Manual FDT
Manual FDT
Model 710
User Manual
ii
Copyright
2013 Carl Zeiss Meditec, Inc. All rights reserved.
Trademarks
Humphrey and FDT are either registered trademarks or trademarks of Carl Zeiss Meditec,
Inc. in the United States and/or other countries.
All other trademarks used in this document are the property of their respective owners.
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iii
Contents
(1) Safety Information ........................................................................ 1-1
Product Safety ...................................................................................................1-1
Symbols and Labels............................................................................................1-3
Protective Packing Symbols .......................................................................1-4
Product Labels and Serial Number Location ...............................................1-4
External Device Equipment.................................................................................1-4
Standards ..........................................................................................................1-5
Product Compliance ..................................................................................1-5
Electromagnetic Compatibility (EMC)..................................................................1-5
Guidance and Manufacturers Declarations ........................................................1-6
(2) Introduction.................................................................................... 2-1
Intended Use .....................................................................................................2-1
Indications for Use.............................................................................................2-1
Essential Performance ...............................................................................2-1
About the User Manual.....................................................................................2-3
Instrument Overview ..........................................................................................2-3
Controls and Connectors ....................................................................................2-4
Instrument Components, Patient Side ........................................................2-5
Instrument Components, Operator Side .....................................................2-5
Instrument Components.....................................................................................2-6
FDT Overview.....................................................................................................2-6
Patient Video Screen Patterns ....................................................................2-7
(3) Operation ....................................................................................... 3-1
Unpacking .........................................................................................................3-1
Preparation For Use and Power On.....................................................................3-2
Preparing for a Patient Test................................................................................3-6
Enter the Patients Age..............................................................................3-7
Prepare the Patient ...................................................................................3-7
Patient Refraction .....................................................................................3-7
Explain the Test Procedure to the Patient ...................................................3-8
Running a Screening or Threshold Patient Test...........................................3-9
Displaying and Printing the Test Results ...........................................................3-12
Using the RS-232 Serial Computer Interface .....................................................3-12
Understanding the Screening C-20 and N-30 Test Results.................................3-13
Understanding the Threshold C-20 and N-30 Test Results.................................3-15
Screening C-20 Test Result Sample ..........................................................3-18
Threshold C-20 Test Results Sample.........................................................3-19
Threshold N-30 Test Results Sample ........................................................3-20
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iv
(4) Calibration and Set-up .................................................................. 4-1
Calibration and Set-up .......................................................................................4-1
Set Date and Time.....................................................................................4-1
Set-up Instrument Options.........................................................................4-2
Calibration ................................................................................................4-3
Software Upgrade .....................................................................................4-4
Maintenance .....................................................................................................4-4
Printer Paper Replacement ........................................................................4-4
Fuse Replacement .....................................................................................4-6
FDT Replacement Parts and Accessories .............................................................4-6
Cleaning, Disinfection, Sterilization and Disposal ................................................4-7
Cleaning ...................................................................................................4-7
Disinfection...............................................................................................4-7
Sterilization...............................................................................................4-7
Instrument Disposition .......................................................................................4-7
Troubleshooting.................................................................................................4-8
(5) Service Information ....................................................................... 5-1
Technical Assistance Information........................................................................5-1
(6) Specifications ................................................................................. 6-1
Instrument.........................................................................................................6-1
Environmental ...................................................................................................6-1
Operating Conditions ................................................................................6-1
Storage and Shipping Conditions...............................................................6-1
Test ...................................................................................................................6-1
Screening Test Strategies:..........................................................................6-1
Threshold Test Strategies: ..........................................................................6-1
Reliability Indices: .....................................................................................6-2
Stimulus:...................................................................................................6-2
Screening Test Results: ..............................................................................6-2
Threshold Test Results: ..............................................................................6-2
2660021149532 A
Summary
CAUTION: Before connecting the power cord to the appliance inlet, verify that the
voltage selector switch is correctly set (115 V or 230 V) to match the power
requirements in your region.
CAUTION: Always replace fuses with the same type and rating (T 0.400 A 250 V).
Refer to Fuse Replacement section for instruction on changing fuses.
CAUTION: Do Not Sterilize the instrument or any of its components.
CAUTION: After unpacking the instrument, pull down the printer door (below the
LCD display), using the finger cutouts on the sides of the door (near the top), and
remove the foam shipping wedge before using the printer. Close the printer door. Be
sure the paper is sticking out through the slot in the door. Failure to remove the
shipping wedge will result in improper operation of the printer.
CAUTION: Do not use the instrument near other equipment which produces strong
magnetic fields (such as MRI). The video monitor performance may be adversely
affected.
Product Safety
This instrument is classified as follows:
Class I Equipment Protection against electrical shock.
Type BF Degree of protection against electric shock of applied part (forehead rest
and Patient Response button).
Ordinary Equipment (IPX0) Degree of protection against ingress of liquids (none).
Continuous Operation Mode of operation.
WARNING: This device contains visual stimuli, including flickering light
and flashing patterns, between 5 and 65 Hz. Medical professionals need to
determine whether this device should be used for patients who may be
photosensitive, including those with epilepsy.
WARNING: To prevent electric shock, the instrument must be plugged into
an earthed ground outlet. Do not remove or disable the ground pin.
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1-2
Safety Information
CAUTION: Do not use the printer or the instrument with an extension cord or a
power strip (multiple portable socket outlet).
WARNING: Do not open the instrument covers. Opening the instrument
covers could expose you to electrical and optical hazards and will VOID the
warranty.
CAUTION: If a table is available, do not reconfigure system components on the table,
nor add non-system devices or components to the table, nor replace original system
components with substitutes not approved by Carl Zeiss Meditec. Such actions could
result in failure of the table height adjustment mechanism, instability of the table,
tipping and damage to the instrument, and injury to operator and patient.
WARNING: This instrument may cause ignition of flammable gases or
vapors. Do NOT use in the presence of flammable anesthetics such as
nitrous oxide, or in the presence of pure oxygen.
WARNING: The instrument itself is transportable and may be moved from
one location to another. However, if the instrument is placed on a power
table provided by CZM, do not move the table to another location while
the instrument and any other peripherals are placed on it. Doing so may
cause the system components to tip over and cause harm to the patient,
the operator, or others in the vicinity.
