instrumental strategies
A Revolutionary Refractionist
Topcon introduces the world's first patient-assisted refraction system.

When I heard about the new Topcon BV-1000 Visual Acuity Testing System, I immediately wanted to evaluate this instrument. Could a device really exist that would not only reduce the thousands of times a day that I seem to say, "Better one or two?" but that would also reduce my dependence on a technician? Was it possible that the same sequence and consistency could occur each and every time I performed refraction? At Vision Expo West, I found a crowd surrounding this refracting system.

Love at first listen

With one touch on the computer's screen, the BV-1000 came to life and started educating me on the process that was to follow. The instrument had a friendly voice (Topcon says it's the only automated voice-guided subjective refraction system). It quickly taught me to use the joy stick and get used to seeing landolt "Cs" and a dot pattern for the computerized "better one or twos." It lined up my eyes and took a series of accurate binocular autorefractions and autokeratometry. Then it went into its subjective mode. My new friend Ms. Computerized Refraction presented a series of refractive techniques to me, including:

• Red and green charts
• Cross cylinder chart
• Cross Phoria screening chart
• Single Landolt Ring chart
• Va 20/200 down to 20/12.

My computerized refractionist was patient with me as I went through the refracting process; if I couldn't make a decision, she showed me the choices again. Then I found out she spoke several languages. Wow! And my refraction was extremely accurate. I asked to test the BV-1000 in the real world of my office.

	The BV-1000 offers a high-tech approach to the age-old process of refraction.

Succeeding in the real world

The instrument required little physical space (it's dimensions are 50" w x 20"d x 25" h). The trainer had my staff educated and trained within minutes. We were up and running within the hour and began testing patients. The computerized voice taught patients quickly and the refraction occurred accurately and efficiently. The Topcon BV-1000 has an objective simultaneous refraction measurement range of:

• Hyperopia up to +22.00D
• Myopia up to -25D
• Astigmatism up to -8.00D.

Additionally, it has a subjective measurement range of:

• Hyperopia up to +18.00D
• Myopia up to -18.00D
• Cylinder up to -8.00D without those annoying auxiliary lenses.

Here are some of my favorite features: You can modify the vertex distance depending if you're doing a spectacle prescription or an over-refraction for contact lenses; there's a simultaneous binocular alignment system; and the printout is easy-to-read (It's available in the standard size, or an 8" x 11" size that will fit into your hard record chart). The BV-1000 also inputs to many paperless medical record systems, thus eliminating transcription errors.

Time is of the essence

As the routine eye examination process has expanded to include new tests and time commitments for the doctor, it's become more important to develop strategies to improve patient management and flow. The BV-1000 is probably the most significant change in refraction that I've seen -- it actually allows you to delegate refractions to your patients.