CR-2 PLUS can image pupils as small as 3.3mm.
Canon’s digital non-mydriatic retinal camera brings practitioners closer to improving eye exam efficiency.
The Canon CR-2 PLUS is a non-mydriatic digital camera that offers color photography and—here comes the “PLUS”—also features fundus autofluorescence (FAF) photography. FAF has gained publicity for its ability to mark areas of lipofuscin accumulation secondary to abnormalities in the retinal pigment epithelium and photoreceptors. FAF highlights outer retinal dysfunction caused by hereditary retinal degenerations and age-related macular degeneration. It’s also increasing popularity in the detection and management of diabetic retinopathy and vascular occlusive disease.


The CR-2 PLUS uses digital filter processing in the form of red-free and cobalt blue filters for enhanced screening exams of the retina. The red-free filter is useful for evaluating the retinal nerve fiber layer (RNFL) for documenting diseases like glaucoma and the vascular structure of the retina. The cobalt blue helps assess the optic disc, the RNFL, and optic disc drusen. Green and red channel digital filters for viewing the retina and choroid, respectively, are also included.

Many changes seen using FAF and the various digital filters may be missed on routine ophthalmoscopy, which makes these additional imaging techniques more valuable. This is especially beneficial in highlighting stressed and diseased areas of the retina that are invisible to ophthalmoscopy and color fundus images. FAF imaging is becoming more prevalent as an imaging tool because disease progression can be assessed more accurately, as well as the effect of drugs being studied to treat some retinal diseases.

Using invisible infrared light alignment and Xenon tube flash, the CR-2 PLUS can image pupils as small as 3.3mm (small pupil mode). It provides an additional advantage in imaging patients who do not dilate well, such as patients with synechiae from prior inflammation and patients who have had cataract extraction.

A low flash intensity minimizes pupil miosis, thereby shortening the time to get stereo photos. And an automatic exposure function automatically measures the amount of infrared light coming from the retina and then adjusts the flash intensity.

The camera uses an 18 megapixel high-definition CMOS sensor; the field of view goes out to 45°. A LED dot matrix fixation point makes it easy to steer patients for more peripheral views if needed.

Canon Retinal Imaging Control Software allows the images to be captured, viewed, processed, and printed out and/or saved to a more permanent storage database as DICOM or JPEG files.

The CR-2 PLUS can fit into small spaces, measuring 12 in. x 19.7 in. x 20.2 in. The control panel is illuminated for when in a dimly lit or darkened room. The one-handed joystick is convenient to use for positioning the camera, leaving the other hand free if needed.

With the help of FAF photography, in addition to standard fundus photography found on the CR-2 PLUS, practitioners can now better assess and monitor visual deficiencies.

Sherry J. Bass is a Distinguished Teaching Professor at State University of New York (SUNY) College of Optometry.


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