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Need Your Reichert TonoPen XL Repaired?

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  • Instill a drop of topical anesthetic onto the eye to be examined.
  • Position the patient, seated or supine, in front of a fixation target; or have the patient fixate on a point of reference (i.e. ear, nose, distant object) to minimize eye movement. 

Note: The Tono-Pen XL unit will function in any stable position. 

  • Instruct the patient to look straight ahead at the fixation target (i.e. ear, nose, distant object) to minimize eye movement, with eyes fully open.
  • Hold the Tono-Pen XL unit as you would a pencil and position yourself to facilitate viewing of the probe tip and patient’s cornea where contact will be made. For normal corneas, central corneal contact is recommended.
  • The corneal surface needs only to be momentarily contacted. Indentation or excessive pressure is not required and may lead to injury to the eye. Refer to Figure 6. 

  • Brace the heel of your hand on the patient’s cheek for stability while holding the Tono-Pen XL unit perpendicular to and within 1/2 inch of the patient’s cornea. Refer to Figure 6 for correct positioning.
  • To initiate an IOP measurement, depress the Operator’s Button once, and only once.
  • Initially you will see a brief display of [8888]. This is a self-test of the LCD (Liquid Crystal Display). 

Note: If any of the LCD segments are not displayed, the Tono-Pen requires service.

Note: If a momentary display of [CAL] is seen, followed immediately by a single row of dashes [- – – -], it indicates that the Tono-Pen requires calibration before it will measure. 

  • If a double row of dashes [====] is seen and a “beep” tone is heard, it indicates that the Tono-Pen is ready to measure IOP. Proceed with applanation within 15 seconds. 

Note: After acquiring the double row of dashes [====], if more than 15 seconds elapses prior to applanation, the Tono-Pen will not measure. The software will have initiated a battery-saving func- tion, indicated initially by the display of a single row of dashes [- – – -], then followed in sequence by a blank display [ ]. A new IOP measurement can be initiated by depressing the operator’s button once. 

Note: Anytime the operator’s button is depressed twice within 1.5 sec- onds, (which may be caused by operator’s inadvertent pressure on the button) the software will interpret this as a demand for calibration. Then a sustained display of [CAL] will be seen which initiates the calibration sequence. The calibration sequence must be successfully completed before further measurements can be accomplished. 

  • Once activated, after [====] is displayed and a “beep” tone is heard, gently apply the Tono-Pen XL tip to the cornea in a brief tapping motion, then withdraw. Repeat several times. The corneal surface needs only to be momentarily contacted; indentation or excessive force is not required and may lead to inaccurate readings or patient injury. 
  • A chirp will sound and a digital IOP measurement will be displayed each time a valid reading is obtained. The single horizontal bar at the bottom of the LCD, indicating statistical reliability, will not be displayed with each single IOP measurement. 
  • After four (4) valid readings are obtained, a final beep will sound and the averaged measurement will appear on the LCD along with the single bar denoting statistical reliability. 

Note: If a single row of dashes [- – – -] appears on the LCD after the final beep, an insufficient number of valid readings was collected. If this occurs, repeat the patient examination procedure, starting at step 1. To take another measurement, reactivate the Tono-Pen XL unit by pressing and releasing the activation switch as described in step 5.

Note: If not reactivated within 25 seconds, the Tono-Pen XL unit will automatically turn off and the LCD will clear, placing the device in sleep mode, to conserve battery life. If this occurs, activate the TONO-PEN XL by pressing the Operator’s Button once.

  • Replace the Ocu-Film Tip Cover before using the Tono-Pen XL unit on another patient and before storage.

Note: Failure to replace the Ocu-Film Tip Cover between patients may result in unreliable readings of IOP by allowing debris to enter the transducer assembly.

Note: A reused Ocu-Film Tip Cover may leak. This may cause damage to the strain gauge and void the Warranty.

The number display represents IOP in millimeters of mercury (mmHg.) A number with a single horizontal bar displayed at the bottom of the LCD is an average of the valid measurements. A number without the single bar is a single measurement of IOP. Refer to Figure 7.

The display of one of four horizontal bars located along the lower border of the LCD block indicates the statistical reliability of the averaged measurement. For example, if the 5% bar is displayed, the standard deviation of the valid measurements is 5% or less of the number shown.

If the reliability measure is 20% or > 20%, a repeat measurement is recommended.

A single row of dashes [- – – -] indicates that the instrument is activated. Two rows of dashes [====] followed by a “beep” indicates that the instrument is ready to take measurements.

  • [CAL] indicates that the instrument is in the process of calibration check or the instrument needs to undergo calibration check procedure. If [CAL] is displayed following a long beep and [- – – -], the latter is the case. A [Good] calibration check must be obtained.
  • [Lob] indicates the need to replace both batteries prior to using the instrument.
  • [UP] indicates that the instrument is being calibrated and the probe tip should be turned from pointing down to pointing up.
  • [Good] indicates the calibration check procedure was successful. After two [Good] calibration checks, the Tono-Pen XL unit is ready for use in patient examinations.
  • [bAd] indicates the calibration check procedure was unsuccessful and must be repeated.

 

The Tono-Pen XL unit is internally calibrated, thus the instrument calibration should be checked only before the first use each day or in the event of unanticipated readings. Calibration must be routinely and successfully performed once daily prior to instrument use. Calibration should also be performed whenever it is indicated by the LCD display, when batteries are replaced, or after an unsuccessful calibration. It is not necessary to check calibration prior to each use.

  • Point the transducer end of the Tono-Pen straight down towards the floor. Refer to Figure 5. 
  • Depress the Operator’s Button two times rapidly. The time between the first and second button press must be between 0.5 and 1.5 seconds. The Tono-Pen will “beep” and display [CAL]. 
  • Wait approximately 15 seconds for the Tono-Pen to “beep”. The display will change from [CAL] to [UP]. 
  • Immediately (within 1 second) invert the Tono-Pen smoothly, pointing the transducer end straight up. Refer to Figure 5. 
  • A properly functioning Tono-Pen will display [Good] followed by a “beep”. 
  • Repeat this Calibration Procedure if [bAd] is displayed.
  • After [Good] is displayed, depress the Operator’s Button one time
    and the Tono-Pen will display [8888], followed by a single row of dashes, [- – – -], and then by a double row of dashes [====] followed by a “beep” tone, indicating the instrument is ready to measure IOP (Depressing the activation button a second time will interrupt this process and send the unit to calibration mode)

If several consecutive attempts at checking the calibration are unsuc- cessful:

  • Loosen or remove the Ocu-Film Tip Cover from the Tono-Pen XL probe tip and repeat the calibration check.
  • Spray the probe tip with compressed gas, and repeat the calibration check.
  • Replace the batteries and repeat the calibration check.

Note: If [CAL] appears followed by a row of four dashes [- – – -], the unit did not go into calibration mode. To correct this, depress the button quicker two times or slower two times. 
Note: Do not take measurements with the instrument if two consecutive [Good] calibration checks cannot be obtained. The instrument will not take a measurement when the prior calibration check was [bAd]. 
Note: If the Tono-Pen XL fails to yield a [Good] calibration, call Reichert Technical Service. 

A. Tip – location of sensor.

B. Transducer Assembly – housing for sensor.

C. Activation Button – Applanation Mode select button.

D. LCD – displays the IOP in mmHg, statistical confidence indicator, and battery life status.

E. Battery Compartment – Where are the batteries are located.