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E300 User Manual

1. Figure 26 Zernike Settings Dialog This dialog allows you to select the Zernike components that should be included in the display Comments Tab This tab allows you to add or edit comments for the exam Setting Up the Color Key 54 The color keys control the mapping of data values to colors There are two types of Color Keys Standard used to convert data values into colors and Difference used to convert the difference between data values into colors Difference color keys are always balanced about zero i e the minimum color key value is the negative of the maximum value and zero difference is always the same color light green Medmont E300 Corneal Topographer Analysing and Viewing Exam Results Standard Color Keys The E300 provides a number of predefined color keys for each map type Map Type Available Color Keys Axial Power Standard Power Normalized Power Universal Standard Scale K Scale Tangential Standard Power Normalized Power Universal Power Standard Scale K Scale Axial Curvature Standard Curvature Normalized Curvature Tangential Curvature Height Standard Height Normalized Height Refractive Standard Power Normalized Power Universal Power Standard Scale K Scale Standard Elevation Normalized Elevation Tear Film Quality Standard Curvature Normalized Curvature Tear Film Quality Color Key Descriptions There are seven standard based color
2. Contact Lens Data The software calculates the required contact lens power by combining the vertex adjustment and manifest refraction with the power required to correct for the tear film lens If the refraction axes do not align with the corneal keratometric axes then a cross cylinder calculation is used to combine them The required power is displayed in two forms e Lens Power Toric is the full calculated refraction including cyl required to correct any residual astigmatism e Lens Power is the spherical equivalent power in Diopters and may be used to simplify the lens design when the residual astigmatism is not large These values and other lens design parameters are displayed in the Data tab Printing the Contact Lens Design First select the contact lens or lenses that you wish to print by selecting them in the Explorer pane Select the printer to print to and paper size by clicking the File gt Print menu then click the Settings button To print immediately use the File gt Quick Print menu then click OK Alternatively use the File gt Print Preview menu to adjust titles and margins and view output before printing A typical fluorescein print is shown in Figure 47 Medmont E300 Corneal Topographer 79 Fitting Contact Lenses Figure 47 Example fluorescein printout in Print Preview 80 Medmont E300 Corneal Topographer Managing Exams and Calibrations 9 Managing Exams and Calibrations This sec
3. MEDMONT E300 CORNEAL TOPOGRAPHER USER MANUAL W Medmont International Pty Ltd 5 56 Norcal Rd NUNAWADING VICTORIA 3131 AUSTRALIA Phone 61 3 9259 0800 Fax 61 3 9877 643 1 e mail help medmont com au Web www medmont com au Doc No P 1470 V2 6 MEDMONT Dec 2014 CE Table of Contents MANUAL CONVENTIONS sisssssscsstasssccssssasccssacasscssestscssdacsscsssssaacsssadacecdscsascass 1 INTENDED PURPOSE asica eei anaa a aeaa eia aa o eiaa aeaee 2 POWer Conec Oisen n aaeceunstaces iti edaeaateed Snepeceeseces 3 Standard E300 ACCESSORIES sits reaches A A 4 Optional System Accessories available from Medmont cee 5 DP Aes ALS saints tanta ae tale eats nile at Denccishte E 5 Consumables y iernii in esha das ds Ganctud E S 5 THe Ts 300 SOLOW Are ioni vet eater wnttenAbsgeualevaiiecd ace enteten 5 Software Conventions 5 WARRANTY wisbechecssccccadivaavessscccasceissesecsucustenel sdedenasscswcesissmtesddvesuuedlsdsvesssaceteucus 7 TIER OR TAIN TD DAC TS oaa E aE 8 Explanation of Symbols and Labels 9 Regulatory Information 10 This instrument complies with all applicable Regulatory requirements and Safety Standards 10 Classification 10 Clinical Results 10 Accuracy and Calibration 10 Radiation 11 Electromagnetic Compatibility and Emissions 16 This instrument conforms to the EMC Standard IEC 60601 1 2 The device emits no harmful or undesired electromagnetic emissions 16 Interference 16 Side effects 16 Electrical sa
4. p 35 00 Standard Power K Scale Standard Power Universal Standard Scale Normalized Power Custom Edit Figure 27 Selecting the current Color Key Custom Color Keys You can customise the color key to highlight a particular aspect of an exam Drop down the Color Key selection box see Figure 28 and click on the Custom entry This will present the Custom Settings dialog shown in Figure 28 The Base Color Scale text box shows the base scale of the currently selected key and the three spin boxes show that key s parameters see Manual Conventions on page 1 Medmont E300 Corneal Topographer 57 Analysing and Viewing Exam Results Base Colour Scale Universal Standard Scale Absolute O Normalized Min Value 30 00 Max Value 67 50 Step Size 1 50 Cancel Figure 28 Color Key Custom Settings dialog The radio buttons provide for switching between Absolute and Normalized versions of the current Color Key The Absolute setting displays the data in the current image mapped into a fixed range of colors that defines the selected Color Key The Normalized setting linearly re scales the current Color Key so that its upper and lower bounds correspond to the limits of the data in the image An example is shown in Figure 29 for the Universal Standard Scale key g io m as eee es EEEbES ue Figure 29 An example showing the difference between an Absolute on the left and a Norma
5. 37 7 E300 Exam Sample User Sample Practice L L 4 Dec 1998 4 35 12 PM Jolly Nick Left 4 Dec 1998 4 3 38 7 E300 Exam Sample User Sample Practice L R5 Dec 1998 11 33 22 AM Fifer Michele Right 5 Dec 1998 11 39 1 E300 Exam Sample User Sample Practice L L5 Dec 1998 11 36 25AM Fifer Michele Left 5 Dec 1998 11 39 1 E300 Exam Sample User Sample Practice L L3 Jul 2004 2 00 49 PM Maenhout Johnny Left 3 Jul 2004 2 0 39 6 E300 Exam Dumon Patrick Contactlens Cent L R2 Dec 1998 12 51 11 PM Mills Karen Right 2 Dec 1998 12 43 1 E300 Exam Sample User Sample Practice L L2 Dec 1998 12 52 02 PM Mills Karen Left 2 Dec 1998 12 43 1 E300 Exam Sample User Sample Practice L L25 Nov 1998 12 36 05 PM Wong John Left 25 Nov 1998 1 43 3 E300 Exam Sample User Sample Practice L R 25 Nov 1998 12 35 00 PM Wong John Right 25 Nov 1998 1 43 3 E300 Exam Sample User Sample Practice L R4 Dec 1998 1 14 58 PM Wong John Right 4 Dec 1998 1 1 433 E300 Exam Sample User Sample Practice L L4 Dec 1998 1 15 34 PM Wong John Left 4 Dec 1998 1 1_ 43 3 E300 Exam Sample User Sample Practice 63 Analysing and Viewing Exam Results Adding and Editing Attributes 64 Medmont has already defined an extensive set of attributes You can define your own attributes to extend this standard set Access the Attributes control dialog on the Configure tab by clicking Attributes The Attributes dialog is shown in Figure 35 The Description column shows the derivatio
6. Polar Grid Colour Map Keratometric Axes roe Omg 70 Colour Map Opacity Auto SimKUnits ee KY Perspective ae ei i R H Pz S ssa U Perspective Scaling e EUnits a a Data s Setting Numeric Data Annotations SOS Ss Cartesian Grid Z Readout Zoom Pan Cursor Options Defaults Patients King Sue Blood John 10 Sep 1943 Breaden Andrew 24 Dec 1934 Briggs Warren 20 Oct 1917 Canon CR6 45NM 11 Oct 1990 Cherry Steven 16 Jan 1953 Citizen John 26 Aug 1961 Corneal Scar Corneal Denham Ada 18 Dec 1926 Fifer Michele 6 Nov 1959 Fredericks Fred 13 Apr 1920 Handle Maurice 13 Sep 1926 Hennessy Pauline 25 Apr 1919 A James Dorothy 1779 19 Nov 1916 1916 Jolly Nick 26 Mar 1960 2053 Ep pri Normalized Height Distance 0 00 mm Angle 0 Height Opm y King Sue 19 Mar 1961 2 Dec 1998 9 27 23 AM Right 22 Dec 1998 9 28 20 AM Left 16 Sep 2014 4 10 49 PM v lt gt i OA Y 34 found 50 45 40 35 30 25 20 15 10 05 00 05 10 15 20 25 30 35 40 45 50 amp Patients Exams L 200 Instruments Data Section Zoned K Comments Figure 14 Map View Medmont E300 Corneal Topographer Analysing and Viewing Exam Results Combination View This view displays four separate views of the selected Patient Exam see Figure 15 The Map Type and settings for each image can be controlled independently Use this view for an ov
7. 29 Testing a Patient While the software does not set a hard upper limit on the number of frames to capture captured images are written to memory and consequently this will impose a physical upper limit on the number of frames that may be captured Once the test has begun it can a King Sue be restarted at any point by 19 Mar 1964 clicking on Home gt Video gt 2 Dec 1998 9 27 23 AM Restart Restart will discard I Right the captured images in the qo 2 Dec 1996 2 26 20 AM preview window and capture a fag Cn new set of images using the P Right current capture control setting Navigate to Home gt Exam gt Save All button H will save the video against the current patient A video sequence appears in the patient explorer window as shown above Alternate Methods of Patient Selection Exams cannot be saved unless a patient is selected If a patient or a patient exam is currently selected before starting the Capture window then a new exam is created for that patient Otherwise the exam is created without reference to a patient However a patient can be selected or deselected from the Capture window while capturing a patient exam The Home gt Exam gt Clear button clears the currently referenced patient for the exam If a patient is currently selected her name is displayed in the caption bar of the window Click on the Home gt Patient gt Select button amp to bring up the Find Patient dialog see Figure 1
8. 60 73 87 100 Standard Elevation ig Fitting Zone 0 0 60 mm Best Fit Sphere 7 0 mm Fitting Sphere 7 0 mm Data Elevation Section ZonedK Comments e e __EEEIIIIIIIIIIIITTIIIIIIIIIEIIIIIIIEIIIIIIIIIEREIEIEIIIIIIIIIIIIIIIIIIRIRRRR a Figure 23 Elevation Tab The Elevation tab displays the following settings e Fitting Zone specifies an annulus of height data to use for fitting Best Fit Sphere the best fit sphere calculated over the fitting zone The best fit sphere is the one passing through the eye surface defined by the fitting zone minimising the surface elevations on either side e Fitting Sphere the radius of the sphere used to calculate the displayed elevation data This sphere is fitted to the fitting zone and the elevation in microns from the eye to the fitted sphere is displayed Clicking on the Display gt Map Type gt Data Settings button displays the Elevation Settings dialog shown in Figure 24 This allows you to change the Fitting Zone and Fitting Sphere By default the software uses the best fit sphere when calculating elevation data However you can force it to calculate the elevations from a sphere of a radius you specify by deselecting the Use Best Fit Sphere option Being able to specify a fixed fitting sphere can be useful when displaying elevation differences to ensure that both exams use the same baseline elevation Medmont E300 Corneal Topographer 51 Analysing and Viewing Exam Results C
9. CSV readable by most spreadsheets Exam Filters 62 Exam filters allow you to restrict which exams are shown in the Explorer pane Select the exams tab at the bottom of the Explorer pane and the select the Filter entry as shown in Figure 32 Figure 32 E300 exam filter selection This displays the dialog shown in Figure 33 and shows the many criteria that may be used for exam filtering You can also define your own selection criteria in the Advanced filter tab Medmont E300 Corneal Topographer Analysing and Viewing Exam Results Standard Advanced Exams With Exam Type Clinician _ Find Exams Without a Clinician fy To O Right Date of Exam gr Eye Left Binocular Categories Age 0 Of Patients With Date of Birth Sex Female Procedures Conditions Categories Figure 33 E300 exam filter selection dialog Sorting E300 Exams The E300 exams displayed in the Explorer pane can be sorted by any of the column headings when the exams tab is active Click on the heading for any column and the display will show exams sorted by entries in that column Click again to reverse the sort order Figure 34 shows an example of sorting exams by patient age Figure 34 E300 exams sorted by Age Medmont E300 Corneal Topographer Exams 3 Exam Patient Eye Date AgewhenTest Categories Type Clinician Practice L R2 Dec 1998 9 40 51 AM Smith Sandra Right 2 Dec 1998 9 4 17 9 E300 Exa
10. Corneal Topographer 69 Analysing and Viewing Exam Results Pupil Figure 39 Pupil Annoations showing the lock symbol Deleting Annotations To delete an annotation select the annotation by clicking once on it and then clicking on the Annotate gt Selection gt Delete button You can also right click the mouse button and select Delete Annotation Saving and Abandoning Changes Changes and additions you make while working with an exam are not automatically saved You will notice that as soon as you add an annotation two buttons will become available on the Annotate gt Changes ribbon bar group the Save and Undo buttons Use these buttons to control the saving or not of any current work If you do not use either the system will display a warning dialog when you attempt to move away from the edited exam Removing Artefacts 70 It is now possible to remove known artefacts from E300 maps If tear film or other artefacts are present on the eye being examined they can be removed using this tool Select an E300 exam from the tree view and click on the Analysis gt Data Points gt Edit button If raw analysis data is not already present the exam will be re analysed This will enable the eraser tool Medmont E300 Corneal Topographer Analysing and Viewing Exam Results 5 Dec 1998 11 36 25 AM Left Tangential Power 50 00 i i Imon 49 00 Bi 48 00 r 47 00 ge E 46 00 9 ee NS LA 45 00 S Sig ma 44 00
11. Default Cancel Figure 46 ACL TriCurve contact lens designer dialog Enter values in the numeric text boxes by clicking the spin buttons or using the keyboard see Software Conventions on page 5 For some lens designs changing values may cause other values to be recalculated to match For instance when the base optic radius is changed the peripheral curve parameters are generally automatically updated For the lens design dialogs where this occurs the automatically generated values can be overridden by changing them manually and you can uncheck the Auto Update option if you do not want the peripheral curves to be updated when you change the base curve or diameter of the lens Click on the Apply button to display the simulated fluorescein pattern for the new parameters The Defaults button restores the default settings for contact lens designs based on the eye geometry Moving the Contact Lens 78 The contact lens can be moved over the eye to determine how the fit varies as the lens moves Select the contact lens by clicking on the outside border or central dot You may need to move the section indicator first When selected the lens border and central dot are displayed in pink Hold the mouse button down while dragging the lens to move it When you release Medmont E300 Corneal Topographer Fitting Contact Lenses the mouse button the lens is left at the current location and a new simulated fluorescein pattern is generated
12. Results Filename hgt corneal height data in mm Filename dst radial distance data in mm Filename slp corneal slope data Each line of the file contains the data for a single spoke centred at the keratometric axes with data points for each ring Missing data is indicated by zero values There are 300 spokes each with 32 rings 74 Medmont E300 Corneal Topographer Fitting Contact Lenses 8 Fitting Contact Lenses The E300 software provides a simulated fluorescein display for evaluating the fit of RGP contact lenses see Figure 43 Note the T and N letters denote the Temporal and Nasal orientation of the lens The fluorescein display is a simulation and should only be used as a guide to the expected fit Simulated fitting of lenses larger than the captured data area is based on extrapolated data and may therefore be less accurate A NOTE trial lens fitting should always be performed to confirm the simulation results Custom 3 Curve 23 Sep 2014 4 13 47 PM 100 ee e meee Saar medmont a 87 amp X ie ie Fy 80 A 67 60 j ii 53 4 T N 47 i 40 A i 20 H 13 B 7 f Si Be aS ee a i Standard Fluorescein i Distance 6 12mm Angle 196 TFC No Data v amp Flatk 762mm 30 _ Steep K 6 49mm 120 AK 1 13 mm amp Flat e 0 28 30 Steep e 0 19 120 Lens Power 5 99 7 72x120 RX 0 00 0 00x0 S Diameter 9 00 mm BOZD 7 00 mm BOZR 7 33 mm Diameter 1 8 20 mm Wid
