Veatch’s completely integrated HDR-8000 Digital Eye Exam incorporates advanced equipment into one precise, efficient system.

Automated refraction systems improve comfort for optometrists while also increasing efficiency in the exam room.

A recent study compared the prevalence of musculoskeletal disorders among ophthalmologists and optometrists with family medicine physicians and found that the group of eye-care practitioners had a higher prevalence of neck, hand/wrist, and lower back pain due to repetitive tasks, prolonged awkward or cramped positions, and bending and twisting.

How can we avoid this debilitating pain and discomfort and continue to practice at a high level, even into our golden years? The evolution of computerized equipment, along with electronic medical records (EMRs), has revolutionized today’s eye exam. Instead of manually flipping the dials in the phoropter, changing the projector with each line, or spending hours hunched over a desk with a pen, an eyecare practitioner can now sit comfortably while even being more efficient. Here are a few companies offering digital refraction systems that decrease the amount of repetitive motions we do during an exam.

According to the company, Marco’s EPIC automated refracting system increases patient throughput by 50% to 75% and decreases workup and pre-testing time to less than 10 minutes per patient. This efficient system allows the refraction to be performed in under five minutes. Using half the space of a traditional lane, EPIC frees up other rooms to be used for additional procedures and testing. The system combines an electronic refractor, keratometer, chart projector, adjustable arm, and a motorized table. Also unique to this system is a reversible color touch screen, which allows for ideal control and selection. Built-in near reading card lights, a tilt screen for near vision testing, and multiple near tests combine to make for more precise, optimum results.

The state-of-the-art TRS-5100 electronic refraction system gives practitioners control over the whole refraction process from a keypad, which can even be held in your lap. This keypad not only controls the phoropter, but also the chart projector and the whole system can be programmed so refraction occurs in a specific sequence.

As a streamlined system, the TRS-3100 has a completely wireless interface with the autorefractor and autolensometer. A small keypad and touch screen maximizes workspace and decreases the risk of shoulder and neck injury. It can also be networked into a paperless EMR system and features a dedicated real-time processor that delivers ideal operational speed, responsive specificity of function, ease of use, and the security of sustained performance integrity.

The completely integrated HDR-8000 Digital Eye Exam system from Veatch Ophthalmic Instruments incorporates advanced equipment into one precise, efficient system. Its HRK-8000A Wavefront Autorefractor/Keratometer accurately measures all-important second order aberrations, while the HLM 7000 Autolensometer comes equipped with a color LCD display for easy reading of all prescriptions from single vision to progressive, and with any frame size. The HDC-4000 Visual Acuity System integrates to deliver coordinated letters with the HDR-7000, and is now available with EyeMotion animations. Its truefit Digital Dispensing completes the system and provides precise frame measurements. This system is fully networkable for multiple exam rooms.

The HRS-7000 Futura Digital Refraction System combines the technology of the above, but in a space-saving system. High-tech, in-depth refraction can be performed in an exam room as small as 7 ft. x 7 ft. with the Futura exam chair and stand while using the CDC-4000 Mirrored Auto Chart Projector.
The Luxvision system from US Ophthalmic lets allows practitioners refract remotely from the ease of a desk.

The flagship refraction systems from Topcon Medical Systems, Inc. are the EXAM-5000 and the CV-5000S. Topcon’s CV-5000S Vision Tester combines a high-speed lens chamber, small optical head, and a one-dial controller with a large color LCD touch screen to make refraction quicker. It automatically imports data from pre-test instruments, making the information gathering and processing more streamlined. The unique color-coded cross cylinder makes it an easy-to-use system as well. While the interactive patient education software makes it simple to address any medical conditions or findings during the exam, the eyeglass-selling feature helps enhance optical revenue and profit. The paperless refractions work synergistically with EMR systems.

EXAM-5000 combines the CV-5000S Vision Tester with a chair and stand, chart projector, autorefractor, and topographer into one linked system. The 6 ft. x7 ft. system saves on valuable office space while the motorized worktable is wheelchair accessible. With this instrument, one is able to record a full 21-point refraction. The tester can also store up to five user-defined personalized refraction programs, customizable to each doctor’s particular style. There are even onscreen technician scripts to allow for smooth prompting and delegation for staff.

New from Reichert Technologies is the Auto Phoropter RS™ which allows practitioners to perform all refraction functions and improve efficiency. They can perform refractions while seated comfortably using a portable controller box with a color screen. Eyecare practitioners can also show patients different prescriptions with the touch of a button. This system can easily be incorporated into a current lane setup, and is able to be fully integrated with the ClearChart® 2 digital acuity system, lensometers, autorefractors, and patient data from EMRs.

The Luxvision digital system from US Ophthalmic permits eyecare practitioners to perform a whole refraction remotely from the comfort of a desk using a control console. Users can monitor what the patients are reading on the Luxvision LCP-2600 projector without turning or straining their neck. The Luxvision LRK-2600 autorefractor/keratometer allows for greater precision and speed, while the Luxvision LDR-2600 offers fast, accurate lensometry readings and the ability to compare old and new prescriptions. Ezer Digital Practice includes the ECP-5200 projector, the EDR-5200 digital refractor, and the ERK-5200 autorefractor/keratometer—another option to streamline your exam. The intuitive and simple design of these systems makes training and usage easy and will provide patients with a more high-tech experience.

Optometrists tend to have a long career, many practicing into their 60s and 70s. However, the repetitive motions that they perform during exams can lead to many practitioners suffering from overuse and strain injuries of their hands, elbows, shoulders, neck, and back. By seamlessly integrating these digital refraction systems, along with EMR, into your exam, you will not only see more patients in less time, but feel better at the end of the day. OO


1. Change your body position frequently—standing or sitting for long periods of time can induce strain and fatigue. Get up, walk around, and stretch.
2. Use a height adjustable table for your slit lamp to accommodate different patients.
3. When using the slit lamp, bend from your hips instead of rounding out your back.
4. Use proper lighting when writing in charts or using the computer—if we recommend it to our patients, it works for us!
5. If you are presbyopic, consider a task specific pair of glasses or an office progressive lens.
6. Use a height adjustable stool, and make sure your feet are planted firmly on the ground and not swinging or barely touching.
7. Keep good posture throughout the day—keep your back and body straight and well supported and avoid twisting or turning.
8. Keep everything handy. Look at your exam room—are you constantly reaching for the light switch, twisting to reach for a pen or remote to change your projector?
9. Avoid sitting “side saddle” behind the slip lamp—face straight ahead without twisting your back.
10. Exercise—keep your core and back strong with good abdominal exercises to promote strength and flexibility.

Jennifer L. Stewart is in private practice at Norwalk Eye Care in Norwalk, CT.


Marco • 800-874-5274 •

Reichert Technologies • 888-849-8955 •
Topcon Medical Systems, Inc. • 800-223-1130 •
US Ophthalmic • 888-334-4640 •
Veatch Ophthalmic Instruments • 800-447-7511 •


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