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  • 1. REFRACTIVE POWER / CORNEAL ANALYZER ARK-10000 OPERATOR’S MANUAL
  • 2. Original instructionsNIDEK CO., LTD. : 34-14, Maehama, Hiroishi-cho, Gamagori, Aichi 443-0038, Japan(Manufacturer) Telephone: +81-533-67-6611 Facsimile: +81-533-67-6610NIDEK CO., LTD. : 3F Sumitomo Fudosan Hongo Bldg., 3-22-5, Hongo,(Tokyo Office) Bunkyo-Ku, Tokyo 113-0033, Japan Telephone: +81-3-5844-2641 Facsimile: +81-3-5844-2642NIDEK INCORPORATED : 47651 Westinghouse Drive, Fremont, California 94539, U. S. A.(United States Agent) Telephone: +1-510-226-5700 Facsimile: +1-510-226-5750NIDEK S.A. : Europarc 13, rue Auguste Perret, 94042 Créteil, France(EU Authorized Representative) Telephone: +33-1-49 80 97 97 Facsimile: +33-1-49 80 32 08 November 2010 32166-P902F Printed in Japan
  • 3. BEFORE USE OR MAINTENANCE, READ THIS MANUAL.This Operator’s Manual contains information necessary for operating the NIDEK RefractivePower/Corneal Analyzer ARK-10000 (OPD-Scan II).The device complies with ISO 10342: 2010 Clause 4.This manual includes operating procedures, safety precautions, and specifications.The dioptric powers are indicated with reference wavelength Od = 587.56 nm.For correct use, this manual is needed. Especially, cautions for safety and operating proceduresmust be thoroughly understood before using the instrument.Keep this manual handy to verify use whenever necessary.If you encounter any problems or have questions about the instrument during use, pleasecontact your authorized distributor. * OPD-Scan II is the common name of the ARK-10000 V2.00 or later.
  • 4. Table of Contents§1 INTRODUCTION .......................................................................................................Page 1-1 1.1 Outline of the Instrument ............................................................................................. 1-1 1.2 Intended Use .............................................................................................................. 1-1 1.3 Classifications ............................................................................................................. 1-2 1.4 Symbol Information .................................................................................................... 1-3 1.5 Preparing for Use ....................................................................................................... 1-4§2 SAFETY ......................................................................................................................... 2-1 2.1 Storage, Transportation and Installation ....................................................................... 2-1 2.2 Plugging the Instrument In and Handling the Power Cord ............................................. 2-3 2.3 In Use ........................................................................................................................ 2-4 2.4 Maintenance ............................................................................................................... 2-7 2.5 Disposal ..................................................................................................................... 2-8 2.6 Connection to Network .............................................................................................. 2-8 2.7 Labels ........................................................................................................................ 2-9§3 INSTRUMENT DESCRIPTION ................................................................................. 3-1 3.1 Names and Explanations of Parts ................................................................................ 3-1 3.2 Names and Explanations of Optional Function Screens .............................................. 3-19§4 BASIC USAGE .............................................................................................................. 4-1 4.1 Operation Flow .......................................................................................................... 4-1 4.2 Power-ON and Power-OFF ...................................................................................... 4-3 4.2.1 Power-ON ....................................................................................................... 4-3 4.2.2 Reactivating instrument from power saving mode ................................................ 4-5 4.2.3 Power-OFF ...................................................................................................... 4-6 4.3 Selecting Measurement Mode ..................................................................................... 4-7 4.4 Measuring in ARK Mode ........................................................................................... 4-8 4.4.1 AR and KM measurements ............................................................................... 4-8 4.4.2 AR measurement ............................................................................................. 4-14 4.4.3 KM measurement ........................................................................................... 4-17 4.5 Measuring in ARK/CT Mode ................................................................................... 4-19 4.5.1 REF and CT measurements ............................................................................. 4-19 4.5.1.1 REF and CT measurements (Multiple measurement mode) ................... 4-29 4.5.2 REF measurement ........................................................................................... 4-35 4.5.2.1 REF measurement (Multiple measurement mode) ................................. 4-38 4.5.3 CT measurement ............................................................................................. 4-42 4.5.3.1 CT measurement (Multiple measurement mode) ................................... 4-45 4.6 Viewing Maps (Map View)....................................................................................... 4-49 4.6.1 Displaying map via measurement screen ........................................................... 4-49 4.6.2 Retrieving exam from database and displaying it in map .................................... 4-50
  • 5. Page 4.6.3 Displaying map on another map set .................................................................. 4-52 4.6.4 Switching between right and left eyes ............................................................... 4-53 4.7 Printing ..................................................................................................................... 4-54 4.7.1 Printing measured data .................................................................................... 4-54 4.7.2 Printing color maps .......................................................................................... 4-56 4.8 Saving Measured Data ............................................................................................. 4-58§5 HANDLING ADVANCED FUNCTIONS MORE EFFICIENTLY ............................ 5-1 5.1 Color Maps ............................................................................................................... 5-2 5.1.1 Axial map .......................................................................................................... 5-2 5.1.2 Instantaneous map ............................................................................................. 5-3 5.1.3 “Refractive” map ............................................................................................... 5-4 5.1.4 Elevation map ................................................................................................... 5-5 5.1.5 TopoClassifier map (Optional) ........................................................................... 5-9 5.1.6 Eye image ....................................................................................................... 5-15 5.1.7 OPD map ....................................................................................................... 5-16 5.1.8 Target “Refractive” map .................................................................................. 5-17 5.1.9 Internal OPD map ........................................................................................... 5-18 5.1.10 Wavefront High Order map ........................................................................... 5-20 5.1.11 Wavefront Total map ..................................................................................... 5-21 5.1.12 Wavefront Group map ................................................................................... 5-22 5.1.13 Zernike graph ................................................................................................ 5-25 5.1.13.1 RMS graph ....................................................................................... 5-25 5.1.13.2 Coefficient graph ............................................................................... 5-28 5.1.14 Difference map .............................................................................................. 5-30 5.1.15 Table at the bottom of Map View screen ........................................................ 5-30 5.2 Specifying Maps in Advance (Map View settings) ..................................................... 5-31 5.2.1 Setting “View 1”, “View 2” and “View 3” ......................................................... 5-31 5.2.1.1 Assigning entered map set to “View1”, “View2” and “View3” ............... 5-32 5.2.1.2 Entering new map set .......................................................................... 5-34 5.2.1.3 Modifying existing map set ................................................................... 5-37 5.2.1.4 Entering modifications made on Map View Settings screen to map set ........................................................................................... 5-38 5.2.1.5 When selecting Wavefront Group map ................................................. 5-39 5.2.1.6 When selecting Zernike graph and displaying RMS graph ..................... 5-43 5.2.1.7 When selecting Zernike graph and displaying Coefficient graph ................................................................................. 5-47 5.2.1.8 When selecting Difference map ............................................................ 5-53 5.2.1.9 Deleting map set .................................................................................. 5-54 5.2.2 Setting color scale ........................................................................................... 5-55 5.2.3 Displaying PSF ............................................................................................... 5-58 5.2.4 Other settings related to maps .......................................................................... 5-59 5.3 Changing Displayed Maps (Map View) ..................................................................... 5-62 5.3.1 Changing map types and overlay options ................................................. 5-63 5.3.2 Changing color scale (Select color scale) ................................................ 5-67 5.3.3 Changing exam displayed on map to another exam No. ........................... 5-69 5.3.4 Magnifying map ...................................................................................... 5-70
  • 6. Page 5.3.5 Checking distance between two points .................................................... 5-705.4 Displaying Difference Map ........................................................................................ 5-715.5 Manual Pupillary Distance (PD) Measurement........................................................... 5-725.6 Database .................................................................................................................. 5-73 5.6.1 Importing external data into database (Import) ................................................. 5-73 5.6.2 Outputting exam from database (Export) .......................................................... 5-76 5.6.3 Editing data ..................................................................................................... 5-83 5.6.3.1 Editing patient data (Edit Patient Information) ....................................... 5-83 5.6.3.2 Editing exam data (Edit Exam Information) ........................................... 5-84 5.6.3.3 Deleting data (Delete) .......................................................................... 5-845.7 OPD Database Manager .......................................................................................... 5-86 5.7.1 Creating new database (in the ARK-10000) .................................................... 5-86 5.7.2 Changing database (Select Database) .............................................................. 5-89 5.7.3 Using database in another ARK-10000 on network ......................................... 5-91 5.7.4 Backing up database (Database Backup) ......................................................... 5-93 5.7.5 Rebuilding database (Rebuild Database) .......................................................... 5-96 5.7.6 Setting location for data backup, import, and export ......................................... 5-99 5.7.7 Setting data deletion criteria (Backup Settings) ............................................... 5-103 5.7.8 List of connected computers .......................................................................... 5-105 5.7.9 List of computers that have been connected ................................................... 5-1065.8 Outputting Map Data .............................................................................................. 5-108 5.8.1 Outputting numerical data from map (Save Map Information) ......................... 5-108 5.8.2 Outputting map images (Save Map Image) ..................................................... 5-1105.9 Accommodation Measurement Function (Optional) ................................................. 5-112 5.9.1 Setting accommodation stimulus ..................................................................... 5-112 5.9.2 Accommodation measurement ....................................................................... 5-114 5.9.3 Display of accommodation measurement result ............................................... 5-1165.10 Wavefront Contact Lens Measurement Function (Optional) ................................... 5-1175.11 Editing Detected Edges (Tools) ............................................................................. 5-120 5.11.1 Entering edge edit mode .............................................................................. 5-120 5.11.2 Adjusting curved edge (Move) ..................................................................... 5-121 5.11.3 Moving end point (Extend) .......................................................................... 5-122 5.11.4 Closing gap (Close) ..................................................................................... 5-123 5.11.5 Erasing edges (Erase) .................................................................................. 5-1245.12 Editing Detected Pupil Edge .................................................................................. 5-125 5.12.1 Entering pupil edge edit mode ...................................................................... 5-125 5.12.2 Erasing edges (Erase) .................................................................................. 5-126 5.12.3 Moving pupil edge (Move) .......................................................................... 5-127 5.12.4 Finishing editing pupil edge .......................................................................... 5-1275.13 Settings ................................................................................................................ 5-128 5.13.1 Setting parameters (Settings) ....................................................................... 5-128 5.13.2 Setting date and time ................................................................................... 5-136 5.13.3 Selecting whether or not to assign patient ID automatically ............................ 5-1365.14 Formatting Floppy Disk ........................................................................................ 5-1395.15 Transmitting Data to Refractor Through Cable ....................................................... 5-142 5.15.1 Transmitting day measurement data .............................................................. 5-143 5.15.2 Transmitting night measurement data as well ................................................. 5-144
  • 7. Page 5.16 Exporting Data to Automatic Optometry System Using Eye Care Card .................. 5-146 5.16.1 Exporting day measurement data ................................................................. 5-147 5.16.2 Exporting night measurement data as well ..................................................... 5-149§6 TROUBLESHOOTING GUIDE .................................................................................. 6-1§7 MAINTENANCE .......................................................................................................... 7-1 7.1 Replacing Roll of Printer Paper ................................................................................... 7-1 7.2 Attaching Stack of Chinrest Paper ............................................................................... 7-3 7.3 Replacing Fuses ......................................................................................................... 7-4 7.4 Checking Measurement Accuracy ............................................................................... 7-5 7.5 CT Measurement Calibration ...................................................................................... 7-6 7.6 Cleaning Exterior ........................................................................................................ 7-7 7.7 Cleaning Measurement Window .................................................................................. 7-8 7.8 List of Parts for Replacement ...................................................................................... 7-8§8 DISINFECTING PROCEDURES ............................................................................... 8-1§9 SPECIFICATIONS ....................................................................................................... 9-1§10 ACCESSORIES .......................................................................................................... 10-1 10.1 Standard Accessories ............................................................................................. 10-1 10.2 Optional Accessories .............................................................................................. 10-1APPENDIX. A GLOSSARY .................................................................................................. A-1APPENDIX. B INSTALLATION ......................................................................................... B-1APPENDIX. C OBTAINING RELIABLE EXAM DATA .................................................. C-1APPENDIX. D BEFORE FIRST BACKUP PROCEDURES ............................................. D-1APPENDIX. E POINTS TO NOTE WHEN UTILIZING INTERNAL OPD MAP .......... E-1APPENDIX. F EMC (ELECTROMAGNETIC COMPATIBILITY) .................................. F-1
  • 8. §1 INTRODUCTION1.1 Outline of the Instrument The ARK-10000 measures the refractive condition and analyzes corneal shape of the patient’s eye. The refractive condition is measured by weak infrared rays, and corneal shape is analyzed based on placido rings projected onto the cornea. The ARK-10000 has two measurement modes: ARK mode and ARK/CT mode. In the ARK mode, AR- and KM-measured data are obtained and printed out. AR-measured data: Refractive power in the central area of the eye that is equal to the data obtained by an auto refractometer. KM-measured data: Keratometry data simulated by the analyzed result of a captured placido ring image. In the ARK/CT mode, the curvature radius and refractive power of the whole eyeball are measured and the measured data is displayed in color maps. The obtained examination data is stored in the built- in database for future display of it in color maps. The ARK-10000 has a main body and a measuring unit integrated on one base. On the base is a chin rest on the patient’s side and a floppy disk drive on the operator’s side which is used to store measured results and the maps of corneal shape. On the main body is a joystick and a printer*1 which prints measured results. On the patient’s side of the measuring unit are placido rings, while a display is on the operator’s side. The touch-screen panel not only displays a patient’s eye and measured data, but allows the operator to control the instrument through the screen.1.2 Intended Use The OPD-Scan™ is a diagnostic instrument that is indicated for use: • Mapping of refractive power distribution of the eye, by measurement and analysis of spherical power, cylindrical power, and cylinder axis. • The measurement and analysis of corneal curvature (corneal refractive power), cylindrical power, and cylinder axis of the cornea. Mapping and display of the corneal shape, and screen out possibility of having corneal diseases or conditions.*1 The built-in printer prints out AR-measured data etc. To print a map of corneal shape, an optional color printer is needed.
  • 9. 1-21.3 Classifications [Classification under the provision of 93/42/EEC (MDD)] Class a The ARK-10000 is classified as a Class a instrument. [Form of protection against electrical shock] Class The ARK-10000 is classified as a Class instrument. A Class instrument is an instrument in which protection against electric shock does not rely solely on basic insulation. The Class instrument includes additional safety precautions that provide for the connection of accessible conductive parts to a protective (earth) grounding conductor in the fixed wiring of the installation. Use a power outlet which is equipped with a ground terminal. [Degree of protection against electrical shock] Type B The ARK-10000 is classified as a Type B instrument. A Type B instrument provides an adequate degree of protection against electrical shock, particularly regarding the following: - allowable leakage currents - reliability of the protective earth ground connection (if applicable) [Degree of protection provided by enclosures] IP20*2 The ARK-10000 is classified as an IP20 instrument*2 , as such does not provide protection with respect to harmful effects due to the ingress of water although it is protected against access to hazardous parts with a solid matter such as a finger of 12.5mm in diameter. Avoid immersion of any type. [Degree of protection against flammability] The ARK-10000 is classified as an instrument not suitable to be used in a potentially flammable environment. Do not operate the instrument near flammable type materials. [Method(s) of sterilization or disinfection recommended by the manufacturer] The forehead rest and chin rest can be cleaned with a cloth dampened with disinfecting alcohol as necessary. [Mode of operation] Continuous operation*2 In accordance with IEC 60529
  • 10. 1-31.4 Symbol Information This symbol on the instrument indicates that caution must be taken, and it is necessary to refer to a related description in the Operator’s Manual before operating parts with this symbol. This indicates that the instrument is classified as a type B instrument. This symbol indicates the state of the power switch. If the symbol side of the switch is flipped down, power is supplied to the instrument. This symbol indicates the state of the power switch. If the symbol side of the switch is pressed down, power is not supplied to the instrument. This symbol indicates the fuse rating. This symbol indicates that the instrument must be supplied only with alternating current. This symbol indicates that printer paper can be torn by pulling it toward the arrow. This symbol indicates the keyboard connector. This symbol indicates the mouse connector. This symbol indicates the network connector. This symbol indicates the connector for data communication. This symbol indicates the printer (option) connector. This symbol indicates the connector for an external monitor etc. This symbol indicates the connector for a USB device. This symbol indicates that this product shall be disposed of in a separate collection of electrical and electronic equipment in EU.
  • 11. 1-41.5 Preparing for Use1. Connect the cable of the keyboard to the keyboard connector.2. Set a roll of printer paper. See “7.1 Replacing Roll of Printer Paper” for the method.3. Connect the power cord to the power connector and the power outlet.4. Set a stack of chinrest paper. See “7.2 Attaching Stack of Chinrest Paper” for the method. Power connector Keyboard connector
  • 12. §2 SAFETY In this manual, the signal, CAUTION is used to designate and indicate a degree or level of safety hazards or damages. The definition is as follows. CAUTION: Indicates a potentially hazardous situation which, if not avoided, may result in minor or moderate injury or a property damage accident. Even cases when CAUTION is given may result in serious injury under certain conditions. Be sure to observe the instructions for CAUTION.2.1 Storage, Transportation and Installation CAUTION • Never store the instrument in a place where water may splash or poisonous gas or liquid is present. • Never store the instrument in a place exposed to dust, direct sunlight, or hot and humid surroundings. • Never pull the power cord to move the instrument. An injury or a failure of the instrument may result. • To carry the instrument to another location, its base should be held from both sides by two persons. (Never hold the forehead rest, main body, or measuring unit.) If the instrument is carried only by one person, or a part other than the base is held, an injury or a failure of the instrument may result. • To transport the instrument, store it in the attached shipping carton without locking the measuring unit to the base. A breakdown of the instrument may result. • Store the instrument in a place where it cannot be splashed with water. Exposure to water may result in an electric shock or a failure of the instrument. • Install the instrument on a stable and level place which is not subjected to vibration or shock. Incorrect measurement or a failure of the instrument may result. An injury from the instrument being knocked over by a shock may also result. • Keep the touch screen panel away from direct sunlight or excessive ultraviolet rays. They will damage the touch-screen panel. • Install the device in area where the outlet that the power plug is inserted into is easily accessible during use. In addition, ensure that the power plug can be disconnected without the use of a tool. Otherwise, it may interfere with disconnection of the device from the input power source in case of abnormality.
  • 13. 2-2 CAUTION• Install the instrument under the following conditions: Dust-free environment Disturbance-light-free environment Vibration-free and shock-free environment• Install and use the instrument in a place where the temperature and humidity are maintained to the following: Use conditions: Temperature: 10 to 35 ºC Humidity: 30 to 75% (Non-condensing)• The instrument has been tested and found to comply with the limits for medical devices to the IEC 60601-1-2: 2001. These limits are designed to provide reasonable protection against harmful interference in a typical medical installation. This instrument generates, uses and can radiate radio frequency energy and, if not installed and used in accordance with the instructions, may cause harmful interference to other devices in the vicinity. However, there is no guarantee that interference will not occur in a particular installation. If this instrument does cause harmful interference to other devices, which can be determined by turning the instrument off and on, the user is encouraged to try to correct the interference by one or more of the following measures: - Reorient or relocate the receiving device. - Increase the separation between the instruments. - Connect the instrument to an outlet on a circuit different from that to which the other device(s) are connected. - Consult the manufacturer or field service technician for help.• In installation and operation of the device, observe the following instructions about EMC (electromagneticcompatibility): - Do not use the device simultaneously with other electronic equipment to avoid electromagnetic interference with the operation of the device. - Do not use the device near, on, or under other electronic equipment to avoid electromagnetic interference with the operation of the device. - Do not use the device in the same room with other equipment such as life-support equipment, other equipment that has major affects on the life of the patient and results of treatment, or other measurement or treatment equipment that involves small electric current. - Do not use the device simultaneously with portable and mobile radio frequency communication systems because it may have an adverse effect on operation of the device. - Do not use cables and accessories that are not specified for the device because that may increase the emission of electromagnetic waves from the device or the system and decrease the immunity of the device to electromagnetic disturbance.• The International Electrotechnical Commission sets the essential requirements for electrical and electronic equipment that may disturb, or be disturbed by, other equipment. The ARK-10000 complies with these requirements as tabled on pages F-1 to F-3. Follow the guidance in the tables for use of the device in an electromagnetic environment.
  • 14. 2-32.2 Plugging Instrument In and Handling Power Cord CAUTION • Use power outlets which meet the specified power requirements. If voltage is too high or low, the instrument may not deliver full performance, or a failure or a fire may result. • Do not overload one electrical outlet. A fire may result. • Never use a table tap or extension cable to supply the device with power. The electrical safety may be lowered. • Be sure to use a (HOSPITAL GRADE) power outlet equipped with a grounding terminal in order to avoid an electric shock or a fire in the event of a power leak. • Insert the mains plug into an outlet as far as the pins of the plug go. Imperfect connection may result in a fire. • If the instrument will not be used for a long period, disconnect the mains plug from the outlet. A fire may result. • Be sure to hold a plug instead of holding its cord when disconnecting the plug from an outlet. A break in the metal core inside the cord may cause a short circuit or an electric shock. • Do not crush with heavy objects nor squeeze the power cord. The damaged power cord may cause an electric shock or a fire. • If the internal wires of the power cord are exposed, power to the instrument is turned ON or OFF when the power cord is moved, or the cord or the plug gets extremely hot, the power cord itself is damaged. Immediately discontinue use of the power cord, and replace it with a new one. Otherwise, the power cord may cause an electric shock, or a fire. • Clean between the prongs of the mains plug using a dry cloth every once in a while. If dust settles thickly on them, it is likely to attract moisture, and may cause a short circuit, or a fire. • Do not use any power cord other than the specified one that comes with the instrument. Do not use the specified power cord for any other instrument. Failure or a fire may result.
  • 15. 2-4 CAUTION • When connecting the device to the PC* that does not comply with IEC60601-1, be sure to supply power through an isolation transformer. (*Except for the PC that adopts the class II AC adapter certified with IEC60950-1.) Electric shock may occur. For installation of the isolation transformer, consult NIDEK or your authorized distributor. • When connecting to peripheral equipment like a PC with LAN connector via a medical facility network, insert or connect the isolation transformer between medical electrical equipment an network device (such as HUB), or networked device and other electrical equipment. Depending on the types or numbers of other electrical equipment may occur. For installation of the network isolation transformer, consult NIDEK or your authorized distributor.2.3 In Use CAUTION • Do not allow the patient to touch the placido ring unit on the patient’s side inadvertently. Because the placido ring unit moves up, down, to the left, or to right during automatic alignment, do not insert fingers under the unit. Fingers may be pinched in a space between the bottom of the placido ring unit and rear panel of the main body and injured. • Check the external view and operation of the instrument before use. If any abnormality is found, do not use the instrument. Use of an abnormal instrument may not produce the intended result or cause unexpected health hazard by unexpected malfunction or wrong diagnosis. • Wipe the forehead rest and chin rest before every measurement with a cloth dampened with disinfecting alcohol. Remove a sheet of chin rest paper if a pad of the paper is mounted on the chin rest. • Never smear the measuring window with fingerprints, dust, or such. The smeared window will result in extremely lower measurement accuracy. • Never use the instrument for other than its intended use. NIDEK assumes no responsible for any accidents or failures caused by the neglect of this instruction. • The objective refraction measured by the ARK-10000 is intended to be used as a reference of lens prescription for the correction of visual acuity with spectacle or contact lenses. Subjective refraction must also be used as the basis for spectacle or contact lens prescription. • Never eject a floppy disk while the lamp of the floppy disk drive is being illuminated. Damage to the floppy disk or disk drive may result.
  • 16. 2-5 CAUTION • When turning OFF the instrument, be sure to follow the instructions in “4.2.3 Power-OFF” instead of turning OFF the power switch. Turning OFF the power switch before Windows is shut down may result in a loss of data or a malfunction. • While the pointer ( ) is changed into the hourglass ( ), do not perform any operation through the touch-screen panel. A malfunction may result or the system may lock up. • The ARK-10000 runs on Windows OS of Microsoft Corporation. Follow general precautions in using Windows. For example, before shutting the computer OFF, make sure that Windows is shut down. • Operators are responsible for managing their data. NIDEK assumes no responsibility for a loss of data. • Be sure to back up measured data on storage disks such as a ZIP disk or DVD-RAM. In case of the corruption of the built-in hard disk, saved data will never be usable again. In addition, storage disks such as CD-R, CD-RW, DVD-R which need writing software are improper for data backup. • Do not touch the touch-screen panel with anything other than fingers or the tip of a touch-screen pen. Contact of a hard or sharp object such as a ball point pen with the panel may scratch the panel. In addition, although the tip of a touch-screen pen is covered with resin which is unlikely to scratch the panel, the panel may be scratched by strongly pressing the pen against the panel. • Never press two or more points on the touch-screen panel at the same time. A malfunction may result. • In case of an instrument failure, disconnect the power cord from the outlet, and contact your authorized distributor without touching the internal structure of the instrument. • Do not install Windows application software other than the ARK-10000 software. The installation of any other Windows application software may lead to abnormal operation of the ARK-10000 and loss of stored data. In addition, the warranty may not cover the ARK-10000 if Windows application software other than the ARK-10000 software is installed. • Turn OFF power to the instrument and put a dust cover over the instrument while it is not in use. Accumulated dust, dirt, etc. may adversely affect measurement accuracy. • Never disassemble or touch the internal structure of the instrument. An electric shock, or a failure of the instrument may result. • This device is classfied as Group 1 set by ISO 15004-2: 2007 Light Hazard and comforms to the standard.
  • 17. 2-6{ Patient environment The patient environment is the volume of space in which contact can occur between the patient and any part of the device (including connected devices) or between the patient and any other person(s) touching the device (including connected devices). Use devices that comply with IEC60601-1 in the patient environment. If any device that does not comply with IEC60601-1 is to be used, use an isolating transformer or common protective grounding. Radius of 1.5 m 2.5 m 1.5 m 1.5 m
  • 18. 2-72.4 Maintenance CAUTION • Before the replacement of fuses, turn OFF power to the instrument and disconnect the power cord from the outlet. An electric shock may result. • Use only fuses of the specified rating. A fire may result. • Pay attention not to change the numbers in the voltage indication window while replacing fuses. Accidental changing of improper voltage may result in a failure or a fire. • Only the NIDEK service personnel or those who have been trained by NIDEK are allowed to repair or disassemble the instrument. • Never use organic solvents such as a thinner, or detergents with abrasives to clean the covers, touch-screen panel, and placido rings. The covers or touch-screen panel may be corroded or scratched. Especially, cleaning of the placido rings with organic solvents or detergents with abrasives will disturb concentric ring shapes, which may lower measurement accuracy. • If the touch-screen panel becomes dirty, soak a soft cloth or gauze in water, wring it well, and wipe the panel with it. • Blow the dust off the placido rings with a blower. Careless wiping may disturb concentric ring shapes, and may lower the measurement accuracy. NOTE • There may be a few “missing” or “dead” pixels in your touch-screen panel, which appear as black dots on an all-white background or there may be “lit” pixels, which appear as ones or several randomly-placed red, blue and/or green pixel elements on an all-black background. This does not represent a failure of the touch-screen panel; This is due to the structure of the liquid crystal display.
  • 19. 2-82.5 Disposal NOTE • Follow local governing ordinances and recycling plans regarding disposal or recycling of device components. The instrument uses a lithium battery mounted on a board inside. Follow your local governing ordinances in disposing of the lithium battery since the disposal method differs according to the local government. Inappropriate disposal may contaminate the environment. • When disposing of packing materials, sort them by material and follow local governing ordinances and recycling plans. Inappropriate disposal may contaminate the environment.2.6 Connection to Network CAUTION • If this instrument is used with other software such as OPD-Station to share the database, do not connect them to the network that can connect to the Internet. Configure a local network only with related instruments and software such as this instrument, OPD-Station, and Final Fit. NIDEK will not assume responsibility or compensate for damages caused by any virus infection and development due to connection of the instrument to a network that can connect to the Internet. This instrument is a medical equipment. If the user changes the setting of the instrument by installing other software such as antivirus software, NIDEK will not guarantee proper operation of the instrument.
  • 20. 2-92.7 Labels [Right side view] See “2.2 Plugging Instrument In and Handling Power Cord” (p.2-3). See “2.2 Plugging Instrument In andSee “2.5 In Use” (p.2-5). Handling Power Cord” (p.2-3).See “2.4 Maintenance” (p.2-7).
  • 21. 2 - 10[Patient’s side view] See “2.3 In Use” (p.2-4).
  • 22. §3 INSTRUMENT DESCRIPTION3.1 Names and Explanations of Parts Touch-screen panel Start button Joystick Locking knob Floppy disk drive Operator’s side Touch-screen panel Floppy disk drive Displays various kinds of operation screens, Used to store map images or numerical data exam data, and maps. obtained from measurements on a floppy disk. Touching the displayed buttons allows Use a MS-DOS-formatted 2HD 3.5-inch operation of the instrument. floppy disk. Start button Printer Used to start the measurement. The built-in printer is used to print out the AR- and KM-measured data (equivalent to the mea- Joystick sured values by Auto Ref/Keratometer). Used to move the main body to the right, left, back and forth. By turning the top of this le- Mouse connector ver, the main body can be moved up and down. Used to connect a mouse. Connectable mouse type: PS/2 mouse Locking knob Used to fix the main body to the base unit. Printer connector To lock the main body, bring the main body Used to connect an optional color printer. to the center of the base unit, and turn the knob counterclockwise while holding it down. Ethernet connector To temporarily lock the body at any position, Used to connect the instrument to Ethernet. To turn the knob clockwise. do this, it is necessary to set Windows. (In “Net- Do not lock the main body with this locking work Connections” in “Control Panel”, the right knob when transporting the instrument. connector is set to “Local Area Connection”, and Breakage of the instrument may result. the left connector to “Local Area Connection 2”.)
  • 23. 3-2 Printer PD window Mouse connector Power switch Printer connector Fuse Ethernet connector AC inlet USB connector Right side view VGA connector COM connector Keyboard connectorUSB connector Keyboard connectorThis connector is for connecting an USB device. Used to connect the keyboard.Used to connect an external storage device. Power switchVGA connector Flip the power switch to the “ | ” side to turnUsed to connect an external monitor or video the instrument ON.printer. When turning it OFF, be sure to press on the touch-screen panel instead of pressingCOM connector this switch. After Windows has stopped allUsed to connect an interface cable when trans- its operations, the instrument automaticallymitting data to the refractor, NIDEK RT-2100/ shuts off.RT-5100, or an external computer. CAUTION • Equipment connected to the analog or digital interfaces must be certified according to the representative appropriate national standards (such as EN 60601-1 and IEC 60601-1.) Furthermore, all configurations shall comply with the system standard IEC 60601-1-1.Anyone who connects additional equipment to the signal input part or signal output part configures a medical system, and is therefore responsible that the system complies with the requirements of the system standard IEC 60601-1-1. If in doubt, consult the technical service department or your local representative.
  • 24. 3-3 Forehead rest Placido rings Eye level marker Measuring window Chin rest Chin rest knob Patient’s side Eye level marker A guide for the patient’s eye level during mea- surement. The height of the chin rest should be adjusted so that the center level of the patient’s eye roughly aligns with this line. Chin rest knob Turning this knob moves the chin rest up and down. You may use the eye level marker as a guide to adjust the patient’s eye level to a com- fortable height for measurement.
  • 25. 3-4 [Measurement screen (ARK mode)] The screen is displayed when the refractive power and curvature radius of the eye are measured. TargetFocusing indicator Alignment light Measurement select button Measurement mode button Tracking button Auto-shot button Measurement select button : The auto-shot function is turned OFF. Every time the button is pressed, the measure- : The auto-shot function is turned ON ment type is selected in the order of (AR (active). and KM measurements) => (AR measure- The button cannot be changed into if ment) => (KM measurement) => the tracking button is . (Manual PD measurement*5). The auto-shot function is disabled during : Both AR and KM measurements KM measurement. : Only AR measurement : Only KM measurement Tracking button : Manual pupillary distance measurement Used to toggle the auto-tracking function. : The instrument automatically aligns the Measurement mode button measuring unit with a patient’s eye. Used to toggle between the (ARK mode) : The auto-tracking function is not active. and (ARK/CT mode). * Auto-tracking function: When roughly aligned to the corneal vertex point, the Auto-shot button ARK-10000 automatically detects the Used totoggle the auto-shot function. corneal vertex point, and it performs a fine alignment and focusing.*5 The button is selectable only when the “Auto PD” check box is unchecked on the Settings screen.
  • 26. 3-5 Used to print out measured exam data with the built-in printer. While the data is temporarily saved in the memory, the button is marked by a small circle in the upper right corner like . When starting a measurement after press- ing the button, the instrument clears the saved data in the memory, and starts mea- surement. Used to delete the exam data which is being displayed on the screen. Used to switch the screen to the Settings screen where various settings can be speci- fied. Used to exit the ARK-10000 software and turn the instrument OFF. Be sure to use this button when turning the instrument OFF. Never turn the instru- ment OFF by pressing the power switch as it may result in a malfunction. Used to display on-screen help related to the screen.
  • 27. 3-6 [Measurement screen (ARK/CT mode)] The screen is displayed when the refractive power and curvature radius of the eye are measured. Target Focusing indicator Alignment light Measurement select button Measurement mode button Auto-shot button Tracking button Measurement select button Auto-shot button Every time the button is pressed, the measure- Used to toggle the auto-shot function. ment type is selected in the order of (REF : The auto-shot function is turned OFF. and CT measurements) => (REF measure- : The auto-shot function is turned ON ment) => (CT measurement) => (active). (Manual PD measurement*6). The button cannot be changed into if : Both REF and CT (Corneal Topog- the tracking button is . raphy) measurements The auto-shot function is disabled during : Only REF measurement CT measurement. : Only CT (Corneal Topography) mea- surement Tracking button : Manual pupillary distance measurement Used to toggle the auto-tracking function. : The instrument automatically aligns the Measurement mode button measuring unit with a patient’s eye. Used to toggle between (ARK mode) and : The auto-tracking function is not active. (ARK/CT mode). * Auto-tracking function: When roughly aligned to the corneal vertex point, the ARK-10000 automatically detects the corneal vertex point, and it performs a fine alignment and focusing.*6 The button is selectable only when the “Auto PD” check box is unchecked on the Settings screen.
  • 28. 3-7 Used to print out exam data such as AR data Used to display on-screen help related to the and corneal curvature radius with the built-in screen. printer, and to save the data into the database. While the data is temporarily saved in the Detection in progress display memory, the button is marked by a small The “ ” mark (red) is displayed while the de- circle in the upper right corner like . tection of the placido rings is in progress. The When starting a measurement after press- “ ” mark (gray) is displayed while the detec- ing the button, the instrument clears the tion of the pupil is in progress. saved data in the memory, and starts mea- If two or more readings are in progress, the num- surement. ber is displayed on the side of the mark. When exam data has been saved in the data- (Example: The indication “ ” is dis- base after printout, the button changes into played when two readings of pupil are in . progress.) In Multiple measurement mode, pressing this button displays the Data Selection screen. ID: and Patient buttons Used to open the “Select Patient” dialog box for patient data entry (such as a patient name) or Used to switch the screen to the Map View patient data selection. screen. After entering patient data, the ID No. and The latest exam data will be displayed in the patient name are displayed on the buttons. map layout of “View 1”. Used to delete the exam data which is being dis- played on the screen. Used to switch the screen to the Patient Selec- tion screen. Used to switch the screen to the Settings screen where various settings can be specified. Used to exit the ARK-10000 software and turn the instrument OFF. Be sure to use this button when turning the instrument OFF. Never turn the instru- ment OFF by pressing the power switch as it may result in a malfunction.
  • 29. 3-8[Map View screen] The Map View screen can include 6 maps at the maximum. Because 6 maps cannot be fit into the screen at a time, scroll through all the maps using the scroll bar on the right side to view the six maps. In addition, pressing below the color scale of each map enlarges that map only. The available map types are: Axial map, Instantaneous map, “Refractive” map, Elevation map, OPD map, Target “Refractive” map, Internal OPD map, Wavefront High Order map, Wavefront Total map, Wavefront Group map, Zernike graph and Difference map. On the screen, the Eye Image can also be displayed in stead of a map. (Selectable on the Map View Settings screen.) Scroll barUsed to print out a map image with an optional Used to toggle the eye maps (Left/Right).color printer. The button is operative only when data of both When exam data is stored in a database eyes is obtained with the same Exam No. after printout, the button changes into . Used to go to the screen where a map set (al-Used to output a map image into a file in the ready entered map layout) of both left andJPEG format or the BMP format. right eyes is selected.Used to output numerical data of measured Used to go to the screen where a map set (al-results into a text file in the CSV format. ready entered map layout) is selected.
  • 30. 3-9 Used to go to the Map View Settings screen where map types, layouts, color scales and so on are specified. Used to exit from the Map View screen to the measurement screen, or to the Patient Selec- tion screen. Used to display on-screen help related to the screen.
  • 31. 3 - 10[Data Selection screen] On the Data Selection screen, sets of data to be saved are selected from those measured in Multiple measurement mode. Pressing the desired sets of data to be saved selects it and frames it in green. Pressing selected data again cancels selection of the data. Eye direction box Scroll bar Scroll bar
  • 32. 3 - 11 Eye direction box Data for each measurement Used to toggle the Data Selection screen be- S, C, A: AR measurement value tween the right and left eyes. RMS@3 mm: RMS in I 3 mm area The numeric characters beside “R” and “L” RMS@5 mm: RMS in I 5 mm area indicate the numbers of pairs being selected. (See “5.1.7 OPD map”.) (An OPD data and a CT data makes a pair.) Pupil Size: Pupil diameter Ex. 1 pr. = 1 pair Pupil Detect: Result of pupil edge detection 2prs. = 2 pairs Offset: Alignment deviation in OPD measurement All Off button Displayed in green when less than Used to cancel all the selections. I 0.3 mm. Becomes yellow and red as the deviation increases. button Used to magnify the map beside it. Pupil image Pupil images in mesopic vision. Cyan line: pupil contour in mesopic vision Axial map image Cyan cross: pupil center in mesopic vision Axial map with the Smolek-Klyce [1.5D] color scale. OPD map image OPD maps with Adjustable, Common (Middle: Pupil image 0.00), and AutoStep color scale. Pupil images in photopic vision. Violet line: pupil contour in photopic vision Violet cross: pupil center in photopic vision Cancel button Used to return to the measurement screen with- out saving the measured data. Data for each measurement The measured data are deleted. Sim’ K1: Refractive power@angle along the steepest meridian Sim’ K2: Refractive power@angle along New Exam button the flattest meridian Used to return to the measurement screen to Rings: The number of rings from the in- perform additional measurement. ner ring detected without a gap. TED: Result of check whether the iris Save button image is applicable to the TED Used to save the selected sets of data in the da- function in the EC-5000. tabase. Pupil Detect: Result of pupil edge detection Offset: Alignment deviation in CT mea- Save All button surement Used to save all the sets of data in the database. Displayed in green when less than I 0.3 mm. Becomes yellow and red as the deviation increases.
  • 33. 3 - 12[Display Data Selection screen] On the Display Data Selection screen, sets of data to be displayed are selected from those selected in the Data Selection screen. Pressing the desired sets of data to be displayed selects it and its pair by framing them in green. (When the measurement data was selected and saved in the Data Selection screen, the sets of OPD and CT data are automatically paired in order of measurement. The formed pairs cannot be changed.) Eye direction box Scroll bar Scroll bar
  • 34. 3 - 13 Eye direction box Data for each measurement Used to toggle the Display Data Selection screen S, C, A: AR measurement value between the right and left eyes. RMS@3 mm: RMS in I 3 mm area RMS@5 mm: RMS in I 5 mm area button (See “5.1.7 OPD map”.) Used to magnify the map beside it. Pupil Size: Pupil diameter Pupil Detect: Result of pupil edge detection Axial map image Offset: Alignment deviation in OPD Axial map with the Smolek-Klyce [1.5D] color measurement scale. Displayed in green when less than I 0.3 mm. Becomes yellow and red as the deviation increases. Pupil image Pupil images in photopic vision. Pupil image Violet line: pupil contour in photopic vision Violet cross: pupil center in photopic vision Pupil images in mesopic vision. Cyan line: pupil contour in mesopic vision Cyan cross: pupil center in mesopic vision Data for each measurement Sim’ K1: Refractive power@angle along OPD map image the steepest meridian Sim’ K2: Refractive power@angle along OPD maps with Adjustable, Common (Middle: the flattest meridian 0.00), and AutoStep color scale. Rings: The number of rings from the in- ner ring detected without a gap. Cancel button TED: Result of check whether the iris Used to return to the measurement screen with- image is applicable to the TED out displaying maps in the Map View screen. function in the EC-5000. Pupil Detect: Result of pupil edge detection button Offset: Alignment deviation in CT mea- Used to go to the Map View screen of the se- surement lected data. Displayed in green when less than I 0.3 mm. Becomes yellow and red as the deviation increases.
  • 35. 3 - 14[Patient selection screen] The screen is for selecting exam data to be displayed on maps from the database. The screen is also used for editing data. By pressing an item on the top (ID, Name, Sex, Group, Last Exam Date) once, data can be sorted in ascending order within the item field. Pressing the item once again sorts the data in descending order. (ascending order) or (descending order) on an item indicates the item on which the sort order is based. Press any item on the desired patient line to select exam data. Map Selection area Number of listed data itemsUsed to go to the Map View screen of the se- Used to display the Import (Outside to Inside)lected data. screen through which data is imported. The button is for importing exam data ob- tained by another ARK-10000 into the data-Used to go to the Map View Settings screen base of your ARK-10000.where map types and a layout etc. are speci-fied. Used to display the Export (Inside to Outside) screen through which data is output to stor-Used to display the “Search Patient Data” dia- age disks such as a floppy disk etc.log box. Used to display the Delete screen throughUsed to display the Edit Patient Information which data can be deleted.screen where patient data is modified or theEdit Exam Information screen where examdata is modified.
  • 36. 3 - 15 Number of listed data items Used to display the “OPD Database Manager” Shows the total number of data items (A) and dialog box on which to create, change, backup, the number of data items listed (B). or rebuild the database. Patient Data 20 of 20 displayed Number of data items listed (B) Total number of data items (A) Used to open the “Database Settings” dialog box. When data is not retrieved by the “Search Pa- tient Data” dialog box below, (A) equals (B). Used to re-detect the edges of CT-measured Map Selection area data saved in the database. Used to set a layout of the maps to be dis- played on the Map View screen. See expla- nation below for details. Used to return to the measurement screen.[“Map Selection” area] Four operations available in the “Map Selection” area on the Patient Selection screen: NOTE • Specifications on the Patient Selection screen are temporarily applicable to a map. The map set will be reset back to the one specified on the Map View Settings screen once you select another patient. Specify a permanent map set that is applied to all the patients on the Map View Settings screen. I. Selecting a map layout from among the three map sets (“View 1” to “View 3”) to be applied to the maps displayed on the Map View screen Select the desired map set to be used from among “View 1”, “View 2” and “View 3” by pressing a radio button ( ). The map button will represent the selected layout. Radio button Layout of “View 1” Layout of “View 2” Layout of “View3” Map button Whether or not a map is to be printed in the layout is shown. In this case, the map is printed in the “View 1” layout and “View 2” layout.
