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The following is the basic operation flow.
1. Turn ON the power switch. The indications as in below image, appear on the screen.
• The indication of the eyelid detection mode appears if those modes are set beforehand with the sub-switches.
2. Check the instrument before use. (Check the following items for any abnormality.)
• The indication explained in Step 1 above is on the screen. • No dust or contamination on the air nozzle.
• No abnormal sound is heard.
• The joystick moves smoothly.
3. Change the measurement range and the alignment mode.
• Press the RNG switch to select the measurement range. Every pressing of this switch changes the measurement range in the order of “APC 40” → “APC 60” → “40” → “60”→ “APC 40” . * When the power switch is turned ON, the initial setting is “APC 40”.
4. Prepare the patient for measurement
• Wipe the forehead rest and chinrest that contact the patient with clean absorbent cotton or gauze dampened with rubbing alcohol. If chinrest paper is used, remove one piece for each patient.
• Have the patient remove contact lenses or glasses and sit on the chair.
• Have the patient place their chin on the chinrest as deeply as possible, and their forehead on the forehead rest lightly.
• Align the patient’s eyes with the eye level marker by turning the chinrest elevation knob.
5. Set the safety space between the patient’s eye and air nozzle with the safety stopper (pictured above)
WARNING: Before measurement, be sure to set the safety stopper. The air nozzle may touch and scratch the cornea.
• Pressing the safety stopper, operate the joystick so that the air nozzle approaches the cornea slowly.
• While watching from the left side of the instrument, release the stopper when the space between the patient’s eye and the air nozzle becomes 7 to 8mm. The safety stopper returns to the up position and makes a click sound when it locks the main unit to the determined position.
• Slightly move the joystick back and forth to confirm that the main unit does not move beyond the locked position.
6. Explain the measurement to the patient
• To help the patient relax, make an explanation like the following one to the patient before starting measurement:
Example – “You may be surprised by air puffed into your eye, but do not worry. Please be patient and relax for a moment until I can measure your intraocular pressure three times per each eye.”
7. Move the joystick in the front, back, right, and left directions, and rotate it to get a clear eye image in the center of the screen.
8. Instruct the patient to look at the fixation target light (green LED) in the air nozzle.
NOTE: Confirm that the eyelashes and eyelid are not in the applanation area and confirm that the eye is not watery. These facts cause measurement errors or decrease the accuracy of measurements. If the eyelashes and eyelid are in the applanation area, help raise them. If the eye is watery, have the patient blink their eyes or wipe the tears.
9. Perform alignment to the eye to be measured.
• In Case of “AUTO” – alignment in the up, down, right, and left directions is automatically performed.
• In the case of “MANUAL” – bring the alignment spot inside the alignment target by moving the joystick to the right and left or rotating it.
10. Adjust the focusing on the eye to be measured.
• While keeping the alignment, move the joystick back and forth to change the focusing indicator to the proper alignment.
11. When the focusing indicator maintains the proper alignment, the measurement starts.
• Air is puffed out automatically and the measurement starts. The condition for the start of the measurement may differ according to the selected measurement mode.
• Air is puffed out automatically when the alignment is “AUTO” or “MANUAL”.
• To obtain accurate measurement data, perform the measurement under the condition that the eye is opened wide enough, eye fixation is proper, and the patient’s posture is table.
• In some cases, the air is puffed out while the eye is blinking. In this case, accurate measurement data cannot be obtained and the patient will feel uncomfortable. Therefore, pull the joystick toward you and hold it until the eye stops blinking.
• If the alignment spot canon be displayed sharply on the cornea because of scratches on the cornea, etc. the instrument may not start measurement even when the proper alignment and focusing is obtained. Even in such a case, measurement can be performed by pressing the start button.
12. The measurement data appears on the screen
• The measurement data and average appear on the screen
• After the air is puffed out, the charge indicator appears for several seconds to indicate that the instrument is in the standby mode.
NOTE: If the measurement is not performed correctly for some reason, an abbreviated error message appears on the top right of the measurement range alignment mode indication. In this case, eliminate the cause of the error and performs he measurement again.
13. Repeat steps 9 to 12 and measure the intraocular pressure three times or more.
14. Pull the joystick toward you once and move the main unit to the other eye.
• The indication of the eye toward which the joystick has been moved blinks. The measuring unit returns to the original position.
15. Measure the intraocular pressure of the other eye int eh same way as steps 7 – 13.
16. Press the “PRINT” button to switch to print out the measure data.
• After printing, the measurement data are cleared and the memory lamp is turned OFF. Then the measure unit returns to the original position.
NOTE: Only when the memory lamp is lit is printing out possible.
17. To measure for the next patient, return to Step 4.
18. To finish the intraocular pressure measurement, turn OFF the power switch.
19. Check and clean the air-nozzle.
20. Cover the instrument with the attached dust cover.
If the measurement is not performed correctly for a specific reason, an abbreviated error message appears and blinks for several seconds.
In this case, eliminate the error following the instructions below.
(1) APL: Applanation error
As the eyelid was not opened enough, applanation was not proper.
Instruct the patient to open his/her eyes wider. If he/she cannot do so, let an assistant open the eyelids wider by using a swab, etc..
(2) ALM: Alignment error
Alignment is not proper.
Perform the alignment and the measurement again.
(3) BLK: Blinking and slight movement of the eye
Measurement is impossible because of blinking and slight movement of the eye. Instruct the patient not to blink or move the eye until measurement is finished. After the blinking and slight movement stop, perform the measurement again.
(4) OVR: Over the measurement range
The intraocular pressure exceeds the measurement range of the present setting
• Change the measurement range to “APC 60” or “60” Then perform measurement again.
(5) PCE: APC error
The patient’s eye cannot be measured with the air pressure which is controlled by the APC function because of considerable fluctuation of the intraocular pressure.
• Change the measurement range from “APC 40” to “40” or from “APC 60” to “60”. Then perform the measurement again.
(6) PRS: Pressure error
The air pressure is not enough.
• Check the air pressure using the test mode. If this error occurs repeatedly, contact NIDEK or your authorized distributor.
(7) CHECK THE EYE: Condition of the patient’s eye needs to be checked.
This error appears on the screen when the APL error occurs five times consecutively. Check the condition of the patient’s eye.
• If the patient cannot open the eye widely or eyelashes are over the applanation area, you have to help the patient open the eye wider. In the case of a watery eye, have the patient blink his/her eyes, or wipe the tears.
This error is cancelled when normal measurement data is obtained.
The APL error may occur consecutively though the eye seems to be in the normal condition. In this case, change the setting of the parameter “SET LOW CONFIDENCE” to “YES” and then perform the intraocular measurement again. In this case, the “*” mark*7 will be put on the measurement data.
(8) TOO CLOSE
The message “TOO CLOSE” appears on the screen when the measuring unit is too close to the patient’s eye even though it has already reached the limit of the operator side.
• Pull the joystick fully toward you once. Then perform the alignment again.