User`s Manual
---------------------------------------------------------------- Applanation Tonometer HT-5000
User’s Manual
Applanation Tonometer HT-5000
1
2
Applanation Tonometer HT-5000
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IMPORT NOTICE
This product may malfunction due to electromagnetic waves caused by portable
personal telephones, transceivers, radio-controlled toys, etc. Be sure to avoid having
objects such as, which affect this product, brought near the product.
The information in this publication has been carefully checked and is believed to be
entirely accurate at the time of publication. HUVITZ assumes no responsibility,
however, for possible errors or omissions, or for any consequences resulting from
the use of the information contained herein.
HUVITZ reserves the right to make changes in its products or product specifications at
any time and without prior notice, and is not required to update this documentation to
reflect such changes..
Ver 1.0
© 2004 - 2011 – Huvitz Co..Ltd.
-689-3, Gumjeong-dong,Gunpoci, Gyeonggi-do
435-862,Republic of Korea
All rights are reserved. Under copyright laws, this manual may not be copied, in whole or
in part, without prior written consent of HUVITZ Co.,Ltd.
---------------------------------------------------------------- Applanation Tonometer HT-5000
3
Contents
1.
2.
3.
Safety Infomation .................................................................................................... 5
1.1.
Introduction…………………………………………………………………………5
1.2.
Safety symbols
1.3.
Environmental Considerations ....................................................................... 8
1.4.
Safety (Note for Use) ................................................................................... 10
Product Description .............................................................................................. 14
2.1.
Introduction.………………………………………………………………………14
2.2.
Pressure Measurement Method………………………………………………..14
2.3.
Operation and Storage Condition………………………………………………16
2.4.
Configuration……………………………………………………………………..17
2.5.
Basic Unit………………………………………………………………………....18
Installation ............................................................................................................. 19
3.1.
4.
………………………………………………………………6
Product Installation……………………………………………………………….19
Operation the Equipment ...................................................................................... 21
4.1.
Preparation before Using………………………………………………………..21
4.2.
Equipment Control and Battery Replacement………………………………...23
4.3.
Correct Measurement……………………………………………………………28
4.4.
Tips for Measurement……………………………………………………………39
4.5.
Astigmatism……………………………………………………………………….40
4
Applanation Tonometer HT-5000
5.
Maintenance...........................................................................................................41
5.1.
6.
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Applanation Tonometer HT-5000 Check……………………………………….42
Cleaning / Disinfection of Prism ...........................................................................44
6.1.
Disinfection of Prism……………………………………………………………..44
6.2.
Accessories Disinfection…………………………………………………….......45
7.
Technical Standard ................................................................................................46
8.
EMC information ....................................................................................................48
9.
Service Information ..................................................................................................52
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5
1. Safety Information
1.1 Introduction
Safety is everyone’s responsibility. The safe use of this equipment is largely
dependent upon the installer, user, operator, and maintainer. It is imperative
that personnel study and become familiar with this entire manual before
attempting to install use, clean, service or adjust this equipment and any
associated accessories. It is paramount that the instructions contained in this
manual are fully understood and followed to enhance safety to the patient and
the user/operator. It is for this reason that the following safety notices have
been placed appropriately within the text of this manual to highlight safety
related information or information requiring special emphasis. All users,
operators, and maintainers must be familiar with and pay particular attention to
Cautions incorporated herein.
1.
CAUTION
!
CAUTION
Please pay attention to this word.
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Applanation Tonometer HT-5000
2.
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Product Classification
※ This product is medical device
1) CE- Regulatin MDD 93/42/EEC ; Class Im (measuring functions)
2) FDA – Class ll
3) KFDA – Class ll
3.
Intended Use: Use for glaucoma diagnosis.
1.2 Safety Symbols
The International Electrotechnical Commission (IEC) has established a set of
symbols for medical electronic equipment which classify a connection or
warn of any potential hazards. The classifications and symbols are shown
below.
Type B Isolated patient connection.
