820 nm diode laser;

870 nm SLD

488 nm OPS laser;

790 nm diode laser;

820 nm diode laser;

870 nm SLD scanning laser technology;

Class II;

Solid State;

532 wavelength;

Laser

830 nm superluminescent diode

55°, 35°, 30°, 25°,

20°, 15°; composite images up to 120°

55°, 35°, 30°, 25°,

20°, 15°; composite images up to 120°

55°, 35°, 30°, 25°,

20°, 15°; composite images up to 120°

55°, 35°, 30°, 25°,

20°, 15°; composite images up to 120° posterior pole;

20x20°; Peripapillary

(inc. post. pole);

35x20°; Optic Disc

10x10°; Fundus imaging to 40x60° or 60x72° variable up to

31 degrees

All claims made by manufacturer

20-S

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SP0709 DIBG-OMD-0630:OMD-OM DIBG 7/3/09 12:42 AM Page 21

Macula and retinal layers, RNFL and optic nerve head. optic nerve head;

RNFL macula & peripheral retina anterior segment & corneal layers; epithelium to endothelium retinal layers, RNFL, posterior pole retinal layers, RNFL, posterior pole & wideangle fundus images posterior pole & wideangle fundus images retinal layers, RNFL, posterior pole & wide angle fundus images retinal layers, RNFL, posterior pole & wide-angle fundus images posterior pole; optic nerve head and peripapillary; fundus & perimacular; macular thickness w/actual

3D anatomical crosssectioning fovea, retina, inner/outer retinal layers, RPE, posterior pole, optic nerve, RNFL

AREA OF RETINA

ANALYZED

Full retinal thickness and RNFL; contoured

C-slices of retinal layers; vessel flow using Doppler

Full retinal thickness and RNFL; contoured

C-slices of retinal layers; vessel flow using Doppler

Contoured C-slices of retinal layers; vessel flow using

Doppler

Macula and retinal layers; segmented

RPE and ILM layers; RNFL nerve fiber layer

R E T I N A L S C A N N E R S

PRINTOUT

DETAIL

SDOCT image, study information

SDOCT image, study information

SDOCT image, study information

Data from single macula cube scan provides: high resolution cross-hair image; 3D layer map of ILM and RPE; 3D retinal thickness map; 3D cube image; LSO fundus image;

OCT fundus image with overlay of thickness map, OCT fundus or slab. Comparison to normative data. Adjustable five-line raster scan provides exquisite high-definition B-scan images. Optic disc scan provides RNFL thickness map and deviation map with comparison to normative data, TSNIT graph and OU analysis.

GPA analysis shows comparison of RNFL thickness measurements from the Optic Disc Cube scan over time and determines if statistically significant change has occurred. The results show event analysis, trend analysis and a quantified rate of change.

Deviation map; thickness map; NFI score; TSNIT parameters; TSNIT graph; quality score; patient & practice information; single & serial analysis formats.

Objective RNFL & retinal thickness; normative data comparison for RNFL & macula thickness; optic nerve head analysis w/disc, cup & rim measurements & ratios. GPA Advanced Serial Analysis for RNFL.

Comprehensive optic nerve reports: OU w/cup, rim, RNFL & asymmetry analysis

Retina reports: Graphic & statistical analysis of retina with 2D & 3D topography; thickness and reflectance maps and trend analysis.

In-vivo histology & semi-automatic endothelial cell count analysis; live movie capture

ADDITIONAL FEATURES

HHP SDOCT provides high-resolution, high-speed SDOCT imaging in a hand-held, robust, and easily transportable solution that is ideal for clinical, bedside, and operating room imaging. Advanced spectrometer design permits single-shot, falloff-mitigated imaging at 17 frames per second. Standard resolution approaches 4.5 µm in tissue and the broadband option affords < 3 µm ultra-high resolution imaging. Fully customizable scan geometry and density enable pathology-targeted imaging. Registration, averaging, and volume rendering ehance data display.

On-screen calipers provide manual distance measurements. Open access to both raw and processed data.

Optional accessories include the telecentric cornea bore, HHP microscope base, and chin-rest mounted scanner.