CAUTION: Avoid tipping. Do not use the instrument on an uneven or sloped surface.
Also, do not roll the instrument table in deep pile carpet or over objects on the floor
such as power cords. Failure to observe these precautions could result in tipping of
the instrument and/or table and resulting injury to operator or patient and damage
to the instrument.
CAUTION: (United States) Federal law restricts this device to sale by or on the order
of a licensed healthcare practitioner.
WARNING: SERVICE or REPAIR to be performed by QUALIFIED,
AUTHORIZED PERSONNEL ONLY. There are NO USER SERVICEABLE PARTS
INSIDE the Humphrey FDT instrument. Disassembly of the instrument
presents a possible ELECTRICAL SHOCK hazard and will VOID the warranty.
If the unit fails, contact CZM for instructions.
WARNING: REPLACEMENT PARTS and ACCESSORIES Use only approved
replacement parts and accessories.
CAUTION: The appliance coupler is the main disconnect device of the instrument.
Position the instrument in such a way to have easy access to disconnect the
appliance coupler in case of an emergency.
CAUTION: In case of an emergency, disconnect the appliance coupler.
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CAUTION
WARNING: Follow instructions for use. Failure to read and follow instructions may result in hazards
that can lead to serious injury. Instructions may also describe potential serious adverse reactions
and safety hazards.
Type BF applied parts: The Patient Forehead Rest and Patient Response button.
OI
Alternating Current
Power: Off On
Manufacturer
Authorized European Community Representative
Serial number
Catalog number / part number
Model number
European Conformity
Disposal of the Product within the EU. Do not dispose via domestic waste disposal system or
communal waste disposal facility.
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1-4
Safety Information
Protective Packing Symbols
The protective packing symbols specify the handling requirements and the transport and
storage conditions.
Handling Requirements
Keep Dry
This end up
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OR
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1-6
Safety Information
Guidance and Manufacturers Declarations
Guidance and Manufacturers Declaration Electromagnetic Emissions
The Humphrey FDT is intended for use in the electromagnetic environment specified below. The customer or user of the
Humphrey FDT should assure that it is used in such an environment.
Emissions Test
Compliance
RF Emissions
CISPR 11
Group 1
The Humphrey FDT uses RF energy only for its internal function. Therefore, its
RF emissions are very low and are not likely to cause any interference in
nearby electronic equipment.
RF Emissions
CISPR 11
Class B
Harmonics
IEC 61000-3-2
Class A
The Humphrey FDT are suitable for use in all establishments including
domestic and those directly connected to the public low-voltage power supply network that supplies buildings used for domestic purposes.
Flicker
IEC 61000-3-3
Complies
IEC 60601
Test Level
Compliance Level
ESD
IEC 61000-4-2
6kV Contact
8kV Air
6kV Contact
8kV Air
EFT
IEC 61000-4-4
2kV Mains
1kV I/O
2kV Mains
Not Applicable
Surge
IEC 61000-4-5
1kV Differential
2kV Common
1kV Differential
2kV Common
>95% Dip in
5 Seconds
>95% Dip in
5 Seconds
3 A/m
3 A/m
Power Frequency
50/60Hz
Magnetic Field
IEC 61000-4-8
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IEC 60601
Test Level
Compliance
Level
Conducted RF
IEC 61000-4-6
Radiated RF
IEC 61000-4-3
3 Vrms
150 kHz to 80MHz
(outside ISM
bands)
3 V/m
80 MHz to 2.5 GHz
V1 = 3 Vrms
3.5
d = -------- P
3
3.5
d = -------- P
3
E1 = 3 V/m
7
d = --- P
3
80 to 800 MHz
Where P is the max power in watts and d is the recommended separation distance in meters.
Field strengths from fixed transmitters, as determined
by an electromagnetic site survey, should be less than
the compliance levels (3 Vrms and 3 V/m).
Interference may occur in the vicinity of equipment
containing a transmitter.
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Safety Information
1-8
Separation (m)
80 to 800MHz
Separation (m)
800MHz to 2.5GHz
d = 1.167 P
d = 1.167 P
d = 2.3333 P
0.01
0.11667
0.11667
0.23333
0.1
0.36894
0.36894
0.73785
1.1667
1.1667
2.3333
10
3.6894
3.6894
7.3785
100
11.667
11.667
23.333
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Introduction 2-1
(2) Introduction
Intended Use
Humphrey FDT is an AC-powered device intended to determine the extent of the peripheral
visual field of a patient. The device is intended to determine the amount of visual field loss
in a patient, which can then be used to diagnose/track the progression of glaucoma and
other eye diseases.
Wheelchair user
Very low or not measurable visual acuity
Fixation problems
Deafness
Large body, but not those above 99th percentile based on anthropomorphic data
There is a general requirement that the patient be able to sit upright and be able to place
their face in the forehead rest of the instrument (with or without supplemental human or
mechanical support).
Part of the Body
The Humphrey FDT physically interacts with the patients forehead and chin. The patient's
hand and fingers (or similar ability) are also required to press the Patient Response button.
Application
The Humphrey FDT is designed for continuous use, although it is expected that most sites
operate the instrument for 10 hours or less per day, indoors, within a medical office or
hospital setting. This setting shall have clean air free of soot, vapors from adhesives,
2660021149532 A
2-2
Introduction
grease, or volatile organic chemicals. Other Operating Environment specifications are given
in Chapters 1 and 6, Safety and Specifications. Application related warnings are given in
this chapter and elsewhere.
User Profile
We assume that users are clinicians with professional training or experience in the use of
ophthalmic equipment, and in diagnostic interpretation of the tests. Specific assumptions
regarding the profiles of individuals performing instrument operation or data interpretation
are given below. This manual contains information that will aid in the proper instrument
operation and interpretation of the resultant data.