This symbol identifies a safety note. Ensure you
understand the function of this control before
using it. Control function is described in the
appropriate User’s or Service Manual.
It indicates the year of manufacture and the
manufacturer.
Manufacturer
Authorised Representative in the European
Community
Identifies the point where the system safety
ground is fastened to the chassis. Protective
earth connected to conductive parts of Class I
equipment for safety purposes.
---------------------------------------------------------------- Applanation Tonometer HT-5000
Temperature Limitation
Keep DRY
UL60601-1
CAN/CSA
C22.2
NO.601.1
MEDICAL EUIPMENT
WITH RESPECT TO ELECTRIC SHOCK
FIRE AND MECHANICAL HAZARDS
ONLY IN ACCORDANCE WITH
UL 60601-1, AND
CAN/CSA C22.2 NO.601.1
Disposal of your old appliance
When this crossed-out wheeled bin symbol is
attached to a product it means the product is
covered by the European Directive 2002/96/EC.
All electrical and electronic products should be
disposed of separately from the municipal waste
stream via designated collection facilities
appointed by the government or the local
authorities.
The correct disposal of your old appliance will
help prevent potential negative consequences
for the environment and human health.
4. For more detailed information about disposal
of your old appliance, please contact your city
office, waste disposal service or the shop where
you purchased the product.
7
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Applanation Tonometer HT-5000
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1.3 Environmental Considerations
Please avoid the environment below for the operation and storage of the
equipment.
Where the equipment is exposed to water vapor.
Don’t operate the equipment with wet hands.
Where the machine is exposed directly to the
sunlight.
Where the temperature changes frequently (Normal
temperature for operation of the machine is at the
range of 10C ~ 40C, and the humidity is at the
range of 30%~75%.
Where any heaters are at the close distance to the
machine.
Where the humidity is high and there are problems to
the heat dissipation and/or ventilation.
Where the equipment is subject to excessive shocks
or
Vibrations.
---------------------------------------------------------------- Applanation Tonometer HT-5000
9
Where the machine can be exposed to the chemical
or flammable substances.
Please keep the equipment out of dust and do not
let inserted any metal parts such as coins, clips, etc.
Do not disassemble or open the machine. The
manufacture shall have no responsibility for any
problems caused by these.
Do not close the thermal ventilation outlet.
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Applanation Tonometer HT-5000
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1.4 Safety (Note for Use)
1.
This product can use only glaucoma diagnosis.
2.
Applanation Tonometer must be used only through people to a medical
treatment relation occupation.
3.
Applanation Tonometer could be Transfortation / Storage / Operation
from this environment.
4.
Ambient condition
Temperature : -40 °C ~ +70 °C
Transportation
Air Pressure : 500 hPa ~ 1060 hPa
Humidity : 10% ~ 95%
Temperature : -10 °C ~ +55 °C
Storage
Air Pressure : 700 hPa ~ 1060 hPa
Humidity : 10% ~ 95%
Temperature : +10 °C ~ +40 °C
Operation
Air Pressure : 800 hPa ~1060 hPa
Humidity : 30% ~ 90%
5.
Installation, Dispatch
-
To avoid condensation, allow the instrument to adjust to
roomtemperature several hours before unpacking.
-
The Applanation Tonometer should be verified for damage after
unpacking.
-
The
maintenance
according
to
“After
use
custody
and
---------------------------------------------------------------- Applanation Tonometer HT-5000
11
management method”.
-
Check : do the connection pieces fit (tonometer on slit lamp,
measuring prism).
-
Defective equipment should always be returned in an appropriate
packaging.
6.
Operation, Environment
-
The instrument may be operated by qualified and trained staff.
Training is the responsibility of the user.
7.
-
Only HUVITZ accessories may be used.
-
Must be satisfied with operational condition of using environment.
Cleaning body
-
Use only a cloth that has been moistened slightly and if
necessary a little soap.
8.
-
No fluids, abrasive mediums or caustic substances may be used.
-
The instrument is not to be sprayed.
Guareantee and third-party product liability
-
Instrument and accessories are produced from high-quality
materials using the most modern methods. They have left our
factory in a faultless condition. Nevertheless, if you should have
any complaints, please consult your representative.
-
The manufacturer grants a guarantee on the instrument. For
information regarding guarantee conditions, please refer to your
local huvitz representative. The manufacturer guarantee covers
breakdowns and defects that are caused by materials and design.
Breakdowns and defects that are caused by improper use or
outside influences are excluded from the guarantee.
-
Should non-authorised persons handle the instrument then all
guarantee liabilities are null and void. Should the instrument be
12
