Slide 1 of 156
Optonet Vision Unit
Click on the arrow to start
The Optonet Vision Unit (OVU) is an advanced web platform, CE marked Class I medical device, registered with theMedicines and Healthcare products Regulatory Agency (MHRA), with reference number: 5943
Slide 2 of 156
The OVU offers a comprehensive range of vision charts, tools, and digital services for the assessment of visualfunction and binocular vision training. It adapts to various clinical environments, including In-person consultations,Domiciliary Visits, Video Consultations and Research. Internet access … but keeps working offline in the clinic!
Slide 3 of 156
Vision charts can be calibrated for any viewing distance: far, near or intermediate, with millimetric accuracy
Slide 4 of 156
Smart Case History
Slide 5 of 156
The vision Unit incorporates an innovative interactive questionnaire to remind key questions when taking the CaseHistory, based on patient’s symptoms and characteristics. The program will also suggest a list of tentative diagnosis
Slide 6 of 156
Visual Acuity
Slide 7 of 156
LogMAR VA chart with Sloan letters, usually known as Original ETDRS (1982).
This is considered the gold standard for VA, for its better accuracy and reliability
Equal number of letters per row (5)
Sloan letters
of similar legibility
Geometric progression
of letter size
Space uniformity
between letters
and rows (0.1 log)
Letter by letter VA scoring system
Slide 8 of 156
Revised ETDRS logMAR chart (1993): combinations of letters were adjusted from a study in7420 eyes, to balance the difficulty per row
Slide 9 of 156
LogMAR VA chart with original British Standard letters (BS 4274-1: 1968) as designed by Bailey & Lovie (1976)
Slide 10 of 156
Bailey & Lovie LogMAR VA chart with latest British Standard letters (BS 4274-1: 2003)
Slide 11 of 156
LogMAR VA chart with round numbers in a 5x4 proportion
Slide 12 of 156
LogMAR VA chart with square shaped numbers in 5x5 grid (similar to Snellen tumbling “Es”)
Slide 13 of 156
LogMAR VA chart with Landolt C rings. It can be displayed in either 5 or 8 different positions (2 options)
Slide 14 of 156
LogMAR VA chart with “Tumbling Es” in a 5x5 grid
Slide 15 of 156
Vanishing Optotypes for VA
Slide 16 of 156
Vanishing Visual Acuity ETDRS charts designed for early detection of Age-related Macular Degeneration (AMD)
Slide 17 of 156
Vanishing Visual Acuity charts with Landolt rings for early detection of AMD
Slide 18 of 156
Children’s Visual Acuity
Slide 19 of 156
Kay pictures are the only fully researched and validated picture optotypes that havebeen shown to provide accurate measurements earlier than letter and symbol charts
Slide 20 of 156
Children’s logMAR VA chart with Landolt Rings (Broken Glasses™ chart)
Slide 21 of 156
Children’s logMAR VA chart with Symmetrical letters.
Any combination of letters can be chosen from the following: X, V, O, H, U, T
Slide 22 of 156
Single rows of 5 symmetrical letters with a crowding effect and in a logMAR progression,
specially designed for plotting children's VA Percentile graphs
Slide 23 of 156
LogMAR ETDRS chart with Symmetrical letters (H, O, T, V) and crowding effect, as described in
The Amblyopia Treatment Study - Visual Acuity Testing Protocol
Arch Ophthalmol. 2001;119(9):1345-1353. doi:10.1001/archopht.119.9.1345
Slide 24 of 156
Options for
VA measurement
Each and every VA chart offers a wide variety of options to assist clinical measurement. Some of those will beshown next
Slide 25 of 156
Any row of letters (or symbols) can be highlighted with red lines on both sides
Slide 26 of 156
A row of letters can also be isolated, and its size changed
Slide 27 of 156
It is possible to add contour interaction, and also use a red arrow to point to the letter of interest
(very useful for young children)
Slide 28 of 156
We can keep adding the next row down, with smaller letters
Slide 29 of 156
A column of letters (or symbols) of equal size can be isolated
Slide 30 of 156
We can also isolate a column with letters of a decreasing size; useful for a quick estimation of visual acuity
Slide 31 of 156
A single letter can be isolated, with or without contours (for crowding effect)
Slide 32 of 156
The vision Unit also allows changing randomly the distribution of letters (or symbols), to preventthe patient from memorizing the charts
Slide 33 of 156
Automated VA calculation andrepeated meaurements
Slide 34 of 156
Automated VA calculation for easy logarithmic measurement. It is activated by pressing the number of letters seenper row (0 to 5) on the keyboard or remote-control menu. At the endpoint, the VA score is shown in different scales
Slide 35 of 156
Taking several VA measurements is very useful for a more accurate VA measurement, and to determine personalpatient response variability, for future visits. The program calculates the mean VA and standard deviation (SD)
Slide 36 of 156
Intermediate VA steps
Slide 37 of 156
Accuracy and reliability can be improved by adding middle sized rows of letters
(changing size by 0.05 log steps, rather than the standard step of 0.1 log)
Slide 38 of 156
Refraction: Sphere
The vision Unit offers a wide variety of vision tests for a thorough eye care examination.
