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Optonet Vision Unit
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The Optonet Vision Unit is a state-of-the-art software, CE marked Class I medical device, registered with the Medicinesand Healthcare products Regulatory Agency (MHRA), with reference number : 5943
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A software with a comprehensive set of charts for the assessment of visual function, both in clinical and remote settings.Internet access …   but keeps working offline in the clinic!
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Vision charts can be calibrated for any viewing distance: far, near or intermediate, with millimetric accuracy
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Smart Case History
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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
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Visual Acuity
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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
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Revised ETDRS logMAR chart (1993): combinations of letters were adjusted from a study in 7420eyes, to balance the difficulty per row
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LogMAR VA chart with original British Standard letters (BS 4274-1: 1968) as designed by Bailey & Lovie (1976)
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Bailey & Lovie LogMAR VA chart with latest British Standard letters (BS 4274-1: 2003)
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LogMAR VA chart with round numbers in a 5x4 proportion
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LogMAR VA chart with square shaped numbers in 5x5 grid (similar to Snellen tumbling “Es”)
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LogMAR VA chart with Landolt C rings. It can be displayed in either 5 or 8 different positions  (2 options)
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LogMAR VA chart with “Tumbling Es” in a 5x5 grid
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Vanishing Optotypes for VA
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Vanishing  Visual Acuity ETDRS charts designed for early detection of Age-related Macular Degeneration (AMD)
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Vanishing  Visual Acuity charts with Landolt rings for early detection of AMD
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Children’s Visual Acuity
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Children’s logMAR VA chart with Landolt Rings (Broken Glasses chart)
Gafas Rotas
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Children’s logMAR VA chart with Symmetrical letters.
Any combination of letters can be chosen from the following:  X, V, O, H, U, T
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Single rows of 5 Symmetrical letters with crowding  effect, and in a logMAR progression.
Specially designed for the plotting of children’s VA Percentile Graphs
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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
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Options for
VA  measurement
Each and every VA chart offers a wide variety of options to assist clinical measurement. Some of those will be shown next
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Any row of letters (or symbols) can be highlighted with red lines on both sides
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A row of letters can also be isolated, and its size changed
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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)
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We can keep adding the next row down, with smaller letters
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A column of letters (or symbols) of equal size can be isolated
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We can also isolate a column with letters of a decreasing size; useful for a quick estimation of visual acuity
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A single letter can be isolated, with or without contours (for crowding effect)
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The vision Unit also allows changing randomly the distribution of letters (or symbols), to prevent the patientfrom memorizing the charts
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Automated VA calculation andrepeated meaurements
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Automated VA calculation for easy logarithmic measurement. It is activated by pressing the number of letters seen
per row (0 to 5) on the keyboard or remote-control menu. At the endpoint, the VA score is shown in different scales
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Taking several VA measurements is very useful for a more accurate VA measurement, and to determine personal patientresponse variability, for future visits. The program calculates the mean VA and standard deviation (SD)
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Intermediate VA steps
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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)
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Refraction: Sphere
The vision Unit offers a wide variety of vision tests for a thorough eye care examination.
Let’s start with refraction charts
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A Duochrome mask is available for all logMAR visual acuity charts
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Various Duochrome charts are also included. Letter combinations and size can be easily changed
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Duochrome Rings chart
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Duochrome test with dots
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Duochrome with single line of letters
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Grid to be used with binocular ±0.50 D cross  cylinders (minus axes at 90º), for sphere power calculation
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Refraction: Astigmatism
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Dot target for cross-cylinder testing
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Verhoeff rings for cross-cylinder test
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Clock Dial test
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Fan & Block test
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Fan & Block test for Cyl axis calculation.
The arrow can be turned in 1-degree steps, until patient sees both sides appearing equally sharp
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Power is then calculated by adding cyl lenses until both sets of lines appear equally sharp
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Binocular Balance
Clinical Refraction should always be completed with a Binocular Balance, to ensure equal accommodativerequirements for both eyes
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Binocular Balance test to be used with vertical prisms
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Turville Infinity Binocular Balance test to be used with a septum (which can be placed on the  near vision rodof the phoropter head)
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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 circular polarizedfilters for ocular dissociation
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Polarized visual acuity chart  for binocular refraction: here the left eye (LE) can be refracted (LE sees all the letters), whilethe right eye (RE) can only see the central column (for fusion lock)
UBM
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Polarized dot target for cross cylinder under binocular conditions.
