AUTO REF/KERATO/TONOMETEROPERATOR’S MANUALModel
VIII: MaintenanceDisposalCAUTION• Only service technicians properly trained by NIDEK can repair the device.NIDEK is not responsible for any accidents
86OPERATING PROCEDURES: Parameter Settings[FUNCTION 1 (Various functions 1)]* Underlined options indicate factory settings61 : WINDOW CHECK (measuring
87OPERATING PROCEDURES: Parameter Settings266 : AR BRIGHTNESS (light intensity of AR measurement screen)Brightness of the LCD screen during the ARK me
88OPERATING PROCEDURES: Parameter Settings73 : CHANGE SPEED (Measurement changeover speed)Setting of the time period required when the measurement mod
89OPERATING PROCEDURES: Parameter Settings22.8.2 Setting the date and timeWhen the date and time of the printout is not correct, set the correct date
90OPERATING PROCEDURES: Parameter Settings4 Press the up button or down button tomove the highlight to an item to be changed.5 Press the right but
91OPERATING PROCEDURES: Parameter Settings22.8.3 Entering commentsComments to be printed can be changed (factory setting: “NIDEK TONOREF II”).1 Press
92OPERATING PROCEDURES: Parameter Settings4 Press the right button or left button toselect the position where a character is enteredor changedThe
9333.OPERATION WHEN PERIPHERAL DEVICES ARE CONNECTEDThe TONOREF II exports data to an external device such as NIDEK motorized refractor (hereafterrefe
94OPERATION WHEN PERIPHERAL DEVICES ARE CONNECTED: Connecting to the NIDEK Motorized Refractor (RT) or Computer3.1.2 Connecting procedure1 Connect th
95OPERATION WHEN PERIPHERAL DEVICES ARE CONNECTED: Connecting to the NIDEK Auto Lensmeter33.2 Connecting to the NIDEK Auto Lensmeter (LM)3.2.1 Outline
IX:{ Patient environmentThe patient environment represents a space where there is a possibility of direct contact between thepatient or the operator a
96OPERATION WHEN PERIPHERAL DEVICES ARE CONNECTED: Connecting to the NIDEK Auto Lensmeter (LM)3.2.3 Operating procedure1 After lens measurement with
97OPERATION WHEN PERIPHERAL DEVICES ARE CONNECTED: Connecting to the Eye Care Card System33.3 Connecting to the Eye Care Card System3.3.1 OutlineData
98OPERATION WHEN PERIPHERAL DEVICES ARE CONNECTED: Connecting to the Eye Care Card System3.3.3 Transferring data with the EyeCa-RWThe procedure for wr
99OPERATION WHEN PERIPHERAL DEVICES ARE CONNECTED: Connecting to the Eye Care Card System3{ When not printing measured dataSet the 39. PRINT parameter
100OPERATION WHEN PERIPHERAL DEVICES ARE CONNECTED: Connecting to the Eye Care Card System
10144.MAINTENANCE4.1 TroubleshootingIn the event that the device does not work correctly, correct the problem according to the followingtable before c
102MAINTENANCE: TroubleshootingIf the symptom cannot be corrected with the above actions, contact NIDEK or your authorized distributor.The auto-tracki
103MAINTENANCE: Error Messages and Countermeasures44.2 Error Messages and CountermeasuresIf one of the following error codes is displayed on the scree
104MAINTENANCE: Error Messages and CountermeasuresERR021 • Error related to control signals for communication (input port)Ensure that the interface ca
105MAINTENANCE: Error Messages and Countermeasures4ERR051 • Error related to the movable prism.A malfunction of the movable prism motor, movable prism
Table of ContentsX1. BEFORE USE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.1 Outline of the device. . . . . . . . . . .