Let’s start with refraction charts
Slide 39 of 156
A Duochrome mask is available for all logMAR visual acuity charts
Slide 40 of 156
Various Duochrome charts are also included. Letter combinations and size can be easily changed
Slide 41 of 156
Duochrome Rings chart
Slide 42 of 156
Duochrome test with dots
Slide 43 of 156
Duochrome with single line of letters
Slide 44 of 156
Grid to be used with binocular ±0.50 D cross cylinders (minus axes at 90º), for sphere power calculation
Slide 45 of 156
Refraction: Astigmatism
Slide 46 of 156
Dot target for cross-cylinder testing
Slide 47 of 156
Verhoeff rings for cross-cylinder test
Slide 48 of 156
Clock Dial test
Slide 49 of 156
Fan & Block test
Slide 50 of 156
Fan & Block test for Cyl axis calculation.
The arrow can be turned in 1-degree steps, until patient sees both sides appearing equally sharp
Slide 51 of 156
Power is then calculated by adding cyl lenses until both sets of lines appear equally sharp
Slide 52 of 156
Binocular Balance
Clinical Refraction should always be completed with a Binocular Balance, to ensure equalaccommodative requirements for both eyes
Slide 53 of 156
Binocular Balance test to be used with vertical prisms
Slide 54 of 156
Turville Infinity Binocular Balance test to be used with a septum (which can be placed on the nearvision rod of the phoropter head)
Slide 55 of 156
Polarized Binocular Refraction
& Binocular Balance
(Only for passive 3D monitors)
The vision Unit also includes of binocular charts for 3D passive monitors (or TVs), that require circularpolarized filters for ocular dissociation
Slide 56 of 156
Polarized visual acuity chart for binocular refraction: here the left eye (LE) can be refracted (LE sees all theletters), while the right eye (RE) can only see the central column (for fusion lock)
Slide 57 of 156
Polarized dot target for cross cylinder under binocular conditions.
In this example, the chart is only seen by the right eye, through the filters
Slide 58 of 156
Polarized Binocular Balance test. The top row is only seen by the right eye, the lower by left eye, while themiddle one is observed with both eyes
Slide 59 of 156
In the Polarized Binocular Balance test, letters can be randomly distributed, their size can be changed, and thesame or different letters can be shown to each eye
Slide 60 of 156
Polarized Binocular Balance chart: the first two letters of each row are only seen by the RE, the last two by theLE, and the central column is observed by both eyes
Slide 61 of 156
All polarized Binocular Balance tests also offer the option to show either different or equal letters to each eye,
as in this image
Slide 62 of 156
Letter rows can also be isolated in the Polarized Binocular Balance chart
Slide 63 of 156
Duochrome polarized Binocular Balance test, especially useful in patients with different VAs in each eye, whereit is not possible to use conventional binocular balance tests
Slide 64 of 156
Near Vision Charts
The vision Unit incorporates various tests and optotypes to assess near vision
Slide 65 of 156
Unrelated sentences in logarithmic progression for near vision (the OVU has to be calibrated for viewingdistance first). The phrase of interest can be pointed with red lines
Slide 66 of 156
Phrases for near vision can also be isolated
Slide 67 of 156
Binocular Vision
A wide variety of binocular tests is also available in the vision Unit
Slide 68 of 156
Heterophoria
Slide 69 of 156
Test for Horizontal Heterophoria measurement using a vertical prism. The test is calibrated in prism dioptersfor the viewing distance
Slide 70 of 156
Test for Horizontal Heterophoria measurement using the Maddox rod.
The test is calibrated in prism diopters for the viewing distance
Slide 71 of 156
Test for Vertical Heterophoria measurement using the Maddox rod, calibrated in prism diopters
Slide 72 of 156
Fixation Disparity
Slide 73 of 156
Horizontal Fixation Disparity (FD) test, that may be used to measure horizontal associated phoria (the prismthat compensates FD). Red/blue filters required
Slide 74 of 156
The Fixation Disparity test allows measuring FD in minutes of arc (calibrated for the viewing distance selected).