13. Settings ccccccccccccccessssseseesseeeeeeeceeeeeeeeaeaas Map Types Axial Curvature Map Axial Power Map Tangential Power Map Elevation Map Height Map Height Map Zernike Fit Height Map Zernike Residual Ray Error Map Refractive Power Map Tangential Curvature Map Wavefront Error Map Wavefront Error Map Zernike Fit Tear Film Quality Data View Display Settings Color Map Opacity Perspective Scaling Sim K Units E Units Display Options Image Color Map Cartesian Grid Polar Grid Keratometric Axes Medmont E300 Corneal Topographer Annotations 45 Exam Tab Pane 46 Data Tab 46 Section Tab 48 Zoned K Tab 49 Elevation Tab 50 Zernike Tab 53 Comments Tab 54 setine Wp the Color Key sre got uicsncscaatecaille a 54 Standard Color Keys 55 Color Key Descriptions 55 Custom Color Keys 57 Difference Color Keys 59 Zoomin and P AMM neca aa 60 Using the Mouse to Pan and Zoom 60 Displaying Analysis Details dacen ER 61 Exam Falters ei aasnaueeas eee 62 porting E5001 amis ste ieia cinta T ictal 63 Adding and Editing A tir Dues sectcsseounsseSvensdeeosauasne sur dvetasounestSvemneesaas 64 Cr ating a Composite EXAM 3 ii ic6 iw iisncthedadthencedabendss acca EE 66 Creatine an Ideali zed Eye ssrin a assent R 66 Adde Anno ON Sessan E E O 67 Text Annotations 67 Callout Annotations 68 Shape Annotations 68 Annotation Attributes 68 Editing Annotations 69 Locking Annotations 69 Deleting Annotations 70 Saving and Abando
14. a section line is displayed on the main map view to indicate the location of the slice of data being displayed You can move this line anywhere over the view to explore a specific cross section The dotted half of the indicator corresponds to the dotted portion of the cross section data The indicator has three handles Use the left mouse button to click and drag the handles to a new location Rotate the cross section about its centre using the outer handles Move the cross section Medmont E300 Corneal Topographer Analysing and Viewing Exam Results through the image using the centre handle The cross section data updates dynamically as the handles are dragged The vertical axis of the Section graph covers the same range as the current color key Note that the image may contain data that is outside the currently selected color key resulting in parts of the section graphic being clipped at the window edge s If you need to see the entire graphic use the Normalize button in the color key Custom Settings dialog see Custom Color Keys on page 57 Standard Elevation Distance 16 10 mm Angle 322 Elevation NoData v aca PEAS ERRIRE RODOQANION VAENE WEEER SRO CERESE NO NS TEA SC REAR E 9 EO REAR ERA mmr tnt ORREN DEERE oc p aa pp ss Sanaa eee acer Fikes RIE nears NUS NS nosh Aer Mees eer a ED a LAE Rene Sever Se Sass i H T ad i EE E A wdee a 6 0 AS 40 35 30 2 5 20 15 10 4 5 0 0 05 4 0
15. domestic and may be used in domestic establishments and those directly connected to the public low voltage power supply network that supplies buildings used for domestic purposes provided the following warning is heeded Warning This equipment system is intended for use by healthcare professionals only This equipment system may cause radio interference or may disrupt the operation of nearby equipment It may be necessary to take mitigation measures such as re orienting or relocating the E300 USB Corneal Topographer or shielding the location RF emissions CISPR 11 Class A Electromagnetic Compatibility and Emissions This instrument conforms to the EMC Standard IEC 60601 1 2 The device emits no harmful or undesired electromagnetic emissions Interference Strong electromagnetic interference from other unprotected devices may affect the performance or results of the E300 If the use of such devices with high electromagnetic emissions cannot be avoided do not use the E300 and the device simultaneously Side effects No undesired side effects to patient or clinician or other persons are known when using this instrument under normal conditions and for the intended purpose 16 Medmont E300 Corneal Topographer Important Facts Electrical safety of medical electrical system All the equipment connected of the E300 topographer shall be certified to EN TEC60950 It must be powered by an isolation transformer compliant to
16. keys Three apply to the Map types Medmont E300 Corneal Topographer 55 Analysing and Viewing Exam Results w medmont Standard Power The standard Medmont E300 color mapping for refractive power values in Diopters to color Similar to the USS scale but with a restricted range Normalized Power A normalized scale for mapping refractive power values in Diopers to a color scale using a linear Color Key such that it s upper and lower bounds correspond to the limits of the data in the image Universal Standard Scale USS An implementation of the proposed Universal Standard Scale for Corneal Topography by Smolek Klyce amp Hovis Maps refractive power values in Diopters to color K Scale An alternative scale for mapping refractive power values in Diopters to color Additional color scales are e Standard Curvature Maps the axial and tangential curvature values in mm to color e Standard Elevation Maps the elevation values in microns to color 56 Medmont E300 Corneal Topographer Analysing and Viewing Exam Results e Standard Height Maps the corneal height values in microns to color e Fluorescein Maps the contact lens fitting clearances in microns to the Fluorescein color scale The current Color Key type is displayed in a caption at the bottom left of each map display The keys can be selected from the drop down menu that appears by clicking on the caption see Figure 27
17. may affect performance and results of the E300 CAUTION Customers using their own table should ensure the linear guides are assembled parallel and positioned as per Figure 3 and that the table is adequately secured in Figure 3 Table setup and dimensions Medmont E300 Corneal Topographer 19 Installation Software Installation It is important that you read the Medmont Studio manual for additional details on installation The E300 software is a part of the Medmont Studio software package A single CDROM is supplied with installation software for all Medmont Studio components e Insert the Medmont Studio CDROM and run the Setup program found in the root directory Select the E300 component when asked which components to install e Select the correct frame grabber hardware for your system e Restart the computer when the software installation is complete Running the Software Select Medmont Studio from the Start gt Program Files gt Medmont gt Medmont Studio 6 menu or double click the W desktop icon Connecting the E300 instrument The following steps should be followed to connect the Medmont E300 Corneal Topographer to the PC for the first time Note the E300 Corneal Topographer requires Microsoft Windows 7 or greater to be installed Connecting the USB Video Converter box 1 Firstly connect the USB Video Converter box to the mains power using the supplied mains power cable Do not switch
18. of defining the best fit ellipse over the steep and flat meridians The following definitions are based on the definition of an ellipse as Visual axis C SS This is the standard mathematical definition of the eccentricity of an ellipse and is computer from e min a b Bice O anaa max a b Note that this e term for eccentricity cannot distinguish between oblate and prolate eyes p This shape factor attempts to overcome the limitation of the e value It is defined as Using this shape factor a circle can be described by p 1 a prolate ellipse has a p value less than 1 and an oblate ellipse has a p value greater than 1 Q This shape factor can be used to indicate how far a particular curve departs from sphericity Itis defined as Q p l Spheres have a Q value of zero Prolate shapes have negative values and oblate shapes have positive values Medmont E300 Corneal Topographer 43 Analysing and Viewing Exam Results 44 e2 This shape factor is similar to Q except that prolate shapes have positive values and oblate shapes have negative values Itis defined as prele a a Notes on Shape factors e p and Q The shape factors are useful in partially quantifying aspects of the shape of the eye They are all derived from an ellipse that approximates a specific cross section of the eye typically the steep or flat axis The applicability and usage of these terms is particularly well covered in the art
19. on the Analysis gt Create gt Ideal Eye button The software calculates the average steep and flat angles of the selected exams and creates a toric ellipsoidal surface based on the average height values at a set chord along these axes The chord used is that set for measuring shape factors in the E300 Options dialog Note that unlike the Composite Eye function the selected exams are not aligned to a common axes before being averaged The Ideal Eye function should therefore only be used on a single exam or exams where the pupil is aligned Medmont E300 Corneal Topographer Analysing and Viewing Exam Results Adding Annotations Graphical annotations can be added to E300 exams using the options in the Annotate ribbon bar tab The Display gt Show Hide gt Annotations check box must be checked to enable annotations Annotations are stored with the exam and may be printed exported and imported Annotations can also be added to the comparison view of two exams In this case the annotation is stored and the next time the same two exams are compared the annotation is displayed Text Annotations Clicking on Annotate gt Add Annotation gt Text changes the cursor to allow you to place a text annotation on the image Click at the location to place the anchor for the annotation the left hand end of the text The Text Annotation dialog see Figure 38 is then displayed allowing you to enter the text to be displayed You can us
20. that the software expects to use for image capture Keratometric power For a given line through the centre of the surface this is the axial power at the point on the line where a keratometer would take its measurement maximized when the given line is the steep axis Power maps Axial tangential and refractive power representations of the surface measured in diopters Reference axis On the physical instrument the longitudinal axis passing through the centre of all the Placido rings In the mathematical 3 dimensional space in which the surface is reconstructed it is a line passing through the centre of the image roughly orthogonal to the surface Refraction Summary of the patient s current spectacle prescription Consists of sphere cylinder axis and vertex Score An automatic percentage rating of the quality of an image Three basic scores are computed for each image measuring the amount of movement how well centered the eye is and the distance from the eye to the ideal capture plane A total score which is the product of the three basic scores is also computed Sim Ks Simulated keratometer values measured along the steep axis and the flat axis see keratometric power Steep Axis The axis along which keratometric power is maximized Surface Asymmetry Index SAI The SAI is the centrally weighted average of the difference in power between corresponding points at the same chord 180 degrees apart on the eyes sur
21. the medical standard EN IEC 60601 1 UL2601 or CSA22 2 601 1 see USB Video Converter box USB 2 0 cable e Calibration Object R 8mm with mounting screw e Standard Table Top e Chinrest e Instrument Cover e Accessory box including 2 Rail covers 4 mounting screws for chinrest 2 chinrest pins 1 box chinrest paper Caution label EN IEC60950 equipment Com port insulation plug spare fuse e E300 USB Quick install guide e Medmont Studio Installation Software and calibration file on USB key e Software license activation number Optional System Accessories available from Medmont on page 4 Disposal The expected service life of E300 equipment is 8 years For disposal at the end of the product life cycle please follow national regulations Medmont E300 Corneal Topographer 17 Installation 5 Installation The installation instructions and this user manual provide guidelines on the installation process Medmont or Authorised Distributors can provide this service for a fee If a third party installer is commissioned by the customer only a qualified PC technician should perform the hardware and software installation The basic tasks associated with installing the E300 are e Setting up the Instrument in a suitable environment e Installing the Medmont Studio Software PC and Associated Equipment Requirements When acquiring a PC for the Medmont E300 please observe the minimum requirements as given in the Medmont Studio
22. 00 exams This can be done by selecting a particular instrument then clicking the Install button It is recommended that ALL instruments are calibrated after their initial setup due to transportation To calibrate the instrument select the instrument and click Calibrate For more information about the calibration process see page 83 Disconnecting the E300 instrument 22 The following steps should be followed to disconnect the Medmont E300 Corneal Topographer from the PC and the Mains Power socket if the USB Video Converter box supplied Disconnecting the USB Video Converter box 1 Turn off the USB Video Converter box first 2 Disconnect the E300 Corneal Topographer 8 pin DIN plug from the USB Video converter box Medmont E300 Corneal Topographer Installation 3 Disconnect the USB Video Converter box from the PC by removing the supplied USB cable from the PC Disconnecting from the Mains Power outlet 1 Disconnect mains power by pulling out the supplied mains power cable connected to the USB Video Converter box Medmont E300 Corneal Topographer 23 Testing a Patient 6 Testing a Patient The following sections describe the steps to performing an examination with the Medmont E300 instrument Patient Selection The recommended practise is to have a patient selected before starting to capture and analyse an exam Figure 5 shows the Medmont Studio initial display with a patient selected in the explorer pane
23. 1 30 Medmont E300 Corneal Topographer Testing a Patient LastName First Name External ID Date of Birth Matching Patients Last Name Canon i H Cherry F Citizen First Name CR6 45NM Steven John Birth Date 11 Oct 1990 16 Jan 1953 26 Aug 1961 Denham Fifer amp Fredericks amp Handle E seren O Retesn Ada Michele Fred Maurice New Patient Figure 11 Patient Selection Dialog 18 Dec 1926 6 Nov 1959 13 Apr 1920 13 Sep 1926 Cancel Select a patient from this list and click OK You can now save an exam against this patient Medmont E300 Corneal Topographer 31 Analysing and Viewing Exam Results 7 Analysing and Viewing Exam Results The E300 software provides a variety of ways in which to view exam results The Exam View mode controls how selected exams are displayed see Setting the Exam View Mode on page 32 For each of these modes you can set the type of data to display see Changing the View Settings on page 36 and the color mapping see Changing the Display Settings on page 36 Selecting the Exam Results The first step in viewing Exam Results is selecting the exam s to view To select the exam for a particular patient click on the exam symbol L or the date of the exam in the Medmont Studio Explorer pane To select multiple exams hold down the control key while clicking on the symbols Setting th
24. 1 5 20 245 30 35 40 45 50 Data Elevation Section Zoned K Comments Figure 21 Section Tab If Keratometric axes are displayed then you can click on the steep and flat axes to move the section indicator to the selected flat or step angle Zoned K Tab The Zoned K Tab displays keratometric values over 3 zones 3mm 5mm and 7mm Each zone is independently analysed to locate the primary most steep and most flat and the secondary second most steep and second most flat area The primary steep and flat zones are shown on the map display using a thick red or blue line whilst the secondary steep and flat are shown using a thin red or blue line respectively Medmont E300 Corneal Topographer 49 Analysing and Viewing Exam Results Unit of measurements are specified by the Sim K units drop down box on the Display tab Standard Elevation Distance 4 85mm Angle 203 Elevation No Data y Central 0 3 mm Mid 3 5 mm Periphery 5 7 mm 54 02 D 116 56 38 D 133 58 12 D 295 49 63 D 277 53 73 D 270 55 40 D 180 42 58 D 28 39 61 D 23 40 76 D 25 45 94 D 199 45 98 D 188 51 35 D 195 Data Elevation Section Zoned K Comments p Figure 22 Zoned K Tab Elevation Tab The Elevation tab see Figure 23 is only displayed when the Elevation map type is selected via the Display gt Map Type ribbon 50 Medmont E300 Corneal Topographer Analysing and Viewing Exam Results 100
