PLUSOPTIX A12C How to use

Binocular Autorefractor
Short Manual 2
“Preparing and performing a measurement”
Plusoptix GmbH
Neumeyerstrasse 48
90411 Nuremberg
Germany
www.plusoptix.com
Edition: 09/17/2018

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Table of Contents
1Preparing for a measurement..........................................................................................3
1.1 Preparing the measurement area................................................................................. 3
1.2 Entering or retrieving patient data................................................................................. 4
1.3 Selecting the measurement mode................................................................................ 4
2Performing a measurement .............................................................................................5
2.1 Preconditions for a successful measurement ............................................................... 5
2.2 Starting the measurement and adjusting the Plusoptix Binocular Autorefractor............ 6
List of figures
Figure 1: Measuring environment.......................................................................................... 3
Figure 2: Home page............................................................................................................. 4
Figure 3: Aligning the plusoptiX A12 model........................................................................... 6
Figure 4: Detecting the correct measuring distance............................................................... 7
This manual is a supplementary short manual. For general information about your
Plusoptix device, such as its intended use, basic handling, technical information,
maintenance, service, and warranty information, please refer to the user manual that
was delivered with your device. This user manual can also be downloaded on our
homepage www.plusoptix.com, under support.
List of further supplementary short manuals
1. Adjusting settings and setting up WLAN
2. Preparing and performing a measurement
3. Viewing the measurement results
4. Entering, retrieving or deleting patient data
5. Documenting measurement results electronically
6. Documenting measurement results on paper
7. Exporting back-ups and reports (only plusoptiX A12C and A16)
8. Downloading software updates
9. Troubleshooting malfunctions and measuring interruptions

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1 Preparing for a measurement
1.1 Preparing the measurement area
The measurement is carried out using infrared light, which is also contained in
sunlight and in the light of bulbs and halogen spotlights, for example. This infrared
light is invisible to the human eye and completely safe.
To obtain correct measurement values, it is important to avoid disruptive sources of
infrared light in the examination room. Close curtains, roller blinds and shutters to
block out the sun’s rays.
Turn off all light sources that produce heat. This does not mean that the
examination room should be dark. Cold light sources, such as energy saving bulbs
and neon lights, do not affect the measurement values.
The child must look at the Plusoptix Binocular Autorefractor in order for a measurement to be
taken. Make sure that the child is sitting straight and its head is not turned over their
shoulder. The child’s knees and nose should be facing the camera.
The attention of infants is steered towards the Plusoptix Binocular Autorefractor by playing a
special warble sound. However, this only works if the child is not distracted by other people
or objects in the examination room. Close the door of the examination room and avoid any
attention-grabbing activities, such as walking around and clicking your fingers. Do not use
any additional fixation aids!
Note:
The attention span of infants is very short. You can use the fact that the examination
room is unfamiliar to the infant to your advantage. An attention-grabbing warble
sound and the child-friendly Plusoptix smiley face in this unfamiliar environment will
always arouse interest. Avoid any lengthy conversations with the parents before the
measurement.
1 meter measuring
distance
At eye level
See chapter 4.2
No direct sunlight
See chapter 3.5
Pupil diameter
Minimum 4 mm
Maximum 8 mm
Figure 1: Measuring environment

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1.2 Entering or retrieving patient data
A measurement can be performed anonymously or by indicating patient data (1). More
information about entering or retrieving data in the internal patient database can be found in
supplementary short manual 5 and 6.
If no patient data is entered or no saved patient data is selected, the measurement is
performed under an anonymous consecutive patient ID. The patient ID has the following
structure:
<last 4 digits of the serial number>-<consecutive number>-<date>-<time>
You have the following options for entering the patient data (see supplementaryshort manual 4)
- Entering and retrieving patient data before the measurement
- Entering and retrieving patient data after the measurement
- Importing patients from the EMR software before the measurement
Note:
The “plusoptiX A12R” has no internal patient database. After the measurement a
single line to enter patient data will be portrayed, where you can fill in individual
patient data. These data will also be portrayed in the screening report and on the
self-adhesive label.
1.3 Selecting the measurement mode
After you have set the time and date, the home page will be displayed every time you turn
the “plusoptiX A12” on again.
Figure 2: Home page
Choose the measuring mode by touching one of the following buttons:
Start the measurement directly after selecting the measuring mode.
1)
Monocular measurement:
Measurement of the right
eye (OD)
Binocular measurement:
Measurement of the left (OS) and
right eye (OD) simultaneously
Monocular measurement:
Measurement of the
left eye (OS)