  • 37. 3 - 16II. Changing a layout assigned to a map set (“View 1” to View 3”) 1) Select the button which is immediately under the selected radio button of a map set (“View 1” to “View 3”). In the case of the figure on the right, press AxOPD2 button. The screen where a map layout can be selected is displayed. 2) Press the desired layout to designate. This is a temporary designation. The designated layout will be reset back to that of the “View” specified on the Map View Settings screen when selecting other patient data.III. For a patient with multiple items of exam data, designating where to locate individual maps 1) Designate exam data to be displayed. Press the desired exam data line. Map button 2) Designate a map position on which the exam data will be displayed. Press a map button to designate. The designated map button No. will be entered in the “Map No.” box in a list. 3) Repeat Steps 1) to 2) to designate data to be displayed and its map position. This is a temporary designation. The designated layout will be reset back to that of the “View” specified on the Map View Settings screen when selecting other patient data.IV. Selecting a map layout from “View 1” to “View 3” in which maps are printed by pressing on the Map View screen Select of “View 1” to “View 3”. Multiple selections of the buttons are allowed. Ÿ Maps are printed in the layout. Ÿ Maps are not printed in the layout. This is a temporary designation. The designated layout will be reset back to that of “View” specified on the Map View Settings screen when selecting another patient’s data. Designate a map layout that is permanently applied in printing on the Map View Settings screen.
  • 38. 3 - 17[“Search Patient Data” dialog box] By using the “Search Patient Data” dialog box, the operator can easily search for patient data which meet all the entered specifications only and select the desired patient’s data. 1) Press to display the “Search Patient Data” dialog box. 2) Enter the desired specifications in the corresponding fields and press . ID, Name, Group Ÿ Only the data whose items contain the entered characters is searched. Last Exam Date Ÿ Checking searches only for the data from the designated period back from the last measurement date. Today: Today’s data only Week prior: Data obtained for the last 7 days One Month prior: Data obtained for the last 30 days Three Month prior: Data obtained for the last 90 days Period: Data obtained during the date range designated in the “From” and “To” fields Sex Ÿ Select “Male” (Male patients only are searched), “Female” (Female patients only are searched), or “Both” (Both male and female patients are searched). Patient data which meet all the entered specifications only is searched. button: Used to exit to the Patient Selection screen without searching. button: Used to return the specifications to the initial ones. (“ID”, “Name” and “Group” fields will be blanked, “Both” of “Sex” will be selected, and “F Last Exam Date” will be unchecked: The 1st day of the last month will be entered in the “From” fields, and the current date will be entered in the “To” fields.) F Save search specifications even after shutdown If the check box is checked, the data searched with the dialog box will be saved even after shutdown. To return the searched patient data to the previous status before searching, press on the Search Patient Data dialog box to return the specifications to the initial ones, and then press . If the check box is unchecked, the searched patient data is returned to the previous state before searching when the Patient Selection screen is closed. Be aware that this check box is not displayed and the searched data is not maintained when the Search Patient Data dialog box is displayed by way of the Select Patient dialog box or Import (Outside to Inside) screen. On the condition that patient data is searched using the Search Patient Data dialog box, the background color of the patient list is changed from white to yellow. NOTE • The Patient Selection screen cannot list more than 5,000 items of patient data. If the patient number exceeds 5,000, enter a specification to narrow the scope of a search.
  • 39. 3 - 18[Settings screen]This screen is used to make settings related to measurements, the built-in printer, communica-tion and others. The screen is also used for exiting the ARK-10000, and for returning to theWindows screen.Used to go to the Calibration selection screen. Used to cancel modifications and to return toTry not to press this button except when per- the measurement screen.forming calibration for the CT measurement be-cause changing the setting improperly results in amalfunction of the instrument. Used to display on-screen help related to the screen.Used to display the version of the ARK-10000software. Used to exit the ARK-10000 software and to return to the Windows screen.Used to fix modifications and to return to themeasurement screen.
  • 40. 3 - 19 [OPD Database Manager screen] This screen is used for selecting the desired database, database back-up, and such. This screen ap- pears by clicking the button in the Select Patient screen, double-clicking the icon on the task tray at the bottom right of the Windows screen, or clicking “Open OPD Database Manager” option that appears by right-clicking the icon on the task tray. <Normal Settings> <Advanced Settings> Start button Linked Comp List button Used to start connection of the device with the Used to display a list of computers connected to database. the database. After changing the settings in this screen, press This button is enabled when the selected data- this button to start connection with the database. base is in the ARK-10000. Stop button Advanced Settings/Normal Settings Used to stop connection of the device with the Used to toggle the Advanced Settings and Nor- database. mal Settings screens. Before selecting or backing up database, stop connection between the device and the database Minimize button using this button. Used to minimize the OPD Database Manager screen to the icon on the task tray. Local and Other computer radio buttons Used to toggle local database or database on an End button external computer. Used to close OPD Database Manager. Local – Database on the ARK-10000. Other computer – Database on a OPD Data- base Manager-installed ex- ternal computer
  • 41. 3 - 20Backup buttonUsed to display the Database Backup screenwhere the database can be backed up.Setting buttonUsed to display the Backup Settings screenwhere the criteria for deleting data sets in thedatabase can be set.Rebuild buttonUsed to display the Rebuild Database screenwhere database can be rebuilt. “Enabling the entry of alphanumeric characters only” check boxWhen the check is removed, patient names andcomments can be input in Japanese.Be sure to check this box when using the FinalFit software.Characters other than alphanumeric charactersmay become unreadable. Ref... button (in Local box of Advanced Setting screen)Used to display the Select Database screenwhere database setting or selection can be per-formed. Computer name boxUsed to input the computer name to connect to.The desired computer name can be selected fromthe list that appears by clicking the triangle but-ton shown to the right of the box. Ref... buttonUsed to display the computer reference screenwhere the desired computer to connect to canbe selected. Server history buttonUsed to display a list of computers the deviceconnected with in the past. The desired com-puter to connect to can be selected or the com-puter names can be deleted from the list.
  • 42. 3 - 213.2 Names and Explanations of Optional Function Screens [Accommodation measurement (optional)] This screen is used to measure the distribution of refractive power while applying the stimulus is to accommodation. Near/Far toggle button Chart position indicator Stimulus box Measurement mode button Near/Far toggle button Stimulus box Used to toggle between (Far vision The amount of stimulus is set. measurement) and (Near vision The default stimulus amount is set in the Set- measurement). tings screen. This value cannot be changed in the near vi- sion measurement. Chart position indicator Indicates the current chart position. Measurement mode button F: SE value position in far vision measure- ment Each pressing of this button changes the mea- N: Target position in near vision measurement. surement mode in order of (ARK/CT The position moved from the F position in mode), (ARK mode), and (Accom- the near vision direction by the amount of modation measurement mode). the stimulus. The chart position cannot be changed in Near vision measurement mode.
  • 43. 3 - 22[Wavefront Contact Lens measurement (optional)]This screen is used to perform measurement to calculate data for wavefront-guided contact lens. Fine adjustment button Input box Output Folder box Results box Pupil contour (blue line) Pupil center (blue cross) MarksFine adjustment button Output Folder boxUsed to adjust the positions of the mark of the Destination of the output measurement result filesame color finely. is input.Input box buttonLens ID: Used to open the Browse for Folder screen in Displays the contact lens ID. which the destination of the output measurement The contact lens ID is automatically applied file is selected to be displayed in the Output from the patient ID, exam No., and measure- Folder box. ment date.Trial lens pwr (D): Refractive power of the trial contact lens is input.Trial lens B.C.: The base curve of the trial contact lens is se- lected between “flat: 1” and “steep: 2”.* The control window can be moved by dragging. Move the control window if it hides the marks on the trial contact lens.
  • 44. 3 - 23 Results box Decentration: Displays the positional deviation of the pupil center from the center of the trial contact lens in the unit of mm. Horizontal: Displays the deviation in the horizontal di- rection. When the pupil center is deviated to the right, the sign becomes “+.” Vertical: Displays the deviation in the vertical di- rection. When the pupil center is deviated upward, the sign becomes “+.” Lens rot: Displays the amount of rotation of the trial contact lens. The horizontal position is 0º. The sign is “+” when the trial contact lens is ro- tated in counterclockwise direction. Zernike at I *.* (—m): The number after “I” indicates the diameter of the area used for Zernike analysis. The box below shows the wavefront RMS error. OK button Used to output the measurement result to the destination selected in the Output Folder box. R / L button Used to toggle the right and left eyes. The character in the button is displayed in blue only when the REF measurement is performed for both eyes. If the “R/L Format” setting in the Settings screen is “OD/OS”, this button is displayed as “ OD / OS .” button Used to return to the measurement screen with- out outputting the measurement result.
  • 45. §4 BASIC USAGE This section explains basic usages as: Measuring the eye in the ARK mode. o Printing out measured data. Measuring the eye in the ARK/CT mode o Viewing measured data displayed in a map. o Saving the measured data in the database. Recalling the measured data from the database and displaying it in the map. Printout Saving of Measure of Display of Mode Purpose data in ment type measured maps database data Refractive power and corneal curvature radius in the central area of the eye are AR measured. measurement, Not ARK This mode is not for saving the measured KM Print Not save display data in the database but for printing KM- measurement and/or AR-measured data. Corneal curvature radius and the distribution of the refractive power are measured. This mode is for checking REF ARK/ measurement, the distribution of the refractive power of CT Print Display Save CT the whole eyeball, saving it into the measurement database and displaying it in maps in the future. Measurement Details of measurement type Measures the refractive power of the central area of the eye in the same AR measurement manner that the auto refractometer does. The placido ring image projected over the cornea is captured. From the analysis result of the projected image, corneal curvature radius in the KM measurement approximately 3 mm area, the direction of the steepest meridian and the amount of corneal astigmatism are obtained. The fundus is scanned by slit-shaped ray bundles and data for displaying REF measurement the OPD map is obtained. The placido ring image projected over the cornea is captured. From the CT measurement analysis result of the projected image, a map illustrating the distribution of the corneal curvature radius or the refractive power is obtained.4.1 Operation Flow [ Measuring the eye in the ARK mode. o Printing out measured data.] 4.2.1 Power-ON Check the instrument before operation. (Step 4 of “4.2.1 Power-ON”.) Measuring 4.4.1 AR and KM measurements 4.4.2 AR measurement 4.4.3 KM measurement 4.7.1 Printing measured data 4.2.3 Power-OFF
  • 46. 4-2 [ Measuring the eye in the ARK/CT mode o Viewing measured data displayed in a map. o Saving the measured data in the database.] 4.2.1 Power-ON Check the instrument before operation. (Step 4 of “4.2.1 Power-ON”.) Entering a patient name (Step 4, p4-20) Measuring 4.5.1 REF and CT measurements 4.5.2 REF measurement 4.5.3 CT measurement 4.6.1 Displaying map via measurement screen 4.7.1 Printing measured data (The measured data is saved in the database simultaneously with the printout of the measured data.) 4.2.3 Power-OFF [ Recalling the measured data from the database and displaying it in the map.] 4.2.1 Power-ON 4.6.2 Retrieving exam from database and displaying it in map 4.2.3 Power-OFF
  • 47. 4-34.2 Power-ON and Power-OFF4.2.1 Power-ON 1. Make sure that no floppy disk is inserted in the disk drive. 2. When using an optional color printer, turn it ON. 3. Turn ON the power switch of the ARK-10000. Windows starts up and then the ARK-10000 also starts up. *7 Power switch NOTE • Because the ARK-10000 has Microsoft Windows installed, the instrument may be started in “Safe Mode”, or “Scandisk” may be accidentally initiated on startup. In such cases, follow the instructions below. If the instrument starts in “Safe Mode” Ÿ Turn OFF the instrument after startup and restart it. See [Restarting the instrument in Safe Mode] (p.4-5). If the instrument still starts in “Safe Mode”, contact NIDEK or your authorized distributor. If “Scandisk” is initiated Ÿ Allow “Scandisk” startup. If the ARK-10000 does not start up properly after “Scandisk” has ended, contact NIDEK or your authorized distributor. • If the built-in hard disk space is not enough at startup, a message appears during the program startup to encourage the operator to back up data and to free up disk space by deleting unwanted data. In this case, make more disk space as instructed: Erase unwanted data. Back up data on a storage disk as a ZIP disk or DVD-RAM and delete the backed up data from the hard disk. See “5.7.4 Backing up database”. • When backing up or rebuilding the database, connect an external storage device first, turn it ON, and then turn the ARK-10000 ON (When designating an external storage device as a target location for backup.). If the external storage device has not been connected when turning the ARK-10000 ON, the storage device may not be function properly.*7 Windows is the registered trademark of Microsoft Corporation, U.S.A.
  • 48. 4-4 NOTE · If the instrument power automatically turns off immediately after turning on the power switch, start up the instrument by pressing the Reset button as described below. While pressing the Reset button with the attached touch-screen pen, turn on the power switch. Release the touch-screen pen from the Reset button after about two seconds. At this time, take care not to press the Reset button for an excessively long time as it will turn off the power. Do not press the Reset button during instrument use. Pressing it inadvertently shuts down the instrument.4. Check the instrument before operation. Check the following points before operating the instrument. - The error message is not displayed. - The main body moves smoothly with the joystick. - The measuring window is not soiled. - Measurement accuracy (See “7.4 Checking Measurement Accuracy” (p.7-5).)
  • 49. 4-5[Restarting the instrument in Safe Mode] When starting the instrument in Safe Mode, shut the instrument down once after startup and restart it. Be aware that the touch-screen panel does not function in the Safe Mode. Use the keyboard to shut down the instrument as instructed below. 1) Press F4 key while pressing Alt key. The “Shut Down Windows” dialog box opens. 2) Make sure that the “Shut down” option is selected. If not, select the “Shut down” option with n key or p key. 3) Press Enter key. After a while, Windows is shut down and the instrument power is turned off automatically.4.2.2 Reactivating instrument from power saving mode The instrument will automatically be shut off for power conservation after a set period of time of non-operation. In the power saving mode, the title screen will dim. To reactivate the instrument from the power saving mode, do one of the following: • Touch the touch-screen panel. • Press any key of the keyboard. • Press the start button. • Manipulate the joystick to move the measuring unit to place it in front of the left eye or right eye. * According to the status of the screen, the instrument may not be put into the power saving mode. * The preset time of no operation can be set with the Settings screen. See “5.9.1 Setting parameters”.
  • 50. 4-64.2.3 Power-OFF CAUTION •When turning OFF the instrument, be sure to follow Steps 1 to 4 as below instead of turning OFF the power switch. Turning OFF the power switch of the instrument before Windows is shut down may cause a loss of data, or a failure of the instrument. *6 If the instrument cannot be operated through the touch-screen panel or keyboard, and therefore Windows cannot be shut down, turn OFF the power switch once, and turn it ON again and confirm that the instrument operates properly. 1. Press on the measurement screen. The “Shutdown” dialog box opens. 2. Press OK . The ARK-10000 and Windows are shut down, the measuring unit is moved to its lowest position, and the instrument power is automatically turned off.*8 3. If an optional color printer is connected, turn the printer OFF. 4. Put the dust cover on the instrument.[To exit the ARK-10000 software and return to the Windows screen] 1. Press on the measurement screen. The Settings screen opens. 2. Press . The “Exit” dialog box opens. 3. Press OK . The ARK-10000 software is exited, and the Windows screen opens.*8*8 Windows is the registered trademark of Microsoft Corporation, U.S.A.
  • 51. 4-74.3 Selecting Measurement Mode The ARK-10000 has two measurement modes: ARK mode and ARK/CT mode. Pressing the measurement mode button on the measurement screen switches the measurement mode between the two modes.*9 ARK mode ARK/CT modeMeasurement mode button Measurement mode button Switching the measurement mode will clear the measured data saved in the memory. If the measurement mode button is pressed on condition that the measured data is saved in the memory (on condition that or button is displayed), the dialog box is displayed, asking the operator if he/she is sure that he/she wants to switch the measurement mode after erasing the measured data in the memory. OK button Ÿ The measurement mode will be switched. Cancel button Ÿ The measurement mode will not be switched.*9 When the optional accommodation measurement function is incorporated, the measurement mode is switched among three modes. See “5.9 Accommodation Measurement Function (Optional).”
  • 52. 4-84.4 Measuring in ARK Mode In the ARK mode, refractive errors of the central part of the eye and corneal curvature radius are measured. The mode should be used for printing the AR- and KM-measured data without saving them in the database. In the ARK mode, two types of measurement are available. The measurement select button allows you to select both AR measurement and KM measurement, AR measurement only, or KM measurement only. Measurement Measurement Measurement type See … select button mode button AR measurement and 4.4.1 AR and KM measurements KM measurement AR measurement 4.4.2 AR measurement KM measurement 4.4.3 KM measurement Manual PD measurement (Only when the 5.5 Manual Pupillary Distance “Auto PD” box is (PD) Measurement checked on the Settings screen.) AR measurement: In the same manner as an auto refractometer, the refractive power of the central eye is measured. KM measurement: The placido ring image projected onto the cornea is captured. Then the corneal curvature radius, the direction of the steepest meridian and corneal astigmatism in about 3 mm-dia zone in the center of the cornea are obtained from the analyzed image.4.4.1 AR and KM measurements Both AR measurement (Objective measurement of refractive power) and KM measurement (Measurement of corneal curvature radius) are performed. NOTE • To obtain reliable measured results, be sure to read “APPENDIX C. OBTAINING RELIABLE EXAM DATA” (at the end of this book) before measuring a patient’s eye for the first time.1. Turn the instrument ON. The ARK-10000 starts up, and the measurement screen is displayed.2. Prepare the patient. 1) Clean the forehead rest and chin rest with a clean cloth such as gauze or cotton dampened with disinfecting alcohol. When a stack of chin rest paper is mounted on the chin rest, remove one sheet of the paper.
  • 53. 4-9 2) Instruct the patient to remove glasses or contact lenses if wearing, and to sit in the chair. NOTE • It is recommended to have patients who always wear contact lenses in daily life, wear glasses for about one week before measurement in order to obtain accurate results. This is to measure a cornea restored to its original shape after being slightly deformed by the wearing of contact lenses. [Overrefraction] In the case of overrefraction (when measuring the patient’s eye with spectacle glasses), the focusing indicator may not appear. (See p.4-10.) During AR measurement, bring the patient’s eye in focus by minimizing the alignment light as much as possible. Be aware that the reliability of the AR-measured data may be lowered according to the degree of the deflection of the measuring beam caused by the lens of eyeglasses (refractive index of eyeglasses). During KM measurement, the reflected frame image of spectacles will obstruct the placido ring image (a placido ring image will have breaks), or lenses will cause image magnification to vary. As a result, the reliability of the KM-measured data will be lowered. 3) Instruct the patient to place his/her chin on the chin rest and gently place his/her forehead against the forehead rest. 4) Adjust the height of the chin rest with the chin rest knob, and roughly align the center of the patient’s eye with the eye level marker. NOTE • To relax the patient, explain the following before measurement: “This instrument measures your eye to find which kind of lens fits you, and your corneal shape. The weak infrared rays and red light used in the measurement do not harm your eyes.”3. Set the measurement mode to the ARK ( ) mode. Every time the measurement mode button (the second button from the left in the bottom) is pressed, the measurement mode is alternately switched. See “4.3 Selecting the Measurement Mode”.4. Set the measurement type to the “AR/KM” ( ). Every time the measurement select button (in the lower left corner) is pressed, the selected measurement will be switched alternately. The symbol in the measurement select button represents the currently-selected measurement.
  • 54. 4 - 105. Perform focusing. 1) Instruct the patient to; “Look through the measuring window. As you will see a picture of a balloon, watch the center of it without straining. Try to open your eye as wide as possible.” 2) Manipulate the joystick to display the patient’s eye on the screen. By moving the joystick to the right or left, pulling it forward or pushing it back, the main body is moved to the right, left, backward and forward. By turning the top of the joystick, the measuring unit is moved up and down. Align the eye position to the measuring point with right, left, up and down movements. Adjust the focus with back and forth movements. Focusing indicator Target Alignment light [When using the auto-tracking function ( )] 3) Manipulate the joystick to move the alignment light closer to the target . As the alignment light comes closer to the target , the activated auto-tracking function will move the main body so that the eye to be measured is in alignment with the main body and in focus. NOTE • The auto-tracking function does not work unless the alignment light is at around the center of the measuring field. If the alignment light is off the center, manipulate the joystick to move the alignment light to the center. When the position of the alignment light goes outside the working range of the auto- tracking, the limit mark (the letters “LIMIT” and arrow) appears on the touch-screen panel. In such cases, either move the joystick slightly in the direction of the arrow, or pull the main body forward once again to make the instrument focuses on the eye again. LIMIT mark LIMIT : Tilt the joystick to the left. LIMIT : Tilt the joystick to the right. LIMIT : Slightly move the chin rest up. LIMIT : Slightly move the chin rest down. LIMIT F: Tilt the joystick backward (toward the patient). LIMIT B: Tilt the joystick forward (toward the operator). • The two dotted line circles on the measurement screen represent the 2-mm and 6-mm dia. zones to be measured. If the patient’s eyelashes interfere with the inner circle, the reliability of the measured data will be lowered. In such cases, instruct the patient to open his/her eyes wide.
  • 55. 4 - 11 [When not using the auto-tracking function ( )] 3) After moving the alignment light inside the target , bring the patient’s eye into focus so that the focusing indicator shows the most ideal state “ ” by manipulating the joystick. [Focusing indicator] Too close to the patient’s eye Pull the joystick forward to move the main body away from the patient’s eye. Ideal state Push the joystick to move the main body closer to the patient’s eye. Too far from the patients eye6. Perform measurement. When both left and right eyes are “AR-measured” and “KM-measured”, the measurement order is selectable between (A) and (B): (A) The ARK-10000 “AR-measures” and then “KM-measures” one eye and then it measures the other eye in the same order: Example) AR measurement (Right eye) o KM measurement (Right eye) o AR measurement (Left eye) o KM measurement (Left eye) (B) The ARK-10000 “AR-measures” both eyes and then “KM-measures” both eyes. Example) AR measurement (Right eye) o AR measurement (Left eye) o KM measurement (Left eye) o KM measurement (Right eye) The explanation in this manual is based on measurement order (A). In measurement order (A), the reliability of the PD measured during AR measurement may be lower than the PD value obtained in measurement order (B). This is because the patient’s head may shift slightly during the longer interval between the right-eye AR measurement and left-eye AR measurement. * The switching between the right and left eyes is automatically performed when the main body is moved with the joystick and the eye to be measured is displayed on the screen. [When using the auto-shot function ( )] AR measurement takes place automatically when the instrument is best aligned and focuses on the eye. p After repeated AR measurements until AR median values (S, C, A) are obtained by taking the median of the first 3 usable values, the letters “AR” in the upper right of the screen will change to the blinking letters “KM”. Instruct the patient to slowly blink once or twice to make his/her corneal surface smooth and optically clear. p After confirming that the instrument is best aligned and focuses on the eye, press the start button to start KM measurement. KM measurement takes place 3 times.
  • 56. 4 - 12 [When not using the auto-shot function ( )] AR measurement takes place when the start button on the joystick is pressed. Repeat the measurement until AR median values (S, C, A) are obtained by taking the median of the first 3 usable values. p After repeated AR measurements until AR median values (S, C, A) are obtained by taking the median of the first 3 usable values, the letters “AR” in the upper right of the screen change to the blinking letters “KM”. Instruct the patient to slowly blink once or twice to make his/her corneal surface smooth and optically clear. p After confirming that the instrument is best aligned and focuses on the eye, press the start button to start KM measurement. KM measurement takes place three times. The latest AR-measured and KM-measured median values are displayed: Latest AR values and KM median values (An error No. will be displayed if an er- Right/Left KM measurement ror occurs during the measurement.) The measured eye indication blinks. count AR measurement count Latest AR values (Right eye/Left eye) KM median values (Simulated KM-measured values) (Right eye/Left eye) Pressing the button clears all the displayed data on the screen. NOTE • The sign “E” may be shown next to the latest AR-measured values displayed in the lower portion of the measurement screen. This sign represents a lower reliability of the AR data. This sign will be frequently shown in the case of keratoconus or a highly-irregular cornea after a corneal transplantation. However, if the Print High RMS Data check box is unchecked on the Settings screen, low-confidence measured data with the E sign is not displayed.
  • 57. 4 - 13 [AR measurement count] When the auto-shot function is turned ON Ÿ AR measurement takes place repeatedly when the main body is best-aligned and focuses on the eye until AR median values (S, C, A) are automatically obtained by taking the median of the first 3 usable values. When the auto-shot function is turned OFF: • When the “AI Mode” box is checked ( ) on the Settings screen: ŸPressing the start button once triggers the instrument to perform AR measurement a single time. Holding down the start button makes the instrument perform AR measurement repeatedly until AR median values (S, C, A) are automatically obtained by taking the median of the first 3 usable values. • When the “AI Mode” box is not checked ( ) on the Settings screen: ŸPressing the start button once triggers the instrument to perform AR measurement a single time. While the start button is held down, the instrument keeps performing AR measurement. If the “Single Fogging” box is checked throughout the repeated AR measurements, fogging is maintained throughout measurement.7. Measure the other eye in the same manner.8. After completion of the measurement, press . The measured results are printed. See “4.7.1 Printing measured data”.
  • 58. 4 - 144.4.2 AR measurement Only AR measurement (objective measurement of the refractive power) is performed. NOTE • To obtain reliable measured values, be sure to read “APPENDIX C. OBTAINING RELIABLE EXAM DATA” before measuring a patient’s eye for the first time.1. Turn ON the power. The ARK-10000 starts up, and the measurement screen is displayed2. Preparing the patient. See Step 2 of “4.4.1 AR and KM measurements”. NOTE • To relax the patient, explain the following before measurement: “This instrument measures your eye to find which kind of lens fits you. The weak infrared rays used in the measurement do not harm your eyes.”3. Set the measurement mode to the ARK ( ) mode. Every time the measurement mode button (the second button from the left in the bottom) is pressed, the measurement mode is alternately switched. See “4.3 Selecting Measurement Mode”.4. Set the measurement type to the “AR” ( ). Every time the measurement select button (in the lower left corner) is pressed, the selected measurement will be switched alternately. The symbol in the measurement select button represents the currently-selected measurement.5. Perform alignment and focusing. See Step 5 of “4.4.1 AR and KM measurements”. NOTE • The two dotted circles on the measurement screen represent the 2-mm diameter and 6- mm dia. zones on the cornea to be “AR-measured”. If eyelashes are on the innermost circle, the reliability of the measured data will be lower. In such cases, instruct the patient to open his or her eye wider.
  • 59. 4 - 156. Performing measurement. [When using the auto-shot function ( )] AR measurement takes place automatically when the instrument is best aligned and focuses on the eye. [When not using the auto-shot function ( )] Press the start button on the joystick. AR measurement takes place. On the touch-screen panel, the latest AR values are displayed. Latest AR values (An error No. will be displayed if an error occurs dur- Right/Left ing AR measurement.) The measured eye indication blinks. AR measurement count Latest AR values (Right eye/Left eye) Pressing the button clears all the displayed values on the screen. NOTE • The sign “E” may be shown next to the latest AR-measured values displayed in the lower portion of the measurement screen. This sign represents a lower reliability of the AR values. This sign will be frequently shown in the case of keratoconus or a highly-irregular cornea after a corneal transplantation. However, if the Print High RMS Data check box is unchecked on the Settings screen, low-confidence measured data with the E sign is not displayed.
  • 60. 4 - 16 [AR measurement count] When the auto-shot function is turned ON Ÿ AR measurement automatically takes place in succession on the condition that the instrument is best aligned and focuses on the eye until AR median values are automatically obtained (S, C, A) by taking the median of the first 3 usable values. When the auto-shot function is turned OFF: • When the “AI Mode” box is checked ( ) on the Settings screen Ÿ Pressing the start button once triggers the instrument to perform AR measurement a single time. Holding down the start button makes the instrument perform AR measurement repeatedly until AR median values are obtained (S, C, A) by taking the median of the first 3 usable values. • When the “AI Mode” box is not checked ( ) on the Settings screen Ÿ Pressing the start button once triggers the instrument to perform AR measurement a single time. While the start button is held down, the instrument keeps performing AR measurement. If the “ Single Fogging” box is not checked on the Settings screen, fogging is maintained throughout the repeated AR measurements.7. Measure the other eye in the same manner.8. After completion of measurement, press . The measured results are printed. See “4.7.1 Printing measured data”.
  • 61. 4 - 174.4.3 KM measurement Only KM measurement (measurement of the corneal curvature radius) is performed. NOTE • To obtain reliable measured results, be sure to read “APPENDIX C. OBTAINING RELIABLE EXAM DATA” before measuring a patient’s eye for the first time.1. Turn ON the power. The ARK-10000 starts up, and the measurement screen opens.2. Prepare the patient. See Step 2 of “4.4.1 AR and KM measurements”. NOTE • To relax the patient, explain the following before measurement: “This instrument measures corneal shape. The red light used in the measurement does not harm your eyes.”3. Set the measurement mode to the ARK ( ) mode. Every time the measurement mode button (the second button from the left in the bottom) is pressed, the measurement mode is alternately switched. See “4.3 Selecting the Measurement Mode”.4. Set the measurement type to the “KM” ( ). Every time the measurement select button (in the lower left corner) is pressed, the selected measurement will be switched alternately. The symbol in the measurement select button represents a currently-selected measurement.5. Perform focusing. See Step 5 of “4.4.1 AR and KM measurements”.
  • 62. 4 - 18 6. Perform measurement. [When using the auto-shot function ( )] Press the start button on the joystick. KM measurement takes place three times. (During KM measurement, the auto-shot function is disabled.) [When not using the auto-shot function ( )] Press the start button on the joystick. KM measurement takes place three times. The KM-measured median values are KM median values displayed. (An error No. will be displayed Right/Left KM measurement if an error occurs during the measurement.) The measured eye indication blinks. countKM median values(Simulated KM-measured values)(Right eye/Left eye) Pressing the button clears all the displayed values on the screen. 7. Measure the other eye in the same manner. 8. After completion of KM measurement, press . The measured results are printed. See “4.7.1 Printing measured data”.
  • 63. 4 - 194.5 Measuring in ARK/CT Mode In the ARK/CT mode, the corneal curvature radius and the distribution of the refractive power are measured. The mode should be used for viewing the distribution of the refractive power of an entire eye or for saving measured data in the database and for viewing a map of the data at a later date. In the AR/CT mode, two types of measurement are available: REF measurement and CT measurement. The measurement select button allows you to select both REF measurement and CT measurement, REF measurement only, or CT measurement only. Measurement Measurement Measurement See… select button mode button REF measurement and 4.5.1 REF and CT measurements CT measurement REF measurement 4.5.2 REF measurement CT measurement 4.5.3 CT measurement Manual PD measurement (Only when the 5.5 Manual PD Measurement “Auto PD” box is checked on the Settings screen.) REF measurement: The REF (Auto Refractometer) measurement value is calculated by scanning the fundus with slit-shaped ray bundles, dividing the area between I 2mm and 6 mm into four zones, and measuring the zones at every 1 degree. The OPD maps is displayed by calculating refractive powers (D) at multiple points within the I 6 mm area from the center. In addition, I2 the wavefront aberration map can be displayed as a variation of the OPD map. I6 CT measurement: The projected placido rings on the cornea are captured, the ring images are analyzed, and then a map illustrating the distribution of corneal curvature radiuses or that of the refractive power and KM-measured data (simulated keratometry values) are obtained. Check the Multiple box on the Setting screen to enter the Multiple measurement mode. In normal mode, only the latest measurement data is saved in the database in the REF and CT measurements. In Multiple measurement mode, sets of data to be saved can be selected from multiple measurements (maximum of ten times). However, the Multiple box cannot be selected if the instrument is used with LAN connection to the OPD-Station of earlier than V2.00. See “4.5.1.1 REF/CT measurement (Multiple measurement mode)”, “4.5.2.1 REF measurement (Multiple measurement mode)”, and “4.5.3.1 CT measurement (Multiple measurement mode).”
  • 64. 4 - 204.5.1 REF and CT measurements Both REF measurement and CT measurement are performed. NOTE • To obtain reliable measured results, be sure to read “APPENDIX C. OBTAINING RELIABLE EXAM DATA” (at the end of this book) before examining a patient’s eye for the first time.1. Turn the instrument ON. The ARK-10000 starts up, and the measurement screen opens.2. Set the measurement mode to the ARK/CT ( ) mode. Every time the measurement mode button (the second button from the left in the bottom) is pressed, the measurement mode is alternately switched. See “4.3 Selecting Measurement Mode”.3. Set the measurement type to the REF/CT ( ). Every time the measurement select button (in the lower left corner) is pressed, the selected measurement will be switched alternately. The symbol in the measurement select button represents the currently-selected measurement.4. Input a patient’s ID and name. Press the ID: or Patient button on the top of the measurement screen. The “Select Patient” dialog box is displayed. If a patient has already been entered: Ÿ Press the patient line and then press . Pressing an item name on the upper part of the screen (ID, Name, Sex, Group, Last Exam Date) once sorts the data in ascending order within the item field. Pressing the item name once again sorts the data in descending order. The (ascending order) or (descending order) next to an item name indicates the item on which the sort order is based. To search for data, use the “Search Patient Data” dialog box. See “[“Search Patient Data” dialog box]” (p.3-17).
  • 65. 4 - 21 If a patient has not been entered yet: Ÿ Enter the patient as new data. Press . The “Input Patient” dialog box opens. Type in a patient’s ID and name using the keyboard. Select the sex by pressing a radio button “Male” or “Female”. Type in the date of birth in the Birthday box. The system ID No. will be transferred as an initial No. in the “Patient ID” box.*10 NOTE • Use an unique ID such as a carte number. If an already assigned Patient ID is entered, the message, “The input Patient ID already exists.” is displayed, and the entered Patient ID will be rejected. • When the measurement data is to be used for the Final Fit, failure to input any of Patient ID, Last Name, First Name, Sex, and Birthday disables creating shot data. Inputting the patient information beforehand is recommended. • A future date cannot be input in the Birthday box. To enter more detailed patient information: 1) Press to open the Edit Patient Information screen. 2) Pressing the desired item twice opens an entry box. Input characters using the keyboard. The item with a “ ” on its left will not accept any entry. 3) Press . The “Input Patient” dialog box is displayed. 4) Press .*10 It is possible to disable the automatic patient ID assignment function. See “5.11.3 Selecting whether or not to assign patient ID automatically”.
  • 66. 4 - 22[Entering the patient data when the instrument is used with LAN connection to the OPD-Station] The measurement data can be registered in the patient selected from the existing patient list displayed on the Select Patient screen. Register new patients by inputting Patient ID, First Name, Last Name, Sex, and Birthday on the Input Patient screen in the same manner as saving measurement data in the ARK-10000. NOTE • If the OPD-Station software version is 1.02 or earlier, upgrade it to the latest version. With the version 1.02 or earlier, Patient ID, Fist Name, Last Name, Sex, and Birthday input on the Input Patient screen cannot be registered in the OPD-Station. • If anything other than alphanumeric characters is used for the patient information registered in the OPD-Station, the information in the Select Patient screen of the ARK-10000 becomes unreadable. • See “1.6.6 Modifying the settings of ARK-10000” of the OPD-Station operator’s manual for the ARK-10000 settings when it is connected to the OPD-Station. 5. Prepare the patient. 1) Clean the forehead rest and chin rest with a clean cloth such as gauze or cotton dampened with disinfecting agent. When a stack of chin rest paper is mounted on the chin rest, remove one sheet of the paper. 2) Instruct the patient to remove the glasses or contact lenses if wearing, and to sit in the chair. NOTE • It is recommended to have a patient who always wear contact lenses, wear glasses for about one week before measurement in order to obtain accurate results if he or she wears contact lenses in daily life. This is to measure a restored corneal shape from a deformed one which was fit under contact lenses. [Overrefraction] In the case of overrefraction (when measuring the patient’s eye with spectacle glasses), the focusing indicator may not appear (See p.4-10.) During REF measurement, bring the patient’s eye in focus by minimizing the alignment light as much as possible. Be aware that the reliability of the REF-measured data may be lowered according to the degree of the deflection of the measurement beam caused by the lens of eyeglasses (refractive index of eyeglasses). During CT measurement, the reflected frame image of spectacles will obstruct the placido ring image (a placido ring image will have breaks), or lenses will cause image magnification to vary. As a result, the reliability of the CT-measured data will be lowered.
  • 67. 4 - 23 3) Instruct the patient to place his/her chin on the chin rest and gently place his/her forehead against the forehead rest. 4) Adjust the height of the chin rest with the chin rest knob, and roughly align the center of the patient’s eye with the eye level marker. NOTE • To relax the patient, explain the following before measurement: “This instrument measures your eye to find which kind of lens fits you, and your corneal shape. The weak infrared rays and red lights used in the measurements do not harm your eyes.”6. Perform alignment, and focusing. 1) Instruct the patient to; “Look through the measuring window. As you will see a picture of a balloon, watch the center of it without straining. Try to open your eyes as wide as possible.” 2) Manipulate the joystick to display the patient’s eye on the touch-screen panel. By moving the joystick to the right or left, pulling it forward or pushing it back, the main body is moved to the right, left, backward and forward. By turning the top of the joystick, the measuring unit is moved up and down. Align the eye position to a measuring point with right, left, up and down movements. Adjust the focus with back and forth movements. Focusing indicator Target Alignment light
  • 68. 4 - 24 [When using the auto-tracking function ( )] 3) Manipulate the joystick to move the alignment light closer to the target . As the alignment light comes closer to the target , the measuring unit will automatically be aligned to the measuring point (alignment), and focuses on the eye (focusing) by the auto-tracking function. NOTE • The auto-tracking function does not work unless the alignment light is at around the center of the measuring field. If the alignment light is off the center, manipulate the joystick to move the alignment light to the center. When the position of the alignment light goes outside the working range of the auto- tracking, a limit mark (the letters “LIMIT” and arrow) appears on the touch-screen panel. In such a case, either move the joystick slightly in the direction of the arrow, or pull the main body forward once again to align the main body. LIMIT mark LIMIT : Tilt the joystick to the left. LIMIT : Tilt the joystick to the right. LIMIT : Slightly move the chin rest up. LIMIT : Slightly move the chin rest down. LIMIT F: Tilt the joystick backward (toward the patient). LIMIT B: Tilt the joystick forward (toward the operator). • The two dotted line circles on the measurement screen represent the innermost and outermost (2-mm dia. and 6-mm dia.) zones to be “REF-measured” . If the patient’s pupil is smaller than the outer circle, only data obtained within the pupil is accurate. To obtain an OPD map of the entire 6-mm diameter, use a mydriatic agent without cycloplegic effects under instruction of a physician. [When not using the auto-tracking function ( )] 3) After moving the alignment light inside the target , bring the patient’s eye into focus so that the focusing indicator shows the most ideal state “ ” by manipulating the joystick. [Focusing indicator] Too close to the patient’s eye Pull the joystick forward to move the main body away from the patient’s eye. Ideal state Push the joystick to move the main body closer to the patient’s eye. Too far from the patients eye
  • 69. 4 - 25 NOTE • The dotted double circle on the measurement screen represents the innermost and outermost (2-mm dia. and 6-mm dia.) zones to be “REF-measured”. If the patient’s pupil is smaller than the outer circle, only the obtained data within the pupil is accurate. To obtain the OPD map of an entire 6-mm diameter, use a mydriatic agent without cycloplegic effect under an instruction of a physician.7. Perform measurement. When both left and right eyes are “REF-measured” and “CT-measured”, the measurement order is selectable between (A) and (B): (A) The ARK-10000 “REF-measures” and then “CT-measures” one eye and then it measures the other eye in the same order: Example) REF measurement (Right eye) o CT measurement (Right eye) o REF measurement (Left eye) o CT measurement (Left eye) (B) The ARK-10000 “REF-measures” both eyes and then “CT-measures” both eyes Example) REF measurement (Right eye) o REF measurement (Left eye) o CT measurement (Left eye) o CT measurement (Right eye) This manual is based on the measurement order (A). In measurement order (A), reliability of the PD measured during REF measurement may be lower than the PD value obtained in measurement order (B). This is because the patient’s head may shift slightly during the longer interval between the right-eye and left-eye REF measurements. * The switching between the right and left eyes is automatically performed when the main body is moved with the joystick and the eye to be measured is displayed on the screen. [When using the auto-shot function ( )] REF measurement takes place automatically when the instrument is best aligned and focuses on the eye. p After repeated REF measurements until median values (S, C, A) are obtained by taking the median of the first 3 usable values, the letters “REF” in the upper right of the screen change to the blinking letters “CT”. Instruct the patient to slowly blink once or twice to make his/her corneal surface smooth and optically clear. p After confirming that the instrument is best aligned and in focuses on the eye, press the start button to start CT measurement. [When not using the auto-shot function ( )] REF measurement takes place when the start button on the joystick is pressed. Repeat the measurement until median values (S, C, A) are obtained by taking the median of the first 3 usable values. p After repeated REF measurements until median values (S, C, A) are obtained by taking the median of the first 3 usable values, the letters “REF” in the upper right of the screen change to the blinking letters “CT”. Instruct the patient to slowly blink once or twice to make his/her corneal surface smooth and optically clear. p After confirming that the instrument is best aligned and focuses on the eye, press the start button to start CT measurement.