Instrument Operation
Demographic
The user should be adult, and at least one of the following:
Ophthalmologist or other Medical Doctor
Optometrist or equivalent
Nurse
Certified Medical Technician
Ophthalmic Photographer
Non-certified Assistant
Occupational Skills
The user should be able to perform all of the following tasks:
Power on the instrument
Enter, find, and modify patient identifying data
Clean surfaces that contact patient
Instruct the patient
Align the patient with the instrument
Select and initiate a test
Review and save a test or try again
Generate an analysis report
Review the analysis report for completeness
Save, print, or export the analysis report
Archive data
Power off the instrument
Data Interpretation
Demographic
The user should be one of the following:
Ophthalmologist or other Medical Doctor
Optometrist or equivalent
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Introduction 2-3
Job Requirements
The user should have training and certification in the analysis and treatment of ophthalmic
diseases or other eye-related medical issues as required by governing bodies.
Instrument Overview
The FDT Visual Field Instrument is an innovative, efficient, compact and affordable
automated visual field testing instrument. Years of research and clinical trials of patented
Frequency Doubling Technology have resulted in an instrument which provides rapid,
clinically validated and user-friendly visual field testing.
Key features of the FDT Visual Field Instrument include:
Supra-threshold screening tests in less than 1 minute per eye
Threshold tests in approximately 4 minutes per eye
Easy to use; no special training is needed/minimal operator instruction
No corrective (trial) lens needed; patients can wear their own correction or none at all
(must only be within 6D of patients refraction)
No eye patch needed for the opposite (untested) eye - its automatically occluded
Not affected by ambient lighting - can be used in normal room lighting
Not affected by pupil size (as small as 2 mm)
Extensive age-normative reference database incorporated
World-class clinical validation by leading researchers in the field
Software upgrade capability for future enhancements
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2-4
Introduction
Controls and Connectors
LCD Display Contrast Use the UP and DOWN arrows adjacent to the contrast symbol
below the LCD display to adjust the LCD contrast for optimum viewing, based on lighting
conditions.
Patient Response
Button Connector
Software Upgrade
Connector
Computer
Interface
Connector
Serial Number
Location
PATIENT RESPONSE BUTTON CONNECTOR Connect ONLY the patient response button
supplied with the instrument or an approved replacement to the patient response button
connector on the bottom of the instrument. Connection of any other device to the patient
response button connector may damage the instrument or create an unsafe condition and
will void the warranty.
COMPUTER INTERFACE CONNECTOR Connect only RS-232 serial compatible computer
ports to the computer interface connector on the bottom of the instrument. Use the
null-modem configuration computer interface cable supplied with the instrument or an
approved replacement cable. Connection of any other computer port or device to the
computer interface connector may damage the instrument. Refer to the computer interface
instructions for additional information.
SOFTWARE UPGRADE CONNECTOR The blank label on the bottom of the unit adjacent to
this symbol covers the SOFTWARE UPGRADE CONNECTOR. The blank label should only be
removed during a software upgrade and should be replaced when the upgrade is
complete. Refer to the software upgrade instructions to update the instrument software.
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Introduction 2-5
Instrument Components, Patient Side
Forehead Rest
Patient Visor
Calibration Cap
Patient Eyepiece
Power Cord
Voltage Selector
Indicator
115V
Power Switch
Operator Control
Panel
Operator Buttons
(Blue)
Operator LCD
Cancel/Backup
Button (Green)
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2-6
Introduction
Instrument Components
The instrument has seven Buttons to control the operation of the instrument, located
adjacent to the Operators Liquid Crystal Display (LCD).
Four BLUE Operator Buttons along the left side of the Operator LCD Display
A GREEN Cancel/Backup Button below the four BLUE Buttons
Two Operator LCD Display Contrast Adjustment Buttons (Down Arrow and Up Arrow)
adjacent to the Contrast Symbol and directly below the LCD Operator Display
Further below the Operator LCD Display is a Paper Access Door which opens to provide
access to the internal thermal printer for replacement of paper, when needed. The
instrument has a sliding Patient Visor which aids in the selection of the eye to be tested
and automatically occludes the opposite (untested) eye. Detachable Patient Response
Button, Power Cord, and Calibration Cap are also provided.
FDT Overview
FDT isolates a subset of retinal ganglion cell mechanisms in the magnocellular (M-cell)
pathway. These M-cells have large diameter fibers and comprise only 3% to 5% of all
retinal ganglion cells. The damage of these cells in the disease process makes FDT efficient
and effective for the detection of visual field loss.
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Introduction 2-7
Patient Video Screen Patterns
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2-8
Introduction
2660021149532 A
Operation 3-1
(3) Operation
Unpacking
Personnel using this instrument should read and understand the operating instructions
manual before using the instrument. Interpretation of the results should be performed only
by appropriately trained eyecare professionals.
Open the shipping box by carefully cutting the packing tape securing the top flaps of the
box. Lift out the foam insert containing the Patient Response Button, Power Cord and extra
roll of paper. Lift the instrument out of the remaining foam insert by grasping the
instrument at the two cutouts provided and set the instrument on a flat, stable surface.
Remove the plastic bag from the FDT Visual Field Instrument. Use of an adjustable height
chair and/or table is recommended when performing testing.
After you have unpacked the instrument and its components, confirm that you have
received the following items in good condition:
Humphrey FDT Visual Field Instrument
Calibration Cap (covering the Patients Eyepiece inside the Patient Visor)
Patient Response Button
Power Cord (appropriate for local operating voltage)
Extra roll of paper
Note: Retain the shipping materials (box and packaging) in the event of shipping
damage or for return, if necessary, to an authorized service or distribution location at
any time in the future.
After unpacking the instrument, pull down the Paper Access Door (below the LCD display)
using the Finger Tabs on the sides of the door. Remove the foam shipping wedge before
using the printer. Close the Paper Access door while guiding Printer Paper through the
Paper Slot in the door. Failure to remove the shipping wedge will result in improper
operation of the printer.
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3-2
Operation
Tip
50/60 Hz 315mA/160mA
Serial Number
Location
U L 2 601
I EC 601-1
C SA C 22 . 2
N O . 601-1
7422 7
PAT. PEND.
MADE I N U. S.A.
Operator Side
While facing the Patient Side of the FDT instrument, tilt the instrument to plug the Patient
Response Button connector into the small round connector jack. The jack is located
underneath the base of the unit (at the center) and near the patient response button
symbol.