25. 33 E 44 00 BB 43 00 a 6 00 E 42 00 ia 487 I 41 00 E 40 00 fz 3 33 Hl 39 00 Hl 33 00 g 2 00 E 37 00 i E 36 00 Hr a 0 67 E 35 00 300 l j A 0 67 Standard Power ce 0 00 mm Angle 0 Power 45 27 D o 2 00 Exam B E a 3 33 Wong John Right 4 Dec 1998 13 14 PM 50 00 ip g Ma medmon 2 4 67 Hl 49 00 20 60 E 42 00 5 Be 45 Ej 6 00 E 47 00 T 46 00 30 4500 E 44 00 E 43 00 E 42 00 EE 41 00 1 33 E 8 67 a 10 00 Standard Power Diff Distance 0 00mm Angle 0 Power 0 53D v a Data Section Figure 16 Compare View Changing the Display Settings You can customise the information displayed for a Patient Exam for each Exam View see Setting the Exam View on page 32 Once an exam is selected the Display ribbon tab will become available see Figure 17 allowing you to set the Map Type to display and other options 36 Medmont E300 Corneal Topographer Analysing and Viewing Exam Results Axial Power x _ of Image Ww Polar Grid ea 70 Colour Map Opacity Auto SimKUnits Z Colour Map Keratometric Axes aP WY Perspective i 0 Perspective Scaling e E Units Numeric Data M Annotations Fanat Jass 4 Cartesian Grid Z Readout Map Type Settings Options Defaults Figure 17 Exam Display Ribbon tab These options are applied to the image as you change them and are immediately visible You can click
26. Do not use strong oxidising agents or solvents as they could damage surface coatings Do not use any aerosols or sprays that could contaminate the optics Use soft non abrasive cloth only Special care of the inside of the cone is required and is described in the section below Cleaning of contaminated Optics 96 The following optics are externally accessible and subject to contamination from dust residues from evaporated liquids body acids and fats and makeup e Cone surface e Imaging lens front surface e Profile illumination window on RH channel just inside cone edge e Profile image window on LH channel inside cone edge Internal optical surfaces are not accessible without disassembly Do not attempt to disassemble or turn any of the sealed mounting screws as the alignment of the optics and the calibration may be altered considerably Do not put any objects into the cone other than those listed Recommended cleaning materials e Cotton tips For Profile windows preferred tapered cotton tips e Micro fibre cleaning cloth or lint free lens paper e Non smear optics cleaner or diluted IPA Medmont E300 Corneal Topographer Cleaning Maintenance and Service The cone assembly is made of polymer products This means the cone is sensitive to mechanical surface damage scratches dents and may not be chemically resistant to certain solvents Do not use any abrasive cloth or strong organic solvents like acetone The i
27. GR Move To L A 0 Ye Add a be ae S Copy To Digita _ Corneal ntact Perimetry mos f Find New Delete Delete image Topography ens Exam i Jobs Add Submit Export kd Patient Exam New Exam Favorites DICOM Peridata Patients King Sue Jolly Nick 26 Mar 1960 Jones Chris 18 Nov 1971 King Sue 19 Mar 1961 Love Sarah 17 Sep 1976 Madison Charlie 4 Jun 1974 Marshall Trevor 13 Aug 1962 McCallister Pip Title 23 Dec 1954 Mills Karen LastName Ki 9 Oct 1955 3 Mowbray Lois First Name 19 Jun 1918 Patterson Stefanie Middle Name 20 Sep 1928 Peterson Margaret Date of Birth 19 Mar 1961 8 Nov 1944 Preston Nola 11 Feb 1922 Radford Christine Sex _ 21 Aug 1970 Female Rogers John 9 Jan 1990 Ryan Rita 24 Feb 1907 Senior Lynn 16 Jun 1924 Smith Ben 17 Jan 1936 Smith Sandra 24 Dec 1980 v 3 Al v 34 found amp Patients Exams L E300 Instruments E D gt General Clinical Comments External Record C Male Figure 5 Patient selection 24 Medmont E300 Corneal Topographer Testing a Patient Positioning the Patient In order to capture good quality and accurate images some precautions should be followed in positioning the patient correctly While these are well known and standard practice for corneal topography examinations here we reiterate the most important points as they apply to the E300 The patient should sit comfortably in the chair Ask the
28. Menu and Icon Reference spoke with the highest average axial power whilst the flat axis is always set at 90 degrees from the steep axis Annotations Toggles on off the Annotations stored within the exam Annotate Tab Items The Edit tab is added by the E300 component It is only displayed when a Patient Exam is selected Text add a text annotation to the image Callout add a callout annotation to the image I amp Ruler create ruler annotations used to measure distances on the image to Circle create circle annotations to Ellipse create ellipse annotations gi Rectangle create rectangle annotations gE Square create square annotations Polygon create polygon area annotations is Curved create curved area annotations va Freehand create freehand area annotations A Properties change the properties of the selected annotation A Delete delete the selected annotation g Pupil allows you re compute the pupil i Iris allows you to define the iris 92 Medmont E300 Corneal Topographer Glossary of Terms 12 Glossary of Terms Analysis The process by which the Placido rings or segments thereof are identified on the image and from their distortions as much of the corneal surface as possible is reconstructed Calibrate The process in which an optimal calibration is obtained such that the overall error in reconstructing the surfaces for the calibration i
29. User manual Use only a PC and associated equipment that has been certified to the Standard EN IEC60950 Information CAUTION Technology Equipment and the Standards for Electromagnetic Emissions CISPR22 EN55022 If used within a patient environment power the PC and associated equipment with an EN IEC60601 1 compliant ai isolation transformer e g TR2450 230 240V Cover any open PC communication ports that have accessible conductors with dummy plugs if used in a patient environment CAUTION Instrument Environment The E300 is highly precise measuring equipment and must be located in a suitable and clean environment The environmental requirements for the E300 are 18 Medmont E300 Corneal Topographer Installation Room temperature 10 C to 40 C Relative humidity 10 to 80 Keep the instrument away from direct sunlight and avoid unnecessary exposure to heat and light Avoid overly bright rooms to keep stray light level low Set up the instrument that any unavoidable bright light sources are opposite the cone opening Set up the instrument that all interface and power cables are easy to access Do not set up the instrument in proximity to devices with high electromagnetic emissions Temperatures too low may cause condensation on the optics while temperatures too high may result in de calibration of the instrument After such an event a calibration check is recommended Strong surrounding electromagnetic fields
30. acai Gee stecas oa miei aale 86 MENU AND ICON REFERENCE cissccscscssscccscsasccsssssscscdscsscsssssassscsasasecsscsaass 88 Home Tiben oo cist nt essiitvcisedeailtatelavatidecilesttaasaeied cies neianesiewedatadaa ates 88 CONT CUTS Tab Tems ve scacinsa esacscscenseraissnesndcencanamncnadecanasuveonseaasadieencinemecsess 88 IV FCW AH TIS A tana A E E A E AE E E tetas 89 Analysis TaD MEMS yneuers dinaa aN 89 Display Va Tte Misosi r T ti chareeausdesie le ecaniasceale 90 Annotate aple MS esnean a a a 92 GLOSSARY OF TERMS sccsssssesaciacincavedsicsesescartasecetesasieeinctinceiereserseiasadeiniiiss 93 CLEANING MAINTENANCE AND SERVICE seeeececccsccssssssssccceceeesssso 96 Routine Hy eiene aid C lednih sucre O O 96 Cleaning of contaminated Optics ccccccccccccccccssssssesesseeeeeeeeeeeeeeeeeaaas 96 2 al DE ATION O DCC bezesi aa A 97 TSDC ALON case sacs annua vatecuiaina Ga au A dea aveadecucaveras 97 SY 1S oe ss see sess steer E E 97 TROUDIESNOOHNG xis iisecet cies weston aN nea 98 SPECIFICATIONS siisccisesesccesesscncssesacsesesnecsesesosdcesssdccssessacdesesbecessesasacesesdecss 100 DECLARATION OF CONFORMITY eeeeecccccccssssssesseceecccsosoosssssssseeeee 102 REPRESENTATIVES scscautesscdctzsacisvivctigdedocaseaoniesccciniessvciaceteceinsaiosenesesadsieets 103 Medmont E300 Corneal Topographer Manual Conventions 1 Manual Conventions In discussing the normal interaction between the software and those involved in a part
31. age values of the currently selected exams Edit Allows you to edit the E300 exam to highlight and remove artefacts Remove Selected Removes a point s that have been highlighted as an artefact for removal Display Tab Items 90 The Display tab is added when a graphical E300 view is selected or taking an E300 exam see Setting the Exam View Mode A m H o es we Reset resets the zoom and pan to the default settings for the displayed view Zoom In zooms in on the displayed views Zoom Out zooms outwards on the displayed views Pan Left pan to the left of the displayed views Pan Right pan to the right of the displayed views Pan Up pan towards the top of the displayed views Pan Down pan towards the bottom of the displayed views Select set the cursor mode of the displayed views to enable selection of the section indicator and cursor readout Pan set the cursor mode of the displayed views to enable interactive panning using the mouse Zoom set the cursor mode of the displayed views to enable zooming using the mouse Planar image data is displayed as a plan color map Medmont E300 Corneal Topographer Menu and Icon Reference Perspective image data is display a color map overlayed on a perspective 3D view of the eye Reset Resets the Display tab options back to their default settings Map Type a drop down list box that allows
32. and Viewing Exam Results In Zoom mode click on the point in the image that you wish to zoom in on The image will continue to zoom in while the left mouse button is held down If you hold the Ctrl key down while clicking then you zoom out instead of in Displaying Analysis Details The Analysis Details dialog provides numerical readouts of various analysis parameters at a specified meridian and chord for the currently selected exam s Note that you can select more than one exam to analyse Click on the Analysis gt Show gt Details button to display the Analysis Details dialog see Figure 31 This displays the corneal height shape factor and apical curvature at the selected chord and meridian The Steep and Flat buttons set the meridian to the steep and flat axis respectively Meridian degrees Chord mm 180 Exam Apical Curvat Weighted Ave e Values e Eccentricity Axial Curvatun Tangential Cu Height Surface No gt 3 Dec 1998 4 09 17 PM 6 983 No Data 0 39 0 62 No Data No Data No Data No Data u mean 6 983 undefined 0 39 0 62 undefined undefined undefined undefined a standard deviation undefined undefined undefined undefined undefined undefined undefined undefined Print Print Preview Figure 31 Analysis Details Dialog The tabulated data shows the values for the currently selected exam The statistical measures of mean and standard deviation are also given The section and readout indicators of di
33. ard Table Top Chinrest Instrument Cover Accessory box including 2 Rail covers 4 mounting screws for chinrest 2 chinrest pins 1 box chinrest paper Caution label EN IEC60950 equipment Com port insulation plug spare fuse E300 USB Quick install guide Medmont Studio Installation Software and calibration file on USB key Software license activation number Medmont E300 Corneal Topographer Intended Purpose Optional System Accessories available from Medmont e DV2000 Diagnostic Video Imaging software module e Medical Isolation Transformer e Electric Table e Converter box upgrade kit e Reverse adaptor cable e replacement slide rail replacement kit for E300 E300 W Spare Parts Calibration Ball PN 0274 370 Com Port insulation plug PN 0744 Main Cable Replacement Kit PN 2097 Consumables Chinrest Paper models E300 E300W pack 300 pc models E300 U E300 USB pack 300 pc Cotton swabs Tapered double headed on 150mm wooden sticks Cat No MG 8112 100 bag of 100 The E300 Software The E300 Software is part of the Medmont Studio integrated software environment See the Medmont Studio documentation for help on installing and using the Medmont Studio environment Software Conventions Medmont E300 Corneal Topographer 5 Intended Purpose When referring to menu selections the notation Home gt Patient gt New means click on the Home ribbon bar tab then look for the Patient group on the ribbon bar and click on
34. at any time on the Display gt Defaults gt Reset button to restore the software defaults Map Types The Map Type controls the type of data displayed for a Patient Exam The types displayed in the following list are selected from the drop down boxes on the Display ribbon bar tab In each case the images are of the same exam g medmont Axial Curvature Map Displays the curvature of the surface in mm with respect to the keratoscope axis Axial Power Map Displays the paraxial power of the surface in Diopters with respect to the keratoscope axis Tangential Power Map Displays the local paraxial power of the surface in Diopters Medmont E300 Corneal Topographer 37 Analysing and Viewing Exam Results 38 my medmont Elevation Map Displays the distance from a specified best fit sphere to the surface in microns Positive values indicate the surface is above the best fit sphere Height Map Displays the distance along the axis from the apex of the eye to the surface in microns Height Map Zernike Fit A decomposition of the height data in terms of the Zernike components These can be added or removed from the display by selecting the Data Setting button underneath the Map drop down list Medmont E300 Corneal Topographer Analysing and Viewing Exam Results Height Map Zernike Residual A decomposition of the height data in terms of the Zernike components These can be added or
35. ce according to frequency of transmitter output power of transmitter m 150 kHz to 80 MHz 80 MHz to 800 MHz 800 MHz to 2 5 GHz d 1 2VP d 1 2VP d 2 3VP For transmitters rated at a maximum output power not listed above the recommended separation distance d in metres m can be estimated using the equation applicable to the frequency of the transmitter where P is the maximum output power rating of the transmitter in watts W according to the transmitter manufacturer NOTE 1 At 80 MHz and 800 MHz the separation distance for the higher Medmont E300 Corneal Topographer Important Facts frequency range applies NOTE 2 These guidelines may not apply in all situations Electromagnetic propagation is affected by absorption and reflection from structures objects and people Electromagnetic Emissions This device does not emit harmful or undesired electromagnetic emissions The device is compliant with medical standard EN IEC60601 2 MEDICAL ELECTRICAL EQUIPMENT needs special precautions regarding EMC and needs to be installed and put into service according to the EMC information provided in the ACCOMPANYING DOCUMENTS If the E300 USB Corneal Topographer is used in a domestic establishment or connected to the Mains Public Network following warning shall apply WARNING WARNING WARNING This equipment system is intended for use by healthcare professionals only This equipment system may cause radio interference o
36. d Body identification The date below this symbol shows the year and month of manufacturing The patient environment comprises a 1 5m radius around the area in which patient or some other person can touch parts of the medical system intentionally or unintentionally This label is to be attached in a visible position on any EN IEC 60950 compliant equipment used within the electro medical system of the E300 Protection against ingress of water Power Indicator on rear side of unit The E300 is powered if indicator is illuminated green unpowered if un illuminated Medmont E300 Corneal Topographer Important Facts COVER OPEN PC COM PORT IN PATIENT camo ENVIRONMENT henset International Pty Ltd Australia This label is found on the PC port insulation plugs These plugs are for RS232 and Network ports and these ports are to be covered if the PC is used within the patient environment E300 Device Label here shown for the USB CORNEAL TOPOGRAPHER ai wooe E300Us8 M Q variant positioned at bottom of base next to nga cable exit 12 VDC 6W via E300 USB Converter C E 100 240 VAC 0 25 0 15A 50 60 Hz Regulatory Information This instrument complies with all applicable Regulatory requirements and Safety Standards Classification In accordance with IEC 60601 1 the E300 Corneal Topographer is classified Protection against electric shock Class I Protection against harmful ingress of Ordinary no water pr
