Welch Allyn PanOptic 118 Series Instruction Manual

PanOptic™Ophthalmoscope
118 Series
Operating
Instruction
Manual
Eye Care Menu
Service Manual

©2001 by Welch Allyn, Inc. All rights reserved. No part of this manual
may be reproduced or transmitted in any form or by any means, elec-
tronic or mechanical, including photocopy, without prior consent in writ-
ing from Welch Allyn. Printed in the U.S.A.

Table of Contents
Symbols. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
Warnings and Cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
The PanOptic™ Ophthalmoscope . . . . . . . . . . . . . . . . 4
Set-up Instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
Conducting an Examination with the PanOptic
Ophthalmoscope. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Apertures and Filters . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
The Eye . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14
Lamp Replacement Instructions . . . . . . . . . . . . . . . . . . . 15
Cleaning and Repair Instructions. . . . . . . . . . . . . . . . . . .16
Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Accessory and Replacement Parts List . . . . . . . . . . . . . . 19
Service and Warranty Information. . . . . . . . . . . . . . . . . .20
Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

1
Symbols
Attention. Read Operating Manual for Cautions and
Instructions for Use.
TYPE BF –Indicates this is a product with Type BF
applied parts (the patient eyecup).
The CE mark on this product indicates it has been tested
to and conforms with the provisions noted within the
93/42/EEC Medical Device Directive.

2
Warnings and Cautions
CAUTION: To minimize lamp housing temperatures, on-
time should not exceed 2 minutes with off-time not less than
10 minutes.
CAUTION: No acute optical radiation hazards are identified
for ophthalmoscopes. However, Welch Allyn recommends
limiting the intensity of the light directed into the patient’s
eye to the minimum level that is necessary for diagnosis.
Infants, aphakes, and persons with diseased eyes are at a
greater risk. The risk is also increased if the examined per-
son has had any exposure with the same instrument or any
other ophthalmic instrument using a visible light source
within the previous 24 hours. This will apply particularly if
the eye has had exposure to retinal photography. The
intended use of this device is for routine ophthalmic exams
on the order of typically less than 60 seconds per eye.
Although there is a benefit versus risk factor in any medical
procedure, these more complicated exams should not
exceed a three minute exam time in 24 hours. Significant
use of this device beyond its intended use is not recom-
mended; it may cause harm to the eyes.
Use only PanOptic Patient Eyecups (part number 118092)
with this product.
CAUTION: Federal Law restricts this device to sale by or
order of a physician.
CAUTION: Spectrally weighted photochemical radiance LB
and LA give a measure of the potential hazard that exists for
a beam of light to cause photochemical damage to the retina.
LB gives the measure for eyes in which a crystalline lens is
not in place. LA gives this measure either for eyes in which
the crystalline lens has been removed (aphakes) and has not
been replaced by a UV-blocking lens or for the eyes of very
young children.
The value stated for this ophthalmoscope gives a measure of
hazard potential when the instrument is operated at maxi-

3
mum intensity and maximum aperture. Values of LB or LA over
17.50 mW/(cm2*sr) are considered high.
The retinal exposure dose for a photochemical hazard is a product
of the radiance and the exposure time. For instance, at a radiance
level of 17.50 mW/(cm2*sr), a 3-minute exposure would produce a
retinal exposure dose level at the recommended limit. If the value
of radiance were reduced to 8.75 mW/(cm2*sr), twice that time (i.e.
6 minutes) is needed to reach the recommended limit. The
recommended exposure dose is based on calculations using the
American Conference of Governmental Industrial Hygienists
(ACGIH) Threshold Limit Values for Chemical Substances and
Physical Agents (2000 edition).
The 118 Series Ophthalmoscope has spectrally weighted
photochemical radiances at maximum intensity and
maximum aperture of .287 mW/(cm2*sr) for LBand.306
mW/(cm2*sr) for LA (aphake). The relative spectral output of
the device is shown on page 3.
Welch Allyn 118 Series Ophthalmoscope
300 345 390 435 480 525 570 615 660 705 750 795 840 885 930 975
1020 1065
Wavelength (nm)
Relative Spectral Irradiance
(W/cm^2)