  • 70. 4 - 26 The captured image during CT measurement and the “Edge Detection” dialog box are displayed. Make sure that a concentric ring image has no distortion or irregular breaks. If image-capturing failed, press the Retake button to cancel analysis. After the completion of the CT-captured image analysis, the confirmation screen displays analysis results. In the lower left and right of the screen, the thumbnails (reduced samples) of the iris images obtained during REF measurement (OPD Pupil) and CT measurement (CT Pupil) are displayed. Pressing a thumbnail switches the displayed image in the center of the screen to the one of the selected thumbnail; this allows the operator to view the iris at a higher scale. To use the Torsion Error Detection (TED) function when performing refractive surgery with the EC-5000, check if the iris image is usable enough to be subjected to the TED function (p.4-28).8. Judging a captured image and detected ring edges. Make a judgment based on the following conditions: • No influence from patient’s blinking nor eyelashes • Was the patient’s eye wide open? • Did the eye shift and go out of focus? • Were the ring-edges detected properly? (The detected edges are shown in red and yellow. The edge of the ring closer to I 6.00 (at R7.8 mm) is displayed in blue. Depending on the purposes for which the measurement result is used, it is important that the rings inside the blue ring are detected properly. ) If the captured image and detected edges are satisfactory Ÿ Press . If it is necessary to edit edges Ÿ Press . See “5.11 Editing Detected Edges”. The captured image and detected edges are not satisfactory Ÿ Press . Pressing displays the “Placido Intensity” dialog box. Press to return to the measurement screen and perform measurement again. If an iris of a blue eye etc. appears too bright on a captured image, adjust the illumination brightness for capturing with the dialog box. The adjusted brightness takes effect only for a single measurement just after the brightness adjustment. The placido ring will be illuminated for about 15 secs. before the second measurement to prevent the patient who are surprised with the suddenly-illuminated placido ring from blinking accidentally. It is possible to perform the measurement even while the placido ring is illuminated or after the placido ring has shut off after about 15 seconds.
  • 71. 4 - 27 On the touch-screen panel, the latest AR values, and simulated KM values are shown. Right/Left Latest values (The “Error No.” sign The measuring eye is blinking. may be shown if an error occurs dur- ing REF measurement) AR:3 Right KM:1 REF measurement count S C A S C A Latest AR values (Right eye/Left eye) -1.25 -0.75 178 -1.25 -0.75 178 R1 R2 A R1 R2 A Simulated KM values 7.94 7.59 170 7.94 7.59 170 Pressing clears the displayed data. NOTE • The sign “E” may be shown next to the latest AR-measured values obtained in REF measurement and displayed in the lower portion of the measurement screen. This sign represents a lower reliability of the measured data. This sign will be frequently shown in the case of keratoconus or a corneal transplant due to a highly-irregular cornea. AR:3 Right KM:1 S C A S C A -1.25 -0.75 178E -1.25 -0.75 178E R1 R2 A R1 R2 A 7.94 7.59 170 7.94 7.59 170 However, if the Print High RMS Data check box is unchecked on the Settings screen, low-confidence measured data with the E sign is not displayed.[REF measurement count] When the auto-shot function is turned ON Ÿ On the condition that the instrument is best-aligned and focuses on the eye, REF measurement takes place repeatedly until median values (S, C, A) are automatically obtained by taking the median of the first 3 usable values. When the auto-shot function is turned OFF: • When the “AI Mode” box is checked ( ) on the Settings screen: ŸPressing the start button once triggers the instrument to perform REF measurement a single time. Holding down the start button makes the instrument perform REF measurement repeatedly until median values (S, C, A) are automatically obtained by taking the median of the first 3 usable values. • When the “AI Mode” box is not checked ( ) on the Settings screen: ŸPressing the start button once triggers the instrument to perform REF measurement a single time. While the start button is held down, the instrument keeps performing REF measurement. If the “Single Fogging” box is checked throughout REF measurement, fogging is maintained throughout repeated REF measurements.
  • 72. 4 - 28 9. Measure the other eye in the same manner.10. After completion of measurement, press or . Measured results are saved in the database simultaneously with printout. See “4.7.1 Printing measured data” and see “4.8 Saving Measured Data”.[When using the TED (Torsion Error Detection) function when performing refractive surgeryusing the EC-5000] To apply the data measured by the ARK-10000 to the TED (Torsion Error Detection) function with the EC-5000, a proper iris image should be obtained in CT measurement. Check if the iris image obtained in CT measurement is usable and applicable to the TED function on the confirmation screen (Step 8) as instructed below. 1) Check the “TED Check” check box in advance on the Settings screen. See “5.13.1 Setting parameters”. 2) Perform CT measurement and check the background color. Check the color. Green background Ÿ Applicable to the TED function. Green background Ÿ Usable Red background Ÿ Not applicable to the TED function. Red background Ÿ Not usable Press and perform CT White background Ÿ The “TED Check” measurement again. check box is not checked. NOTE • Whether the data is applicable to the TED function or not can be confirmed also on the Edit Exam Information screen. TED Check OK: Applicable to the TED function NG (***): Not applicable to the TED function Error numbers are indicated in the brackets ( ) OFF: No judgment TED Version Version of the software used for the judgment is indicated (unless the TED Check is “OFF”) The Edit Exam Information screen is displayed by selecting the desired set of data to know whether it is applicable to the TED function and pressing the button on the Patient Selection screen.
  • 73. 4 - 294.5.1.1 REF and CT measurements (Multiple measurement mode) In Multiple measurement mode, sets of data to be saved can be selected from multiple measurements. To perform measurement in the Multiple measurement mode, the Multiple box must be checked beforehand on the Setting screen. Multiple measurements can be performed consecutively without confirming the condition of the edge detection. However, the CT measurement cannot be performed by pressing the start button when the alignment deviation is 0.6 mm or more. In that case, the CT measurement value display on the center of the screen is cleared to “0”. Perform the measurement with a correct alignment. NOTE • To obtain reliable measured results, be sure to read “APPENDIX C. OBTAINING RELIABLE EXAM DATA” (at the end of this book) before examining a patient’s eye for the first time.1. Turn the instrument ON. The ARK-10000 starts up, and the measurement screen opens.2. Set the measurement mode to the ARK/CT ( ) mode. Every time the measurement mode button (the second button from the left in the bottom) is pressed, the measurement mode is alternately switched. See “4.3 Selecting Measurement Mode”.3. Set the measurement type to the REF/CT ( ). Every time the measurement select button (in the lower left corner) is pressed, the selected measurement will be switched alternately. The symbol in the measurement select button represents the currently-selected measurement.4. Input in a patient’s ID and name. See Step 4 of “4.5.1 REF and CT measurements.5. Prepare the patient. See Step 5 of “4.5.1 REF and CT measurements. NOTE • To relax the patient, explain the following before measurement: “This instrument measures your eye to find which kind of lens fits you, and your corneal shape. The weak infrared rays and red lights used in the measurements do not harm your eyes.”
  • 74. 4 - 306. Perform alignment, and focusing. See Step 6 of “4.5.1 REF and CT measurements”. NOTE • The dotted double circle on the measurement screen represents the innermost and outermost (2-mm dia. and 6-mm dia.) zones to be “REF-measured”. If the patient’s pupil is smaller than the outer circle, only the obtained data within the pupil is accurate. To obtain the OPD map of an entire 6-mm diameter, use a mydriatic agent without cycloplegic effect under an instruction of a physician. The patient’s eyelashes over the inner circle may interfere with accurate measurement. In this case, instruct the patient to open his/her eye wide.7. Perform measurement. [When using the auto-shot function ( )] 1) REF measurement takes place automatically when the instrument is best aligned and focuses on the eye. p 2) After repeated REF measurements until median values (S, C, A) are obtained by taking the median of the first 3 usable values, the letters “REF” in the upper right of the screen change to the blinking letters “CT”. p 3) Instruct the patient to slowly blink once or twice to make his/her corneal surface smooth and optically clear. p 4) After confirming that the instrument is best aligned and in focuses on the eye, press the start button to start CT measurement. After the CT measurement, the letters “FINISH” is indicated on top left of the screen. p 5) Repeat Steps 3) to 4) and perform the CT measurement several times. A maximum of ten sets of measurement data can be saved in the instrument. When more than ten sets of data are saved, the oldest data is deleted. [When not using the auto-shot function ( )] 1) REF measurement takes place when the start button on the joystick is pressed. Repeat the measurement until median values (S, C, A) are obtained by taking the median of the first 3 usable values. p 2) After repeated REF measurements until median values (S, C, A) are obtained by taking the median of the first 3 usable values, the letters “REF” in the upper right of the screen change to the blinking letters “CT”. p 3) Instruct the patient to slowly blink once or twice to make his/her corneal surface smooth and optically clear. p 4) After confirming that the instrument is best aligned and in focuses on the eye, press the start button to start CT measurement. After the CT measurement, the letters “FINISH” is indicated on top left of the screen. p 5) Repeat Steps 3) to 4) and perform the CT measurement several times. A maximum of ten sets of measurement data can be saved in the instrument. When more than ten sets of data are saved, the oldest data is deleted.
  • 75. 4 - 31 On the touch-screen panel, the latest AR values, and simulated KM values are shown. Right/Left Latest values (The “Error No.” sign The measuring eye is blinking. may be shown if an error occurs dur- ing REF measurement) AR:3 Right KM:3 REF measurement count S C A S C A Latest AR values (Right eye/Left eye) -1.25 -0.75 178 -1.25 -0.75 178 R1 R2 A R1 R2 A Simulated KM values 7.94 7.59 170 7.94 7.59 170 Pressing clears the displayed data. NOTE • The sign “E” may be shown next to the latest AR-measured values obtained in REF measurement and displayed in the lower portion of the measurement screen. This sign represents a lower reliability of the measured data. This sign will be frequently shown in the case of keratoconus or a corneal transplant due to a highly-irregular cornea. AR:3 Right KM:3 S C A S C A -1.25 -0.75 178E -1.25 -0.75 178E R1 R2 A R1 R2 A 7.94 7.59 170 7.94 7.59 170 However, if the Print High RMS Data check box is unchecked on the Settings screen, low-confidence measured data with the E sign is not displayed.[REF measurement count] When the auto-shot function is turned ON Ÿ On the condition that the instrument is best-aligned and focuses on the eye, REF measurement takes place repeatedly until median values (S, C, A) are automatically obtained by taking the median of the first 3 usable values. When the auto-shot function is turned OFF: • When the “AI Mode” box is checked ( ) on the Settings screen: ŸPressing the start button once triggers the instrument to perform REF measurement a single time. Holding down the start button makes the instrument perform REF measurement repeatedly until median values (S, C, A) are automatically obtained by taking the median of the first 3 usable values. • When the “AI Mode” box is not checked ( ) on the Settings screen: ŸPressing the start button once triggers the instrument to perform REF measurement a single time. While the start button is held down, the instrument keeps performing REF measurement. A maximum of ten sets of measurement data can be saved in the instrument. When more than ten sets of data are saved, the oldest data is deleted.
  • 76. 4 - 32 If the “Single Fogging” box is checked throughout REF measurement, fogging is maintained throughout repeated REF measurements. 8. Measure the other eye in the same manner. 9. After completion of measurement, press . The Data Selection screen appears at the same time as printout. If only an eye has been measured, a message is displayed. When the Data Selection screen is opened, the optimum data is being selected for each eye. However, no data is selected if no data is appropriate.10. Press and select the OPD data to be saved. The selected data is framed in green. Pressing the data again cancels the selection. Select the data based on the following criteria: • Patient is not blinking during measurement • Alignment is appropriate (green offset indication) • Eyelid is not lowered • Eye is opened wide • Avoid small pupil • There is no abnormality in map Pressing magnifies the map. Pressing the Select button selects the data of the magnified map, and display of the magnified map is closed. Pressing the Close button closes the magnified map display. Pressing the All Off button cancels all the selections.
  • 77. 4 - 3311. Press and select the CT data to be saved. Selected data is framed in green. Pressing the data again cancels selection. Select the data based on the following criteria: • Patient is not blinking during measurement • Alignment is appropriate (green offset indication) • Eyelid is not lowered • Eye is opened wide • There is no abnormality in map Pressing magnifies the map. Pressing the Select button selects the data of the magnified map, and display of the magnified map is closed. Pressing the Close button closes the magnified map display. Pressing any area other than the buttons in the magnified map display screen displays the ring detection status. Pressing the All Off button cancels all the selections.12. Switch the eyes in the Eye direction box, and select the OPD and CT data to be saved in the same manner as Steps 10 to 11. Selected data is framed in green. Pressing the data again cancels selection.
  • 78. 4 - 3413. Press the Save button. Selected data is saved in the database. If the data of only one eye is selected, a message appears. The selected sets of OPD and CT data are automatically paired in order of measurement. Therefore, if the numbers of the OPD data sets and CT data sets differ, a message appears to inform that there is a set of data that cannot be paired. Pressing the Save All button saves all the data in the database. To perform additional measurements, press the New Exam button to return to the measurement screen. If data is not saved, press the Cancel button to return to the measurement screen. When saving of data is completed, the Display Data Selection screen appears.14. Select the data to display the map. Select the desired data in the same manner as Steps 10 to 12. Only a pair of data can be selected. When the OPD data is selected, the CT data of its pair is also selected. When the CT data is selected, the OPD data of its pair is also selected. Pairs of OPD and CT data cannot be changed.15. Press the button. The Map View screen of the selected data is displayed. Pressing the Cancel button returns to the measurement screen. Pressing the button in this Map View screen returns to the Display Data Selection screen where another sets of data to display the map can be selected.
  • 79. 4 - 354.5.2 REF measurement Only REF measurement (objective measurement of refractive error) takes place. NOTE • To obtain reliable measured values, be sure to read “APPENDIX C. OBTAINING RELIABLE EXAM DATA” before examining a patient’s eye for the first time.1. Turn ON the power. The ARK-10000 starts up, and the measurement screen opens.2. Set the measurement mode to the ARK/CT ( ) mode. Every time the measurement mode button (the second button from the left in the bottom) is pressed, the measurement mode is alternately switched. See “4.3 Selecting Measurement Mode”.3. Set the measurement type to REF ( ). Every time the measurement select button (in the lower left corner) is pressed, the selected measurement type will be switched alternately. The symbol in the measurement select button represents the currently-selected measurement.4. Type in a patient’s ID and patient’s name. See Step 4 of “4.5.1 REF and CT measurements”.5. Prepare the patient. See Step 5 of “4.5.1 REF and CT measurements”. NOTE • To relax the patient, explain the following before measurement: “This instrument measures your eye to find which kind of lens fits you. The weak infrared rays used in the measurements do not harm your eyes.”6. Perform alignment and focusing. See Step 6 of “4.5.1 REF and CT measurements”.
  • 80. 4 - 36 NOTE • The dotted double circle on the measurement screen represents the innermost and outermost (2-mm dia. and 6-mm dia.) zones to be “REF-measured”. If the patient’s pupil is smaller than the outer circle, only the obtained data within the pupil is accurate. To obtain the OPD map of an entire 6-mm diameter, use a mydriatic agent without cycloplegic effect under an instruction of a physician. The patient’s eyelashes over the inner circle may interfere with accurate measurement. In this case, instruct the patient to open his/her eye wide.7. Perform REF measurement. [When using the auto-shot function ( )] The measurement takes place automatically when the instrument is best aligned and focuses on the eye. [When not using the auto-shot function ( )] Press the start button on the joystick. REF measurement takes place. On the touch-screen panel, the latest AR values are shown. Latest values (The “Error No.” sign may be shown if an error oc- Right/Left curs during the measurement) The measuring eye is blinking AR:3 Right KM:0 REF measurement count S C A S C A Latest AR values -1.25 -0.75 178 -1.25 -0.75 178 (Right eye/Left eye) R1 R2 A R1 R2 A 0.00 0.00 0 0.00 0.00 0 Pressing clears the displayed data. NOTE • The sign “E” may be shown next to the latest AR-measured values in the lower portion of the measurement screen. This sign represents lower reliability of the measured data. This sign will be frequently shown in the case of keratoconus or a corneal transplant due to a highly- irregular cornea. AR:3 Right KM:0 S C A S C A -1.25 -0.75 178E -1.25 -0.75 178E R1 R2 A R1 R2 A 0.00 0.00 0 0.00 0.00 0 However, if the Print High RMS Data check box is unchecked on the Settings screen, low-confidence measured data with the E sign is not displayed.
  • 81. 4 - 37 [REF measurement count] When the auto-shot function is turned ON Ÿ REF measurement automatically takes place in succession on the condition that the instrument is best aligned and focuses on the eye until median values (S, C, A) are automatically obtained by taking the median of the first three usable values. When the auto-shot function is turned OFF: • When the “AI Mode” box is checked ( ) on the Settings screen Ÿ Pressing the start button once triggers the instrument to perform REF measurement a single time. Holding down the start button makes the instrument perform REF measurement repeatedly until median values (S, C, A) are obtained by taking the median of the first three usable values. • When the “AI Mode” box is not checked ( ) on the Settings screen Ÿ Pressing the start button once triggers the instrument to perform REF measurement a single time. While the start button is held down, the instrument keeps performing REF measurement. If the “Single Fogging” box is checked, fogging is maintained throughout repeated REF measurements.8. Measure the other eye in the same manner.9. After the completion of measurement, press or . Measured values are saved in the database simultaneously with printout. See “4.7.1 Printing measured data” and see “4.8 Saving Measured Data”.
  • 82. 4 - 384.5.2.1 REF measurement (Multiple measurement mode) In Multiple measurement mode, sets of data to be saved can be selected from multiple measurements. To perform measurement in the Multiple measurement mode, the Multiple box must be checked beforehand on the Setting screen. NOTE • To obtain reliable measured results, be sure to read “APPENDIX C. OBTAINING RELIABLE EXAM DATA” (at the end of this book) before examining a patient’s eye for the first time.1. Turn the instrument ON. The ARK-10000 starts up, and the measurement screen opens.2. Set the measurement mode to the ARK/CT ( ) mode. Every time the measurement mode button (the second button from the left in the bottom) is pressed, the measurement mode is alternately switched. See “4.3 Selecting Measurement Mode”.3. Set the measurement type to the REF ( ). Every time the measurement select button (in the lower left corner) is pressed, the selected measurement will be switched alternately. The symbol in the measurement select button represents the currently-selected measurement.4. Type in a patient’s ID and name. See Step 4 of “4.5.1 REF and CT measurements”.5. Prepare the patient. See Step 5 of “4.5.1 REF and CT measurements”. NOTE • To relax the patient, explain the following before measurement: “This instrument measures your eye to find which kind of lens fits you. The weak infrared rays used in the measurements do not harm your eyes.”6. Perform alignment, and focusing. See Step 7 of “4.5.2 REF measurement”.
  • 83. 4 - 39 NOTE • The dotted double circle on the measurement screen represents the innermost and outermost (2-mm dia. and 6-mm dia.) zones to be “REF-measured”. If the patient’s pupil is smaller than the outer circle, only the obtained data within the pupil is accurate. To obtain the OPD map of an entire 6-mm diameter, use a mydriatic agent without cycloplegic effect under an instruction of a physician. The patient’s eyelashes over the inner circle may interfere with accurate measurement. In this case, instruct the patient to open his/her eye wide. 7. Perform measurement. See Step 7 of “4.5.2 REF measurement”. 8. Measure the other eye in the same manner. 9. After completion of measurement, press . The Data Selection screen appears at the same time as printout. If only an eye has been measured, a message is displayed.. When the Data Selection screen is opened, the optimum data is being selected for each eye. However, no data is selected if no data is appropriate.10. Press and select the OPD data to be saved. Selected data is framed in green. Pressing the data again cancels selection. Select the data based on the following criteria: • Patient is not blinking during measurement • Alignment is appropriate (green offset indication) • Eyelid is not lowered • Eye is opened wide • Avoid small pupil • There is no abnormality in map
  • 84. 4 - 40 Pressing magnifies the map. Pressing the Select button selects the data of the magnified map, and display of the magnified map is closed. Pressing the Close button closes the magnified map display. Pressing the All Off button cancels all the selections.11. Switch the eyes in the Eye direction box, and select the OPD data to be saved in the same manner as Step 10. Selected data is framed in green. Pressing the data again cancels selection.12. Press the Save button. Since the CT measurement is not performed, the message shown to the right appears to inform that a pair cannot be made.13. Press the Yes button. Selected data is saved in the database. Pressing the Save All button saves all the data in the database. To perform additional measurements,press the New Exam button to return to the measurement screen. If data is not saved, click the Cancel button to return to the measurement screen.
  • 85. 4 - 41 When saving of data is completed, the Display Data Selection screen appears.14. Select the data to display the map. Select the desired data in the same manner as Steps 10 to 12. Only a set of data can be selected for each eye.15. Press the button. The Map View screen of the selected data is displayed. Pressing the Cancel button returns to the measurement screen. Pressing the button in this Map View screen returns to the Display Data Selection screen where another sets of data to display the map can be selected.
  • 86. 4 - 424.5.3 CT measurement Only CT measurement (Corneal Topography measurement) is performed. NOTE • To obtain reliable measured results, be sure to read “APPENDIX C. OBTAINING RELIABLE EXAM DATA” (at the end of this book) before examining a patient’s eye for the first time.1. Turn ON the power. The ARK-10000 starts up, and the measurement screen opens.2. Set the measurement mode to the ARK/CT ( ) mode. Every time the measurement mode button (the second button from the left in the bottom) is pressed, the measurement mode is alternately switched. See “4.3 Selecting Measurement Mode”.3. Set the measurement type to CT ( ). Every time the measurement select button (in the lower left corner) is pressed, the selected measurement type will be switched alternately. The symbol in the measurement select button represents the currently-selected measurement.4. Type in a patient’s ID and patient’s name. See Step 4 of “4.5.1 REF and CT measurements”.5. Set up the patient for measurements. See Step 5 of “4.5.1 REF and CT measurements”. NOTE • To relax the patient, explain the following before measurement: “This instrument measures the corneal shape. The red light used in the measurements does not harm your eyes.”6. Perform alignment and focusing. See Step 6 of “4.5.1 REF and CT measurements”.
  • 87. 4 - 437. Perform measurements. [When using the auto-shot function ( )] Press the start button of the joystick (During CT measurement, the auto-shot function is disabled.) [When not using the auto-shot function ( )] Press the start button on the joystick. CT measurement takes place. The captured image during CT measurement and the “Edge Detection” dialog box are displayed. Make sure that the concentric ring image has no distortion or irregular breaks. If image capturing failed, press the Retake button to cancel the analysis. After the completion of CT-captured image analysis, the confirmation screen displays analysis results. In the lower right of the screen, the thumbnail (reduced samples) of the iris image obtained during CT measurement (CT Pupil) is displayed. Pressing the thumbnail switches the displayed image in the center of the screen to the one of the thumbnail; this allows the operator to view the iris at a higher scale. To use the Torsion Error Detection (TED) function before performing refractive surgery with the EC-5000, check if the iris image is usable enough to be applied to the TED function. (p.4-28).
  • 88. 4 - 44 8. Judge the captured image, and ring edge detection result. Make a judgment based on the following conditions: • No influence from patient’s blinking nor eyelashes • Was the patient’s eye wide open? • Do ring-edges appear distorted by excess tears? • Did the eye shift from the measuring position (misalignment)? • Were the ring-edges detected properly? (The detected edges are shown in red and yellow. The edge of the ring closer to I 6.00 (at R7.8 mm) is displayed in blue. Depending on the purposes for which the measurement result is used, it is important that the rings inside the blue ring are detected properly. ) If the captured image and detected edges are satisfactory Ÿ Press . If it is necessary to edit edges Ÿ Press . See “5.11 Editing Detected Edges”. If the captured image and detected edges are not satisfactory Ÿ Press . Pressing displays the “Placido Intensity” dialog box. Press to return to the measurement screen and perform the measurement again. If an iris of a blue eye etc. appears too bright on the captured image, adjust the illumination brightness for capturing with the dialog box. The adjusted brightness takes effect only for a single measurement just after the brightness adjustment. The placido ring will be illuminated for about 15 seconds before the second measurement to prevent the patient who are surprised with the suddenly-illuminated placido ring from blinking accidentally. It is possible to perform the measurement even while the placido ring is illuminated or after the placido ring has shut off after about15 seconds. On the touch-screen panel, the simulated KM values are shown. AR:0 Right KM:1 S C A S C A 0.00 0.00 0 0.00 0.00 0 R1 R2 A R1 R2 A Simulated KM values 7.94 7.59 170 7.94 7.59 170 Pressing clears the displayed data. 9. Measure the other eye in the same manner.10. After the completion of measurement, press or . Measured results are stored in the database simultaneously with printout. See “4.7.1 Printing measured data” and “4.8 Saving Measured Data”.
  • 89. 4 - 454.5.3.1 CT measurement (Multiple measurement mode) In Multiple measurement mode, sets of data to be saved can be selected from multiple measurements. To perform measurement in the Multiple measurement mode, the Multiple box must be checked beforehand on the Setting screen. Multiple measurements can be performed consecutively without confirming the condition of the edge detection. However, the CT measurement cannot be performed by pressing the start button when the alignment deviation is 0.6 mm or more. In that case, the CT measurement value display on the center of the screen is cleared to “0”. Perform the measurement with a correct alignment. NOTE • To obtain reliable measured results, be sure to read “APPENDIX C. OBTAINING RELIABLE EXAM DATA” (at the end of this book) before examining a patient’s eye for the first time.1. Turn ON the power. The ARK-10000 starts up, and the measurement screen opens.2. Set the measurement mode to the ARK/CT ( ) mode. Every time the measurement mode button (the second button from the left in the bottom) is pressed, the measurement mode is alternately switched. See “4.3 Selecting Measurement Mode”.3. Set the measurement type to CT ( ). Every time the measurement select button (in the lower left corner) is pressed, the selected measurement type will be switched alternately. The symbol in the measurement select button represents the currently- selected measurement.4. Type in a patient’s ID and patient’s name. See Step 4 of “4.5.1 REF and CT measurements”.5. Set up the patient for measurements. See Step 5 of “4.5.1 REF and CT measurements”. NOTE • To relax the patient, explain the following before measurement: “This instrument measures the corneal shape. The red light used in the measurements does not harm your eyes.”6. Perform alignment and focusing. See Step 6 of “4.5.1 REF and CT measurements”.
  • 90. 4 - 46 7. Perform measurement. 1) Instruct the patient to slowly blink once or twice to make his/her corneal surface smooth and optically clear. p 2) After confirming that the instrument is best aligned and in focuses on the eye, press the start button to start CT measurement. After the CT measurement, the letters “FINISH” is indicated on bottom left of the screen. p 3) Repeat Steps 1) to 2) and perform the CT measurement several times. A maximum of ten sets of measurement data can be saved in the instrument. When more than ten sets of data are saved, the oldest data is deleted. 8. Measure the other eye in the same manner. 9. After completion of measurement, press . The Data Selection screen appears at the same time as printout. If only an eye has been measured, a message is displayed.. When the Data Selection screen is opened, the optimum data is being selected for each eye. However, no data is selected if no data is appropriate.10. Press and select the CT data to be saved. Selected data is framed in green. Pressing the data again cancels selection. Select the data based on the following criteria: • Patient is not blinking during measurement • Alignment is appropriate (green offset indication) • Eyelid is not lowered • Eye is opened wide • There is no abnormality in map
  • 91. 4 - 47 Pressing magnifies the map. Pressing the Select button selects the data of the magnified map, and display of the magnified map is closed. Pressing the Close button closes the magnified map display. Pressing any area other than the buttons in the magnified map display screen displays the ring detection status. Pressing the All Off button cancels all the selections.11. Switch the eyes in the Eye direction box, and select the CT data to be saved in the same manner as Step 10. Selected data is framed in green. Pressing the data again cancels selection.12. Press the Save button. Since the REF measurement is not performed, the message shown to the right appears to inform that a pair cannot be made.13. Press the Yes button. Selected data is saved in the database. Pressing the Save All button saves all the data in the database. To perform additional measurements, press the New Exam button to return to the measurement screen. If data is not saved, press the Cancel button to return to the measurement screen.
  • 92. 4 - 48 When saving of data is completed, the Display Data Selection screen appears.14. Select the data to display the map. Select the desired data in the same manner as Steps 10 to 11. Only a set of data can be selected for each eye.15. Click the button. The Map View screen of the selected data is displayed. Pressing the Cancel button returns to the measurement screen. Pressing the button in this Map View screen returns to the Display Data Selection screen where another sets of data to display the map can be selected.
  • 93. 4 - 494.6 Viewing Maps (Map View) There are two methods to display measured results in color maps. . Displaying measured data in color maps just after measurement See “4.6.1 Displaying map via measurement screen”. . Retrieving measured data from the database and displaying it in color maps See “4.6.2 Retrieving exam from database and displaying it in map”. * The “Difference” map that displays the difference in measured data between two different Exam Nos. can be displayed only in the case of . See “5.4 Displaying Difference Map”. * Color maps are displayed in a map layout (number of map, placement, map types and so on) specified in advance. In the case of .… Maps are displayed in the map layout of “View 1” In the case of .…Maps are displayed in a selected map layout from among “View 1”, “View 2” and “View 3” Scroll arrow Map set name (Used to move upward one map) The “Map View” screen can include six maps at the maximum. However, because six maps do not fit inside the window at a time, view all six maps in a window by scrolling through them vertically. Scroll bar Scroll arrow (Used to move downward one map)4.6.1 Displaying map via measurement screen Press on the measurement screen. The screen switches to the “Map View” screen and the latest measured data is displayed in color maps with the map layout of “View 1”. Used to return to the measurement screen
  • 94. 4 - 504.6.2 Retrieving exam from database and displaying it in map An exam which is saved in the database can be called up and displayed on a map on the screen. This allows you to view maps obtained on different dates at the same time, and to make a comparison between them.1. Open the Patient Selection screen. Press on the measurement screen in the ARK/CT mode.2. Press the desired patient’s data line to display it on the maps. Pressing an item name on the upper part of the screen (ID, Name, Sex, Group, Last Exam Date) sorts the data in ascending order within the item field. Pressing the item name once again sorts the data in descending order. (ascending order) or (descending order) on an item name indicates the item on which the sort order is based. To retrieve the desired data, use the “Search Patient Data” dialog box. See “[“Search Patient Data” dialog box]” for details (p.3-17). 1) Press to open the “Search Patient Data” dialog box. 2) Enter the desired specification in a corresponding field and press . To return the screen to its original status (before searching), press on the “Search Patient Data” dialog box to return the specifications to the initial ones, and then press . NOTE • If “Save search specifications even after shutdown” check box is checked, the data searched with the dialog box will be saved even after shutdown. • The Patient Selection screen cannot list more than 5,000 items of patient data. If the patient number exceeds 5,000, enter a specification to narrow the scope of a search.
  • 95. 4 - 513. Confirm the “Map Selection” field on the right side of the screen. Select “View 1”, “View 2” or “View 3” whose map types and layout suit your preference. It is possible to change a map set assigned to “View 1”, “View 2” or “View 3” seeing “ of [“Map Selection” area]” (p.3-15).4. If the patient has multiple items of measured data (exam), select an exam to be displayed on the maps. 1) Multiple exams of the patient’s data are listed in the bottom area of the screen. Press the desired exam line. When displaying multiple exams at a time, go to Steps 2) and 3). In the other cases, go to Step 5. 2) Press a map position on which the selected Map button exam is displayed. Designate a map button in the “Map Selection” area on the right. The designated map button No. will be entered in the “Map No.” box. 3) Repeat Steps 1) and 2) to select exams to be displayed, and each map position.5. Press . The screen is switched to the Map View screen and the maps are displayed in the selected manner. Used to return to the Patient Selection screen
  • 96. 4 - 524.6.3 Displaying map on another map set Select a map set from the entered map sets to choose the number of maps to be displayed and where to locate individual maps. As for the method of entering a map set, see “5.2.1.2 Entering new map set”.1. Press or on the Map View screen. The map set selection screen opens. Ÿ For selecting a map set from the entered sets with both eyes displayed Ÿ For selecting a map set from all the entered map sets Pressing the map set name shown in the upper part of the Map View screen corresponds to the pressing of . Map set name2. Select the desired map set. The screen returns to the Map View screen where maps are displayed in the selected map set. NOTE • A selected map set displayed on the Map View screen by the above steps is temporarily applied. The above operation does not change the specifications for “View1”, “View2”, or “View3”. The selected map set will be reset back to the specified map on the Map View Settings screen once you select another patient or turn OFF the instrument.
  • 97. 4 - 534.6.4 Switching between right and left eyes A displayed color map can be switched between the right and left eyes. Two switching methods are available: Switching the eyes of all displayed maps, and switching the eyes for each individual map. * The switching of eyes is available only when exams of both eyes are saved with the same Exam No. [Switching the eyes of all the displayed maps] Press on the Map View screen. Eyes are switched throughout all the displayed maps. However, when both left and right maps are simultaneously displayed, either the right-eye or left-eye map only will be displayed. [Switching eyes for each individual map] Measuring eye indication Press the measuring eye indication (“Right” or “Left”) on the desired map in the Map View screen. The eye is switched in the map. NOTE • Switching of eyes on the Map View screen is temporary. The eye will be reset back to the preset ones once you select another patient or turn OFF the instrument.
  • 98. 4 - 544.7 Printing4.7.1 Printing measured data After the completion of measurement, the printout of the measured values is started by the built-in printer by pressing or on the measurement screen. The converted values from CT-measured results into keratometry values, and Auto Refraction measured values are printed out. In the ARK/CT mode, pressing also saves measured results into the database automatically. When the measured results have been saved, the button changes into . (If a patient is not selected or the patient’s name has not been entered prior to measurement, the “Select Patient” dialog box opens. To print the measured results and save them in the database, select a patient or enter data of the patient and press . To print the measured results without saving them in the database, press .) NOTE • After measurement, is marked by a small circle in its upper right ( ). This shows that the measured results have already been saved in the memory temporarily. Printout of the measured results is possible when the button is shown as or . • After printing, former data in the memory will automatically be cleared when the next measurement has begun. • Do not touch the printer paper while the printer is working. Inconsistencies in density of the printout may result. • If the measured data of only one eye has been measured, or if the performed measurement type is different between the right and left eyes, the warning dialog box is displayed after or is pressed. To finish measurement and print out the measured data Ÿ Press the OK button. To continue measurement without printing out the measured data Ÿ Press the Cancel button. • In the sample printout on the next page, AR-measured data and KM-measured (keratometry) data for the right eye and then AR-measured data and KM-measured data for the left eye are printed in order. It is also possible to change the order of the printed data (In the order of AR-measured data for the right eye, AR-measured data for the left eye, KM-measured data for the right eye and KM measured data for the left eye) by changing the corresponding parameter setting. See “5.13.1 Setting parameters”. • The sign “E” may be printed next to AR-measured data. This sign represents lower reliability of the measured data. (If the Print High RMS Data check box is unchecked on the Settings screen, low-confidence measured data with the E sign is not printed out.)
  • 99. 4 - 55[Sample printout (ARK mode)] Patient No. Patient name, Sex (M/F) Date and time of measurement Vertex distance Auto Refraction (AR) values AR median values Simulated keratometry values R1: Flattest meridian, R2: Steepest meridian AVE: Average of R1 and R2 CYL: Corneal astigmatism and cylinder axis angle PD value (Right-eye monocular PD, Left-eye monocu- lar PD) (The monocular PDs are measured only when the start button is pressed when the[Sample printout (ARK/CT mode)] main body is aligned with the middle of the nose bridge.) Patient ID Patient name, Sex (M/F) Date and time of measurement Vertex distance Auto Refraction (AR) values AR median values Simulated keratometry values R1: Flattest meridian, R2: Steepest meridian AVE: Average of R1 and R2 CYL: Corneal astigmatism and cylinder axis angle PD value (Right-eye monocular PD, Left-eye monocular PD) (The monocular PDs are measured only when the start button is pressed when the main body is aligned with the middle of the nose bridge.)
  • 100. 4 - 564.7.2 Printing color maps The use of an optional color printer permits a color map to be printed out.1. Press on the Map view screen. The “Select Printer Device” dialog box opens. If a measured result is not saved in the database, the button is symbolized as . Pressing the button starts printout and simultaneously, saves a measured result in the database. (If the patient has not been selected yet or the patient’s data has not been entered prior to measurement, the “Select Patient” dialog box opens. Select a patient or enter data of the patient and press . The data (patient’s data and exam) will be saved in the database.2. To print the color map of only one eye, uncheck “Automatic both eyes print.” Printing of both eyes is the default setting. If the set layout is for displaying both eyes, the color map of both eyes is printed regardless of check box setting.3. Press . A color map printed in the preset layouts of “View”; The map will not always be printed in the displayed layout. [Checking a layout to be applied to a printed color map] Layouts to be applied to printed maps can be Shows a layout to be applied checked in the “Map Selection” area of the to a color map on the Map Patient Selection screen. button on the View screen right side of each “View” radio button shows Layout of “View 1” whether the “View” will be applied to printed maps or not. Layout of “View 2” Layout of “View 3” Ÿ The layout will be applied to printed maps. Ÿ The layout will not be applied to printed maps. Whether or not a map is to be printed in the lay- out is shown. In this case, the map is printed in the “View 1” layout and “View 2” layout.
  • 101. 4 - 57[Designating a layout to be applied to a printed color map] Designate a layout to be applied to a printed map from among “View 1”, “View 2” and “View 3” as instructed below. A designation of multiple items of “View” is allowed. Temporary designation: Press in the “Map Selection” area of the Patient Selection screen to designate. The designation will be cleared once you select another patient’s data. See (p. 3-16). Permanent designation: Check “F Print Out” on the desired “View” page of the Map View Settings screen to apply the “View” to a printed map. See “5.2.1.1 Assigning entered map set to “View1”, “View2” or “View3” ”.
  • 102. 4 - 584.8 Saving Measured Data After the completion of the measurement in the ARK/CT mode, a measured result is saved in the database by pressing on the measurement screen simultaneously with a printout of the measured result. See “4.7 Printing”. Only the latest data when is pressed is saved in the database. When the patient has not been selected or the patient’s data (parameters) was not entered before measurement, the “Select Patient” dialog box opens. Select a patient, or enter data of the patient. See Step 4 on p.4-20. Likewise, printing a color map after measurement (pressing on the Map View screen) saves the measured result in the database. NOTE • If the measured data of only one eye has been measured, or if the performed measurement type is different between the right and left eyes, the warning dialog box is displayed after is pressed. To finish measurement and saving the measured data Ÿ Press the OK button. To continue measurement without saving the measured data Ÿ Press the Cancel button. • If the amount of misalignment during measurements is 0.3 mm or more, pressing the button displays the following warning dialog box against the misalignment. It is recommended to press the Cancel button and re-measure the eye. To finish measurements and save the measured data, press the OK button. In Multiple measurement mode, the Data Selection dialog box appears. Select the desired data and press the Save button. The selected data is saved in the database.
  • 103. §5 HANDLING ADVANCED FUNCTIONS MORE EFFICIENTLYThis section explains more advanced functions to allow you to use the ARK-10000 more efficiently: Displayable maps Ÿ 5.1 Color Maps Specifying usually-applied map sets Ÿ 5.2.1 Setting “View 1”, “View 2” and “View 3” Setting an usually-applied color scale Ÿ 5.2.2 Setting color scale Displaying PSF Ÿ 5.2.3 Displaying PSF Changing a currently-displayed map on the Map View screen Ÿ 5.3 Changing Displayed Maps Zooming in on a map Ÿ 5.3.4 Magnifying map Checking the distance between two points on a map Ÿ 5.3.5 Checking distance between two points Displaying the Difference map Ÿ 5.4 Displaying Difference Map Manually measuring the PD Ÿ 5.5 Manual Pupillary Distance (PD) Measurement Importing external data obtained by another ARK-10000 unit Ÿ 5.6.1 Importing external data into database Outputting measured data to an external device Ÿ 5.6.2 Outputting exam from database Editing and deleting an exam in the database Ÿ 5.6.3 Editing data Backing up the database Ÿ 5.7.4 Backing up database APPENDIX. D BEFORE FIRST BACKUP PROCEDURES Outputting a map’s numerical data Ÿ 5.8.1 Outputting numerical data from map Outputting a map’s image data Ÿ 5.8.2 Outputting map images Editing detected edges of a CT-captured image Ÿ 5.11 Editing Detected Edges Setting the parameters Ÿ 5.13.1 Setting parameters Setting date and time Ÿ 5.13.2 Setting date and time
  • 104. 5-2 5.1 Color Maps Eleven types of maps and eye image captured during CT measurement are available: 5.1.1 Axial map This map shows by the equation below converted refractive powers (of the analyzed image captured during CT measurement) from the corneal curvature radiuses which were obtained with respect to an optical axis of the cornea (CT axis) in the same manner as a general keratometer. 337.5 P (Corneal refractive power) = r [Corneal curvature] Map title Measuring eye Measurement date and time , Exam No. Cross cursor Can be moved to the desired po-This mark moves in accordance with sition. Values at the cursor posi-the value of the cursor position. tion are shown in the lower right corner of this map.Represents a specified colorscale. Indicates values at the cursor posi-Norm : Normalize tion. Indv : Individual Corneal refractive power of Axial Com : Common (Curvature radius), Number : Increment Distance from the center to the crossAdj: Adjustable cursor@Angle Com : Common Amount of misalignment Number: Increment Distance to the corneal vertexAbs.: Absolute from the measurement light @Angle S-K 1.5: Smolek- Klyce [1.5D] (See the footnote on p.5-3.) 26: Absolute [26] Color of Amount of misalignment lettersComment (Enter on the Edit Exam 0 < Amt. of misalignment < 0.3 GreenInformation screen.) 0.3 < Amt. of misalignment < 0.4 Yellow 0.4 < Amt. of misalignment RedSIM K’s data: From the upper item,Refractive power of the steepest meridian (Curvature radius)@Angle,Refractive power of the flattest meridian (Curvature radius)@Angle,dk: Difference in refractive powers between the flattest meridian andthe steepest meridian (Curvature radius mm) About SIM K’s A general keratometer measures the central cornea. (3 mm dia. zone) It also calculates curvature radiuses of each steepest meridian and flattest meridian which cross each other at right angles and corneal refractive powers. With a closer method, SIM K’s values are curvature radiuses and refractive powers along the meridians which cross each other at right angles calculated based on the data in a 3mm dia. zone of the Axial map. About color scale The Axial map color-codes corneal refractive powers or curvature radiuses. The higher the refractive powers become (smaller curvature radiuses), the warmer the colors on the map become; The lower the refractive powers become (larger curvature radiuses), the cooler the colors on the map become.