37. d m below any levels known to be hazardous Electromagnetic Interference Strong electromagnetic interference from unprotected devices or portable and mobile RF communications WARNING equipment or mains disturbances voltage dips transient surges or electrostatic discharge may affect the performance or results of the E300 USB Corneal Topographer Avoid using the device while such high interference is present The device is compliant with medical standard EN IEC60601 2 Guidance and manufacturer s declaration electromagnetic immunity The E300 Corneal Topographer is intended for use in the electromagnetic environment specified below The customer or the user of the E300 USB Corneal Topographer should assure that it is used in such an environment IMMUNITY test IEC 60601 Compliance Electromagnetic test level level environment guidance Electrostatic 6 kV contact 6 kV contact Floors should be wood discharge ESD 8 kV air 8kV air concrete or IEC 61000 4 2 ceramic tile If floors are covered with synthetic material the relative humidity should be at least 30 Medmont E300 Corneal Topographer 1 Important Facts Electrical fast transient burst IEC 61000 4 4 Surge IEC 61000 4 5 Voltage dips short interruptions and voltage variations on power supply input lines IEC 61000 4 11 Power frequency 50 60 Hz magnetic field IEC 61000 4 8 2 kV for power supply lines 1 kV for input outpu
38. de to analyse the image before saving If this is the case then click on the Home gt Exam gt Save button la A Patient Exam item is added to the Explorer pane under the current patient You can save more than one exam if you wish To view the Exam Results select the Exam in the Data pane and the View Mode see Analysing and Viewing Exam Results on page 32 Capturing Video The E300 can capture video at frame rates of up to 25 frames per second fps Click on the Home gt New Exam gt Corneal Topography button L to display the E300 Capture View see Figure 7 The red illumination rings inside the E300 cone should turn on Navigate to Home gt Capture Mode gt Video Figure 10 Make your selection for the maximum duration and the frames per second from the two spin boxes If previous video images were captured the Start button will be greyed and you must press the Home gt Exam gt Clear button S to prepare for the next capture sequence Ready the patient as before When focussing and centring are correct press the F9 key on the keyboard or click Start to start the capture sequence The E300 will continue capturing until it has either captured the set number of images or the F9 key or Home gt Video gt Stop button amp is pressed again dF Max Duration sec 10 00 00 Frames Per Sec 20 ba Compress Images Capture Mode Video Video Settings Figure 10 Video capture controls Medmont E300 Corneal Topographer
39. e Exam View The active View controls how the selected Patient Exams are displayed You select the active view by going to View gt Active View from ribbon bar Configure View Details Image Compare Combination Active View Figure 12 Possible E300 Exam Views Details View This displays textual information about the selected Patient Exam see Figure 13 It provides for the clinician to add comments and where an exam has been attributed to the wrong patient to change the owning Patient see Editing Exam Details on page 81 32 Medmont E300 Corneal Topographer Analysing and Viewing Exam Results 2 Dec 1998 9 27 23 AM Right Patient King Sue Change Exam Date 2Dec 1998 09 27 23 AM al Eye Left Right Instrument E30120 Calibration Calibration 23 Nov 98 2 08 PM hia Analysis Type Normal Categories wg Fractice Sample Practice al Clinician Sample User Ba Comments Figure 13 Patient details view Medmont E300 Corneal Topographer 33 Analysing and Viewing Exam Results 34 E Image View This displays up to four different selected Patient Exams with the same Map Type see Map Types on page 37 and Color Key see Setting Up the Color Key on page 54 Select multiple exams by first holding down the Control key then left click the mouse on the subject exams Use the View mode to display full screen color map images of a single exam or to display images of multiple exams Image
40. e and qualified providers Medmont will make available on request to Medmont E300 Corneal Topographer 97 Cleaning Maintenance and Service the service provider circuit diagrams components parts lists and instructions etc as required Troubleshooting The following guide is an aid for the user to help identify describe and remove certain errors No video image 12V indicator light is OFF Instrument ON OFF switch on Check power adaptor is fully plugged in Return back to supplier for repair No video image USB power indicator is Ensure USB plug is properly OFF connected at both the PC and converter box ends Return back to supplier for repair No video image Error indicator is flashing Disconnect and reconnect the USB connection to perform system reset Return back to supplier for repair No video image MEDMONT E300 USB Instrument ON OFF switch on device not displayed in Check status lights are showing Device Manger correct power connection Check USB port is at least USB 2 0 or higher Check Windows XP SP2 or higher is installed Reboot the computer to re Initialise the USB port Return back to supplier for repair No cone Illumination only comes on Instrument ON OFF switch on illumination for a few seconds when Check power adaptor and D plug computer boots up or to frame grabber are not loose when in Capture mode Check frame grabber card is firmly in PCI slot 98 Medmont E300 Corneal To
41. e the various controls to change the Font Background color no background color Transparent Text Color and Text horizontal Alignment and Vertical position Font Arial Bold 12 Point Background Transparent Text Color Text Alignment Vertical Position Save as default Figure 38 Text Annotation Dialog Medmont E300 Corneal Topographer 67 Analysing and Viewing Exam Results 68 Callout Annotations Clicking on Annotate gt Add Annotation gt Callout changes the cursor to allow you to place a text callout annotation on the image This consists of a text label and line pointing to the selected anchor location A dialog similar to Figure 38 is displayed to allow you to enter the text for the annotation Shape Annotations The Annotate gt Add Annotations ribbon bar group includes a number of shapes you can use to delineate areas in the image These are Circle Ellipse Rectangle and Square with an additional three tools for drawing polygonal Areas The shapes are shown in the Medmont Studio user manual You can also draw a ruler that resembles a Callout annotation where the callout is automatically the current length of the ruler in mm The Area drawing tools all work in a similar way to each other The Annotate gt Add Annotations gt Polygon tool draws a straight line between each point you define by pressing the left mouse button Press the right mouse button to automatically close the pol
42. e wizard will automatically capture the Medmont E300 Corneal Topographer Calibrating the E300 image Press the Next button and repeat the process to capture each of the five images a na Capturing Image 1 of 5 Mountthe calibration object on the chin restand align the topographer to automatically capture the image Press Next to continue Figure 50 Capturing Calibration Images Checking the Current Calibration When the five images have been captured the wizard calculates the error in the current calibration and displays it see Figure 51 This screen allows you to choose to recalibrate the instrument or continue using the current calibration The wizard will recommend a course of action depending on the degree of error in the current calibration Medmont E300 Corneal Topographer 85 Calibrating the E300 Verification Complete The current calibration error is 0 204 Medmont recommends that instruments with an error greater than 0 15 should be recalibrated C Quick Recalibration iS Full Recalibration Highly Recommended C Use the current calibration Note Quick Recalibration generally requires less than an hour Full Recalibration may take up to 6 hours depending on the speed of your computer and the current calibration error Figure 51 Verifying the Current Calibration Recalibrating the Instrument 86 If you elect to recalibrate the instrument the Calibration Wizard will run the calibration
43. easing asymmetry in corneal power distribution e Surface Regularity Index SRI a measure of the surface irregularity It increases as central corneal irregularity increases e HVID this is a measure of the horizontal visible iris diameter You will need to manually define an iris for this attribute to be defined 46 Medmont E300 Corneal Topographer Analysing and Viewing Exam Results e TFSQ a measure of the tear film surface quality Tear film breakup results in a large standard deviation in the local widths of the reflected mires and results in a larger Tear Film Quality value at that point The TFSQ attribute is an average of the local Tear Film Quality value over the entire eye e TFSQ Central a measure of the tear film surface quality over the central region 4mm chord of the eye Flat K 44 33D 30 Steep K 52 05 D 120 AK Flat e 0 28 30 Steep e 0 19 120 IS Index Jf SAI 4 05 SRI 1 55 Pupil Width Pupil Area 13 3 mm HVID mm TFSQ TFSQ Central Data Section ZonedK Comments Figure 19 Data Tab You can select the attributes to be displayed and their order by clicking on the Arrange user defined attributes button on the left of the tab This displays the Arrange Attributes dialog shown in in Figure 20 The Available column on the left is the list of available attributes while the Selected column on the right is the list of those attributes selected for display You can move any
44. ed as described in this manual and only for the intended purpose Figure 1 The E300 Instrument 2 Medmont E300 Corneal Topographer Intended Purpose Power Connection A typical power connection between the various units is shown in Figure 2 USB Video Converter Box E300 Custom Cable USB Connection Mains Isolation Power Transformer Monitor Figure 2 Typical Power Connection Medmont E300 Corneal Topographer Intended Purpose CAUTION For the diagnosis treatment or monitoring of a patient under medical supervision there are three area definitions Patient Environment Medically used room and Non medically used CAUTION room Each area demands different electrical safety requirements for your system Please make sure that your system is set up correctly in the right environment When used in a Patient Environment the PC and its Monitor if separate refer to Figure 2 must be powered via a protective isolation transformer compliant to the governing medical standard IEC60601 1 or UL2601 CSA22 2 601 1 for North America only A hospital grade power cord must be used to achieve reliable grounding Tthe Isolation Transformer must be certified either cULus or cCSAus for North America or UL for US market or CSA for Canadian market or meet National Electrical Regulations Standard E300 Accessories USB Video Converter box USB 2 0 cable Calibration Object R 8mm with mounting screw Stand
45. erview of the corneal data King Sue 2 Dec 1998 9 28 20 AM Left Axial Power E Axial Power E E 50 00 Q medmont E 50 00 aia G medmont E 4 00 E 49 00 ie Hl 42 00 Hl 42 00 Bi 47 0 Be 47 00 I 46 00 I 46 00 gt 45 00 gt 45 00 My 44 00 MN 44 00 Bl 43 00 7 Bl 43 00 7 BE 42 00 BE 42 00 41 00 E 4100 E 40 00 E 40 00 E 39 00 E 39 00 E 32 00 E 22 00 E 27 00 E 27 0 35 35 00 4 A i i i Standard Power Stance 0 00 mm Angle 0 Power 44 03 D Standard Power Stance 0 00 mm Angle 0 Power 44 03 D A A Tangential Power E Elevation E pape medmont by medmont i E 73 E 42 00 E co F s 46 00 20 45 00 7 EE uo P E 42 00 E 33 E 42 00 E 4100 mm 73 HB 40 00 ma 27 HM 39 00 MM i00 paes Standard Elevation 1ce 0 00mm Angle 0 Elevation 1 um 5 v E 26 00 A E o iy Fitting Zone 0 0 6 0 mm Standard Power Stance 0 00 mm Angle 0 Power 44 05 D a Dat Elevation Section ZonedK Comments Figure 15 Combination View Medmont E300 Corneal Topographer 35 Analysing and Viewing Exam Results ise Compare View This view displays two selected Patient Exams and the difference between them Use this view to observe changes over time and healing patterns Exam A a Exam B minus Exam A a Wong John Right 25 Nov 1998 12 35 PM Axial Power E 50 00 een e E 49 00 u 60 a 10 00 Q medmont E 42 00 15 5 E 47 00 ta p 8 67 E 46 00 f 30 4500 a 7
46. f income or service and repair costs for components and associated equipment Warranty claims are the responsibility of the outlet where the device was purchased The warranty and calibration is void if the QA seal between camera and optics housing is broken Medmont E300 Corneal Topographer 7 Important Facts 4 Important Facts The E300 Corneal Topographer is a highly accurate measuring instrument It measures and maps the surface of the human cornea and represents the results in various quantities and output forms that can be applied in various medical applications It combines these results with theoretical surface shapes to form the basis for precise contact lens fitting 8 Medmont E300 Corneal Topographer Important Facts Explanation of Symbols and Labels gt CAUTION A NOTE EN IEC 60950 CERTIFIED EQUIPMENT IS USED WITHIN PATIENT ENVIRONMENT USE TOGETHER WITH AN ISOLATION TRANSFORMER OR ADDITIONAL PROTECTIVE EARTH TERMINAL TO CAUTION SYSTEM GROUND p PATIENT ENVIRONMENT ATTACH TO AFFECTED APPLIANCE 7 IPX1 eo _ POWER _ Caution In event of user error or equipment fault condition there may be a serious risk to health or life of patients or operator or product damage or loss may occur Precaution Attention consult accompanying documents Alternating current Compliance with the EC Directive 93 42 EEC for medical devices here shown with Notifie
47. face 6 R Where R radial distance from the keratometer axis Surface Regularity Index SRI This is a calculation of amount of local variation in the power of the eye within the average virtual pupil The predicted power at a point is calculated as the average of the values of its rectilinear neighbours The difference between the predicted power and the actual power is averaged over the central 4mm chord area Medmont E300 Corneal Topographer Glossary of Terms The SRI is then given by SRI log ZERO _ POINT SCALING _FACTOR x ave abs Pr edictedP ActualP Where PredictedP Predicted Tangential Power based on the average power of the rectilinear neighbours Actual P Actual Tangential Power SCALING_FACTOR 10 0 ZERO_POINT 0 90 Tear Film Clearance TFC The distance between the surface of the eye and the contact lens at a point Medmont E300 Corneal Topographer 95 Cleaning Maintenance and Service 13 Cleaning Maintenance and Service To maintain the life of the components and the accuracy of the instrument regular maintenance is required in the form of lubrication and cleaning Routine Hygiene and Cleaning All surfaces coming in contact with patients need regular disinfecting Standard instrument grade disinfectant like IPA Isopropylalcohol diluted with 50 water may be used on all external surfaces Wipe surfaces with a damp cloth only to avoid liquid entering delicate parts and optics
48. fety of medical electrical system 17 Disposal 17 INSTALLATION iiianoe e e SaO O En ESNE 18 PC and Associated Equipment Requirements cccccccceeeeeeeeeeeees 18 Instrument EnvitonmMeNt seernes i r ai 18 Software Installation sissies cazyscsseecdiacedanogauvenctanesenes ideas ceemsenaaedeseaciremseniies 20 Running the Software 20 Connecting the E300 instrument oise 20 Connecting the USB Video Converter box 20 Checking the E300 instrument is connected 21 IriStallinie the SOO ict teceit i a ierinoes te nhaaamueds 22 Disconnecting the E300 instrument ssssssssssssoooeeeeeeeesssssssssssssseseeereee 22 Disconnecting the USB Video Converter box 22 Disconnecting from the Mains Power outlet 23 Medmont E300 Corneal Topographer ll SEIN G Fa TIEN as sac case cscs eee secede EAEE R EEEa Patent SC oC OM tad arseespacdannsnded don tsacatsieasaades E AE r AE E Enia POS TO Mito the Patient guctatececcedosicoccsnendeiactuitnahanncsctecosicueassentessaeul aetenncees CC aon Parent TX AIS senne n E EEEE Saying the Best Mape scesi EEE Ca UU VideO sieisen en ae E Alternate Methods of Patient Selection c cc sssssesssssseeeeeeeeeeeeeeeeeaaas ANALYSING AND VIEWING EXAM RESULTS cccssssscceceeeeeees Selec ns the Exam RES ULES sses EEE Seting the Exam Vie W secret ca nacec cececceeieresvesueeieaeisaned ancecesseiesesunntcas Details View Oo Image View a0 Combination View ag Compare View Changing the Display
