Stimuli™ 4.1 Advanced Duo Manual - Haag
Contents
1. Pressing the Select button or Space Select key makes the dot disappear and reappear The 4 and feature buttons or comma and period keys Blink and Animate the dot respectively For convenience the Left and Right F buttons duplicate the feature buttons The animated dot moves in a varying trajectory in the patient s central field The Up 4 and Down I buttons turn the background white or black respectively Page 18 Sizable 4 Dot Test me EnA Our unique sizable Four Dot chart sets the standard The test is correctly calibrated for the refraction distance The intensity of of the circles may be adjusted for different Red Green eyewear to assure maximum extinction via the Four Dot Setup This test can be sized with the Up and Down P buttons The external and internal angles in degrees can be displayed or spoken via the button or Z Page 19 Astigmatic Dial The Astigmatic dial can be presented and a confirmation dot can be displayed with the Left and Right F buttons or keys The indicators can be cleared with the Select button or Space Select key The optional foot pedals duplicate the Left a and Right F buttons and the Select button Page 20 Contrast Sensitivity EO EnaA ba A Contrast chart with similar features to the normal Acuity charts has the ability to lower contrast of the optotypes Sizes are selected with the Up and Down buttons A new li2. express or implied including but not limited to the implied warranties of mer chantability and fitness for a particular purpose and noninfringement of third party rights Under no circumstances shall Ac commodata Corporation be liable for any incidental special or consequential damages that result from the use or inability to use the software or related documentation even if Accommodata Corporation has been advised of the possibility of such damages In no event shall Accommodata Corporation s liability exceed the license fee paid if any This Agreement shall be governed by the laws of the State of Ohio If for any reason a court of competent jurisdiction finds any provision of this Agreement or portion thereof to be unenforceable that provision of the Agreement shall be enforced to the maximum extent permissible so as to affect the intent of the parties and the remainder of this Agreement shall continue in full force and effect The software and documentation is provided with RESTRICTED RIGHTS Use duplication or disclosure by the Govern ment is subject to restrictions as set forth in subdivision b 3 i1 of The Rights in Technical Data and Computer Software clause at 252 227 7013 Manufacturer is Accommodata Corporation 20950 Edgecliff Road Euclid OH 44123 Accommodata Corporation 20950 Edgecliff Road Euclid OH 44123 Under License from Accommodata Corporation U S Patent Number 6 108 634 U K Patent Number 232999
3. C eee o o S ee o e Page 16 Programmability The initial test screen presented to the patient is a progressive letter chart from 20 20 up to and including 20 80 depending on screen size However Stimuli also supports a programmable chart starting point To program your favorite chart size optotype and presentation option into memory 1 Navigate to your favorite test chart such as the Pediatric single line with Pointer at 20 100 2 Press the Pause J button on the remote or the Pause Q key The test screen will go into Sleep mode black 3 Press the bottom left button Star button twice or the Legends Z key You will hear a Ding Dong your test is now programmed To return to the programmed favorite chart from anywhere go into Pause and then press the Square remote button or the backquote key at the top left of the Direct Access keyboard Stimuli will return directly to your programmed choice This feature greatly speeds vision testing and helps keep the patient s attention The programmed test can be changed at any time Page 17 Fixation Dot me EnaA Upon entering this test you will be presented a white dot on a black background Stimuli includes many features to make this the most flexible and useful fixation device The different features supported include 1 Disappearing Dot Game 2 Reversed Black Dot on White background 3 Animated dot 4 Flashing Dot 5 Combinations
4. Control Panel then the Stim uli Calibration Setup screen will come to the front occluding the Control Panel Simply select the Sys tem Preferences function again Close the Displays Control Panel Click once on the Calibration Setup screen to ensure it is in the front to receive commands Now press the Menu ii button once on the remote or Return Menu on the keyboard to get to the Menu screen and using the Down T arrow button select Quit and press the Select S button on the remote or Space Select on the keyboard The system will save all settings then quit Simply relaunch as de scribed in Starting Up above and the Stimuli system is ready to use OUTCOME You have calibrated your system to a fine accuracy You can easily check the calibration of your system at any time by going to the Calibration window and measuring the actual refraction distance and the size of the calibration target and checking it against the denoted size and refraction distance Page 10 Configuring The System Your Stimuli Advanced Duo can be adjusted to suit a great number of individual preferences Highlight a particular feature with the Right or Left arrow buttons then use Up and Down arrow but tons to select the desired option The system allows changing numerous features Feedback E Clicks _ Silent Calibration units English or Metric units for refraction computer Optotype Units Snellen logMAR or Decimal
