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SELF INSTALLATION INFORMATION MANUAL FOR KERATRON SCOUT, KERATRON BRIDGE,

PICCOLO, AND WAVE

Any reference as to the Keratron Scout software als o applies to the Keratron Bridge and the Keratron Piccolo.

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THANK YOU FOR YOUR PURCHASE!

Enclosed is everything you will need to install and operate your Keratron Scout, Keratron Bridge, or Keratron Piccolo Topography system and Wave Contact Lens Design system. It is our goal to make the self installation process as easy as possible for such technologically advanced systems. If you need any assistance at all during the self installation procedure, please do not hesitate to contact our Technical Service Representative at 877-393-8676. Please review over the material in our Inspection Packet. You can join our Wave Contact Lens Designers Google site at http://groups.google.com/group/Wave-Contact-Lens-Designers . If you have any questions about the Google site or wish to get an invitation to join please email the Wave Contact Lens Designers site administrator at Wave-Contact-Lens-Designers @googlegroups.com. We also have a Wave/EyeQuip User discussion board that you may join to share cases with other Wave doctors. Once you have completed your installation refer to the Scout and Wave User Training Program insert and call, 1877-393-8676, to schedule your Training.

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Self Installation Information

START HERE When installing software

Please follow these steps when installing your soft ware programs from the EyeQuip Program Disk. 1. Install the Keratron Scout program first.

2. Next install the Wave Contact Lens program. *

(Do not complete the User ID and Password fields. C lick the Accept button)

3. Do not install the OnWaveII program. (You will install once you have completed your Wave CWD, (Certified Wave Designer), training.) If you come to a point where you need further assistance do not hesitate to call our Technical Service Representative at 877-393-8676.

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Options for Customizing Screen Views

While optional we suggest that you complete these steps as they have been found to be the most common setup options for most people. This will also allow you to familiarize yourself with the Options settings and tailor your screen view to your personal preferences. Please make changes with no maps displayed. You can open a map and check results after you have clicked OK in the Options window.

Customizing Screen Views: (Optional) These have been found to be the most popular settings for screen views.

1. Start the Scout Software and click the ‘AZ” button, (second from the left on the second menu bar).

2. At the top menu bar click “Tools” then “Options”.

3. In the “Options “ window under the tab “Graphics” in the “Map Panel” section click the check boxes for “Show Pupil”, “Show Meridians”, “Show 3-Zone”, “Show eye references” (S-I-N-T)

4. In the “Cursor Move” panel click “Synchronous”.

5. In the “E-Values” panel click “8mm zone”.

6. Click the “General” tab and at the bottom in the “Privacy output data” pane, uncheck the “Ask for privacy output” checkbox.

7. Click the “Process” tab. In the “Repeatability Check” panel click “After Process All…” checkbox. In the “Default View” panel click the drop down arrow at “Borders”. Select “Rings”.

8. In the “Move axis resolution” panel select “High”.

9. Click the “Database” tab. In the “Database Explorer” panel click the check box at “Single click to open”. In the ”Alpha order” panel click “Test Date”. In the “Chrono order” panel click “Test Date”.

10. Click the ”Print-I/O” tab. In the “Port type” panel select the type of port that will be used for communication between the computer and the Scout. (Usually USB.)

11. Click the “Contact Lens” tab. In the “View” panel click the check boxes for “Show Pupil” and “Show Tilt Buttons”.

12. Click the “Wavefront” tab. In “Wavefront Map Overlay” panel select “Show Pupil”, “Show Meridians”, “Show 3-Zone”, “Show eye references…”, “No Grid”. Leave “Colors” panel as is.

13. Click the “Profiles & 3D” tab. In the “Profile Type” panel select “Meridians”. Click “OK” at the bottom of the “Options “ window.

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Scout Calibration Instructions Before you can use the Scout, it must be calibrated. This simple operation takes just a few seconds. And since the Scout is a portable instrument, we advise you to do routine calibration more often than with the full size table mounted Keratron (i.e. at least once a day and not just when installing, moving the VK or replacing the mires cone),

For battery powered units : remove the Scout from the docking base follow the capture procedure below ; then return it in the docking base and click on the Calibrate icon. (Check that the value in the Calibration Sphere box is the same as on your Calibration sphere. If not, click “Change” and correct the value and click “OK: twice to complete calibration and the unit will be ready for use. For corded Scouts click on the Calibrate icon first then follow the capture procedure below . Click “OK” and the automated calibration process will complete calibration and the unit will be ready for use.