HHP SDOCT provides high-resolution, high-speed SDOCT imaging in a hand-held, robust, and easily transportable solution that is uniquely designed for pediatric imaging. Custom imaging bore optics provide unparalleled resolution in premies, neonates, infants, toddlers, and children. Advanced spectrometer design permits single-shot, falloff-mitigated imaging at 17 frames per second for fast alignment and imaging in uncooperative patients.

Standard resolution approaches 4.5 µm in tissue and the broadband option affords < 3 µm ultra-high resolution imaging. Fully customizable scan geometry and density enable pathology-targeted imaging. Open access to both raw and processed data. Optional accessories include the telecentric cornea bore, HHP microscope base, and chin-rest mounted scanner.

HHP SDOCT provides high-resolution, high-speed SDOCT imaging in a hand-held, robust, and easily transportable solution that is uniquely designed for preclinical research, enabling true bench-to-bedside imaging with one system. Optimized imaging optics are available for mouse (FOV given here, lateral resolution less than 3 µm), rat, and macaque. Uniquely designed small-animal imaging mount enables high throughput imaging of mouse and rat models with rapid, accurate alignment every time. All benefits of the HHP SDOCT Adult Retina system plus solutions for preclinical research. Optional accessories include mouse or rat bite bars for fine alignement and motion reduction, telecentric cornea bore, and HHP imaging base.

Designed for efficiency. Easy and fast scan acquisition. Small footprint. Modern integrated design fits in the corner of a room. Anterior segment imaging provides visualization of the angle and central corneal thickness measurement. No add-on lens is required. Auto-center feature aligns peripapillary circle for RNFL analysis.

RNFL repeatability SD of 1.3 µm in normal subjects and 1.2 µm in patient eyes. Unique Fovea Finder function ensures accurate registration and excellent repeatability of macular thickness measurements. Central Subfield

Macula Thickness repeatability SD of 2.2 µm.

Operator independent; has intuitive printout; no dilation required; less sensitive to variations in disc size than are other instruments. Ideally suited for those specializing in glaucoma or building a glaucoma practice.

Provides direct cross-sectional images & retinal measurements; images & analyzes macular thickness, retinal nerve fiber layer (RNFL) & optic disc; FDA-cleared normative data for RNFL & macula provide age-matched reference values for comparison w/normal population. Now GPA Advanced Serial Analysis identifies statistically significant change and rate of change to RNFL.

The HRT Glaucoma Module with TruTrack option for management of the glaucoma patient. Use in combination with other HRT modules for retina and cornea applications.

™ Image Alignment Technology provides clinicians with a powerful

Proprietary TruTrack ™ Image Alignment Technology enables repeat scanning and alignment of images essential for tracking change with retinopathies, such as DME, CME, AMD. Network applications and viewing licenses available.

The Rostock Cornea Module adds confocal laser microscopy to the HRT system, enabling capture and review of finely detailed images of the cornea’s cellular structure, from epithelium to endothelium.

Displays infrared, OCT, posterior pole and RNFL analyses.

At 40 kHz, Spectralis ® OCT scans 100 times faster than time-domain OCT. Proprietary TruTrack tracking enables precise repeat scanning and noise reduction.

™ active eye

Displays infrared, OCT, posterior pole and RNFL analysis.

Displays infrared, red-free, fundus autofluorescence, FA, ICGA images

Displays infrared, red-free, fundus autofluorescence, FA, OCT, posterior pole & RNFL analysis

Displays infrared, red-free, fundus autofluorescence,

FA, ICGA, OCT, posterior pole & RNFL analysis.

At 40 kHz, Spectralis ® OCT PLUS scans 100 times faster than time-domain OCT. Proprietary TruTrack ™ active eye tracking enables precise repeat scanning, noise reduction and widefield imaging. Upgradable to FA+OCT and

HRA+OCT models.

TruTrack ™ Image Alignment Technology enables precise tracking over time, noise reduction, and stunning widefield pan-retinal images in real time. It produces fundus images of the retina and choroid unseen in digital or film photography.

At 40 kHz, Spectralis ® FA+OCT scans 100 times faster than time-domain OCT. Proprietary TruTrack ™ active eye tracking enables precise repeat scanning, noise reduction and widefield imaging. Upgradable to HRA+OCT model.