49. ge If you disable one or the other of the Image or Color Map checkboxes clicking on the checked box will flip the display between these two settings Numeric Data Toggles on off the display of numeric data at specific points on each 30 degree spoke The data displayed at each point will depend on the chosen map type Cartesian Grid Toggles on off the display of a one millimetre rectangular grid centred on the keratoscope axes overlaying on the color map Polar Grid Toggles on off the display of a polar reference ring centred on the keratoscope axis overlaying the color map Keratometric Axes Toggles on off the display of the Keratometric Axes on the map The steep axis is calculated as the spoke with the highest average axial power whilst the flat axis is always set at 90 degrees from the steep axis Annotations Toggles on off the display of any annotations added to the exam including the outline of the pupil Readout Displays a readout marker a white cross over the color map The location of the readout marker relative to the keratoscope axis and the data values at that location are displayed in the bottom right hand corner of the image The values presented are in terms of the currently selected Map Type see Medmont E300 Corneal Topographer 45 Analysing and Viewing Exam Results Map Types on page 37 Clicking and dragging with the left mouse button moves the readout marker and updates the read
50. hanging the Fitting Zone is useful for viewing changes induced by surgery or Ortho K to the central zone of the eye For instance set the inner radius to 3 mm and the width to 1 mm The sphere will be fitted to the data in the 3 4 mm radius zone which will not change significantly before and after surgery thus providing a stable baseline for comparison Fitting Zone 0 00 Inner Radius 6 00 Width Fitting Sphere Use Best Fit Sphere 6 00 gt Radius Cont Figure 24 Elevation Settings dialog 52 Medmont E300 Corneal Topographer Analysing and Viewing Exam Results Zernike Tab fed 35 Dec 1996 4 09 17PM Right Height Zernike Fit 6157 5487 4818 4148 3479 2809 2140 3215 3885 Normalized Height Zemike Coefficients ai medmont Distance 16 10 mm Angle 322 Height No Data y Data Zemike Section ZonedK Comments Figure 25 Zernike Tab The tab displays the current Zernike coefficients that are included in the color mapped data Clicking on the Display gt Map Type gt Data Settings button displays the Zernike Settings dialog shown in Figure 26 Medmont E300 Corneal Topographer 53 Analysing and Viewing Exam Results H 0 0 Piston A 1 1 Tilt H 1 1 Tilt Hi 2 2 Astigmatism H 0 2 Defocus A 2 2 Astigmatism H H 3 3 Tifa H H 1 3 Coma H 1 3 Coma H 3 3 Trifaal H 4 4 Tetratail H 2 4 2 ary astigmatism
51. icle Corneal Asphericity The e s p s and Q s of Corneal Shape by Swarbrick H in Refractive Eyecare for Opthalmogologists December 2004 How is the ellipse approximated Medmont computes the unique ellipse that gives the same axial curvature at a specified chord and apical curvature as the actual eye In practice this method gives repeatable and reliable shape factor readings An alternative method uses height instead of axial curvature but it is more sensitive to noise hence less repeatable and less reliable Can you reconstruct height data from the shape factors While the original ellipse can be reconstructed mathematically from these parameters the height information thus obtained describes a crude approximation rather than the actual eye A better alternative is to use the height data obtained from the Height view directly Display Options The Display gt Options ribbon group allows you to toggle on off the display of certain features Image Toggles on off the display of the video image The color map is displayed transparently over the image You can set the level of transparency with the Medmont E300 Corneal Topographer Analysing and Viewing Exam Results Display gt Options gt Color Map Opacity spin box see Color Map on page 45 and Manual Conventions on page 1 Color Map Toggles on off the display of the color mapped data Disabling the color map allows you to examine the raw video ima
52. icular operation exam or exam review this manual uses the term Clinician to refer to the person operating the equipment and Patient to refer to the person undergoing the exam A small glossary is included for terminology that either originated with Medmont or is common usage in corneal topography It also includes some common terms where they apply to Medmont equipment It is not a definitive glossary of corneal topography Medmont E300 Corneal Topographer 1 Intended Purpose 2 Intended Purpose The Medmont E300 Corneal Topographer is a computerised Video keratometer using Placido rings to map the surface of the human cornea The map is captured in three dimensions and can be displayed subsequently using a number of representations The cornea map can be represented in two dimensional surface coordinates Cartesian or Polar with the third dimension expressed in curvature mm optical power Diopters elevation mm or corneal height mm The map is presented as a 2D color map or a 3D perspective It can be displayed according to different definitions of curvature or elevation The options are axial curvature and power tangential curvature and power refractive power elevation corneal height shape factor and best fit radius The clinical applications include providing measured corneal data for contact lens fitting refractive surgery orthokeratology and general assessment of the corneal surface The E300 shall only be us
53. igure 4 Device Manager showing a successful connection to the Medmont E300 Corneal Topographer If the E300 Corneal Topographer does not appear as per these instructions refer to the troubleshooting section in this manual for suggested solutions Medmont E300 Corneal Topographer 21 Installation Installing the E300 Double click on the Medmont Studio desktop icon or select Medmont Studio from the Windows Start gt Programs gt Medmont gt Medmont Studio 6 menu A banner with the Medmont Studio logo is displayed while the software loads To begin the installation process click on the Configure gt E300 gt Instrument Setup button Le Click New to install the instrument You will be prompted to enter the serial number of your E300 instrument Enter the serial number the format should be E3X XXX and press OK Next click the Import Calibration button to import the instruments calibration file You will be presented with a standard Windows file selection menu Insert the Medmont Studio USB Flash Drive medium which contains the calibration file into your PC Once the USB flash drive is available browse to your flash drive ensure the file with the ECF extension is highlighted and click Open From the Instrument setup window you can select edit to add a comment to the instrument and select delete to delete that particular instrument and its configuration You will need to select the E300 instrument that will be used for E3
54. is selected in the Explorer pane Details displays the details for the selected E300 Exam and allows you to edit them see Editing Exam Details on page 81 Map displays a color contour map or 3D perspective map of up to four selected E300 Exams see Setting the Exam View on page 32 Combination displays four different views of the selected E300 Exam see Setting the Exam View on page 32 Compare displays a contour map of the difference between two selected E300 see Setting the Exam View on page 32 Analysis Tab Items The Analysis tab is added by the E300 component It is only displayed when a Patient Exam is selected 18 1 Composite Uses the information from the currently selected exams and creates a new map using the combined coverage of the selected exams Reset clears the analysis of the selected E300 Exams This forces the software to re analyse the selected exams Export creates a set of text files containing raw E300 Analysis data for the selected E300 Exam see Exporting the Analysis on page 73 Details displays numerical readouts for apical curvature sagittal height and shape factor etc calculated at a specified meridian and Medmont E300 Corneal Topographer 89 Menu and Icon Reference chord diameter for the selected E300 exams see Displaying Analysis Details on page 61 Ideal Eye creates an idealized symmetric toric ellipsoidal surface based on the aver
55. ite Exam The id Create Composite Eye function allows you to combine multiple E300 exams for the same patient into a single composite exam This can be useful for extending the coverage of the E300 by combining several off axis exams left right up down with a central exam to maximize the analysed coverage area It can also be used to improve the accuracy of the instrument and minimize transient tear film effects by providing an exam which is the average of several exams Select the exams that you wish to combine Ensure that the pupil was correctly detected in each exam If necessary redefine the pupil using the Annotate gt Add Attribute gt Pupil button Click on the Analysis gt Create gt Composite Eye button The software aligns the axes of each of the selected exams with most central exam the exam with the pupil closest to the instrument axes and creates a composite exam by combining the aligned exam data Creating an Idealized Eye 66 The Lo Create Ideal Eye function allows you to create an idealized symmetric toric ellipsoidal surface based on the average values of the currently selected exam s This can be useful when fitting some contact lens designs that are based on a symmetric ellipsoidal model of the eye It creates a new exam which also allows you to compare the real surface with the best fit toric ellipsoid surface to visualize higher order visual defects Select the exams you wish to base the idealized eye on click
56. lised Color Key 58 Medmont E300 Corneal Topographer Analysing and Viewing Exam Results Difference Color Keys There are four predefined difference color keys e Standard Power Difference Maps the axial tangential and refractive power differences in Diopters to color e Standard Curvature Difference Maps the axial and tangential curvature differences in mm to color e Standard Height Difference Maps the elevation differences in microns to color e Normalized Height Difference Maps height differences in micro meters to a linear color scale using a maximum and minimum corresponding to the data being mapped The current Difference Color Key type is displayed at the bottom left of a Difference map display similar to a standard map view like Figure 16 The Custom Settings dialog is the same as shown in Figure 28 For difference views the result of normalising the color key will usually show a more dramatic change because the differences typically have a smaller range Figure 30 demonstrates on the left an Absolute color key with the expanded scale around zero and on the right a Normalized color key of the same image showing the color key re mapped from the standard 100 to 100 to cover just the image data range Note that the scale will always be symmetrical about zero even if the data is not Medmont E300 Corneal Topographer 59 Analysing and Viewing Exam Results Figure 30 An example difference betwee
57. m Sample User Sample Practice L L2 Dec 1998 9 41 20 AM Smith Sandra Left 2 Dec 1998 9 4 17 9 E300 Exam Sample User Sample Practice L R 2 Dec 1998 9 21 00 AM Love Sarah Right 2 Dec 1998 9 2 22 2 E300 Exam Sample User Sample Practice L L2 Dec 1998 9 21 57 AM Love Sarah Left 2 Dec 1998 9 2 22 2 E300 Exam Sample User Sample Practice L R 6 Jun 2006 2 31 31 PM Aalbers Karin Right Jun 2006 2 3 23 9 E300 Exam Van Der Werf Van Der Werf Opt L L6 Jun 2006 2 32 46 PM Aalbers Karin Left 6 Jun 2006 2 3 23 9 E300 Exam Van Der Werf Van Der Werf Opt L L 7 May 2014 3 16 31 PM Harrison Emma Left 7 May 2014 3 24 1 E300 Exam Unknown clinician Centre for Eye H L L7 May 2014 3 21 43 PM Harrison Emma Left 7 May 2014 3 24 1 E300 Exam Unknown clinician Centre for Eye H fec R 25 Feb 2014 9 27 39 AM Eye Composite Right 25 Feb 2014 9 24 2 E300 Exam Unknown clinician Unknown practice L R2 Dec 1998 11 44 12 AM Jones Chris Right 2 Dec 1998 11 27 0 E300 Exam Sample User Sample Practice L L2 Dec 1998 11 44 54 AM Jones Chris Left 2 Dec 1998 11 27 0 E300 Exam Sample User Sample Practice L R3 Dec 1998 4 09 17 PM_ Citizen John Right 3 Dec 1998 4 0 373 E300 Exam Sample User Sample Practice L L3 Dec 1998 4 11 03 PM Citizen John Left 3 Dec 1998 4 1 37 3 E300 Exam Sample User Sample Practice L L2 Dec 1998 9 28 20 AM King Sue Left 2 Dec 1998 9 2 37 7 E300 Exam Sample User Sample Practice L R2 Dec 1998 9 27 23 AM King Sue Right 2 Dec 1998 9 2
58. mage lens is positioned near the apex of the cone and difficult to access Unless the optical performance of the lens is noticeably affected we do not recommend approaching the lens Dust on this surface is not visible on the image Its effect is a lowering of image brightness and overall resolution not local blurs only The profile windows are 2 x 2 mm in size To reach the corners of these windows use tapered cotton tips or if not available from the tip of a standard cotton applicators with tweezers to a pointed rectangular shape and wet slightly with optics cleaner The narrow end of the cone can easily be reached with the cotton applicators For the entrance area cloth or cotton gives a good result Calibration Object The calibration object has a delicate optical surface After use clean with isopropanol and a lint free cloth to prevent acid corrosion from fingerprints Use the same technique to remove any contamination prior to using the object again Lubrication All parts except the exposed horizontal shaft are permanently lubricated and do not require any additional lubricant The horizontal shaft should be cleaned from dust and old oil residues and oiled every few months This also protects the shaft from corrosion The oil used should be acid free fine instrument oil e g sewing machine oil Apply only a fine film with a lint free cloth Service For servicing and repair please contact your local agent to advice on suitabl
59. mages is minimized Calibration A set of parameters used during the analysis of an image to compensate for small variations in the manufacture of the instrument Calibration object A small reflective ball of known radius Calibration images A set of currently 5 images of a Calibration object Categories A set of clinician provided descriptions that may be used to describe a particular eye Examples would be pre op post op corneal graft Color key An on screen column of colors with their corresponding value listed beside each color Color scale A sequence of colors used to color a representation of a surface Elevation The difference between the height and either a best fit or user specified sphere e Eccentricity of an ellipse on a plane slicing through the reference axis and a specified axis on the surface The ellipse is fitted to the central point and a specified point on the surface axis Usually the steep axis and flat axis are used to give a pair of e values Flat axis The axis orthogonal to the steep axis Idealized eye A symmetric toric ellipsoidal surface based on the average values of one or more surfaces Inferior Superior IS index The IS is the difference measured in diopters between the average inferior power and the average superior power Medmont E300 Corneal Topographer 93 Glossary of Terms 94 Installed instrument The instrument specified by its serial number
60. may take several hours to complete Medmont E300 Corneal Topographer 83 Calibrating the E300 Select Video Source Select the type of device used to capture video from the E300 Instrument Leutron PCI Capture Card C USB Video Converter Box Figure 49 Choosing Video Source Capturing Calibration Images 84 The Calibration Wizard captures five separate images of the calibration object at different locations within the instrument s working range see Figure 50 It analyses these images to measure the error in the current calibration To start mount the calibration object in the E300 chin rest There is a slot beneath the top rail of the chin rest and a 4mm hole facing the E300 Hold the calibration object with the ball facing the E300 and slide the tab with the threaded hole into this slot from beneath While holding it in position insert the retaining screw with the knurled knob into the hole and screw it into the tab Alignment is not important and only tighten finger tight The E300 joystick allows positioning in three dimensions Move the joystick in the desired direction for movement left and right and for closer to or further away Rotate the joystick knob for movement up and down clockwise to raise anti clockwise to lower Position the instrument to align the centre of the rings with the central cross hair and the focussing bar over the central horizontal cross hair When the instrument is properly positioned th
