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OCULUS C-QUANT Instruction Manual

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OCULUS
C-QUANT
INSTRUCTION MANUAL

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Summary of Contents for OCULUS C-QUANT

  • Page 1 OCULUS C-QUANT INSTRUCTION MANUAL...
  • Page 2 Dr. Tom van den Berg began his research on light scatter in the human eye in the mid - 1980s. It was only recently, some 20 years later, that he found in OCULUS a partner for putting his ideas into practice.

  • Page 3: Table Of Contents

    Table of contents Scope of delivery................................1 Safety instructions..............................1 Safety instructions concerning organisation .................1 Pictogram definitions ..........................2 Safety instructions regarding the use of the C-Quant...............2 Proper Usage ................................4 Transportation and Disposal ..........................4 Transport and storage instructions ....................4 Disposal of used devices .........................4 Electromagnetic Compatibility (EMC) / Cables....................5...
  • Page 4 11 Quick Guide - Performing an examination....................33 11.1 Before the examination ........................33 11.2 Starting an examination........................34 11.3 Printout ............................... 35 12 Practical Guide for operating the C-Quant ....................35 12.1 Measuring procedure..........................35 12.1.1 Patient instruction......................36 12.1.2 After the measurement ....................38 12.2...

  • Page 5: Scope Of Delivery

    Safety instructions Safety instructions concerning organisation The law requires that the manufacturer expressly informs the user about safety aspects concerning the handling of the C-Quant. This chapter contains a summary of the most important points regarding these safety matters. Attention Do not use the device if you have not understood the instruction manual.

  • Page 6: Pictogram Definitions

    Safety instructions regarding the use of the C-Quant Note Before you use the C-Quant for the first time you must be instructed either by us or an authorised dealer. Attention No modifications may be made to this device without the permission of the manufacturer.
  • Page 7 Do not operate or store the C-Quant in damp rooms. Keep the C-Quant away from water that may drip, surge or splash and make sure that no liquids can enter the C-Quant. Do not place any containers with liquid either close to or on the C-Quant.

  • Page 8: Proper Usage

    Use the unit only with original parts and accessories delivered by us and in a technically flawless condition. With the computer controlling the C-Quant it is not permitted to run other software par- allel to the examination software in the foreground (such as screen saver, user programs, etc.).

  • Page 9: Electromagnetic Compatibility (Emc) / Cables

    Description of Unit and its Function The C-Quant measures, in an accurate and objective way, the amount of straylight on the retina caused by light scattering in a patient´s eye. In an ideal eye there would be no light scattering at all, but because the eye media are not optically ideal, there will always be some light scattering;...

  • Page 10: Installation And Electrical Connection

    Place the OCULUS-C-Quant on a level surface. The electrical connectors are on the backside of the device. Link up the C-Quant with the PC via the serial or the USB-cable. Connect the low-voltage socket of the supplied desktop power supply to DC input connector.

  • Page 11: Patient Data Management

    Click the C-Quant icon on the desktop. Fig. 8-1: Patient Data Management Note To enter the C-Quant program, you must either enter a new patient into the "Patient group box" or select an existing patient from the list. Entering new patients To enter a new patient in Patient Data Management, click [New].

  • Page 12: Selecting Existing Patients

    To accept the entries you have made, click [Save]. The patient you have just entered now appears in the patient list. Select this new patient from the patient list and start the C-Quant program. Selecting existing patients The patient list on the left-hand side of the screen displays all previously examined patients in alphabetical order.

  • Page 13: Deleting Examinations

    The input fields for entering the patient data are now activated (white background) and the cursor jumps directly into the top field. Activate the [Save] button. The changes are recorded. Deleting patient data Patient data can be deleted via [Delete patient]. Instruction Manual C-Quant ( G/80000/1007/en) 9 / 56...

  • Page 14: Exporting Patient Data

    Specify the name and destination of the file you are saving. Click [Export]. The patient and examination data have now been saved at the destination specified. You can send data stored on the hard drive as an e-mail attachment. 10 / 56 Instruction Manual C-Quant ( G/80000/1007/en)

  • Page 15: Importing Patient Data

    A software licence purchased from an authorised dealer. This licence includes instal- lation instructions and a Licence-Key. The C-Quant program must be installed on the other PC. If the program is updated on the C-Quant PC (sender), the program on the other PC (recipient) must also be updated.