5. amp buttons to select Custom 1 2 or 3 Use the Left 4 and Right I Navigation buttons to make the cursor square traverse the full list of Opto types and the S button to select the optotypes desired Page 12 Setup Media Pediatric Animal Parade Cebu Cheeseburger Keep Walking Larry Boy Video Thanktfulness Water Buffalo GG m CGCEGEG a J im E u pe s P a am Stimuli s fixation educational videos set the standard Our exclusive Animal Parade is a pediatric favorite with interesting motorized animals that don t wear out or require replacement The automatic sequencing feature moves the system on to a new Animal every few seconds without intervention by the practitioner Both child and examiner can stay focused on the task at hand with Stimuli Animal Parade A set of cartoons 1s also included The Video Play D button or V on the keyboard is used to Play and Pause the selected video clip in the review window Clips can be directly selected with the Size keys A number of Video Clip folders are available The Pediatric Clips folder is included with the system Sets of Multiple Clips may be added The Sets of Multiple Clips allow different varieties of video clips to be kept in different sets This is detailed in Video Clip Sets on page 19 Page 13 Acuity Charts ia ercer D A OF FLOT L vane The four main varieties of Acuity Chart are Progress
6. 2 Japan Patent 3302697 Germany Patent 19781691 Canada Patent 2 251 080 Other Patents Pending 2012 Accommodata Corporation 0607 Page 23
7. Stimuli Stimuli 4 Advanced Duo represents an increase in Integrated Refraction System usability with both remote and a desktop keyboard Test selection and chart features are accessed more effortlessly than ever Egonomic Remote Controller Our small handheld wireless remote control never requires you to point it at the screen Direct Keyboard Access Wireless desktop Direct Access keyboard features single button selection of tests Programmable Tests Based on International Standards Version 4 1 Advanced Duo Accommodata Corporation U S Patent Number 6 108 634 Germany Patent 19781691 U K Patent Number 2329992 Canada Patent 2 251 080 Japan Patent 3302697 Other Patents Pending Page 1 Setting Up Your System Installing the Remote Your system will come with an RF remote which has already been paired with the system Should the remote need to be reinstalled follow these simple steps Step 1 Connect the Remote s USB radio receiver into any available USB port on the computer When connecting the receiver s status light will flash while synchronizing with the system After this synchronization period the blinking will stop and the light will remain on The status light will then blink rapidly while receiving a signal from the remote Step 2 Ensure that the clear battery protector film that separates the Remote s battery located on the back of the remote in the battery compartment is removed Step 3 Be sure
8. arts E Tumbling E Illiterate Chart D 4 Dot Test H HOTV F Fixation L Landolt Rings Special Controls T Traboulsi T Rings Targets Q Blank Screen Pause N Numerals V Videos R Red Green Duochrome Space Bar Select New Chart C Contrast Sensitivity Return Key Main Menu Next and previous tests sub tests and charts as well as changing sizes optotypes and programming a test with special size optotpe and chart are also all available The Stimuli remote control and the Stimuli Direct Access Keyboard can be used separately or together Page 4 Controlling the Stimuli System Stimuli System Main Menu is reached through the Menu E button on the remote or the Return Menu key on the keyboard To return from any setup screen press the Menu E button or Return Menu key again Hali a ACID Help Displays functions of the Wireless Remote Control Calibration Allows access to Calibration controls of the unit Configuration Permits adjustment of Stimuli options amp features Optotypes Supports selection of optotypes presented Media Adjusts all film clip display and volumes Quit Allows you to leave the Stimuli program Shutdown Quits and shuts down the computer Navigation of the control screen is affected by the Up 4 and Down F navigation buttons on the Remote or Keyboard Simply scroll to the desired feature and press the Select button or Space Select o
9. creen resolu tion Page 9 Step 3 Setting the Refraction Distance Measure the refraction distance from screen to patient s eyes Using the Left 4 and Right E arrow buttons move the Highlight Box to the Foot adjustment and select the refraction distance to the nearest foot using the Up and Down arrow buttons Using the Right E arrow button highlight the Inches adjustment and adjust the inches for the refraction dis tance as measured in the room If you prefer to work in meters then navigate to the Configuration screen and select Units Metric For an LCD flat panel monitor Confirm the measurement of the calibration target E Measurement is best effected by closing one eye and looking directly at the edge of the letter while aligning a ruler laid on the screen The indicated measurement should be within a fraction of a millimeter of the measured size For an older CRT monitor To calibrate Cathode Ray Tube monitors use the Height and Width size adjustments on the monitor it self refer to monitor s User Manual adjust the size of the calibration target E until it exactly equals the calculated size If the Displays Control Panel is in front of the letter and blocking your view simply use the mouse to move the window by clicking and holding the title bar at the top of the window and dragging the win dow to a new position Note If you happen to click anywhere outside the