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Operation 3-3
CAUTION: VERIFY OPERATING VOLTAGE SELECTION The FDT voltage
selector switch is normally set to the appropriate operating voltage before
shipment (115 V or 230 V). Before applying power to the FDT, verify that the
Voltage Selector Indicator adjacent to the O/I Power Switch displays the
115V
115V-T400L
230V-T400L
In case you need to change the operating voltage, make sure that the Power Cord is NOT
connected and use a flat screwdriver to pry open the Fuse Drawer Cover. Remove the Fuse
Carrier/Voltage Selector, by again using a flat screwdriver. Rotate the Fuse Carrier/Voltage
Selector so the proper voltage will be visible when the Fuse Drawer Cover is closed.
Re-install the Fuse Carrier. Close the Fuse Drawer Cover and check to be sure the proper
voltage appears in the Voltage Selection Window.
In case you need to replace the fuses, remove the fuse carrier/voltage selector as described
above. Replace both fuses on the two sides of the fuse carrier with new fuses (Type T 0.400
A 250 V). Reinstall the fuse carrier making sure the voltage selection is correct.
2660021149532 A
Operation
Power Switch
115V
230V
PRSR
230V
115V
PRSR
3-4
Make sure that the two fuses are inserted so that they are closest to the protruding metal flanges.
Selected Voltage
Plug the appropriate approved Power Cord into the Power Cord Inlet on the operators
right-hand side and plug the opposite end into a standard power outlet.
2660021149532 A
Operation 3-5
115V
115V-T400L
230V-T400L
Power Switch
To turn the instrument ON, switch the Power Switch (O/I), adjacent to the power connector,
to the ON (I) position. The instrument will perform internal self-diagnostic checks and after
approximately 15 seconds, two double beeps will sound and the FDT MAIN MENU will
appear on the Operator LCD Display. Refer to the troubleshooting section of this manual if
the FDT MAIN MENU does not appear.
Note: You may need to adjust the LCD contrast in order to read the Operator LCD
Display; use the triangle shaped buttons below the Operator LCD Display to increase
(up-arrow) or decrease (down-arrow) the LCD contrast.
Increase Contrast
Return to Main Menu
Decrease Contrast
Note: the GREEN Button may be used at any time to back-up to the previous menu and
to return to the FDT MAIN MENU (it may need to be pressed several times to reach the
FDT MAIN MENU.
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3-6
Operation
Preparing for a Patient Test
Remove the CALIBRATION CAP from the Patient Eyepiece. Replace the calibration cap on
the Patient Eyepiece when the instrument is not in use to minimize the accumulation of
dust and debris in the Patient Eyepiece.
Select RUN PATIENT TESTS from the FDT MAIN MENU to prepare for a SCREENING C-20
TEST, SCREENING N-30 TEST, THRESHOLD C-20 TEST or a THRESHOLD N-30 TEST.
There are two screening test programs. The N-30 Screening program adds two additional
test locations presented above and below the horizontal midline between 20 and 30
degrees eccentricity in the nasal visual field, like with the N-30 Threshold test. Also, there
are two screening level options for each screening program: the -5 (default) and -1. The
Screening C-20-5 and N-30-5 programs utilize the P=5% significance limit as the baseline
normal contrast level, whereas the Screening C-20-1 and N-30-1 programs utilize the
P=1% significance limit as the baseline normal contrast level. See the clinical example
and refer to the Primer for Frequency Doubling Technology for a further explanation of the
-5 and -1 screening level options.
To change the default screening level found in the SCREENING TEST MENU from the
C-20-5 & N-30-5 (5% level) programs to the C-20-1 & N-30-1 (1% level) programs,
follow these keystrokes:
==> UTILITIES MENU ==> SET-UP INSTRUMENT MENU
==> SET-UP OPTIONS MENU ==> SET DEFAULT SCREENING LEVEL
and use NEXT CHOICE and ACCEPT SETTINGS to select SCREENING - 1%
Note: Once RUN PATIENT TESTS is selected, typical FDT stimulus presentations are
automatically displayed to demonstrate the test to the patient until the test actually
starts.
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Operation 3-7
Enter the Patients Age
The unit will start with an AGE of 50 years. Select +10 YEARS (TOP BLUE Button) to
increase the AGE by 10 year increments (e.g. to 60, 70, and so on). Select -10 YEARS (2nd
BLUE Button from the top) to decrease the AGE by 10 year increments. Select + 1 YEAR
(3rd BLUE Button from the top) to increase the AGE in 1 year increments to adjust to the
exact age of the patient (e.g. 51, 52, and so on). Select ACCEPT SETTING (BOTTOM BLUE
Button) when the correct AGE is displayed.
Slide the Patient Visor to the right eye test position (this is to your right when looking at the
patient from the operators side).
Note: If you want to skip the right eye (i.e., only test the left eye), then slide the Patient
Visor to the left eye test position now (this is to your left when facing the patient
from the operators side) and select SKIP RIGHT EYE.
Prepare the Patient
Place the Patient Response Button in the patients hand and show them how to press it.
Ask the patient to place their forehead on the Forehead Rest and look into the Patient
Eyepiece at the video screen. Adjust the height of the chair or table (or both) to obtain a
comfortable position for the patient. Confirm that the patient can see the entire lit video
screen, including all four corners, in the Patient Eyepiece and the black dot in the middle of
the screen.
Note: Be sure the patient is positioned comfortably (not hunched over) by adjusting the
height of the chair or table (or both).
Patient Refraction
The FDT test may be taken with or without the patients correction (if the patient is within
6D of their refraction). If a patient is wearing glasses, confirm that their glasses frame does
not obscure any of the lit portion of the display. Ask the patient to remove their glasses for
2660021149532 A
3-8
Operation
the test if their lenses or contact lenses are tinted or change contrast based on lighting
conditions (photochromatic). Tests may be taken with bifocal or progressive lenses (unless
the progressive lenses have more than 3D equivalent sphere distance correction).
Explain the Test Procedure to the Patient
A demonstration of the test is running now. Can you see the black dot in the center and
the entire lit video screen? You need to stare at the black dot in the center of the screen
during the entire test.