Spectralis ® HRA+OCT is the ultimate combination platform. It combines the best of cSLO fundus imaging and angiography with SD-OCT. It is the only SD-OCT with TruTrack repeat scanning, noise reduction and widefield imaging.

™ active eye tracking, which enables precise

Fundus imaging; retinal thickness w/actual retinal image slits; topography; optic nerve head mapping; color fundus images; 2D & 3D thickness maps; topography printouts; RNFL cross-section charts; horiz./vert. crosssection graphs/normative probability maps; progression analysis w/deviation indices; Dynamic 3D anatomical cross-sections.

Versatile & modular imaging system; wide range of comprehensive diagnostic testing for early detection & effective monitoring of diabetic retinopathy, AMD, other retinal pathologies & glaucoma. Capabilities include: retina & disc imaging w/individual slit analysis; quantified topography & 3D disc topography; thickness analysis & RNFL thickness measurement; objective progression analysis w/automated image registration for consistent comparative analysis; dynamic 3D anatomy image across full scan area w/video presentation capture & wellness screening program.

Combined OCT B-Scan and confocal SLO images with exact Fully automated Auto-focusing and Auto Coherence for quick and easy operation; 27,000 A-scan/sec, location/orientation of the OCT image on the SLO Fundus image, “RETEST” feature automatically ensures repeated location of the OCT scans and microperimetry testing.

Combined topography thickness report with up to 6 high resolution radial B-Scan OCT images, “Auto-Compare” report of multiple topography maps (progression/regression plot) including location of retinal thickness changes overlaid on the

SLO Fundus image. High resolution raster OCT scan and

Optional - microperimetry retinal function with real-time SLO tracking. Optional cornea/anterior segment

OCT imaging and analysis of cornea and anterior segment. macula scan. Optic nerve head & RNFL analysis including

(over time) “Auto-Compare” regression map of multiple scans.

User selected “customize reports.”

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COMPANY

Optos

Optos

Optos

Optos North

America

Optovue, Inc.

MODEL

P200

P200C

P200MA

Optomap

Retinal Exam

RTVue

TYPE OF LASER

scanning laser technology; low-powered red (633 nm) and green (532 nm) lasers scanning laser technology; low-powered red (633 nm) and green (532 nm) lasers scanning laser technology; low-powered red (633 nm); green (532 nm) and blue (488 nm) lasers scanning laser technology; low-powered

(633 nm) and

(532 nm) lasers

840 nm superluminescent diode

FIELD

OF VIEW

200°

200°

200°

200°

32 degrees x 23 degrees

Topcon Medical

Systems

3D OCT-1000 840 nm superluminescent diode

45º

For information on the latest OCT advances and h

Figure 3. Reflex UBM from Reichert attracted by UBM studies and then won over by the images. Manufacturers and users alike predict that UBM use will increase as more doctors are exposed to the technology.

“This technology is the first and only complete anterior segment imaging device to evaluate anterior chamber anatomy, as well as the sulcus and ciliary body — places we can’t normally see,” Dr. Ahmed says.

“It’s become a very valuable and easy adjunct in surgical assessment. And the ClearScan cover has been a huge improvement in convenience and patient comfort.”

Mr. Durante explains, “Differential diagnosis is easily accomplished with UBM. The devices have become much more user-friendly in the last 2 to 5 years, and the device’s multiple capabilities for many specialties are attractive to large and small practices alike.”

Mr. Dickerson agrees, adding that enhanced ease of use and financial incentives will give UBMs a boost.

“The new ClearScan cover eliminates the drawbacks of the old scleral shell, or shell-and-gel technique, in terms of setup, patient comfort, procedure time, safety and sterility,” he says.

“And not only is this a Medicare-reimbursable procedure, it also will help doctors better determine if and when they should refer patients.”

Dr. Fram has seen that UBM technology helps keep patients — and billable services — inside her doors. “It’s amazing to have this technology,” she says. “Previously, we’d have to send these cases to a university for testing.

However, now we can provide this state-of-the-art care in the private office setting.” OM

COMPANY

Marco

M&S

Technologies Inc.

