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Adaptica 2WIN Operator's Manual

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2WIN
OPERATOR MANUAL
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Summary of Contents for Adaptica 2WIN

  • Page 1 2WIN OPERATOR MANUAL...
  • Page 2 Revision notes Software configuration version 4.2.170426 Publication date 2017/05/03 Hardware configuration version Version 17.0 and earlier Rev Num.

  • Page 3: Table Of Contents

    LASSIFICATION AND TYPE OF APPLIED PARTS ................................9 CLASSIFICATION ............................9 LECTROMAGNETIC COMPATIBILITY ................................9 PPLIED STANDARDS QUICK USER GUIDE ............................10 2WIN ..................................10 ................................11 AIN APPLICATIONS ................................11 XAM CONDITIONS ................................11 XAM PROCEDURE ................................13 EASUREMENT TIPS DESCRIPTION OF THE DEVICE..........................14...
  • Page 4 ..............................80 TORAGE INSTRUCTIONS ......................80 NSTRUCTIONS FOR CORRECT DISPOSAL OF THE DEVICE ..................80 EPARATE COLLECTION FOR ELECTRICAL AND ELECTRONIC EQUIPMENT 2WIN APPLICATIONS SPECIFIC MANUALS ......................82 ................................. 82 EGENDS OF SYMBOL 2WIN A ) ..................82 PPLICATIONS INSTALLATION THE SAME STEPS FOR EVERY APP (CR-A ) ......................
  • Page 5 Standard mode ................................ 97 Manual mode ................................98 Calibration mode ..............................99 Exam display................................101 Browsing mode ..............................102 Post exam measurements ............................. 103 (LC-A ) ..........................109 ENTERING PPLICATION Lens Centering Application activating ........................109 Measurement with the App activated ........................110 Activation in Browsing mode..........................

  • Page 6: Manufacturer Identification

    1. Manufacturer identification Manufacturer Adaptica S.r.l. Address Via San Marco, 9/H 35129 Padova (PD) Italy Telephone +39 049 773 968 Mail: contact@adaptica.com Web: www.adaptica.com 2. Legend of symbols Manufacturer identification data Date of manufacturing Electrical / electronic device subject to the WEEE...

  • Page 7: Glossary

    Auto Shutdown A procedure whereby 2WIN stops to work and switches off automatically. Auxiliary window Graphical window that displays additional data.
  • Page 8 Parallelism of visual axes, the normal eye muscle balance. 2WIN Applications Additional software features that can be installed directly on 2WIN. Refraction When referred to human eye, this term, or the term Refractometry, are used to indicate the measurement of the Refractive Error, that is the error in the focusing of light by the eye.

  • Page 9: Intended Use Of The Device

    4. Intended use of the device Instrument for the measurement of binocular and monocular refraction, dynamic photoskiascopy. 5. Classification and Applied Standards Classification according MDD 93/42/EEC, Annex IX Class IIa Classification and type of applied parts There are no applied parts. IP classification IPX0 (degree of protection provided by the external plastic shells with reference to the penetration of any special material or water).

  • Page 10: Quick User Guide

    Important • The 2WIN is a binocular refractometer and vision analyzer. It measures refraction of both eyes at the same time, at a distance of 1 meter. • The 2WIN should not be confused with a table-top auto-refractometer (AR). ARs are designed to measure refractive errors of one eye at time, in an artificial condition of far fixation.

  • Page 11: Main Applications

    • A stable measurement distance of 1 meter is also important. Exam procedure • Turn the 2WIN ON by pressing the ON/OFF button for 1 sec. and wait until the stand-by screen appears. • Instruct the patient to keep his/her eyes wide open, clear of eyelids or eyelashes, and to fixate the centre of the camera.
  • Page 12 Screen examination – blurred, not in focus. Adjust the distance from the patient • Adjust the distance to focus the image until the top bar is green and the focusing indicator based on corneal reflex shape appears in the centre of the screen. •...

  • Page 13: Measurement Tips

    2WIN displays “high M” (myopia) or “high H” (hyperopia). In the case the 2WIN displays “high M” or “high H” without displaying a numerical result, 2WIN will write in the upper part of the display “n.a.” (not accessed measurement).

  • Page 14: Description Of The Device

    It can be connected to a mini-printer, via IrDA (Infrared Data Association) interface, to print the measurement results onto a strip of paper. 2WIN data can be saved inside the 2WIN and downloaded outside the instrument through USB connection or WiFi...
  • Page 15 ATTENTION: during any data access to the 2WIN data ad in particular when connecting 2WIN to a computer via USB or WiFi the SD card of 2WIN must be inside inside the 2WIN SD card connector (SD card filesystem must be FAT32).