61. menu to print the displayed exams immediately or alternatively select the Print Preview to adjust titles and margins and view output before printing see the Medmont Studio documentation for more detail Printing to a color printer provides a concise summary of the exam see Figure 42 Medmont E300 Corneal Topographer Analysing and Viewing Exam Results Medmont Studio Page 1 n John 3 Dec 1998 4 09 17 PM Right Axis Power 100 5 A medmont 95 5 Flat K 44 33 D 30 Steep K 52 05 D 120 AK 7 72D Flate 0 28 30 Steep e 0 19 120 IS Index Oooo D SAI 085 SRI et 7 Pupil Width 4 1 mm Pupil Area 13 3 mm HVID mm TFSQ 0 299 TFSQ Central 0 106 Q Medmont Studio Version 6 0 0 11 24 Sep 2014 02 38 41 PM Figure 42 Standard exam printout in Print Preview Exporting the Analysis The E300 software provides the facility to dump raw topography data for the selected exam to a set of text files This data can then be imported and manipulated by external software and tools First select the exam to export Then click the Analysis gt Data gt Raw Export button ie Specify the root name and location of the files to create Typically the file name is based on the patient s name for example JohnSmyth The following files are created Filename axl axial curvature data in mm Filename tgl tangential curvature data in mm Medmont E300 Corneal Topographer 73 Analysing and Viewing Exam
62. n of that particular attribute For example the Flat Angle attribute depends for its value on the FlatAngle system function The system functions have direct access to the current exam details Exam Type 300 Exam Name Description ER Age when Tested fx BFS radius Fx Chord Length fex Conversions fre Flat Angle Calculated Calculated Calculated Code Block Calculated ie Flat e free Flat e Fe Flat K fr Flat p Calculated Calculated Calculated Calculated Import Evaluate All Calculated Calculated Calculated Calculated fx Flat Q FX Focal point x fX Focal point y f x Focal point z Figure 35 Attributes dialog To explore how you can define your own attributes we will change the Flat Angle attribute to display in radians First ensure the Flat Angle attribute is highlighted in the Attributes dialog Figure 35 and then click on the Edit button This will bring up the Edit Calculated Attribute dialog shown in Figure 36 Position the cursor after the text in the Expression edit box and add 0 01745 Now the Flat Angle attribute is going to return radians We need to make the display match this fact so change the text in the Units box to rad and change the Decimal Places setting from 1 to 3 At this point the expression editor should look like Figure 37 Medmont E300 Corneal Topographer Analysing and Viewing Exam Results Name Display Name Flat A
63. n two exams showing how the differences visible with the Absolute Color Key on the left can be highlighted with a Normalised key on the right Zooming and Panning 60 You can zoom and pan the currently displayed Patient image by navigating to the Display gt Zoom Pan ribbon bar group You can use the Display gt Defaults gt Reset item to reset the default image view When multiple images are displayed zooming and panning of the images is synchronised The Capture focus window can also be zoomed but not panned as the keratoscope axis must always be visible for focussing Using the Mouse to Pan and Zoom You can also use the mouse to pan or zoom within a single image If the mouse is fitted with a wheel the wheel is always enabled as zoom control You can also change the cursor mode by pressing the spacebar clicking the right mouse button within the image and selecting an option from the popup menu or by navigating to the Display gt Zoom Pan ribbon bar group The shape of the cursor will change to reflect the current cursor mode In Pan mode click on the image and drag the mouse in the direction you wish to move the image The image will continue to move in that direction while the mouse button is down or until a boundary is reached The speed and direction of movement is proportional to the distance of the current cursor position from the position when the mouse button was pressed Medmont E300 Corneal Topographer Analysing
64. ng system current and previous version Placido Diameter 0 25 11 mm 11 5mmH x 11mmV Red 660nm Green 565 nm Blue 430nm Luminance lt 50 cd m 10 100 Diopters 32 9 600 102 000 lt 0 1 Diopters R8 000mm 0 001mm Width 320mm Depth 400mm 352 382mm 5 5kg without table chinrest 100 240 V AC 10 VA PC not included 12 VDC 6W via E300 USB Converter Medmont E300 Corneal Topographer Specifications PC and mains powered peripherals PC Printer Back Up Operating conditions Isolation Transformer Transport Storage Conditions Compliance with EN IEC60950 CISPR22 EN IEC55022 See Medmont Studio Manual Bubblejet Laser Color Monochrome CDROM or DVD burner 10 to 40 C max 80 relative humidity Compliance with EN IEC 60601 1 National electrical safety regulations 15 to 40 C 10 to 95 relative humidity 500 to 1060 hPa Medmont E300 Corneal Topographer 101 Declaration of Conformity 15 Declaration of Conformity The Medmont Corneal Topographer E300 USB has been manufactured by Medmont International Pty Ltd Australia and has been classified as a Class I medical device and is in compliance with the essential requirements and provisions of the European Council Directive 93 42 EEC and is in compliance with the provisions of the RoHS2 Directive 2011 65 EU on the restriction of the use of certain hazardous substances in electrical and electronic e
65. ngle Decimal Places 0 _ Scientific Format Classify Function Expression FlatAngle I abs sin cos tan exp log sqrt atan Data Functions Attributes ApicalCurvature sAngle AverageCornealHeight sAngle sHalfChord AverageTearFilmQuality sMinHalfChord sMaxHalfChord sMinAngle AverageTearFilmQuality sMinHalfChord sMaxHalfChord sMinAngle AxialCurvature sAngle sHalfChord AxialPower sAngle sHalfChord Figure 36 Edit Calculated Attribute dialog When you are satisfied with this click on the OK button to copy the new expression to the attributes database Click on the Close button in the Attributes dialog and then force an attribute re computation by clicking the Recalculate button You should see the Flat Angle attribute now display in radians Name Flat_Angle Display Name Flat Angle Units rad Decimal Places 3 _ Scientific Format Classify Function v Expression FlatAngle 0 01745 I abs sin cos tan exp log sqrt atan Figure 37 Revised calculation to display Flat Angle in radians This is probably not the way you would want Flat Angle to display so repeat the above procedure and reverse the changes Insert the degree symbol by holding down the Alt key and typing 167 on the numeric keypad Medmont E300 Corneal Topographer 65 Analysing and Viewing Exam Results Creating a Compos
66. nike Result Calculated Wavefront Error Tear Film Quality Displays a measure of the tear film quality over the surface of the eye Tear film breakup results in a large standard deviation in the local widths of the reflected mires and results in a larger Tear Film Quality value at that point 40 Medmont E300 Corneal Topographer Analysing and Viewing Exam Results Data View The data may be viewed as either a two dimensional plan as above or as a three dimensional image These views are selected by clicking the appropriate button Oo Planar 2 dimensional Q Perspective 3 dimensional A 3 dimensional exam view is displayed without the eye image An example for the same image used above is shown in Figure 18 Y medmont 40 00 5a 5 a m Oste Saso Zomedk Comments Figure 18 A Perspective or 3 dimensional exam view When the Perspective view is selected the Display gt Settings gt Perspective Scaling spin control is enabled and provides for magnifying the vertical perspective scaling see Perspective Scaling on page 42 and Software Conventions on page 5 For the Map View and Compare View modes the Display gt Map Type ribbon bar group shown below provides a quick means of changing the map and display type Medmont E300 Corneal Topographer 41 Analysing and Viewing Exam Results 42 i LY Perspective ka mtk p e aTa ma be Lar ad La Tf Bei a E Map Type For the Combinati
67. ning Changes 70 REMOVE ATICTACS xsi icaatanheincestedotendacdoncaantaed oahadetegiledetehlackedcasataedesety 70 Printine the Exam RESOIS csc sce eita taia 72 EX portine he Atal StS ecs 73 FITTING CONTACT LENSES wisisseccceiastuticadsdcesseutsiicssituivinteniaaieencesteeiea 75 Creating a new Contact Lens vccccccd cseiacet daietetiisiiieneinnelicniss 76 Restricting the Available Designs ccccccccccsssssssssssssseeeeeeeceeeeeeeneaaas 76 Selects theLens Desi carts ciieetadson tts oats a a 77 Edits the Lens Desi eessen E TI Moving bhe Contact LCS ssc cists n a A 78 Contact ens Datisca na a N E E cece 79 Printinge the Contact Lens Desis ecccsniessuceni ii ele ccmmiaudenadls 79 Medmont E300 Corneal Topographer ill 10 11 12 13 14 15 16 iV MANAGING EXAMS AND CALIBRATIONS ssssssssssssscccccccceesees 1 Editus Exam Detail S 223 ieoctcenstetete asta Genctakadiodathetirecs tbl sasehesGanetiadaadsmetetent 81 Moving an Exam to a Different Patient 81 Changing the Calibration Used for an Exam 81 Categories 81 Deleting Exams Contact Lenses and Calibrations ccceceeeeeeee 82 CALIBRATING THE E300 sivscssscscecasssessssesscacestaieviscssncadiasssancstesucacessasevisasanes 83 Choosing the Video SOURCE assesses ieee ea aoia 83 Caprurine Calibration Lima es c tacsieesstcasks a a a 84 Checking the Current Calibration cncennedududionennin 85 Recalibratine the nis triiments sities csa nda tus
68. on View mode Figure 15 a different map type and data view can be selected for each of the four display areas Each map can be selected for changing by left clicking on the title bar of the exam view this contains the name of the patient Display Settings The Display gt Settings ribbon group allows you to control how various data is displayed Color Map Opacity This spin control allows you to set the level of transparency of the color map when it is displayed over the raw video image A value of 0 0 makes the video image transparent A value of 1 0 makes the video image opaque Perspective Scaling This spin control allows you to display 3D Perspective views with enhanced distortion The deviation of the eye surface from the best fit sphere is multiplied by the scaling factor and added to the original surface A value of zero produces a true 3D Perspective Sim K Units This allows the user to select the units for the standard Flat K and Steep K as well as Zoned K measurements displayed in the Data tab and on the map Options are mm millimetres D Diopters or Auto K which will automatically select the best unit of measurement based on the chosen map type E Units This allows the user to select the units of measurement for the Flat and Steep E values displayed in the Data tab at the bottom of the exam view Medmont E300 Corneal Topographer Analysing and Viewing Exam Results These provide alternative ways
69. or all from one side to the other using the arrow keys in the centre The single arrows will move a selected attribute from the Available list to the Selected list or remove it from the Selected list The double arrows will copy the entire Available list to the Selected list or completely clear the Selected list Medmont E300 Corneal Topographer 47 Analysing and Viewing Exam Results 48 Show Undefined Attributes Select the attribute s to be displayed Available 15 Index SAI Pupil Width Pupil Area HVID TFSQ TFSQ Central Focal point x Focal point Focal point z H 0 0 Piston H 0 2h Defocus H 0 4 Spherical abere Figure 20 Arrange Attribute dialog The up and down arrows on the right allow for changing the order in which the selected attributes are displayed The top item will be the first attribute displayed Selecting an attribute in the Selected list and then clicking on the up arrow will move that attribute towards the top of the list Some statistics are not applicable to all exam types There will also be some pre Medmont Studio exams that will be missing the later statistics These attributes are normally shown in italics with no value By un checking the Show Undefined Attributes check box these particular attributes will automatically be removed from the list Section Tab The section tab see Figure 21 displays a graph of a 2D slice through the data When the tab is selected
70. otection Mode of Operation Continuous Operation Clinical Results This manual does not provide guidance on interpretation of clinical results The clinician must ensure that he or she has received appropriate medical training in such interpretation For this reason Medmont cannot be held responsible for any misdiagnosis of results Accuracy and Calibration The E300 is delivered to the end user quality tested calibrated and as per specifications It is not the responsibility of Medmont to guarantee or police Medmont E300 Corneal Topographer Important Facts the accuracy of this instrument after delivery The E300 is delivered with a calibrated and certified test object with an accuracy based on the national standard The customer can verify the accuracy of the instrument with the calibration object provided Medical Regulations require that the functional accuracy of equipment used for professional purposes be verified every two years This can be achieved by re calibrating the test object Medmont or their authorised agents can provide this service in return for a fee The E300 must then be re calibrated by the customer using the newly calibrated test object Radiation The E300 emits radiation in the visual range for illumination in the distinct wavelength 660nm red LED cone illumination 565nm green LED fixation target and 430nm blue LED profile illumination The levels of intensity of this illumination are less than 50 c
71. out in real time Exam Tab Pane A tabbed pane is located at the bottom of the Exam View to display additional information about the exam This pane can be expanded by clicking and dragging on the horizontal separator between it and the main view The pane can also be completely hidden by clicking on the small expand collapse indicator at the top right of the pane The content of the tabs is described below Data Tab The data tab displays predefined and custom attributes for the exam The following predefined attributes are always displayed e Flat K Steep K displays the simulated Keratometric power and angle along the flat and steep axes of the eye The display units Diopters or mm are controlled by the Sim K Units option in the Display gt Settings ribbon e Delta K displays the difference between the flat and steep K values The display units Diopters or mm are controlled by the Sim K Units see page 42 option in the Display gt Settings ribbon e Flat E Steep E displays the elliptical shape factors for the eye along the flat and steep axes The display units are controlled by the E Units see page 42 option in the Display gt Settings ribbon The following standard attributes are also displayed by default e IS Index this is a measure of the difference between the average inferior and superior power in the eye e Surface Asymmetry Index SAD a measure of the asymmetry of the eye It increases with incr
72. ower maps are identical for fixated eyes The tangential power for both images should have their centre in the same position relative to the pupil centre Ask the patient to open her eyelid as much as possible and close the other eye if necessary Capturing Patient Exams Click on the Home gt New Exam gt Corneal Topography button L to display the E300 Capture View see Figure 7 The red illumination rings Medmont E300 Corneal Topographer 25 Testing a Patient inside the E300 cone should turn on Ensure the Normal option is selected in Home gt Capture Mode gt Normal Figure 6 Capture Mode _ Figure 6 Selecting Normal single frames or Video capture control amp fel Save Analyse B D Select Clear Hd Save All Qh Analyse All Chear Right Left Patient Exam Eye Capture Mode oe i a8 a a Exam Details Categories Comments Figure 7 E300 Initial Capture Screen Select the eye to be examined in the Exam Details box the right eye is the default The focussing window shows live video from the E300 The green and red target overlaid on the focussing window provides three dimensional centring and focussing information The green crosshair indicates the keratoscope axis The red bar moving along a three dimensional runway 26 Medmont E300 Corneal Topographer Testing a Patient indicates the distance of the eye from the optimal focussing plane The view is from
