Begin Scanning & Image Capture :
When the Scanning Screen opens as shown in Figure 27 below, the operator can select the Camera Gain for the specific patient pigment. By default, the gain setting is set to MED (1) see green arrow, if the patient has a darker pigment the user can select HIGH gain setting to avoid a darker image. If the patient is light pigmented the operator can set the gain to LOW to avoid over exposed (too bright) image. The image acquisition is defaulted to the central fixation position and to capture a Single image (A) of 133 field of view. If the operator selects to capture a Stitch (B) image the Stitch tab should be selected as show in Figure 27 below and the camera will capture 2 images in two different fixation positions and automatically stitching the images into a 200 field of view retinal image.
Figure 27: Acquire Images selection of Camera Gain: Low, Mid, or High and selection of Single or Stitched image acquisition
By clicking on the Begin Scan tab or by clicking on the Joystick Triger Button (14) the Camera will start scanning in Infra-Red wavelength. The User will observe the external view of the eye that is being examined and will use the slit lamp joystick to maintain position of the camera in the center of the pupil and move forward until the image of the retina fills the field of view as shown in Figure 28 and Figure 29 below.
Figure 28: Capture mode, external infrared view of the eye prior to positioning the camera in the field of view of the retina
As the user continue moving the joystick forward towards the eye, the field of view of the retina increases until the image of the retina fills the entire field of view. When the camera is placed at the right distance from the patient eye, the image of the retina should fill the entire field of view on the screen as shown in the next page in Figure 29 on the right-side image.
Figure 29: As the user continue moving the joystick forward towards the eye, the field of view of the retina increases until the image of the retina fills the entire field of view as shown above on the right side
Patient’s Refraction Correction - Focusing of the retinal image can be achieved by changing the focusing in diopters (D) by the diopter correction as shown in Figure 30. The diopter correction is motorized and cover the range of +15D to -15D. It can be changed in steps of 0.25D by either dragging the Diopter Lever (A) or by the up/down arrows as seen the Figure 30 below.
Figure 30: Focus correction in diopter is achieved by either clicking the + or – (arrows) or by dragging lever as shown above. The selected diopter correction and the internal fixation position will be displayed in the bottom left side of the retinal
The Internal Patient Fixation is covering 133 and the entire field of view of the retina. It displayed on the screen by default at the center field of view as + and to the patient on an internal OLED screen as a blue cross +. The default centre position will place the patient Macula in the center of the field of view. The operator can drag with the mouse or trackpad the + on the screen anywhere in the field of view in order to achieve any peripheral imaging of the retina as shown in Figure 31 below.
In the case of a Stitch image capture, the internal fixation will be placed in 2 preselected positions that will ensure that the two automatically captured image are overlapping in order to generate a 200 field of view of the retina.
⚠️NOTICE: It is important for the operator to instruct the patient to follow the positions of the internal fixation in order for the software to auto-stitch the two retina images into a single 200 field of view image of the retina
Captured Image – When the position of the camera and the patient eye are right and the retinal image fills the field of view, the operator can capture the image by either clicking on the Capture Button on the top of joystick or by clicking on the Capture tab. The captured image is displayed on the laptop screen as in Figure 32 below. The system captures a pair of Color image with matching Infrared image of the retina User can review either the Color image (displayed by default) of click on Infrared image
Figure 32: the captured retina image display. Note that a pair of capture images includes Color image and Infrared image as seen on the thumbnails on the left side of the screen.
Each of the captured images depending on the selected Capture mode will be paired with Infra-red image and temporary saved into the Capture Station laptop as shown in Figure 33 below a pair of Color image with matching Infrared image of the retina.
Figure 33: The capture images (color and Infrared) are displayed. The user to either (1) Save & End Scan or (2) Save & Review. If the user choses to delete the captured image they can click on the Trash icon
After the capture of the pair of color and IR images of the retina as seen in Figure 33 above, the user has a choice to select either Save & End Scan (1) or Save & Review (2). If multiple images were captured the user should verify that the captured image(s) are of satisfactory quality and/or delete any of the captured images that are of poor quality. To delete the poor-quality image(s), the user can click on the Trash Icon to delete the selected image(s) as show in Figure 33 above.
After Clicking on the Trach icon, a warning massage is displayed for confirming the selection to delete the selected image as show in Figure 34 below. Note: once an image is saved to the Patient Database, it can only be deleted by Administrator privileges.
Figure 34: Warning massage before final delete of a capture image.
If the User selects to Save & End Scan (1) will be done after the user verify that the captured image(s) is of satisfactory quality, and it will save the image pair into the patient database and will transfer the user back to the Patient Search Screen (1st screen) for imaging another patient.
The second selection of Save & Review (2) will save the image(s) in the patient database and the user can proceed to image the next patient.