4
The PanOptic™Ophthalmoscope
Transparency of the cornea, lens and vitreous humor permits the
practitioner to directly view arteries, veins, and the optic nerve of
the retina.
Direct observation of the structures of the fundus through a PanOp-
tic Ophthalmoscope may show disease of the eye itself or may
reveal abnormalities indicative of disease elsewhere in the body.
Among the most important of these are vascular changes due to dia-
betes or hypertension and swelling of the optic nerve head due to
papilledema or optic neuritis. In this sense, the eye serves as a win-
dow through which many valuable clinical evaluations may be
made.
When a preliminary diagnosis of an imminently dangerous eye con-
dition, such as acute (angle-closure) glaucoma or retinal detach-
ment, is made by the examiner, prompt referral to an eye specialist
may prevent irreversible damage. Or, when distressing but less
urgent conditions, such as visual impairment due to cataract or vit-
reous floaters, are recognized, the patient can be reassured and
referred.
A
B
CD
E
F
A Patient Eyecup D Aperture/Filter Dial
B Patient’s Side E Focusing Wheel
C Soft Grip Handle F Practitioner’s Side Brow Rest

5
Set-up Instructions
Attaching the PanOptic Ophthalmoscope head to a
Welch Allyn Power Source
Align cutouts in the PanOptic Ophthalmoscope base with lugs on
power source. (The PanOptic Ophthalmoscope fits all 3.5v Welch
Allyn power sources.) Push in slightly and turn 90 degrees.
Attaching the Patient Eyecup to PanOptic
Use only PanOptic Patient Eyecups (part number 118092)
with this product.
Insert eyecup into the patient’s side
of the instrument. Push and twist in
one motion until you feel the two
“lock”together.
See “Accessory and Replacement
Parts List”on page 19 to reorder new
PanOptic Patient Eyecups.
TURN HANDLE
COUNTER-
CLOCKWISE
TWIST

6
Attaching Corneal Viewing Lens to PanOptic (Model
11820 only)
Insert Corneal Viewing Lens into patient’s side of the instrument.
Push and twist in one motion until you feel the two “lock”together
as shown on page 5, except replacing Patient Eyecup with the Cor-
neal Viewing Lens. Verify that the line on the lens housing is
aligned with the top seam of the PanOptic instrument

7
Conducting an Examination with the PanOptic
Ophthalmoscope
1. To examine the right eye, stand or sit to the patient’s right side.
2. Remove Spectacles (preferred,
but not required).
3. Look through the scope (from
the doctor’s side) with your
thumb on the focusing wheel.
Focus the scope on an object
roughly 15 feet away. (This
procedure will make any
adjustments for your own eye’s
corrective needs.)
4. Start with the small aperture
(green line position on the
aperture dial).

8
5. Turn the scope on (using any
Welch Allyn 3.5V power
source). Adjust light intensity
rheostat to maximum position.
You are now ready to begin the examination:
6. Examiner should be positioned
approximately 15 degrees to the
temporal side of the patient.
7. Instruct the patient to look
straight ahead at a distant
object.
8. Begin from about 6 inches away,
looking through the scope and
shining the light at the patient’s
eye while looking for the red
retinal reflex.
9. Rest your left hand on the
patient’s forehead. (optional)

9
10. Slowly follow the red reflex
toward the patient and into the
pupil. Get as close as possible
for the optimum view (the
eyecup should contact the
patient’s brow).
11. Once you have a stable view of
the fundus rotate the focusing
wheel until you have a crisp
view of the optic disc and the
vessels surrounding it.
Note: For the largest view,
compress the eyecup
halfway against the
patient’s brow. This enables
the user to view the entire
optic disc plus many
surrounding vessels (about
25°field of view) at one
time.

10
12. Examine the optic disc for
clarity of outline, color,
elevation and condition of the
vessels. Follow each vessel as
far to the periphery as you can.
To locate the macula, focus on
the disc, then move the light
approximately one (1) disc
diameter temporally. You may
also have the patient look at the
light of the ophthalmoscope,
which will automatically place
the macula in full view. Examine for abnormalities in the
macular area. The red-free filter facilitates viewing of the center
of the macula, or the fovea.
13. To examine the extreme periphery instruct the patient to:
A look up for examination of the superior retina
B look down for examination of the inferior retina
C look temporally for examination of the temporal retina
D look nasally for examination of the nasal retina.
This routine will reveal almost any abnormality that occurs in
the fundus.

11
14. To examine the left eye, repeat
the procedure outlined above.
However, unlike traditional
ophthalmoscopy, a unique
feature of PanOptic is that the
examiner does not have to
switch to his/her left eye. The
practitioner can use either eye
to examine either patient eye
because of the greater working
distance between patient and
practitioner. This permits those
who are strongly dominant in
one eye to always use that eye
in the fundus exam.