  • 105. 5-3 5.1.2 Instantaneous map The Instantaneous map shows corneal curvature radiuses calculated from shapes between infinitesimal intervals along meridians whereas the Axial map shows corneal curvature radiuses calculated with respect to a measuring light axis. For this reason, the Instantaneous map reflects more partial corneal curvatures (shapes) than the Axial map. This Instantaneous map is also called a Tangential map. The conversion equation into corneal refractive powers is the same as that for the Axial map. Ra: Axial radius (mm) Ri: Instantaneous radius (mm) Da: Axial power Da = 1000 × (n-1)/Ra Di: Instantaneous power Di = 1000 × (n-1)/Ri n: Corneal refractive index (1.3375) Refractive index of the entire cornea (Cornea Index A) The Instantaneous map that presents subtle changes in corneal surface is suitable for checking patients’ eyes for early-stage keratoconus etc. Map title This mark moves in accordance with Measuring eye Measurement date and time , Exam No. the value of the cursor position. Cross cursor Can be moved to the desired Represents a specified color position. Values at the cursor scale. position are shown in the Norm : Normalize lower right corner of this map. Indv : Individual Indicates values at the cursor Com : Common position: Number : Increment Corneal refractive power of In- Adj: Adjustable stantaneous (Curvature radius), Com : Common Distance from the center to the Number: Increment cross cursor@Angle Abs.: Absolute S-K 1.5: Smolek- Klyce [1.5D] Amount of misalignment 26: Absolute [26] Distance to the corneal vertex from the measurement light @Angle*11 Color ofValues calculated from the data over 3 mm dia. circle: From the upper item, Comment (Input on Amount of misalignment lettersRefractive power of the steepest meridian (Curvature radius)@Angle, the Edit Exam Infor- 0 < Amt. of misalignment < 0.3 Green 0.3 < Amt. of misalignment < 0.4 YellowRefractive power of the flattest meridian (Curvature radius)@Angle, mation screen.) 0.4 < Amt. of misalignment Reddk: Difference in refractive power between the flattest meridian and thesteepest meridian (curvature radius mm), About color scale The Instantaneous map color-codes corneal refractive powers or curvature radiuses. The higher the refractive powers become (smaller curvature radiuses), the warmer the colors on the map become; The lower the refractive powers become (larger curvature radiuses), the cooler the colors on the map become. *11 If the amount of misalignment could not be detected, the following characters are shown in red: “Offsets:---@---” Ÿ The amount of misalignment could not be detected during the measurement. “Offsets: No data” Ÿ The data had been obtained with the program V1.11 or earlier and it has no information of the amount of misalignment.
  • 106. 5-4 5.1.3 “Refractive” map This map shows the distribution of corneal refractive powers calculated by Snell’s law. The calculated refractive powers with 1.3760 of the corneal refractive index is closer to the real refractive power. This map is displayed based De (in the eye)=1000/L on the refractive powers converted into Dc (in Dc (in the air)= n × De the air). The distribution of corneal refractive powers tells the degree of spherical aberration. n: Corneal refractive index (1.376) Refractive index of the real This map helps the operator know the degree that cornea (Cornea Index B) errors in corneal shape adversely affect refractive powers. The “Refractive” map allows the operator to check the amount of correction by comparing preoperative and postoperative “Refractive” maps. (Although this comparison involves some errors because the measuring light axis may vary among measurements.) Map title Measuring eye Measurement date and time, Exam No. Cross cursorThis mark moves in accor- Can be moved to the desireddance with the value of the position. Values at the cursorcursor position. position are shown in the lower right corner of this map. Represents a specified color Indicates values at the cursor scale. position: Norm: Normalize Corneal refractive power, Indv: Individual Distance from the center to the Com: Common cross cursor@Angle Number: Increment Amount of misalignment Adj: Adjustable Distance to the corneal vertex Com: Common from the measurement light @Angle Number: Increment (See the footnote on p.5-3.) Abs.: Absolute Color of S-K 1.5: Smolek- Klyce [1.5D] Amount of misalignment letters 26: Absolute [26] 0 < Amt. of misalignment < 0.3 Green 0.3 < Amt. of misalignment < 0.4 Yellow 0.4 < Amt. of misalignment Red Comment (Input on the Edit Exam Values calculated from the data over 3 mm dia. circle: From the upper item, Information screen.) Refractive power of the steepest meridian@Angle, Refractive power of the flattest meridian@Angle, dk: Difference in refractive power between the flattest meridian and the steepest meridian About color scale The “Refractive” map color-codes corneal refractive powers. The higher refractive powers become, the warmer the colors on the map become; The lower refractive powers become, the cooler the colors on the map become.
  • 107. 5-55.1.4 Elevation map This map shows the differences in elevation between a reference sphere and the cornea that intersect with each other. Generally, Best Fit Sphere*12 is applied as the reference sphere. The reference sphere value is changeable. (See p.5-8.) This map, showing the differences in elevation from the reference sphere allows the operator to check astigmatic components in shape. This map also indicates the progress of keratoconus with protrusions from the reference sphere. In the case of keratoconus, protrusions from the reference sphere are shown in red. Upward protrusions from the reference sphere are warm-colored, and downward protrusions from the reference sphere are cold-colored. The scroll bar permits the user to view the map from different directions. Adjusting the “Elevation Scale” in the bottom of the display is Sliding the slider rightward enlarges an image in the direction of elevation. used to change the magnification in elevation. The Elevation map is displayed in either of three display modes: Wire Frame, color 2D, color 3D. The display mode can be selected for each individual map. Wire Frame Map title Measured eye Measurement date and time, Exam No. Magnification elevationColor scaleAlso functions as a vertical scrollbar. Press or move a finger or apen along the scale to use thescroll bar.Represents a specified colorscale.Norm : Normalize Indv : Individual Pressing here permits you BFS: Radius of Best Fit Sphere as the reference sphere (mm) Com : Common to change a reference Zone: Area to which Best Fit Sphere is applied Number : Increment sphere.Adj: Adjustable Com : Common Number: Increment If the “Hidden Line” option is checked, the reverse side of the wire frame is invisible. When “Hidden Line” is checked
  • 108. 5-6 Color 2D Represents height distribution in colors. The right side of the map corresponds to the 0º direction and the upper side of the map corresponds to the 90º direction. Measurement date and time, Map title Exam No. Measured eye Applicable area of Best Fit Sphere Vertex of Best Fit SphereThis mark moves in accordance (Small white cross)with a value of the cursor position. Indicates values at the cursor position.Represents a specified color Difference in height betweenscale. the reference sphere and cor-Norm : Normalize nea Indv : Individual Distance from the center to Com : Common the cross cursor@ Angle Number : Increment Pressing here permits you BFS: Radius of Best Fit Sphere as the reference sphere (mm)Adj: Adjustable to change the reference Zone: Area to which Best Fit Sphere is applied*12 Com: Common sphere. Number: Increment Color 3D Map title Measurement date and time, Measured eye Exam No. Magnification in elevationColor scaleAlso functions as a vertical scrollbar. Press or move a finger ora pen along the scale to use thescroll bar.Represents a specified colorscale.Norm : Normalize Indv : Individual Pressing here permits you BFS: Radius of Best Fit Sphere as the reference sphere (mm) Com : Common to change the reference Zone: Area to which Best Fit Sphere is applied*12 Number : Increment sphere.Adj: Adjustable Com : Common Number: Increment*12 The Best Fit Sphere is a sphere that best fits on an applicable corneal area. A default value is automatically entered; With the default, the largest possible circle is set whose 60% or more area is effective (not obstructed by eyelash etc.) for data acquisition and whose center is the measuring light axis.
  • 109. 5-7 The scroll bar permits you to view the map from a different direction. The vertical scroll bar also functions as the color scale. Press or move a finger or a pen along the scroll bar to use the scroll bar. Scroll bar Selecting a display mode and options for the Elevation map Select a display mode and options by opening the “Select Map Type/Pattern” dialog box via the Map View screen, or select on the Map View Settings screen. [Selecting in the “Select Map Type/Pattern” dialog box] See “5.3.1 Changing map types and overlay options. Select the radio button of the desired display mode. Select an option as necessary. [Selecting in the Map View Settings screen] See “5.2.1 Setting “View 1”, “View 2” and “View 3””. Select the radio button of the desired display mode. Select options as necessary.[Options] Hidden Line: Makes the reverse side of the wire frame invisible. (Only in the case of “Wire Frame”) Cross Cursor: Dragging the cross cursor displays refractive power (Pwr), corneal curvature radius (Rad), distance from the center (Dist), and Axes at the cursor position. (Only for color 2D) Border Line: This is for setting whether or not to draw boundaries in black. (Only for color 2D and color 3D) Grid: Sections (1-millimeter squares), the corneal vertex point, and the point of measuring light axis (only for the color 2D)
  • 110. 5-8 NOTE • Changes to the display mode or options for the Elevation map in the “Select Map Type/ Pattern” dialog box via the Map View screen are temporarily applied. The changed displayed mode or options will be reset back to as before the changes once you select another patient or you turn OFF the instrument.[Changing the reference sphere] The Elevation map is displayed with respect to the Best Fit Sphere, the reference sphere. The reference sphere may be changed by changing the area to which the Best Fit Sphere is applied or by specifying the radius of the reference sphere: Changing the area to which the Best Fit Sphere is applied: 1) Press in the Elevation map. The “Best Fit Sphere” dialog box is displayed. Diameter of target area (mm) 2) Enter the desired diameter (mm) of the target area in the “Zone” field and press . The Elevation map is displayed with respect to the Best Fit Sphere, the reference sphere, with the entered diameter. To return the entered values in the “Zone” and “BFS” fields back to the defaults, press on the right. Specifying the radius of the reference sphere: When a value is entered, the title will 1) Press in the Elevation map. change from “BFS” to “RefSphere”. The “Best Fit Sphere” dialog box is displayed. Radius of reference sphere (mm) 2) Enter the desired radius (mm) of the reference sphere in the “BFS” field and press . The Elevation map is displayed with respect to the reference sphere with the entered radius. To return the entered value back to the default of the Best Fit Sphere, press on the right of the “RefSphere” field.
  • 111. 5-95.1.5 TopoClassifier map (Optional)* The TopoClassifier map displays either “Statistics (corneal index)” or “Graph (diagnostic result graph)” as the results obtained by the Corneal Navigator function. The desired one can be selected between them for individual maps. Corneal Navigator function: Calculates various indices that indicate the characteristics of corneal shape that are obtained by the CT measurement, and classifies the results obtained by inputting those indices in the neural network into various cases: NRM, AST, KCS, KC, PMD, PKP, MRS, HRS, and OTH. CAUTION • The Corneal Navigator displays diagnostic results that are estimated based on the relationship between many corneal indexes and cases. Ophthalmologists must make a final diagnostic judgment by checking measured results. Graph display Map title Measured eye Used to switch the view to exam No. the Statistics view.Shows the possibility of eachsymptom as a percentage. Statistics display Map title Measured eye Used to switch the view to exam No. the Graph view. Shows the cornea index values. The values are Shows the range of normal, shown in green when suspicious, and abnormal normal, yellow when values for the selected index suspicious, and red (in white characters and un- when abnormal. derlined).* The TopoClassifier map is an optional function. To use this function, the optional Corneal Navigator software needs to be purchased.
  • 112. 5 - 10 The map set that shows the Graph and Statistics displays of TopoClassifier and comments is registered as “Corneal Navigator” so that the analysis result obtained by Corneal Navigator can be viewed efficiently. In Corneal Navigator, the displayed maps and values of an identical eye are displayed. The map set “Corneal Navigator” can be selected only when optional Corneal Navigator is incorporated in the instrument. Graph display Statistics display Comments (Corneal Navigator’s Comment): Summary of the diagnosis If the alignment deviation is large during the measurement, a warning message appears here. * The image above is a layout for when the map image data is output or printed, and differs from the layout displayed on the screen.
  • 113. 5 - 11 Graph display Diagnosis results obtained by the neural network are displayed. Possibility of each case is displayed as a percentage. NRM: Normal (astigmatism of within 0.5D) ART: Astigmatism exceeding 0.5D KCS: Keratoconus suspect*13 KC: Clinical keratoconus*14 PMD: Pellucid marginal degeneration PKP: Penetrating keratoplasty MRS: Myopic refractive surgery HRS: Hyperopic refractive surgery OTH: Unclassified variations Statistics display When the mouse cursor is aligned with the abbreviation of each corneal index, the meaning of the abbreviation is displayed. The indexes are color-coded to indicate whether they fall in the normal, suspect or abnormal range: Green Ÿ Within the normal range, Yellow Ÿ Suspected value, Red Ÿ Abnormal value. When the abbreviation of a corneal index is pressed, the abbreviation is highlighted and underlined in white. The normal, suspect and abnormal ranges are color-coded on the scale at the bottom of the map. SimK1/SimK2: Simulated keratometry Shows the powers and axes of the steepest and flattest meridians in about 3 mm diameter on cornea. The steepest and flattest meridians should be orthogonal with each other. Higher than normal values are often associated with keratoconus, penetrating keratoplasty, and the occasional steep normal. Lower than normal values occur with myopic refractive surgical corrections and the rare flat normal. MinK: Minimum keratometry value Shows the lowest power and axis in about 3 mm diameter on cornea. Often the steepest and flattest meridians are not orthogonal in case of irregular astigmatism. It is useful to know the meridian for which the actual minimum power occurs, particularly in the planning of astigmatic keratotomy or Limbal Relaxing Incisions (LRI). This situation most often occurs with keratoconus, penetrating keratoplasty, and trauma, although it may be present after cataract surgery as well. ACP: Average corneal power The ACP is an area-corrected average of the corneal power ahead of the entrance pupil. It is generally equal to the keratometric spherical equivalent except for decentered refractive surgical procedures. Abnormal values occur for the same reasons as for keratometry.*13 The diagnosis result of KCS (keratoconus suspect) is considered to be due to either early-stage keratoconus or a change in the shape of the cornea by a contact lens. The final determination of the diagnosis result requires a detailed examination. For example, if there is a difference of 30 —m or more in the corneal thickness or a difference of 1.4D or more in the K value between the portion of the cornea where keratococus is suspected and the portion of the cornea symmetric to that portion about the corneal center, the possibility of keratoconus is said to be high.*14 If KC is 50% or more, KSI (Keratoconus Severity Index) that shows severity of keratoconus is displayed on the bar graph.
  • 114. 5 - 12 CYL: Simulated keratometric cylinder Difference between the SimK1 and SimK2. Higher than normal values of CYL are associated with several pathologies, trauma, and surgery. CVP: Coefficient of variation of corneal power Shows the index representing the power distribution of the entire cornea. CVP = 1000 × Standard Deviation of corneal Powers (SDP)/Grand average of corneal powers This fundamental statistic is high when there is a broad range of powers in the corneal surface and has been found to be a good measure of corneal varifocality. High values of CVP are found in moderate to severe keratoconus corneas, as well as in during corneal transplants in the early post-operative period. Achieving a proper corrected visual acuity with eye glasses is difficult for eyes with high CVP. But paying attention to refraction is important especially for such a patient to evaluate the possilbility of correction of visual acuity with eye glasses. SDP: Standard deviation of corneal power The SDP is calculated from the distribution of all corneal powers in a videokeratograph. SDP is often high for keratoconus corneas, transplants, and trauma - all situations in which there is a wide range of powers occurring in the measured topography. AA: Analyzed area The AA gives the fraction of the corneal area covered by the mires that could be processed by the OPD-Station. AA is lower than normal for corneas with gross, irregular astigmatism, which causes the mires to break up and not be resolved. A lower than normal AA is found with early postoperative corneal transplants, advanced keratoconus, and trauma. CEI: Corneal eccentricity index The CEI is a measure of corneal eccentricity, a global shape factor. Positive value: prolate cornea (normal cornea) 0: Sphere Negative value: Oblate cornea A positive (normal) value is obtained for a prolate surface, a nil value for a sphere and a negative value is used to indicate an oblate surface. Out of range values include keratoconus (higher than normal) and negative values often found with contact lens wear and myopic refractive surgical corrections. PVA: Potential visual acuity Irregularities in corneal topography ahead of the entrance pupil reduce the visual potential of the eye. The consequence of these irregularities are assessed by the calculation of the Surface Regularity Index which has been correlated to PVA in a published clinical study. The PVA is given as the range of best spectacle-corrected Snellen visual acuity that might be expected from a functionally normal eye with the topographical characteristics of the analyzed cornea. Diagnostic evaluation should consider the fact that tear film breakup can greatly influence PVA (and SRI). Prolonged gazing at a fixation target by a patient without blinking can produce tear film breakup, transiently reduced vision, and abnormal values of PVA and SRI. With proper blinking, abnormal values of PVA are associated with true irregular corneal astigmatism as is often observed with keratococonjunctivitis sicca, contact lens warpage, lamellar keratoplasty, and herpes keratitis.
  • 115. 5 - 13LogMAR: Log minimum angle of resolution LogMAR is a standard unit for expressing high contrast (Snellen) visual acuity (see PVA). It relates directly to how well the eye can discriminate between two points of light. A useful aspect of this metric is the determination of average acuity in a clinical study. To convert LogMAR values to Snellen Acuity, multiply the Snellen number (20 or 6 for example) by the number 10 raised to the power of the LogMAR value and round the result to the nearest integer. EX.: LogMAR = 0, 20*10^0 = 20 (Snellen VA = 20/20, decimal visual acuity = 1.0) LogMAR = 1, 20*10^1 = 200 (Snellen VA = 20/200, decimal visual acuity = 1.0) LogMAR = 0.1, 20*10^0.1 = 16 (Snellen VA = 20/16, decimal visual acuity | 1.2)DSI: Differential sector index The corneal surface was divided into eight pie-shaped sectors, each subtending an angle of 45deg. The average power was calculated for each sector based on area-corrected refractive power. DSI reports the greatest difference of the average power between any two sectors.SRI: Surface regularity index The SRI is a correlate to potential visual acuity (PVA) and is a measure of local fluctuations in central corneal power. When SRI is elevated, the corneal surface ahead of the entrance pupil will be irregular. High SRI values are found with dry eyes, contact lens wear, trauma, and penetrating keratoplasty.SRC: Area compensated surface regularity index Area compensated Surface Regularity Index. SRC is an area-weighted form of the Surface Regularity Index. See SRI.SAI: Surface asymmetry index The SAI measures corneal asphericity. The SAI is often higher than normal in keratoconus, penetrating keratoplasty, decentered myopic refractive surgical procedures, trauma, and contact lens warpage.IAI: Irregular astigmatism index The IAI is an area-compensated average summation of inter-ring power variations along every meridian for the entire corneal surface analyzed. The IAI increases as local irregular astigmatism in the corneal surface increases. IAI is high in corneal transplants shortly after surgery.OSI: Opposite sector index The corneal surface was divided into a pattern of eight pie-shaped sectors, each subtending an angle of 45 deg. The average power was calculated for each sector based on area- corrected refractive power. OSI represents the maximum difference in area-corrected corneal powers between opposite sectors.CSI: Center-surrounded index CSI is the difference in the average area-corrected power between the central area (3mm diameter) and an annulus surrounding the central area (3.00mm to 6.0 mm).
  • 116. 5 - 14 KPI: Keratoconus prediction index The Keratoconus Prediction Index is similar to the one described in Maeda N, Klyce SD, Smolek MK, Thompson HW: Automated keratoconus screening with corneal topography analysis. Invest Ophthalmol Vis Sci 35:2749-2757, 1994. The KPI is used by the classifier to help differentiate keratoconus from other interpretations. EDP: Elevation/depression power EDP calculates the average power of apparent islands (or peninsulas) and valleys for those areas of the cornea that are within the demarcated pupil. If the pupil is not available for a given exam, EDP is calculated from an area 4 mm in diameter centered on the videokeratoscope axis. Together with EDD, EDP can be used to estimate the size of so- called central islands after excimer laser photorefractive keratectomies. Any power within the pupil that is 1 diopter or more beyond the mode (most frequently occurring power) is multiplied by the cornea local area. It represents (area compensation) and summed into a total that is divided by the total area of the summed powers. The units are diopters. Normal corneas with cylinder, corneal grafts, and clinical keratoconus will also exhibit degrees of abnormal EDP and EDD. EDD: Elevation/Depression Power EDD is the equivalent diameter of the area found to contain powers within the pupil 1 diopter or more from the mode. The units are mm. Index Normal (green) Suspicious (yellow) 39.09[D]<Simk1d40.85[D] Simk1 40.85[D]<Simk1<47.92[D] 47.92[D]<Simk1d49.68[D] 38.24[D]<Simk2d39.65[D] Simk2 39.65[D]<Simk2<45.25[D] 45.25[D]<Simk2d46.65[D] 38.03[D]<MinKd39.48[D] Mink 39.48[D]<Simk1<45.30[D] 45.30[D]<Simk2d46.75[D] 39.20[D]<ACPd40.66[D] ACP 40.66[D]<Simk1<46.48[D] 46.48[D]<ACPd47.94[D] CYL CYL<1.43[D] 1.43[D]dCYL<1.78[D] CVP CVP<27.33 27.33dCVP<32.21 SDP SDP<1.19[D] 1.19[D]dSDP<1.40[D] AA AA>66.76[%] 59.76[%]<AAd66.76[%] -0.09<CEId0.07 CEI 0.07<CEI<0.71 0.71dCEI<0.88 PVA PVA>20/30 20/40<PVAd20/30 LogMAR LogMAR<0.10 0.10dLogMAR<0.30 DSI DSI<2.98 2.98dDSI<3.44 SRI SRI<0.70 0.70dSRI<0.89 SRC SRC<0.77 0.77dSRC<0.97 SAI SAI<0.54 0.54dSAI<0.62 IAI IAI<0.50 0.50dIAI<0.54 OSI OSI<1.79 1.79dOSI<2.21 -0.29<CSId-0.10 CSI -0.10<CSI<0.67 0.67dCSI<0.86 KPI KPI<0.21 0.21dKKPI<0.23 EDP EDP<1.99[D] 1.99[D]dEDP<2.53[D] EDD EDD<3.76[mm] 3.76[mm]dEDP<5.06[mm] * If the value is out of the ranges above, it is displayed in red as an abnormal value.
  • 117. 5 - 15 5.1.6 Eye image Captured image during CT measurement with an eye image overlaid. Allows the operator to check the state of alignment and focusing. Map title Measuring eye Date and time of measurement, Exam No. Cross cursor Can be moved to the desired position. Val- ues at the cursor position are shown in the lower right corner of this map. Indicates values at the cursor position. Distance from the center to the cross cursor@ Angle Amount of misalignment Distance to the corneal vertex from the measurement light @Angle (See the footnote on p.5-3.) Color of Amount of misalignment letters Comment (Input on the Edit Exam Information screen.) 0 < Amt. of misalignment < 0.3 Green 0.3 < Amt. of misalignment < 0.4 Yellow 0.4 < Amt. of misalignment Red When the “Pupil Contour” overlay option is selected, the map displays a pupil image instead of a captured placido image. (See p. 5-64.) The “Photopic” option is selected Ÿ Photopic pupil image (Pupil image captured during CT measurement) The “Mesopic” option is selected Ÿ Mesopic pupil image (Pupil image captured during REF measurement Pupil outline Violet outline: Photopic pupil outline Cyan outline: Mesopic pupil outline Pupil center Violet cross: Photopic pupil centerPhotopic: Photopic pupil size Cyan cross: Mesopic pupil center (during CT measurement)Mesopic: Mesopic pupil size (during REF measurement) PDst: Distance between the corneal reflexMPDist: Distance between spot and the photopic pupil center@Angle the photopic pupil center MDist: Distance between the corneal reflex and mesopic pupil spot and the mesopic pupil center@Angle center@angle When the “Pupil Contour” and “Photopic” overlay options are selected:
  • 118. 5 - 165.1.7 OPD map This map represents the distribution of refractive errors obtained by REF measurement, showing the amount to be corrected at respective points in a 6mm-dia. zone on the cornea. (In detail, this map shows the distribution of refractive errors of an eyeball including the corneal crystalline lens and vitreous body to be corrected when you correct the eye into emmetropia.) A conventional auto refractometer measures refractive powers of the central eye only, whereas the ARK-10000 measures refractive powers of peripheral areas of an eye, which allows the operator to view refractive power distribution. The OPD map also shows optical aberrations etc. The data on the map is calculated when the VD (Vertex Distance) is zero (fixed). “S” (SPH), “C” (CYL) and “A” (AXIS) values shown in the lower left corner of this map are calculated when the VD is the set value on the “Settings” screen. Map title Date and time of measurement, Exam No. Cross cursorThis mark moves in accor- Measured eye Can be moved to the desireddance with the value at the position. Values at the cursorcursor position. position are shown in the lower right corner of this map.Shows the measured data ofthe refractive powers of the Indicates values at the cursorcentral eye (AR-measured position:data). If RMS is 1 or higher, Refractive power of OPDthe characters are shown in (VD=0: Fixed),yellow with the “High RMS” Distance from the center to theindication. cross cursor@Angle Amount of misalignmentRepresents a specified color Distance to the corneal vertexscale. from the measurement light @AngleNorm : Normalize (See the footnote on p.5-3.) Indv : Individual Color of Amount of misalignment letters Com : Common 0 < Amt. of misalignment < 0.3 Green Number : Increment 0.3 < Amt. of misalignment < 0.4 YellowAdj: Adjustable Comment (Enter on the 0.4 < Amt. of misalignment Red Com : Common Edit Exam Information Sphero-cylindrical parameters (S, C, and A) calculated from the data over Number: Increment screen.) 3mm dia. and 5mm dia. circles are obtained by the fitting of each circle (least squares method). (Data is shown in yellow if no pupil outline is ob- tained.) These approximate S, C and A values alone do not tell the actual refrac- tive error distribution. The reliability of these values is expressed by RMS (Root Mean Square fit error). The reliability decreases with the increasing value of RMS, and the RMS of 0 means that the refractive error distribu- tion is expressed perfectly by the sphero-cylindrical parameters. The RMS of a regular astigmatic eye is less than about 0.5. An eye whose RMS is higher than 0.5 is regarded as an eye with an irregular astigmatism. 360 ¦ ^D T
  • 119. D T
  • 120. ` T 1 real SCA 2 RMS [ Dptr ] About the color scale 360 The OPD map color-codes the distribution of total refractive powers of the eye corrected into emmetropia. The higher refractive errors of the myopic eye become, the warmer the map colors become; The higher refractive errors of the hyperopic eye become, the cooler the map colors become.
  • 121. 5 - 17 5.1.8 Target “Refractive” map The sum of the data on the “Refractive” map and that on the OPD map. This map shows the distribution of corneal refractive powers of an eye corrected into emmetropia. This mark moves in accordance with Map title the value of the cursor position. Measured eye Date and time of measurement, Exam No. Cross cursor Can be moved to the desired position. Values at the cur- sor position are shown in theRepresents a specified color scale. lower right corner of this map.Norm : Normalize Indv : Individual Com : Common Indicates values at the cursor Number : Increment position:Adj: Adjustable Corneal refractive power Com : Common Distance from the center to the Number: Increment cross cursor@AngleAbs.: Absolute S-K 1.5: Smolek- Klyce [1.5D] Amount of misalignment 26: Absolute [26] Distance between the corneal vertex during CT measurement and that dur- ing REF measurement@Angle Comment (Enter on the Edit Values calculated from the data over 3mm dia. (See the footnote on p.5-3.) Exam Information screen.) circle: From the upper item, Color of Amount of misalignment letters Refractive power of the steepest meridian @Angle 0 Amt. of misalignment 0.3 Green Refractive power of the flattest meridian @Angle 0.3 Amt. of misalignment 0.4 Yellow dk: Difference in refractive power between the flat- 0.4 Amt. of misalignment Red test meridian and the steepest meridian (Data is shown in yellow if no pupil outline is ob- tained.) About color scale The Target “Refractive” map color-codes the distribution of corneal refractive powers of an eye corrected into emmetropia. The higher refractive powers become, the warmer the map colors become; The lower refractive powers become, the cooler the map colors become. NOTE • If the map has areas with missing data, interpolation or extrapolation is carried out within these areas to obtain expected data as much as possible; in this way, the map of 6 mm pupil is displayed. Only the data within the pupil where rings have been traced is reliable. Select the Pupil Contour and Rings overlay items to check the reliably measured area on the map.
  • 122. 5 - 18 5.1.9 Internal OPD map This map illustrates the distribution of internal astigmatism from the posterior surface of the cornea to the retina. It is assumed that of the total refractive power of the eye, the cornea is responsible for 75% and the crystalline lens is responsible for the remaining 25%. With the ARK-10000, the distribution of the corneal refractive power obtained by corneal topography and the distribution of total refractive power of the eye obtained by REF measurement and illustrated on the OPD map are available. This Internal OPD map illustrates the distribution of astigmatism of the internal eye calculated from the data. This map shows if internal astigmatism (especially, lenticular astigmatism) is involved. Mostly, total astigmatism results from corneal shape (corneal astigmatism). However, in some patients, lenticular astigmatism counteracts the corneal astigmatism. (About 20% of astigmatic eyes involve internal astigmatism). When prescribing contact lenses or performing corneal refractive surgery, it is important to consider both corneal astigmatism and internal astigmatism. Map title Date and time of measurement, Cross cursor Measured eye Exam No. Can be moved to the desired position. Values at the cursorThis mark moves in accordance with position are shown in the lowerthe value at the cursor position. right corner of this map. Shows values at the cursor po- sition: Represents the specified color Power, Distance from the cen- scale mode. ter to the cross cursor@Angle Norm: Normalize Indv: Individual Com: Common Amount of misalignment Number: Increment between the corneal vertex Adj: Adjustable during CT measurement and Com: Common that during REF Number: Increment measurement@Angle (See the footnote on p.5-3.) Comment Color of (Enter on the Edit Exam Information screen.) Amount of misalignment letters 0 Amt. of misalignment 0.3 Green Values calculated from the data over 3 mm dia. and 5 mm dia. circles: 0.3 Amt. of misalignment 0.4 Yellow From the top item, 0.4 Amt. of misalignment Red Internal astigmatism in the direction of the steepest meridian @Angle Internal astigmatism in the direction of the flattest meridian @Angle Reading setting of CYL mode CYL: Difference between the internal astigmatism between the steepest and on the Settings screen + flattest meridians Internal Internal (Data is shown in yellow if no pupil outline is obtained.) + astigmatism astigmatism increases total counteracts The sign of the Cyl of the Internal OPD map is determined by the formula: (Not displayed) CYL data astigmatism. total Sign of Cc + Ci = Co (A calculation may contain an error.) astigmatism. Internal Intraocular (Cc; CYL of the “Refractive” map, Ci; CYL of the Internal OPD map, Co; CYL astigmatism astigmatism counteracts increases total of the OPD map, C represents a vector.) total astigmatism. This sign of the CYL shows whether the internal astigmatism increases or astigmatism. counteracts total astigmatism. (See the table.) About color scale The Internal OPD map color-codes the distribution of astigmatism of the internal eye. When the average power is regarded as 0 D (green), the higher the power becomes in the negative direction, the warmer the map colors become; The higher the power becomes in the positive direction, the cooler the map colors become.
  • 123. 5 - 19 NOTE • If the map has areas with missing data, interpolation or extrapolation is carried out within these areas to obtain expected data as much as possible; in this way, the map of 6 mm pupil is displayed. Only the data within the pupil where rings have been traced is reliable. Select the Pupil Contour and Rings overlay items to check the reliably measured area on the map. The “Standard2” map set is factory-set that displays various numerical data with the Internal OPD map at the center and allows efficient checking of the measured data. “Standard2” includes the maps and measured data of one eye of the patient.Refraction:Spherical power, cylindrical power and cylinder axis ob-tained from the OPD map. These items of data repre-sents an error to be corrected to correct the eye into em-metropia. (when VD = 0) : Values calculated from the data over 3 mm dia. circle : Values calculated from the data over 5 mm dia. circle (Data is shown in yellow if no pupil outline is obtained.)Residual Astig: Amount of internal astigmatism obtained from the In- ternal OPD map. (Data is shown in yellow if no pupil outline is obtained.)Cornea Refractive: The corneal refractive powers in the direction of the steepest and flattest meridians obtained from the “Re- fractive” map @angleKeratometry: SimK value obtained from the Axial mapAsphericity: Value representing asphericity of the cornea (See p.5-30.) e: eccentricity Q: Q value The value after “Asphericity” shown in the unit of “rings” or “mm” is the range in which the values above were calculated. (Changeable) The characters “(m)” and “(e)” indicate the method of calculation. (See p.5-61.) (m): Qm (e): QeSph. Aber.6.0mm —m (D): “Sph. Aber.” stands for “Spherical Aberration.” Spherical aberration (Z12) of a 6.0 mm analysis area is shown in unit of —m. The LSA (Longitudinal Spherical Aberration) value is shown in the brackets in unit of diopter. The LSA represents the difference between refractive powers at the central and peripheral areas of the corneal surface.Pupillometry Pupil information during REF and CT measurements Photopic: Photopic pupil size (during CT measurement) Mesopic: Mesopic pupil size (during REF measurement) MPdist: Distance between the photopic pupil center and mesopic pupil center@Angle Pdist:Distance between the corneal reflex spot and the photopic pupil center@Angle
  • 124. 5 - 205.1.10 Wavefront High Order map This map shows only high-order components from the third order to the specified order (up to the 8th order) in the Zernike pyramid that are extracted from the Wavefront Total map in wavefront aberration analysis using Zernike polynomials. This map shows aberrations which cannot be corrected by spectacles. Map titleThis mark moves in accordance with Measured eye Measurement date and time, Exam No.a value at the cursor position. Cross cursor Can be moved to the desired posi- tion. Values at the cursor position is shown at the bottom right of this map.Represents a specified colorscale. Indicates values at the cursor position:Norm : Normalize Wavefront elevation, Indv : Individual Distance from the center to the cross Com : Common cursor@Angle Number : IncrementAdj: Adjustable Amount of misalignment, Com : Common Distance between the measurement axis Number: Increment and corneal vertex@Angle (See the footnote on p.5-3.) Comment (Input on the Edit RMS wavefront error Color Amount of misalignment of Exam Information screen.) Zone: Analysis area Diameter (mm) letters Order: Highest analysis order of Zernike pyramid 0 = Amt. of misalignment 0.3 Green 0.3 = Amt. of misalignment 0.4 Yellow 0.4 = Amt. of misalignment Red About color scale The Wavefront High Order map allows the operator to check wavefront shapes of the third or higher order by color distribution. With respect to the lower-order wavefronts (1st to 2nd), the farther away in the forward direction the wavefront aberrations are positioned, the warmer the map colors become, and the farther away in the backward direction the wavefront aberrations are positioned, the cooler the map colors become. To change an analysis zone and order Map type change button Open the “Select Map Type/Pattern” dialog box and change an analysis area (Zone) and order (Dim) in the “Zernike Analysis” area at the bottom left of the dialog box. The “Zernike Analysis” area is displayed only when Wavefront HO map, Wavefront Total map, Wavefront Group or Zernike Graph is assigned to the map type change button.
  • 125. 5 - 21 5.1.11 Wavefront Total map This map shows the wavefront aberration of the patient’s eye with reference to an emmetropic eye with no aberration. (Total wavefront aberration from the 0th order to a specified order in the Zernike pyramid) This map is calculated from the OPD map. Map title Date and time of measurement, Exam No. Measured eye side Cross cursor Can be moved to the desired posi- tion. Values at the cursor positionThis mark moves in accordance are shown in the lower right cornerwith a value at the cursor position. of this map. Indicates values at the cursor position: Wavefront elevation, Distance from the center to the cross Represents a specified color cursor@Angle scale. Norm : Normalize Amount of misalignment, Indv : Individual Distance between the measurement axis Com : Common and corneal vertex@Angle Number : Increment (See the footnote on p.5-3.) Adj: Adjustable Color Amount of misalignment of Com : Common letters Number: Increment 0 = Amt. of misalignment 0.3 Green 0.3 = Amt. of misalignment 0.4 Yellow 0.4 = Amt. of misalignment Red Comment (Input on the Edit Exam Information screen.) ZS: SPH within analysis zone calculated using Zernike polynomials ZC: CYL within analysis zone calculated using Zernike polynomials ZA: AXIS within analysis zone calculated using Zernike polynomials VD: Corneal vertex distance RMS wavefront error (excluding error of zeroth-order components) Zone: Analysis zone Diameter (mm) Order: Highest analysis order of Zernike pyramid Color scale The Wavefront Total map color-codes shapes of a total wavefront aberration of the 0th to the specified order (up to 8th order). With respect to the reference wavefront, the farther away in the forward direction (myopia) the wavefront aberrations are positioned, the warmer the map colors become, and the farther away in the backward direction (hyperopia) the wavefront aberrations are positioned, the cooler the map colors become.
  • 126. 5 - 22 5.1.12 Wavefront Group map This map shows only the wavefront aberration components extracted from a designated group by wavefront aberration analysis using Zernike polynomials. Map title Measured eye Date and time of measurement, Exam No. This mark moves in accordance Group name with a value at the cursor position. Cross cursor Can be moved to the desired po- sition. Values at the cursor posi- tion are shown in the lower right Represents a specified color corner of this map. scale. Indicates values at the cursor position: Norm : Normalize Wavefront elevation, Indv : Individual Distance from the center to the cross Com : Common cursor@Angle Number : Increment Adj: Adjustable Amount of misalignment, Com : Common Distance between the measurement axis Number: Increment and corneal vertex@Angle (See the footnote on p.5-3.)Comment (Input on the Edit Exam ColorInformation screen.) RMS wavefront error (excluding zeroth-order values) Amount of misalignment of Zone: Analysis zone Diameter mm letters 0 = Amt. of misalignment 0.3 Green Order: Highest analysis order of Zernike pyramid 0.3 = Amt. of misalignment 0.4 Yellow Color scale 0.4 = Amt. of misalignment Red With respect to the reference wavefront, the farther away in the forward direction (myopia) the wavefront aberrations are positioned, the warmer the map colors become, and the farther away in the backward direction (hyperopia) the wavefront aberrations are positioned, the cooler the map colors become. A. Selecting a combination of aberration components (group) to be displayed on the map 1) Press a group name in the upper right corner of the map. The “Zernike Coefficient Selection” dialog box is displayed. 2) Press of the “Coefficient Group Name” field. The entered groups (combination of aberration components) are listed. 3) Press the desired group name to select. Aberration components that are included in the selected group will be checked in the Zernike pyramid. 4) Press to go back to the Map View screen.
  • 127. 5 - 23* Factory-entered combinations of aberration components (groups) entered in the “Coefficient Group Name” field: “Total”: Coefficient term = 0th to 44th terms, The displayed map will be the same as the Wavefront Total map. “Tilt (S1)”: Coefficient term = 1st and 2nd terms (Tip, Tilt) “High”: Coefficient term = 6th to 44th terms, The displayed map will be the same as the Wavefront High Order map. A coefficient term of an aberration “Coma”: Coefficient term = 7th and 8th terms (Coma) component: {th term represents “Trefoil”: Coefficient term = 6th and 9th terms (Trefoil) the number above each term in “T. Sph”: Coefficient term = 12th, 24th and 40th terms the Zernike pyramid. “T. Coma”: Coefficient term = 7th, 8th, 17th, 18th, 31th EX.: Coefficient term = 3th term and 32th terms “T. Trefoil”: Coefficient term = 6th, 9th, 16th, 19th, 30th and 33th terms “T. Astig”: Coefficient term = 11th, 13th, 23th, 25th, 39th and 41th terms “T. 4Foil”: Coefficient term = 10th, 14th, 22th, 26th, 38th and 42th terms “T. 5Foil”: Coefficient term = 15th, 20th, 29th and 34th terms “Low (S1 + S2)”: Coefficient term = 1st to 5th terms “S2”: Coefficient term = 3rd to 5th terms (Astigmatism, Defocus) “S3”: Coefficient term = 6th to 9th terms (Coma, Trefoil) “S4”: Coefficient term = 10th to 14th terms (Spherical) “S5”: Coefficient term = 15th to 20th terms (Secondary coma) “S6”: Coefficient term = 21th to 27th terms (Secondary spherical) “S7”: Coefficient term = 28th to 35th terms “S8”: Coefficient term = 36th to 44th terms “S3 + S5 + S7”: Coefficient term = 6th to 9th terms, 15th to 20th terms, 28th to 35th terms “S4 + S6 + S8”: Coefficient term = 10th to 14th terms, 21th to 27th terms, 36th to 44th terms “HiAstig”: Coefficient term = 11th, 13th, 23th, 25th, 39th and 41th terms (2ndAstig, 3rdAstig, 4th Astig)The factory-entered groups are shown in blue and user-entered groups are shown in black. NOTE • A group selected or entered in the “Zernike Coefficient Selection” dialog box by opening it on the Map View screen is temporarily applicable. The selected or entered group will be reset back to the previous one once you select another patient or turn the instrument OFF. For setting a permanent group on the Map View Settings screen, see “5.2.1.5 When selecting Wavefront Group map”.
  • 128. 5 - 24 B. Setting a combination of aberration components (group) to be displayed on the map 1) Press a group name in the upper right corner of the map. The “Zernike Coefficient Selection” dialog box is displayed. 2) Press . The “Coefficient Group Name” field will be cleared and aberration components in the Zernike pyramid will be unchecked. 3) Enter a group name in the “Coefficient Group Name” field. 4) Only select aberration components in the Zernike pyramid to be displayed on a color map by checking them. All_ON Ÿ Checks all the aberration component boxes. All_OFF Ÿ Deselects all the aberration component boxes. 5) Press again. The “Message” dialog box opens. 6) Press Yes . The screen returns to the Map View screen. The displayed Wavefront Group map will show aberration components of a selected group. NOTE • A group selected or entered in the “Zernike Coefficient Selection” dialog box by opening it on the Map View screen is temporarily applicable. The selected or entered group will be reset back to the previous one once you select another patient or turn OFF the instrument. For setting a permanent group on the Map View Settings screen, see “5.2.1.5 When selecting Wavefront Group map”.
  • 129. 5 - 255.1.13 Zernike graph This graph shows coefficients of aberration components in the Zernike polynomials in wavefront aberration analysis. The Zernike graph has 2 graph modes: RMS graph and Coefficient graph The RMS graph demonstrates root-sum-square values of components entered by each group for comparison among several groups. The Coefficient graph shows individual coefficients for a group (a combination of aberration components). toggles between the RMS graph and Coefficient graph.5.1.13.1 RMS graph The graph represents grouped results of aberration components. The root-sum-square values of the components entered by each group are displayed. This map is especially useful for confirming aberration components such as coma aberration or defocus. Map title, Measured eye, Exam No. Region ,Order number Group set name The RMS values of 0th components are not contained. Group name Used to enter a new group set.Used to zoom in on the graph. Used to display values or to clear values Used to open the “Select Used to switch the graph Used to display the “Zernike Coef- Color Scale” dialog box. to the Coefficient graph. ficient Selection” dialog box. A. Selecting a group combination (group set) to be displayed on the graph 1) Press the group set name field in the upper left of the graph. Entered group set names are listed. 2) Press the desired group set name to select. The RMS graph of the selected group set will be displayed. * Factory-entered group sets “V. Sets”: Total, Tilt (S1), High, T. Coma, T. Trefoil, T. 4Foil, T. Sph, HiAstig “H. Sets”: Total, Tilt (S1), High, S3 + S5 + S7, S4 + S6 + S8 The factory-entered groups are shown in blue and user-entered groups are shown in black.