  • Page 16: Backup (Saving Data)

    PC (or the device) will not be needed for some time. To initiate data storage, activate the button [Save]. OCULUS Optikgeräte GmbH recommends making a periodical backup of patient data. 12 / 56 Instruction Manual C-Quant ( G/80000/1007/en)
  • Page 17 Activate this function in the “Settings” menu (see next paragraph). This function should only be used if an additional drive with replaceable data carriers is available. Instruction Manual C-Quant ( G/80000/1007/en) 13 / 56...

  • Page 18: Settings

    This setting will be loaded every time the program is restarted. The button [Cancel] deletes the selected alterations and deactivates the function. The Patient Data Management software version is displayed at the bottom right. 14 / 56 Instruction Manual C-Quant ( G/80000/1007/en)

  • Page 19: Settings "Devices

    Alternatively the drive and the directory can be searched for by pressing the button. “Data-folder” Here you enter the drive and sub-directory in which the data are located. Alternatively the drive and the directory can be searched for by pressing the button. Instruction Manual C-Quant ( G/80000/1007/en) 15 / 56...
  • Page 20 PC workstation, whe- ther the respective device is actually connected or not. If it is connected, activate the write permission checkbox. The write permission must be deactivated for all other devices. 16 / 56 Instruction Manual C-Quant ( G/80000/1007/en)

  • Page 21: Settings "Import/Export

    .DAT and .BMP . Control unit If the data import/export is to be done from a control unit, the appropriate interface can be preset here. Instruction Manual C-Quant ( G/80000/1007/en) 17 / 56...

  • Page 22: Settings "Email

    When an E-mail function has been activated, you can write a subject line and a default text for the body of the E-mail in the “Default Text” field. These are then automatically inserted when the E-mail is written. 18 / 56 Instruction Manual C-Quant ( G/80000/1007/en)

  • Page 23: Settings "Interface

    Settings “Interface” Fig. 8-12: "Interface" - Box On this tab panel, you can specify the storage locations for various interface types. These interfaces are intended for the integration of the OCULUS instruments into third- party software. Instruction Manual C-Quant ( G/80000/1007/en)

  • Page 24: Settings "Smartcardreader

    Fig. 8-13: Box Smartcardreader If you have a standard smart card reader, you can read your patient data directly from the patient’s insurance card into the OCULUS Patient Data Management. Click on the [Enable] checkbox . To install and configure your smart card reader, click the [Config] button.

  • Page 25: Settings "Miscellaneous

    Then activate the checkbox [Update database in a network with GO older than Version 6.0] (A tick/ checkmark must be visible in the checkbox). For all other Versions 6.x, this checkbox must be deactivated (no tick/checkmark in the box). Instruction Manual C-Quant ( G/80000/1007/en) 21 / 56...

  • Page 26: Starting The C-Quant Program

    9 C-Quant Program 8.10 Starting the C-Quant program Note Switching from Patient Data Management to the Examination program: After you have selected a patient (sect. 8, page 7) start the Examination program by clicking [C-Quant]. Alternately, you can start the program by double clicking the patient you have selected.

  • Page 27: Information Boxes (C-Quant Program)

    Very young and healthy eyes are more effectively studied with a lower range setting. Very old patients or high straylight eyes are more effectively studied with a higher range setting (see sect. 12, page 35). Instruction Manual C-Quant ( G/80000/1007/en) 23 / 56...
  • Page 28 Alternatively you can use the keyboard shortcut [Alt]-t. Automatic When this option is activated (default setting) the next stimulus is shown automatically as soon as the patient has responded to the one before. 24 / 56 Instruction Manual C-Quant ( G/80000/1007/en)

  • Page 29: Result Fields

    If Esd < 0.08 and Q > 0.5, the reliability is considered to be acceptable. A warning is given if Esd > 0.08 or Q < 0.5. [On the right is a field for entering comments on the examination performed]. Instruction Manual C-Quant ( G/80000/1007/en) 25 / 56...