10. greement This is a legal agreement between you and Accommodata Corporation covering your use of Accommodata Corporation soft ware Be sure to read the following agreement before using the software IF YOU DO NOT AGREE TO THE TERMS OF THIS AGREEMENT DO NOT USE THE SOFTWARE AND DESTROY ALL COPIES OF IT The software including any documentation electronic keys images photographs animations video audio music text and fonts accompanying this License whether on disk in read only memory on any other media or in any other form are li censed to you by Accommodata Corporation Accommodata Corporation does not transfer title to the software to you This License allows you to install and use the software on a single computer at atime You cannot use the software without obtaining an electronic key from the copyright owner You may not decompile reverse engineer disassemble modify rent lease loan sublicense distribute or create derivative works based upon the software in whole or part or transmit the software over a network or from one computer to another If you violate any part of this agreement your right to use this software terminates automatically and you then must return all copies of this software documentation and electronic keys to Accommodata Corporation The software and related documentation are provided AS IS and without warranty of any kind and Accommodata Corpora tion expressly disclaims all other warranties
11. ill indicate the Chart Mode and test details A second press of the star button or Z key provides a second page of legends for multi line optotype charts Audible Legends may also be selected which announce the size of the first optotype line and then an nounce the identity of each optotype upon a second press of the star button or Z key Young chil dren like this Talking test feature which can simplify some testing Optional Foot Pedals Stimuli was first with foot pedal control of charts This hands free innovation is a boon to those working with younger patients or patients with special needs This option is especially useful if the practitioner wishes to use a number of hand held devices such as an occluder The optional foot pedal unit allows handsfree control of the chart size Up 4 and Down IT and Select buttons Page 15 Direct Access to Tests Stimuli has always been the easiest system to use In addition to providing for direct access to different optotype sizes and for direct access to film clips when playing Stimuli supports direct access to tests in more than one way In addition to the keyboard based test selection they can be accessed when Paused 1 Press the Pause button 2 Press any direct access key Key numbers correspond to the different available tests Modified Progression sizes and videos Pro Programmed Favorite Chart Favorite Chart backquote T E mses O A o C eee o o o
12. ive Lines Single Line Single Character and Mul tiple Lines of the same size These are chosen with the Left S and Right arrow buttons Sizes are varied with both the Up a and Down buttons and with the number row keys of the Direct Access keyboard Note additional sizes beyond those represented by the Direct Access keys are avail able with variations in progression If the Modified Progression is configured in Setup then Up and Down arrows and the Direct Access keys are equivalent shown with their Snellen 20 equivalents 5H ao las IPs0 Ia0 l sol20 N70 I 20 Iiod tag IC TL If the Logarithmic Progression is configured the Up and Down buttons step through the standard loga rithmic progression while the Direct Access keys continue to provide the finer steps of the Modified Progression For these the Plus and Minus keys also serve to step through the Modified Progression This gives the practitioner more choices Page 14 In Chart mode the volume Up and Down amp remote buttons or shift Up and shift Down arrow keys on the keyboard select the different optotypes available for testing Some of which are optional Option Buttons E E The two feature buttons and or comma and period keys provide features which act upon the selected chart These features include a single column when in chart mode isolation contour bars pointer and an optional inverse light on dark Pointer A poin