Test Sphere Capture Procedure: Press the "OD" or "OS" button on the Scout's membrane panel. Hold the calibration sphere against the mires cone, making sure the two protrusions on the cone fit into the two recesses on this tool. While holding the calibration sphere with your thumb and middle finger, use your forefinger to rotate the alignment wheel. The rotation will move the sphere back and forth across the

Scout's alignment beam. The sphere is in proper position when the "OK" LED (right side of LCD screen on the Scout's membrane) panel illuminates and the beeping is stable. Turn the wheel forth and back a little to adjust it so to be just in the middle the "OK" led is illuminated. Press the green OK button.

Note: If the calibration sphere image was not exactly centered when you pressed the OK button the Scout will instruct you to center the cross in the middle ring with the mouse and click to continue. Inspect images and answer questions.

Scout Quick Start Operating Instructions

1. For new patients Click File – New Patient. Fill in as much information as the operator would like in the Patient tab. For contact lens patients type in city of residence in the “Address” line. For those who will have contact lenses designed enter spectacle refraction at the OD and OS tabs respectively. Click Save in the lower left when finished with all data entry.

2. Once the patient is in the database find and click on the patient’s name to highlight it before capturing images. Go to the Scout Database Explorer and click the alpha folder containing the patient’s last name. Click to highlight the desired patient.

3. When capturing images with the battery powered Scou t, remove the Scout from the Docking Base, acquire images and place the Scout in the Docking Base. Click the Acquire images icon or press Ctrl+A on the keyboard. The rings images will download. For corded systems click the patient’s name then the Acquire Images icon. Click yes to confirm patient name and then acquire images. The images will download as they are captured.

4. To process the images, click the Process All Images icon or press Ctrl+P on the keyboard. The rings images will process into color maps. (Refer to Automatic and Manual Centering section in the online help, icon that looks like a book, for images that do not find center automatically).

5. To save the test without printing, click the Save Test icon (floppy disc icon) to display Save options. Enter any desired information and click Save. The files will be saved and the Scout desktop will be cleared. Note : If you select the wrong patient Highlight the correct patient’s name in the Database Explorer. Right mouse click the patient’s name. Select “Set patient data to acquisition”. The patient’s name will be used when the “Save” icon is clicked.

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6. To save and print before clearing the desktop using templates click File, Save Test (No exit). The maps will remain on the desktop. Click the “Print” icon and choose OK to use the selected template(s). See “Templates” in the Help section for more about template printing.

7. To print a previously saved test using templates , click the patient’s name, select the correct test date/test file box line. Click the “Print” icon and choose OK to use the selected template(s). See “Templates” in the Help section for more about template printing. .

8. To print using the Print Screen Function An alternative print function, “Print Screen” can be used. Display the saved maps, usually one OD and one OS map, and click the “Show/Hide Database Explorer” icon, firstfrom the left, to hide the database. Click the “Print Screen” icon. (For the first time you will need to click “Fit to page” and then “Center” buttons in the Print Screen dialog box before clicking “OK” to print.)

How to recall patient maps Find the patient as described above in Step 2 “Quick Start”. To review all tests within the file box drag the file box to the Scout desktop and all of the tests in the file box will be displayed.

If you wish to review only one or only a few of the tests available, you may double click the individual tests you wish to review and they will be displayed. You may also drag any individual map to the desktop for display.

Image Acquisition Tips

1. Patient should be seated and if in an examination chair the head should be against the chair’s headrest.

2. For patients with non-receding or non-protruding foreheads the cone should be in the mid range of it’s up and down positioning within the instrument. Patients with receding foreheads should have the cone in one of the upper positions and those with protruding foreheads or very deep-set eyes should have the cone adjusted to one of the lower stops to facilitate image capture. Slit lamp mount systems should have the cone at its mid range position but the position can be changed to facilitate various orbit depths and positions.

3. The patient should be advised that they should look at the green fixation light inside the cone and that they can blink normally.

4. The base of the Scout should be parallel with the floor with the cone level with the patient’s eyes. The operator should observe the patient and bring the Scout towards the patient’s face with the cone pointing at the eye. When the headrest is about 1 to 2 inches from the patient’s forehead the operator should shift observation to the Scout LCD screen and locate the patient eye in the screen.

5. While observing the patient’s eye on the LCD screen continue to approach the patient with the Scout keeping the image of the eye as centered as possible until the forehead rest touches the patient’s forehead.

6. Continue forward towards the patient until the beeping and the position indicator lights on the Scout’s display panel show that the position is above the center “OK” indication.