Precision Vision

Precision Vision

MODEL

SSC-350

HACSS-Holladay

Automated Contrast

Sensitivity System

Chart (Cat. No. 2126)

Glare Filter (Cat. No. 2147)

Low Photopic Filter

(Cat. No. 2148)

Portable Illuminated Cabinet

(Cat. No. 914)

ETDRS Illuminator Cabinet

(Cat. No. 2425)

TYPE

stand alone; 1.1 meter test distance from exam chair

Automated CSF system, including hardware & software. Can be integrated with Smart

System 2020 visual acuity system.

translucent letter chart; back-illuminated in portable fluorescent light box back illuminated portable fluorescent light box

ALIGNMENT

MONITOR

n/a n/a n/a n/a

Precision Vision

Precision Vision

Precision Vision

Precision Vision

Stereo Optical

Co. Inc.

Rabin Super Vision Chart

(Cat. No. 2128)

NVG Filter (Cat. No. 932)

Colenbrander Mixed Contrast

Chart (Cat No. 4071) and

Colenbrander Mixed Contrast

Chart (Cat. No. 4070)

Translucent letter chart, backilluminated must be used with

Cat. No. 914 cabinet. NVG filter is used to simulate military night vision goggles.

n/a

Chart 4071 is a translucent letter n/a chart, back-illuminated to be used with Cat. No. 2425 Cabinet. Chart

4070 is an opaque mixed contrast letter and text chart in near, computer and intermediate distance test

PVVAT (Cat. No. 6001 - 6008) Computerized Visual Acuity

Software with Contrast

Sensitivity testing n/a

IVA (Cat. No. 6100) n/a

Functional Vision Analyzer

Interactive Computerized

Visual Acuity Software with

Contrast Sensitivity testing closed vision tester w/EyeView software yes

All claims made by manufacturer

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R E T I N A L S C A N N E R S

AREA OF RETINA

ANALYZED

central pole & periphery; up to 200° internal scan; more than 80% of the retina w/standard gaze; up to 90% of the retina w/eye steering central pole & periphery; up to 200° internal scan; more than 80% of the retina w/standard gaze; up to 90% of the retina w/eye steering central pole & periphery; up to 200° internal scan; more than 80% of the retina w/standard gaze; up to 90% of the retina w/eye steering central pole & periphery; up to 200° internal scan; more than 80% of the retina w/standard green gaze; up to 90% of the retina w/eye steering

PRINTOUT

DETAIL

Includes image enhancements, such as area of interest magnified; individual laser separations; image annotations

& gray scale detail views, ResMax mode for enhanced central pole detail, as well as 3D Wrap patient orientaton tool for enhanced patient education

Includes image enhancements, such as area of interest magnified; individual laser separations; image annotations & gray scale detail views, ResMax mode for enhanced central pole detail, as well as 3D Wrap patient orientaton tool for enhanced patient education

Includes image enhancements, such as area of interest magnified; individual laser separations; image annotations & grayscale detail views, ResMax mode for enhanced central pole detail, as well as 3D Wrap patient orientaton tool for enhanced patient education

Includes image enhancements, such as area of interest magnified; individual laser separations; image annotations

& grayscale detail

Ganglion Cell Complex, Ganglion cell complex analysis, progression analysis, symmetry

RNFL, ppRNFL, retinal layers, analysis, retinal thickness, retinal layer segmentation, optic optic nerve head, macula, nerve head analysis with parameters, 3D imaging, Normative posterior pole Database comparison

Macula and retinal layers;

RNFL; RPE; ILM; IS/OS;

Bruch’s membrane

Retinal thickness map; 3D; B scan; compare; fundus image; retinal layer segmentation

ADDITIONAL FEATURES

Green laser scans from sensory retina to RPE; red laser scans from RPE to choroid; Proprietary review software enables image magnification; contrast, brightness and gamma adjustment; annotation, notes; individual laser separation views; P200 produces optomap ® Retinal Exam procedures to support screening and wellness examinations (20 microns) and optomap® plus Medical Retinal Exam (17 microns) with enhanced features supporting medically necessary reimbursable procedures.

Green laser scans from sensory retina to RPE; red laser scans from RPE to choroid; Proprietary review software enables image magnification; contrast, brightness and gamma adjustment; annotation, notes; individual laser separation views; P200 produces optomap ® Retinal Exam procedures to support screening and wellness examinations (20 microns) and optomap® plus Medical Retinal Exam (14 microns, RexMax = 11 microns) with enhanced features supporting medically necessary reimbursable procedures.

