instrumental strategies

Refraction Satisfaction

System offers efficiency, accuracy and practitioner comfort

FRANK D. TANGEMAN, O.D.

After 37 years of practice and more than 100,000 exams, refractions had become time consuming and physically painful — that is until I added the TRS-3100 automated refraction system, from Marco, to my practice.

Here, I explain why.

Efficiency

The TRS-3100 enables you to operate a key panel, display screen, chart projector and printer, all via a 5.7-inch dot matrix screen. (The phoropter's spherical range is +16.75D to -19.00D with a cylinder up to 6.00D and a prism up to 20.00D.) Having all the necessary refraction components in one location has greatly improved the efficiency of the process. Specifically, the touch screen is divided up into different boxes you select with an accompanying stylus pen.

For instance, to select a specific visual acuity chart from your projector, you choose the miniature projector chart box, located at the screen's bottom. Once you touch this box, the entire screen transforms into a display of all your visual acuity chart possibilities. When you select, or touch, the individual chart possibility, the TRS-3100 not only displays the chart on the screen automatically, but it also inserts the correct auxiliary lenses in the phoropter to correspond with your selection. If you select an eye-muscle balance chart, for example, the prism lenses in the phoropter change automatically to make the patient see double. In other words, you don't have to get up from your chair or constantly lean forward to mechanically flip lenses — a real time saver, not to mention a relief on one's body.

TRS-3100 Automated Refraction System

HEIGHT: 10.87 inches WIDTH: 13.98 inches DEPTH: 3.94 inches WEIGHT: 7.72 lbs COST: Below $14,000

In addition, the screen includes individual selections for “unaided vision,” “lensometer (or previous prescription),” “autorefraction” and “subjective visual acuity.”

Also, columns for sphere, cylinder, axis, add, prism and visual acuity are present. Further, date, time, pupillary distance (with remote adjustment), a vertex check window, phoropter level and a two-sided near point card is automatically illuminated with the simple touch of the stylus to the screen.

Because the projector is run through the TRS-3100, I don't have to operate a separate projector remote control. Also, I'm not required to turnaround to make sure the chart is positioned correctly in front of the patient, as I can see exactly what he sees via the screen.

As a brief note, Marco's CP-770 projector is connected to my TRS-3100. The projector offers 37 visual acuity charts, including nine letter, five number, four tumbling E's, two Early Treatment Diabetic Retinopathy Study, three children's and four polarized charts, as well as a red-green, a Worth dot and Maddox rod chart. You can, however, opt for another TRS-3100 compatible projector, which includes Marco's CP-690, CP-770, SC-1700, SC-2000.

Accuracy

In addition to improving the efficiency of the refraction process, the automated refraction system also provides excellent prescription accuracy. The device displays axis changes in 45° increments, and you can make 5° or 1° axis changes by simply turning the TRS-3100's key panel wheel. So, you don't have the hassle of the manual phoropter axis that only goes in 5° steps. This device enables you to dial it in correctly every time. Further, by pushing the button on top of the wheel, you can change the display to sphere, cylinder or axis.

Ergonomics

Before using the TRS-3100, performing refractions caused a great deal of strain on my body. In fact, I sustained extreme joint pain in my shoulder, a hyper-extended knee and carpal tunnel syndrome as a result of the repetition required by manual operation. Now, I can sit comfortably through the process, watching the patient's expressions, checking head tilts and keeping vertex distances stable — all of which enhances my refraction efficiency and accuracy, not to mention patient satisfaction.

If performing refractions has become mundane and physically painful, consider using the TRS-3100 automated refraction system. It's not only made the refraction process more timely, accurate and comfortable, it's also reinvigorated my love for ophthalmic lens prescribing via its' state-of-the-art and fun features. It has actually made my patients excited about getting their vision checked. OM