The latest developments in instrumentation will help you embrace new exam room technology.

The pace of changes continues to accelerate the practice of optometry with new products that make eye exams more efficient and convenient for both patients and practitioners. Exam room testing that was once both manual and analog is now becoming automated, computer-assisted, and digital. For instance, take a look at the following companies that are looking toward the future.

The SVOne autorefractor from Smart Vision Labs can be attached to a
smartphone to objectively determine the refractive error of the eye.

A patient-flow bottleneck is the centralized pre-test area containing multiple instruments: autorefractor/autokeratometer, corneal topographer, visual field screener, and retinal camera. For the cost of a full-sized autorefractor, it may be possible to have a smartphone-based autorefractor in each exam room instead.

Smart Vision Labs: The company recently launched the SVOne autorefractor, a FDA Class I 510(k) Exempt handheld autorefractor that utilizes a Shack-Hartmann wavefront sensor and low-power laser, and weighs less than 16 oz. The device includes an iPhone 5s, which is utilized for its imaging and processing power. It acquires five readings in five seconds and averages the results using an internal algorithm. Power range is -10.00D to +10.00D for sphere, -5.00D to +5.00D for cylinder with 1° increments for axis. Smart Vision Labs has more instruments in development that are highly accurate, compact, and smartphone-based that will change the way we think about diagnostic instruments in eyecare.

EyeNetra: At the recent Future In Focus Meeting in Las Vegas, NV, Vitor Pamplona, PhD, chief technology officer and co-founder of EyeNetra, proclaimed, “Honey, we shrunk the optometrist’s office.” That’s because the company created what’s being called a hyper-affordable mobile refractive kit. The briefcase-sized kit contains the Netra (smartphone autorefractor), the Netrometer (smartphone autolensometer), and a lightweight handheld phoroptor. The devices are listed as Class 1 Exempt FDA medical devices, and have been used extensively to perform over 43,000 refractions globally.

Improving efficiency with refraction is central to great patient care. Every practitioner develops their own subjective technique which is refined over their career. Computer-assisted refracting systems are now available to provide your techs with a pre-programmed sequence that matches how you refract. Data can be automatically transferred to your office’s EMR system eliminating transcription errors.

Reichert Technologies: The new Phoroptor VRx Digital Refraction System provides this functionality. Your technician can be comfortably seated using the remote touch-screen display, keypad, and multi-function control knob. The phoroptor head is thin and compact with very fast and quiet lens exchanges, plus  it has motorized prism lenses that retract when you no longer need them. It also connects with Reichert’s ClearChart Digital Acuity Systems.

Marco: Refined over many years, the TRS-5100 digital refractor can be seamlessly deployed in a traditional exam room or as part of an EPIC 5100 workstation. This workstation combines the TRS-5100 with an autorefractor, lensometer, and unique distance acuity chart that communicate together with Marco Connect SW, and integrate with all leading EMR systems. The compact workstation has a 5-ft. x 6-ft. footprint which provides patients with a remarkably efficient, multi-modality experience from a single position.

A modern slit lamp is central to visualizing both the anterior and posterior segments of the eye. Having efficient mechanical controls, multicoated optics, and a finely controlled illumination system will make exams easier and more efficient. Among the newest technology in this equipment category is the use of light-emitting diodes for the illumination source. Conventional halogen illumination systems deliver the majority of light in the 600nm range lacking the shorter 460nm range. LEDs are more power efficient, emit less heat, and last hundreds times longer than halogen light sources, making LEDs a great choice for the light source in biomicroscopes.

Topcon: Instead of a traditional halogen bulb, the SL-2G slit lamp features a compact illumination unit with an LED illumination system. The oculars are Galileo-convergence type and accept the attachment of a beam splitter. Magnification changes are done through a rotating drum with 10x, 16x, and 25x magnification. It employs an adjustable slit mechanism with up to 14mm of aperture. The slit angle can be rotated 180° and a set of red free and cobalt blue filters can be inserted by lever movement.

Trevi Technology: The iBEX 5-Step LED slit lamp has a Galilean optical design and provides six magnification steps. IBEX’s LED illumination delivers a radiant white 4,300K color temperature that breaks the barriers of conventional slit lamp observation. It delivers a host of observation gains including enhanced tissue differentiation, increased depth of field (3D), and shadow reduction.

Topcon’s SL-2G slit lamp employs
LED illumination instead of
traditional halogen bulbs.

One of the most important instruments used in comprehensive eyecare is the BIO. Viewing the fundus in stereopsis through a widely dilated pupil and observing the fine structural details of the posterior pole is still an amazing experience. But, tripping over the power cord when maneuvering around a patient wearing a BIO while holding a condensing lens in a darkened exam room, can be a very humbling one. Efficient LED illumination combined with lithium or metal hydride rechargeable batteries has eliminated the power cord from biomicroscopes used in the exam room.

Keeler: The Vantage Plus Convertible LED Wireless Slimline BIO uses advanced engineering materials to provide a lighter, smaller, and more compact instrument. The new convertible technology permits use of a neutral 4,000K LED for longer life and whiter light. LED illumination provides brighter illumination, longer battery life, and freedom from purchasing bulbs. The new compact and high-contrast viewing optics offer glare-free views of the retina while being 15% lighter and 20% smaller. The lithium polymer rechargeable battery is 70% lighter while providing superior performance over the standard battery. Instruments can be used when battery is charging. LEDs indicate when battery life is low, charging, or fully charged.

Heine: OMEGA 500 UNPLUGGED BIO combines LED illumination with a lightweight rechargeable battery integrated into the headband. At 6.3 oz., it is extremely comfortable, and the battery level indicator provides information on the remaining charge. The OMEGA’s small pupil system will allow stereo views in pupils 10mm down to 1mm, and out into the periphery.

There has never been a better time to update the technology in your office’s pre-test area and exam rooms. The technology in your smartphone has become a driving force for smaller, lower-cost, and more intelligent diagnostic instruments. LED illumination will continue to replace incandescent, halogen, and compact fluorescent bulbs. More efficient rechargeable batteries will help eliminate cords and cables. And with developments in wireless power, you may have to explain to your grandchildren the concept of power cords!

Richard Clompus is professional editor of Optometric Office.



Heine •800-367-4872 •

Keeler Instruments, Inc. •800-523-5620 •

Marco •800-874-5274 •

Reichert Technologies •716-686-4500 •

Smart Vision Labs •212-796-6124 •

Topcon Medical Systems, Inc. •800-223-1130 •

Trevi Technology •614-754-7175 •


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