Green laser scans from sensory retina to RPE; red laser scans from RPE to choroid; Proprietary review software enables image magnification; contrast, brightness and gamma adjustment; annotation, notes; individual laser separation views; P200 produces optomap examinations (20 microns); optomap ®

® Retinal Exam procedures to support screening and wellness plus Medical Retinal Exam (14 microns, RexMax = 11 microns) with enhanced features supporting medically necessary reimbursable procedures, and optomap® fa

Angiography Procedure.

Green laser scans from sensory retina to RPE; red laser scans from RPE to choroid; v2.1 software enables image magnification; contrast; brightness & gamma adjustment; annotation, notes; individual laser separation views; Optomap ® plus Medical Retinal Exam for reimbursable procedures.

RTVue comes with the largest OCT normative database for glaucoma and retina, and with the exclusive

Ganglion Cell Complex (GCC) analysis. In addition to imaging and analyzing the posterior pole, the RTVue also images the cornea and anterior segment — all in one device.

Only SD-OCT with an integrated non-mydriatic retinal camera. True 3-D view of the retina, featuring Topcon’s

TrueMap ™ software. Pin-point Registration ™ allows doctor to map exact location of the OCT image with the the fundus image. Comes with EyeRoute ® On Board, Topcon’s image management system, pre-loaded on it.

nd how to incorporate this technology into your practice, see article beginning on page 20

CONTRAST

SENSITIVITY TYPE

4 contrast levels on all available optotypes

(Snellen, ETDRS, numbers, tumbling E and children’s charts)

US Patent Number: 7,354,155.Sinusoidal bulls-eye displayed at photopic (85cd/m2)

& mesopic (3cd/m2) levels. FDA required protocol from 18 down to

1.5 cycles per degree.

DAY/NIGHT TARGET

ILLUMINATION

yes; normal and low photopic luminance viewing conditions day & night includes

NDF filter to reduce luminance levels from

85 cd/m2 to 3cd/m2.

C O N T R A S T S E N S I T I V I T Y T E S T S

DAY/NIGHT GLARE

LUMINANCE

Day & Night Monocular and Binocular glare;

3 glare levels yes, 3 glare levels

ADDITIONAL FEATURES

Wireless remote control; 27 chart types: letter, numbers, tumbling “E,” ETDRS, color, stereo, phorias, binocular balance children’s charts: ability to isolate single character, horizontal line and vertical line on all. Compatible with EPIC or TRS refraction system.

Fully automated system eliminates technician bias; includes Quick Test program for repeat patient screening thereby minimizing test time; automatic data collection & export feature into M&S DataRight Services. Complies w/ANSI & ISO standards, FDA guidelines. Test time 5 minutes per eye.

letter chart consisting of 20/50 letter size at 13.1 ft.; contrast decreases by row in 0.25 logarithmic steps

Wide selection of high and low contrast charts sold separately

8 different Log CS levels plus high contrast acuity yes; includes normal & low photopic luminance viewing conditions

The 914 Cabinet is self illuminated with ND filters available. The 2425 ETDRS

Cabinet is self illuminated at

160 cd/m 2 with available mesopic filter for 3 cd/m 2 .

yes; includes glare filter w/central low luminance target surrounded by higher luminance glare no glare no glare

Includes normative values & by-letter score sheet for precise clinical & research applications.

Precision Vision’s 914 Cabinet is approved and presently the only illuminated cabinet used by all branches of the US Armed Forces. Portable and storage pockets in back with an optional adjustable base. The ETDRS 2425 is used by the National Eye Institute and FDA-approved as the world’s first ETDRS illuminated cabinet for full and low contrast testing. Can be wall mounted or used with an optional adjustable base.

Developed by Jeff Rabin, OD, PhD, LTC US Army (Ret.). Charts are useful in general practice and research.

High contrast (black) and

20% Weber low contrast

Highly adjustable contrast levels in 6 different optotypes crowded or uncrowded in single presentation, one line or ETDRS chart layout

Multiple contrast levels in 6 different optotypes crowded or uncrowded in single presentation, one line or ETDRS chart layout

3-choice, 5-frequency sine-wave (FACT) or low-contrast letters (CAT)

Intended for use in well-lit offices no glare Developed by August Colenbrander, MD, this test provides high-contrast targets on left and low-contrast targets on the right for fast and effective contrast testing with uniform illumination and distance.