7. Have the patient blink to distribute an even tear film and then open both eyes wide. Press and hold the “OK” button.

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8. Confirm centering and slowly withdraw the instrument so that the beeping and position indicator LED’s come down and cross the center “OK” point where the image will be acquired automatically. Repeat for the other eye.

9. It is imperative that the operator becomes familiar with the centering technique that involves moving the Scout up and down and side to side. For many the tendency will be to incorrectly pivot the Scout about the forehead rest. This will not result in centering motions. Rather, move the entire Scout up/down/left/right. (Note that the hand, eye coordination will become second nature with just a little practice.)

10. Instruct the patient to open BOTH eyes as WIDE as possible. (If necessary you can help open the eye with your fingers outside of the cone.)

11. Acquire at least 3 images per eye; observe automatic repeatability check, eventually saving the best OD and OS images.

Up to a maximum of 8 images can be captured.

Note: It is very important that the patient opens both eyes very wide, to avoid typical eyelashes artifacts (see last page in this manual). If the eyelash shadows reach the horizontal line passing through the center picture, they can fool the detection system and you will get a map with abnormally high curvatures. In case of doubt take more than one photo and check for repeatability. We suggest taking at least 4 photos of each eye. If necessary help the eye aperture with your fingers and re-instruct the patient to open widely. Note: Do not waste time to align perfectly the cross within circles. Even a 4-5 rings error generates an error lower than 0.1 D. It is more important that the eyes are wide open. Note: If the Tear Film is bad, ask the patient to blink. If any dust or grime doesn’t go away, ask the patient to gently rub his eyelids.

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Image Acquisition with Piccolo In reference to acquiring images there is a difference between how you view the way you acquire the image between the Keratron Scout and the Keratron Piccolo. With the Keratron Scout you have a LCD display panel on the back of the unit. The Keratron Piccolo display panel will be on the Computer monitor. In the Keratron Scout Software program from the Acquire menu, select New Image ; the Image acquisition window will appear on the display.

Virtual panel with live image When the virtual OS or OD key (or the S key and the D key on the PC's keyboard) is pressed, the window goes from standby to the acquisition state in which a beeping sound signals the new state, and on the PC’s screen, at the center of the virtual panel, is shown the live shot from the video camera. To suspend the acquisition at any time it is possible to press either the CLR key on the panel or ESC on the keyboard. Adjust the cone vertically and slightly rotate the adapter sideways so to avoid that the cone hurt the nose or the eyebrow of the patient. Adjust the height of the chin-rest to the most stable position. While moving towards the eye, use the slit lamp's joystick to center the cross that appears on the virtual panel in the center of the circles. It is not necessary to be extremely scrupulous in this operation, as the software will compensate automatically the possible decentration. If the length of the acquisition is excessive, the patient's eye could become tired and the lacrimal film could break. While centering, use the joystick of the slit lamp to get to the proper distance from the eye. The lower LED, with an arrow pointing upward indicates that you should move closer to the eye. The upper LEDS with arrows pointing downwards indicate that you should move back from the eye; if the arrow inverts its direction pointing upwards, the correct focusing has been exceeded. Correct focusing is reached when the central OK LED is on. At this point the photograph that was acquired is transferred to the window in the background image and the virtual panel returns to standby. To exit the virtual panel, press ESC or press the X in the upper right-hand corner. If you would like to acquire other images, press the D or S key on the keyboard. Be careful not to hit the patient with the cone whe n moving the Keratron® Piccolo forward.

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Scout - Wave Standard Operating Procedures

1. Find the patient as described in Scout “Quick Start” instructions (“How to recall patient maps”). Double click the first test you want to work with (usually an OD) to display the color map. Right mouse click the color map and select “Photo/process” from the drop down list. A rings image will be displayed. Use the Eraser function to clean up the periphery if necessary. (See “Using the "Eraser" in Photo/Process” in the “Special Tools and Functions” section of the Help in Scout.)

2. Click the “Extrap.” button in the lower right corner of the rings image window. (A “Click point #1 on the scleral border with the mouse.” message appears in the upper left.) For the OD eye: click around the 10 o’clock position on the scleral/corneal border. Next click point #2 around the 8 o’clock position. Finally click point #3 outward from the scleral corneal border so as to center the white ring around the rings image. (Go to the scleral/corneal border at the 3, 4 or 5 o’clock position in order to position the white ring as shown in the sample ring image to the right.) The word Extrapolate in yellow in the upper left corner of the rings image window.

3. Clicking the” Wave” icon on the Scout’s icon menu bar. Insure your name and account # are correct. (If not call 877-393-8676. Lenses cannot be processed by the automated processing center without the correct account #.) Click the “Accept” button to process the design.