13. n the keyboard to enter the chosen control screen Page 5 The Help Screen Legends Menu The Help screen provides explanations of the different tests and the buttons used to control test features The graphical help for the Remote for each test is adjusted to the features which are included with the system For example here is a help screen for a DuoChrome test The Direct Access Keyboard map is also shown and the analogous controls e g Up Down amp c on the Keyboard serve the same control functions as depicted for the Remote Page 6 Calibrating the System 5 Refraction Distance 192 7 inches al S S 0 16 O Tan Platform E iMac _ 21 5 _ Other 89 mm l4 Screen Size 13 1920 x 1080 i2 102 6 0 248 DPI mnvP 1 Screen Width 10 18 7 j 475 mm Current resolution 9 1920 1080 8 7 feet Q System Preferences Your system should be delivered calibrated for your examination room from your local dealer If for some reason you wish to change the calibration or if you have moved the unit and need to adjust the calibration follow these instructions Press the Menu amp button on the handheld remote control to reach the main Menu screen Using the Up and Down tY arrow buttons scroll down until Calibration is highlighted and press Select on the re mote or Space Select on the keyboard You can navigate the calibration screen controls with the Right E and Left ar
14. ne of optotypes is generated each time the Select button Space Select key is pressed The 4 and buttons comma and period keys will adjust contrast level from 100 down to 0 6 The contrast level and size can be displayed via the Legend button Z key Page 21 Playing Video Video 1 Video 2 Video 3 Video 4 Video 5 Video 6 Video 7 Video amp The Video Play D button V key controls playing and stopping of video clips When a video clip is playing the Up and Down P buttons and the Direct Access keys control selection of additional clips The volume Up and Down A buttons shift Up and shift Down keys are used to adjust volume when a film clip is playing The Mute E button mutes the audio while the clip continues to play The Pause button Q key will pause the video In addition to the provided set of pediatric cartoons other sets of video clips or still images may be customized simply by creating a folder of videos or stills and placing it in the Videos folder in the Stimuli folder Stimuli will automatically recognize the new folder and add it to the clip sets Sets of multiple video clips can be selected using the and feature buttons when a clip is playing When a Clip Set is selected and playing the Direct Access buttons allow direct selection of the first eleven clips in each set The Up 4 and Down L buttons allow selection of every clip in the set Page 22 Software License A
15. row buttons and then use the Up Down arrow buttons to adjust each aspect The on screen calibration calculator tells the user the measurable on screen size The maximum resolu tion setting for the computer must be used For older CRT displays that have adjustable rasters the fol lowing procedure requires confirming the size of the test E by measuring it on the screen with a ruler Page 7 Calibration of the Stimuli System requires three steps Step 1 Adjust display to its maximum resolution The maximum resolution setting for the computer must be used The computer should arrive already set to its maximum resolution To confirm this or to adjust the reso lution of the screen launch the System Preferences on top of Stimuli by pressing the Star button or Z on the keyboard 25 Refraction Distance Id INA an Personal System Preferences 21 ae 0 Chen aa Q Q Appearance Desktop amp Dock Expos amp Language amp Security Spotlight 9 Screen Saver Spaces Text 18 17 A 16 Keyboard Mouse Print amp Fax Sound 15 14 i E FA T 3 S 13 KA 4 MobileMe Network Bluetooth Sharing l1 System Q o O l g 7g amp eo y 2 9 Accounts Date amp Time Parental Software Speech Startup Disk Time Machine Universal g Controls Update Access Other 7 feet Candelair Choose the Displays function in under Hardware to set to the maximum resol
16. ter is available when in Line mode This helps with many younger older and foreign language speaking patients It is easily controlled by the 44 and H buttons or comma and period keys along with other test features The pointer is used to indicate the desired test object in a given line of charac ters The pointer automatically sizes to be easily viewable to the patient Isolation Contour Bars When operating in the Line or Single Character mode isolation is available The two feature buttons directly above the navigation buttons t and or comma and period keys selectively provide an isolation box along with the other features When in single character mode contour bars are also available Random Charts For common letter charts the first set in a size is a common selection of characters Each time the Se lect button or Space Select key is pressed a new chart of optotypes is presented which eliminates memorization by the patient The second and third sets of common optotypes are different but consis tent so that the practitioner can eventually memorize them After the third chart all charts are randomly generated This randomly generated selection eliminates the problematic Memory Effect of conven tional automatic and manual projector systems Legends Legends are controlled by the star button or Z key Visible legends can be selected in the Setup menu If a remote display panel is used it w