In this example, the chart is only seen by the right eye, through the filters
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Polarized Binocular Balance test. The top row is only seen by the right eye, the lower by left eye, while the middle one isobserved with both eyes
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In the Polarized Binocular Balance test, letters can be randomly distributed, their size can be changed, and the same ordifferent letters can be shown to each eye
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Polarized Binocular Balance chart: the first two letters of each row are only seen by the RE, the last two by the LE, and thecentral column is observed by both eyes
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All polarized Binocular Balance tests also offer the option to show either different or equal letters to each eye,
as in this image
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Letter rows can also be isolated in the Polarized Binocular Balance chart
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Duochrome polarized Binocular Balance test, especially useful in patients with different VAs in each eye, where it is notpossible to use conventional binocular balance tests
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Near Vision Charts
The vision Unit incorporates various tests and optotypes to assess near vision
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Sentences in logarithmic progression for near vision (the Unit has to be calibrated for viewing distance first). The phrase ofinterest can be pointed with red lines
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Phrases for near vision can also be isolated
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Binocular Vision
A wide variety of binocular tests is also available in the vision Unit
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Heterophoria
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Test for Horizontal Heterophoria measurement using a vertical prism. The test is calibrated in prism diopters for theviewing distance
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Test for Horizontal Heterophoria measurement using the Maddox rod.
The test is calibrated in prism diopters for the viewing distance
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Test for Vertical Heterophoria measurement using the Maddox rod, calibrated in prism diopters
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Fixation Disparity
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Horizontal Fixation Disparity (FD) test, that may be used to measure horizontal associated phoria (the prism thatcompensates FD). Red/blue filters required
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The Fixation Disparity test allows measuring FD in minutes of arc (calibrated for the viewing distance selected).
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Polarized versions of Fixation Disparity tests are also included  (for 3D passive monitors)
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Vertical Fixation Disparity test for Associated Phoria calculation and / or measuring FD (in minutes of arc).
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This Vertical Fixation Disparity test can also measure FD (in minutes of arc).
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Polarized version of the Vertical Fixation Disparity test
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Foveal Suppression
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Foveal Suppression test: with the red/blue filters, blue letters are only seen by right eye eye whilst red letters areonly seen by left eye (red filter before RE). The central column is seen with both eyes (binocularly)
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It is also possible to show the first two letters of each row to one eye, the last two to the other,while the central column is seen by both eyes
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The Foveal Suppression test allows isolating single rows of letters
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The polarized version of the Foveal Suppression test offers all the options shown
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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)
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Polarized version of the Worth Suppression test.
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Stereoacuity
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Contour Stereoacuity test (local stereopsis), to be viewed with red/blue filters
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Polarized version of the contour Stereoacuity test
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Random-dot Stereoacuity Test for red/blue filters. It is possible to choose the type of letters or figures to show in 3D, aswell as their size
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Random-dot Stereoacuity test with Symmetrical letters as stimuli. There  are no monocular cues when viewed throughthe filters
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Random-dot Stereoacuity test, with Geometrical shapes as stimuli
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Aniseikonia
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Aniseikonia with red/blue filters. The size can be changed in 0.25% steps for greater accuracy
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In order to quantify aniseikonia, the size of the image seen by the right eye is changed to match the size of the imageperceived by the left eye
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Polarized version of the Aniseikonia test
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Cyclorotation
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Cyclorotation test for red/blue filters
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The lines should be rotated until perceived as parallel through the filters.