106MAINTENANCE: Replacing Printer Paper4.3 Replacing Printer PaperWhen a red line appears on the side of printer paper, it means that paper is running
107MAINTENANCE: Replacing Printer Paper43 Insert new printer paper.Load printer paper as shown in the picture on theright.Set printer paper so that it
108MAINTENANCE: Fixing Chinrest Paper4.4 Fixing Chinrest Paper1 Disconnect the two fixing pins from the chinrest.2 Remove a proper number of chinrest
109MAINTENANCE: Checking the AR/KM Measurement Accuracy44.5 Checking the AR/KM Measurement AccuracyTo check the accuracy of measured data, use the pro
110MAINTENANCE: Checking the AR/KM Measurement Accuracy{ Values marked on the labels of the spherical model eyeVertex distanceDiopter (Unit: D)Corneal
111MAINTENANCE: Cleaning44.6 CleaningWhen the cover or panel of the device becomes dirty, wipe with a soft cloth. For stubborn dirt, immersethe cloth
112MAINTENANCE: Cleaning5 Check if the window is cleaned using a penlight. If not, clean it again with new cleaningpaper.Apply light with a penlight a
113MAINTENANCE: Cleaning44.6.2 Cleaning the air nozzle1 Display the NT measuring screen.2 Check the glass part of the air nozzle from an oblique dire
114MAINTENANCE: List of Replacement Parts4.6.3 Cleaning the printerAfter repeated usage, the paper slot of the auto cutter of the printer may become s
11555.SPECIFICATIONS AND ACCESSORIES5.1 Classifications[Classification under the provision of 93/42EEC (MDD)] Class IIaThe TONOREF II is classified as
XI:2.8 Parameter Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 762.8.1 Parameter tab
116SPECIFICATIONS AND ACCESSORIES: Safety Features5.2 Safety FeaturesTo ensure safe use, the device is provided with the following safety features.<
117SPECIFICATIONS AND ACCESSORIES: Specifications55.3 Specifications{ Measurement of refractive error (AR measurement){ Measurement of corneal curvatu
118SPECIFICATIONS AND ACCESSORIES: Specifications{ PD measurement{ CS measurement{ PS measurement{ Measurement of intraocular pressure (NT measurement
119SPECIFICATIONS AND ACCESSORIES: Specifications5{ Other functions{ Dimensions and weight{ Environmental conditions (during use){ Environmental condi
120SPECIFICATIONS AND ACCESSORIES: Standard Configuration5.4 Standard Configuration5.4.1 Standard accessories5.4.2 Optional accessories• Printer paper
12166.EMC (ELECTROMAGNETIC COMPATIBILITY)The Electromagnetic Compatibility Directive sets the essential requirements for electrical andelectronic equi
122EMC (ELECTROMAGNETIC COMPATIBILITY)Guidance and manufacturer's declaration - electromagnetic immunityThe TONOREF II is intended for use in the
123EMC (ELECTROMAGNETIC COMPATIBILITY)6Guidance and manufacturer's declaration - electromagnetic immunityThe TONOREF II is intended for use in th
124EMC (ELECTROMAGNETIC COMPATIBILITY)Recommended separation distances between portable and mobile RF communications equipment and the TONOREF IIThe T
12577.GLOSSARY{ Terminology related to the AR/KM measurementz AI modeIn this mode, the measurement is automatically completed after three or more meas
: XII5.4 Standard Configuration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1205.4.1 Standard access
126GLOSSARY: z Focusing indicatorThe indicator which shows the distance between the corneal center of the patient’s eye andthe tip of the air nozzle.z
127GLOSSARY:7z Vertex Distance (V.D.)The distance between the corneal vertex to the posterior surface of the spectacle lens.{ Terminology related to t
128GLOSSARY: z Low confidence dataMeasured data with a “*” indication. This is displayed on the screen when measurement isperformed in spite of a meas
12988.INDEXAAir nozzle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6Alignment spot . . . . . . . . . . . . . . . . . . .