From time to time, you will see patterns of flickering black and white vertical bars that will
briefly appear in different areas of the screen. The patterns will sometimes be very faint and
at other times be very distinct. You are not expected to see the bar patterns at all times.
Each time you see the flickering black and white vertical bars of one of the patterns, press
the response button once. Can you see these patterns in the demonstration running now?
You may practice now by pressing the Button to respond to the patterns.
It is OK to blink and a good time to blink is when you press the response Button. If you
need to rest or ask questions during the test, you can pause the test at any time by
pressing and holding down the response Button. Do you have any questions? Do you
understand how to take the test?
I will now start the test. There will be a few brief flashes and then the test will begin. Press
the response Button once each time you see the flickering black and white vertical bars of
one of the patterns, even if the bars are very faint. Please remember to stare at the black
dot in the center of the screen during the entire test.
Note: A separate demonstration test is available from the FDT MAIN MENU to help
facilitate the patients understanding of the test, if needed. To run a practice test, select
RUN DEMONSTRATION (2nd BLUE Button from the top) from the FDT MAIN
MENU. A demonstration of the test stimulus automatically begins. The patient should
use this time to become familiar with the test and practice using the PATIENT
RESPONSE BUTTON (Ask the patient to look into the Patient Eyepiece within the
Patient Visor and then test the procedure.) Press the GREEN Button to cancel the
practice test and return to the FDT MAIN MENU.
2660021149532 A
Operation 3-9
Be sure to prepare the patient as described above before running a practice test.
Running a Screening or Threshold Patient Test
Select either SCREENING TEST MENU or THRESHOLD TEST MENU from the RIGHT EYE TEST
MENU. If running a screening test, choose either RUN SCREENING C-20-1 (or -5) or RUN
SCREENING N-30-1 (or -5). If running a threshold test, choose either RUN THRESHOLD
C-20 or RUN THRESHOLD N-30. The right eye test will begin immediately after a
momentary check of the proper calibration..
Note: To skip the right eye test and proceed directly to the left eye test, select SKIP
RIGHT EYE (BOTTOM Operator Button from the top) before selecting a
SCREENING or THRESHOLD test.
2660021149532 A
3-10
Operation
Note: The Operator LCD Display will indicate if there is too much ambient light to
perform a reliable test. Lower the room lighting or change the test location until suitable
test conditions are achieved. Also, if the Patient Response Button is not connected or
the Patient Visor is in the wrong eye position, this will be indicated on the Operator LCD
Display.
The PERCENT COMPLETE scale, field location being tested, PATIENT RESPONSE, FIXATION
ERRORS, FALSE POS ERRORS and FALSE NEG ERRORS are displayed on the Operator LCD
Display during the test. Remind the patient to keep looking at the dot in the middle of the
screen and inform them of the approximate percent complete 3 or 4 times during the test
to encourage good patient compliance. Monitor the catch trials (FIXATION ERRS, FALSE
POS ERRS, and FALSE NEG ERRS) during the test. The catch trial display fields will be
highlighted on the Operator LCD Display if 2 or more catch trials have been responded to
by the patient. A high ratio on any of the catch trials indicates unreliable results and that
the test should be restarted or repeated.
For the right eye, near the end of a SCREENING N-30 TEST or a THRESHOLD N-30 TEST, the
FDT will pause for approximately 15 seconds. The internal fixation target will move to the
right on the screen. This allows two extra nasal points to be tested. At the same time the
following instructions will appear on the screen: Inform Patient Fixation Moved Right.
Advise the patient to re-fixate on the black spot in its new position and continue to press
the Button until the test completes. The instruction will note fixation moved to the left
when testing the left eye.
Patient reliability (Fixation, False Positive, and False Negative) errors that exceed 1 are
highlighted on the operator LCD and marked with an asterisk (*) on the results printout.
2660021149532 A
Operation 3-11
False Negative and False Positive catch trial presentations are indicated by the symbols (+)
& (-) on the operator LCD so they can be distinguished from regular teststimulus
presentations.
Note: You can PAUSE or RE-START the test by pressing the GREEN Button at any time
during the test. Follow the Operator LCD Display instructions to CONTINUE TEST or to
RE-START TEST from a pause. The patient can also PAUSE the test (for a break, etc.) by
simply pressing and holding down the Patient Response Button. The test will resume
automatically once the patient releases the Patient Response Button. During patient
pause, you may also select OPERATOR PAUSE (GREEN Button) so that the test will
remain paused until you restart it.
Note: A SCREENING C-20 TEST takes less than 1 minute (per eye) to complete, a
THRESHOLD C-20 TEST takes approximately 4 minutes (per eye) to complete and a
THRESHOLD N-30 TEST takes about 4-1/2 minutes.
At the end of the right eye test, the Operator LCD Display will prompt for a left eye test.
Slide the Patient Visor to the left eye test position (this is to your left when facing the
patient from the operators side). Prepare the patient. Select RUN SCREENING C-20 TEST
(TOP Operator Button), RUN THRESHOLD C-20 TEST (2nd Operator Button from the top), or
RUN THRESHOLD N-30 TEST (3rd Operator Button from the top) from the LEFT EYE TEST
MENU to begin the left eye test immediately after a momentary check for proper
calibration.
Note: To skip the left eye test, select SKIP LEFT EYE (Bottom Operator Button) to
proceed to the results menu.
2660021149532 A
3-12
Operation
Displaying and Printing the Test Results
You can both view the results on the Operator LCD Display and print them out from the test
results menu. At the end of a test, the results will be automatically printed (default set-up is
automatic printing) and then the test results menu will automatically appear on the
Operator LCD Display.
Select either VIEW RIGHT EYE RESULTS (3rd Operator Button from the top) or VIEW LEFT
EYE RESULTS (Bottom Operator Button) to view the individual eye results for the patient just
tested on the Operator LCD Display. Use the GREEN Button to back-up to the previous
screen to allow you to toggle between the eye results or to return to the FDT MAIN MENU
(press it twice if necessary). Select PRINT REPORT (TOP Operator Button) to obtain
additional copies of the results for the patient just tested (you can print as many copies as
youd like).