  • Page 16: Labels

    Explanation Manufacturer identification data: name and address Model name Serial number, including manufacturing date: 2WIN = model code D = year (A=2009 B=2010 ..) F = lot 00001 = unique serial number Battery operating voltage CE mark and Notified Body...

  • Page 18: Package Labeling

    Package labeling Label Detail Explanation Manufacturer identification Data: name and address Fragile – handle with care This side up – do not reverse Keep dry Storage minimum maximum temperature...

  • Page 19: Interfaces

    Interfaces Front View Rear View Inside the USB & SD connection door there are a Micro USB port and a Micro SD card holder.
  • Page 20 Open connection door On the bottom of the device there is also a 1/4”-20 threaded hole for a tripod. A summary of the functions of the buttons is reported below. Patient side: BUTTON S1 & S2 Operator side: BUTTON A BUTTON B CROSS BUTTON BUTTON C...
  • Page 21 • push CENTRE to enter menu or to say OK; o push RIGHT to go down into the submenu; o push LEFT to go up from the submenu; o push UP to scroll up the menu; o push DOWN to scroll down the menu; •...
  • Page 22 All the button functions are summarized in the following figure: KEY- DATE TI- SCREEN BUTTON HOME BROWSE MENU IN MEASURE BOARD Hold A on/off on/off 2WIN Applications Exit Exit cancel cancel exit Hold B print Print Zoom Zoom Change field Change field...

  • Page 23: Graphical User Interface

    Graphical user interface The graphical user interface is displayed in these figures:...

  • Page 24: Precautions

    8. Precautions Electromagnetic compatibility This device has been tested and found to comply to the limits for medical devices contained in IEC60601-1-2 and in Medical Device Directive 93/42/EEC. These limits are intended to provide reasonable protection against harmful interference in a typical medical installation.
  • Page 25 Inside the 2WIN SD memory card is stored the patient data. This information can contain personal information such as name/surname/age. This information management is responsibility of the operator.

  • Page 26: Operative Information

    Registration takes less than 1 minute! It's highly recommended to register your 2WIN at: http://www.adaptica.com/user-registration/ Registering your 2WIN instrument you will be updated from Adaptica on any recent news or software update of the 2WIN. Operating conditions The device needs to be operated under the following environmental conditions: 10 –...

  • Page 27: Insert Battery

    Insert battery To insert the battery: slide the battery lock, hold it and gently open the battery door located in the lower side of the device. Insert the battery. Pay attention in inserting the battery with its connector facing down towards the instrument's inside so that the connector of the battery matches the connector inside the device.

  • Page 28: Battery-Charging

    2WIN device. Please notice that the device will not be able to perform any exam while connected via micro-USB port.

  • Page 29: Data Management Disclaimer

    The operator is asked to read the document and accept the terms, if not 2WIN will work but some functionalities will be disabled (Telemetry and Remote access). You can read the document at the end of this manual (Appendix A) for all the details.

  • Page 30: A Environment Setup

    a) Environment setup b) Instrument setup c) Preparation of the patient d) Measurement...
  • Page 31 Environment setup For a proper use of the device it is important to prepare the environment for the examination. ✓ Verify adequate light conditions The ambient light should be dim, there should be no direct light pointed towards the instrument and every direct source of light should not be seen by the device or reflected by eyes of the patient.

  • Page 32: Eye Selection

    Good light conditions are equivalent to a value of VIS between 30 and 80, and of IR less than 30. Instrument setup As soon as powered ON, the device will perform a fast auto-test, then it will turn directly to exam mode, and the display will show the screen depicted below.

  • Page 33: Interactivity/Attraction Of The Patient

    Please notice that the there is an inversion of left and right due to the fact that the patient and the machine are one in front to the other. Therefore the sign OS will appear on the right half of the screen, and viceversa. Performing a monocular examination, the contralateral eye can be covered or kept open at (choice of the Operator).

  • Page 34: Patient Data

    To resume the last patient data, enter in keyboard active mode (long press left) and press Button D / resume. IMPORTANT NOTE: If 2WIN has Wi-fi capabilities, it's possible to insert patient data in a different way. Look at paragraph 9 “Wi-fi connection” pag.61.

  • Page 35: Browsing Mode

    (circular shape arrow) appears. If a stored patient data has been saved with a 2WIN sw version previous to 2.0 (but not lower than 1.4), then the browsing mode shows an exclamation point icon indicating that some fields are incomplete.

  • Page 36: Preparation Of The Patient

    Preparation of the patient During the exam the patient must look at the device, staring to the central front hole of the device. The operator shall instruct the patient to look at the device and to try to open wide his eyes so to avoid eyelashes covering the pupils.