Applanation Tonometer HT-5000
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used although damaged through incorrect use then this can lead
to injury to persons. In this case the manufacturer rejects all
liability.
9.
Do not examine in case of eye infections or injured corneas.
-
There is no contraindication for performing tonometry. Medical
assessment is necessary and due care is to be exercised.
10. Do not use damaged measuring prisms.
-
Prior to each use, the contact surface of the measuring prism
must be checked for contamination or damage (scratches, cracks
or sharp edges.) This must be carried out using the slit lamp
microscope at a 10 to 16 x magnification. When found to be
damaged, the measuring prism may no longer be used to avoid
damage to the patient’s cornea.
-
Disinfectant can penetrate into cracks in the measuring prism and
lead to chemical burns on the patient’s eye during tonometry.
11. Period of use
-
Due to the large number of variables to be taken into account
(type and concentration of the disinfectants used, number of
patients, handling etc.) it is practically impossible to make a
statement as to how often and/or how long a measuring prism
can be safely used. HUVITZ measuring prism recommends a
maximum service life of two years before the expiry date. This
service life applies subject to normal conditions of use, i.e., in
compliance with the instructions contained in this manual for use.
The period of use begins with the first application. The given time
periods are not valid for damaged measuring prisms, they must
be immediately replaced.
---------------------------------------------------------------- Applanation Tonometer HT-5000
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Applanation Tonometer HT-5000
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2 Product Description
2.1 Introduction
Applanation Tonometer HT-5000 is made for measuring intraocular pressure
and It can assemble to HUVITZ Slit lamp(HS-5000). Applanation Tonometer HT5000 can assemble another slit lamp. Must be used only through people to a
medical treatment relation occupation.
2.2 Pressure Measurement Method
The Applanation Tonometer functions according to the 'Goldmann method'.
The measuring of the pressure required to maintain a uniform applanation of
the surface of the cornea.
The Corneal is applanated by feeler arm with measuring prism. The diameter of
contact surface diameter of measuring prism is 7.0 mm. The corner of the
measuring prism is made roundly.
Measuring prism is contacted to patient’s eyes according to forward movement
of slit lamp.
Increase
measurement
knob
until
prism
applanation
surface
becomes
ø = 3.06 mm (area = 7.354 mm2)
According to ISO 1000, pressure is N(Newton), mN(milli Newton)
Display value
Force
Pressure
10
9.81mN
1.33kPa≒10mmHg
The measurement of the flattened surface is made directly on the cornea. The
---------------------------------------------------------------- Applanation Tonometer HT-5000
15
built-in duplication system in the measuring prism divides the image and
displaces the two semi circular halves from each other by 3.06 mm.
Before measuring, it will be necessary to anesthetise the cornea locally, to
place a strip of fluorescein paper in the conjunctival sac and switch on the blue
filter of the slit lamp. The inner border of the ring represents the line of
demarcation between the cornea flattened by applanation and the cornea not
flattened.
The major advantage of applanation tonometry is the small bulbus deformation
which amounts to only 0.56 mm3. The values found by this method of tonometry
are only slightly influenced by scleral-rigidity and radius of corneal curvature, the
intraocular tension increases by about 2.5% only.
The principle of applanation tonometry is simple. The careful construction of
the apparatus is a guarantee of its continued correct performance. Nevertheless,
in order to obtain exact results, the method of use indicated must be strictly
followed. The readings obtained are based on the assumption that a cornea with
a 'normal' thickness is being measured, alteration of the corneal thickness leads
to changes in the measured IOP. A 'normal' corneal thickness is considered to be
within the area of 530 to 560 microns.
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Applanation Tonometer HT-5000
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2.3 Operation and Storage Condition
1.
2.
Storage
-
Temperature
: –10˚C ~ +55˚C
-
Air Pressure
: 700 hPa ~ 1060 hPa
-
Humidity
: 10% ~ 95%
Operation Condition
-
Temperature
: +10˚C ~ +40˚C
-
Air Pressure
: 800 hPa ~ 1060 hPa
-
Humidity
: 30% ~ 90%
---------------------------------------------------------------- Applanation Tonometer HT-5000
17
2.4 Configuration
1.
Measuring prism : Part for contacting to patient’s cornea
2.
Feeler arm : Part for locking up the measuring prism
3.
Control weight insertion : Part for connecting the weight bar
4.
Control drum : The IOP is measured by rotating control drum
5.
Connection arm : Part for installing the tonometer to slit ramp
6.
Adapter : Part for fixing the tonometer to slit ramp
7.