  • 130. 5 - 26 B. Confirming aberration components in each group 1) Press a group name to select it. 2) Press . The “Zernike Coefficient Selection” dialog box is displayed. The checked aberration components are included in the group. 3) Press or . The screen returns to the Map View screen. C. Setting a new group set 1) Press . The “RMS Graph Name” dialog box is displayed. 2) Enter a new group set name. 3) Press . The group set will be entered with the entered name and with a set of groups that are displayed. 4) Add or delete groups to the desired combination of groups. See “D. Changing a group set (adding a group)” and “E. Changing a group set (deleting a group)” (p.5-27).
  • 131. 5 - 27D. Changing a group set (Adding a group) Add a group to a group set. Only user-entered group sets (shown in black) can be changed. 1) Press a group name to select it. (A new group name is inserted in the line immediately above the selected group name here.) List of entered group names 2) Press . A line is inserted above the selected group name in Step 1). 3) Press of the inserted line. Entered groups are listed. 4) Press or to move the desired group name into view. 5) Press the desired group to select. The selected group will be inserted.E. Changing a group set (Deleting a group) Delete an unwanted group from a group set. Only user-entered group sets (shown in black) can be changed. 1) Select a group name to be deleted. 2) Press . The selected group name in Step 1) will be deleted. NOTE • Changes to the RMS graph made on the Map View screen are temporary. The changes to the graph will be reset back to those before the changes once you exit from the Map View screen.
  • 132. 5 - 285.1.13.2 Coefficient graph The graph shows coefficients of individual aberration components included in a group (combination of aberration components). A side-by-side display of the preoperative and postoperative Coefficient graphs tells differences in each aberration component. Map title, Measured eye, Exam No. Region ,Order number Group name Each aberration component Number: Assigned ordinal number in the Zernike pyramid Used to zoom in on the graph. Used to open the “Select Used to display or clear Color Scale” dialog box. values. Used to switch the graph to the RMS graph A. Selecting a combination of the aberration components to be displayed 1) Press a group name in the upper left corner of the graph. The “Zernike Coefficient Selection” dialog box is displayed. The checked aberration components are included in the displayed group. 2) Select a combination of aberration components (group) from in the “Coefficient Group Name” field. 3) Press the desired group name to select. Aberration components that are included in the selected group will be checked in the Zernike pyramid. 4) Press to go back to the Map View screen. The Coefficient graph of the selected group will be displayed.
  • 133. 5 - 29* Factory-entered combinations of aberration components (groups) entered in the “Coefficient Group Name” field: Aberration components included in each group in the case of 8th-order: Only the aberration components of up to the designated order are included. “Total”: Coefficient term = 0th to 44th terms “Tilt (S1)”: Coefficient term = 1st and 2nd terms (Tip, Tilt) “High”: Coefficient term = 6th to 44th terms A coefficient term of an aberration component: “Coma”: Coefficient term = 7th and 8th terms (Coma) {th term represents a number above each term “Trefoil”: Coefficient term = 6th and 9th terms (Trefoil) in the Zernike pyramid. “T. Sph”: Coefficient term = 12th, 24th and 40th terms EX.: Coefficient term = 3th term “T. Coma”: Coefficient term = 7th, 8th, 17th, 18th, 31th and 32th terms “T. Trefoil”: Coefficient term = 6th, 9th, 16th, 19th, 30th and 33th terms “T. Astig”: Coefficient term = 11th, 13th, 23th, 25th, 39th and 41th terms “T. 4Foil”: Coefficient term = 10th, 14th, 22th, 26th, 38th and 42th terms “T. 5Foil”: Coefficient term = 15th, 20th, 29th and 34th terms “Low (S1 + S2)”: Coefficient term = 1st to 5th terms “S2”: Coefficient term = 3rd to 5th terms (Astigmatism, Defocus) “S3”: Coefficient term = 6th to 9th terms (Coma, Trefoil) A root-sum-square value of “S4”: Coefficient term = 10th to 14th terms (Spherical) the checked aberration com- “S5”: Coefficient term = 15th to 20th terms (Secondary coma) ponents is displayed by bar “S6”: Coefficient term = 21th to 27th terms (Secondary spherical) graph. “S7”: Coefficient term = 28th to 35th terms “S8”: Coefficient term = 36th to 44th terms “S3 + S5 + S7”: Coefficient term = 6th to 9th terms, 15th to 20th terms, 28th to 35th terms “S4 + S6 + S8”: Coefficient term = 10th to 14th terms, 21th to 27th terms, 36th to 44th terms “HiAstig”: Coefficient term = 11th, 13th, 23th, 25th, 39th and 41th terms (2ndAstig, 3rdAstig, 4th Astig)The factory-entered groups are shown in blue and user-entered groups are shown in black.B. Setting a new group 1) Press a group name in the upper left corner of the graph. The “Zernike Coefficient Selection” dialog box is displayed. 2) Set a group in the same manner as “B. Setting a combination of aberration components (group) to be displayed on the map” (p.5-24). NOTE • A group entered in the “Zernike Coefficient Selection” dialog box by opening it on the Map View screen is temporarily applicable. The selected or entered group will be reset back to the previous one once you select another patient or turn the instrument OFF. For specifying a permanent group on the Map View Settings screen, see “5.2.1.7 When selecting Zernike graph and displaying Coefficient graph”.
  • 134. 5 - 305.1.14 Difference map This map shows differences between two selected exams obtained at different dates that are retrieved from the database. See “5.4 Displaying the Difference Map”. Note that you should select two exams of the same map type and of the same eye (left or right) of a patient. Otherwise, a Difference map cannot be generated. The Difference map cannot be selected from the Map View screen. Assign the Difference map to View 1, View 2 or View 3 on the Map View Settings screen.This mark moves in accor- Map title Nos. of maps to obtain a differencedance with the value of thecursor position.Represents the display mode ofthe scale. Cross cursorNorm : Normalize Can be moved to the desired Indv : Individual position. Values at the cur- Com : Common sor position are shown in the Number : Increment lower right corner of this map.Adj: Adjustable Com : Common Map data at the cursor position, Number: Increment Distance from the center to theAbs.: Absolute cross cursor@Angle S-K 1.5 : Smolek- Klyce [1.5D] 26: Absolute [26]5.1.15 Table at the bottom of Map View screen In the bottom of the Map View screen, AR median values, data that is equal to data measured by a general keratometer, eccentricity and pupil diameter are displayed in tabular form. Photopic pupil diameter [mm] AR median values Simulated keratometry values Mesopic pupil diameter [mm] SPH [D] Max. refractive power [D]([mm])@ Direction [º] O (Ocular) - whole eye SA [D] CYL [D] Min. refractive power [D]([mm])@ Direction [º] C (Corneal) - corneal SA [D] AXIS [º] Difference [D] ([mm]) Eccentricity (Q value*15)Corneal refractive index, Q valueanalysis diameter (see p. 5-61), andwavelength used for calculation*15 Q value represents asphericity of the cornea. Parabola Q –1: Hyperbola Q = –1: Parabola Hyperbola Prolate ellipse –1 Q 0: A part of prolate ellipse Circle Q = 0 : A part of circle Oblate ellipse 0 Q: Oblate ellipse
  • 135. 5 - 315.2 Specifying Maps in Advance (Map View settings) Specifications for maps on the Map View Settings screen are explained. NOTE • The specifications made on the Map View Settings will be maintained even though the instrument is turned OFF.5.2.1 Setting “View 1”, “View 2” and “View 3” The most frequently-used three map sets are assigned as “View 1”, “View 2”, and “View 3”. When opening the Map View screen from the measurement screen: Ÿ A map is displayed with the layout of “View 1”. When opening the Map View screen from the Patient Selection screen: Ÿ A map is displayed with the designated layout of “View1”, “View 2” or “View 3”. When pressing or on the Map View screen: Ÿ Printout is made of the checked layout of “View1”, “View2” or “View 3” at “F Print Out”. Map layout, map type, eye, and overlay options can be entered in the setting called “map set”. Multiple map sets can be entered. Enter or modify a map set as neces- AxOPD2 AxOPD4B sary. CTOPD6 CTOPD6B See “5.2.1.2 Entering new map set”, “5.2.1.3 Modifying existing map set”, “5.2.1.4 Standard map Entering modifications made on Map View screen to map set”. WF6 WF6B Map set in blue: Factory-entered map sets (Unchangeable) Map set in black: User-entered map sets (changeable) Assigning a map set applied to displayed maps or printed maps. See “5.2.1.1 Assigning entered map set to “View1”, “View2” or “View3””. On the Patient Selection screen, select a radio button of a map set to be applied to displayed maps. Note that a displayed map via the measurement screen is shown with “View 1”. Select a map set to be applied to a map to be printed from among “View1”, “View2” and “View3”. (Multiple desig- nations are allowed.) EX.: A map that has just been obtained after measurement will be displayed and printed smoothly by performing the following: Assign such maps as the Axial map and OPD map to View1 that allow the operator to quickly check placido-ring images for obstruction of tears, eyelid and eyelashes. Select “View2” or “View3” to be applied to printed maps and check “F Print Out”.
  • 136. 5 - 325.2.1.1 Assigning entered map set to “View1”, “View2” and “View3”1. Open the Map View Settings screen. Press on the Patient Selection screen or Map View screen. Tab2. Press the “View 1” tab.3. Select a map set with the desired layout and map types from the entered map sets. 1) Press of the “Map Set” field. The entered map sets are listed. 2) Press the desired map set to select. To create a new map set, see “5.2.1.2 Entering a new map set”. To modify an entered map set, see “5.2.1.3 Modifying an already-entered map set”. Map set in blue: Factory-entered map set (Not changeable) Map set in black: User-entered map set (change- able)4. Choose overlay options for each individual map. 1) Press an overlay option field next to a map button. The overlay options are listed.
  • 137. 5 - 33 2) Check the desired overlay options. See [Overlay options] (p.5-65). Angle Scale: Protractor-like angle scale Cross Cursor: Dragging the cross cursor displays refractive power (Pwr), corneal curvature radius (Rad), distance from the center (Dist), and Axis at the location. Grid : Sections (1-millimeter squares), vertex point and a point of the measuring light axis Eye Image: Patient’s captured eye image Pupil Image: Pupil image during REF measurement (Available on the OPD map only) Keratometric: Individual maximum and minimum diopters and their directions over 3mm-dia., 5mm-dia., and 7mm-dia. circumferences. Pupil Contour: Pupil edge For the Eye Image, select “Photopic” (photopic pupil image) or “Mesopic” (mesopic pupil image). In the case of the OPD map, Target “Refractive” map, Internal OPD map, Wavefront High Order map, Wavefront Total map and Wavefront Group map, the area outside the pupil outline is shaded. Rings: Detected placido-ring edges (shown in red and yellow lines) Border Line: This is for setting whether or not to draw boundaries in black. Use this option when the areas of adjacent steps are shown in closer colors. 3) Press . F 5. If necessary, check “F Print Out”. To print maps with the map set when or is pressed on the Map View screen, check “F Print Out”. 6. Press . The Message dialog box is displayed. 7. Press Yes . The selected map set will be entered together with designated overlay options and “c Print Out” specifications as “View 1” . 8. In the same manner as Steps 2 to 7, set “View 2” and “View 3”. 9. Press . The message dialog box on the right is displayed.10. Press Yes . The screen returns to the Patient Selection screen or to the Map View screen.
  • 138. 5 - 345.2.1.2 Entering new map set Frequently-used map layouts, map types, eyes (left or right), overlay options and printout specifications can be entered as a new map set.1. Open the Map View Settings screen. Press on the Patient Selection screen or Map View screen. Tab2. Press a tab of “View 1”, “View 2” or “View 3” whose specifications are to be changed.3. Press .4. Enter a map set name in the “Map Set” field.5. In the “Layout” field, select the number of a map and a layout. Using the scroll bar, press the button with the desired map number and layout. Scroll bar6. For each individual map, select the left or right eye. Use the R or L button. To display maps of both eyes, designate the right-eye (R) for the maps on the left side and the left eye (L) for the maps on the right side. To display maps of either left eye or right eye only, designate either the right eye (R) or the left eye (L) for all the maps. Pressing in the Map View screen switches between the right-eye map and left-eye map.
  • 139. 5 - 357. For each individual map, select a map type. 1) Press a map button. Map types are listed. 2) Press the desired map type. Map button See “5.1 Color Maps”. When selecting “Wavefront Group”: Ÿ The “Zernike Coefficient Selection” dialog box is displayed. See “5.2.1.5 When selecting Wavefront Group map”. When selecting “Zernike Graph”: Ÿ The “Zernike Coefficient Graph Settings” dialog box is displayed. See “5.2.1.6 When selecting Zernike graph and displaying RMS graph”. See “5.2.1.7 When selecting Zernike graph and displaying Coefficient graph”. When selecting “Difference”: Ÿ The “Difference Map Settings” dialog box is displayed. See “5.2.1.8 When selecting Difference map”.8. For each individual map, select overlay options. 1) Press the overlay option field next to a map button. Overlay options are listed. 2) Check the desired overlay options. See [Overlay options] (p. 5-65). Angle Scale: Protractor-like angle scale Cross Cursor: Dragging the cross cursor displays refractive power (Pwr), corneal curvature radius (Rad), distance from the center (Dist), and Axis at the location. Grid: Sections (1-millimeter squares), vertex point and a point of the measuring light axis Eye Image: Patient’s captured eye image Pupil Image: Pupil image during REF measurement (Available on the OPD map only) Keratometric: Respective maximum and minimum diopters and their directions over 3mm- dia., 5mm-dia., and 7mm-dia. circumferences. Pupil Contour: Pupil outline. For the Eye Image, select “Photopic” (photopic pupil image) or “Mesopic” (mesopic pupil image). In the case of the OPD map, Target “Refractive” map, Internal OPD map, Wavefront High Order map, Wavefront Total map and Wavefront Group map, the area outside the pupil outline is shaded. Rings: Detected placido-ring edges (displayed in red and yellow lines) Border Line: This is for setting whether or not to draw boundaries in black. Use this option when the areas of adjacent steps are shown in closer colors.
  • 140. 5 - 36 3) Press . F 9. If necessary, check “F Print Out”. To print maps of the map set when or is pressed on the Map View screen, check “F Print Out”.10. Press . The “Message” dialog box is displayed.11. Press Yes . The map set is entered as “View 1”, “View 2” or “View 3” as selected in Step 2.12. Press . The message dialog box on the right is displayed.13. Press Yes . The screen returns to the Patient Selection screen or to the Map View screen.
  • 141. 5 - 375.2.1.3 Modifying existing map set An entered map set (map layout, map types, left-eye or right-eye, overlay options and printout specifications) is modified. NOTE • Factory-entered map sets (shown in blue) may not be modified except for their overlay options and printout specifications.1. Open the Map View Settings screen. Press on the Patient Selection screen or Map View screen. Tab2. Select the tab of “View 1”, “View 2” or “View 3” to which a modified map set is to be assigned.3. Select the desired map set to be modified from entered map sets. 1) Press of the “Map Set” field. The entered map sets are listed. 2) Press a map set to be modified to select.4. As necessary, modify the number of maps, eye Map set in blue: Factory-entered map set (Not (left or right), map types, overlay options and changeable) printout specifications and enter the map set. Map set in black: User-entered map set (change- See Steps 5 to 12 of “5.2.1.2 Entering new map able) set.”
  • 142. 5 - 385.2.1.4 Entering modifications made on Map View Settings screen to map set Change map layout, map types, overlay options, or the eye applied to a displayed color map in the Map View screen and enter the changes to a map set. NOTE • Only user-entered map sets (shown in black on the Map View Settings screen) may be modified.1. Change map layout, map types, overlay options or the eye of a displayed map on the Map View screen. See “4.6.3 Displaying map on another map set”, “4.6.4 Switching between right and left eyes”, “5.3.1 Changing map types and overlay options”.2. Display the Map View Settings screen. Press . The map set of the selected tab from among “View1”, “View2” and “View3” will be modified. F3. If necessary, check “F Print Out”. To print maps of the map set when or is pressed on the Map View screen, check “F Print Out”.4. As necessary, change the map set name in the “Map Set” field. When not changing the map set name Ÿ Modify the map set. When changing the map set name Ÿ Enter the map set as a new one.5. Press . The Message dialog box is displayed.6. Press Yes . The map set will be entered.7. Press . The screen returns to the Map View screen.
  • 143. 5 - 395.2.1.5 When selecting Wavefront Group map When “Wavefront Group” is selected in Step 7 of “5.2.1.2 Entering new map set”, the “Zernike Coefficient Selection” dialog box is displayed. Select a combination of aberration components (group). [Designating a combination of aberration components (group) to be displayed]1. Press in the “Coefficient Group Name” field and select a combination of aberration components (group). The checked aberration components in the Zernike pyramid will be displayed in the Wavefront Group map.2. Press . The screen returns to the Map View Settings screen. The selected group name is shown in yellow on a map button. * Factory-entered combinations of aberration components (groups) in the “Coefficient Group Name” field: Aberration components included in each group in the case of 8th-order: Only the aberration components of up to the designated order are included. “Total”: Coefficient term = 0th to 44th terms, The displayed map will be the same as the Wavefront Total map. “Tilt (S1)”: Coefficient term = 1st and 2nd terms (Tip, Tilt) “High”: Coefficient term = 6th to 44th terms, The displayed map will be the same as the Wavefront High Order map. “Coma”: Coefficient term = 7th and 8th terms (Coma) “Trefoil”: Coefficient term = 6th and 9th terms (Trefoil) “T. Sph”: Coefficient term = 12th, 24th and 40th terms “T. Coma”: Coefficient term = 7th, 8th, 17th, 18th, 31th and 32th terms “T. Trefoil”: Coefficient term = 6th, 9th, 16th, 19th, 30th and 33th terms
  • 144. 5 - 40 “T. Trefoil”: Coefficient term = 6th, 9th, 16th, 19th, 30th and 33th terms “T. Astig”: Coefficient term = 11th, 13th, 23th, 25th, 39th and 41th terms A coefficient term of aberration “T. 4Foil”: Coefficient term = 10th, 14th, 22th, 26th, 38th component: {th term represents and 42th terms the number above each term in the Zernike pyramid. “T. 5Foil”: Coefficient term = 15th, 20th, 29th and 34th EX.: Coefficient term = 3th term terms “Low (S1 + S2)”: Coefficient term = 1st to 5th terms “S2”: Coefficient term = 3rd to 5th terms (Astigmatism, Defocus) “S3”: Coefficient term = 6th to 9th terms (Coma, Trefoil) “S4”: Coefficient term = 10th to 14th terms (Spherical) “S5”: Coefficient term = 15th to 20th terms (Secondary coma) “S6”: Coefficient term = 21th to 27th terms (Secondary spherical) “S7”: Coefficient term = 28th to 35th terms “S8”: Coefficient term = 36th to 44th terms “S3 + S5 + S7”: Coefficient term = 6th to 9th terms, 15th to 20th terms, 28th to 35th terms “S4 + S6 + S8”: Coefficient term = 10th to 14th terms, 21th to 27th terms, 36th to 44th terms “HiAstig”: Coefficient term = 11th, 13th, 23th, 25th, 39th and 41th terms (2ndAstig, 3rdAstig, 4thAstig) The factory-entered groups are shown in blue and user-entered groups are shown in black. [Entering a combination of aberration components (group) to be displayed on the map] Enter a new group. Enter a group name.1. Press . Check aberration components The “Coefficient Group Name” field will be to be displayed. cleared and all the aberration components in the Zernike pyramid will be unchecked.2. Enter a group name in the “Coefficient Group Name” field.3. In the Zernike pyramid, only check aberration components to be displayed on a color map. All_ON Ÿ Checks all the aberration component boxes. All_OFF Ÿ Deselects all the aberration component boxes.4. Press again. The Message dialog box is displayed.
  • 145. 5 - 41 5. Press Yes . The “Zernike Coefficient Selection” dialog box is displayed again. The set group will be entered. 6. Press . The set group will be entered, and the screen returns to the Map View Settings screen. An entered group name will be shown in yellow on a map button. Pressing returns to the Map View Settings screen without the set group being entered.[Modifying an already-entered group] Aberration components included in an user-entered group (shown in black) may be changed. However, factory-entered groups (shown in blue) may not be modified. 1. Press of the “Coefficient Group Name” field. Entered groups are listed. 2. Press a group to be modified to select it. 3. In the Zernike pyramid, only check aberration components to be displayed on a color map. 4. Press . The screen returns to the Map View Settings screen. The selected group name will be shown in yellow on a map button.
  • 146. 5 - 42 [Deleting an already-entered group] User-entered groups (shown in black) may be deleted. Factory-entered groups (shown in blue) may not be deleted.1. Press of the “Coefficient Group Name” field. The entered groups will be listed.2. Press a group to be deleted and select it.3. Press . The Message dialog box is displayed.4. Press OK .5. Press . The selected groups will be deleted and the screen will return to the Map View Settings screen. Pressing will return the screen to the Map View Settings screen without the group being deleted. NOTE • Only user-entered groups may be deleted or modified. Factory-entered groups may not be deleted or modified.
  • 147. 5 - 435.2.1.6 When selecting Zernike graph and displaying RMS graph When “Zernike Graph” is selected in Step 7 of “5.2.1.2 Entering new map set”, the “Zernike Coefficient Graph Settings” dialog box is displayed. The Zernike graph has 2 graph modes: RMS and Coefficient. The following explains the settings to be made for RMS graph display. The graph represents grouped results of aberration components. The root-sum-square values of the components entered for each group are displayed. This map is especially useful for confirming aberration components such as coma aberration or defocus.1. Select the “RMS Graph” radio button of the “Graph Mode” field.2. Press . The entered group set names are listed.3. Press the desired group set name to select. The group names included in the selected group set will be listed on the right. * Factory-entered group sets “V. Sets”: Total, Tilt (S1), High, T. Coma, T. Trefoil, T. 4Foil, T. Sph, HiAstig “H. Sets”: Total, Tilt (S1), High, S3 + S5 + S7, S4 + S6 + S8 Factory-entered group sets are shown in blue, whereas user-entered group sets are shown in black.4. Press . The screen returns to the Map View Settings screen. The entered group set name is shown in yellow on the map button.
  • 148. 5 - 44 [Entering a new group set]1. Confirm that the “RMS Graph” radio button is selected in the “Zernike Coefficient Graph Settings” dialog box.2. Press . The field for a group set name will be cleared.3. Enter a group set name. becomes active. Enter a group set name.4. Insert required group names. 1) Press a group name in the list on the right to select it. 2) Press . A line is inserted immediately over the selected group name in Step 1).
  • 149. 5 - 45 3) Press of the inserted line. The entered groups are listed. 4) Press the desired group name to select it. The selected group name will be inserted.5. Delete unwanted group names. 1) Press a group name to be deleted. 2) Press . The selected group name in Step 1) will be deleted.6. In the same manner as Steps 4 and 5, insert or delete group names and arrange selected groups in the desired order.7. Press . The Message dialog box is displayed.8. Press Yes .9. Press . The group set will be entered. The screen will return to the Map View Settings screen. The entered group set name will be shown in yellow on the map button. Pressing returns to the Map View Settings screen without the group set entered.
  • 150. 5 - 46 [Modifying an entered group set] The included groups in a user-entered group set (shown in black) may be changed, whereas a factory-entered group set (shown in blue) may not be modified.1. Confirm that the “RMS Graph” radio button is selected in the “Zernike Coefficient Graph Settings” dialog box.2. Select a group set to be changed using of the field for group set.3. Change the groups included in the group set in the same manner as Steps 4 and 6 of [Entering a new group set] (p. 5-44).4. Press . The screen returns to the Map View Settings screen. Pressing returns the display to the Map View Settings screen without changing the group. [Deleting an entered group set] User- entered group sets (shown in black) may be deleted, whereas factory-entered group sets (shown in blue) may not be deleted.1. Confirm that the “RMS Graph” radio button is selected in the “Zernike Coefficient Graph Settings” dialog box.2. Select a group set to be deleted using of the field for group set.3. Press . The Message dialog box is displayed.4. Press OK .5. Press . The selected group set in Step 2 will be deleted, and the screen returns to the Map View Settings screen. Pressing returns the display to the Map View Settings screen without deleting the group set.
  • 151. 5 - 47 NOTE • Only user-entered group sets may be deleted or modified. Factory-entered group sets may not be deleted or modified.5.2.1.7 When selecting Zernike graph and displaying Coefficient graph When “Zernike Graph” is selected in Step 7 of “5.2.1.2 Entering new map set”, the “Zernike Coefficient Graph Settings” dialog box is displayed. The Zernike graph has two graph modes: RMS and Coefficient. The following explains the settings to be made for Coefficient graph display. The Coefficient graph represents the coefficients of the aberration components included in a group (a combination of aberration components). A side-by-side comparison of preoperative and postoperative Coefficient graphs tells the changes in individual aberration components.1. Select the “Coefficient Graph” radio button of the “Graph Mode” field.2. Press . The entered group names are listed.3. Press the desired group name to select. The aberration components included in the selected group are listed on the right.
  • 152. 5 - 48 * Factory-entered group and aberration components included in each individual group. Aberration components included in each group in the case of 8th-order: Only the aberration components of up to the designated order are included. “Total”: Coefficient term = 0th to 44th terms “Tilt (S1)”: Coefficient term = 1st and 2nd terms (Tip, Tilt) “High”: Coefficient term = 6th to 44th terms “Coma”: Coefficient term = 7th and 8th terms (Coma) “Trefoil”: Coefficient term = 6th and 9th terms (Trefoil) “T. Sph”: Coefficient term = 12th, 24th and 40th terms “T. Coma”: Coefficient term = 7th, 8th, 17th, 18th, 31th and 32th terms “T. Trefoil”: Coefficient term = 6th, 9th, 16th, 19th, 30th and 33th terms “T. Astig”: Coefficient term = 11th, 13th, 23th, 25th, 39th and 41th terms “T. 4Foil”: Coefficient term = 10th, 14th, 22th, 26th, 38th and 42th terms “T. 5Foil”: Coefficient term = 15th, 20th, 29th and 34th terms “Low (S1 + S2)”: Coefficient term = 1st to 5th terms “S2”: Coefficient term = 3th to 5th terms (Astigmatism, Defocus) “S3”: Coefficient term = 6th to 9th terms (Coma, Trefoil) “S4”: Coefficient term = 10th to 14th terms (Spherical) “S5”: Coefficient term = 15th to 20th terms (Secondary coma) “S6”: Coefficient term = 21th to 27th terms (Secondary spherical) “S7”: Coefficient term = 28th to 35th terms “S8”: Coefficient term = 36th to 44th terms “S3 + S5 + S7”: Coefficient term = 6th to 9th terms, 15th to 20th terms, 28th to 35th terms “S4 + S6 + S8”: Coefficient term = 10th to 14th terms, 21th to 27th terms, 36th to 44th terms “HiAstig”: Coefficient term = 11th, 13th, 23th and 25th, 39th, and 41th (2ndAstig, 3rdAstig, 4thAstig) The factory-entered groups are shown in blue and user-entered groups are shown in black.4. Press . The screen returns to the Map View Settings screen. The selected group name is shown in yellow on the map button.
  • 153. 5 - 49 [Entering a new group]1. Confirm that the “Coefficient Graph” radio button is selected in the Zernike Coefficient Graph Settings dialog box.2. Press . The “Zernike Coefficient Selection” dialog box is displayed.3. Enter a group name in the “Coefficient Enter a group name. Group Name” field. Check aberration components becomes active. to be displayed on a graph4. Check only the aberration components to be displayed in the Coefficient graph. All_ON Ÿ Checks all the aberration component boxes. All_OFF Ÿ Deselects all the aberration component boxes.5. Press . The Message dialog box is displayed.
  • 154. 5 - 506. Press Yes The screen returns to the “Zernike Coefficient Graph Settings” dialog box.7. Press . A group will be entered. The screen returns to the Map View Settings screen. The entered group name will be shown in yellow on a map button. Pressing returns the display to the Map View Settings screen without entering a group.
  • 155. 5 - 51 [Modifying an entered group] The included groups in a user-entered group (shown in black) may be modified, whereas a factory-entered group (shown in blue) may not be modified.1. Confirm that the “Coefficient Graph” radio button is selected in the “Zernike Coefficient Graph Settings” dialog box.2. Press . Entered groups are listed.3. Press a group to be modified and select it. The included aberration components into the selected group will be listed.4. Press . The “Zernike Coefficient Selection” dialog box is displayed. Check only the aberration components to be displayed.5. Press only the aberration components to be displayed on the Coefficient graph. All_ON Ÿ Checks all the aberration component boxes. All_OFF Ÿ Deselects all the aberration component boxes.6. Press . The “Zernike Coefficient Graph Settings” dialog box re-opens.7. Press . The screen returns to the Map View Settings screen.
  • 156. 5 - 52 [Deleting an entered group set] User- entered group sets (shown in black) may be deleted, whereas factory-entered group sets (shown in blue) may not be deleted.1. Confirm that the “RMS Graph” radio button is selected in the “Zernike Coefficient Graph Settings” dialog box.2. Press . Entered groups are listed.3. Press a group to be deleted and select it. The aberration components included in the selected group are listed on the right.4. Press .5. Press OK . The “Zernike Coefficient Graph Settings” dialog box is displayed again.6. Press . The selected group set in Step 3 will be deleted, and the screen returns to the Map View Settings screen. NOTE • Only user-entered groups may be deleted or modified. Factory-entered groups may not be deleted or modified.
  • 157. 5 - 535.2.1.8 When selecting Difference map When “Difference” is selected in Step 7 of “5.2.1.2 Entering new map set”, the “Difference Map Settings” dialog box is displayed. The Difference map shows differences between two maps which are currently displayed. Note that the two maps should be the same type of map. (A combination of a “Refractive” map and a Target “Refractive” map is allowed.) The following explains one example of showing differences between map (1) and map (2) on map (3).1. Select target maps. [Example: Displaying the Difference map of “Map (1) – Map (2)”] 1) Press the Map (1) button. 2) Press the Map (2) button. The characters “1-2” is shown in the lower field. The map selected in Step 2) should be the same map type as Map (1) selected in Step 1). Otherwise, selected maps will not be shown in the lower field. To re-select a map type, press Cancel to go back to the Map View Settings screen and change the map type.2. Press OK . The screen returns to the Map View Settings screen.3. Press . The “Message” dialog box is displayed.4. Press Yes .
  • 158. 5 - 545.2.1.9 Deleting map set User-entered map sets may be deleted, whereas factory-entered map sets (the map sets shown in blue and “Standard map”) may not be deleted.1. Open the Map View Settings screen. Press on the Patient Selection screen or Map View screen.2. Select a map set to be deleted from the “Map Set” field of “View 1”. A map set of “View 2” and that of “View 3” may be selected in the same manner.3. Press . The Message dialog box is displayed.4. Press OK . The selected map set is deleted and “Standard map” will automatically be selected in the “Map Set” field.5. Re-assign a map set to “View 1”. See Steps 3 to 7 of “5.2.1.1 Assigning entered map set to “View1”, “View2” or “View3”.6. Press . The message dialog box on the right is displayed.7. Press Yes . The screen returns to the Patient Selection screen or to the Map View screen.
  • 159. 5 - 555.2.2 Setting color scale A color scale can be specified for each individual map type.1. Display the Map View Settings screen. Press on the Patient Selection screen or Map View screen. Scale tab2. Press the “Scale” tab. Map type tab3. Select a map type whose color scale is to be set using the map type tab on the left side of the screen. CT-A: Axial, Instantaneous CT-R: “Refractive”, Target “Refractive” OPD: OPD WF: Wavefront Total, Wavefront High Order, Wavefront Group Elev: Elevation For resetting displayed specifications Zgrph: Zernike Graph to the default ones For saving displayed specifications Int. OPD: Internal OPD4. Set the color scale. 1) Select a color scale with a radio button ( to ) and enter values as necessary. Relative color scale with which an incre- Relative color scale with which an increment and intermedi- ment and intermediate value are calcu- ate value are calculated for each individual map type. Maps lated for each individual map. of the same type are displayed by the same scale. Minimum increment value for Minimum step value the Difference map Intermediate value, Incre- An increment and intermediate ment, and Increment specifi- value can be specified. Maps cation for the Difference map of the same type are displayed by the same scale. An appropriate increment for a specified intermediate value is automatically selected. Absolute color scale with which the 30D to 67.5D Absolute color scale with which the 9D to 101.5D range is shown in 26 colors. range is shown in 26 colors.
  • 160. 5 - 56 Available color scales on the ARK-10000 can be broadly divided into 2 types: Relative color scale and Absolute color scale. Relative color scale (Normalize): A histogram of a map is calculated and then an appropriate increment (Step) and intermediate value (Middle) are automatically set for the best possible use of the color scale. The set increment and intermediate value cannot be changed. Select the number of color and color scheme from the “Color” area. Individual Ÿ For each individual map, the increment and intermediate value are calculated from the maximum and minimum values of a map to make the best possible use of the color scale. Common Ÿ For each individual map type, the Maps displayed based on the same color scale as “Common” increment and intermediate value are Axial map and Instantaneous map calculated from the maximum and “Refractive” map and Target “Refractive” map minimum values. Wavefront High Order map, Wavefront Total map and Wavefront Group map However, respective map pairs shown in the right table will be displayed with the same color scale. Min Step Ÿ This is for designating the minimum increment value. The calculated increment in the case of the “Individual” or “Common” of the “Normalize” does not become smaller than the designated value. Diff Min Step Ÿ This is for specifying the minimum increment for the Difference map. Common of Adjustable: This is also a relative scale. Unlike the “Common” of the “Normalize”, an intermediate value (Middle) and step (Step) can be specified. Checking ( ) “F Auto Step” will automatically select an appropriate step for a specified intermediate value. Absolute color scale (Absolute): With this scale, an increment and range are constant. Regardless of the patient’s refractive conditions, the areas of a same diopter are always shown in the same color on a map. This color scale is useful for comparisons among multiple maps. Select from two types of absolute color scales. Smolek_Klyce [1.5D]: The Smolek Klyce scale is a fixed color scale. An area in the 30D to 67.5D range is shown in 26 colors in increments of 1.5D with the fixed color scale. Absolute [26]: The Absolute scale has the same color scheme as the Smolek Klyce scale and the same 26 colors. Peripheral diopters in the 9D to 101.5D range are shown in wider increments. * The absolute color scale is selectable only for the Axial, Instantaneous, “Refractive” and Target “Refractive” maps. 2) As necessary, enter color schemes and number of the colors available with the color scale in the “Color” area. (only for the relative color scale) ISO Ÿ The color schemes are in conformity with the ISO-recommended ones. Designate a color number in the entry field to the right of the “ISO” radio button. (15 to 25 color schemes: Red Green Blue) NIDEK Ÿ Designate a color number in the entry field to the right of the “NIDEK” radio button. White Red Yellow Green Blue Violet (9 to 51 colors) Smolek_Klyce ŸProvides the same color scheme as that of the Absolute color scale (Pink Red Yellow Green Blue Navy blue) with a fixed color number of 26.
  • 161. 5 - 57 3) As necessary, set the unit of a color scale in the “Scale” area (only for the Axial map and Instantaneous map) mm (Curvature radius)/ Diopter (Refractive power) * For maps other than the Axial and Instantaneous maps, they are displayed in fixed units of measured data. Map name Unit “Refractive” map Diopter (Refractive power) Target “Refractive” map Diopter (Refractive power) Internal OPD map Diopter (Refractive power) OPD map Diopter (Refractive power) Elevation map μm Wavefront High Order map μm Wavefront Total map μm Wavefront Grop map μm Zernike graph μm5. Press . The Message dialog box is displayed.6. Press Yes . The specifications for the scale are saved.7. Press . The screen returns to the Patient Selection screen or the Map View screen.
  • 162. 5 - 585.2.3 Displaying PSF The Point Spread Function (PSF) simulates how a point source of light like a star appears to the patient when he or she looks at it. This function calculates how a point at far appears to the patient based on the amount of optical aberrations of the eye obtained in the REF measurement. Be aware that in this calculation, the processing by the optic nerve system of how the brain recognizes the point formed on the retina is not taken into account. For this reason, the simulation result may be different from what the patient actually sees. F1. Check the “F Show” check box in the PSF box on the “Other” tab of the Map View Settings screen. See “5.2.4 Other settings related to maps”. If the “F Show” check box is checked, the thumbnail of PSF (reduced sample image) is displayed in the lower right of the wavefront HO, Wavefront Total and Wavefront Group maps.2. Display the Wavefront HO, Wavefront Total or Wavefront Group map and press the thumbnail in the lower right of the map. Thumbnail The displayed map is switched to the PSF display. To return to the original map display, press the button in the lower right.
  • 163. 5 - 595.2.4 Other settings related to maps The specifications related to map calculation, map display and printout are set.1. Open the Map View Settings screen. Press on the Patient Selection screen or on the Map View screen. Others tab2. Press the “Others” tab. For displaying various settings of the instrument For displaying the software For saving the displayed version information specifications3. Change the displayed parameters. [Default Printer] This is for setting a color printer. The settings will be applied to the “Select Printer Device” dialog box as default ones when printing a map. Driver Used to specify a color printer. Form Used to set a printer paper size. [AR Measurement] This is for setting an indication increment for AR-measured values. Step: 0.25, 0.125, 0.01 Factory setting: 0.25 [D] This is for setting indication increments for SPH and CYL values. The increment is also applicable to keratometry data at the time of printout.
  • 164. 5 - 60 VD: 0.0, 10.5, 12.0, 13.75, 15.0, 16.5 Factory setting: 13.75 [D] Corneal vertex distance (Distance from the corneal vertex point to the posterior surface of a lens) Axis: 1, 5 Factory setting: 1º Indication increment for Axis measurements. CYL Mode: –, MIX, + Factory setting: – This field is for setting a reading mode for CYL values. However, for keratometry data, the data is shown in “+” mode when the “+” radio button is selected. When the “–” or “MIX” radio button is selected, the data is shown in “–” mode. [Cornea Index] This field is for setting the corneal refractive index to be used in calculation. NA: Corneal refractive index to be used for calculation of the Axial map and Instantaneous map displays. Factory setting: 1.3375 NR: Corneal refractive index to be used for calculation of the “Refractive” map and Target “Refractive map displays Factory setting: 1.3760 Press an entry field to select and enter an index with a keyboard. [Zernike Analysis] This field is for setting an area to be analyzed and the highest order analysis used in calculations for the Wavefront High Order map, Wavefront Total map, Wavefront Group map and Zernike graph. Zone Factory setting: 6.0 [mm] This is for setting an analysis area. Radial order Factory setting: 6 This is for setting the highest order analysis. [Map Color] This area is for setting color-related specifications for a map displayed on the Map View screen. Background Factory setting: Black This is the background color of a map. Text Factory setting: White This is for setting the text color on a map. However, the texts of items changeable by pressing are shown in green. Press the color area on the right to open the “Color” dialog box and select the desired color.
  • 165. 5 - 61 [Background Image] This is for setting the background of maps when outputting map image data. File Image data as the background of a map is designated. Pressing displays the “Select Background Image File Name” dialog box. Selecting background data makes it possible to save map image data with its background changed. [e/Q/S] This is for setting the value representing asphericity of the cornea to be displayed in the table at the lower part of the Map View screen. (See *15 on p. 5-30.) Factory setting: e (Q) e (Q): Eccentricity and Q value e (S) : Eccentricity and Shape factor [PSF] Show Factory setting: Not checked This is for setting whether or not to display the PSF thumbnail on the Wavefront HO, Wavefront Total and Wavefront Group maps. [Q Value Analysis] This is for setting the method and area to with which the Q value is obtained. Factory setting: Qm, Zone: 6.0 mm Qm: Q value that is calculated based on the data on the meridian that passes through the corneal vertex. This Q value is in accordance with the definition in “Corneal Topography” by ISO. The area used to calculate the Q value is set in diameter (Zone). Qe: Q value that is calculated by fitting the specified area of the cornea to an ellipsoid. Stabler calculation results than those of Qm can be obtained due to a greater amount of data used for the calculation. However, the calculation may take longer than that for Qm. The area used to calculate the Q value is set by the number of rings from the center or in diameter (Zone). The table below shows the correspondence between the number of rings and area diameter for general eyes. Number of rings 6 7 8 9 10 11 12 13 14 15 16 17 Approximate area I 3.2 I 3.8 I 4.4 I 4.8 I 5.2 I 5.8 I 6.4 I 6.8 I 7.4 I 7.8 I 8.4 I 9.0 diameter (mm)4. Press . The “Message” dialog box is displayed.5. Press Yes . The settings will be saved.6. Press . The screen returns to the Patient Selection screen or Map View screen.
  • 166. 5 - 625.3 Changing Displayed Maps (Map View) The items shown in green on the Map View screen are changeable. A displayed map may be modified by pressing these items although the modifications are temporarily applied to the map. The modifications will be canceled when you select another patient’s data or turn off the instrument. Changing the layout Changing to another exam Changing the map type and overlay options Switching between the left-eye and right-eye Changing the color scale Magnifying Selecting a map type Ÿ “5.3.1 Changing map types and overlay options” Changing overlay options Ÿ “5.3.1 Changing map types and overlay options” Changing a color scale Ÿ “5.3.2 Changing color scale” Changing to another exam Ÿ “5.3.3 Changing exam displayed on map to another exam No.” Changing a layout Ÿ “4.6.3 Displaying map on another map set” Switching between the left-eye and right-eye Ÿ “4.6.4 Switching between right and left eyes” Magnifying a map Ÿ “5.3.4 Magnifying map”
  • 167. 5 - 635.3.1 Changing map types and overlay options For each individual map that is displayed, a map type and overlay options can be changed. * The “Difference” map cannot be selected from the “Map View” screen. Select the “Difference” map from the Map View Settings screen. Map title1. On the Map View screen, press the title of a map to be changed. The “Select Map Type/ Pattern” dialog box opens.2. Press a map type change button in the “Map Type” area. Map types are listed. Map type change button3. Press the desired map type to select. See “5.1 Color Maps”.