Slide 75 of 156
Polarized versions of Fixation Disparity tests are also included (for 3D passive monitors)
Slide 76 of 156
Vertical Fixation Disparity test for Associated Phoria calculation and / or measuring FD (in minutes of arc).
Slide 77 of 156
This Vertical Fixation Disparity test can also measure FD (in minutes of arc).
Slide 78 of 156
Polarized version of the Vertical Fixation Disparity test
Slide 79 of 156
Foveal Suppression
Slide 80 of 156
Foveal Suppression test: with the red/blue filters, blue letters are only seen by right eye eye whilst red lettersare only seen by left eye (red filter before RE). The central column is seen with both eyes (binocularly)
Slide 81 of 156
It is also possible to show the first two letters of each row to one eye, the last two to theother, while the central column is seen by both eyes
Slide 82 of 156
The Foveal Suppression test allows isolating single rows of letters
Slide 83 of 156
The polarized version of the Foveal Suppression test offers all the options shown
Slide 84 of 156
Worth Suppression test with red/blue filters. The Unit allows changing the size of the circles, in degrees.
(To vary the size of the retinal area stimulated)
Slide 85 of 156
Polarized version of the Worth Suppression test.
Slide 86 of 156
Stereoacuity
Slide 87 of 156
Contour Stereoacuity test (local stereopsis), to be viewed with red/blue filters
Slide 88 of 156
Polarized version of the contour Stereoacuity test
Slide 89 of 156
Random-dot Stereoacuity Test for red/blue filters. It is possible to choose the type of letters or figures to showin 3D, as well as their size
Slide 90 of 156
Random-dot Stereoacuity test with Symmetrical letters as stimuli. There are no monocular cues when viewedthrough the filters
Slide 91 of 156
Random-dot Stereoacuity test, with Geometrical shapes as stimuli
Slide 92 of 156
Aniseikonia
Slide 93 of 156
Aniseikonia with red/blue filters. The size can be changed in 0.25% steps for greater accuracy
Slide 94 of 156
In order to quantify aniseikonia, the size of the image seen by the right eye is changed to match the size of theimage perceived by the left eye
Slide 95 of 156
Polarized version of the Aniseikonia test
Slide 96 of 156
Cyclorotation
Slide 97 of 156
Cyclorotation test for red/blue filters
Slide 98 of 156
The lines should be rotated until perceived as parallel through the filters.
In this example there is an Ex-cyclodeviation of 3 degrees
Slide 99 of 156
The Cyclorotation test shows now an In-cyclodeviation of 2 degrees
Slide 100 of 156
Polarized version of the Cyclorotation test
Slide 101 of 156
Incomitancy
The vision Unit also includes tests to evaluate incomitant deviations
Slide 102 of 156
Horizontal ocular deviation test, calibrated in prism diopters for the chosen viewing distance (viewed withred/blue filters)
Slide 103 of 156
Vertical ocular deviation test calibrated in prism diopters
Slide 104 of 156
Hess Screen test to map incomitant ocular deviations in different gaze directions (with red/blue filters)
Slide 105 of 156
Test results in the Hess screen assessment of ocular motility in 9 diagnostic gaze positions for each eye
Slide 106 of 156
Polarized version of the Hess-Lancaster test for the assessment of non-comitant deviations
Slide 107 of 156
Ocular Health
Slide 108 of 156
Contrast Sensitivity
Several methods are offered for the assessment of contrast sensitivity
Slide 109 of 156
Low contrast visual acuity charts. Any level of contrast can be set, from 0 to 2.25 log, in 0.15 log steps
Slide 110 of 156
Contrast sensitivity charts with letters of fixed size (as proposed by Pelli-Robson).
Any letter size can be selected
Slide 111 of 156
Potential Visual Acuity
Slide 112 of 156
Potential visual acuity Super-Pinhole to be used in patients with cataracts and other ocular media opacities
Slide 113 of 156
Amsler Grids
Slide 114 of 156
White grid over black background
Slide 115 of 156
Amsler grid with diagonals for patient with central scotoma
Slide 116 of 156
Amsler charts – Red grid over Black background
Slide 117 of 156
Amsler charts – black grid over white background
Slide 118 of 156
Red desaturation test, useful in the detection of visual field defects
Slide 119 of 156
Pseudoisochromatic Ishihara Plates: the most commonly used colour vision test
Slide 120 of 156
The Farnsworth D-15 colour vision test offers a quantitative analysis of colour perception anomalies, especiallythose acquired (which are usually tritan: yellow-blue). The Lanthony Desaturated D-15 version is also included,for improved sensitivity.