  • Page 37: D Measurement

    2WIN and the patient. When the top bar is RED adjust the distance between the 2WIN and the patient in order to focus the image and to obtain a GREEN top bar. Try every time to focus as best as you can, looking at the corneal reflex.
  • Page 38 4. Adjust the distance to focus the image until the top bar is green and the focusing indicator based on corneal reflex shape appears in the centre of the screen. 5. When the top bar is PERMANENTLY green and the focusing indicator reaches the highest peak (as shown in the following photo) release the BUTTON S1/S2.
  • Page 39 Data Processing Wait until the measurement process is finished and the results of the measurement are displayed on the screen. A two beep sound indicates that the measurement has been correctly taken (this is an option selectable from Measurement>Sound>Alerts>Ending Beep). •...
  • Page 40 If n.a. is displayed when High M/H appears, this indicates that the refraction is outside the range of the 2WIN measurements range. In case of binocular measurement, two values are shown overlapped to the image, inside the blue rectangle; they are...
  • Page 41 • Press LEFT BUTTON to recall last valid measurement performed (in case of invalid, uncompleted measurement). • Press RIGHT BUTTON for auxiliary window results, in normal 2WIN activities this will bring to the amblyopia screening table. • long left push: activates keyboard to insert patient name and date of birth: ACTIVE KEYBOARD MODE.

  • Page 42: Zoom Function

    Zoom function When the measurement is performed, the operator can make a zoom on the acquired pupils of the patient. In order to do that SHORT PRESS the PRINT button. In order to come back to the main visualization just short press the power botton. The Zoom App has two main functions on the bottom left of the screen: the Zoom function (lens) and the Pan function (hand).
  • Page 43 If you hold the down button the zoom will became 1x, if you hold the up button the zoom will became 4x centered on the selected pupil. If you want to change pupil you have to press the right and the left buttons that allows you to choose on wich of the two pupils the zoom will take place.
  • Page 44 How to activate zoom on other measures You can use the Zoom App on an image took from another measure by selecting the Zoom function and loading the image. The Zoom App sometimes does not automatically identify the pupils. Auto-research of pupils In case of automatically identifing of the pupils, the situation will be the same as the normal situation shown earlier.
  • Page 45 you can position the pupils by the pan function and then save their positions after reaching it by pressing the pupil button to memorize its position, both right and left. After selecting the two pupils you have to return to the main screen by clicking the power button and then you can save the exam and the pupils position by holding the print button.
  • Page 46 To navigate on the menu use the arrows on the cross button: UP and DOWN buttons will move up and down the highlighted choice, RIGHT button will select the highlighted choice navigating deeper by one level in the menu, LEFT button will step back to previous menu level towards main menu page.
  • Page 47 • The submenu Display allows to change the way results are presented on the display. PLUS CYLINDER REFRACTION MINUS CYLINDER DISPLAY DEGREE GAZE HIRSCHBERG TEST Refraction: allows choice between plus and minus cylinder visualization. Once the measure is displayed, it is still possible to toggle between the two visualization modes by pressing the UP arrow on the cross button.
  • Page 48 Most of the items in the submenu Rainbow Fixation are self-explanatory. They are different ways of turning on the visible led in front of the 2WIN. Custom sequence is to be configured by placing a proper custom file in the SD card. See the Customization...
  • Page 49 SCREEN DISPLAYED SCREEN MAX AXIS SCREEN MIN AXIS • 'Update User Table' is selected when uploading a user table, and for uploading a newly compiled user table. ‘Threshold Settings’: (a) Screen Min Axis: you are measuring with a notation that minimize the sphere –this mode is independent by how the data is displayed;...
  • Page 50 Please notice that the brighter the display, the faster the battery gets discharged. The menu Functions configures three feature: 2WIN APPLICATIONS...

  • Page 51: Quick Menu

    Those information should be used for the reporting abnormalities to your distributor. Quick menu In order to get access to the preferred and most used functions of the 2WIN, it is possible to activate the Quick Menu. With this Menu is possible to recall rapidly any 2WIN function/item that is commonly used by the operator.

  • Page 52: Contextual Help

    Mode, Data and Time Modification. Example of contextual help. Note that the two light blue circle at the top and at the bottom of the window represent the two frontal START buttons, while the other symbols all the 2WIN backside butto...