73. patient to put her chin onto the chinrest and put her forehead firmly against the forehead rest She should then push her chin forward on the chinrest If the patient has deep set eyes instruct her to move her head back from the headrest This rotates the eye away from the eyebrow and eyelashes and produces better coverage and fewer interruptions of rings on the upper cornea Adjust the eye height to the level marks on the chinrest Ask the patient to look into the centre of the green fixation target and keep her gaze on this target The target centre point together with the centre of the ring pattern on the eye defines the Video Keratoscope axis VK axis the reference axis to which the axial radius power is calculated the values for tangential radius power are less affected by the fixation If the patient is fixating on the target the VK axis is aligned with the line of sight When an image is taken with the patient not fixated on the target the axial power is not referenced to the line of sight but to an arbitrary axis which may not be reproducible in future exams and may not represent the visual refractive properties of the patient s eye In most cases examining the position of the centre of the pupil easily identifies this For images with good fixation the pupil centre is aligned with the centre of the VK axis centre of the Polar and Cartesian grids If unsure re capture the image and view the difference between the two images Axial p
74. pographer Cleaning Maintenance and Service Distance bar in capture window not working oversensitive or jumping Instrument does not calibrate Blue LED is normally always on when instrument ON OFF button is on Possible reasons One or more images taken out of distance range One or more images too far off centre One or more of the calibration balls not clean Profile optics misaligned Dirt on profile optics Too much stray light in image Too much movement in image Illumination defect Is bright light source present which contaminates profile signal If yes Remove light source or reposition instrument If no Check RH channel from front look in sideways into small rectangular opening Is blue light on If yes Has instrument been subjected to excessive shock vibration or impact If yes check calibration and recalibrate if necessary Identify problem re capture affected images if applicable and recalibrate Medmont E300 Corneal Topographer 99 Specifications 100 14 Specifications Model Type Variant Product Life Method of measurement Coverage Field of View Illumination Power range Number of Rings Measurement Points Analysed Points Repeatability Calibration Object Footprint Eye level adjustable on unit Weight Power requirements E300 USB Service life 8 years software support limited Studio software current platform only Operati
75. process It displays the current status of the calibration see Figure 52 If you select the Quick Recalibration option then the calibration will stop automatically once the software is unable to reduce the error any further over a number of consecutive calibration cycles If you select Full Recalibration then the calibration will complete the maximum number of calibration cycles Full Recalibration is generally only required for new instruments done at the factory or for instruments where the capture device or other physical hardware has been changed Medmont E300 Corneal Topographer Calibrating the E300 Calibrating Error 0 204 Status Running Cycle 1 of Max 10000 Figure 52 Recalibrating the Instrument Calibration of the E300 involves analysing and adjusting over 80 software parameters to match the exact physical dimensions of the instrument Consequently depending on the speed of the PC Full Recalibration may take several hours A Quick Recalibration usually can be completed in under an hour and generally takes between 10 and 15 minutes The calibration process can be stopped at any stage and resumed later At the completion of calibration the verification screen is displayed again and the software recommends whether further calibration is required based on the calibration error Medmont E300 Corneal Topographer 87 Menu and Icon Reference 11 Menu and Icon Reference The E300 software component adds the follo
76. quipment The instrument complies with the following harmonised standards IEC 60601 1 ed 3 Medical electrical equipment Part1 General requirements for basic safety and essential performance IEC 60601 1 2 ed 3 Medical electrical equipment Part 1 2 General requirements for basic safety and essential performance Collateral standard Electromagnetic compatibility Requirements and tests As identification of its conformity the Medmont Automated Perimeter is labelled with the CE mark as shown below on the instrument label positioned visibly on the main body of the device CE 102 Medmont E300 Corneal Topographer Representatives 16 Representatives The EU Authorised Representative BiB Ophthalmic Instruments Unit 8 The Orbital Centre Cockerel Close Gunnels Wood Road Stevenage Hertfordshire SGI 2NB UK Tel 0044 0 1438 740823 Fax 0044 0 1438 356093 Your Local Medmont Authorised Agent is Medmont E300 Corneal Topographer 103
77. r may disrupt the operation of nearby equipment It may be necessary to take mitigation measures such as re orienting or relocating the E300 USB Corneal Topographer or shielding the location The use of ACCESSORIES transducers and cables other than those specified with the exception of transducers and cables sold by the MANUFACTURER as replacement parts for internal components may result in increased EMISSIONS or decreased IMMUNITY of the E300 USB Corneal Topographer The E300 USB Corneal Topographer should not be used adjacent to or stacked with other equipment and that if adjacent or stacked use is necessary the ME EQUIPMENT or ME SYSTEM should be observed to verify normal operation in the configuration in which it will be used Medmont E300 Corneal Topographer 15 Important Facts Guidance and manufacturer s declaration electromagnetic emissions The E300 Corneal Topographer is intended for use in the electromagnetic environment specified below The customer or the user of the Automated Perimeter should assure that it is used in such an environment Emissionstest Compliance Electromagnetic environment guidance The E300 USB Corneal Topographer uses RF Pearce energy only for its internal function Therefore its CISPR 14 Group 1 RF emissions are very low and are not likely to cause any interference in nearby electronic equipment The E300 USB Corneal Topographer is suitable for use in all establishments other than
78. removed from the display by selecting the Display gt Map Type gt Data Setting button underneath the Map drop down list Selecting Show Residual will display the Zernike Residual This measures the error in fitting the height using Zernike functions Residual Zernike Height Height Ray Error Map The deviation on the image plane between the focal point and a ray from an on axis distant object refracted through the cornea Refractive Power Map Displays the true refractive power of the surface in Diopters Tangential Curvature Map Displays the local curvature of the surface in mm Medmont E300 Corneal Topographer 39 Analysing and Viewing Exam Results Wavefront Error Map The difference in optical path length of a ray from an on axis distant object refracted through the cornea and the principle ray which passes through the centre of the cornea to an ideal spherical wavefront inside the eye divided by 550 nm the assumed wavelength of the light ray Wavefront Error Map Zernike Fit This is a decomposition of the wavefront error data in terms of the Zernike components Individual Zernike components can be added removed from the display by selecting the Display gt Map Type gt Data Setting button underneath the Map drop down list Selecting Show Residual will display the Zernike Residual This measures the error in fitting the wavefront error data using Zernike functions Residual Zer
79. ser of the E300 USB Corneal Topographer should assure that it is used in such an environment IMMUNITY test IEC 60601 Compliance level Electromagnetic environment test level guidance Portable and mobile RF communications equipment should be used no closer to any 12 Medmont E300 Corneal Topographer Important Facts part of E300 USB Corneal Topographer including cables than the recommended separation distance calculated from the equation applicable to the frequency of the transmitter Recommended separation distance d 1 2VP Conducted RF 3 Vrms IEC 61000 4 6 150 kHz to 80 MHz d 1 2VP 80 MHz to 800 MHz 3 V m d 2 3VP 800 MHz to 2 5 GHz Radiated RF 80 MHz to IEC 61000 4 3 2 5 GHz where P is the maximum output power rating of the transmitter in watts W according to the transmitter manufacturer and dis the recommended separation distance in metres m Field strengths from fixed RF transmitters as determined by an electromagnetic site survey a Should be less than the compliance level in each frequency range Interference may occur in the vicinity of equipment marked with the following symbol o NOTE 1 At 80 MHz and 800 MHz the higher frequency range applies NOTE 2 These guidelines may not apply in all situations Electromagnetic propagation is affected by absorption and reflection from structures objects and people a Field strengths from fixed transmitters such as base sta
80. splayed exams are linked to the Meridian and Chord slider to provide visual feedback of the measurement location This means that if the Section tool is displayed clicking and dragging the Meridian slider will rotate the Section indicator line on the Map view to a matching angular position with the attribute display reflecting the data under the white data point cross Similarly clicking and Medmont E300 Corneal Topographer 61 Analysing and Viewing Exam Results dragging the Chord slider will move the cross along the Section indicator line Alternatively with this dialog displayed dragging the Section indicator line around will move the dialog sliders correspondingly The data point cross will be displayed even if the Section tool is not While you can use the lower scroll bar to scroll through the tabulated attributes the dialog itself can be resized to display more or less of the tabulated data First move the cursor over an edge of the dialog When it changes to a double headed arrow click and drag the edge as required You can also click and drag a column divider in the Exam row to vary the column s width The weighted Average Height column displays the weighted average of the corneal height at either end of the specified chord The weighting is designed to correct for corneal tilt this allows the value to be used in 3 party software that assumes a symmetric eye model The Export buttons produces a comma separated file
81. t lines 1 kV line s to line s 2 kV line s to earth lt 5 UT gt 95 dip in UT for 0 5 cycle 40 UT 60 dip in UT for 5 cycles 70 UT 30 dip in UT for 25 cycles lt 5 UT gt 95 dip in UT for5s 2 kV for power supply lines 1 kV for input output lines 1 kV line s to line s 2 kV line s to earth lt 5 UT gt 95 dip in UT for 0 5 cycle 40 UT 60 dip in UT for 5 cycles 70 UT 30 dip in UT for 25 cycles lt 5 UT gt 95 dip in UT for5s Mains power quality should be that of a typical commercial or hospital environment Mains power quality should be that of a typical commercial or hospital environment Mains power quality should be that of a typical commercial or hospital environment If the user of the E300 SUB Corneal Topographer requires continued operation during power mains interruptions it is recommended that the ME EQUIPMENT or ME SYSTEM be powered from an uninterruptible power supply or a battery Power frequency magnetic fields should be at levels characteristic of a typical location in a typical commercial or hospital environment NOTE UT is the a c mains voltage prior to application of the test level Guidance and manufacturer s declaration electromagnetic immunity The E300 USB Corneal Topographer is intended for use in the electromagnetic environment specified below The customer or the u
82. tch or dent the object surface it is a es delicate optical device The calibration object should be verified and re calibrated every two years as stated on the calibration label either by Medmont or a Certified Measuring Laboratory If any surface defects are identified the object must be replaced to ensure the best calibration result You should check the calibration of the instrument e After installation or moving the system to another location e Ona monthly basis To calibrate the installed instrument navigate to Configure gt E300 gt Instrument Setup Then from the E300 Instruments window click on the installed instrument and click Calibrate to run the Calibration Wizard which allows you to check the current calibration and optionally recalibrate the instrument The following sections describe the Calibration Wizard steps Choosing the Video Source The first step of the calibration wizard is to specify the device used to capture video from the E300 topographer see Figure 49 The first option is Leutron PCI Capture Card choose this if your topographer connects to a PCI card using a long flat D shaped connector The second option is USB Video Converter Box choose this if your topographer connects to a grey box using a round 8 pin connector which then connects to the PC with a USB cable If you are upgrading from Leutron to USB now is the time to change the Video Source device Doing so requires a full factory calibration which
83. th 1 0 60 mm Radius 1 7 83 mm Diameter 2 9 00 mm Width 2 0 40 mm dt Radius 2 8 83 mm kd K Data Section ZonedK Figure 43 Simulated Fluorescein Display Medmont E300 Corneal Topographer 75 Fitting Contact Lenses Creating a new Contact Lens Before proceeding with contact lens fitting you should have captured exams for both eyes of the patient see Capturing Patient Exams on page 25 Select the Patient Exam on the Explorer pane and click on the Home gt New Exam gt Contact Lens button J This displays the Contact Lens Design dialog shown in Figure 45 Restricting the Available Designs If required you can restrict the set of available lens designs to better suit your practice Click on Manufacturers within Contact Lens Design dialog to display the lens design selection dialog shown in Figure 44 Check or uncheck the manufacturers as required Contact Lens Manufacturers _ Contact Lens Centre Australia New Zez _ Contact Lens Laboratory of South Afric _ Contamac Figure 44 Contact Lens design selection dialog 76 Medmont E300 Corneal Topographer Fitting Contact Lenses Selecting the Lens Design The Contact Lens Design dialog see Figure 45 allows you to select the lens design to use When a new design is selected from the drop down selection box the recommended parameters for the design are automatically calculated based on
84. the examination You can add delete and change the available categories see the Medmont Studio user manual Categories are displayed in the Details view which can be accessed by selecting View gt Active View gt Details from the ribbon bar menu Medmont E300 Corneal Topographer 81 Managing Exams and Calibrations HF Gitizen John 3 Dec 1998 4 11 03 PM Left Patient Citizen John Change Exam Date 3Dec 1998 04 11 03 PM E Eye Left Right Instrument 30120 Calibration Calibration 23 Nov 98 2 08 PM Analysis Type Normal Categories v Practice Sample Practice v Clinician Sample User v Comments Figure 48 Exam Details dialog Deleting Exams Contact Lenses and Calibrations You can delete exams contact lenses and calibrations but keep the following in mind e Deleting a calibration also deletes all of its calibration tests e You cannot delete a calibration that is used by a patient exam In general it is not a good idea to delete calibrations Select the item s to be deleted in the Explorer pane Then click on Home gt Exam gt Delete 82 Medmont E300 Corneal Topographer Calibrating the E300 10 Calibrating the E300 The accuracy and repeatability of exam results is dependent on ensuring that the E300 is correctly calibrated The instrument is supplied with a calibration object which is calibrated to the National Standard Handle and maintain this object with care Do not touch scra