Note: Once the test is completed, you can also select LAST PATIENT RESULTS (3rd
Operator Button from the top) from the FDT MAIN MENU to display or print out the
results of the patient just tested. The results of the most recently tested patient will
remain in memory only until you begin a new test or until the instrument power is turned
off.
2660021149532 A
Operation 3-13
Understanding the Screening C-20 and N-30 Test Results
A plot of the 17 visual field locations tested will be printed (see samples on the following
pages) and displayed on the Operator LCD Display for the supra-threshold SCREENING
C-20 TEST for each eye tested. There are 19 visual field locations tested with the
SCREENING N-30 TEST. Each test location will be either clear white or will have one of
three possisble levels of shading.
A
WITHIN NORMAL LIMITS The patient responded positively (on either the
first or second opportunity) when tested at the contrast level that 99% (P > =
1%) of normal subjects of the same age would respond to for the test location
with this shading.
MILD RELATIVE LOSS The patient failed to respond positively when tested
at the 1% age normative contrast level (P = 1%) after being given 2
opportunities to do so (the instrument will re-test any point missed at the 1%
age normative level a second time) for the test location with this shading.
SEVERE LOSS The patient failed to respond positively after being given 4
opportunities to do so for the test locations with this shading; the 3
opportunities listed above and a fourth at the maximum contrast level of the
instrument.
When reviewing the results of the visual field test, careful consideration must be given to
the reliability indicators (catch trials). The following two test reliability indicators appear on
the printed report and Operator LCD Display for the screening test. They are an important
measure of patient reliability in taking the test (and of the reliability of the results). They are
indicated as a ratio of the number responded to the number presented. For example, 1/3
indicates that the patient responded to 1 of the 3 catch trials presented.
FIXATION ERRS: 0/3
FALSE POS ERRS: 0/3
FIXATION ERRORS - The ratio of the number of times the patient responded to a target
placed in the blind spot versus the total number of times fixation was tested (i.e., total
number of targets placed in the blind spot). Three FIXATION catch trials will be randomly
presented for each eye. Fixation errors indicate the patient is not maintaining good fixation
during the test, is misaligned, or does not understand the test.
FALSE POSITIVE ERRORS - The ratio of the number of times the patient responded to a
pause in the testing sequence (i.e., no target presented) versus the total number of
pauses in the testing sequence. Three FALSE POSITIVE catch trials will be randomly
presented for each eye. False positive errors indicate the patient is pressing the Button
even if the patient doesnt see any patterns or does not understand the test.
2660021149532 A
3-14
Operation
Because the FDT Screening N-30-1 (or C-20-1) and N-30-5 (or C-20-5) programs utilize
different baseline normal contrast levels, they also differ in how they flag (shade) test
locations as being outside normal limits. With the N-30-1 (or C-20-1) test, points are
initially flagged when they reach the P<1% probability significance level (i.e. the sensitivity
level which is found less than 1% of the time in the normal population). With the N-30-5
(or C-20-5) test, points are initially flagged when they reach the P<5% probability
significance level (i.e. the sensitivity level which is found less than 5% of the time in the
normal population), and thus there is a greater chance that any point may be deemed
outside normal limits. Therefore, the N-30-5 (or C-20-5) test is slightly more sensitive,
readily identifying more extensive loss. Below is a clinical example that demonstrates this
difference with a comparison between the Screening N-30-1 and N-30-5 programs.
2660021149532 A
Operation 3-15
Understanding the Threshold C-20 and N-30 Test Results
A plot of the 17 or 19 visual field locations tested will be printed (see samples on the
following pages) and a combination plot will be displayed on the Operator LCD Display for
the THRESHOLD C-20 and N-30 TEST for each eye tested. The first printed results plot will
contain a numerical contrast threshold level in units of dB for each location tested. The
second printed results plot is a deviation plot and will be either clear white or will have one
of four possible levels of shading corresponding age normative significance levels for each
location tested. The results combination plot displayed on the Operator LCD Display will
indicate both the numerical contrast threshold level and the shading for each location
tested.
A
The patient achieved a threshold level in the range that 95% (P > = 5%) of
normal subjects of the same age achieved for the test locations with this
shading.
The probability is less than 5% (P < 5%) that a normal subject of the same age
would perform at the threshold level that this patient achieved for the test
locations with this shading.
The probability is less than 2% (P < 2%) that a normal subject of the same age
would perform at the threshold level that this patient achieved for the test
locations with this shading.
The probability is less than 1% (P < 1%) that a normal subject of the same age
would perform at the threshold level that this patient achieved for the test
locations with this shading.
The probability is less than 0.5% (P < 0.5%) that a normal subject of the same
age would perform at the threshold level that this patient achieved for the test
locations with this shading. This shading will also occur if the patient failed to
respond at the maximum contrast level of the instrument (0 dB will be
indicated).
B
C
D
E
When reviewing the results of the visual field test, careful consideration must be given to
the reliability indicators (catch trials). The following three indicators appear on the printed
report and on the LCD Display for the threshold test. They are an important measure of
patient reliability in taking the test (and of the reliability of the results). They are indicated
as a ratio of the number responded to the number presented. For example, 1/3 indicates
that the patient responded to 1 of the 3 catch trials presented.
FIXATION ERRS: 0/0
FALSE POS ERRS: 0/0
FALSE NEG ERRS: 0/0
FIXATION ERRORS - The ratio of the number of times the patient responded to a target
placed in the blind spot versus the total number of times fixation was tested (i.e., total
number of targets placed in the blind spot). Six FIXATION catch trials will be randomly
presented for each eye in the C-20 TEST and N-30 TEST. Fixation errors indicate the patient
is not maintaining good fixation during the test, is misaligned, or does not understand the
test.
2660021149532 A
3-16
Operation
FALSE POSITIVE ERRORS - The ratio of the number of times the patient responded to a
pause in the testing sequence (i.e., with no target presented) versus the total number of
pauses in the testing sequence. Six FALSE POSITIVE catch trials will be randomly
presented for each eye in the C-20 TEST, eight in the N-30 TEST. False positive errors
indicate the patient is pressing the Button even if patient does not see any patterns or the
patient does not understand the test.