  • Page 53: Summary Of Menu Entries

    Summary of menu entries 1.0 Measurement 1.1 Display 1.1.1 Refraction 1.1.1.1 Plus Cylinder 1.1.1.2 Minus Cylinder 1.1.2 Gaze 1.1.2.1 Degrees 1.1.2.2 Hirschberg Test 1.2 Sound 1.2.1 Volume 1.2.1.1 Level 1 1.2.1.2 Level 2 1.2.1.3 Level 3 1.2.1.4 Level 4 1.2.2 Jingles 1.2.2.1 Jingle 1 1.2.2.2 Jingle 2 1.2.2.3 Jingle 3...
  • Page 54 3.0 Settings 3.1 Wireless 3.1.1 Wireless ON 3.1.2 WiFi Status 3.1.3 WiFi Config 3.1.4 WiFi Options 3.1.4.1 2WIN Password 3.1.4.2 Auto Connect WiFi 3.1.5 Connections 3.1.5.1 VisionFit Connection 3.2 Date/Time 3.2.1 Date/Time Format 3.2.1.1 Format H12 3.2.1.2 Format H24 3.2.2 Set Date/Time 3.3 Aux...

  • Page 55: Print To Portable Infrared Printers

    1) Manufacturer GEBE – Model 11898 GPT-4378-Flash-79-V.24-IrDA a. Compatible with 2WIN software version greater than 4.1.161213 b. If bought from Adaptica the printers works out of the box while if the operator will buy in a different moment, the printer must be configured. See Appendix 2) Manufacturer SEIKO –...

  • Page 56: Mail Printing

    BUTTON B pressed for 1 second. Mail Printing It is possible to send a mail with 2WIN pdf attachment in order to allow mail printing from 2WIN or to receive via email the measurement. In order to activate this service, place a file (*.txt file) named mailPrinting in the SD root containing the email you want the files to...

  • Page 57: Save Exam

    If the SD card printing is inserted, a set of 4 files for each examination will be saved into the SD card, into the folder Patients (“2WIN Exams” if the software version is the 4.0 or more), there creating a subfolder named 2WINExam _date_number, where date is current date and number is a sequential number.
  • Page 58 An example of the exam report in .pdf An example of the extended exam (with Grid on Report option) is shown in report for screening in .pdf (with Grid on the following Figure Report option) is shown in the following Figure Exam report in .pdf...
  • Page 59 The 2WIN is seen as an external memory storage, when the USB symbol appears on the 2WIN display it is possible to copy data from the 2WIN SD card to the PC. It is important to safely remove (unmount, check the PC Operative System for this) the external memory storage of the 2WIN from the PC after data have been saved on PC and before disconnecting the USB cable.
  • Page 60 Print screening on IRDA...
  • Page 61 Menu>Print>Options>Strip in Pdf. CVS Exporter Tool The 2WIN permits to export all the patient data stored in the SD card in a CVS (Comma Separated Value) file. This text-based file can be used to share data from 2WIN and spreadsheet documents.
  • Page 62 Once activated the export patient, the 2WIN will create in the root of the SD memory card the CVS file with the following name-format: Resume_Date_Hour. Gaze The maps indicate the gaze (that is the eye position), not the corneal reflex. The eye...
  • Page 63 In the images you can see the position of eye on maps, and you can easily understand how Tropia is evidenced simply comparing position in binocular (first line) respect a cover test (under). During cover test, the only eye the patient are using is fixating perfectly. On the binocular vision can happens that one eye is not fixating.

  • Page 64: Hirschberg Test

    Low fidelity message Hirschberg Test If “Hirschberg test” is selected for the representation of the gaze, either in the MENU or by toggling the visualization type via cross button (DOWN arrow), the results for patient's fixation will be expressed by the Hirschberg test coding: ET = esotropia EP = esophoria HT = ipertropia...
  • Page 65 printouts (both to portable printer and to file) will be customized by adding the first three lines contained in such file. Sample: Winning Eye Clinic 5, Trafalgar Sq. London www.winningeye.com NOTE: The text file must be saved in UTF-8 codification from your text editor. Custom RGB sequence By creating in the root folder of the SD card a file named rgbCustomSequence.txt...

  • Page 66: Notification Center

    WiFi networking status and logins and notifications on the additional software Applications installed. When a new notification is added to Notification Center, 2WIN logo will be shown with a red background. The notifications are stored in the Notification Center in a recursively way, the last 20 information are always showed.

  • Page 67: Screening Table

    Measurement>Screening, The current table, either default (based on AAPOS guidelines) or custom (defined by the user), is displayed. The screening table is the set of thresholds that are used by the 2WIN to determine if a patient is inside or outside the guideline for amblyopia detection screenings.
  • Page 68 Minimum age, Maximum age: age interval Hyperopia, Myopia, Astigmatism, Anisometropia, Anisocoria, Gaze: numerical thresholds Last two columns: numerical value set to 0. A measurement is considered positive (the screening is passed) if the value is compliant to the following thresholds: Hyperopia: the measured spherical value on all meridians must be lower than this threshold [in Measurement>Screening>Threshold Settings there are three possibilities: (a) Screen Min Axis, (b) Screen Max Axis, (c) Screen Displayed]...