Self illuminated for use with or without lights

Self illuminated for use with or without lights day & night homogenous illumination (continually calibrated to ensure accuracy)

Glare source sold separately

Glare source sold separately day & night binocular glare testing

2 glare levels (continually calibrated to ensure accuracy)

Precise calibration of contrast levels, brightness, sizes, and spacing in selectable progression; logarithmic ETDRS or traditional Snellen on a high quality display/computer. Complies with ANSI & ISO standards.

Automated, interactive computer program for determination of peak contrast sensitivity and a low contrast acuity at various contrast levels. A high quality display that is calibrated for low-contrast testing. Complies with ANSI & ISO standards.

Features distance/near lens system; new unsurpassed homogenous illumination; only new vision tester that complies w/American National

Standards Institute std. Z80.21-1992 (R1998); includes EyeView software demonstrating contrast sensitivity results by pictures.

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What Are Your Choices?

Several ultrasound biomicroscopes (UBMs) are

currently on the market, providing variety in terms of portability and features.

• Aviso (Quantel). The Aviso has many ergonomic features to facilitate image acquisition, such as the intuitive, accessible controls and a touch screen. Its software also helps technicians make measurements, marks and comments.

Two proprietary software features, Cineloop and

Varigain, provide automatic image recording and adjustable gain on images, respectively. The Aviso is also portable, so eyecare practitioners can move it between clinics if necessary.

• Reflex UBM (Reichert). Reichert describes the

Reflex as “ultra-compact” and “ultra-easy.” These terms reflect the device’s compact size and easy setup, as well as its touch-screen interface for analysis tools (a keyboard and mouse are also included). Like many new devices, the Reflex has software tools designed to make data and measurement acquisition achievable without extensive training.

The probe design of the Reflex enables technicians to perform the scan without a water bath, while the patient sits or reclines, and a foot pedal enables hands-free image acquisition. The Reflex has a 35 MHz or 50 MHz transducer. The Reflex records 60 seconds of data per eye and six images per scan, and users can export files in AVI, JPEG or

DICOM formats.

• UBM Plus (Accutome). Most UBMs have a cart, an arm and a monitor, but in the UBM Plus, all of the ultrasound technology is contained in the freehand probe, which connects by wire to a laptop or desktop computer. According to the manufacturer, this eliminates signal loss for sharper images, and the device’s

15-micron electronic resolution is the highest available.

The UBM Plus utilizes what Accutome calls Smooth

Zoom technology, which performs 2x full image zoom either during a scan or when you review the images later. You can also capture 34-second film loops.

Doctors can use built-in report templates, easily print or share information, and store images compactly. Accutome continually enriches its software and works to make the UBM Plus easy to use.

• VuMax-II UBM (Sonomed). The PC-based

VuMax-II system has an 18.5-mm x 14-mm deep scanning field to capture the entire anterior segment in one scan, which enhances intraocular measuring.

Technicians can take 45-second video, adjusting features, such as gain, TGC, contrast, zoom and freeze. The UBM also exports both AVI and JPEG file formats.

Like all imaging devices today, UBMs require the right software to help doctors interpret vast amounts of data. For the VuMax-II, this includes software, such as post-processing tools, auto measuring and image-enhancing focus software. In addition, the

VuMax-II’s handpiece can be used with a 35 MHz or

50 MHz transducer.

COMPANY

Stereo Optical

Co. Inc.

Stereo Optical

Co. Inc.

Stereo Optical

Co. Inc

VectorVision Inc.

MODEL

Optec 5500(P)

Optec 5000(P)

Optec 1000P

CSV-1OOO

TYPE

stand-alone vision tester; requires 2 sq. ft.

stand-alone vision tester; requires 2 sq ft.

stand-alone stand-alone; 8 to 4 meter test distance from exam chair; non-view-in

ALIGNMENT

MONITOR

yes yes yes

3 choice;

4 frequency sine wave

COMPANY

Canon Medical

Systems

Gulden

Ophthalmics

Haag-Streit USA

Haag-Streit USA

Haag-Streit USA

Keeler

Instruments

Kowa

Optimed Inc.