FALSE NEGATIVE ERRORS - The ratio of the number of times the patient did not respond to
a test pattern at the maximum possible contrast level of the instrument versus the total
number of times that maximum possible contrast level patterns were tested. Three FALSE
NEGATIVE catch trials will be randomly presented for each eye in the C-20 TEST, five in the
N-30 TEST. False negative errors indicate the patient is likely to not be paying attention,
does not understand the test, or has a severe loss at the location of the FALSE NEGATIVE
catch trial(s).
For the threshold tests, the device utilizes a staircase threshold strategy known as a
Modified Binary Search (MOBS)1. The range of possible threshold level values for the raw
data (patient threshold scores) is between 0 dB Maximum Contrast (lowest patient
sensitivity) and 56 dB Minimum Contrast highest patient sensitivity). The formula used to
calculate the dB values is log10(2048/c)*10*H where c ranges from 1 (minimum contrast) to
2048 (maximum contrast) and H is approximately 2. Note that XX dB will be displayed, if
the threshold cannot be determined due to inconsistent patient responses which do not
meet the MOBS threshold criteria. The magnitude of the threshold level values is directly
correlated to the Humphrey Field Analyzer values.
The device also provides MD & PSD global statistical indices calculated from points over
the entire visual field for the threshold test. These indices reduce the individual threshold
scores to a single number to provide overall information about the entire visual field. The
magnitude of the MD & PSD values are directly correlated to the Humphrey Field Analyzer
MD & PSD indices. The actual formulas used for the MD & PSD indices calculations can be
found in the references (2, 3).
The MD (Mean Deviation) index signifies overall severity of field loss. It is affected both by
the degree of loss and the number of affected locations. A positive number indicates that
the average sensitivity is above the average normal for age, whereas a negative number
indicates that the average sensitivity is below the average normal value. 2
When the MD value is LESS than that of 95% of normal FDT fields, the percentile
probability is given (P < 5%, P < 2%, P < 1%, or P < 0.5%) on the Operator LCD Display
and on the printed report.
The PSD (Pattern Standard Deviation) index is the standard deviation of the difference of
each sensitivity value from an expected value (based on the normal value at that location
and the mean deviation index), each difference weighted according to the variance of the
normal values at that point. The PSD is small in a normal field, or in a field where all points
are equally abnormal. The PSD becomes large as some points are more affected than
others, and thus the PSD is an index of localized change in the field. 3
2660021149532 A
Operation 3-17
When the PSD value is GREATER than that of 95% of normal FDT fields, the percentile
probability is given (P < 5%, P < 2%, P < 1%, or P < 0.5%) on the Operator LCD Display
and on the printed report.
Pattern Deviation plots are displayed and printed with Threshold test results. Refer to the
Primer for Frequency Doubling Technology for information on Pattern Deviation plots.
Tyrrell RA, Owens DA: A New Technique to Rapidly Assess the Resting States of the Eyes and Other Threshold Phenomena: the
Modified Binary Search (MOBS) Whitely Psychology Laboratories, Pennsylvania State University.
Anderson, DR: Automated Static Perimetry Mosby Year Book, St. Louis, 1992; p. 84.
Anderson, DR: Automated Static Perimetry Mosby Year Book, St. Louis, 1992; p. 86.
2660021149532 A
3-18
Operation
Screening C-20 Test Result Sample
2660021149532 A
Operation 3-19
Threshold C-20 Test Results Sample
2660021149532 A
3-20
Operation
Threshold N-30 Test Results Sample
2660021149532 A
UTILITIES MENU
SET-UP INSTRUMENT MENU
RUN SELF-CALIBRATION
INSTRUMENT TESTS MENU
ABOUT FREQUENCY DOUBLING TECHNOLOGY
24 JUN 1997 04:01 pm
2660021149532 A
4-2
Select NEXT CHOICE (3rd Operator Button from the top) to select the clock setting you
want to change. (s) INCREASE (TOP Operator Button) and (t) DECREASE (2nd Operator
Button from the top) to change the setting. Select ACCEPT SETTINGS (BOTTOM Operator
Button) when the correct CLOCK settings are displayed. Press the GREEN Button twice to
return to the FDT MAIN MENU.
INCREASE
YEAR:
1997
MONTH: JUN
t DECREASE
DAY:
HOUR:
NEXT CHOICE
MINUTE: 2
12 HOUR FORMAT
24
4 pm
ACCEPT SETTINGS
24 JUN 1997 04:02 pm
2660021149532 A
UTILITIES MENU
SET-UP INSTRUMENT MENU
RUN SELF-CALIBRATION
INSTRUMENT TESTS MENU
ABOUT FREQUENCY DOUBLING TECHNOLOGY
24 JUN 1997 04:01 pm
Note: Be sure to cover the Patient Eyepiece with the Calibration Cap shipped with each
unit. If the Calibration Cap is not available, substitute something that will temporarily
block light from entering the Patient Eyepiece or perform the calibration in a completely
darkened room (black cloth over Patient Visor, etc.). The Operator LCD Display will
indicate if there is too much ambient light to complete the calibration.
2660021149532 A
4-4
Maintenance
This instrument requires no preventive inspection or maintenance. The only user
maintenance required is replacing the printer paper and surface cleaning as necessary.
Printer Paper Replacement
To load a new roll of paper, pull down the Paper Access Door (below the Operator LCD
Display) using the Finger Tabs on the sides of the door (near the top). Remove the empty
paper spool from the paper well.
Unwrap the paper from its bag, loosen the leading edge of the paper from the roll, and
place the new roll of paper into the paper well with the leading edge of the paper facing
toward the outside of the unit (toward you see the diagram on the inside of the printer
door).
2660021149532 A
Note: Use only an appropriate heat-sensitive printer paper designed to be used with the
Seiko Instruments 5000 series printer inside the instrument (reverse wound rolls only) or
the print quality may be degraded, the printer life may be shortened, and the instrument
warranty voided. Appropriate paper may be ordered through any authorized
representative. Refer to the Replacement Parts and Accessories section of this manual
for part number and ordering information.
Note: Because the printer paper is thermally activated, no printing will appear on the
paper if it is inserted backwards.
Note: The printer paper is thermally activated, so it must be stored in a cool, dry, dark
location to prevent exposure and degraded performance over time.