  • Page 69: Upload

    To display the Screening Measurement result, from the home screen, press the right button of the Cross button. The following window is visualized: NOTE: Screening Measurement Result is an Auxiliary window. Read the relative paragraph for more information. Pairing and transferring a 2WIN test to VisionFit...
  • Page 70 The second Adaptica’s product, VisionFit or VisionFit-SC, can be connected to the 2WIN. Since VisionFit system is a mobile and wearable subjective refractor (phoropter), it’s pos- sible to transmit 2WIN objective refraction results to the VisionFit in order to speed-up the refraction process.
  • Page 71 To transfer a 2WIN measurement to VisionFit, follow the steps below: Perform a test using the 2WIN. Press the joystick down in 2WIN. 2WIN data will appear instantly on the right side in VisionFit (Reference data area). If the 2WIN test has already been performed, browse the 2WIN “Browsing Mode”...

  • Page 72: Wireless Connections

    This picture shows that before starting any networking operations the 2WIN must be connected to a wifi Local Area Network. The user must insert the appropriate credentials in order to log the 2WIn to the Wifi access point present in the office/room. The access point will...
  • Page 73 In order to enable the wireless (WiFi connectivity) in the 2WIN-W is necessary to follow the following steps: In order to enable the wireless (WiFi connectivity) in the 2WIN-W is necessary to follow the following steps: Click on “Wireless ON” from Menu >...
  • Page 74 Click on the item WiFi Status (or directly from Notification Center) to (1) check if the 2WIN is connected to your network and to (2) determine the IP of 2WIN. – WARNING – The default password of 2WIN for networking services (SFTP and VNC + SSH) is adaptica.

  • Page 75: Sftp E Vnc + Ssh Access Credentials

    Sftp e vnc + ssh access credentials The sftp access to 2WIN is carried out with the following setting: User: 2winftp Password: adaptica* There must be a Micro SD card to view the content. Port: *adaptica is the default password if not changed by user...

  • Page 76: Sftp And Vnc+Ssh Suggested Softwares

    MUST read those manuals. Keyboard command for the use of vnc+ssh Once the VNC + SSH app is connected to the 2WIN, the procedure to input patient data (after the measurement) is: Type with your virtual keyboard the Enter button.

  • Page 77: Applications (Packages)

    (from version 4.0 the new name of these packages is “APPLICATIONS”); Each application will be described at the end of this manual. You will be notified via email about the availability of a new 2WIN software application. In this document it is described the installation/management of additional applications. Installation Send an e-mail for a application request with the serial number of your 2WIN.

  • Page 78: Visualization

    When you don’t use the default application for refraction measurement, the main measure window is blue coloured. Auxiliary Windows From Main Screen of 2WIN, push right the CROSS button to display the Auxiliary window (default is screening result). es. Screening Results Press BUTTON B (print button) to display the Auxiliary Window choosing tab.

  • Page 79: Software Upgrade Instructions

    Strip, pdf. 13. Software upgrade instructions In case of future software releases to upgrade the 2WIN, the user will be contacted by means of an information note (email/fax/phone call) containing the description step by step of the instructions to upgrade the device.

  • Page 80: Maintenance And Cleaning Instructions

    14. Maintenance and cleaning instructions No maintenance operations are required by the system. If the measurement never ends correctly and the hardware test does not reveal any hardware problem, the system may be periodically verified, by means of a procedure called “white fielding”.
  • Page 81 collect such WEEE separately. The available return and collection system is defined by the local public administration, or in alternative an authorized company can recycle the WEEE. Please refer to public administration about the separate collection, if this information is not available, contact the manufacturer of the equipment.

  • Page 82: Win Applications Specific Manuals

    A new device will appear on the computer where you attached the 2WIN. Drag and drop the file “2WIN Applications.2wp” on the new device icon or with the file Explorer of your computer copy the file “2WIN Applications.2wp” and past it in the Root directory of the new device.

  • Page 83: Analysis Of Corneal Reflexes Position (Cr-App)

    2WIN on; the 2WIN Application is now available for activation; Analysis of Corneal Reflexes Position (CR-App) This function can provide information regarding the corneal reflexes position. The App will add the feature to collect data from 3 measurements and analyze the corneal reflex.
  • Page 84 Modes screen Main Visualization - Corneal Reflexes...