Kowa

Optimed Inc.

Marco

Marco

Paradigm Medical

Industries

Reichert

Ophthalmic

Instruments

Reichert Ophthalmic

Instruments

MODEL

TX-F Full Auto

Tonometer

Schiotz

Goldmann Applanation

Tonometer AT 870

Goldmann Applanation

Tonometer AT 900

Perkins Mk2 Handheld

Applanation Tonometer

Pulsair Easy Eye

Noncontact Tonometer

KT-800 Noncontact

Tonometer

HA-2

M3

NT-510

Ocular Blood

Flow Analyzer

(BFA)

Model 30

Pneumatonometer

Tono-Pen XL

TYPE

fully automated; just press start contact applanation applanation applanation noncontact noncontact applanation noncontact noncontact applanation contact applanation contact applanation noncontact Reichert Ophthalmic

Instruments

PT100 Portable

NTC

Reichert Ophthalmic

Instruments

Reichert Ophthalmic

Instruments

ATP Auto

NCT/Pachymeter

Ocular Response

Analyzer

Tono-Pen AVIA Reichert Ophthalmic

Instruments

Reichert Ophthalmic

Instruments

Shin-Nippon

Shin-Nippon

Reichert 7

B-45

C-84

CT-80 Topcon Medical

Systems

Woodlyn Inc.

#44000 R900

Ziemer Ophthalmic

Systems

Ziemer Ophthalmic

Systems

PASCAL Dynamic

Contour Tonometer

Wireless PASCAL

Dynamic Contour

Tonometer

All claims made by manufacturer

MEASUREMENT

RANGE

0 to 60 mm Hg

0 to 127.5 mm Hg

0 to 80 mm Hg

0 to 80 mm Hg n/a

7 to 50 mm Hg

0 to 60 mm Hg

0 to 60 mm Hg

0 to 60 mm Hg

0 to 60 mm Hg

IOP measurement: 6 high: no upper limit

5 to 80 mm Hg

5 to 80 mm Hg

0 to 60 mm Hg noncontact noncontact

0 to 60 mm Hg

1 to 60 mm Hg contact applanation noncontact applanation applanation noncontact applanation/

Goldmann contact dynamic color contact dynamic color

5 to 55 mm Hg

7 to 60 mm Hg

(ISO 8612 tonometer standard)

0 to 80 mm Hg

0 to 80 mm Hg

0 to 60 mm Hg

0 to 80 mm Hg

5 to 200 mm Hg

5 to 200 mm Hg

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SP0709 DIBG-OMD-0630:OMD-OM DIBG 7/2/09 9:59 PM Page 25

)

CONTRAST

SENSITIVITY TYPE

3-choice, 5-frequency sine-wave

(FACT) or low-contrast letters (CAT)

3-choice, 5-frequency sine-wave (FACT) or low-contrast letters (CAT)

3-choice, 5-frequency (FACT) or low-contrast letters (CAT) self-calibrated light instrument (patented)

DAY/NIGHT TARGET

ILLUMINATION

day only (factory calibrated); homogenous illumination day only (factory calibrated); homogenous illumination day only (factory calibrated) self-calibrated light box (patented)

C O N T R A S T S E N S I T I V I T Y T E S T S

DAY/NIGHT GLARE

LUMINANCE

no glare no glare

ADDITIONAL FEATURES

Features distance/near lens system; choose from 150 different tests that can include distance/near Snellen acuity (ETDRS format) color, stereo test, lateral/vertical phoria & potential acuity.

Features distance/near lens system; choose from 150 different tests that can include distance/near Snellen acuity (ETDRS format) color, stereo test, lateral/vertical phoria & potential acuity.

Distance only w/Snellen acuity.

no glare yes Wireless remote control; interchangeable test faces; everything from contrast gratings to pediatric symbols; ETDRS acuity.

automatic automatic manual automatic manual manual manual/ automatic manual manual manual

ALIGNMENT

full auto/ manual manual manual manual manual manual

3D automatic alignment manual manual or automatic manual or automatic manual manual manual manual tabletop/instrument stand 30 lbs.

tabletop/instrument stand 30 lbs.

handheld, portable

71 g.

tabletop/instrument stand 30 lbs.

slit lamp accessory,

1.42 lbs.

slit lamp accessory,

1.4 lbs.

about 18 kg or

39.7 lbs.

mounts to slit lamp;

1.33 lbs.