Weight bar : For verification of equitment, the mark is indicated to 0, 20,
60 mmHg position
8.
Manufacturing label
9.
Function button : Function button is used for power on / off or function
control
10. Battery cover : The alkaline battery is stored inside the battery cover (1.5V
x 4)
11. Digital display(FND) : The IOP is displayed.
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Applanation Tonometer HT-5000
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2.5 Basic Unit
This product supplied in the condition which is packed packing. Take out a
product from packing and must check the next parts.
-
Applanation Tonometer HT-5000 body
-
Connection arm
-
Weight bar
-
Measuring prism (2EA)
-
User’s manual
---------------------------------------------------------------- Applanation Tonometer HT-5000
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3 Installation
!
CAUTION
This product be supplied packing condition which be stand various transportation and
standard storage condition. If product be defected, must be called immediately to the
HUVITZ.
3.1 Product Installation
1.
When install on the slit lamp of another company product, must confirm
the part which is assembled of equipment.
2.
When assembles Applanation Tonometer, need the mount adapter with
screw.
①
Unscrew the set screw to be found above and in the middle of the
cylinder body of the microscope.
②
Position the mounting base for the tonometer and tighten the set
screw.
③
When don’t use this product, please turn rightward.
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Applanation Tonometer HT-5000
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---------------------------------------------------------------- Applanation Tonometer HT-5000
21
4 Operating the Equipment
4.1 Preparation before Using
!
CAUTION
Only to use ‘HUVITZ’ measuring prisms can guarantee trouble-free function. Stenilised
Fluorescein paper should always be used because pathogenic excciters thrive well in
Flrourescein solutions.
Should the measuring prism come into contact with the cornea without the pressure
having previously been correctly set, sone vibrations can occur in the feeler arm that will
produce unpleasant fellings for the patient.
1.
Patient preparation
①
Anaesthetize both eyes with each e.g. 2-3 drops of an anaesthetic
within half a minute. Always anaesthetize both eyes as otherwise
blinking is unavoidable.
②
Place a fluorescein paper strip in the outer external canthus in the
lower conjunctival sac. After a couple of seconds the tear fluid has
taken on enough sufficient fluorescein. The paper strip can be
removed.
③
When using drops, a 0.25 % to 0.5 % sodium fluorescein solution is
recommended. Should a 1 % or a 2 % fluorescein solution be
instilled, a small drop is introduced to the conjunctival sac using a
glass rod.
④
2.
The correct eye height of the patient can be set at the chin rest.
For Huvitz Slit lamp and HT-5000
①
The focus of the eyepiece is to be checked before the examination.
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Applanation Tonometer HT-5000
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②
Set the magnification to 10x.
③
Set the equipment power supply / the control drum to the lowest
setting.
④
The illumination device of the slit lamp set position of the blue filter
and open the slit diaphragm fully.
⑤
Feeler arm into place so that the axis of the measuring device and
the microscope coincide.
⑥
Turn the tonometer on and adjust it to a value between 5 and 10.
⑦
Bring the illumination device from the left into contact with the
tonometer bearer arm. This is the only illumination position in which
both the patient’s left and right eye can be examined (no 60°
position). This arrangement simplifies the splaying of the patient’s
eyelids should this be necessary to make measurements. The
illumination of the applanated surface through the prism head is
generally reflection-free.
3.
Patient instructions
①
Press the head firmly on the chin rest and forehead support. If
necessary use a holding band to fix the head’s position.
②
The patient must look straight forward. If necessary, the small fixing
light can be used to steady the eyes.
③
It is recommended that the patient should be repeatedly requested
to open the eyes wide during the examination. The examiner must
perhaps keep the eye open by splaying the eyelids with thumb and
index finger. This must be done without pressure to the eye.
---------------------------------------------------------------- Applanation Tonometer HT-5000
23
4.2 Equipment Control and Battery Replacement
1.
Turn On / Off
-
Turn the tonometer on, by briefly pressing the function button. The
tonometer is ready for use when the digital display lights up and
displays the last set tonometer value. The tonometer turns off
automatically after 90 seconds, if no other adjustment has been
made.
2.
LED Display
-
The LED below the display is to check whether the measuring prism
works in the allowable range during the measurement. It glows red, if
the tonometer is not in contact with the cornea, and changes to
“LED off” when measure body is in a good distance to the cornea. If