  • Page 85: Corneal Reflexes Exam

    Measurement tips: usually the RED condition depends on a bad distance between the 2WIN and the patient. When the top bar is RED adjust the distance between the 2WIN and the patient in order to focus the image and to obtain a GREEN top bar.
  • Page 86 4. Adjust the distance to focus the image until the top bar is green (for details on screen tips also see: Verify the position of the subject in 2WIN Operator Manual). 5. When the top bar is STEADILY green release the BUTTON S1/S2 – the message "MEASURING"...
  • Page 87 Green Indicator 7. Click the BUTTON C ( ) and select the eye where you want to perform the cover test, using the Binocular Occluder provided by Adaptica (NOT OTHER OCCLUDERS) to cover the contralateral eye. Cover OD 8. Repeat the steps 1 to 6 to get the measurement.

  • Page 88: Exam Results From 'Corneal Reflexes' App

    Exam Results from ‘Corneal Reflexes’ App Once completed the test, auxiliary window for the corneal reflexes analysis is opened automatically (Menu > Functions > 2WIN Applications > Corneal Reflexes > Options > Show at End). This is an example of exam results of Reflex Symmetry application.
  • Page 89 Note that the operator can switch between this description (baricentral fixation) to the simple pictures of the pupils just pressing the EYE button on the 2WIN. When the position of the corneal reflexes comparing the binocular test with the monocular...
  • Page 90 (mm) selected in the settings (Menu > Functions > 2WIN Applications > Corneal Reflexes > Options > Threshold), the output is "ORTHO". When a manifest asymmetry of the corneal reflexes is detected without cover test the output is ET: esotropia;...

  • Page 91: Print

    Threshold levels can be changed, by default they are factory set to 5DP for the kx output and to 4DP for the ky output. Menu > Functions > 2WIN Applications > Corneal Reflexes > Options > Threshold The following picture gives a graphical representation of the codes.
  • Page 92 An example of Corneal Exam Report (PDF) In the printout the results are displayed in degrees or prism diopters, the concentric circles representing 10 units steps of that unit (10, 20, 30 Prism diopters or degrees). The pupil is sized accordingly and cropped if bigger that 7 mm. In the report is also possible to see all the pupil pictures.

  • Page 93: Measurement Reset

    • By saving data on SD memory • By choosing a new application • By clicking Reset from Menu > Functions > 2WIN Applications > Corneal Reflexes > Reset Reset in Corneal Reflexes New measurement overwrites old data with new data automatically.

  • Page 94: Dynamic Pupillometry Application

    This function can provide information regarding the pupils response (diameter during time) when the eyes of the patient are illuminated with a known visible and programmable white light created by the 2WIN. The visible stimulus light can be programmed by the operator in intensity and duration.

  • Page 95: Dynamic Pupillometry Application Activation

    After the installation this application must be activated to be utilized. Activation: click the 2WIN BUTTON A ( ) 2WIN Applications screen will be shown to display. Doing this, it is possible to navigate and to see all the installed applications into the device.

  • Page 96: Dynamic Pupillometry Exam And Modes

    3) Calibration mode: like the Manual mode, this exam mode needs a configuration file written in the SD card of 2WIN. At the beginning of the exam this mode illuminates the patient with 4 calibration impulses in order to understand automatically the good final exam impulse.

  • Page 97: Exam

    The standard mode is activated in the Dynamic Pupillometry applications only if it’s not present in the 2WIN SD card the right configuration file or if this file is not edited in the proper way. The standard mode creates (after a dark second) a sequence of 4 bright light impulses.

  • Page 98: Manual Mode

    Moreover, if the ambient light is too low all the pulses (calibration and final one) will be reduce by half (in this case in the display of 2WIN the maximum value will be 1 and NOT 2 Manual mode In order to activate this mode the operator has to write with a text editor a file (named pupilresponse.txt) and copy it in the SD memory of the 2WIN.

  • Page 99: Calibration Mode

    The four calibration intensities are written in the configuration file with A,B,C,D letters. A,B,C,D values must be placed in ascending order. The 2WIN during this calibration mode will start the exam with a starting 1 second of dark condition, then it will switch between the 4 A,B,C,D calibration intensities, each of them turned on for 1 second).
  • Page 100 NOTE: in the case T value is missing in the configuration file, then the standard mode will be used by the 2WIN. On the other hand if any of the other numerical values (P,A,B,C,D) are missed in the configuration file (or written in the wrong format), then 2WIN will use the...