  • Page 30: Examination Fields

    The "0" and "1" at the bottom indicate with which key the patient can produce the re- sponses "0" or "1" in the examination response chart. If you want to first explain the examination procedure to the patient, activate "Simulate". 26 / 56 Instruction Manual C-Quant ( G/80000/1007/en)

  • Page 31: Examination Response Chart

    10 How the C-Quant works 9.1.5 Examination response chart Fig. 9-9: Responses given in the course of an examination This diagram shows all the responses given in the course of an examination. Responses can only take on either of the values "0" or "1".
  • Page 32 10 How the C-Quant works These two fields are shown in black in the diagram below. straylight source (outer ring) central test field Fig. 10-1: Stimulus field Now the outer ring starts to flicker. The phase when the ring is on is referred to as the "on-phase" and the phase when it is off is referred to as the "off-phase".

  • Page 33: Compensation Comparison Method

    10 How the C-Quant works To determine the amount of light that is scattered by the patient’s eye the test field is now made to flicker itself, but counter-phase to the straylight source: When the straylight source is off the test field is on and vice versa.
  • Page 34 10 How the C-Quant works straylight source (outer ring) right test field left test field During the examination a number of short stimuli are presented to the patient and he is then asked to decide which of the two test fields flickers more intensely.

  • Page 35: The Psychometric Function

    10 How the C-Quant works The right test field shows compensation light at intensity level 5. This means that the left test field has a flicker intensity of 10, while the right field has a flicker intensity of 10 -5 = 5. The response will most often be "0". If the stimulus is repeated suffi- ciently often he will sometimes give "1".

  • Page 36: Strategy Details

    10 How the C-Quant works The psychometric function can be used to determine a person’s straylight value with great precision on the basis of only a few stimuli responses. Rather than by determining the straylight value "directly" this is done by finding the point on the curve where the response value becomes 0.5.

  • Page 37: Quick Guide - Performing An Examination

    (see sect. 12.1, page 35). The patient should open his eye as wide as possible to prevent light scatter by his eyelashes. The examination should preferably be performed in a dimly lit room. Instruction Manual C-Quant ( G/80000/1007/en) 33 / 56...

  • Page 38: Starting An Examination

    Alternatively you can increase the response time by a factor of two and continue, or enter a response yourself. Note The following practical guide (sect. 12, page 35) contains more detailed information on the measurement with the OCULUS C-Quant. 34 / 56 Instruction Manual C-Quant ( G/80000/1007/en)

  • Page 39: Printout

    It is assumed that you are already familiar with basic operation of the C-Quant. Please start to familiarize yourself with the measurement by testing your own eye.

  • Page 40: Patient Instruction

    Position the eye close to the eyepiece, keeping a minimal distance (figure a). A slight touch is good, but not firmly against it. If the eye is tightly against the eye- piece, condensation may form on the lens of the C-Quant, which will influence the measurement outcome (figure b).
  • Page 41 Pay attention to flicker in the two half fields, decide which one flickers more clearly/ strongly, and press the corresponding button on the C-Quant (left button if the left test field flickers stronger, right button if the right test field flickers stronger).

  • Page 42: After The Measurement

    “Reliability not optimal. Consider to repeat the measurement” appears. What to do in such a case? This depends on the actual value of esd. The reliability requirements employed in the ≤ C-Quant are rather strict. In most clinical cases, measurements with esd 0.1 or ≤ even esd 0.12 are sufficiently reliable, even ignoring the Q value (Example 2).
  • Page 43 12 Practical Guide for operating the C-Quant The "Range" setting might be too low if the straylight value of the patient is much increased. In this case, there are too many 0 responses and not enough 1 responses (Example 5).