Note: Do not use transparent adhesive tape on printed portions of the printout, as those
portions of the printout will then fade.
Note: Do not store the printed side of the printout in contact with plastic folders or
sheets, as those portions of the printout will then fade.
Note: Do not allow any cleaning or disinfection solutions or other liquids to come into
contact with the printer paper. Degraded print quality or printer damage may occur for
new printouts and degraded printouts of previously printed results may occur (especially
with Isopropyl alcohol).
2660021149532 A
4-6
PART NUMBER
2660021101300
0000001096628
0000001034279
0000001272153
0000001272743
0000001045678
0000001054028
2660021131921
2660100022511
0000001145999
2660021133168
2660021131890
2660021134021
2660021149532 A
Instrument Disposition
When it comes time to upgrade the FDT, please contact Carl Zeiss Meditec to inquire about
trade-in or upgrade values we may offer. Should you not wish to trade in the instrument,
please dispose of it in accordance with local and national electrical and electronic
equipment recycling requirements.
Disposal
This product contains electronic components. At the end of its lifetime, the product should
be disposed of in accordance with the relevant national regulations.
Disposal of the Product within the EU
Packaging materials should be retained for future relocation or repair. If you wish to
dispose of the packaging material, contact a recognized collection system for recycling.
The device contains electronic components. At the end of its lifetime, the product and its
integrated batteries should be disposed of in accordance with the relevant national
regulations.
2660021149532 A
4-8
Troubleshooting
The INSTRUMENT TESTS MENU (from the UTILITIES MENU) provides the ability to test the
instruments inputs, outputs, serial port and A/D circuitry, if needed, for troubleshooting.
Follow the menu choices to test the area of concern.
If the unit fails to power on (Operator LCD Display is off, no double beep), confirm:
Approved power cord is connected to a power outlet and to the instrument Power
Cord Inlet
Power Switch is on (I)
Operator LCD Display contrast is set to allow the display to be visible (use the
triangular Up/Down Contrast Adjustment Buttons)
Proper operating voltage selection
Power outlet is live
Fuses condition
Note: Refer to the Preparation for Use and Power On section of this manual for
instructions to select the proper operating voltage or to inspect or change the fuses.
If the instrument does not print out the results, confirm the foam shipping wedge has been
removed. Pull down the Paper Access Door below the Operator LCD Display) using the
Finger Tabs on the sides (near the top) and remove the foam shipping wedge if not already
removed. Close the printer door. Be sure the paper is sticking out through the slot in the
door. Failure to remove the shipping wedge will result in improper operation of the printer.
If the results printout is blank, confirm the paper is inserted correctly. Blank printouts will
occur if the printer paper is inserted backwards. Also, confirm the correct type printer paper
is being used. Improper paper type may cause blank or faint printouts. Refer to the Printer
Paper Replacement section of this manual for instructions.
If you have an instrument problem that you cannot resolve, refer to the Service Information
section of this manual for Technical Assistance information.
2660021149532 A
1-800-341-6968
Phone: +49 36 41 22 03 33
Fax: 925-557-4101
Fax: +49 36 41 22 01 12
2660021149532 A
5-2
Service Information
2660021149532 A
Specifications 6-1
(6) Specifications
Instrument
Dimensions:
Weight:
Patient display size:
Power requirements:
Power Connection:
Power Cord:
Computer Interface:
Printer:
Environmental
Operating Conditions
Temperature:
Humidity:
Pressure:
Altitude:
+15 C to +35 C
10% to 90% non-condensing
700 hPa to 1060 hPa
Up to 3000 m above sea level
-20 C to +49 C
0% to 95% non-condensing
700 hPa to 1060 hPa
Test
Screening Test Strategies:
Supra-threshold 20 (SCREENING C-20 - 1)
Contrast values: p = 1% (2 times), p = 0.5%, maximum contrast
Supra-threshold 20 (SCREENING C-20 - 5)
Contrast values: p = 5% (2 times), p = 1%, maximum contrast
Supra-threshold 20 (SCREENING N-30 - 1)
Contrast values: p = 1% (2 times), p = 0.5%, maximum contrast
Supra-threshold 20 (SCREENING N-30 - 5)
Contrast values: p = 5% (2 times), p = 1%, maximum contrast
2660021149532 A
6-2
Specifications
Reliability Indices:
Fixation Monitoring: Heijl-Krakau fixation monitor
Catch trial contrast: 6 dB (~ 50%)
3 catch trials in SCREENING C-20 and N-30 TESTS
6 catch trials in THRESHOLD C-20 and N-30 TESTS
Presentation Order: Pseudo-Random
Pattern: 1 diameter circular FDT stimulus
False Positive Catch Trials:
Catch trials contrast: 56 dB (~ 0%)
3 catch trials in SCREENING C-20 and N-30 TESTS
6 catch trials in THRESHOLD C-20 TEST
8 catch trials in THRESHOLD N-30 TEST
Presentation Order: Pseudo-Random
False Negative Catch Trials:
Catch trial contrast 0 dB (~ 100%)
3 Catch trials in THRESHOLD C-20 TEST
5 Catch trials in THRESHOLD N-30 TEST
Presentation Order: Pseudo-Random
Pattern: 1 of 17 FDT Patterns, Random
Stimulus:
17 or 19 FDT patterns plus OD and OS fixation catch trial patterns (4 patterns per visual field
quadrant plus a central 5 radius pattern)
Presentation Order: Random
Spatial Frequency: 0.25 cycles/degree, cosinusoidal modulation
Temporal Frequency: 25 Hz counter-phase flicker
Duration: 200 to 400 ms
Color: black and white
Mean Background Illumination: 100 cd/m2 nominal
Contrast Range: 56 dB (~ 0%) to 0 dB (~ 100%) in log10 steps
Interstimulus Internal: 0 to 500 ms, Random
2660021149532 A
Dublin, CA 94568
07745 Jena
USA
Germany
Toll Free:
Phone: +49 36 41 22 03 33
Phone:
Fax:
Fax:
[email protected]
www.meditec.zeiss.com
+49 36 41 22 01 12
2660021149532 A
Humphrey FDT User Manual
www.meditec.zeiss.com
Specifications subject to change without notice