  • Page 101: Exam Display

    The exam will finish after 14 seconds. After that, the main window of the 2WIN will display in the upper part the maximum and minimum pupil diameter for each OD and OS. By pressing the RIGHT button in the 2WIN Joystick it’s possible to analyze the complete result of the exam.

  • Page 102: Browsing Mode

    DOWN button of the 2WIN joystick. Than the operator can read/browse the previous exams by pushing the UP or DOWN button. Then, the main window of the 2WIN will display in the upper part the maximum and minimum pupil diameter for each OD and OS.

  • Page 103: Post Exam Measurements

    The second line can be adjusted manually by long pressing the MENU button (CENTRAL button of the 2WIN joystick). When the line is selected it be- comes dashed and white colored, in this form the operator can move it toward the left or the right of the display by pressing LEFT or RIGHT button in the joystick.
  • Page 104 When the second axis (line) is positioned, automatically the response time of the pupil (in seconds) will appear in the lower part of the display of the auxiliary window of the 2WIN. On the next pressing of the MENU button the selected (and editable) line will be the third, showing the exact time the pupil response finishes to react to the light illumination impulse.
  • Page 105 When the slope axis (line) is positioned, automatically the slope angle value will appear in the lower part of the display of the auxiliary window of the 2WIN. This last line will be white if it is related to a decrease in the pupil diameter, while it will be black if it is related to an increase.
  • Page 106 By pressing the EYE (Button D) button in the 2WIN, the system of four lines will be dis- played on the following event of transition in the pupil diameter. Then if the EYE button is pressed again the overall measurement procedure will be started in the DX eye.
  • Page 107 PDF Report The PDF Report is composed of the pupil response graphic and of the corresponding data: • The graphic includes both the pupil eye responses and a partial reproduction of the axes that have been positioned earlier (axes could be out of the image and conse- quently you can’t see them) •...
  • Page 108 The Constriction phase has three variables which are: 1. LoC = Latency of Constriction, which is the reaction time used by the pupil to start constricting after the light switching on. 2. DoC = Duration of Constricting, which is the time used by the pupil to constrict and stabilize.

  • Page 109: Lens Centering Application (Lc-App)

    Lens Centering Application (LC-App) Lens Centering Application activating To activate Lens Centering Application you have to press the Button A, and select the right Application by moving by the arrows of the joystick. To activate it you have to press the central button of the joystick and the system will return to the main screen.

  • Page 110: Measurement With The App Activated

    Measurement with the App activated When the App is activated, the operator have to make the measurement as in 2WIN standard way following the “green” condition (see previous paragraphs to learn how). The only difference is that the patient have to wear the frame the operator want to center/measure.

  • Page 111: Activation In Browsing Mode

    Activation in Browsing mode To activate Lens Centering App in a measurement already saved you have to enter in the browsing mode by holding the down button of the joystick till the loading of the exams history. When the exams have been loaded you can browse them by the down and up button of the joystick and select the exam you want.
  • Page 112 Lens Centering system allows to position and tilt the axes in order to do the measuring. If the measuring isn’t valid or if it has been loaded another measure of a different App you will see on the display an error message that means the positions of the pupils are not present or an essential data for the measuring.

  • Page 113: Navigation

    Navigation You can select the axis you want to move by pressing the central button of the joystick, it will highlight red the axis allowing the changes. At the first pressing you will see the horizontal axis; at the second pressing you will see the vertical axis on the left;at the third pressing you will se the vertical axis on the right;...

  • Page 114: How To Position The Vertical Axes

    How to position the vertical axes The positioning of vertical axes can be done by left and right button of the joystick that will move the axes along the horizontal axis between the pupils. The central axis will be automatically located between the two movable axes. Centering values You can see the main values written directly on the top of the screen and the auxiliary data written on the bottom of the screen.

  • Page 115: Printing On Sd And Creating Of The Report

    - the lower value and the measure between the center of the optic axis and the corresponding stud (XR, XL). Under the image there are two other values that represent the head tilt and the distance between the two centers of the optic axes. The values written in brackets are the names of the report values.
  • Page 116 Report PDF The PDF Report is composed of the lens centering graphic and the corresponding data. The image represents the axes graphic previously positioned. The report is divided in right and left eye, the values expressed for each eye represent: •...

  • Page 117: Intermediate Vision Test

    Intermediate Vision Test The 2WIN measures the patient’s refraction while reading at a distance of 66 cm (24”). In all those cases when reading at such distance proves difficult, the 2WIN calculates the necessary additional power (ADD) to restore best vision.

  • Page 118: Intermediate Vision Application Activation

    After the installation the application must be activated to be utilized. Activation: click the BUTTON A ( ) 2WIN Applications screen will be shown to display. Doing this, it is possible to navigate and to see all the installed applications into the device.