the tonometer is too close to the eye, the led color changes to red
again. A warning indicates the user that he has left the measuring
range and that the sensor is operating in the allowable range. The
measuring range is 3 to 75 mmHg. Above this range, the display will
24
Applanation Tonometer HT-5000
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show. [LoP] / [HiP]
3.
Adjust display brightness
-
The brightness of the display can be changed with the function
button. Hold down the function button about 1 second. The display
shows [---](three dashes) and an audible signal sounds. Release
the button again. The display shows [Fn] and a level from 1 to 3. By
briefly pressing the button you can adjust the brightness. It is
recommended that you use the device on the basic attitude [Fn2] to
ensure a long operation time of the batteries. If you set [Fn1], you
save more batteries power. By pressing the button again for more
than one second the tonometer enters to the mode to adjust the
volume. [Fn1]
---------------------------------------------------------------- Applanation Tonometer HT-5000
4.
25
Adjust volume
-
The volume can be changed with the function button. Hold down the
function button 1 second. The display shows [---](three dashes)
and an audible signal sounds. Release the button again. The display
shows [Vo] and a level from 1 to 3. By briefly pressing the button
you can adjust the volume. By pressing the button again for more
than one second the tonometer returns to the normal measuring
mode. [Vo1]
26
Applanation Tonometer HT-5000
5.
--------------------------------------------------------------
Set rounded off function
-
The rounded off function can be set with the function button. Hold
down the function button about 1 second. The display shows [--](three dashes) and an audible signal sounds. Release the button
again. The display shows [don]. By briefly pressing the button you
can set the rounded off function in order of [don] -> [doF]. If you
set [don], the IOP is displayed up to decimal point in measuring
mode. Otherwise, if you set [doF], it is runded off the nearest tenth.
By pressing the button again for more than one second the
tonometer returns to the normal measuring mode. [don]
6.
Status of batteries
-
If after the activation of the tonometer the screen displays [LoB], the
batteries should be changed (4x1.5V batteries type AAA). [LoB]
---------------------------------------------------------------- Applanation Tonometer HT-5000
7.
27
Replacement of batteries
-
Drag carefully “Battery SW" to the bottom and remove the battery
compartment cover while tilting it back.
-
Remove the cells. Always replace all batteries with new ones, do not
combine old batteries with new batteries. Always use sealed 1.5V,
AAA batteries.
-
Pay attention to the polarity of the batteries. Please take the old
batteries to a professional disposal. Pay attention to respect the
28
Applanation Tonometer HT-5000
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correct order according the inscription in the battery compartment.
-
Once the batteries are exchanged, put the tabs on the underside of
the lid into the grooves of the housing and close it by tilting upwards.
-
Press gently on the cover and lock the battery compartment by
pushing “Battery SW” back in its place.
-
Remove these batteries if EQUIPMENT is not likely to be used for
some time.
4.3 Correct Measurement
1.
Immediately before taking the measurements, the patient should be made
to close the eyes briefly so that the cornea becomes sufficiently
---------------------------------------------------------------- Applanation Tonometer HT-5000
29
moistened with the lacrimal fluid and fluorescein.
2.
By moving the slit lamp forward, the measuring prism is brought into
contact with the center of the cornea over the pupils. The limbus of the
cornea will be illuminated with a bluish hue. This illumination is best
observed by direct sight from the opppsite side of the illumination unit by
the examiner.As soon as the limbus of the cornea illuminates, cease any
further forward movement of the slit lamp immediately.
3.
After obtaining contact, commence observing the cornea through the
microscope. A regular pulsation of the two semi circular fluorescein rings,
which can be of varying size dependent on the ocular pressure, will show
that the tonometer is on the correct measuring posion. The required
correction is made with the guide lever until the applanated surface is
observed as two semi circular surfaces of the same size in the center of
the field of sight (picture.1).
4.
Increase the pressure by turning the measuring drum on the tonometer,
untile the edges of both fluorescein rings just meet(picture.2). The width
of the fluorescein ring should be 1/10 approximately of the diameter of the
applanation surface.
5.
-
Reading the display in mmHg.
If the number of display is 10.0, It means 10mmHg.
30
Applanation Tonometer HT-5000
(1)
--------------------------------------------------------------
(2)
---------------------------------------------------------------- Applanation Tonometer HT-5000
6.
31
Sources of error
-
Fluorescein band incorrect