1 lb.

1 lb.

T O N O M E T E R S & B L O O D F L O W A N A LY Z E R S

PORTABILITY/WEIGHT

45.2 lbs.

OPTIONS SPECIAL FEATURES

Up to 10 measurements per eye; includes automatic shifting between 30/60 mm Hg; IOP warning; extremely soft air puff; RS232C data output.

Very portable; lightweight; great for emergency use; inexpensive; durable.

0.5 lbs.

slit lamp mounted slit lamp mounted handheld yes, weighs less than 9 lbs.

tabletop/instrument stand 39.6 lbs.

handheld/battery operated 0.53 lbs.

desktop unit automatic (55 lbs.) desktop unit (42 lbs.) portable; console: 12 lbs.

workstation: 23 lbs.

12 lbs.

2.25 oz.

handheld/portable;

2.7 lbs.

carrying case; rechargeable battery optional 3x long eye relief for presbyopic users optional 3x long eye relief for presbyopic users printer, rechargeable battery comes std.

printer; slit-lamp adaptability tonography wireless IR printer; carrying case; rechargeable battery; charging base internal printer

Wall, desk or slit-lamp mountable; accuracy within ±0.6 mm Hg Goldmann, Soft Puff technology & built-in printer.

3-D auto alignment function; soft airflow, no measurement range switching; eyelid obstruction monitor; electronically operated chin rest; built-in video camera & TFT color 5.6 monitor for ease of use.

Softer air puff; measures pupil size & corneal size; autorefractor/keratometer, adjustable monitor; motorized chin rest; high speed measurements; interfaces w/EPIC, TRS & Evolution.

Advanced soft-air pulse control; automatic safety lock.

Identify POAG & NT; identify glaucoma suspects w/low pulsatile ocular blood flow (POBF); identify central retinal vein occlusions; monitor & quantify the effect of glaucoma treatment plans; measure IOPs & POBF by volume; monitor & manage current systemic drug therapy.

An easy-to-use instrument providing fast accurate tonometry & opt. tonography functions. The system measures

IOP in the range of 5 to 80 mm Hg. Forty readings per second are recorded & charted, including ocular pulse.

The chart recorder produces a permanent printout of the desired test for patient files.

An easy-to-use portable, handheld instrument providing fast & accurate intraocular pressure readings w/accuracy comparable to the Goldmann tonometer. Harvesting data at a rate of 500 samples per second, the Tono-Pen gently contacts the cornea & displays the average of four independent readings, along w/a statistical coefficient.

Cordless, wireless data transmission; patient eye illumination; demo puff; icon-based operating system; macroview of eye.

n/a internal printer n/a n/a optional adjustable instrument table carrying case; rechargeable batteries wireless printer; carrying case; rechargeable batteries

Includes built-in ultrasound pachymeter.

Measures IOP & Corneal Hysteresis (CH), the world’s first indicator of corneal biomechanical properties, & IOPcc

(corneal compensated IOP), which is less affected by corneal properties than traditional methods of tonometry.

Portable, light & user-friendly. Provides fast measurements, strongly correlated w/Goldmann tonometry.

Long battery life, w/no need for calibration. Ergonomic design provides maximum comfort & ease of use & large LCD screen display readings on both sides of instrument.

Demo puff, icon-based operating system, softest puff in the industry, full auto-alignment and 1-touch operation.

Fits most tower-type slit lamps.

Fits most compact-type slit lamps.

Built-in video camera & monitor; auto measurement, digital display & built-in printer; triple safety function; dual sensor system & 30% faster interval time.

Provides highly accurate IOP; Ocular Pulse Amplitude & Quality score; IOP not affected by corneal biomechanical properties; validated in in-vivo clinical trials; easy to use; www.pascal-tonometer.com

Provides highly accurate IOP; Ocular Pulse Amplitude & Quality score; IOP not affected by corneal biomechanical properties; validated in in-vivo clinical trials; easy to use; digital display w/option of using wireless printer;

EMR ready.

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