  • 168. 5 - 644. Select overlay options. From the “Option” area, check overlay options to be laid over the map. See [Overlay options] (p. 5-65). Angle Scale: Protractor-like angle scale Cross Cursor: Dragging the cross cursor displays refractive power (Pwr), corneal curvature radius (Rad), distance from the center (Dist), and Axis at the cursor position. Grid: Sections (1-millimeter squares), vertex point and point of measuring light axis Eye Image: Captured patient’s eye image Pupil Image: Pupil image during REF measurement (Selectable for the OPD map only) Keratometric: Respective maximum and minimum diopters and their directions over 3mm- dia., 5mm-dia., and 7mm-dia. circumferences. Pupil Contour: Pupil edge For the Eye Image, select “Photopic” (photopic pupil image) or “Mesopic” (mesopic pupil image). In the case of the OPD map, Target “Refractive” map, Internal OPD map, Wavefront High Order map, Wavefront Total map and Wavefront Group map, the area outside the pupil outline is shaded. In the case of the Axial map, Instantaneous map, and “Refractive”map, the pupil contour in photopic and mesopic visions respectively with white solid and white dotted lines. Rings:Detected placido-ring edges (shown in red and yellow lines) Border Line: This is for setting whether or not to draw boundaries in black. Use this option when the areas of adjacent steps are shown in closer colors with an absolute color scale etc.5. Press . The screen returns to the Map View screen and the displayed maps will be updated as specified. NOTE • Changes to map types and overlay options in the “Select Map Type/ Pattern” dialog box are temporary ones. The changed will be cleared once you select another patient or turn OFF the instrument. For setting permanent map types and overlay options on the Map View Settings screen, see “5.2.1 Setting “View 1”, “View 2” and “View 3””.
  • 169. 5 - 65 [Overlay options] Vertex point (Red cross)*16 Angle Scale Cross Cursor Sections Point of measuring light (Black cross)*17 Angle Scale, Cross Cursor, Grid Captured eye image Maximum and minimum refractive (Eye Image) powers and their directions Eye Image Keratometric*16 Checking the “Grid” overlay option displays a vertex point (small red cross) and point of the measuring light (small black cross) as well as sections. Because these 2 points are located close to each other, the small red cross may overlap with the small black cross and the small red one may not be able to be seen.*17 Checking the “Grid” overlay option displays a vertex point (small red cross) and point of the measuring light (small black cross) as well as sections. The small black cross represents a point of the CT- measuring light axis (measuring center) in the case of the following maps: Axial map, Instantaneous map, “Refractive” map, Target “Refractive” map, Elevation map (Color 2D), Eye Image or Internal OPD map. The small black cross represents the point of the REF measurement axis (measurement center) in the case of the following maps: OPD map, Wavefront High Order map, Wavefront Total map, an Wavefront Group map.
  • 170. 5 - 66 Pupil contour in Pupil contour in Captured image Pupil center photopic vision mesopic vision (Pupil Image) (White cross) Pupil contour Pupil center (White cross) Pupil Contour Pupil Image, Pupil Contour Pupil image during Pupil center Mesopic pupil outline CT measurement (Mesopic: Cyan, Photopic: Violet) (Cyan outline) Rings (Detected placido ring edges)Photopic pupil outline(Violet outline) Rings Photopic pupil contour (In the case of “Eye Image”) Border Line
  • 171. 5 - 675.3.2 Changing color scale (Select Color Scale) The color scale for the displayed map can be changed.1. Press an area below the color scale to be changed on a map on the Map View screen. Pressing an area displays the “Select Color Scale” dia- log box. The “Select Color Scale” dialog box opens.2. Change the color scale settings. Mode: For setting the color scale type. Two types of color scales are available: Relative color scale and absolute color scale Relative color scale (Normalize): A histogram of a map is calculated and an appropriate increment (Step) and intermediate value (Middle) are automatically set for the best possible use of the color scale. The set increment and intermediate value cannot be changed. Select an unit of the scale (D/mm) from the “Scale” area and number of color and color scheme from the “Color” area. Individual Ÿ For each individual map, an increment and intermediate value are calculated from the maximum and minimum values of the map to make the best possible use of the color scale. Common Ÿ For each individual map type, an increment and intermediate value are calculated from the maximum and minimum values. However, the color map Maps displayed based on the pairs shown in the right same color scale as “Common” Axial map and Instantaneous map table are respectively “Refractive” map and Target “Refractive” displayed based on the map Wavefront High Order map, Wavefront same color scale. Total map and Wavefront Group map
  • 172. 5 - 68 Min Step Ÿ This is for specifying the minimum increment value. The calculated increment in the case of the “Individual” or “Common” of the “Normalize” does not become smaller than the specified value here. Common of Adjustable: This is also a relative scale. Unlike the Intermediate “Common” of the “Normalize”, the calculated increment and intermediate value value can be changed in the “Middle Step” area by viewing the histogram. Checking ( ) “F Auto Step” will automatically set an appropriate increment for a specified intermediate value. Histogram Absolute color scale (Absolute): With the scale, the increment and range are constant. Regardless of the patient’s refractive conditions, areas of the same diopter are always shown in the same color on a map. This color scale is useful for a comparison among multiple maps. Select from two types of the absolute color scales. Smolek_Klyce [1.5D]: The Smolek Klyce scale. An area in the 30D to 67.5D range is shown in 26 colors in increments of 1.5D with the fixed color scale. Absolute [26]: The Absolute scale has the same color scheme as the Smolek Klyce scale and the same 26 colors. Peripheral diopters in the 9D to 101.5D range are shown in wider increments. * The absolute color scale can only be applied to the Axial, Instantaneous, “Refractive”, and Target “Refractive” maps. Color: For setting color schemes and the number of colors available with the color scale. ISO Ÿ The color schemes are in conformity with ISO-recommended ones. Specify a color number in the entry box to the right of the “ISO” radio button. (15 to 25 color schemes: Red Green Blue) NIDEK Ÿ The following color schemes are available. Designate a color number in the entry box to the right of the “NIDEK” radio button. White Red Yellow Green Blue Violet (9 to 51 colors) Smolek_Klyce ŸProvides the same color scheme as that of the Absolute color scale (Pink Red Yellow Green Blue Navy blue) with a fixed color number of 26. Scale: Unit setting of the color scale. mm (Curvature radius), —m or Diopter (Refractive power) The set unit is applicable to the Axial map and Instantaneous map only. For the other maps, the unit is fixed. 3. Press . The changed color scale will be applied.Green characters under the color scale show the specified color scale.Norm : Normalize Indv : Individual Com : Common Number : IncrementAdj: Adjustable Com : Common Number: IncrementAbs.: Absolute S-K 1.5: Smolek- Klyce [1.5D] 26: Absolute [26]
  • 173. 5 - 69 NOTE • Changes to a color scale in the “Select Color Scale” dialog box are temporary. The changes will be cleared once you select another patient’s data or turn the instrument OFF. For setting a permanent color scale from the Map View Settings screen, see “5.2.2 Setting color scale”.5.3.3 Changing exam displayed on map to another exam No. For a patient with multiple exams saved in the database, it is possible to change an exam displayed on a map to one with another Exam No. (This is available only when displaying an exam on a map retrieved from the database.).1. Press the measurement date and time in the desired map on the Map View screen. The patients’ Exam Nos. and their comments if any will be listed. Exam Nos. of single-eye data only will not be displayed2. Press the desired Exam No. to select. The map of the selected Exam No. will be displayed. NOTE • A change of an Exam No. displayed on a map on the Map View screen is temporary. The changed Exam No. will be reset back to the previous one once you select another patient or turn the instrument OFF.
  • 174. 5 - 705.3.4 Magnifying map Pressing under the color scale of each map enlarges the map only. Used to enlarge a map. Pressing reduces the map to the original size.5.3.5 Checking distance between two points The distance between the desired two points on a color map may be checked.1. Make the cross cursor (“Cross Cursor” overlay option) appears on a color map. See “5.3.1 Changing map types and overlay options”. Difference in diopter between the starting point and end point,2. Press a starting point on a map to designate Distance between the starting point while pressing Shift . Starting point and end point@Angle The cross cursor moves to a starting point.3. Drag the cross cursor to the desired point as an end point by pressing Shift . The difference in diopter between the starting point and end point (dPwr) and the distance (dDist) are displayed over the cross cursor. Pressing any point on the map without pressing Shift returns the cross cursor to a normal one. End point The distance between two points is uniformly displayed in all the maps with cross cursors displayed. [When displaying a distance between the two desired points respectively on each individual map] Specify the starting point and endpoint in each map as instructed from Step 1 to Step 3. In Step 2 and Step 3, specify the starting point and endpoint while simultaneously pressing the Shift key and the Ctrl key instead of the Shift key only.
  • 175. 5 - 715.4 Displaying Difference Map A Difference map shows differences between two maps which are being displayed. Note that both maps should be of the same eye (Left or Right). In addition, be aware that it is impossible to display a difference between two Elevation maps on the Difference map. The following explains one example of showing differences between map (1) and map (2) on map (3).1. Select “View 1”, “View 2”, or “View 3” to which the Difference map is assigned. See “5.2.1 Setting “View 1”, “View2”, and “View 3” or “5.2.1.8 When selecting Difference map”.2. Designate two exams whose difference is to be displayed. [Example: Obtaining the difference between Exam No.1 and Exam No.4 of a patient whose ID is 000009.] 1) Press the patient’s line whose ID is “00009” (the desired patient line). Map (1) button Map (2) button Exams of the selected patient are listed in the lower field. 2) Press the line for Exam No.1 (to be displayed on map (1)). 3) Press the Map (1) button. The number “1” is entered into the “Map No.” box of the exam line selected in Step 2). 4) Press the line for Exam No.4 (to be displayed on map (2)). 5) Press the Map (2) button. The number “2” is entered into the “Map No.” field of the exam line selected in Step 4).3. Press . The Map View screen including the Difference map opens.
  • 176. 5 - 725.5 Manual Pupillary Distance (PD) Measurement If the “Auto PD” check box on the Settings screen is checked, the pupillary distance (PD) will also be measured automatically . If the “Auto PD” check box is unchecked, the PD will not be measured during REF or AR measurement. In this case, it is also possible to manually measure the PD by selecting the PD measurement mode.1. Uncheck the “Auto PD” check box on the Settings screen.2. Select the PD measurement mode by pressing the measurement select button on the measurement screen several times. When the PD measurement mode is selected, the symbol of the measurement select button will be changed to .3. Instruct the patient not to move his/her head and eyes during the measurement.4. After precise alignment of the right and left eyes, press the start button each time. When the start button is pressed, the color of “Right”,”Center” and “Left” indication will be changed from gray to black. Right-eye monocular PD area Binocular PD area Left-eye monocular PD area NOTE • If the patient’s head is tilted, make it straight before starting measurement. • To measure the monocular PD at the same time as the binocular PD, press the start button every after proper alignment of the right-eye, middle (middle of the nose bridge), and the left-eye. It is recommendable to use the pupillary distance meter such as the NIDEK PM-600 in order to obtain precise monocular PD.
  • 177. 5 - 735.6 Database Loading of measured data from another instrument, outputting of data to another instrument, editing of data, and backing-up of data are explained. As for the procedures for saving measured data into the database and those for retrieving an exam from the database, see “4.8 Saving measured data” and “4.6.2 Retrieving exam from database and displaying it in a map”.5.6.1 Importing external data into database (Import) Output data on a floppy disk from another ARK-10000 unit is loaded into the database for use.1. Insert a floppy disk into the floppy disk drive.2. Open the Patient Selection screen. Press on the measurement screen.3. Press . The screen is switched to the Import (Outside to Inside) screen.4. Press to select a patient line to be loaded. Selecting a patient lists his/her exams in the bottom area of the screen. Pressing selects all the patients from an external source.5. Press the exam data to be loaded. Pressing a patient line in Step 4 automatically selects all the exam data of the selected patient. To load the desired exam (exams) only, press the data line(s) to select. In addition, pressing the second exam and after while holding the Ctrl key or Shift key down makes it possible to select multiple exams. For an exam that obtained results for both eyes in succession: Selecting the exam also selects the exam for the other eye.
  • 178. 5 - 746. Press . Data import is started. At the completion of data import, the message dialog box is displayed. When “Same patient ID exits!” dialog box is displayed Ÿ See [If patient data with the same ID already exists in the database of a target ARK- 10000] below.7. Press OK button. The screen returns to the Import (Outside to Inside) screen.8. Press . The screen returns to the Patient Selection screen.9. Eject the floppy disk.[If patient data with the same ID already exists in the database of a target ARK-10000] If patient data with the same ID, but with a different name and/or sex, already exists in the database of a target ARK-10000, The “Same patient ID exits!” dialog box appears in Step 6. Lines with different data will be shown in yellow. To add the imported patient’s exam data under the existing patient’s personal data: Ÿ Press . A message encouraging the operator to confirm the addition appears. Press Yes . If a patient ID (or the patient data) on a floppy disk (Outside) or in the database (Inside) is incorrect:   1) Press or press twice the “Same patient ID exist!” dialog box. The “Message” dialog box appears.
  • 179. 5 - 752) Press Yes .3) Change the ID (or patient data) and press . Inside: In the database Outside: In a floppy disk The message dialog box appears, encouraging the operator to confirm if he/she modify the ID (or patient data).4) Press Yes . will change to .5) Again, confirm the ID (or patient data) and press . The message dialog box which encourages the operator to confirm if he/she loads the data appears.6) Press Yes to start data import. After the completion of data import, the message dialog box appears to inform the operator of the completion of data import.7) Press OK .8) Press . The screen returns to the Patient Selection screen.
  • 180. 5 - 765.6.2 Outputting exam from database (Export) Exams saved in the database are saved in a designated drive. The output data can be loaded and viewed in a device such as another ARK-10000 unit.1. Open the Patient Selection screen. Press on the measurement screen.2. To save an exam on a floppy disk, insert a Floppy disk drive disk into the floppy disk drive. Use a MS-DOS-formatted 3.5-inch 2HD floppy disk. Refer to “5.14 Formatting Floppy Disk”. Eject button3. Press . The Export (Inside To Outside) screen is opened.4. Press to select patient’s data line to be output. Pressing an item name on the upper part of the screen (ID, Name, Sex, Group, Last Exam Date) sorts data in ascending order within the item field. Pressing the item name once again sorts data in descending order. To search for data, use the “Search Patient Data” dialog box. See “[“Search Patient Data” dialog box]” (p.3-17).
  • 181. 5 - 775. Press to select exam data to be output. Pressing a patient line as in Step 4 automatically selects all the exam data of the selected patient. To load the desired exam (exams) only, press the data line(s) to select. In addition, pressing the second exam and after while holding the Ctrl key or Shift key down makes it possible to select multiple exams. For an exam that obtained results for both eyes in succession: An expected size of a file to be output is calculated and Selecting the exam also selects the exam for the displayed at “Selected file size”. other eye. (1MB = 1000KB, 1GB = 1000MB)6. Press . The “Export Settings” dialog box is displayed. Set whether or not to output pupil image data obtained during CT measurement. Set whether or not to output pupil image data obtained during AR measurement. Set whether or not to output the calibration file on which the output exam data is based. Set whether or not to output the nomogram used when a shot data file is created. If the instrument is to be connected with the Final Fit or Opti- mized Prolate Ablation software, select “Yes”. Set whether or not to output data set that includes multibyte characters. If the output data is to be used with the Final Fit or Optimized Prolate Ablation software, select “No”. Set whether or not to output the patient information with private information deleted for private protection.7. Select data output format and press . Select data output format according to the target device that receives the output data. It is also possible to set so that the “Export Settings” dialog box is not displayed every time data is output. See “[Setting specifications for data output format] ” (p.5-81). NOTE • If the setting of Export Multibyte String is “No”, the multibyte characters are cleared from the exported data. However, if the data about to be exported contains multibyte characters in the Patient name, the Edit Patient Information screen is displayed. In such a case, replace the multibyte characters with alphanumeric characters. If the Cancel button is pressed without replacing the multibyte characters with alphanumeric characters, the data is exported with the multibyte characters deleted.
  • 182. 5 - 78 The selected exam will be saved. At the completion of saving, the “Exporting of exam data has been completed” message appears. If the “Same patient ID exists!” dialog box is displayed Ÿ See [If patient data with the same ID already exists in a destination] (p.5-79).8. After saving data to a floppy disk, eject it. Press the eject button on the floppy disk drive. CAUTION • Do not eject a floppy disk while the lamp of the floppy disk drive is illuminated. Corruption of the floppy disk, or a breakdown of the floppy disk drive may result. [Changing the destination of data output] Select the desired drive and directory in the “Import/Export” area in the “Select Data Directory” dialog box. See “5.6.4.3 Setting location for data backup, import, and export”. It is also possible to change the destination of data output on the Export (Inside to Outside) screen. Checking the target location for imported or exported data Ÿ Target location for imported or exported data The location is shown in the “Import/ Export” field in the upper part of the screen. Changing the target location for imported or exported data Ÿ Press on the right to open the “Browse for Folder” dialog box and select the target location. Creating a new directory Ÿ Press on the right to open the “Create New Directory” dialog box and create a new directory.
  • 183. 5 - 79[If patient data with the same ID already exists in a destination] If patient data with the same ID already exists in a destination, the “Same patient ID exists!” dialog box appears in Step 7. To add the imported patient’s exam data under the existing patient’s personal data: Ÿ Press . A message encouraging the operator to confirm the addition appears. Press Yes . To delete exam data on a destination: Ÿ Press . If a patient ID (or the patient data) on a floppy disk (Outside) or in the database (Inside) is incorrect:   1) Press or press twice the “Same patient ID exists!” dialog box. The “Message” dialog box appears. 2) Press Yes . 3) Change the patient ID (or patient data) and then press . Inside: In the hard drive database Outside: In a floppy disk The “Message” dialog box appears.
  • 184. 5 - 80 4) Press Yes . button changes to . 5) Check the patient ID (or patient data) again and press . The “Message” dialog box appears. 6) Press Yes to start savings.
  • 185. 5 - 81[Setting specifications for data output format] 1) Open the Patient Selection screen. Press on the measurement screen. 2) Open the Database Settings screen. Press . 3) Open the “Export Settings” dialog box. Press . 4) Select either the “Set each time of exporting” option or the “Set now” option. Set each time of exporting. Select an output format for each data export. Set now. Data is exported constantly in the format specified in the “Set now” area. Item Explanation Factory setting File size Export Pupil image during Setting of whether or not to output the captured pupil Yes 170 KB /eye CT measurement. image in the CT measurement together with the data Export Pupil image during Setting of whether or not to output the captured pupil image in the AR measurement together with the Yes 170 KB /eye AR measurement. data Setting of whether or not to output the calibration file Export Calibration files. Yes 15 KB / eye on which the output exam data is based Set whether or not to output the nomogram used Export Nomogram files. when a shot data file is created with Final Fit or Yes About 3 Kbyte/file Optimized Prolate Ablation Software. Set whether or not to output data set that includes Export Multibyte String. No — multibyte characters. Setting of whether or not to output the patient information with private information deleted for private protection. Patient Information Full: Full patient information is output Full — Privacy protection: Patient information is output with private information deleted. Patient name is output in initials. * Data for both eyes with pupil images captured during the CT or AR measurements that is approx.1.3 MBytes in size can be output to a floppy disk. NOTE • If the setting of Export Multibyte String is “No”, the multibyte characters are cleared from the exported data. However, if the data about to be exported contains multibyte characters in the Patient name, the Edit Patient Information screen is displayed. In such a case, replace the multibyte characters with alphanumeric characters. If the Cancel button is pressed without replacing the multibyte characters with alphanumeric characters, the data is exported with the multibyte characters deleted.
  • 186. 5 - 82 5) Press . The screen returns to the Database Settings screen. 6) Press . The screen returns to the Patient Selection screen.
  • 187. 5 - 835.6.3 Editing data Patient data saved in the database can be modified.5.6.3.1 Editing patient data (Edit Patient Information)1. Open the Patient Selection screen. Press on the measurement screen.2. Press the desired patient line to select and press it additional two times. The Edit Patient Information screen is opened. Or select a patient line and press to open the Edit Patient Information screen.3. Modify or type in data in the desired field. Pressing on data heading twice opens its entry field. Modify or type in data using the keyboard. The data with a “ ” mark on its left cannot be modified.4. Press . The screen returns to the Patient Selection screen. NOTE • Use a unique ID such as a carte number. If an already assigned Patient ID is entered, the message, “The input Patient ID already exists.” will appear, and the entered Patient ID will be rejected.
  • 188. 5 - 845.6.3.2 Editing exam data (Edit Exam Information)1. Open the Patient Selection screen. Press on the measurement screen.2. Select a patient. Selecting a patient lists the exams of the selected patient.3. Press twice exam data to be edited. The Edit Exam Information screen is opened. Or select exam data to be edited and press to open the Edit Exam Information screen.4. Modify or type in the desired data. Pressing each data heading twice opens its entry field. Modify or type in data using the keyboard. The data with a “ ” mark on its left cannot be modified.5. Press . The screen returns to the Patient Selection screen.5.6.3.3 Deleting data (Delete) Data retrieved from the database is deleted.1. Open the Patient Selection screen. Press on the measurement screen.2. Press . The Delete screen is opened.
  • 189. 5 - 853. Select data to be deleted. All the exams of the patient are deleted.[Deleting all the data of a patient] Press a patient line to be deleted on the Delete screen. Pressing an item name on the upper part of the screen (ID, Name, Sex, Group, Last Exam Date) once sorts the data in ascending order within the item field. Pressing the item name once again sorts the data in descending order. To search for data, use the “Search Patient Data” dialog box. See “[“Search Patient Data” dialog box]” (p.3-17).[Deleting an exam (exams) of a patient] 1) Press a patient line to select on the Delete screen. Pressing patient line lists and highlights all the exams of the patient in the bottom area of the screen. 2) Press to select an exam line (lines) to be deleted. For an exam that obtained results for both eyes in succession: Selecting the exam of one eye also selects the exam for the other eye. These exams only will be deleted4. Press . A message dialog box appears, encouraging the operator to confirm the deletion of the selected data.5. Press OK . The selected exam will be deleted.6. Press . The Delete screen is switched to the Patient Selection screen.
  • 190. 5 - 865.7 OPD Database Manager The ARK-10000 (OPD-Scan II) manages the data using the database management software, OPD Database Manager. Setting, selection, or backup of the database is performed in the OPD Database Manager screen.5.7.1 Creating new database (in the ARK-10000) Multiple databases can be created and the desired database can be selected. (For the method of selecting the database, see “5.7.2 Changing database (Select Database)”.) A maximum of five new databases can be created. This function cannot be used with an instrument for which “other computer” is selected in the OPD Database Manager screen. In such a case, open the OPD-Database Manager screen on the ARK- 10000 (OPD-Scan II) or the computer in which the database is stored to perform this procedure.1. Open the Patient Selection screen. Press on the measurement screen.2. Press the button The OPD Database Manager screen is displayed. The OPD Database Manager screen is displayed also by pressing the icon in the task tray at the bottom right of the Windows screen.3. Close connection to the database by pressing (Stop). If other ARK-10000s or computers connected to the network are using the database in this instrument, close all the connections to the database. (Press (Stop) on each OPD Database Manager screen.)
  • 191. 5 - 874. Press “Advanced Settings” to display the Advanced Settings screen.5. Press (Ref...). The “Select Database” dialog box is displayed.6. Select any radio button beside a blank DB LABEL.7. Input the database name in the DB LABEL beside the selected radio button. Example: RK-3_20048. Press shown to the right. The folders in which the database will be stored are displayed.
  • 192. 5 - 88 9. Input the target folder names in each boxes from “Index” to “Import/Export” in which the database is to be created. Name the folders as in the table below. Box Folder name Index ...Index Data ...Data Backup Index ...BackupIndex Backup Data ...BackupData Calibration ...Cal Import/Export ...OutSide10. Press (OK). If any folders input in Step 9 do not exist, a message is displayed for each to ask whether or not to create the folder. Press the Yes button for each. The screen returns to the Select Database screen.11. Press (OK). The dialog box shown to the right is displayed.12. Press the Yes button.13. Press . The screen returns to the OPD Database Manager screen.14. Press (Start) to restart connection to the database.15. Press (Minimize) to minimize OPD Database Manager to the task tray.
  • 193. 5 - 895.7.2 Changing database (Select Database) The procedure for selecting a database to be used with the ARK-10000 from multiple databases. To use an ARK-10000 database that is on another ARK-10000 or a computer on the network, see “5.7.3 Using database in another ARK-10000 on network”.1. Open the Patient Selection screen. Press on the measurement screen.2. Press . The OPD Database Manager screen is displayed. The OPD Database Manager screen is displayed also by pressing the icon in the task tray on bottom right of Windows screen.3. Close connection to the database by pressing (Stop). If other ARK-10000s or computers connected to the network are using the database in this instrument, close all the connections to the database. (Press (Stop) on each OPD Database Manager screen.)4. Press “Advanced Settings” to display the Advanced Settings screen.
  • 194. 5 - 90 5. Press (Ref...). The “Select Database” dialog box is displayed. 6. Select the radio button beside the desired database name. The folders in which the database is being saved are displayed by pressing . 7. Press (OK). The dialog box shown to the right is displayed. 8. Press the Yes button. 9. Press . The screen returns to the OPD Database Manager screen.10. Press (Start) to restart connection to the database.11. Press (Minimize) to minimize OPD Database Manager to the task tray.
  • 195. 5 - 915.7.3 Using database in another ARK-10000 on network To use an ARK-10000 database that is on another ARK-10000 or a computer on the network, select “Other Computer” in the “Select database” box on the OPD Database Manager screen. Before continuing, back up the database on the ARK-10000 or computer on which the database to be used is stored. NOTE • Installation of OPD Database Manager (V2.02 or later) is required for a computer to be connected. The ARK-10000 cannot be connected to a computer installed with earlier an OPD Database Manager. In such a case, update OPD Database Manager to the latest version. (The ARK-10000 software or other software does not need to be updated.)1. Open the Patient Selection screen. Press on the measurement screen.2. Press . The OPD Database Manager screen is displayed. The OPD Database Manager screen is displayed also by pressing the icon in the task tray on bottom right of Windows screen.3. Close connection to the database by pressing (Stop). If other ARK-10000s or computers connected to the network are using the database in this instrument, close all the connections to the database. (Press (Stop) on each OPD Database Manager screen.)
  • 196. 5 - 924. Select “Other computer” in the Select database box.5. Press (Ref...) to display the “Browse for Computer” screen. Select the ARK-10000 or computer name in which the database to be used exists. Then press the OK button. If the computer name cannot be found, in put the computer name in the Computer name box.6. Press (Start) to restart connection to the database.7. Press (Minimize) to minimize OPD Database Manager to the task tray.
  • 197. 5 - 935.7.4 Backing up database (Database Backup) It is recommended to regularly back up the database in case of a database crash. The database will be backed up in a directory in a drive that are specified in the “Backup Data” field on the “Select Database” dialog box (p. 5-100). This function is unavailable with instruments whose setting of the Select database box on the OPD Database Manager screen is “Other Computer”. In such a case, back up the database on the ARK- 10000 or the computer on which the database is stored.1. Open the Patient Selection screen. Press on the measurement screen.2. Press . The OPD Database Manager screen is displayed. The OPD Database Manager screen is displayed also by pressing the icon in the task tray on bottom right of Windows screen.3. Close connection to the database by pressing (Stop). If other ARK-10000s or computers connected to the network are using the database in this instrument, stop all the connections to the database. (Press (Stop) on each OPD Database Manager screen.)
  • 198. 5 - 94 4. Press “Advanced Settings” to display the Advanced Settings screen. 5. Press (Backup). The “Database Backup” dialog box is displayed. If both backup destination and database are located in the same drive, a message appears encouraging the operator to designate the backup destination in another drive. Yes Ÿ Backs up data in the drive. No Ÿ Cancels the backup process. 6. Check a backup type to select. Back up: Backs up data. The backed-up data will be saved and used for rebuilding the database. The “Back up” has the following options: Differential Ÿ Only the data added and modified since the last backup will be backed up. Ordinarily, select this option ( ). All Ÿ The whole database including already backed-up data will be backed up. Use this option if a storage disk where the backup data was saved is corrupted or after changing the target location for backup data. Free up: After data backup, data will be deleted from the oldest one in order to free up the specified hard disk space.*18 Delete: The data which has not been retrieved for the specified year will be deleted by an item of patient data.*19 This allows the operator to delete the data which is out of retention period. NOTE • When the data is backed up with “All” selected even to another media (such as Zip disc), the previous backup data becomes unavailable.*18 See “5.7.7 Setting data deletion criteria” to specify a free space. Long-unused data will be deleted in order.*19 See “5.7.7 Setting data deletion criteria” to specify a retention period.
  • 199. 5 - 956. Press (OK). Number of patients whose data will be saved The progress bar reports the progress of the Number of patients whose backup process. data has already been saved The backup may take time. Pressing (Cancel) discontinues the backup process. In such cases, the data backed-up until the backup process was discontinued will be effective. When backup is completed, the “Database backup has been completed.” message is displayed.7. Press the OK button. The screen returns to the Patient Selection screen.8. Press (Start) to restart connection to the database.9. Press (Minimize) to minimize OPD Database Manager to the task tray. CAUTION • Be sure to back up data on a storage disk such as a ZIP disk or DVD-RAM. In case of built-in hard disk corruption, saved data can never be used again. In addition, a storage disk such as CD-R, CD-RW, DVD-R which need writing software are improper for data backup. • Operators are responsible for managing obtained data. NIDEK assumes no responsibility for a loss of data. NOTE • The internal hard disk is factory-selected as a backup location. Backing up data on the internal hard disk instead of specifying a storage disk as a backup destination reduces the internal database capacity by half compared to backing up data on a storage disk. This is because both data in the database and its backup data stored on the internal hard disk take up a part of the internal hard disk space to be allocated for a database.
  • 200. 5 - 965.7.5 Rebuilding database (Rebuild Database) In case of a database crash, rebuild the database from backup data or data remaining in data folders. This function is unavailable with instruments whose setting of the Select database box on the OPD Database Manager screen is “Other Computer”. In such a case, rebuild the database on the ARK- 10000 or the computer on which the database is stored.1. Open the Patient Selection screen. Press on the measurement screen.2. Press . The OPD Database Manager screen is displayed. The OPD Database Manager screen is displayed also by pressing the icon in the task tray on bottom right of Windows screen.3. Close connection to the database by pressing (Stop). If other ARK-10000s or computers connected to the network are using the database in this instrument, close all the connections to the database. (Press (Stop) button on each OPD Database Manager screen.)
  • 201. 5 - 974. Press “Advanced Settings” to display the Advanced Settings screen.5. Press (Rebuild). The “Rebuild Database” dialog box is displayed.6. Check a rebuild type to select. Check the contents…: Used to rebuild the database over the currently-used Index folder and Data folder. Erase the current …: Use to restore backup data after replacing the instrument with another or after replacing the internal hard disk because of a failure etc. CAUTION • Rebuilding the database by selecting the “Erase the current …” option will totally erase the current database. Do not select this option carelessly. To retain the contents of the current database, back up the current database in advance. • After data backup on a storage disk, once-deleted data from the database can never be recovered even by rebuilding the database with the “Check the contents…” option selected.7. Press (OK). If the “Check the contents…” option has been selected: Ÿ The rebuilding of the database is started and progress bar is shown . The rebuilding may take some time. Go to Step 11.
  • 202. 5 - 98 If the “Erase the current…” option has been selected: Ÿ The message dialog box on the right is displayed. Go to Step 8. 8. Press the OK button. The message encouraging the operator to insert a backup disk appears. If the built-in hard disk has been designated as backup location, the database will be rebuilt. Go to Step 11. 9. Insert the backup disk and press the OK button. Rebuilding of the database is performed. When all the data on the inserted backup disk has been loaded, the same message as in Step 7 appears.10. Insert the next backup disk and press the OK button. Repeat Steps 8 and 9 to load all the data on all the backup disks. When the loading of all the data has been completed, press the Cancel button to finish the rebuilding process.11. After the completion of rebuilding, the message “Rebuilding of database has been completed” appears.12. Press OK button. The screen returns to the Database Settings screen.13. Press (Start) to restart connection to the database.14. Press (Minimize) to minimize OPD Database Manager to the task tray.
  • 203. 5 - 995.7.6 Setting location for data backup, import, and export The target location for a backup database, imported data, or exported data is changed. CAUTION • The initial data backup after changing the target location in the “Backup Data” field in the “Select Database Directory” dialog box should be performed on condition that the “All” option of the “Back up” is selected. (See p. 5-94.) • Changing the storage location in the “Index”, “Data”, “Backup Index” or “Backup Data” field to an improper one may result in a loss of exam data. When changing factory-set storage locations, consult NIDEK or your authorized distributor.1. Open the Patient Selection screen. Press on the measurement screen.2. Press . The OPD Database Manager screen is displayed. The OPD Database Manager screen is displayed also by pressing the icon in the task tray on bottom right of Windows screen.3. Close connection to the database by pressing (Stop). If other ARK-10000s or computers connected to the network are using the database in this instrument, close all the connections to the database. (Press (Stop) on each OPD Database Manager screen.)
  • 204. 5 - 1004. Press “Advanced Settings” to display the Advanced Settings screen.5. Press (Ref...). The “Select Database” dialog box is displayed.6. The database being selected with the radio button is being used. Press shown to the right of the selected database. The folders in which the database will be stored are displayed.
  • 205. 5 - 101 7. Change the desired item. Designate the desired drive or directory. It is also possible to designate the desired item from a reference dialog box by pressing on the right side. Entry box Explanation Storage location of the database index. An external storage device Index cannot be designated in this field. Storage location of the exam (analysis) data. Any external storage Data device cannot be specified. It is impossible to designate the same folder as the Backup Data field and Import/Export field. Storage location of the copied index files created when the system is Backup Index shut down. The copy is used for rebuilding the database. An external storage device cannot be designated in this field. Database backup destination. It is impossible to specify the same folder as the Data field and Import/Export field. The internal hard disk is factory-set in this field. It is necessary to change the Backup Data destination to back up the database on an external storage device. When the backup destination has been changed, select the All option when backing up for the first time. Calibration Storage location of the calibration and nomogram files. Data import or export destination. It is impossible to designate the Import/Export same folder as the Data field and Backup Data field. 8. Press (OK). The screen returns to the Database Settings screen. 9. Press (OK). The dialog box shown to the right is displayed.10. Press the Yes button.11. Press . The screen returns to the OPD Database Manager screen.12. Press (Start) to restart connection to the database.13. Press (Minimize) to minimize OPD Database Manager to the task tray.
  • 206. 5 - 102 [When backing up data on a storage disk] It is possible to backup data by connecting a USB or parallel-port external storage drive such as a ZIP drive. USB external storage device = Connect it to the USB connector. External storage device provided with a parallel port = Connect it to the printer connector. As for the connection method of each external storage device, refer to the manual of the device. To back up data on a storage disk, designate a target directory in the “Backup Data” field. To avoid confusion among the used storage disk such as a Zip disk, be sure to assign a label to each volume.
  • 207. 5 - 1035.7.7 Setting data deletion criteria (Backup Settings) The settings are specified for data deletion when saving backup data.1. Open the Patient Selection screen. Press on the measurement screen.2. Press . The OPD Database Manager screen is displayed. The OPD Database Manager screen is displayed also by pressing the icon in the task tray on bottom right of Windows screen.3. Close connection to the database by pressing (Stop). If other ARK-10000s or computers connected to the network are using the database in this instrument, close all the connections to the database. (Press (Stop) on each OPD Database Manager screen.)4. Press “Advanced Settings” to display the Advanced Settings screen.
  • 208. 5 - 1045. Press the Setting button. Warning level at startup The “Backup Settings” dialog box is displayed. Target free space for Retention period “Free up” backup6. Set data deletion criteria. 1. Warning if the disk free…: If free space of the internal hard disk is less than the specified capacity in this field (Unit: MB), the message appears during the ARK-10000 startup to encourage the operator to perform “Free up…” backup (to delete older data after data backup). 2. Free up…: The value shows the target free space of the internal hard disk (Unit: MB). Backup with “Free up…” checked will free up disk space to allocate at least the free space specified in the field. To use once-deleted data after the “Free up…” backup, retrieve the data from a storage disk. 3. Delete patient data permanently…: After the execution of “Delete…” process which is selectable from the “Database Backup” dialog box, the data which has not been updated for the specified year in the field will be deleted If “0” is entered, it is impossible to check “Delete”. To make the “Delete…” selectable, input a retention period in this field (Unit: Year).7. Press (OK). The screen returns to the OPD Database Manager screen.8. Press (Start) to restart connection to the database.9. Press (Minimize) to minimize OPD Database Manager to the task tray.
  • 209. 5 - 1055.7.8 List of connected computers A list of computers being connected to the ARK-10000 database can be viewed.1. Open the Patient Selection screen. Press on the measurement screen.2. Press . The OPD Database Manager screen is displayed. The OPD Database Manager screen is displayed also by pressing the icon in the task tray on bottom right of Windows screen.3. Press (Linked Comp List) to display the Linked Computer List screen. The computers in the list are currently connected to the ARK-10000. NOTE • Connection with computers can be terminated by selecting the desired computer and clicking the Disconnect button. When the selected computer is disconnected in this method, the database cannot be accessed from the disconnected computer, and software such as OPD- Station run on the disconnected computer becomes inactive, resulting in loss of data. To prevent such troubles, perform this procedure after checking the status of the connected computer.4. Press (Close) to return to the OPD Database Manager screen.5. Press (Minimize) to minimize OPD Database Manager to the task tray.
  • 210. 5 - 1065.7.9 List of computers that have been connected A list of computers that have been connected to the ARK-10000 can be viewed.1. Open the Patient Selection screen. Press on the measurement screen.2. Press . The OPD Database Manager screen is displayed. The OPD Database Manager screen is displayed also by pressing the icon in the task tray on bottom right of Windows screen.3. Close connection to the database by pressing (Stop). If other ARK-10000s or computers connected to the network are using the database in this instrument, close all the connections to the database. (Press (Stop) on each OPD Database Manager screen.)4. Press “Advanced Settings” to display the Advanced Settings screen.
  • 211. 5 - 107 5. Select “Other computer” in the Select database box. 6. Press (Server history) to display the Server history screen. A list of computers that have been connected to the ARK-10000 can be viewed. 7. If necessary, delete computer names. To delete computer names from the list, select the desired computer name and click the Delete button. 8. Press (OK). The screen returns to the OPD Database Manager screen. If the Cancel button is pressed, the screen returns to the OPD Database Manager screen is Database Settings screen without deleting any computer name. 9. Press (Start) to restart connection to the database.10. Press (Minimize) to minimize OPD Database Manager to the task tray.
  • 212. 5 - 1085.8 Outputting Map Data The outputting of numerical data or map image of a displayed map is explained.5.8.1 Outputting numerical data from map (Save Map Information) The numerical data of a displayed map is saved on a storage disk such as a floppy disk. The output data can be imported to a computer and loaded into such software as a spreadsheet program. The output file will be in the CSV format.1. To save the data on a floppy disk, insert a disk into the floppy disk drive. Floppy disk drive Use a MS-DOS-formatted 3.5-inch 2HD floppy disk. See “5.14 Formatting Floppy Disk”. Eject button2. Press on the Map View screen. The “Save Map Information” dialog box appears.3. Check the target drive and directory in the “Directory” field. Press and designate a directory where the data file is to be output. To save the data to a floppy disk, input “A:”.4. Press . The numerical data of the displayed map is saved on the floppy disk. When the data has been saved successfully, the message “Saving of the map information has been completed” appears. If the data was not saved because of a shortage of free space on a target floppy disk, the error message “Couldn’t save the map information!” appears.
  • 213. 5 - 1095. Press OK .6. When the data has been saved on the floppy disk, eject it. Press the eject button to eject the floppy disk. CAUTION • Do not eject the floppy disk while the lamp of the floppy disk drive is illuminated. Corruption of the floppy disk, or a breakdown of the floppy disk drive may result.
  • 214. 5 - 1105.8.2 Outputting map images (Save Map Image) The map image that is being displayed on the screen is saved in the procedure below. The map images are output in the JPEG format or in the BMP format.1. Press on the Map View screen. The “Save Map Image” dialog box opens.2. To save the map image on a floppy disk, insert it into the floppy disk drive. Use a MS-DOS-formatted 3.5-inch 2HD floppy disk. See “5.14 Formatting Floppy Disk”.3. Designate an output format from the “Output Type” area. JPEG format: A JPEG file in a compressed image file format is smaller in size but lower in image quality than a BMP file. BMP format: A 16-bit uncompressed image file. Some image processing software does not support the BMP files.4. Confirm a target drive and file name. The file name is automatically assigned as: When “Enter ID to file name” is selected: (ID) (Year/Month/Day) _ (Hour/Minute/Second) .jpg (or bmp) When “Enter Patient Name to file name” is selected: (Name) (Year/Month/Day) _ (Hour/ Minute/Second) .jpg (or bmp) EX.: 00000920020221_173553.jpg ID Date Hour/Minute/Second at file output To change a target drive, press and change the drive on the “Browse for Folder” dialog box. When saving map images on a floppy disk, enter a file name following “A:”. Checking “F Reverse” turns black pixels white and vice versa.5. Press . The image file will be saved and the Message dialog box will be displayed.6. Press OK . [When saving a map image changing its background] Checking the “F Use Background Image” and pressing in the “Background Image” field, opens the “Select Background Image File Name” dialog box. By selecting background data, you can save a map image with the selected background.
  • 215. 5 - 111[When outputting map image data with personal information deleted] To avoid identification of the patient, checking “F Delete patient information on a map for privacy.” Map image data is output without personal information. In this case, the ID is deleted from the file name, and the patient name becomes initials. Ex.) When “Enter ID to file name” is selected: 20061214_112049. jpg (or bmp) Year, month, day Hour, minute, and second at the time of file output When “Enter Patient Name to file name” is selected: F_M_L_20061214_112049.jpg (or bmp) Initials Year, month, day Hour, minute, and second at the time of file output
  • 216. 5 - 1125.9 Accommodation Measurement Function (Optional) The distribution of refractive power is measured in far vision (without accommodation) and near vision (with specified accommodation stimulus).5.9.1 Setting accommodation stimulus The amount and speed of the accommodation stimulus in near vision accommodation measurement are set.1. Set the mode to the Accommodation measurement mode ( ). The measurement mode changes by pressing the measurement mode button (second one from the left in the row at the bottom of the screen) in the measurement screen.2. Display the Settings screen. Press the button in the measurement screen.3. Input the Stimulus and Speed values in the Accommodation box. Stimulus:Accommodation stimulus amount (range: -10.0 to 0.0D) Speed: Speed of chart movement (range: 0.5 to 4.5D/sec.) EX: When “Stimulus” is “-3.5D”, and “Speed” is “1.0D”, the chart moves from the far point by 3.5D closer to the eye at a speed of 1.0D per second.4. Press the button to return to the measurement screen. NOTE • Speed of accommodation differs among individuals. If the subject’s accommodation dose not follow the speed of chart (balloon) movement, reduce the chart speed.
  • 217. 5 - 113[Method of calculating chart position] The position of the chart in near vision measurement can be calculated with the equation below. Dp=Df+Da Dp : Refractive power of chart position (D) Df : Refractive power in far vision (SE value: D) 1 Da : Set value of accommodation stimulus Pp = Dp Pp: Chart position (m) Ex.) When the refractive power in far vision is -2.5D and accommodation stimulus is -3.0D, the refractive power of chart position becomes -5.5D (= -2.5 + (-3.0)), and the chart position becomes 18 cm (= -0.18 m = 1/-5.5)) ahead of the eye (“-” indicates forward of the eye).