: 3~4
Fluorescein band too wide. (3)

The measuring prism was not dried after cleaning or the eyelids came
into contact with the measuring prism.

The slit lamp must be pulled back and the measuring body dried
with a cotton-wool ball.

Fluorescein band too narrow. (4)

The tear fluid has dried during a longer lasting measuring.

One lets the patient close the eyes a few times and then repeat
the measurement.
-
Wrong distance to patient

: 5~6
No semi circular image visible, only markings (5)

The measuring prism does not contact the cornea! If the patient
retreats the head a little, irregular pulsations are caused because the
measuring prism touches the eye only at times. If the patient retreats
still further, then the Fluorescein rings disappear completely.


Use a headband as necessary.
Only parts of both oversize semicircles are visible (6)

If the slit lamp is pushed too far against the patient or the patient
moves towards the slit lamp, the feeler arm pushes against a spring
stop. The applanation surface is too large.

The image does not change when the control knob is moved.
Pull the slit lamp back until uniform pulsations show an
appropriately smaller surface as the correct measuring position.
32
Applanation Tonometer HT-5000
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Pressure changes lead immediately to changes in area.
(3)
(5)
(6)
(7)
---------------------------------------------------------------- Applanation Tonometer HT-5000
-
Position too far to the right / left

33
: 7 ~ 10
Only part of the upper semicircle. (7)

Measuring prism not centered on the eye, eye much too far to the
right.


Using the control lever move the slit lamp to the right.
Only part of the upper semicircle. (8)

Measuring prism not centered on the eye, eye much too far to the
right.


Using the control lever move the slit lamp to the right.
Only part of the lower semicircle. (9)

Measuring prism not centered on the eye, eye too far to the left.


Using the control lever move the slit lamp to the left.
All of the lower semicircle - part of the upper semicircle. (10)

Measuring prism not centered on the eye, eye is too far to the left.


Using the control lever move the slit lamp to the left.
Correct setting! (11)

Two semicircles appear exactly in the middle of the ocular.
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Applanation Tonometer HT-5000
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(7)
(8)
(9)
(10)
(11)
---------------------------------------------------------------- Applanation Tonometer HT-5000
-
Position too high / low

35
: 12 ~ 15
Only part of a semicircle in the upper half. (12)

Measuring prism not centered on the eye, eye too high.


Using the control lever move the slit lamp upwards.
Complete circle in the upper half. (13)

Measuring prism not centered on the eye, eye is still too high.


Using the control lever move the slit lamp upwards.
Nearly complete circles above, incomplete circles below. (14)

Measuring prism not centered on the eye, eye is still too high.


Using the control lever move the slit lamp upwards.
Two incomplete circles, the larger above. (15)

Measuring prism is nearly centered on the eye, eye is still too high.


Using the control lever move the slit lamp upwards.
Correct setting! (16)

Two semicircles appear exactly in the middle of the ocular.
36
Applanation Tonometer HT-5000
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(12)
(13)
(14)
(15)
(16)
---------------------------------------------------------------- Applanation Tonometer HT-5000
-
Incorrect pressure

37
: 17 ~ 19
Contact with the outside borders of the fluorescein bands. (17)

Not enough pressure.

Increase the pressure slightly by turning the knob on the
tonometer.

Fluorescein bands are superimposed to form a band. (18)

Pressure slightly too little.

Increase the pressure slightly by turning the tonometer
adjustment knob.

Bands are not in contact. (19)

Pressure is clearly too high.

Lower the pressure by turning the tonometer adjustment knob in
the opposite direction.