  • Page 44: Measurement - Examples

    12 Practical Guide for operating the C-Quant 12.2 Measurement - Examples Example 1: esd ≤ 08 and Q ≥ 1 This is a reliable measurement. Note that there is almost no overlap between the 0 and 1 responses. More overlap means a less reliable measurement.
  • Page 45 12 Practical Guide for operating the C-Quant Example 2: 0.08 < esd ≤ 0.12. Although reliability is not optimal, this measurement may be accepted as a good measurement in most cases. However, if time allows, it is recommended to repeat the measurement in order to obtain a better reliability.
  • Page 46 12 Practical Guide for operating the C-Quant Example 3a: esd > 0.12 in “G” range If there is no time to repeat the measurement, this measurement can be used to es- timate an upper limit for the straylight value. Because there is a consistent row of 1 responses in the right part of the graph, it is quite certain that the patient does not have a straylight value higher than the out- come of the measurement.
  • Page 47 12 Practical Guide for operating the C-Quant Example 3b: esd > 0.12 in “G” range This example is similar to Example 3a: if there is no time to repeat the measurement, the outcome of this measurement can be used to estimate an upper limit for the straylight value.
  • Page 48 12 Practical Guide for operating the C-Quant Example 3c: esd > 0.12 in “G” range This example is similar to Examples 3a and 3b, only esd is so high that no estimation for the straylight value could be calculated (log(s)=6.00 is a meaningless value).
  • Page 49 12 Practical Guide for operating the C-Quant Example 4: "Range" setting too high This measurement went very well, only there are too many 1 responses and not enough 0 responses for a reliable estimation of the straylight value. Reliability can be improved by repeating the measurement at a lower "Range" set- ting.
  • Page 50 12 Practical Guide for operating the C-Quant Example 5: "Range" setting too low There are too many 0 and not enough 1 responses for a reliable estimation of the straylight value. The measurement reliability can be improved by repeating the measurement at a higher "Range"...
  • Page 51 12 Practical Guide for operating the C-Quant Example 6: unreliable measurement at low "Range" setting From this result you can not tell if the "Range" setting was chosen too low, or if the test is too difficult for the patient.
  • Page 52 12 Practical Guide for operating the C-Quant Example 7: reliable measurement at high "Range" setting The same patient as in Example 6, but measured with the “G” setting. ≤ ≥ This is a reliable measurement (esd 0.08 and Q The chosen range in Example 6 was apparently too low.

  • Page 53: Troubleshooting

    "Out of order" and get in touch with our service representatives. Malfunction Possible cause Remedy No function after the mains switch C-Quant is not connected to the Plug the mains cable of the power is turned on, the mains switch does mains supply. supply into the power outlet or the...

  • Page 54: Cleaning And Care

    Disinfection After every use disinfect eyepiece, hand rests, keys and other surfaces which have been in contact with the patient. OCULUS recommends for disinfection of all surfaces except those of Plexiglass: Merz+Co, PURSEPTâ-A Disinfection cloth D-60318 Frankfurt, Germany Tel.: +49 69 1503 1 Fax: +49 69 596 21 50 Internet: www.merz.de...

  • Page 55: Terms Of Warranty And Servicing

    Prior to and while operating the device it is important that you observe the instruction manual and safety instructions. The C-Quant carries a warranty to which you are entitled in accordance with the legal provisions. If any unauthorised persons interfere with the C-Quant, all warranty entitlements shall be void.

  • Page 56: Assumption Of Liability For Functions And Damage

    16.2 Assumption of liability for functions and damage OCULUS shall only consider itself responsible for the safety, reliability and usability of the C-Quant if the unit is used in accordance with this instruction manual. There are no user-serviceable parts either on or inside the C-Quant.

  • Page 57: Declaration Of Conformity

    We declare in our responsibility that this product complies with the following norms or normative documents: EN 60601-1 EN 60601-1-2 as stipulated by Guideline No. 93/42/EEC for medical devices. Diploma’d Engineer Rainer Kirchhübel Managing Director, OCULUS Optikgeräte GmbH Instruction Manual C-Quant ( G/80000/1007/en) 53 / 56...

  • Page 58: Technical Specifications / Minimum Pc Requirements

    10% to 100% tion Air pressure 500hPa to 1060hPa Minimum PC requirements 750 MHz Operating system Windows 98 SE or higher 256 MB Graphics card 800 x 600 Interface USB or serial 54 / 56 Instruction Manual C-Quant ( G/80000/1007/en)

  • Page 59: Bibliography

    Am J Ophthalmol, 144:358-363; 2007. Additional information More information about the working principles of the C-Quant can be found in the sep- arate document “Compensation Comparison in the Oculus C-Quant straylight meter”. More information about retinal straylight in general and its relation to other measures of visual function can be found in the separate document “Introduction to retinal stray-...
  • Page 60 19 Bibliography 56 / 56 Instruction Manual C-Quant ( G/80000/1007/en)
  • Page 61 The following pages remain free and offer space for personal notes.

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