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2 Performing a measurement
2.1 Preconditions for a successful measurement
a) The measuring distance is correct:
The measuring distance must be between 95 cm and 105 cm. Check whether the
camera image on the screen is in focus. You must be able to see the individual hairs on
the eyelids or the eyelashes clearly on the camera image.
b) Patient is not looking at the camera
The Plusoptix Binocular Autorefractor and the eyes of the patient must be aligned with
one another. The patient must look at the nose of the smiley face. For this reason, an
attention grabbing warble sound is emitted at the beginning of the measurement.
Note:
The attention span of infants is very short. You can use the fact that the
examination room is unfamiliar to the infant to your advantage. An attention-
grabbing warble sound and the child-friendly Plusoptix smiley face in this
unfamiliar environment will always arouse interest. Avoid any lengthy
conversations with the parents before the measurement.
Note:
If a child is not looking at the nose of the smiley face during the measurements,
this can cause a termination of the measurement or inaccurate measurement
values of the gaze symmetry. For this reason, do not use any other external
fixation aids!
c) Both of the patient’s pupils should be completely visible
The pupils must not be covered by eyelids, eyelashes or hair, for example. Check
whether both pupils can be seen completely on the screen and whether they are
encircled in green.
d) The pupil diameters must be between 4 and 8 mm
Note:
If a red error message is displayed, an action recommendation is also displayed
below it. More information is available in supplementary short manual 9.

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2.2 Starting the measurement and adjusting the Plusoptix Binocular
Autorefractor
- Hold the Plusoptix Binocular Autorefractor at eye level to the child, about 1.2 meters
away. The measuring distance is one meter, but it requires practice to correctly estimate
this measuring distance in one go. It is easier to hold the device somewhat further away at
the start of the measurement and then slowly move it towards the child.
Note:
The screen in the plusoptiX A12 models is fixed at a 45° angle to the camera
axis. Tilt your wrists downwards to align the camera. For the plusoptix 16 model,
you do not need to tilt your wrists downwards.
By touching the flashing “GO” button (1) or pressing the trigger, you will start the camera and
a warble sound will be heard. You can now see the camera image on the screen.
Note:
A started measurement can be aborted by touching the screen.
- Adjust the Plusoptix Binocular Autorefractor so that both eyes can be seen on the screen
and then slowly move the Plusoptix Binocular Autorefractor towards the patient until the
camera image can be seen in high-definition on the screen. Firstly, the pupils will be
surrounded by white squares (the image is still very blurred), then with red and finally with
green circles (see Figure 8 on the next page).
1)
Figure 3: Aligning the plusoptiX A12 model

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The image is blurry and two red bars will be displayed next to the camera image. As the
measuring distance is too great, you can see the head of the patient virtually in its entirety.
Move the Plusoptix Binocular Autorefractor towards the patient until the camera image can
be seen in high-definition on the screen and both pupils are encircled in green.
The image is blurry and two red bars will be displayed next to the camera image. As the
measuring distance is too small, the eyes can be seen on the screen. Move the Plusoptix
Binocular Autorefractor away from the patient until the camera image can be seen in high-
definition on the screen and both pupils are encircled in green.
The image can be seen in high-definition on the screen, the bars are green and both pupils
are encircled in green. As soon as both pupils are surrounded by a green circle, the line
between the pupils turns green and another warble sound can be heard. The Plusoptix
Binocular Autorefractor is now a metre away from the child and the measurement begins
automatically. A “ping” sound signalises the end of the measurement.
Figure 4: Detecting the correct measuring distance