17. testing mode or use the Direct Access Keyboard to select the desired test Page 2 The Stimuli Remote Previous Test sien Next Test Legends Menu Designed for ease of use the lightweight Stimuli Remote hand controller allows wireless control of all functions without the need for a bulky controller The geometric layout allows the practitioner to make selections without looking at the remote Logical groupings of functions make control of each test intuitive Its range is over 10M 35 feet and since it uses Radio Frequency it is not necessary for it to be pointed at the screen and can even be concealed in a pocket A Help screen and all Stimuli setup screens are available through the Menu button on the bottom right of the wireless remote The Help option will show which buttons control each individual test Page 3 The Stimuli Direct Access Keyboard Cisl20 fs sole s0l s0 f0 I 20 tool 23 I a SITE 0 Jalkani IT acl IC Jom ee Ac nda Ete xe J ne a Advanced Duo Stimuli has always been the easiest system to use In addition to me ease of coad with our ergonomic handheld remote Stimuli Advanced Duo now includes control of tests and system features with our unique wireless keyboard The Stimuli Direct Access keyboard supports direct access to tests sizes and videos All remote functions are duplicated on the Direct Access Keyboard Letter Charts Additional Ch
18. that the remote s ON OFF button located on the back of the remote is in the ON position Pairing If you cannot proceed after these steps the Remote and the USB Receiver may need to be paired Press the ID Pair button located on the receiver The status LED will blink once per second While it is blinking press the Change ID button located on the back of the remote The LED on the receiver will blink rapidly for a few seconds and then return to solid ON indicating that pairing is complete Installing the Security Key To install the Security Key simply plug the Key into any available USB port on the computer Starting Up Your Stimuli system from Accommodata Corporation can automatically turn on and off at preset times This is adjusted through the Schedule option under Energy Saver of the System Preferences control panel Please refer to Apple documentation You may also start up manually at any time by pressing the Power button on the unit The system will be available for use in about a minute Stimuli is set to launch when the computer is started If it is not configured this way or you have exited Stimuli you may launch Stimuli by pressing the Star button on the remote control If a keyboard and mouse are connected you may also launch Stimuli by double clicking its icon on the desktop When you see the Stimuli startup screen press the Next Test button on the remote control to advance to the vision
19. units for optotype legends Progression American modified Snellen or true logarithmic chart progression Red Green Extinction Allows matching colors to Red Green glasses View Direct viewing or Reflected mirrored examination lane Feedback Clicks when tests change with volume control buttons or Silent operation Legends Allows selection of Far Near Desktop Readout or Audible Max Characters Line Adjust the maximum number of characters on a line Max Lines Chart Allows setting the maximum number of lines on multi line charts Progressive Equal number of optotypes per line or Filled lines on progressive charts Master Volume Overall volume control In general the Menu button Retuen Menu on the keyboard steps back up a level each time it is pressed all the way back to the current test chart Page 11 Setup Optotypes Many optotypes are available Some are options others are included and may be turned on or off at the clinician s preference ABCDEFGHLNOPSTV2Z Highlight an optotype using the Up and Down LT arrow buttons Activate or deactivate optotypes with the Select 5 button Space Select on the keyboard The system is configured to allow customizing of all optotype sets The Right F arrow button moves to a customization screen for each hi lighted optotype Choices include All optotypes Standard Selection or three Custom sets To make a custom set use the volume Up and Down
20. ution Please refer to the Apple documentation that came with your computer Ensure the mouse is connected to the system Page one iMac SSS Resolutions 800 x 600 1024 x 768 1024 x 768 stretched 1280 x 720 1280 x 1024 1280 x 1024 stretched 1344 x 756 1600 x 900 1680 x 1050 1920 x 1080 z Detect Displays l Show displays in menu bar a Brightness ACTION Adjust the Resolution of the monitor to its maximum by choosing the setting Close the Preferences window and click on the Stimuli screen OUTCOME Your system is now set for the highest resolution Step 2 Selecting the Platform ACTION Ensure that the correct Platform is selected by pressing the Right E arrow button to move the white Highlight Box to the Platform pane and select the correct Platform or computer you are using For example when using a typical iMac based system choose iMac_21 5 The Other setting is for any other computer display size such as a larger iMac or an older platform If using Other the horizontal and vertical resolutions must be entered in the fields provided Then screen s resolution may be entered as dots per inch DPI pixels per millimeter or simply by entering the screen s actual width in inches or millimeters The other terms will be automatically calculated OUTCOME The above adjustments have selected the type of computer you are using and provided the s
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