130INDEX:
111.BEFORE USE1.1 Outline of the deviceAUTO REF/KERATO/TONOMETER Model TONOREF II is designed to singly perform objectiverefraction, corneal shape mea
2BEFORE USE: Indications for Use1.2 Indications for UseThe AUTO REF/KERATO/TONOMETER TONOREF II is a medical apparatus which performs mea-surement of
3BEFORE USE: Principles11.3 Principles1. Objective refractionFine measurement beams are projected on the fundus of the patient’s eye by a projectingop
4BEFORE USE: Device Description1.4 Device Description{ Front viewFunction buttonsUsed to set the device and to switch the screen.Functions assigned to
5BEFORE USE: Device Description1• CLR button ( )Used to clear the measured data.When the CLR button is pressed for about a second, all the measured d
NIDEK CO., LTD. : 34-14, Maehama, Hiroishi-cho, Gamagori, Aichi 443-0038, Japan(Manufacturer) Telephone: (81-533) 67-6611Facsimile: (81-533) 67-6610NI
6BEFORE USE: Device Description{ Rear viewForehead restDuring measurements, the patient’s forehead should be gently placed over the forehead rest.Clea
7BEFORE USE: Device Description1Chinrest up/down buttons ( , )Move up or down the chinrest.Safety stopperUsed to provide a safety space so that the a
8BEFORE USE: Device Description{ Bottom viewPower inletUsed to connect the detachable power cord.RS-232C connectorConnect an interface cable to send/r
9BEFORE USE: Measurement Screen Description11.5 Measurement Screen Description1.5.1 R/K measurement screenThe screen for the AR (Refractive error) and
10BEFORE USE: Measurement Screen DescriptionAuto button ( )Selects the auto-tracking function and auto-shooting function.Select auto-tracking from 3D,
11BEFORE USE: Measurement Screen Description1Focusing indicatorIndicates the distance between the main body and the patient’s eye.Operate the joystick
12BEFORE USE: Measurement Screen Description<When Page 2 is displayed>* CS, PS, and PD data, and cataract measurement mode mark are displayed on
13BEFORE USE: Measurement Screen Description1Eyeprint button ( )Prints the eyeprint view of measured data.The eyeprint is printed out regardless of it
14BEFORE USE: Measurement Screen Description1.5.2 NT measurement screenThe following is the screen for NT (Tonometry) measurement.<When Page 1 is d
15BEFORE USE: Measurement Screen Description1Eyelid detection mode button ( )Used to activate the detection (eyelid detection) mode which detects whet
I:Use this device properly and safely."CAUTION! Federal Law (US) restricts this device to sale by or on the order of a physician ora properly li
16BEFORE USE: Labels and Indications on the Device1.6 Labels and Indications on the DeviceTo call the operator’s attention, the device is provided wit
17BEFORE USE: Labels and Indications on the Device1[Underside view]
18BEFORE USE: Checking Contents1.7 Checking ContentsUnpack the contents from the shipping carton and check them.The following are included in the stan
19BEFORE USE: Before First Use11.8 Before First UsePlace the device on a stable table and connect a power cord to it.1 Place the main body on a stabl
20BEFORE USE: Before First Use7 Turn the power switch on ( ).The initial screen is displayed on the LCD dis-play and the device starts initializing.8
21BEFORE USE: Before First Use1{ Please see here when you want to do like this.{ Setting by parameterSetting parameters allows various functions of th
22BEFORE USE: Before First UseSetting contents ParametersMeasurement count of NT measurement 25. NT CONTINUEWhether NT measurement values are displaye
2322.OPERATING PROCEDURES2.1 Operation Flow2.2 Preparation for Measurement (page 24)Turn on the device and configure it us as necessary.Set up the pat
24OPERATING PROCEDURES: Preparation for Measurement2.2 Preparation for Measurement1 Turn the power switch on ( ).The title screen is displayed and the
25OPERATING PROCEDURES: Preparation for Measurement22 The measurement screen is displayed.The measurement screen with the measure-ment mode (R/K or NT
II: Use precautionsBefore UseCAUTION• Do not use the device for other than the intended purpose.NIDEK is not responsible for accidents or malfunctions
26OPERATING PROCEDURES: Preparation for Measurement3: CYL modeCylinder mode, the reading direction of cylinder data in which CYL data (cylindrical pow
27OPERATING PROCEDURES: Preparation for Measurement24) Adjust the height of the chinrest by the chin-rest up/down button ( , ) until the cen-ter level
28OPERATING PROCEDURES: Preparation for Measurement7 Print the measured results.Printing operation varies according to the 31. PRINT parameter setting