Correct setting! (20)

The inner edges of the fluorescein rings touch each other.
38
Applanation Tonometer HT-5000
(17)
(19)
--------------------------------------------------------------
(18)
(20)
---------------------------------------------------------------- Applanation Tonometer HT-5000
39
4.4 Tips for the Measurement
!
CAUTION
The measurements should be carried out as quickly as possible. Should the cornea
epithelium show signs of dryness then check visual acuity and visual field.
The measurement can be repeated. Excited and anxious patients frequently
have a higher intraocular pressure on the first measurement. In the first minute a
falling tension occurs as the patient notices that a tonometry does not cause any
unpleasant feelings.
With an appropriate anaesthesia and fully opened eyes the patient does not
notice anything. This is why a test measurement is carried out on both eyes. The
results are discarded and then three further measurements are carried out on
both eyes. The values are correct when the pressure has stabilized. The
scattering results correspond to ± 0.5 mmHg with the correct procedure.
It can come to drying of the cornea epithelia in both eyes when the
measurement takes a long time. A ring containing fluorescein is formed on the
eye to be measured where the measuring prism contacts the cornea. On the
other eye dry irregular fluorescein patches are formed that are unsuitable for
taking measurements. Extensive dryness disappears quickly without any particular
treatment. The visual acuity is influenced by this light epithelium defect.
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Applanation Tonometer HT-5000
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4.5 Astigmatism
If the cornea is spherical, measurements can be made on any meridian, but it
is most convenient to do it on the 0° meridian. This is not so when eyes with
higher corneal astigmatism than 3 dioptres are examined, as the flattened areas
are not circular but elliptic. It has been calculated that, in cases of larger corneal
astigmatisms, a surface of 7.354 mm2 (ø 3.06 mm) is to be applanated, when
the measuring prism is at an angle of 43° to the meridian of the greatest radius.
Example)
If the corneal astigmatism amounts to
6.5 mm / 30° = 52.0 D / 30° and
8.5 mm / 120° = 40.0 D / 120°
The graduation value 120° of the prism is set at the red 43° mark of the
prism holder.
If there is a corneal astigmatism of
8.5 mm / 30° = 40.0 D / 30° and
6.5 mm / 120° = 52.0 D / 120°
The graduation value 30° is set at the red 43° mark. In other words, set the
axial position of the greatest radius, which is the axis of a minus cylinder,
on the prism graduation at the red mark on the prism holder.
---------------------------------------------------------------- Applanation Tonometer HT-5000
5 Maintenance
1.
Storage after using is according to “safety information”.
2.
Checking the HT-5000 regularly.
This check should be carried out once a month.
When getting wrong results the following points must be checked.
①
Is the measuring prism set correctly?
②
Is the control weight correctly set?
③
Repeat the check.
Defective equipment must be sent immediately to the HUVITZ
!
CAUTION
HUVITZ offers a repair and service packet. For further information give direct liaison to
HUVITZ.
41
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Applanation Tonometer HT-5000
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5.1 Applanation Tonometer HT-5000 Check
1.
Starting position 20 mm Hg
-
The control weight is intended to do this. On the control weight there
are 5 rings. The middle position is 0 mm Hg, both directly to the left
and right correspond to 20 mm Hg, and the two extremes to 60 mm
Hg. Adjust the control weight on one of the starting positions (40 or
60 mm Hg) exactly on the control support (a). Then insert the control
weight in the opening of the tonometer so that the longest part of
the bar points in the direction of the examiner.
①
In the position less than 19.5, the color of LED must be red. If
you turn Control drum, LED’s color will change to green. And If
you turn more, the color will change to red (RED -> GREEN ->
RED , Please turn gradually) At that time, IOP value must be
between 19.5 and 20.5
---------------------------------------------------------------- Applanation Tonometer HT-5000
②
43
In the position more than 20.5, the color of LED must be red. If
you turn Control drum, LED’s color will change to green. And If
you turn more, the color will change to red (RED -> GREEN ->
RED , Please turn gradually) At that time, IOP value must be
between 19.5 and 20.5
2.
Check at 60 mmHg
-
Adjust the control weight at starting position 60 so that the longest
part of the bar points in the direction of the examiner.
①
In the position less than 59, the color of LED must be red. If