In this example there is an Ex-cyclodeviation of 3 degrees
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The Cyclorotation test shows now an In-cyclodeviation of 2 degrees
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Polarized version of the Cyclorotation test
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Incomitancy
The vision Unit also includes tests to evaluate incomitant deviations
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Horizontal ocular deviation test, calibrated in prism diopters for the chosen viewing distance (viewed with red/blue filters)
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Vertical ocular deviation test calibrated in prism diopters
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Hess Screen test to map incomitant ocular deviations in different gaze directions (with red/blue filters)
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Test results in the Hess screen assessment of ocular motility in 9 diagnostic gaze positions for each eye
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Polarized version of  the Hess-Lancaster test for the assessment of non-comitant deviations
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Ocular Health
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Contrast Sensitivity
Several methods are offered for the assessment of contrast sensitivity
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Low contrast visual acuity charts. Any level of contrast can be set, from 0 to 2.25 log, in 0.15 log steps
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Contrast sensitivity charts with letters of fixed size  (as proposed by Pelli-Robson). Any letter size can be selected
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Potential Visual Acuity
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Potential visual acuity Super-Pinhole to be used in patients with cataracts and other ocular media opacities
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Amsler Grids
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White grid over black background
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Amsler grid with diagonals for patient with central scotoma
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Amsler charts – Red grid over Black background
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Amsler charts –  black grid over white background
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Red desaturation test, useful in the detection of visual field defects
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Orthoptics / Vision Therapy
The vision Unit offers a complete range of vision procedures for the treatment of Convergence Insufficiency (either withred/blue filters or 3D polarized  screen). All test have automated feedback
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Blocks game for Anti-suppression therapy and binocular coordination
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Polarized version of the Blocks game
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Anaglyph Fusion Circles for the treatment of horizontal fusional vergences (Convergence & Divergence)
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Fusion Circles Vectograms for the treatment of horizontal fusional vergences (Convergence & Divergence) – for passive 3Dscreens only
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Automated forced-choice anaglyph with accommodative control for the measurement and treatment of horizontalfusional vergences
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Automated forced-choice vectogram with accommodative control for the measurement and treatment of horizontalfusional vergences
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Automated forced-choice anaglyph with accommodative control for the measurement and treatment of vertical fusionalvergences
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Automated forced-choice vectogram with accommodative control for the measurement and treatment of vertical fusionalvergences
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Anaglyph stereograms for the treatment of horizontal fusional vergences. When fused, the image is perceived in 3D (tomonitor patient’s compliance)
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Forced-choice random dot stereograms for the treatment of fusional vergences (convergence & divergence). When fused,a 3D image is perceived
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Polarized version of the automated forced-choice random dot stereograms for the treatment of fusional vergences(convergence & divergence)
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Automated anaglyphs for the measurement and training of horizontal fusional vergences. The patient should click on theletter that is seen in 3D
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Polarized version of the random dot stereogram with automated forced choice measurements for horizontal vergences
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A choice of letters, figures or Landolt rings can be displayed as stereoscopic stimuli.  Landolt Cs are shown here
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Geometrical figures in the stereoscopic random dot charts
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Random dot stereograms for vertical vergence measurement and treatment (infra and supra - vergences)
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Polarized version (vectograms) of the random dot stereograms for vertical vergence measurement and treatment
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Test for automated forced-choice monocular accommodation facility measurement and training
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Polarized version of  the test for automated forced-choice monocular accommodation facility measurement and training
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Chart for ocular saccadic and pursuing eye movements
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Complete patient management and record keeping for Vision Therapy
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Home-based
Orthoptics / Vision Therapy
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The Home Therapy feature offers the professional remote control and monitoring of the exercises prescribed for home
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Options and Configuration
The Optonet vision Unit can easily be adapted to anyone’s needs and preferences (ideal for research)
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The vision Unit incorporates a simple system to calibrate the charts for the viewing distance at each particular testing room
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Optotype displays can be inverted in small examination rooms, when a mirror is required in order to duplicate distance
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Automated scoring system for VA and stereoacuity available, as a simple and accurate method of measurement
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Tests Sequences
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With the vision Unit it is easy to personalize sequences of tests. Then, just pressing one button will take us from one testto the next (or previous) of the sequence
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Remote Control
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A tablet can be paired with the distance vision chart in the testing room, or to the patient’s computer in remoteconsultation, to be used as a remote controller. The tablet will display the replica of the charts displayed for the patient
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Remote Patient Consultations
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The Tele-Consultation function allows connecting to the patient’s computer or tablet, to display visual charts at thepatient’s home. Enables secure distance visual testing, with remote-control of the menus, while preserving patient’s privacy
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The End
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