29OPERATING PROCEDURES: Preparation for Measurement22.2.1 Measuring window check for soiling and puffed air pressure check during startupIt is possibl
30OPERATING PROCEDURES: Preparation for Measurement2) The check result is displayed.• “PRESSURE TEST OK” is displayed:The air nozzle is clean.• If on
31OPERATING PROCEDURES: Preparation for Measurement26) At the completion of the checks, the screen returns to the measurement screen.2.2.2 Switching b
32OPERATING PROCEDURES: Preparation for MeasurementDuring the switching process, the“ ” (during the switchingprocess from R/K mode to NT mode) or“ ” m
33OPERATING PROCEDURES: Finishing the Measurements22.3 Finishing the Measurements2.3.1 Normal shutoff1 Turn off ( ) the power switch.It is allowed to
34OPERATING PROCEDURES: Finishing the Measurements4 When the “PACKING POSITION IS COM-PLETED / SHUT DOWN PLEASE” message isdisplayed, turn the power s
35OPERATING PROCEDURES: Selecting the Mode22.4 Selecting the ModeSelect the measurement mode from the following options:{ Measurement itemsSelect the
III:CAUTION• Do not use a power cord other than the one supplied. Also do not connect thesupplied power cord to any other device.Failure or fire may r
36OPERATING PROCEDURES: Selecting the ModeAR/KM measurement mode is selected by default; there is no need to select when proceed-ing to measurements i
37OPERATING PROCEDURES: Selecting the Mode22.4.1 Switching to manual modeBy pressing the manual mode button during measurements, it is possible to t
38OPERATING PROCEDURES: Selecting the Mode2.4.2 Sleep modeThe device goes into sleep mode automatically to save power if no button have been pressed f
39OPERATING PROCEDURES: AR (refractive error) and KM (corneal curvature radius) Measurements22.5 AR (refractive error) and KM (corneal curvature radiu
40OPERATING PROCEDURES: AR (refractive error) and KM (corneal curvature radius) Measurements1 Instruct the patient to look through the measuringwindo
41OPERATING PROCEDURES: AR (refractive error) and KM (corneal curvature radius) Measurements23D auto-tracking1) Perform rough alignment and focusing b
42OPERATING PROCEDURES: AR (refractive error) and KM (corneal curvature radius) MeasurementsWhen the main body is not within the working range of auto
43OPERATING PROCEDURES: AR (refractive error) and KM (corneal curvature radius) Measurements24 Measurement starts.Measurements take place automaticall
44OPERATING PROCEDURES: AR (refractive error) and KM (corneal curvature radius) Measurements<AR measurement error messages><KM measurement er
45OPERATING PROCEDURES: AR (refractive error) and KM (corneal curvature radius) Measurements25 Measurement completes.• When AI mode is YES:*1When the
IV: During UseWARNING• Before starting NT measurement, set the safety stopper for each patient to prevent theair nozzle from touching the patient’s ey
46OPERATING PROCEDURES: AR (refractive error) and KM (corneal curvature radius) Measurements6 Measure the other eye in the same manner.When the other
47OPERATING PROCEDURES: AR (refractive error) and KM (corneal curvature radius) Measurements2{ CATARACT measurement modeIf cataract or abnormal eyes c
48OPERATING PROCEDURES: AR (refractive error) and KM (corneal curvature radius) Measurements{ Measurement ring image displayThe TONOREF II projects me
49OPERATING PROCEDURES: AR (refractive error) and KM (corneal curvature radius) Measurements22.5.2AR (refractive error) Measurement: AR Measurement Mo
50OPERATING PROCEDURES: AR (refractive error) and KM (corneal curvature radius) Measurements<AR measurement error messages>Error messages are th
51OPERATING PROCEDURES: AR (refractive error) and KM (corneal curvature radius) Measurements22.5.3 KM (corneal curvature radius) Measurement: KM Measu
52OPERATING PROCEDURES: AR (refractive error) and KM (corneal curvature radius) Measurements<KM measurement error messages>Error messages are th
53OPERATING PROCEDURES: AR (refractive error) and KM (corneal curvature radius) Measurements22.5.4 CS (Corneal Size) Measurement1 Press the CS/PS/PD
54OPERATING PROCEDURES: AR (refractive error) and KM (corneal curvature radius) Measurements6 Press the right button or left button toalign the gu
55OPERATING PROCEDURES: AR (refractive error) and KM (corneal curvature radius) Measurements22.5.5 PS (Pupil Size) MeasurementThis is the procedure to
V:CAUTION• There may be a few constantly-lit, missing, or dead pixels in your LCD which are acharacteristic of the LCD. This does not represent failur
56OPERATING PROCEDURES: AR (refractive error) and KM (corneal curvature radius) Measurements5 Press the right button or left button toalign the gu