Slide 121 of 156
Multifixation Campimeter for the screening of visual field defects
Slide 122 of 156
Orthoptics
Binocular Vision Training
The vision Unit offers a complete range of vision procedures for the treatment of Convergence Insufficiency(either with red/blue filters or 3D polarized screen). All test have automated feedback
Slide 123 of 156
Blocks game for Anti-suppression training and binocular coordination
Slide 124 of 156
Polarized version of the Blocks game
Slide 125 of 156
Anaglyph Fusion Circles for the treatment of horizontal fusional vergences (Convergence & Divergence)
Slide 126 of 156
Fusion Circles Vectograms for the treatment of horizontal fusional vergences (Convergence & Divergence) – forpassive 3D screens only
Slide 127 of 156
Automated forced-choice anaglyph with accommodative control for the measurement and treatment ofhorizontal fusional vergences
Slide 128 of 156
Automated forced-choice vectogram with accommodative control for the measurement and treatment ofhorizontal fusional vergences
Slide 129 of 156
Automated forced-choice anaglyph with accommodative control for the measurement and treatment ofvertical fusional vergences
Slide 130 of 156
Automated forced-choice vectogram with accommodative control for the measurement and treatment ofvertical fusional vergences
Slide 131 of 156
Anaglyph stereograms for the treatment of horizontal fusional vergences. When fused, the image is perceivedin 3D (to monitor patient’s compliance)
Slide 132 of 156
Forced-choice random dot stereograms for the treatment of fusional vergences (convergence & divergence).When fused, a 3D image is perceived
Slide 133 of 156
Polarized version of the automated forced-choice random dot stereograms for the treatment of fusionalvergences (convergence & divergence)
Slide 134 of 156
Automated anaglyphs for the measurement and training of horizontal fusional vergences. The patient shouldclick on the letter that is seen in 3D
Slide 135 of 156
Polarized version of the random dot stereogram with automated forced choice measurements for horizontalvergences
Slide 136 of 156
A choice of letters, figures or Landolt rings can be displayed as stereoscopic stimuli. Landolt Cs are shown here
Slide 137 of 156
Geometrical figures in the stereoscopic random dot charts
Slide 138 of 156
Random dot stereograms for vertical vergence measurement and treatment (infra and supra - vergences)
Slide 139 of 156
Polarized version (vectograms) of the random dot stereograms for vertical vergence measurement andtreatment
Slide 140 of 156
Test for automated forced-choice monocular accommodation facility measurement and training
Slide 141 of 156
Polarized version of the test for automated forced-choice monocular accommodation facility measurementand training
Slide 142 of 156
Chart for ocular saccadic and pursuing eye movements
Slide 143 of 156
Complete patient management and record keeping for Binocular Vision Training
Slide 144 of 156
Home-based
Orthoptics / Vision Training
Slide 145 of 156
The Home Training feature offers the professional remote control and monitoring of the exercises prescribedfor home
Slide 146 of 156
Options and Configuration
The Optonet vision Unit can easily be adapted to anyone’s needs and preferences (ideal for research)
Slide 147 of 156
The vision Unit incorporates a simple system to calibrate the charts for the viewing distance at each particulartesting room
Slide 148 of 156
Optotype displays can be inverted in small examination rooms, when a mirror is required in order to duplicatedistance
Slide 149 of 156
Automated scoring system for VA and stereoacuity available, as a simple and accurate method of measurement
Slide 150 of 156
Tests Sequences
Slide 151 of 156
With the vision Unit it is easy to personalize sequences of tests. Then, just pressing one button will take usfrom one test to the next (or previous) of the sequence
Slide 152 of 156
Remote Control
Slide 153 of 156
A tablet can be paired with the distance vision chart in the testing room, or to the patient’s computer inremote consultation, to be used as a remote controller. The tablet will display the replica of the chartsdisplayed for the patient
Slide 154 of 156
Telemedicine
Remote Video Consultations
Slide 155 of 156
The OVU incorporates an innovative video consultation service, developed in collaboration with the BritishNational Health Service (NHS). This service allows video calls in which any vision chart can be shown andadministered remotely on the patient’s personal device (computer, tablet, or phone)
Slide 156 of 156
The End