85. the New icon This format conforms to the Tab gt Group gt Action system for identifying menu items in a ribbon bar menu system Tab kna n n aves inoate S Move To E 0 Action bc i AR Copy To Digitd Corneal Contact Perimetr Image Topography Lens Exam S Delete Corfigure Rewi btt way TS Patent Exam New Exam Group Some keyboard shortcuts can be used when setting spin box controls like the one shown here Use the numeric keys for direct entry up down arrows for small steps PgUp PgDn keys for large steps Colour Map Opacity and the Home End keys to move to the opposite end of the currently selected number 6 Medmont E300 Corneal Topographer Warranty 3 Warranty The E300 Corneal Topographer device has been manufactured with all due care and subjected to stringent testing before leaving the factory The Topographer is guaranteed for 12 months from the date of purchase as evidenced by the invoice During this warranty period Medmont or an authorised agent will repair or replace all defective parts free of charge Such repairs do not extend the warranty period Replaced parts become the property of Medmont The warranty does not cover defects due to incorrect handling installation and setup unauthorised modifications non compliance with the requirements for computer hardware and associated mains powered equipment as specified in the Users Manual loss of the license loss o
86. the camera s perspective so if the red bar is at the top or narrowest part of the runway then the patient is still too far away The E300 joystick allows positioning in three dimensions Move the joystick in the desired direction for movement left and right and for closer to or further away Rotate the joystick knob for movement up and down clockwise to raise anti clockwise to lower Figure 8 Focus examples showing Too Far In Focus and Too Near Using the joystick position the E300 relative to the patient s eye so that the reflection of the Placido rings is centred on the green crosshair and the red bar is over the horizontal green line Once this is achieved the software automatically captures the best set of images and displays them in the image windows along the top of the View pane with the best images to the right Images for automatic capturing are selected according to best centring focussing and least eye movement Figure 9 shows a typical capture screen display It may not be possible to align the red focussing bar over the horizontal cross bar for patients with deep set eyes because of contact between the bridge of the nose and the instrument In this case centre the Placido rings on the green crosshair and bring the red focussing bar as close to the horizontal green line as possible without causing patient discomfort Provided that the red bar is somewhere within the focussing range i e not at the very end the sof
87. the eye geometry The simulated fluorescein pattern is computed and displayed The dialog also allows you to specify the manifest refraction that the software uses to calculate the required contact lens power For a new lens this will be set by default to the current refraction values for the patient from the Patient Management system The dialog is displayed when creating a new contact lens You can also use it to change the design or refraction for an existing contact lens by clicking on the amp Change the lens design button in the Data tab Design ACL AEC 96 Spectacle Refraction Sphere Cylinder Anus Vertex 000 A 40 00 Si ax 0 li amp Figure 45 Contact Lens Design dialog Editing the Lens Design Clicking on the Edit the design parameters button in the Data tab displays the Contact Lens Designer dialog This is normally displayed automatically when you create a new contact lens The parameters that are displayed and can be changed in this dialog depend on the selected lens design An example for an ACL TriCurve is shown in Figure 46 Typically the controls allow you to change parameters such as the lens diameter base optic curve radius and peripheral curve parameters Medmont E300 Corneal Topographer 77 Fitting Contact Lenses Lens Diameter I Toric 4 Auto Update Optic Zone ist Curve BOZD 7 80 Width 0 30 BOZR 7 78 l Radius8 98 Curve 2 Width 0 30 Radius 10 78
88. the unit on 2 Connect the USB Video Converter box to the PC using the supplied USB cable 3 Connect the E300 Corneal Topographer 8 pin DIN plug to the USB Video converter box 4 Turn on the USB Video Converter box 20 Medmont E300 Corneal Topographer Installation Checking the E300 instrument is connected 1 Open Device Manager Under Microsoft Windows 7 this can be done by selecting the Windows Logo in the bottom left corner of the main desktop window Next right click while hovering above Computer and select Manage from the popup menu When the screen titled Computer Management appears select Device Manager from the System Tools menu in the explorer pane left docked 2 Expand imaging devices 3 Ensure that the item MEDMONT E300 USB appears in the list of imaging devices as per the screen in Figure 4 Sy Device Manager le Lajes File Action View Help Wo amp 4 4 MELDSK2013 we T Acronis Devices B Bluetooth Radios gt gl Computer gt Disk drives Display adapters DVD CD ROM drives 3 Human Interface Devices IEEE 1394 Bus host controllers 2 Imaging devices 2 Leutron Vision PicPort 7 MEDMONT E300 USB gt i Jungo gt aD Keyboards F Mice and other pointing devices s Monitors Network adapters gt B Processors 5 a Sound video and game controllers lt Storage controllers gt gill System devices gt E Universal Serial Bus controllers F
89. tion describes general housekeeping procedures for managing various aspects of the E300 database Editing Exam Details Select the Patient Exam entry in the Explorer pane and select Details Exam View mode see Setting the Exam View on page 32 The software displays the Patient Exam details see Figure 13 Enter or change any of the details Any changes will enable a Cancel and Save button Press Save to save your changes The Cancel button discards any changes Moving an Exam to a Different Patient If you accidentally capture an exam against the wrong patient it is possible to transfer the exam to another patient Click on the Change button and enter the details for the correct patient Click OK to make the transfer Changing the Calibration Used for an Exam The software sets the calibration used to analyse a Patient Exam when the Exam is captured It is possible to change this using the Calibration drop down box Usually the only reason for doing this would be if you discovered that the instrument has gone out of calibration see Calibrating the E300 on page 83 Once you have re calibrated the instrument select the Patient Exam that you wish re analyse and select the new calibration using the Calibration drop down box When you next view the Patient Exams in Map Combination or Difference View Mode they will be analysed using the new calibration Categories Categories are user defined words or phrases that describe the nature of
90. tions for radio cellular cordless Medmont E300 Corneal Topographer 13 Important Facts 14 telephones and land mobile radios amateur radio AM and FM radio broadcast and TV broadcast cannot be predicted theoretically with accuracy To assess the electromagnetic environment due to fixed RF transmitters an electromagnetic site survey should be considered If the measured field strength in the location in which the E300 USB Corneal Topographer is used exceeds the applicable RF compliance level above the E300 USB Corneal Topographer should be observed to verify normal operation If abnormal performance is observed additional measures may be necessary such as re orienting or relocating the E300 USB Corneal Topographer gt Over the frequency range 150 kHz to 80 MHz field strengths should be less than 3 V m Recommended separation distances between portable and mobile RF communications equipment and the E300 USB Corneal Topographer The E300 USB Corneal Topographer is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled The customer or the user of the E300 USB Corneal Topographer can help prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications equipment transmitters and the E300 USB Corneal Topographer as recommended below according to the maximum output power of the communications equipment Rated maximum Separation distan
91. tware will automatically compensate for the focussing error Medmont E300 Corneal Topographer 2 Testing a Patient Live Video Figure 9 E300 Image Capture View Saving the Best Image 28 Each image captured is awarded a score out of 100 based on centring focus and movement The score is displayed as a large white number above each captured image A good score for a normal eye will be over 75 Calibration balls can achieve scores of up to 100 Select the best image from those automatically captured Typically this will be the right most image Click on an individual image s Expand Collapse button to expand the image to full screen You should consider the following factors when assessing images e Patient Fixation choose images where the pupil is centred with respect to the Placido rings e Eyelid Position choose images where the patient s eyelid does not obscure large portions of the cornea or cause large eyelash shadows e Central Ring Clarity choose images where the central Placido ring reflection is clearly visible For some patients with extreme conditions Medmont E300 Corneal Topographer Testing a Patient this may require shifting their fixation to get the central Placido ring area over an area with less surface irregularity Click on an image s Save button to save it You can also save the set of images by clicking on the Home gt Exam gt SaveAll HH button Alternatively you may deci
92. wing types of icons to the Medmont Studio Explorer pane L E300 Exam displayed under Patient nodes in the Tree and E300 panes Idealized Eye displayed under Patient nodes in the Tree and E300 panes This represents an idealized symmetrical toric ellipsoidal surface derived from one or more actual eye exams 3 Contact Lens displayed under Patient Exam or Idealized Eye nodes in the Tree pane Home Tab Items The E300 component activates the following menu items for the Medmont Studio Home tab L Corneal Topography displays the E300 Capture screen Contact Lens creates a new Contact Lens for the selected Patient see Fitting Contact Lenses on page 75 Configure Tab Items The E300 component activates the following items in the Medmont Studio Configure tab Instrument Setup Opens the E300 instruments window which allows you to setup delete and calibrate E300 instruments Calibrate Instrument allows you to check the accuracy of the current calibration and recalibrate if required see Calibrating the E300 on page 83 88 Medmont E300 Corneal Topographer Menu and Icon Reference 7 System Settings allows you to configure to adjust the Eccentricity and Shape Factors the height and Wavefront errors which affects the attribute values View Tab Items The E300 component adds the items in Medmont Studio to the View tab note the View tab is only visible when an appropriate item
93. x and you can move the entire shape Alternatively you can click and drag the central cross For Area annotations click on a vertex and you can move that vertex independently of the others For Circles Squares etc this will re scale the annotation The lines joining the vertex will automatically follow To edit a Text annotation double click on the annotation or click on Annotate gt Selection gt Edit and the editor will be displayed allowing you to change the text or attributes You can move text by clicking and dragging using the mouse Locking Annotations Once an annotation has been created it can be locked meaning that it cannot be altered or repositioned until it is unlocked This is to avoid accidently moving or otherwise altering an annotation while left clicking on the exam data to view critical readout data or otherwise navigate around the image data Once you have selected the annotation you can change the status of the locking mechanism in 2 ways 1 Directly on the annotation itself Right lb Select click to bring up the annotation menu and se select Lock to toggle the current status of M Pan the lock 5 Reset View 2 From the menu Select Annotate gt RE Selection gt Lock to toggle the current I Lock l status of the lock Bea Delete Annotation The locked status of an annotation is indicated by the presence of a small lock symbol amp attached to the annotation as shown in Figure 39 Medmont E300
94. ygon boundaries The Annotate gt Add Annotations gt Curved tool does the same only it passes a smoothing curve through the defined points The Annotate gt Add Annotations Freehand tool is just that click and hold the left mouse button and draw the shape you want Annotation Attributes The system will automatically attempt to define the pupil and this is visible as a black polygon if the Display gt Hide Show gt Annotations checkbox is ticked see Figure 17 You can re define the pupil by clicking on the Annotate gt Add Attribute gt Pupil button You can define the iris by clicking on the Annotate gt Add Attribute gt Iris button The Pupil is a curved area annotation the Iris is a circle annotation If the pupil is automatically detected as part of the exam process the annotation will be locked by default to prevent accidental alterations Refer to the Locking Annotations on page 69 for more information on the locking mechanism of annotations When you create Iris and or Pupil annotations the system automatically adds a number of attributes including default text You can edit these as shown below Medmont E300 Corneal Topographer Analysing and Viewing Exam Results Editing Annotations You can move and edit any shape or text For shapes point and click anywhere on the shape outline and it will change color and show small white circles at all vertexes Left click anywhere on the outline except on a verte
95. you to select the type of image data to display Data Settings Map options when the Elevation Height Zernike Fit or Wavefront Error Zernike Fit has been selected from the Map Type drop down list Colour Map Opacity Set the level of transparency for the Colour Map Perspective Scaling A spin control allows you to display 3D Perspective views with enhanced distortion Sim K units Allows the user to select the units of measurement for keratometric data Options are mm millimetres D Diopters or Auto K which will automatically select the best unit of measurement based on the chosen map type E units Allows the user to select the units of measurement for elliptical shape factors Image Toggles on off the raw video image leaving just the colour map Colour Map Toggles on off the colour map leaving just the raw video image Numeric Data Toggles on off the display of numeric data at specific points on each 30 degree spoke The data displayed at each point will depend on the chosen map type Cartesian Grid Toggles on off a one millimetre rectangular grid centred on the keratoscope axes overlaying on the colour map Polar Grid Toggles on off reference ring centred on the keratoscope axis overlaying the colour map Keratometric Axess Toggles on off the display of the Keratometric axes on the map The steep axis is calculated as the Medmont E300 Corneal Topographer 91
96. zoor oi PEN if ff WANA S E 43 00 fi ff 3i E ae fil Fi 2 Bae 42 00 gt 1 F Pic e 5 y j Fi j i e es er Tiot oa ENAN PEPER DE 39 00 Cee Saar Ress 38 00 So A ee 37 00 el 36 00 35 00 Standard Power Distance 5 20mm Angle 124 Power No Data v Figure 40 Eraser Tool With the eraser click and drag over any points you wish to remove from the map When clicked the white dots active test points will be replaced with black dots inactive test points Figure 41 Deleted Points Medmont E300 Corneal Topographer 71 Analysing and Viewing Exam Results If you wish to restore a deleted point hold down the Ctrl key and click again on that point with the eraser tool The point will once again be included in the colour map To apply changes made with the eraser tool click on Analysis gt Data Points gt Remove Selected button A The colour maps and statistics are recalculated excluding the selected points If needed you can always reset the analysis back to its original form on the Analysis menu by clicking Reset Printing the Exam Results 72 Select the patient exam s you wish to print then select the View see Setting the Exam View on page 32 and Map Type see Map Types on page 37 Select the printer and paper size to print by clicking on the File gt Print menu and then clicking on the Settings button Click on the File gt Quick Print

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