57OPERATING PROCEDURES: AR (refractive error) and KM (corneal curvature radius) Measurements22.5.6 PD (Pupillary Distance) Measurement{ Auto-PD measur
58OPERATING PROCEDURES: AR (refractive error) and KM (corneal curvature radius) Measurements3 After proper alignment of the right eye and lefteye, pre
59OPERATING PROCEDURES: AR (refractive error) and KM (corneal curvature radius) Measurements22.5.7 Measuring Hard Contact LensesTo measure hard contac
60OPERATING PROCEDURES: AR (refractive error) and KM (corneal curvature radius) Measurements4 Place the model eye/CL holder with the sur-face of the c
61OPERATING PROCEDURES: NT (Tonometry) Measurement: NT Mode22.6 NT (Tonometry) Measurement: NT ModeDuring NT measurement, the types of the target and
62OPERATING PROCEDURES: NT (Tonometry) Measurement: NT Mode3 Set the safety space between the patient’s eye and air nozzle with the safety stop-per.1)
63OPERATING PROCEDURES: NT (Tonometry) Measurement: NT Mode25 Manipulate the joystick to display the patient’s eye on the screen.By tilting the joysti
64OPERATING PROCEDURES: NT (Tonometry) Measurement: NT ModeIn the case of 3D auto-tracking:1) Perform rough alignment and focusing bymanipulating the
65OPERATING PROCEDURES: NT (Tonometry) Measurement: NT Mode2If the main body gets out of the working range of auto-racking in the back-and-forth direc
VI: CAUTION• Information on the avoidance of overexposure to potentially hazardous opticalradiation (ISO 15004: 1997)Spectrally weighted photochemical
66OPERATING PROCEDURES: NT (Tonometry) Measurement: NT Mode8 Start the measurement.• When the auto-shooting function is on:The measurement takes place
67OPERATING PROCEDURES: NT (Tonometry) Measurement: NT Mode2<Error messages during NT measurement>• If the measurement was not performed correct
68OPERATING PROCEDURES: NT (Tonometry) Measurement: NT Mode{ If the “CHECK THE EYE” error occurs:Check the condition of the patient’s eye.If the patie
69OPERATING PROCEDURES: NT (Tonometry) Measurement: NT Mode211Pull the joystick backward once and move themain body to the other eye.The measured eye
70OPERATING PROCEDURES: NT (Tonometry) Measurement: NT Mode2.6.1 Eyelid detection modeWith this mode, the device always checks the eye for the amount
71OPERATING PROCEDURES: Printing22.7 Printing2.7.1 Printing measured dataMeasured data is printed out by pressing the print button after measurement
72OPERATING PROCEDURES: Printing<Sample printout 2>• Items marked with “ ” indicate whether or not to print according to parameter settings.See
73OPERATING PROCEDURES: Printing2* 1 Vertex distanceThe distance between the corneal vertex to the posterior surface of spectacle lenses.* 2 Near work
74OPERATING PROCEDURES: Printing* 10 PD for near visionPD for a near working distance of 40 cm (factory setting). Use it for prescriptions of reading
75OPERATING PROCEDURES: Printing22.7.3 Printing parameter settingsThe present parameter settings, set time, comments and maintenance program versions
VII:After UseCAUTION• When the device is not in use, turn off the power switch and put the dust cover overthe device.If not, dust may affect the measu
76OPERATING PROCEDURES: Parameter Settings2.8 Parameter SettingsThe TONOREF II is provided with parameters that set various functions according to the
77OPERATING PROCEDURES: Parameter Settings23 Press the execute button to switch to the[PRINT1] screen.Parameters and their settings are displayed.A
78OPERATING PROCEDURES: Parameter SettingsTo change the page of parameter:6 Repeat Steps 4 to 5 to change the desired parameter settings.7 To finish s
79OPERATING PROCEDURES: Parameter Settings22.8.1 Parameter tables[AR (AR measurement)]* Underlined options indicate factory settings.1 : STEP (AR meas
80OPERATING PROCEDURES: Parameter Settings7 : AR THUMBNAILSelects whether or not to display the thumbnail screen of the measurement ring image during
81OPERATING PROCEDURES: Parameter Settings222 : LOW CONF LV (Display of confidence level)Setting of how to express the level of low confidence data wh
82OPERATING PROCEDURES: Parameter Settings[PRINT1 (Print setting 1)]* Underlined options indicate factory settings.31 : PRINT (printing)Selects the me
83OPERATING PROCEDURES: Parameter Settings238 : DATE FORMAT (date format)Selects the format of date.39 : PRINT COMMENTSelects whether or not to print
84OPERATING PROCEDURES: Parameter Settings44 : ERROR DATASelects whether or not to display and print erroneousdata obtained during AR measurement.When
85OPERATING PROCEDURES: Parameter Settings2[PRINT3 (Print setting 3)]* Underlined options indicate factory settings.51 : SE PRINT (printing of SE valu
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