  • Page 119: Intermediate Vision Exam

    Pay attention not to cover 2WIN frontal leds, measurement may not be possible with a wrong chart positioning; • Remove the add-on taking the black prominence and rotating it while pulling out toward the outside;...

  • Page 120: Environment Setup

    Please use an appropriate lamp following these tricks: • Place the light source behind the patient, out of the FOV (field of view) of the 2WIN. Otherwise, measurement could be unstable and have low index of reliability. With these kind of conditions a warning “Ambient light too bright” could be displayed;...

  • Page 121: Exam

    Apply the add-on lens and the Reading chart and on the front side of the 2WIN; Pay attention not to cover 2WIN frontal leds, with a wrong chart positioning measurement may not be possible; Turn the 2WIN on by pressing the BUTTON A Set the 2WIN to operate at Intermediate Vision Distance ;...
  • Page 122 Pay attention to this suggestion (otherwise measurement may be distorted); 6. Intermediate Vision Exam procedure is the same as refraction measurements (see 2WIN Operator Manual – Measurement, pag. 34, adjust the distance to focus the image until the top bar is green) Keep pupils within the display during focusing and measuring;...

  • Page 123: Output

    For this reason we recommend that you ask the patient to usual glasses (if typically used) or contact lenses -not reading glasses In these terms the estimated 2WIN refers to the positive lens additional " Add" to add to the lens held to the patient properly see the display screen .

  • Page 124: Troubleshooting

    For the automatic update, please activate the wifi Settings Switch on the wifi for the web connection update and connect the needed. 2WIN to the web In case of no web connection available for the 2WIN, connect to http://www.adaptic a.com/2WINCALI...

  • Page 125: Additional Information

    Settings Connect http://www.adaptica.com/2WINCALIBRATION/ update http://www.adaptic needed. a.com/2WINCALI BRATION/ with your laptop and follow instruction. 17. Additional information Technical specification Measuring range for spherical defect: -15,00D +15,00D Measurement precision for spherical defect: +/- 0,25 D Measuring range for cylindrical defect: -5,00D +5,00D Measurement precision for cylindrical defect: +/- 0,25 D Measuring range for cylinder axis: 1 –...

  • Page 126: In Flight Use

    Via San Marco 9/H - 35129 - Padova (Italy) Tel. +39 049 773968 Fax +39 049 0970901 email: support@adaptica.com Note for service personnel only Adaptica will make available on request circuit diagrams, components part lists, descriptions, calibration instructions or other information that will assist service personnel...

  • Page 127: Remote Control

    If the service department of Adaptica suggest this option, the customer/operator of the 2WIN is asked to activate the “Remote Control” option of the 2WIN. This option can be enabled only to the 2WIN with WiFi connection enabled. Through the use of this option a direct connection between the 2WIN and the IT department of Adaptica will be enabled in order to give direct support.

  • Page 128: Appendix A (Data Managment Disclaimer)

    Disclaimer of Adaptica S.r.l. pursuant to Article 13 of Legislative Decree No. 196 of 30 June 2003 (the “Privacy Code”) We hereby inform that the utilisation of the 2WIN instrument will give rise to the processing of some data relating to its status of operation (the “Telemetry Data”), which will be acquired by the IT systems and software procedures for the functioning of this instrument whenever it connects to a wireless network.
  • Page 129 Telemetry Data and the Remote Control Data will make the use of the 2WIN instrument impossible to the same. The autonomous owner (“titolare autonomo”) of the Telemetry Data and the Remote Control Data is Adaptica S.r.l., a company with its registered office in Padua, Via San Marco 9/H.
  • Page 130 Place and Date ______________________ Signature of the declarant (legible and written in full) ______________________...

  • Page 131: Appendix B - How To Manually Configure Some Of The Infrared Printers

    • Manufacturer GEBE – Model 11898 GPT-4378-Flash-79-V.24-IrDA o Compatible with 2WIN software version greater than 4.1.161213 o If bought from Adaptica the printers works out of the box while if the operator will buy in a different moment, the printer must be configured.
  • Page 132 D. Press OFF and ON simultaneously: a stripe with the Menu will be printed. You now need to change the configuration of Interface and Font in the Menu fol- lowing these instructions: 1. Press ON once (to change the settings) 2.

  • Page 133: Portable Printer Seiko Dpu - S

    Portable printer SEIKO dpu-s_245 Instructions for proper configuration of the printer in order to accept 2WIN data (via infrared) 1) Please take care that the printer is turned OFF. 2) Press together the button POWER (P) and the button FEED (F)

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