  • 218. 5 - 1145.9.2 Accommodation measurement1. Set the mode to the Accommodation measurement mode ( ). The indication is displayed on the right of the ID box to show that accommodation measurement in far vision is performed. In far vision measurement, the measurement value indication is displayed in light green.2. Set the measurement mode to REF ( ). Each pressing of the button (at the bottom left of the screen) changes the measurement mode. The mark in the button indicates the currently selected measurement mode. NOTE • The REF/CT measurement ( ) cannot be selected in the accommodation measurement mode. Therefore, the measurement cannot be proceeded automatically from REF to CT. The CT measurement must be performed by changing the mode by the measurement mode switch.3. Input the patient name. See Step 4 in “4.5.1 REF/CT measurement.”4. Have the patient prepare for the measurement. See Step 5 in “4.5.1 REF/CT measurement.”5. Perform the alignment. See Step 6 in “4.5.1 REF/CT measurement.”6. Perform the measurement. See Step 7 in “4.5.2 REF measurement.”7. Perform the measurement of the other eye in the same manner.8. Press the measurement mode button (at the bottom left of the screen) and set the measurement mode to CT ( ).9. Perform the alignment. See Step 6 in “4.5.1 REF/CT measurement.”
  • 219. 5 - 11510. Perform the measurement. See Steps 7 to 9 in “4.5.3 CT measurement” and Steps 7 to 9 in “4.5.3.1 CT measurement (Multiple measurement mode)”.11. After far vision measurement, save the measurement data. See Step 10 in “4.5.1 REF/CT measurement.” In Multiple measurement mode, save the far vision data referring to Steps 9 to 13 in “4.5.1.1 REF/CT measurement (Multiple measurement mode)”, press the Cancel button in the Display Data Selection screen, and return to the measurement screen. The Comment box of the saved far vision measurement data displays “Far.”12. Press to change the mode to the Near vision measurement mode. The chart (balloon) moves by the amount of refractive power specified as “Stimulus.” The indication changes to and shows that accommodation measurement in near vision is performed. In near vision measurement, the measurement value indication is displayed in pink. Pressing the button without saving the far vision measurement data displays the message shown to the right. Be sure to save the far vision measurement data after pressing the Cancel button. Pressing the OK button proceeds to the near vision measurement. In that case, the far vision measurement data is saved as near vision measurement data when near vision measurement data is saved.13. Perform near vision measurement in the same manner as Steps 2, and 6 to 11. NOTE • Near vision measurement is performed while the patient is adjusting the focus of vision. Instruct the patient to look at the chart (balloon) properly. • Some patients, especially those with presbyopia, may not be able to focus on the near vision chart. In this case, reduce the accommodation stimulus. In addition, the patients’ pupils tend to contract in the near vision measurement. Therefore, the near vision measurement needs to be performed in a darkened room taking a sufficient amount of time.
  • 220. 5 - 11614. Press when the near vision measurement is completed. The window shown to the right appears to ask if the near vision measurement is continued with different accommodation stimulus or measurement of another patient is performed.15. Select “Save data. Then continue Near measurement.” or “Save data. Then measure the next patient.” To continue the measurement with different accommodation stimulus after saving the near vision measurement data, select “Save data. Then continue Near measurement.” To finish the measurement of the patient after saving the near vision measurement data, select “Save data. Then measure the next patient.” Pressing the Cancel button returns to near vision measurement without saving the near vision measurement data.16. Press the OK button. The near vision measurement data is saved. In Multiple measurement mode, select and save data as in Step 12. The Comment box of the saved near vision measurement data displays “Near. stimulus, (speed D/ sec).” If “Save data. Then continue Near measurement.” is elected in Step 16, perform the procedure below. 1) Change the Stimulus value at top right of the far vision measurement screen. 2) Perform near vision measurement in the same manner as Step 13 to 17 with the new stimulus value.5.9.3 Display of accommodation measurement result By displaying a Difference map of the far (no accommodation) and near (with the specified accommodation stimulus) vision maps, changes before and after the accommodation can be observed. For the maps, the OPD map or Zernike graph is used. The OPD map shows the change in the distribution of the total eye refraction. The Zernike graph shows changes in various types of aberrations.
  • 221. 5 - 1175.10 Wavefront Contact Lens Measurement Function (Optional) This function is for measurement for the Definition Wavetouch soft contact lens manufactured by WaveTouch Technologies. The REF measurement is performed for the patient’s eye wearing a trial contact lens, wavefront analysis of the result is performed, and the data for the Definition Wavetouch soft contact lens is calculated. Definition Wavetouch soft contact lenses are individually designed based on patients’unique wavefront. These customized lenses are fabricated based on measurements of both low order aberrations and high order aberrations. (General commercially available contact lenses are not designed to correct high order aberration.) The ARK-10000 quickly, easily and accurately measures your patient’s precise wavefront, and outputs this information in the specific format to be used by WaveTouch Technologies to design the custom lenses. For details of Definition Wavetouch soft contact lens, contact WaveTouch Technologies. (URL: www.wavetouchtech.com ) * To use this function, set the Print Mode parameter to “Switch” or “None” beforehand.1. Perform the REF measurement for the eye wearing a trial contact lens. See Steps 1 to 8 in “4.5.2 REF measurement.” When the REF measurement is performed, (color: black) on the right of the ID box changes to (color: cyan, green, and yellow) to indicate that measurement of the Wavefront Contact Lens is enabled. The actual measurement with the eye is finished. From Step 2, data and image of the REF measurement is analyzed. Release the patient from the chinrest and forehead rest, and have them sit in a comfortable posture. * The function from Step 2 is available only in ARK/CT mode.2. Press . The Select Patient screen is displayed.
  • 222. 5 - 1183. Set the patient ID and press . Fine adjustment button The Wavefront Contact Lens screen is displayed.4. Touch the cyan, green, yellow circles with the touch-screen pen, and bring them on the marks on the trial contact lens. Cyan circle: left mark Green circle: bottom mark Yellow circle: right mark * If the marks on the trial contact lens is hidden by the control window, move the control window by dragging.5. Adjust the positions of the circles finely with the Fine Adjustment buttons at top left of the screen so that they are precisely adjusted to the marks on the trial contact lens.6. Input the destination of the output measurement data in the Output Folder box. The destination can be specified also in the Browse for Folder screen that is displayed by pressing the button. NOTE • The measurement data for an eye occupies 1.3MBytes. A floppy disk can be specified as the data output destination, however, data for only a single eye can be saved to a floppy disk.7. Input the refractive power of the trial contact lens on the patient’s eye in the “Trial lens pwr” box in “Inputs.” Input in the range between 15.00 and -20.00D.8. Select the base curve of the trial contact lens on the patient’s eye in the “Trial lens B.C.” box in “Inputs.” Select between “flat: 1” and “steep: 2.”
  • 223. 5 - 119 9. Change the eye. Change the eye with the R / L (or OD / OS) button at bottom right of the screen. The eye cannot be changed if the REF measurement has been performed with only one eye.10. Perform Steps 4 to 5 and 7 to 8 for the other eye.11. Press the OK button at bottom left of the screen. The measurement result is output in the specified destination folder. After that the normal measurement screen is displayed. Pressing the button displays the normal measurement screen without outputting the measurement result. The name of the measurement result file becomes as follows: ************.txt and ************.bmp (************ is Lens ID) NOTE • The pupil images of left and right eyes used in the Wavefront Contact Lens measurement are those of the last REF measurement. Even in the Multiple measurement mode, any other pupil images cannot be used.
  • 224. 5 - 1205.11 Editing Detected Edges (Tools) Any obstacles such as eyelashes may cause edges (in red and yellow) to be detected at substantially shifted positions from captured placido rings or to have breaks. Edge editing tools allow you to correct edges that are shifted. Four tools are available: Move: Used to align a detected edge that is shifted from a captured placido ring by moving a midpoint of a designated arc. Extend: Used to move an endpoint of the selected edge to change the selected edge in length or in direction. Close: Used to close a gap in a detected edge. Erase: Used to erase an unwanted edge.5.11.1 Entering edge edit mode The edge editing tools can be activated during an examination or by retrieving a saved exam in the database. The method of entering the edge edit mode is explained for both cases. [During an examination] Other than in Multiple measurement mode, press on the confirmation screen of the detected edges to enter the edge edit mode. The “Tools” dialog box opens and detected edges are shown in blue. [Retrieving an exam from the database] Confirmation screen of a detected result 1) Select exam data to edit from the Patient Selection screen. 2) Press . After loading the CT-captured image, the confirmation screen of a detected result is displayed. 3) Press to enter the edge edit mode. The “Tools” dialog box opens and detected edges are shown in blue. NOTE Edge edit mode • Only exams obtained on your ARK-10000 can be edited on your ARK-10000 by retrieving them from the database. Imported data from another ARK-10000 cannot be edited on your ARK-10000. • Calculations for maps or such are performed based on the edited placido ring edges. Be sure to adjust the edges so that they are placed along the placido ring of the CT measurement image.
  • 225. 5 - 1215.11.2 Adjusting curved edge (Move) This tool is for aligning a detected edge that is shifted from a captured placido ring.1. Enter the edge edit mode. See “5.11.1 Entering edge edit mode”. Detected edges2. Trace an arc in a range of a detected edge that is shifted from a captured placido ring image. The designated range of the arc turns red. To deselect the designated arc, press to return it to blue.3. Press . The arc in the designated range turns into a yellow dashed line with a cyan “×” at the range midpoint.4. Move the cyan “×” to an edge of a captured placido ring.5. Make sure that the yellow dashed arc aligns to the approximate captured placido ring and press . The detected edge will change its curve to that of the yellow dashed arc. Press not to modify the selected arc as indicated by the yellow dashed arc.6. In the same manner, align other substantially shifted edges to the appropriate captured placido ring.7. Press to exit from the edge edit mode. The display returns to the confirmation screen of detected edges.8. After confirming the edited edges, press to exit the confirmation screen. For data retrieved from the database, designate how to save edited data from the “Confirmation” dialog box: Overwrite button Ÿ The edited data is written over original data. (The original data will be deleted.) Addition button Ÿ The edited data is saved with a new Exam No. assigned. Cancel button Ÿ The edited data will not be saved.
  • 226. 5 - 1225.11.3 Moving end point (Extend) Detected edges This tool is for extending a detected edge in the desired direction. A designated arc can be changed in length or in direction by moving a selected end point of the arc.1. Enter the edge edit mode. See “5.11.1 Entering edge edit mode.”2. Trace an arc in a range whose end point is shifted to designate. The arc in the designated range turns red. To deselect the designated arc, press to return it to blue.3. Press . The arc in the designated range turns into a yellow dashed one with a cyan “×” at an endpoint.4. Move the cyan “×” to the desired position.5. Make sure that the yellow dashed arc aligns to the appropriate captured placido ring and press . The detected edge will modify its curve to that of the yellow dashed arc. Press not to modify the designated arc to the carve indicated by the yellow dashed arc.6. In the same manner, align other substantially shifted edges to the appropriate captured placido ring.7. Press to exit from the edge edit mode. The display returns to the confirmation screen of detected edges.8. After confirming the edited edges, press to exit the confirmation screen. For data retrieved from the database, designate how to save edited data from the “Confirmation” dialog box: Overwrite button Ÿ The edited data is written over original data. (The original data will be deleted.) Addition button Ÿ The edited data is saved with a new Exam No. assigned. Cancel button Ÿ The edited data will not be saved.
  • 227. 5 - 1235.11.4 Closing gap (Close) Detected edges This tool is for closing a gap in a detected edge. close a gap1. Enter the edge edit mode. See “5.11.1 Entering edge edit mode”.2. Trace an arc range containing a break to designate it. Trace between both sides of a break in one stroke. Releasing a finger or a touch-screen pen from the panel halfway through tracing results in a designation of one side of the gap only. The arc in a designated range turns red. To deselect the designated arc, press to return it to blue.3. Press . The gap in the designated arc will be bridged by a yellow dashed line.4. Make sure that the yellow dashed arc aligns to the captured placido ring and press . The gap in the detected edge will be bridged as shown by the yellow dashed arc. Press not to close the gap.5. In the same manner, close a gap in an edge.6. Press to exit from the edge edit mode. The display returns to the confirmation screen of detected edges.7. After confirming the edited edges, press to exit the confirmation screen. For data retrieved from the database, designate how to save edited data from the “Confirmation” dialog box: Overwrite button Ÿ The edited data is written over original data. (The original data will be deleted.) Addition button Ÿ The edited data is saved with a new Exam No. assigned. Cancel button Ÿ The edited data will not be saved.
  • 228. 5 - 1245.11.5 Erasing edges (Erase) The tool is for erasing an improperly-detected edge.1. Enter the edge edit mode. See “5.11.1 Entering edge edit mode”.2. Trace to designate an edge range to be erased. The designated range turns red. To deselect a designated edge range, press to return it to blue.3. Press . The designated range turns into a yellow dashed line.4. Make sure that the yellow dashed arc is the one to be erased, and press . The yellow dashed arc will be erased. To cancel the erasing, press .5. In the same manner, erase an edge that is substantially shifted from a captured placido ring.6. Press to exit from the edge edit mode. The display returns to the confirmation screen of detected edges.7. After confirming the edited edges, press to exit the confirmation screen. For data retrieved from the database, designate how to save edited data from the “Confirmation” dialog box: Overwrite button Ÿ The edited data is written over original data. (The original data will be deleted.) Addition button Ÿ The edited data is saved with a new Exam No. assigned. Cancel button Ÿ The edited data will not be saved.
  • 229. 5 - 1255.12 Editing Detected Pupil Edge If the eyelid partially covers the pupil, the pupil edge may not be traced properly. In such a case, the tracing of the pupil edge can be corrected using the Edge Edit mode. The Edge Edit mode offers the following two functions: Move: The edge line can be moved by moving pointers on the edge line. Erase: Parts of the edge line deviated from the pupil edge can be erased. When the OK button is pressed, the erased part is compensated with a new line.5.12.1 Entering pupil edge edit mode The pupil edge can be edited during the measurement or for data from the database. The method of entering the Edge Edit mode for each case is described below. [During the measurement] If the Multiple measurement mode is not selected, the edge detection confirmation screen appears immediately after the REF and CT measurements. In this screen, the Placido ring image is displayed in the center and the thumbnails of pupils in mesopic and photopic visions are displayed at the bottom right and left of the screen. When any of these two thumbnails is pressed, the pressed thumbnail is displayed in the center of the screen. If the traced line is deviated from the pupil edge, click the Confirmation screen of a detected result button to enter the Edge Edit mode. [For data from the database] 1) Select exam data to edit from the Patient Selection screen. Then press to display the placido ring detection result confirmation screen. 2) Press the thumbnail of the pupil to display the pupil edge detection result confirmation screen. 3) Press to enter the edge edit mode. Edge edit mode NOTE • The detected pupil edge line (in photopic or mesopic vision) can be edited only when there are both the calibration file and the CT measurement data. • Calculations for maps or such are performed based on the edited placido ring edges. Be sure to edit the edges so that they are placed along the placido ring of the CT measurement image.
  • 230. 5 - 1265.12.2 Erasing edges (Erase) The tool is for erasing deviated parts of the pupil edge line.1. Enter the edge edit mode. See “5.12.1 Entering pupil edge edit mode”.2. Press . The designated range turns into a yellow dashed line.3. Trace the part to be deleted.4. Press . The traced part of the pupil edge line is erased and compensated with a new line. NOTE • Even if the entire pupil edge line is erased, a new line is drawn when is pressed.
  • 231. 5 - 1275.12.3 Moving pupil edge (Move) Parts of the pupil edge line that are deviated from the pupil edge can be moved to fit the actual pupil edge.1. Enter the edge edit mode. See “5.12.1 Entering pupil edge edit mode”.2. Press . Eight green pointers are displayed.3. Click on the pointers on the deviated part of the pupil line and move them so that the pupil edge line fits the actual pupil edge.4. When correction of the pupil edge line is finished, click .5.12.4 Finishing editing pupil edge1. When editing of the pupil edge is finished, exit the Pupil edge edit mode by pressing . The display returns to the pupil edge detection result confirmation screen.2. After confirming the edited edge, press to exit the confirmation screen. For data retrieved from the database, designate how to save edited data from the “Confirmation” dialog box: Overwrite button Ÿ The edited data is written over original data. (The original data will be deleted.) Addition button Ÿ The edited data is saved with a new Exam No. assigned. Cancel button Ÿ The edited data will not be saved.
  • 232. 5 - 1285.13 Settings The settings of parameters, date, time and automatic assignment of patient ID are explained.5.13.1 Setting parameters (Settings) Specifications related to measurement, the built-in printer, or data communication can be modified from the Settings screen. 1. Open the Settings screen. Press on the measurement screen. 2. Change the desired parameter setting. : The setting is ineffective, : The setting is effective, = Press the option button of the desired value etc. (The button is turned into ). 3. Press . The screen is switched back to the measurement screen.[Measure] Set parameters for the measurement. “Step”, “VD”, “Axis” and “Reading” can be set also under the “Other” tab in the Map View Settings screen. Step: 0.25, 0.125, 0.01 Factory setting: 0.25 [D] Set the indication increment of SPH and CYL data for AR measurement. Printed keratometry data is also based on the increment indicated. VD: 0.0, 10.5, 12.0, 13.75, 15.0, 16.5 Factory setting: 12.0 [mm] Set the vertex distance (distance between the corneal vertex to a posterior surface of a spec- tacle lens if a patient wears spectacle lenses). Axis: 1, 5 Factory setting: 1 [º] Set the Axis indication increment Reading: –, MIX, + Factory setting: – Select the reading of the cylinder power from minus cylinder ( – ), mixed (+/–), and plus cylinder ( + ) forms. For keratometry, the cylinder value is shown in the plus reading ( + ) form when the “+” radio button is selected. When the “MIX” or “–” radio button is selected, the cylinder value is shown in the minus reading ( – ) reading.
  • 233. 5 - 129AI Mode Factory setting: Checked Select the number of times of the AR measurement and REF measurement. Measurement Auto- AI Mode Number of shot during AR measurement mode shot AR/KM, AR, Until median values are obtained (S, C, A) by taking Checked/Not checked ON REF/CT, REF the median of the first 3 usable values. When the start button is pressed once, one shot of AR measurement takes place. While the start AR/KM, AR, button is held down, AR measurement takes place Checked OFF REF/CT, REF repeatedly until AR median values are obtained (S, C, A) by taking the median of the first 3 usable values. When the start button is pressed once, one shot of AR/KM, AR, AR measurement takes place. While the start Not checked OFF REF/CT, REF button is held down, AR measurement takes place repeatedly.Single Fogging Factory setting: Checked When the box is checked, fogging is kept on from the second time and after during repeated AR or REF measurements.Auto PD Factory setting: Checked Toggle the pupillary distance (PD) measurement that is automatically executed when both eyes have been measured in the AR or REF measurement. When this box is not checked, the PD will not be measured automatically; the operator can manually select the PD measurement mode with the measurement select button. (p. 5-72).KM Display: R1 R2, AVE CYL Factory setting: R1 R2 Set the display format for the simulated keratometry data obtained during KM or CT measure- ment and displayed in the measurement screen. R1 R2: Value along the flattest meridian (R1), value along the steepest meridian (R2) and axis angle of R1 AVE CYL: Average of R1 and R2 (AVE), amount of corneal astigmatism (CYL) and axis angle of R1KM Unit: mm, D Factory setting: mm Set the unit for the simulated keratometry data from KM or CT measurement displayed in the measurement screen.Multiple Factory setting: Not checked Toggle Multiple measurement mode in ARK/CT mode. Checking this box enables saving of multiple sets of data selected from multiple measurements in the database. When this boxed is not checked, lastly measured data is saved in the database. However, this box cannot be selected if the instrument is used with LAN connection to the OPD-Station.
  • 234. 5 - 130[Print] Set parameters for the built-in printer. Print Mode: Switch, Finish, None Factory setting: Switch Select the timing to start printing measurement data. Switch: Printing is started when or is pressed. Finish: Printing is started at the completion of both-eye measurement when the auto-shot func- tion is turned ON, or when the “AI Mode” box is checked. None: Measurement data is not printed. Date Format: Y.M.D, M.D.Y, D.M.Y Factory setting: M.D.Y Set the format of date printed along with the measurement data. Y.M.D: Year, Month, Day M.D.Y: Month, Day, Year D.M.Y: Day, Month, Year Print No. (ID) Factory setting: Checked Toggle printing of the ID number. Print All CT Data Factory setting: Not checked Set the printout format for the simulated KM value obtained with the CT-measurement in Multiple measurement mode. When this box is checked, all KM data and median value is printed out. If not, only KM median values (or the latest KM values if no KM median values have been obtained) are printed. Print All KM Data Factory setting: Not checked Set the printout format for the KM-measured data printed along with the ARK mode measure- ment data. When this box is checked, all the KM-measured data is printed. If not, only KM median values (or the latest KM values if no KM median values have been obtained) are printed. Print No. Factory setting: Checked Toggle printing of the patient number in the printout of the ARK mode measurement data. A serial number is printed from 1 to the number specified in the “Range.” box. EX.: If “9999” is entered in the “Range.” box, the patient number is printed from “1” to “9999”. To specify the patient number, input the desired number in the “No.” box.
  • 235. 5 - 131Print Contact Pwr. ID No. or patient No. Factory setting: Not checked Toggle printing of the CL conversion values calculated from the AR median values (or the latest AR values if there is no AR me- dian value), and the SE values calculated from the CL conversion values. Trial lens data CL conversion value and SE valuePrint Trial lens Pwr. Factory setting: Not checked Toggle display of the trial lens data calculated based on AR median values (or the latest AR values if there is no AR median value).Econo Print Factory setting: Not checked Toggle the economical printout. When the box is checked, line-spacing is narrowed to save printer paper.Print All AR Data Factory setting: Checked Select the print format of the AR measurement data. When this box is checked, all the AR measurement data is printed. When the box is not checked, only the AR median values (or the latest AR values if there is no AR median values) are printed.Print Error Factory setting: Not checked Toggle printing of the errors that occur during the AR or REF measurement. This setting is effective only when “Print All AR Data” is checked. Select the desired print format in the “Print Error Code” check box.Print Error Code Factory setting: Not checked Select the desired format for printing errors in the AR or REF measurement. If the “Print Error Code” is checked, an error code is printed as “Error 240”. If not, only “Error” is printed. This setting is effective only when “Print Error” is checked.Print PD Factory setting: Checked Toggle printing of the measured PD.Use user title Factory setting: Not checked When this box is checked, comments are printed along with the measurement data. Enter the comment in the box below.
  • 236. 5 - 132 Order: R-L, AR-KM Factory setting: R-L Set the order of data sets to be printed. Data sets are printed in the following order: R-L: AR data for the right eye, KM data for the right eye, AR data for the left eye and KM data for the left eye AR-KM: AR data for the right eye, AR data for the left eye, KM data for the right eye, KM data for the left eye Print High RMS Data Factory setting: Checked Toggle display and printing of low-confidence AR-measured data (error data). If the setting of this check box is changed during measurements, the displayed indication and the actual operation may become inconsistent. For example, even though “FINISH” is dis- played in the measurement screen, the median values are not printed.[Accommodation] The Accommodation parameters are available only when the optional Accommodation measurement function is installed. See “5.8.1 Setting accommodation stimulus”. Stimulus: -10.0 to 0.0 [D] Factory setting: 0 [D] Set the amount of the accommodation stimulus. Speed: 0.5 to 4.5 [D/sec] Factory setting: 1 [D/sec] Set the speed of the accommodation chart movement.[RS-232C] Set parameters for communication. Baud Rate: 110, 300, 600, 1200, 2400, 4800, 9600, 19200, 38400, 57600, 115200 Factory setting: 9600 [bit/sec] Set the baud rate (bit transmission speed) for communication. Press on the left side of the box. Bit Length: 7, 8 Factory setting: 8 Set the bit number for a single character used in communication. Start Bits: 1, 1.5, 2 Factory setting: 1 Set the starting bit in communication. Stop Bits: 1, 1.5, 2 Factory setting: 1 Set the stopping bit in communication.
  • 237. 5 - 133Parity: Odd (Odd number), Even (Even number), None (parity function disabled) Factory setting: Odd (Odd number) Set the parity.Send 30sec Refraction Factory setting: Checked Toggle transmission of the measurement data to other system such as the Refractor RT-5100. When this box is not checked, the AR-measured data is transmitted. Check this box to transmit more appropriate data for subjective optometry between ZS, ZC and ZA data (SPH, CYL and AXIS data obtained by Zernike polynomials within the set Zernike analysis zone) and AR-measured data. The ZS, ZC and ZA data is calculated from the average map data and AR-measured data to be transmitted is the median value. Whether the ZS, ZC, and ZA data or AR-measured data was transmitted is printed as follows: Example: **WFsent RMS0.19D@3mm** ZS, ZC, and ZA data is transmitted. RMS of AR average @3mm is RMS analysis zone Example: **ARsent RMS1.18D@3mm** AR median values are transmitted. RMS of AR average @3mm is RMS analysis zoneSend HD Exam data Factory setting: Checked Toggle transmission of both the night and day measurement data sets to other systems such as the Refractor RT-5100. When this box is not checked, only the day measurement data is transmitted. Check this box to compare the night and day measurement data sets and choose one to trans- mit to other systems such as the RT-5100. The day measurement data indicates the AR measurement data (median value) or the SPH, CYL, and AXIS (ZS, ZC, and ZA) values obtained by Zernike polynomials within the I 4mm analysis area (depending on the setting of “Send 30sec Refraction”). The night measurement data indicates the SPH, CYL, and AXIS (ZS, ZC, and ZA) values obtained by Zernike polynomials within the pupil in mesopic vision (maximum I 6mm). This setting is disabled when “NCP10” is checked.HD Exam support RT Factory setting: Not checked Check this box if the RT-5100 supports the night measurement data. The control box of the RT-5100 supports the night measurement data from V2.15. This box can be checked only when “Send HD Exam data” has been checked.Use Eye Care Card Factory setting: Not checked Check this box to write measurement data to the Eye Care card. If this box is not checked, night measurement data cannot be correctly written. This box cannot be checked if “NCP10” has been checked.
  • 238. 5 - 134Send All Data Factory setting: Not checked Set the method to transmit the measurement values via communication channels. If this param- eter is checked, all the measurement data sets are transmitted. If the parameter is not checked, only the median values (or latest values if there is no median value) is transmitted.NCP10 Factory setting: Not checked Toggle use of the NCP10 communication protocol to output data to NIDEK’s NAVIS. For other data output, uncheck this box. This setting is not effective when “Send HD Exam data” is checked.Add CR Code Factory setting: Not checked Toggle putting the CR code at the end of the data to be transmitted.
  • 239. 5 - 135[Others] The following are the other settings. As for “Cornea Index”, it is possible to specify on the Other tab of Map Settings screen. Cornea Index A: Factory setting: 1.3375 Set the corneal refractive index used in the calculation to produce the Axial and Instantaneous maps. Cornea Index R: Factory setting: 1.3760 Set the corneal refractive index used in the calculation to produce the “Refractive” and Target “Refractive” maps. To enter a cornea index A and corneal index R, press an entry field to select and type in the desired index. Auto Off: Toggle activation of Power saving mode. In addition, set the idle time for the Power saving mode. If the “Auto Off” box is checked and the idle time lapses, the instrument automatically enters Power saving mode. Factory setting: Checked, 5 (min) The idle time can be selected from 1 to 5 minutes in increments of 1 minute. In Power saving mode, the title screen is dimly displayed. To exit Power saving mode, perform any of the following operations: • Touch the screen • Press any key on the keyboard • Press the start button • Move the joystick to the left or right to switch the measuring eye side (right or left). * Depending on the screen conditions, the instrument may not be put into Power saving mode. TED Check Factory setting: Not checked Toggle checking of the obtained iris image to determine whether it can be used for the Torsion Error Detection (TED) function in refractive surgery performed using the EC-5000. R/L Format: R/L, OD/OS Factory setting: R/L Toggle the display method for the right and left eyes between “R/L” and “OD/OS”.
  • 240. 5 - 1365.13.2 Setting date and time The date and time are set on Windows.1. Call up the Windows screen. 1) Press on the Settings screen. The dialog box for encouraging the operator to confirm whether or not to exit the ARK-10000 appears. 2) Press OK .2. Call up the Control Panel window. 1) Press . 2) Press “Settings”. 3) Press “Control Panel”. The Control panel window appears.3. Press twice in rapid succession. The “Date /Time Properties” dialog box appears.4. Change the date and time, and press OK .
  • 241. 5 - 1375.13.3 Selecting whether or not to assign patient ID automatically Whether or not to automatically assign the same number with System ID as an initial Patient ID at a time of new patient entry is selected. NOTE • It is recommended to enter a patient identification number such as a carte number as the patient ID for data management over an extended period of time. Use the patient ID automatic assignment function if it is unnecessary to manage and save data. A patient ID can be changed at a later date. See “5.6.3.1 Editing patient data”.1. Open the Patient Selection screen. Press on the measurement screen.2. Open the Database Settings screen. Press .3. Press . The “Patient ID Assignment Settings” dialog box is displayed.4. Set whether or not to assign patient ID automatically. When “Auto ID assignment” is selected Ÿ An ID will automatically be assigned. An unassigned ID in the 000001 to 999999 range is automatically entered as the initial ID in the Patient ID box. At that time, the pa- tient ID is changeable. It is essential to enter a last name and first name in order to complete patient entry.
  • 242. 5 - 138 When “Manual ID assignment” is selected Ÿ An ID will not be assigned automatically. A patient ID will not be assigned auto- matically. Enter the desired value. A patient can- not be entered without entering a pa- tient ID.5. Press .
  • 243. 5 - 1395.14 Formatting Floppy Disk The ARK-10000 can also format a floppy disk used for data output. Use 3.5-inch 2HD floppy disk.1. Press on the Setting screen. The dialog box for encouraging the operator to confirm whether or not to exit the ARK-10000 appears.2. Press OK to return to the Windows screen.3. Insert a 3.5-inch 2HD floppy disk into the floppy disk drive.4. Press the “My Computer” icon twice in rapid succession. The “My computer” window appears.5. Press the “3 1/2 Floppy” icon.6. Press “File” on the menu bar. The sub-menu opens.7. Press “Format”. The “Format - 3 1/2 Floppy” dialog box appears.
  • 244. 5 - 140 8. Press Start . The message dialog box appears. 9. Press OK . Formatting of a floppy disk is started. At the completion of formatting, the “Format complete.” dialog box appears.10. Press OK . The “Format - 3 1/2 Floppy” dialog box reappears.11. Eject the floppy disk from the floppy disk drive. CAUTION • Do not eject the floppy disk while the lamp of the floppy disk drive is illuminated. Corruption of the floppy disk, or a breakdown of the floppy disk drive may result.12. Press Close . The “My computer” window reappears.13. Press × on the top right corner of the screen to close the “My computer” window.
  • 245. 5 - 141[Starting ARK-10000 program from the Windows screen] Pressing the OPD-Scan icon twice in rapid succession starts the ARK-10000 program.[Power-OFF from the Windows screen] 1) Press on the lower left corner of the screen. The sub-menu appears. 2) Press the “Shut Down” option. The “Shut Down Windows” dialog box appears. 3) Make sure that the “Shut down” option is selected. 4) Press OK . After a while, the power switch is automatically turned OFF.
  • 246. 5 - 1425.15 Transmitting Data to Refractor Through Cable When the ARK-10000 is connected to the Refractor RT-5100 or such in the same way as connecting the NIDEK AR or ARK series, measurement data obtained with the ARK-10000 can be transmitted to the connected refractor to be used as objective data. With the refractor, subjective measurement can be performed based on the objective data imported from the ARK-10000. With the ARK-10000, measurement data transmitted to a refractor can be selected from the following four types: · AR median value (Day measurement data) · SPH, CYL, AXIS (ZS, ZC, ZA) values (Day measurement data) calculated with a Zernike polynomial · AR median value (Day measurement data) and SPH, CYL, AXIS (ZS, ZC, ZA) values (Night measurement data) calculated with a Zernike polynomial · SPH, CYL, AXIS (ZS, ZC, ZA) values (Day and night measurement data) calculated with a Zernike polynomial The type of measurement data to be transmitted is specified with parameters in the Settings screen. See “5.13.1 Setting parameters (Settings)” (p.5-128). Data to be transmitted Parameters AR median value (Day measurement data) ZS, ZC, ZA values (Day measurement data) AR median value (Day measurement data) ZS, ZC, ZA value (Night measurement data) ZS, ZC, ZA values (Day and night measurement data) *1 If the control box of the Refractor RT-5100 is V2.15 or later, check “HD Exam support RT” as well. * Day measurement data is measurement data based on which the refractive power of glasses used in bright environments is measured. Night measurement data is measurement data based on which the refractive power of glasses used in dark environments is measured. The ZS, ZC, and ZA values are calculated in a 4 mm-diameter area for day measurement data, and in a 6 mm-diameter area for night measurement data. NOTE • Connect the interface cable from the refractor to the COM connector of the ARK-10000. By using an Eye Care card (IC card), data obtained with the ARK-10000 can be exported to the refractor. For details, see “5.16 Exporting Data to Refractor Using Eye Care Card” (p.5-146).
  • 247. 5 - 1435.15.1 Transmitting day measurement data With the ARK-10000, an AR median value or a set of SPH, CYL, and AXIS (ZS, ZC, and ZA) values obtained with the Zernike polynomial can be transmitted to the Refractor RT-5100 or such. The ZS, ZC, and ZA values for day measurement data are calculated in a 4 mm-diameter area. To transmit the ZS, ZC, and ZA values, “Send 30sec Refraction” needs to be checked beforehand in the Settings screen. For details, see “5.13.1 Setting parameters (Settings)” (p.5-128).1. Perform the measurement. Perform the measurement to export the data. When exporting the ZS, ZC, and ZA data, be sure to perform the measurement in ARK/CT mode (Perform CT measurement if necessary).2. Press or . Patient ID When the Select Patient dialog box is displayed, Data No.: enter patient data and press . Used to call up the data The measurement values are printed and with the refractor transmitted to the refractor. AR median values Settings of the zone to be analyzed and analysis order ZS, ZC and ZA data Trial lens (TL) data calculated from ZS, ZC and ZA data (In increments of 0.25 D) Contact lens (CL) conversion data calculated from ZS, ZC, and ZA data (VD=0) ZS, ZC, and ZA data or AR median values which were transmitted to the refractor, and the RMS are printed. WFsent: ZS, ZC, and ZA ARsent: AR median values In the case of ARsent, the TL and CL values are calculated from the AR median values.* The TL and CL data are printed out according to the corresponding parameter settings. NOTE • Even if “Send 30sec Refraction” is checked, in case the irregular astigmatism is large or the difference between the ZS, ZC, and ZA values and the AR average is large, the AR median value is transmitted instead of the ZS, ZC and ZA values. In this case, the letters “ARsent” is printed to indicate that the AR median values was transmitted. The TL and CL values are also calculated from the AR median values. • Also in the Multiple measurement mode, ZS, ZC and ZA data and AR median values are calculated from all REF measurement data, not from selected data.
  • 248. 5 - 1445.15.2 Transmitting night measurement data as well When transmitting objective data from the ARK-10000 to the Refractor RT-5100 or such, night measurement data can be transmitted as well. Night measurement data is the SPH, CYL, and AXIS (ZS, ZC, and ZA) values obtained with a Zernike polynomial within a 6 mm-diameter area. To transmit night measurement data, “Send HD Exam Data” needs to be checked beforehand in the Settings screen. In addition, if the control box of the Refractor RT-5100 is V2.15 or later, check “HD Exam support RT”. For details, see “5.13.1 Setting parameters (Settings)” (p.5-128). To transmit night measurement data in addition to day measurement data, perform the procedure described below.1. Measure eyes in the ARK/CT mode (Perform the CT measurement if necessary).2. Press or .3. If the Select Patient screen is displayed, input the patient data and press the OK button.4. Confirm the contents of the HD EYE EXAM dialog box that appears. If the difference ( ) in the absolute values of night ( ) and day ( ) measurement data is large, those values are shown in red. In such a case, transmitting both night and day measurement data is recommended. Dialog box for when AR median value is transmitted as day measurement data Dialog box for when ZS, ZC, and ZA values are transmitted as day measurement data
  • 249. 5 - 1455. To transmit the night measurement data as well as the day measurement data to the connected refractor, press the “Send both data” button. To not to transmit the night measurement data, press the “Send upper data only” button. In this case, only the day measurement data is transmitted. The measurement values are printed by the built-in printer and transmitted to the connected refractor. Data No. (Day and night measurement data) Used to call up the data from the refractor. If “HD Exam support RT” is checked, “Data No. for RT: ****” is printed (**** is the data No.). Night measurement data @ Analysis area, Analysis order ZS, ZC, and ZA NOTE • Even if the measurement was performed in Multiple Measurement mode, the ZS, ZC, and ZA values are calculated from all the REF measurement data sets, not from the selected ones.
  • 250. 5 - 1465.16 Exporting Data to Refractor Using Eye Care Card In the same way as the NIDEK AR or ARK series, measurement data obtained with the ARK-10000 can be exported to the refractor such as the RT-5100 via the Eye Care card (IC card) (optional Eye Care card system, EyeCa-RW2, is required). With the refractor, the subjective measurement can be performed based on the data imported from the ARK-10000. With the ARK-10000, measurement data exported to the Eye Care card can be selected from the following four types: · AR median value (Day measurement data) · SPH, CYL, AXIS (ZS, ZC, ZA) values (Day measurement data) calculated with a Zernike polynomial · AR median value (Day measurement data) and SPH, CYL, AXIS (ZS, ZC, ZA) values (Night measurement data) calculated with a Zernike polynomial · SPH, CYL, AXIS (ZS, ZC, ZA) values (Day and night measurement data) calculated with a Zernike polynomial The type of measurement data to be transmitted is specified with parameters in the Settings screen. See “5.13.1 Setting parameters (Settings)” (p.5-128). Data to be transmitted Parameters AR median value (Day measurement data) ZS, ZC, ZA values (Day measurement data) AR median value (Day measurement data) ZS, ZC, ZA value (Night measurement data) ZS, ZC, ZA values (Day and night measurement data) * Day measurement data is measurement data based on which the refractive power of glasses used in bright environments is measured. Night measurement data is measurement data based on which the refractive power of glasses used in dark environments is measured. The ZS, ZC, and ZA values area calculated in a 4 mm-diameter area for day measurement data, and in a 6 mm-diameter area for night measurement data. NOTE • Connect the cable from the Eye Care card system, EyeCa-RW2, to the COM connector of the ARK-10000. Set the DIP switch 1, 2, and 4 of the EyeCa-RW2 to OFF, and 3 and 5 to ON.
  • 251. 5 - 1475.16.1 Exporting day measurement data With the ARK-10000, an AR median value or a set of SPH, CYL, and AXIS (ZS, ZC, and ZA) values obtained with the Zernike polynomial can be exported to the Refractor RT-5100 or such via the Eye Care card. The ZS, ZC, and ZA values for day measurement data are calculated in a 4 mm-diameter area. To transmit the ZS, ZC, and ZA values, “Send 30sec Refraction” needs to be checked beforehand in the Settings screen. For details, see “5.13.1 Setting parameters (Settings)” (p.5-128).1. Insert the Eye Care card into the Eye Care Access lamp Eye Care card system card system, EyeCa-RW2, which is connected EyeCa-RW2 the ARK-10000.2. Perform the measurement. Perform the measurement to export the data. When exporting the ZS, ZC, and ZA data, be sure to perform the measurement in ARK/CT mode (Perform CT measurement if necessary). Eye Care card3. Press or . Patient ID When the Select Patient dialog box is displayed, enter patient data and press . Measured data including ZS, ZC and ZA data is printed out from the built-in printer and written to the Eye Care card. AR median values Settings of the zone to be analyzed and analysis order ZS, ZC and ZA data Trial lens (TL) data calculated from ZS, ZC and ZA data (In increments of 0.25 D) Contact lens (CL) conversion data calculated from ZS, ZC, and ZA data (VD=0) ZS, ZC, and ZA data or AR median values which were transmitted to the refractor, and the RMS are printed. WFsent: ZS, ZC, and ZA ARsent: AR median values In the case of ARsent, the TL and CL values are calculated from the AR median values.* The TL and CL data are printed out according to the corresponding parameter settings.
  • 252. 5 - 1484. When the buzzer sounds once and the EyeCa-RW2 access lamp begins to blink slowly in green, remove the Eye Care card. NOTE • Even if “Send 30sec Refraction” is checked, in case the irregular astigmatism is large or the difference between the ZS, ZC, and ZA values and the AR average is large, the AR median value is written instead of the ZS, ZC and ZA values. In this case, the letters “ARsent” is printed to indicate that the AR median values was written. The TL and CL values are also calculated from the AR median values. • Also in the Multiple measurement mode, ZS, ZC and ZA data and AR median values are calculated from all REF measurement data, not from selected data.
  • 253. 5 - 1495.16.2 Exporting night measurement data as well When writing measurement data from the ARK-10000 to the Eye Care card to be read with the Refractor RT-5100 or such, night measurement data can be written as well (on the condition that the Refractor RT-5100 control box is V2.15 or later and the EyeCa-RW2 is V1.01 or later). Night measurement data is the SPH, CYL, and AXIS (ZS, ZC, and ZA) values obtained with a Zernike polynomial within a 6 mm-diameter area. To write night measurement data, “Send HD Exam Data” and “Use Eye Care Card” need to be checked beforehand in the Settings screen. For details, see “5.13.1 Setting parameters (Settings)” (p.5-128). To transmit night measurement data in addition to day measurement data, perform the procedure described below.1. Insert the Eye Care card into the Eye Care card system, EyeCa-RW2, which is connected to the ARK-10000.2. Perform the measurement in ARK/CT mode (Perform the CT measurement if necessary).3. Press or . When the Select Patient dialog box is displayed, enter patient data and press .4. Confirm the contents of the HD EYE EXAM dialog box. If the absolute value ( ) of the difference between the night ( ) and day ( ) measurement data is large, it is displayed in red. In such a case, it is recommended to write both night and day measurement data to the Eye Care card. Dialog box for when AR median value is transmitted as day measurement data Dialog box for when ZS, ZC, and ZA values are transmitted as day measurement data
  • 254. 5 - 1505. To write night measurement data to the Eye Care card, press the “Send both data” button. To not to write night measurement data, press the “Send upper data only” button. In this case, only day measurement data is written to the Eye Care card. The measurement values are printed by the built-in printer and written to the Eye Care card. Night measurement data @ Analysis area, Analysis order ZS, ZC, and ZA6. When the buzzer sounds once and the EyeCa-RW2 access lamp begins to blink slowly in green, remove the Eye Care card. NOTE • Even if the measurement was performed in Multiple Measurement mode, the ZS, ZC, and ZA values are calculated from all the REF measurement data sets, not from the selected ones. • If “Use Eye Care Card” is not checked in the Settings screen, measurement data cannot be correctly written.