Fill in any additional information required in the “Spectacle Plane Refractive Error” box by clicking the value to be changed then clicking the drop down arrow and selecting the value required. When finished click the “Continue” button.

Complete any design changes on the lens as instructed in the various videos.

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4. Upon completion of the design click the “Order” button at the bottom of the design window.

In the next window “Are you sure?” click “OK”.

In the next window, “Do you want to save changes” click “Yes”.

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Fill in the Demographics screen checking that all necessary choices are made and then click “Accept”.

In the last window “You will receive e-mail confirmation for this order………” click on “OK”.

5. In the resulting Scout “Save Test” window, which will be partially covered by the Wave work screen, you must click on “Save” in the lower right hand corner. You can now close the design work window by clicking the “X” in its upper right hand corner.

6. You may close the map and ring images for the completed design by clicking the “Clear all windows” icon at the center of the toolbar.

7. Return to step 2 and complete the process for the left (OS) design. During extrapolation you will use 2 o’clock, then 4 o’clock, then the 9 o’clock positions.

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Follow Wave Order with OnWaveII

You may monitor the progress of your order online. Give the system about 10 minutes to register your orders then right mouse click the OnWaveII program icon located in your system tray. A list of options will be displayed. You can choose Show recent orders… to see a list of orders or you can click Check IOSS…. if you need to see detailed information and options or to reorder a lens in the future.

How to Modify and Reorder Lenses HOW TO REORDER A LENS DESIGN WITH MODIFICATIONS AND RETAIN THE ORIGINAL DESIGN

1. In the Scout Database Explorer open the patient file containing the original design.

2. In the list right mouse click the topography map icon that was used to create the original design and click “Wave design”.

3. In the dialog box that is displayed click “Yes” then click “Accept” in the Wave splash screen.

4. When you click “Yes” the WaveChoice box will pop up and you will click on the type of lens you are going to design. Another box will pop up.

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5. In the “Do you want to start with the previous lens design?” screen click “Yes”.

6. Make your modifications then Save, updating any information regarding Delivery, Exchange, etc.. Reopen the saved design and order.

OnWaveII Wave Contact Lens Order Transmission Software Information

Normally the OnWaveII software runs in the background handling the transmission of your Wave contact lens designs to the processing center. The software has other features you can use to easily perform common tasks related to current and past orders.

The features you can utilize are available when you right mouse click the OnWaveII icon located in your System Tray. The new features are explained below.

• “Show recent orders” This screen will show recent orders and defaults to a 2 week period. You can click the drop down and choose a different period.

From the list you can double click any item and it will take you to IOSS and display that order.

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• “Check IOSS”

This is a direct link to your Internet Order Status System page.

• “Send an Email to Wave Contact Lenses” This will open your default email program and create a new message addressed to customerservice@wavecontactlenses.com .

• “Check for new versions” This will check your system for the most current version of OnWaveII and give you the option to update.

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Emailing Scout and Wave Files

How to email Scout files (which include saved conta ct lens designs) to others with Scout software. These instructions assume that the computer where the Scout program has been installed has been set up to connect with an Internet Service Provider, (Web based email programs, Yahoo, Hotmail, AOL below version 9.0 etc. are not supported.) and a POP3 email client such as Microsoft Outlook, Outlook Express or Mozilla Thunderbird has been set up as the default email client. If this is not the case you or your IT department or a local computer professional should configure your computer as required.

1. In the Scout program click on the folder containing the first letter of the last name of the patient you wish to work with.

2. Click the patient's name. 3. Right mouse click the file box under the patient's name. (if you need to send multiple file boxes point to “Send

to” and click “Test Manager” for each file box to be sent. (fig 4, 4a) Make sure all file boxes in the Test Manager are highlighted (fig 4b)and click the “Email” icon, third from the left. Continue at step 5)

4. Point to "Send To" and click on "Mail recipient…". (fig 1) 5. In the displayed “Email” window make sure “Keratron Scout” and “Custom Selection” are bulleted. (fig 2) 6. Uncheck all items you do not want to send. (Caution: If you have more than one Wave design and you

uncheck a design ahead of any others, all designs a fter the one unchecked will not be sent .) 7. In the lower left make sure that “Compress output files” is checked and then click “Email” at the lower right. 8. In the email window that appears, (fig 3), highlight the "Insert destination mail address here” line in the "To" box

and then type the recipient address. The recipient's address will replace the highlighted "Insert destination mail address here".

9. In the “Subject” line you must type in the patient’s first and last name. 10. Click in the message body area and add appropriate patient information. 11. Click on the "Send" button and the message with the attached .zip file containing the selected maps and Wave

designs will be sent to your email program’s outbox.