12
Apertures and Filters
There is a wide range of practical apertures and filters to select
from: small spot, large spot, micro spot, slit aperture, red-free filter,
cobalt blue filter (optional), and half-moon aperture (optional).
1. Small Aperture: Provides easy view of the fundus
through an undilated pupil. Always start the
examination with this aperture and proceed to micro
aperture if pupil is particularly small and/or sensitive to
light. This position is the “Home”position on the
aperture dial and is denoted by the green marking.
2. Large Aperture: Standard aperture for dilated pupil
examination of the eye.
3. Micro Spot Aperture: Allows easy entry in very small,
undilated pupils.
4. Slit Aperture (Models 11810, 11820 only): Helpful in
determining various elevations of lesions, particularly
tumors and edematous discs.
5. Red-Free Filter (Model 11810, 11820 only): This filter
excludes red rays from the examination field: this is
superior to ordinary light in viewing slight alterations
in vessels, minute retinal hemorrhages, ill-defined exudates
and obscure changes in the macula. The nerve fibers become
visible and the observer may note the disappearance of such
fibers, as in optic nerve atrophy. The background appears gray,
the disc appears white, the macula appears yellow, the fundus
reflex is intense and the vessels appear almost black. This filter
is also used to help distinguish veins from arteries; veins stay

13
relatively blue, but oxygenated arterial blood makes arteries
appear blacker. This greater contrast makes differentiation
easier for the examiner.
6. Cobalt Blue Filter (Model 11820 only): In conjunction
with fluorescein dye applied topically to the cornea
and an add-on magnifying lens (included), this filter is
helpful in detecting corneal abrasions and foreign
bodies. In this way, it can be used as a surrogate to a
Woods Light.
7. Half-Moon Aperture (11810 Only): Provides a
combination of depth perception and field-of view.

14
The Eye
In addition to examination of the fundus, the PanOptic Ophthalmo-
scope is a useful diagnostic aid in studying other ocular structures.
The light beam can be used to illuminate the cornea and the iris for
detecting foreign bodies in the cornea and irregularities of the
pupil.
The practitioner can also easily detect lens opacities by looking at
the pupil through an add-on corneal viewing lens. In the same man-
ner, vitreous opacities can be detected by having the patient look up
and down, to the right and to the left. Any vitreous opacities will be
seen moving across the pupillary area as the eye changes position or
comes back to the primary position.
A) Macula
B) Vitreous humor
C) Sclera
D) Choroid
E) Retina
F) Ora Serrata
G) Canal of Schlemm
H) Anterior chamber
I) Iris
J) Cornea
K) Ciliary body
L) Zonule (Suspensory Ligament)
M) Conjunctiva
N) Lens
O) Hyaloid canal
P) Central retinal vein
Q) Optic nerve
R) Central retinal artery

15
Lamp Replacement Instructions
Lamp Replacement Caution: Halogen lamps are pressurized to pro-
vide maximum efficiency and illumination. Mistreatment may
cause shattering. Protect lamp surface against abrasion and
scratches. Verify power is off when replacing lamp. Dispose of lamp
with care.
CAUTION: Lamps may be hot. Lamp should be
allowed to cool before removal. Use only Welch
Allyn model 03800 lamp with this product
ALIGN TAB
Use your fingernail or
a small prying instru-
ment to remove the
lamp from the oph-
thalmoscope head
base.
To insert the new
lamp, align tab on
lamp with notch in
the base of the oph-
thalmoscope had and
push inward until
firmly seated.

16
Cleaning and Repair Instructions
Cleaning and repairs (with exception of the lamp replacement)
beyond what is specified in the “general cleaning instructions”sec-
tion should be performed at the factory.
General Cleaning Instructions
NOTE: Excess solution entering the optical assembly could damage
internal components. Use caution to ensure cloth is not saturated
with solution.
This is a precision optical instrument. Please follow these specific
cleaning requirements:
•Do not use any solvent based cleaners on the lenses. Use only
the supplied cleaning cloth on the lenses.
•The PanOptic Ophthalmoscope is Non-sterilizable.
•Disinfect housing using soft cloth moistened with alcohol.
•Clean the Patient Eyecup with soft cloth/cotton swab
moistened with alcohol.
•Do not use acetone based products or other harsh chemicals.
No other preventative maintenance is necessary for this product.