  • 255. §6 TROUBLESHOOTING GUIDEIn the event that the instrument is out of working order, try to correct a problem according to thefollowing table before asking for assistance. Symptom Suggestion • The power cord may not be connected securely. Reconnect it securely. • The power switch may not have been turned ON. Check the power switch.Nothing appears on the touch-screen panel. • The fuses may be blown. If so, replace the fuses with new ones. • Display settings may accidentally be changed because of malfunctioning of the built-in computer board. Contact NIDEK or your authorized distributor for details. • The locking knob may be fixing the main body. Loosen the locking knob which is beside the joystick.The main body cannot be moved laterally. • The locking knob may be impeding the main body. Loosen the locking knob which is beside the joystick. • Check the printer paper. If the paper is out, replace with a new printer roll.The internal printer does not work. • “Print Mode” parameter may be set to “None”. Reset the parameter.The paper is fed, however, no characters are • The printer paper roll may be set with the wrongprinted on the paper. side up. Set it with the correct side up.
  • 256. 6-2 Symptom Suggestion • The auto-tracking button may not be on. Turn on the tracking function. • The auto-shot button may not be on. Turn on the auto-shot function. • Light such as from room illumination may be reflecting on the cornea. Change the location and try again. • The auto-tracking function or auto-shot function does not work on some eyes such as keratoconus or recently operated corneas. In such cases, turn off the auto-tracing function to perform Auto-tracking function or auto-shot function measurement. does not work. • For the patient who has substantial ocular ataxia or who cannot fixate his/her eyes, there are cases when the auto-tracking function or auto-shot function does not work. In such cases, turn off the auto-tracking function and start measurement. • If the instrument is installed in the vicinity of a window where the instrument is exposed to sunshine, light interference may adversely affect these functions. Change the installed location of the instrument and perform measurement again. “INVALID DATA” shown in the “Result” box • A mismatched item was found. Contact NIDEK on the Import (Outside To Inside) screen or your authorized distributor. prohibits an import of external data into the database.
  • 257. 6-3 Symptom Suggestion • The patient may have blinked during measurement. Instruct the patient not to blink, and try again. • The eyelid or eyelashes may be obstructing the measurement. Instruct the patient to open their eye wide.“Err code” appears on the touch-screen panel. • The pupil may be too small for measurement. Let the patient be in a dark room for a while until the pupil dilates enough, and try again. • The data may have exceeded the measurable limit. • Restart the ARK-10000. 1) Simultaneously press the “Ctrl” key, “Alt” key and “Delete” key on the keyboard. The “Windows Security” dialog box appears. 2) Press the “Task Manager” button. The Windows Task Manager dialog box appears. 3) Press the Process tab. 4) Select “Rk3awin.exe”.Buttons are inoperative. 5) Press the “End Process” button. 6) Press the Yes button. The ARK-10000 is shut down. 7) Press the x button on top right corner of the screen to close the Windows Task Manager screen. 8) Restart the ARK-10000 by pressing the icon twice.* If the problem cannot be solved by following the suggestions above, contact your authorized distributor. In such cases, let your authorized distributor know the serial number of your instrument and software version. The serial number is printed on the nameplate affixed to the right side of the instrument. The software version is shown on the title bar of the measurement screen.* If an external device is connected to the ARK-10000, perform the setup correctly following the user’s manual for the external device.
  • 258. §7 MAINTENANCE7.1 Replacing Roll of Printer Paper When a red line appears on a side of the printer paper, it means that the paper is running short. In such cases, stop using the printer and replace the roll with a new one. NOTE • Do not run the printer without paper. It ruins the printer head. • Do not pull the paper in the printer forcefully. This may cause a malfunction of the printer.1. Take off the printer cover. Lug Tilt the printer cover toward the front to remove while holding the lug down. Printer cover2. Flip down the lever on the right side, and turn the gear backward to rewind the paper.3. Take out the old paper roll, and take the shaft out of the roll.4. Insert the shaft into a new printer roll. Gear Lever5. Cut the end of the paper with a pair of scissors, and then pass it through the printer as shown below. After inserting the paper through the paper outlet, turn the gear forward to feed the paper. Paper outlet Shaft
  • 259. 7-2 NOTE • If the roll is set in such a way that the paper is upside down, data cannot be printed on the paper. Lever6. Set the roll inside the printer.7. Flip up the lever on the right side.8. Reattach the printer cover. Fit the bottom side of the cover first.
  • 260. 7-37.2 Attaching Stack of Chinrest Paper1. Pull out the two fixing pins from the chin rest.2. Take out the proper amount of chin rest paper from a whole stack. It is impossible to fix a whole stack of chin rest paper at a time. Be sure to fix the stack with a thickness of 6mm or less. Pay attention not to scatter the chin rest papers.3. Insert the fixing pins into the holes in the paper. Fixing pin Insert the removed pins into both holes of the stack. Pad of chin rest paper4. Fix the stack of chin rest paper onto the chin rest. 1) Insert a pin into a hole in the chin rest while holding both fixing pins and the stack of paper. 2) Push the remaining pin into the other hole of the chin rest with your other hand.
  • 261. 7-47.3 Replacing Fuses If the instrument does not work even though the power switch is ON, fuses may be burnt out. In such cases, replace them. CAUTION • Use a specified fuse only: Fuse rating: T 1A 250V Use of fuses other than the specified one may cause a fire.1. Turn off the power. Spare fuses are provided on the reverse side of the printer cover.2. Unplug the power cord from the power inlet. CAUTION • Before a replacement of fuses, turn OFF the power and disconnect the power cord from the outlet. An electric shock may result.3. Pull out the fuse holders. Pull out the fuse holder while pushing both sides of the fuse holder with thin screwdrivers to release the fixing clips. Power cord CAUTION • The fuse holder is also used as a voltage selector. Be careful not to change the numbers indicated in the voltage indication window. If the voltage setting does not match the supplied mains voltage, this may cause Fuse a fire or malfunction. Fuse holder Voltage indication window
  • 262. 7-54. Replace the fuses with the new ones and fit the fuse holder back into the original position. CAUTION • If the fuses frequently blow out, do not touch the internal structure of the instrument, but contact your authorized distributor. Touching the inner structure of the instrument may result in electric shock.7.4 Checking Measurement Accuracy It is strongly recommended to check both REF and CT measurement accuracies at least once a day. To check a measurement accuracy, use the provided model eye.1. Mount the provided model eye onto the chin rest. Fix the model eye so that the pins of the chin rest are inserted deeply into the holes of the model eye base. Model eye Pins2. Set the “Step” parameter in the “Measure” area on the Settings screen to 0.01.3. “REF- and CT-measure” the model eye in the ARK/CT mode and print the measured results. Compare the values with the marked values on the model eye. If a difference between the marked values on the model eye, and measured results is large, measure the model eye again after confirming that “Step” parameter is set to 0.01, and the model eye is Sample printout properly mounted. If the difference in Auto Refraction-measured values is 0.25D or greater, contact NIDEK or your authorized distributor. If a difference in KM values is 0.03mm or greater, perform the calibration for CT measurement. See “7.5 CT Measurement Calibration”.
  • 263. 7-67.5 CT Measurement Calibration If the difference between the marked keratometry values on a model eye, and KM-measured values is 0.03mm or greater, perform CT measurement calibration. 1. Open the Settings screen. Press on the measurement screen. 2. Open the Select Calibration Menu screen. Press . 3. Open the screen for CT measurement calibration. Press . 4. Mount the provided model eye. See “7.4 Checking Measurement Accuracy”. 5. Bring the model eye into focus and measure the provided model eye. The confirmation screen for the captured image is displayed. 6. Check the captured image and detected ring edges. If the they are satisfactory, press . The confirmation screen for the captured image is displayed again. If the captured image and detected edges are not satisfactory, press . Perform the CT measurement again. 7. Check the detected ring edges. If they are satisfactory, press . Be sure to check the detected ring edge because they are different from the ring edges detected in Step 6. If the detected edges are not satisfactory, press . Perform the CT measurement again. 8. In the same manner as Step 5 to Step 7, perform measurements four times additionally (five times in total). 9. Press . Calibration is started, and the screen returns to the Select Calibration Menu screen.10. Press . The screen returns to the Settings screen.
  • 264. 7-711. Press . The “Exit” confirmation dialog box is displayed.12. Press OK to go back to the Windows screen.13. Press the icon of “OPD-Scan” twice in succession to restart the ARK-10000.14. Measure the model eye again and confirm that the difference between the obtained keratometry value and the marked value is 0.02 mm or less. CAUTION • If the difference in AR-measured data is 0.25D or larger, contact NIDEK or your authorized distributor. Only properly-trained service persons at NIDEK are licensed to perform REF measurement calibration. The REF measurement calibration needs special tools. Touching the calibration screen for the REF measurement inadvertently may interfere with a proper measurement.7.6 Cleaning Exterior When the covers or panels get dirty, wipe with a dry and soft cloth. For stubborn dirt, immerse the cloth in a neutral detergent, wring well, and wipe. Lastly, wipe with a dry and soft cloth. NOTE • Never use organic solvents such as a thinner, or detergents with abrasives to clean the covers, touch-screen panel, and placido rings. The covers, or touch-screen panel may be corroded or scratched. Especially, cleaning of placido rings with organic solvents or detergents with abrasives will disturb the concentric ring shapes, which may adversely affect measurement accuracy. • If the touch-screen panel is getting dirty, immerse a soft cloth or gauze in water, wring it well, and wipe the panel with it. • Blow the dust off the placido rings with a blower. Careless wiping may disturb the concentric ring shapes, and may adversely affect measurement.
  • 265. 7-87.7 Cleaning Measurement Window When the measuring window gets fingerprints or dust on it, the reliability of measured values will be lowered substantially. Check the measuring window for dirt before use, and then clean it if it is dirty.1. Blow off the dust on the measuring window with a blower.2. Wrap a sheet of lens cleaning paper around a thin stick such as a chopstick (or cotton swab) and wipe the glass of the measuring window with the paper dampened with alcohol. Use a stick which will not damage the glass. (Never use hard objects such as a metal product.) Wipe the measuring window lightly from center Wrap cleaning paper around the tip. to outside along an arc. Measuring window Pay attention not to get alcohol on covers etc.3. Check if the window is cleaned using a penlight. If not, clean it again with a sheet of new cleaning paper. Expose the measuring window to the light of a penlight and change the viewing angle to properly check for dirt.7.8 List of Parts for Replacement Article Order Number Printer roll 806-20-00001 Chinrest paper 32903-M047 Fuse T 1A 250V: 804-02-02113
  • 266. §8 DISINFECTING PROCEDURESPurpose The purpose of this procedure is to establish a consistent method by which users may clean and disinfect the patient contact surfaces of the OPD-ScanTM unit and to assist the users in establishing a routine for disinfection that will reduce the potential of cross infection.Materials Required • Disinfecting agent such as an anti-germicide or isopropyl alcohol (IPA). • Cloth or cleaning towelsProcedures 1. Locate the patient browrest on the OPD-ScanTM device. 2. Soak the cleaning cloth or towel in disinfecting agent and wipe the surfaces that come in contact with the patient. 3. Locate the patient chinrest on the OPD-ScanTM device. 4. Take the cleaning cloth used in the previous step and wipe the exposed surfaces of the chin rest. 5. Repeat this procedure following each exam.
  • 267. §9 SPECIFICATIONSAR/REF measurement (Objective measurement of refractive power) • Measurable range Spherical power: –20.00 D to + 22.00 D (VD=12 mm) Cylindrical power: 0 D to ± 12.00 D Cylinder axis angle: 0º to 180º This device conforms to “ISO 10342: 2003, Ophthalmic Instruments. Eye Refractometers”. Measurement accuracies required in ISO 10342: 2003 are as follows: Criterion Measuring range Maximum scale Test devicea Tolerance interval -15D to +15D 0D, ±5,±10D ±0.25D Spherical vertex power (Maximum meridional 0.25D vertex power) 0D to 6D ±0.25D Cylindrical vertex power 0D to 6D 0.25D Sph: approx. 0 D ±0.25D Cyl: -3D Cylinder axisb for 0° to 180° 1° Axis: 0°, 90° ±5° cylinder power a...The refractive error of the test device shall not differ by more than 1.0 D form the nomical value above. b...Cylinder axis shall be indicated as specified in ISO 8429. • Indication step Refractive power 0.01 D / 0.12 D / 0.25 D Axis angle 1º /5º • Vertex distance 0 mm / 10.5 mm / 12 mm / 13.75 mm / 15 mm / 16.5 mm • Minimum pupil diameter measurable 2.6 mm diameter • Relaxation of accommodating eye Auto-fogging system • Measuring time (single eye) 0.4 seconds or less • Chart type Scenery chartKM measurement (Corneal curvature radius measurement) • Measurable range Corneal curvature radius (R1, R2, AVE) 5.0 mm to 10.00 mm Accuracy: ± 0.05 mm Corneal refractive power (R1, R2, AVE) 33.75 D to 67.50 D Corneal astigmatism (C) 0 D to ± 12.00 D Cylinder axis angle of corneal astigmatism 0º to 180º • Indication step Corenal curvature radius (R1, R2, AVE) 0.01 mm Refractive power 0.01D, 0.12 D, 0.25 D Axis angle 1º, 5º • KM measurement range 3 mm diameter on cornea (when the corneal curvature radius is 7.9 mm)
  • 268. 9-2CT measurement (Corneal shape measurement) • Measurable range Corneal refractive power10 D to 100 D (n= 1.3375) (Corneal curvature radius) (3.38 mm to 33.75 mm) [Accuracy] ± 0.05 mm (under all the conditions) • Number of placido ring 19 edges (9 rings × 2, Innermost circle) or more • Corneal diameter to be measured Maximum diameter 11 mm dia. (Corneal curvature radius, r = 7.9 mm) Minimum diameter 0.5 mm dia. (Corneal curvature radius, r = 7.9 mm) • Measuring point 6,840 (19 × 360) points or morePupillary distance measurement • Measurable range 30 mm to 85 mm • Measurement increment 1 mmAlignment method • Working range of measuring unit Back and forth (manual): 29 mm Left and right (manual): 85 mm Up and down (motorized): 28 mm • Working range of auto-alignment Up, down, left and right: 4 mm dia. on cornea Back and forth (Focusing direction): ± 2 mmAlignment observation and measurement indication • Observation area 14 mm × 8 mm • Alignment observation method 10.4-inch TFT Color LCD (640 × 480)Analysis and items on display Map type Axial/Instantaneous/”Refractive”/OPD/Difference/ Target “Refractive”/Internal OPD/Elevation/Eye Image/ TopoClassifier/Wavefront High Order/Wavefront Total/ Wavefront Group/Zernike graph Index AR-measured data (SPH, CYL/AXIS), SimK (Steep/Flat/Delta), e, Q, photopic pupil diameter, mesopic pupil diameter, distance between the photopic and mesopic pupil centers, direction
  • 269. 9-3Recording method 58 mm high-speed thermal line printer (Built-in printer: Auto Refraction- and KM-measured data)Storage FDD (2 mode), HDD (Built into the main body)Data import/export RS232C, Ethernet, USBDimensions and mass Dimensions 290 (W) × 520 (H) × 524 (D) mm Mass 25 kgPower source Power source AC 200-220V/230-240V 170VA 50/60 Hz * The power source is factory-configured.Environmental conditions (In transport and storage) • Temperature –20 to 60 ºC • Humidity 10 to 95 % (Non-condensing)Environmental conditions (In use) • Temperature 10 to 35 ºC • Humidity 30 to 75 % (Non-condensing)Service life 8 years from the date of initial operation * Proper maintenance is necessary.
  • 270. §10 ACCESSORIES10.1 Standard Accessories Spare fuses 2 Spare printer paper roll 3 rolls Power cord 1 Dust cover 1 Keyboard 1 Touch-screen pen 1 Model eye 1 Chin rest paper 1 stack Operator’s Manual 1 copy Configuration disk 1*2010.2 Optional Accessories External storage device OPD-Station software IOL-Station software Corneal Navigator software * Provide a color printer by yourself or ask your authorized distributor for a printer. Recommended printer: DeskJet 5550 series, Hewlett-Packard*20 Keep the configuration disk with care because the disk includes unique information to your ARK- 10000 unit such as calibration data.
  • 271. APPENDIX. A GLOSSARY The following terms are used to help you to understand the contents of this manual. Before reading this manual, read thoroughly and understand the following. • Accommodation measurement function (optional) The distribution of refractive power is measured in far vision (without accommodation) and near vision (with specified accommodation stimulus). • AR Measurement Fundus is scanned with slit-shaped ray bundles and measured in increments of 1º in the 2.6 mm zone. AR- measured data is obtained. • AR median values The median values of the first 3 usable values taken during AR-measured values and put in order in a computer. • AR values One of the measured values (SPH, CYL, AXIS) obtained during AR or REF measurement which is equal to values obtained by an auto refractometer. This represents the refractive status of an approximate center of the eye. • Auto-shot A function with which the instrument automatically starts a serial measurement as soon as the instrument is best aligned and in ideal focus. • Auto-tracking A function with which the instrument automatically controls the up, down, right, and left movements and focusing of the measuring unit. • Chart The picture of balloon that can be seen by looking into the measuring window. • Contact lens conversion value The value that the AR median values (or the latest values when the median values have not been obtained) are converted into CL values, letting the vertex distance (VD) be 0mm. • CT measurement The projected placido rings on the cornea are captured, analyzed, and a map is obtained which represents the corneal curvature and distribution of refractive powers. • KM measurement A placido ring image projected over the cornea is captured. The captured image is analyzed and corneal curvature radius in the 3 mm dia. zone on cornea, the direction of the steepest meridian and corneal astigmatism are obtained. • Limit Mark “LIMIT” sign and an arrow which represent a direction appear on the touch-screen panel when the alignment light goes out of the working range of the auto-tracking. • PD Abbreviation of “Pupil Distance” which is the width between the right and left pupils.
  • 272. A-2• Power saving mode If there is no operation for more than a set number of minutes of latent operation, a dimmed title screen appears, which is the power-saving status of the instrument. Touch the touch-screen panel or the keyboard to exit the power saving mode and return to normal mode.• PSF Abbreviation of Point Spread Function. This function simulates what kind of image is formed on the retina when the patent looks at a point source of light like a star.• Q value A value which is referred to when selecting a contact lens. This represents asphericity of the cornea.• REF measurement AR-measured data and OPD map are obtained by scanning the fundus with slit-shaped ray bundles and measuring it in increments of 1º in the 2 mm to 6 mm zone that is divided into 4.• Trial Lens Data Data where the AR median values (or the latest values when the median values have not been obtained) are examined and indicated by a cylindrical value (cylinder reading direction) which would make a spherical trial lens have a lower power for convenience.• Vertex Distance The distance between a corneal vertex to the posterior surface of the spectacle lens.• Wavefront Contact Lens measurement function (optional) This function is for measurement for the Definition Wavetouch soft contact lens manufactured by Optical Connection. Inc. The REF measurement is performed for the patient’s eye wearing a trial contact lens, wavefront analysis of the result is performed, and the data for the Definition Wavetouch soft contact lens is calculated.
  • 273. APPENDIX. B INSTALLATION CAUTION • To carry the instrument to another location, its base should be held on both sides. (Never hold the forehead rest, main body, or measuring unit.) If a part other than the base is held, an injury or failure of the instrument may result. • Install the instrument in the locations instructed in “2.1 Storage, Transportation and Installation”. • It is recommended to install the instrument in a dimly lit room to minimize the adverse effect on AR measurement which is caused by miosis .Installation procedure 1. If the keyboard, mouse or color printer is ready, connect them to corresponding connectors. (See p. 3-2.) 2. Connect the power cord between the power inlet on the lower right side of the instrument, and a (HOSPITAL GRADE) wall outlet. 3. Turn ON the power switch and confirm that the instrument is powered. 4. Measure the provided model eye. See “7.4 Checking Measurement Accuracy”.
  • 274. APPENDIX. C OBTAINING RELIABLE EXAM DATAIMPORTANT!! Read the following information before using the instrument for the first time. To obtain reliable measured data using the ARK-10000, pay attention to the following to : Until you get accustomed to the joystick manipulation, it is recommended to turn OFF the auto-shot function and start measurement by pressing the start button on the joystick. When the auto-shot function is turned ON (See p.4-10 and p.4-24.), a measurement error such as “a measurement took place when the patient blinked” may occur. This is because measurement takes place automatically regardless of an operator’s intention if the auto-shot function is ON. A quick measurement without straining the patient’s eye is an important tip to obtain reliable measured results. When not using the auto-shot function, the timing of pressing the start button on the joystick is: Misalignment in up-and-down and right-and-left directions (See p.4-10 and p 4-23.) Ÿ Up to half of an alignment light going out of the target is acceptable. Misalignment in forward and backward directions (See p.4-10 and p. 4-23.) Ÿ Up to two bars including the middle bar of the focusing indicator is acceptable. If you try to align the measuring unit too precisely, the reliability of obtained results will lower. This is because an excessively precise alignment requires longer aligning time and may induce a shift of the patient’s visual axis, dry cornea, or excess tears. Prior to measurement, explain as below to relieve the patient’s tension and prevent an excess reaction to an accidental flash of the placido during KM or CT measurement: 1) After having the patient place his/her forehead on the forehead rest and his/her chin on the chin rest, instruct as: “You will see a red balloon inside. Gaze at it during measurement.” “During measurement, the rings in front of you will flash. Keep looking at the inside of the measuring window.” 2) After rough alignment of the measuring unit, instruct as: “First, slowly blink your eyes once or twice.” 3) After making sure that the patient has blinked, instruct as: “Open your eye wide and keep looking at the red balloon inside.” 4) Make quick alignment and focusing of the measuring unit and press the start button of the joystick. 5) During the measurement, observe the measuring eye on the panel. If the eye substantially moved, make the measuring unit follow the movement of the eye by manipulating the joystick. 6) After AR (or REF) measurement and before performing KM (or CT) measurement, instruct as: “Slowly blink your eyes once or twice.” 7) After both AR and KM measurements (or REF and CT measurements) have been completed, and the “Edge Detection” dialog box appears, say, “Thank you very much for your cooperation. Now you may blink”. However, to obtain reliable PD (Pupillary Distance) data, do not allow the patient to move his/her face until the measurement of both eyes has been completed since the PD is obtained during both-eye measurement.
  • 275. C-2The following sign displayed in the measured value display area on the LCD during AR orREF measurement indicates that the reliability of the data is low. Re-measure the eye. S C A – 1.25 – 4.25 170EOnly when the same sign always appears after repeating measurement several times, use the dataas “reference” data. (See “OPD-Scan Error Message Table” on p.C-4.) Just after CT measurement, the placido-ring image projected on the patient’s cornea is displayed posterior to the “Edge Detection” dialog box. Check the captured placido-ring image. (See p.4-26.)The concentric ring image may appear “distorted” or may appear to have “irregular breaks”because of insufficient tears by continuous opening of the eye or excess tears just after blinking.Do not analyze such an image; Delete it by pressing on the edge detection confirmationscreen and retry CT measurement. * When retrying CT measurement, the “Placido Intensity” dialog box is displayed. (See p.4-26.) The “Placido Intensity” dialog box should be used for an eye with a light-colored iris such as a blue eye which reflects a large amount of light. Temporarily lower the placido illumination intensity to improve the contrast of the placido-ring image. For an ordinary retry, set “Placido Intensity” to “100”.During operation, an error number such as “Err200” may appear on the screen. In addition,an error number may appear according to the measured results. When an unfamiliarerror number or message appears, see “OPD-Scan Error Number Table” and “OPD-ScanError Message Table” on page.If the pupil size is less than 6 mm in diameter, the periphery may be unnaturally colored inred or blue on the OPD map. These red or blue noises do not represent correct measureddata. In such cases, check the map for the distance of the noises from the center and forthe followings: 1. If the red or blue noises are present within 5 mm in diameter from the map center, Sphere, Cylinder and Axis data in the 5 mm zone on the OPD map is adversely affected by the noises and therefore, the reliability of the data is low. 2. There is a possibility where the reliability of Noises numerical data (WF error, ZS, ZC, ZA) on the Wavefront High Order map, Wavefront Group map, Wavefront Total map, and data on the Zernike graph may be lower. In such cases, it is recommended to decrease the Zone value to exclude the noises from the area to be analyzed. Before starting CT or KM measurement, instruct the patient not to move his or her eyes.A CCD camera that captures 30 frames per second is used for CT and KM measurements.However, it has been verified that the motion of the eyes during measurement causes the capturedimage to blur, and this lowers the measurement accuracy.As this Operator’s Manual includes various instructions, read the manual when turningON or OFF the instrument, saving patient data, measuring eyes and printing measureddata for the first time. Use the instrument safely and properly as instructed in this Manual.
  • 276. C-3OPD-Scan Error Number Table Error No. Content Solution Turn OFF the instrument once and turn it ON again. If the 0 Hardware error same error No. still appears, contact your authorized distributor. 200 - 201 As above As above 220 As above As above 230 - 231 As above As above As above As above Measure the same eye or the attached model eye. If the 240 As above same error No. still appears, contact your authorized distributor. Shut the instrument down once. If the same error No. still 300 As above appears, contact your authorized distributor. Measure the same eye or the attached model eye. If the 311 - 312 Detection error of AR measusame error No. still appears, contact your authorized distributor. 314 As above As above Turn OFF the instrument once and turn it ON again. If the 330 Hardware error same error No. still appears, contact NIDEK or your authorized distributor. 332 As above As above The patient may have blinked during AR or REF 333 Blink Err measurement. Measure the same eye again. If the same error No. still appears, contact your authorized distributor. The patient may have blinked during KM measurement. As above Measure the same eye again. If the same error No. still appears, contact your authorized distributor. 360 - 363 As above As above 370 - 371 As above As above 380 - 381 As above As above A printer paper has run Set the specified printer paper roll. (See p. 7-1 of 400 out. Operators Manual.) The head lever of the Flip the printer head fixing lever upward. (See p. 7-2 of 401 internal printer is open. Operators Manual.) The thermal head of the Do not operate the internal printer for 10 minutes. If the 402 internal printer is same error No. still appears, contact NIDEK or your overheated. authorized distributor. * Error Nos, “240”, “311”, “312” and “314” are shown in the lower middle area of the measurement screen where the latest AR-measured data is displayed. Error Nos. “333”, “334” and “335” are displayed in the lower middle area of the measurement screen where the latest measured data is displayed as “Blink Err” in red.
  • 277. C-4OPD-Scan Error Message Table Message Content Solution Turn OFF the instrument once and turn it ON ERR X Hardware error again. If the same message still appears, contact NIDEK or your authorized distributor. ERR Z As above As above The measuring eye side The PD window is shaded by the Make sure that the patients arm etc does not could not be detected. patients body. shade the PD window. (See p.3-2.) Measure the eye again. AR-measure the same eye again. If the sign isE at the right side of AXIS AR measured data with low confidence still shown, it is probable that the patients eye has of AR-measured data index an irregular astigmatism or is not wide open. Serial shots of AR or REF If AR- (or REF-) measuring the same eye again, Finish measurement are complete. (The release the start button once and then press the message does not mean an error.) button again.A printer paper has run out. The printer runs out of paper.Set the specified printer Set the specified printer paper roll. (See p. 7-1)paper roll.The head lever of theinternal printer is open. Flip The head lever of the built-in printer is Flip up the head lever of the printer. (See p. 7-2)the printer head fixing lever open.upward. The measuring unit has Do not move the measuring unit to the other eyebeen moved to the other eye As described on the left. during measurement. during measurement
  • 278. APPENDIX. D BEFORE FIRST BACKUP PROCEDURESIMPORTANT!! Read the following instruction before performing data backup for the first time. This section explains the first backup procedures and the backup procedures for the second time and after. It is recommended to regularly back up measured data on an external storage disk such as a ZIP disk or DVD-RAM in case of an internal hard disk crash. Operators should be responsible for managing the obtained data. NIDEK assumes no responsibility for a loss of data.D.1 Preparation Have an external storage device (such as a Zip drive) and 2 or more storage disks (such as Zip disk) handy. NOTE • Storage disks such as CD-R, CD-RW, DVD-R which need writing software are improper for data backup. The following explanation is based on the use of a ZIP drive provided with a USB connector. To use any other storage device, be sure to install the driver software for the device. * “Zip” is a registered trademark of Iomega, USA.D.2 Connection Connect a Zip drive. NOTE • In the case of a non USB storage device, connect the external storage device, turn it on first, and then turn ON the ARK-10000.
  • 279. D-2D.3 SettingTarget storage location list dialog box: Change the setting in the “Backup Data” field to “E:”. See “5.7.6 Setting location for data backup, import, and export”. The internal hard disk is factory-selected as a target storage location for backup data. Be sure to select an external storage de- vice (E:) as a target backup location.“Database Backup” dialog box: Maintain the factory setting“Export Settings” dialog box: Unrelated to backup procedures“Rebuild Database” dialog box: Unrelated to backup procedures
  • 280. D-3D.4 Ordinary Backup In this section, the first-time backup procedure and procedure for backing up for the second time and after are respectively explained.D.4.1 First-time backup1. Press on the Patient Selection screen to display the “OPD Database Manager” dialog box. The OPD Database Manager dialog box can be displayed also by pressing on the bottom right of the Windows screen.2. Press (Stop) to close connection to the database.3. Press “Advanced Settings” at the bottom left of the screen to display the items for detailed setting.4. Press (Backup). The Databse Backup screen is displayed.
  • 281. D-4 5. Confirm the setting on the “Database Backup” dialog box and then press . Ordinarily, maintain the factory setting as shown in the figure on the right. Ordinarily, the “Differential” option should be selected. Select the “All” option to make a new backup copy of data just after changing the storage location for the backup data. 6. The message encouraging the operator to insert a new disk appears. Write the displayed volume label (disk name) on an adhesive label of the Zip disk. Volume label NOTE • Be sure to write down the volume label on an adhesive label of the disk to avoid losing track of where the backup data is saved. • Disks can be identified by the volume name as long as the data on the backup disks is from one unit of the OPD-Scan only. When using multiple units of the OPD-Scan, write down the ID information (S/N of the product etc) in addition to the volume name. 7. Insert a Zip disk and press the OK button. Data backup is performed. If one disk cannot hold backup data to be saved, the message requiring the operator to insert a new disk appears. Write down the volume label on an adhesive label of the disk in the same manner as Step 3 and insert the disk. 8. When data backup is completed, the message “Database Backup has been completed” appears. Press the OK button. 9. Press (Start) to restart connection to the database.10. Press (Minimize) to minimize OPD Database Manager to the task tray. The first-time backup procedure is finished.
  • 282. D-5D.4.2 Backup for the second time and after From second-time backup and after, only newly-saved data will be saved. As soon as a disk is full, the ARK-10000 will require the operator to insert a new disk.1. Press on the Patient Selection screen to display the “OPD Database Manager” dialog box. The OPD Database Manager dialog box can be displayed also by pressing on the bottom right of the Windows screen.2. Press (Stop) to close connection to the database.3. Press “Advanced Settings” at the bottom left of the screen to display the items for detailed setting.4. Press (Backup). The Databse Backup screen is displayed.
  • 283. D-65. Confirm the setting on the “Database Backup” dialog box and then press . Ordinarily, maintain the factory setting as shown on the right. Ordinarily, the “Differential” option should be selected. Select the “All” option to make a new backup copy of data just after changing the storage location for the backup data.6. The message encouraging the operator to insert a backup disk appears. Insert the disk of a displayed volume label (disk name) and press the OK button. Data backup is performed. If one disk cannot hold backup data to be saved, the message requiring the operator to insert a new disk appears. Write down the volume label on an adhesive label of the disk and insert the disk.7. When data backup is completed, the message “Database Backup is completed” appears. Press OK .8. Press (Start) to restart connection to the database.9. Press (Minimize) to minimize OPD Database Manager to the task tray. This is the end of the first-time backup procedure.
  • 284. D-7 The following is one example of managing disks. [Example of disk management] Conditions: Storage disk used for backup: 250 MB-Zip disk for data backup Storage disk used for saving the database: Internal hard disk Number of days: 5 days a week (From Monday to Friday) Number of patients: 20 patients/ day Number of eyes: Both left and right eyes × 1 time = 2 eyes /patient (Approx. 2.4MB) Limitations on use: A storage disk whose occupied space is already 90% or more should not be used for adding the backup data of a new patient. Example: Lapsed Media type days Backup Storage 1st day OPD-BAK 0001 (Mon.) 20% occupied : 5th day OPD-BAK 0001 OPD-BAK 0002 (Fri.) 90% occupied 10% occupied 6th day OPD-BAK 0002 OPD-BAK 0001 (Mon.) 30% occupied : 9th day OPD-BAK 0002 OPD-BAK 0001 (Thu.) 90% occupied 10th day OPD-BAK 0003 OPD-BAK 0001 -0002 (Fri.) 20% occupied : 14th day OPD-BAK 0003 OPD-BAK 0004 OPD-BAK 0001 -0002 (Thu.) 90% occupied 10% occupied 15th day OPD-BAK 0004 OPD-BAK 0001 -0003 (Fri.) 30% occupied
  • 285. APPENDIX. E POINTS TO NOTE WHEN UTILIZING INTERNAL OPD MAP In the Internal OPD map, intraocular (from the posterior surface of the cornea through retina) astigmatic components are calculated from the Refractive map calculated from CT (Corneal Topography) measurement and from the OPD map calculated from REF measurement. Therefore, the reliability of the Internal OPD map largely depends on whether the CT and REF measurements were performed accurately. Pay special attention to the following: • The measuring unit should be accurately aligned to the eye during both measurements. (See Step 6 on P.4-23.) • The black and white edges of the placido ring are traced correctly. In addition, for keratoconus, eyes after corneal transplantation, irregular-astigmatic eyes, eyes with excessive myopia corrected etc, carefully interpret the Internal OPD map because the map will be adversely affected by the posterior surface of the cornea due to a substantial deformation of both anterior and posterior surfaces of the cornea. For information, it is strongly recommended to specify the “Standard2” map layout (5 maps: Refractive map, OPD map, Internal OPD map, Axial map and Eye Image) for displaying the Internal OPD map. The examples of real human eyes are illustrated for reference: Astigmatic eye with no intraocular astigmatism: Corneal astigmatism: 1.47 D, Total astigmatism (OPD): 1.50 D, Internal OPD astigmatism: 0.31 D Case where intraocular astigmatism counteracts total astigmatism.: Corneal astigmatism: 1.83 D, Total astigmatism (OPD): 0.49 D, Internal OPD astigmatism: 1.28 D
  • 286. E-2 Case where intraocular astigmatism increases total astigmatism.: Corneal astigmatism: 1.69 D, Total astigmatism: 2.60 D, Internal OPD astigmatism: 1.58 D Case 1 where an intraocular lens is tilted: The pattern in the Refractive map of the cornea is almost symmetrical, whereas the OPD map represents myopia (in red) in the upper right of the map. In the same way, the Internal OPD map also represents myopia in the upper right of the map. These patterns of the IOL (Intraocular lens)-implanted eyes suggest the tilting or decentering of the IOL. If the pupil is about 6 mm in diameter, the position of the IOL can be checked by a spot image reflected from the surface of the IOL on the pupil image map (Eye Image). Case 2 where an intraocular lens is tilted: Regardless of a small amount of corneal astigmatism, astigmatism is observed in the OPD map. It is assumed that the astigmatism observed in the Internal OPD map is caused by the tilting of the IOL.
  • 287. E-3Keratoconus:The Internal OPD map reflects the presence of a large prism, displaying the distribution ofboth warmer and cooler colors. Warmer colors Cooler colorsEye after corneal transplantation:The Internal OPD map reflects the corneal surface after corneal transplantation.
  • 288. APPENDIX. F EMC (ELECTROMAGNETIC COMPATIBILITY)The ARK-10000 complies with the International Electrotechnical Commission standards (IEC 60601-1-2: 2001) for electromagnetic compatibility as listed in the tables below. Follow the guidance on the tablesfor use of the device in the electromagnetic environment. EMC (IEC 60601.1.2:2001) Guidance and manufacturers declaration - electromagnetic emissions The ARK-10000 is intended for use in the electromagnetic environment specified below. The customer or the user of the ARK-10000 should assure that it is used in such an environment. Emissions test Compliance Electromagnetic environment - guidance RF emissions Group 1 The ARK-10000 uses RF energy only for its internal CISPR 11 function. Therefore, its RF emissions are very low and are not likely to cause any interference in nearby electronic equipment. RF emissions Class A The ARK-10000 is suitable for use in all establishments CISPR 11 other than domestic and those directly connected to the Harmonic emissions Class A public low-voltage power supply network that supplies IEC 61000-3-2 buildings used for domestic purposes. Voltage fluctuations/Flicker Complies emissions IEC 61000-3-3 Guidance and manufacturers declaration – electromagnetic immunity The ARK-10000 is intended for use in the electromagnetic environment specified below. The customer or the user of the ARK-10000 should assure that it is used in such an environment. Immunity test IEC 60601 test level Compliance level Electromagnetic environment - guidance Electrostatic ±6kV contact ±6kV contact Floor should be wood, concrete or ceramic Discharge (ESD) ±8kV air ±8kV air tile. If floors are covered with synthetic IEC 61000-4-2 material, the relative humidity should be at least 30%. Electrical fast ±2kV for power supply ±2kV for power supply Mains power quality should be that of a transient/burst lines lines typical commercial or hospital environment. IEC 61000-4-4 ±1kV for input/output ±1kV for input/output lines lines Surge ±1kV ±1kV Mains power quality should be that of a IEC 61000-4-5 Differential mode Differential mode typical commercial or hospital environment. ±2kV ±2kV Common mode Common mode Voltage, dips, 5% U T 5% U T Mains power quality should be that of a short ( 95% dip in U T) ( 95% dip in U T) typical commercial or hospital environment. interruptions and for 0,5 cycle for 0,5 cycle If the user of the ARK-10000 requires voltage variations 40% U T 40% U T continued operation during power mains on power supply interruptions, it is recommended that the (60% dip in U T) (60% dip in U T) input lines IEC ARK-10000 be powered from an for 5 cycles for 5 cycles 61000-4-11 uninterruptible power supply or a battery. 70% U T 70% U T (30% dip in U T) (30% dip in U T) for 25 cycles for 25 cycles 5% U T 5% U T ( 95% dip in U T) ( 95% dip in U T) for 5 sec for 5 sec Power frequency 3 A/m 3 A/m Power frequency magnetic fields should be (50/60Hz) at levels characteristic of a typical location in magnetic field a typical commercial or hospital IEC 61000-4-8 environment. NOTE U T is the a.c. mains voltage prior to application of the test level.
  • 289. F-2 Guidance and m anufacturers declaration - electrom agnetic im m unityThe ARK-10000 is intended for us e in the electrom agnetic environm ent s pecified below . The cus tom er or theus er of the ARK-10000 s hould as s ure that it is us ed in s uch an environm ent. Im m unity test IEC 60601 test level Com pliance level Electrom agnetic environm ent - guidance Portable and m obile RF com m unications equipm ent s hould be us ed no clos er to any part of the AR K-10000, including cables , than the recom m ended s eparation dis tance calculated from the equation applicable to the frequency of the trans m itter. R ecom m ended s eparation dis tanceConducted RF 3Vrm s 3Vrm s d=1.2 P 150 MH z to 80 MH zIEC 61000-4-6 150kHz to 80MHz (V1=3)Radiated RF 3V/m 3V/m d =1.2 P 80 MHz to 800 MHzIEC 61000-4-3 80MHz to 2.5GHz (E 1=3) d =2.3 P 800 MHz to 2.5 GHz w here P is the m axim um output pow er rating of the trans m itter in w atts (W) according to the trans m itter m anufacturer and d is the recom m ended s eparation dis tance in m etres (m ). Field s trengths from fixed RF trans m itters , as determ ined by an electrom agnetic s ite s urvey,a s hould be les s than the com pliance level in each frequency range.b Interference m ay occur in the vicinity of equipm ent m arked with the following s ym bol:NOTE 1 At 80MHz and 800MHz, the higher frequency range applies .NOTE 2 Thes e guidelines m ay not apply in all s ituations . Electrom agnetic propagation is affected byabs orption and reflection from s tructures , objects and people.a. Field s trengths from fixed trans m itters , s uch as bas e s tations for radio (cellular/cordles s ) telephones andland m obile radios , am ateur radio, AM and FM radio broadcas t and TV broadcas t cannot be predictedtheoretically with accuracy. To as s es s the electrom agnetic environm ent due to fixed RF trans m itters , anelectrom agnetic s ite s urvey s hould be cons idered. If the m eas ured field s trength in the location in which theARK-10000 is us ed exceeds the applicable R F com pliance level above, the AR K-10000 s hould be obs erved toverify norm al operation. If abnorm al perform ance is obs erved, additional m eas ures m ay be neces s ary, s uch asreorienting or relocating the ARK-10000.b. Over the frequency range 150kHz to 80MHz, field s trengths s hould be les s than 3V/m .
  • 290. F-3 Recommended separation distances between portable and mobile RF communications equipment and the ARK-10000The ARK-10000 is intended for use in an electromagnetic environment in which radiated RF disturbances arecontrolled. The customer or the user of the ARK-10000 can help prevent electromagnetic interference bymaintaining a minimum distance between portable and mobile RF communications equipment (transmitters)and the ARK-10000 as recommended below, according to the maximum output power of the communicationsequipment.Rated maximum output power of transmitter Separation distance according to frequency of transmitter W m 150kHz to 80MHz 80MHz to 800MHz 800MHz to 2.5Hz d =1.2 P d =1.2 P d =2.3 P 0.01 0.12 0.12 0.23 0.1 0.38 0.38 0.73 1 1.2 1.2 2.3 10 3.8 3.8 7.3 100 12 12 23For transmitters rated at a maximum output power not listed above, the recommended separation distance d inmetres (m) can be estimated using the equation applicable to the frequency of the transmitter, where P is themaximum output power rating of the transmitter in watts (W) according to the transmitter manufacturer.NOTE 1 At 80MHz and 800MHz, the separation distance for the higher frequency range applies.NOTE 2 These guidelines may not apply in all situations. Electromagnetic propagation is affected byabsorption and reflection from structures, objects and people.

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