you turn Control drum, LED’s color will change to green. And If
you turn more, the color will change to red (RED -> GREEN ->
RED , Please turn gradually) At that time, IOP value must be
between 59 and 61
②
In the position more than 61, the color of LED must be red. If
you turn Control drum, LED’s color will change to green. And If
you turn more, the color will change to red (RED -> GREEN ->
RED , Please turn gradually) At that time, IOP value must be
44
Applanation Tonometer HT-5000
--------------------------------------------------------------
between 59 and 61.
6 Cleaning / Disinfection of Prism
6.1 Disinfection of Prism
1.
Must use after clean because measuring prisms are dispatched in a nondisinfected condition.
2.
Measuring prisms are cleaned and disinfected correctly. For an optimal
cleaning and disinfection the measuring prisms must be submerged and
must move freely in the fluid.
3.
Prior to disinfection the measuring prisms must be rinsed under cold
running water for 30 to 60 seconds. Extremely dirty measuring prisms can
additionally be cleaned using a soap and a cotton-wool ball.
4.
Measuring prisms to end disinfection are rinsed cold running water.
-
5.
Caution : Time to rinse in water is 10 to a maximum 60 minutes.
The measuring prisms should be dried after cleaning, and stored in closed
container.
6.
To the measuring prisms must not be a residue. Residues can injure to
irritation of the patient’s eye or chemical burns.
---------------------------------------------------------------- Applanation Tonometer HT-5000
#To the measurement prism there not must be a residue.
Forbidden!
• Disinfection with alcohol
• Cleaning with
acetine
• Disinfection with UV irradiation
• Sterilisation with steam or ethylene oxide
• Immersion in fluid longer than one hour
• Temperatures over 60°C
6.2 Accessories Disinfection / Storage
1.
Cleaning instrument
2.
Storage
3.
Disinfectant 'Pantasept®'
45
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Applanation Tonometer HT-5000
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7 Technical Standard
1.
Measuring force : by leverage weight
2.
Assembly : Fits on a pin on the microscope
3.
Measurement range : 3 - 75 mmHg
4.
Measurement deviation : The measurement deviation is the measuring
prism is in the measurement range from 0 - 58.84mN and amounts to a
maximum of ±1.5%. This is a minimum of ±0.49mN of the nominal value.
Illustration
①
Normal value
②
Maximum limiting derivation
③
Limiting deviation of 0 to 32.66 mN : Maximum = 0.49 mN
④
Limiting deviation from 32.66 mN : Maximum = 1.5% of nominal value
-
Reverse span
: ≤ 0.49 mN
-
Net weight
: HT 5000 0.640 Kg(without accessories)
---------------------------------------------------------------- Applanation Tonometer HT-5000
47
Only in the USA
1. Remove measuring prism carefully from holder.
2. Clean : Wipe prisms clean before finsing for 3060 seconds in running cold water.
3. Disinfect :
Hydrogen Peroxide(10 minutes) or Sodium
Hypochlorite(10 minutes)
4. Rinse
Rinse thoroughly in running, cold drinking water.(rinsing
time in water may not exceed 60 minutes)
5. Dry
With a one-way tissue, clean and soft
6. Store
Place into container clean nad dry.
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Applanation Tonometer HT-5000
EMC Information
--------------------------------------------------------------
---------------------------------------------------------------- Applanation Tonometer HT-5000
49
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Applanation Tonometer HT-5000
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---------------------------------------------------------------- Applanation Tonometer HT-5000
51
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Applanation Tonometer HT-5000
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9 Service Information
If any problem persists or the instrument is damaged or malfunctioning, contact Huvtiz or
local distributor for service with the following information:
 Name of the instrument: Applanation Tonometer HT-5000
 Serial number of the instrument: refer to the 9-digit number on its product label or
name plate
 Descriptions of Problem: In detail
Date of Purchase:
Dealer’s Name:
Dealer Address:
Dealer Phone No.:
Model No.:
Serial No.:
( Huvitz recommends customers to fill up the following form after purchase and retain
this manual as a permanent record of purchase.)
HUVITZ Co., Ltd.
Tel: +82-31-442-8868
689-3 Geumjeong-dong
Fax: +82-31-442-8619
Gunpo-si Gyeonggi-do, South Korea
URL:http://www.huvitz.com
435-862
e-mail: [email protected]
EU Representative
Medical Device Safety Service
GmbH (MDSS)
Schiffgraben 41, 30175 Hannover,
Germany
Tel: +49-511-62628630
Fax: +49-511-62628633
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