How to Import Scout files (which include saved cont act lens designs) Received by Email

1. Open the email message. 2. Right mouse click the attachment. (Attachment should be 6 numerals followed by an .mdb extension. For

example, 000190.mdb. If the attachment ends in.mdb but the numerals are not correct, continue on.) NOTE: IF YOU RECEIVE AN ATTACHMENT THAT IS TITLED test.zip YOU WILL HAVE TO OPEN THE ATTACHMENT AND UNZIP THE .MDB FILE TO YOUR DESKTOP AND THEN SKIP TO STEP 6 BELOW (WINDOWS XP HAS AN UNZIPPPING FUNCTION BUILT IN. IF YOU DO NOT HAVE WIN XP YOU MUST GET AN UNZIPPING PROGRAM FROM THE INTERNET. WE RECOMMEND WINZIP.)

3. Click “Save as”. 4. In the displayed “Save Attachment In” dialog box, instead of using the default “My Documents” folder displayed

in the “Save in” box at the top, click the drop down at the right of the “Save in” box, scroll up to the top and select “Desktop”. This makes the file easier to find than the default “My Documents”.

5. Make sure that the “file name” at the bottom of the displayed “Save Attachment In” dialog box is in the correct format as in the example at step 2. If the file name has too many numerals or odd characters, highlight the file name and rename it 123456.mdb. Click “Save”, then close the email program.

6. Open the Scout program. 7. Click on “File” then “Import Tests”. 8. In the displayed “Browse for Folder” dialog box find the name the attachment was saved in (“Desktop”, you will

need to scroll up) and click the icon. (A list will not be displayed.) 9. Click “OK”.

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10. In the displayed “Import test” window make sure the patient name, or names, which are to be imported, are

highlighted then click the import icon in the upper left section of the window. (A drive icon with 2 arrows pointing in to it.)

If you have received modified Wave designs you must open the modified designs after the files have been imported and then Save them before ordering as the designs will have the Clinical Support Practitioner’s name and account number assigned to the modified designs. Opening and saving then allows your name and account number to be assigned and you can modify delivery method and select the exchange check box and then type in a reason for exchange. This will also allow you to review the design and make note of the changes that were made for learning purposes.

The tests will be imported and be available for review in the Scout Database. At your earliest convenience delete the file from the Windows desktop.

Fig. 1

Fig.2

Fig. 4

Fig. 4a

Fig 4b Email icon

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Email Multiple Scout Files If you need to email more than one set of maps and/or Wave designs you should send them in one message and not individually.

1. Right mouse click the first file box you need to send then point to “Send to” then click “Test Manager”.

2. Repeat step one for subsequent file boxes. 3. In the displayed “Test Manager” window make sure all

items are highlighted. (Hold down the “Ctrl” key and click the un-highlighted items.)

4. Click the email icon, (third from the left). 5. In the “Selection” pane of the displayed “Email” window,

uncheck any images you do not wish to send. (Note that if you have multiple Wave designs you can not uncheck designs above the last one. Even though the remaining designs will be checked they will not be sent.)

6. Check “Compress output files” in the lower left of the “Email” window and then click “Email” in the lower right corner.

Your email program should start. You can now address the message, enter a patient name or reference in the “Subject” line and add text in reference to the case in the body of the message.

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Importing Scout Tests

Import Scout Tests From one Computer to another Com puter with Scout Software Installed

Note: A direct or network connection is necessary t o perform this operation. You may also have a computer professional temporarily install the old h ard drive in the new computer and import from it.

Note that for large databases it may take a very lo ng time to complete the process. Plan time accordingly and do not interrupt the process.

1. Start the Scout Software on the computer that tests are to be imported to.

2. Click “File” then click ‘Import Tests….”.

3. In the “Browse for Folder” window locate the hard drive on the computer the tests are to be imported from. On that hard drive find and open the “Keratron” folder and then find and click the “database” folder so that the yellow folder looks open. (You will not see a list of files yet.)

4. In the “Browse for Folder” window click “OK”.

5. A list will be constructed of the tests from the other computer’s “database folder”. They will all be highlighted. (If the database is too big to list you will be given a choice to list or just start import.)

6. If you wish to import all tests, click the drive icon in the upper left corner of the list window.

7. If you wish to import only selected tests, highlight the first test you wish to import and then, while continuously holding the “Ctrl” key down, click on the each of the rest of the tests that you wish to import.

8. When finished selecting tests release the “Ctrl” key and click the drive icon in the upper left corner of the list window.

The system will import and index the tests.