Canon CR-DGi Digital-exclusive Non-Mydriatic Retinal Camera

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Canon CR-DGiDigital-exclusive Non-Mydriatic
Retinal Camera
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SwitchWhat are all those knobs for?

• -Focus
• Setting Buttons and Monitor Adjustment
• -Fixation Target
• -Alignment
• -Small Pupil
• -Diopter Compensation
• -Infrared Filter
• -Shutter Release Height Adjustment
• -Stage Holding-

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Knobs and Switches (Right Side)(Refer to
Canons CR-DGi Operation Manual Pages 4-5)

• Right Side is from the Photographers
  perspective.
• The following knobs can be found
• Diopter Compensation
• Focus Knob
• Infrared Filter
• Small Pupil

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Focus Knob(Refer to page 4 of the CR-DGi
Operation Manual)

• The Focus Knob allows you to focus on the
  patients eye for Anterior or Fundus images.
• The Focus knob is located on the right andleft
  side of the CR-DGi head.

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Small Pupil Knob(Refer to page 12 of the Canon
CR-DGi Operation Manual)

• The Small Pupil knob is used for pupils that are
  smaller than 4.0 mm in size.
• Turned to the ON position, pupils as small as
  3.7 mm can be photographed.

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DiopterCompensation Slider(Refer to page 15 of
the CR-DGi Operation Manual)

• The DiopterCompensation Slider is used when
  photographing Anterior and Posterior segments.
  There are three settings for this filter.
• 0 (-12 to 15D)
• -(-7 to -33D)
• (11 to 35D)
• This is helpful for
• High Myopeiapatients
• High Hyperopiapatients
• Anterior Photography

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Infrared Filter(Refer to page 26 of the Canon
CR-DGi Operation Manual)

• The INposition should be set for photography.
• Verify the knob is not turned counter clockwise
  (toward the photographer) while photographing.
• NOTE The counter clockwise position turns the
  infrared filter off. This is used for cleaning
  the objective lens.

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Shutter Release and Height Adjustment(Photographe
r Side of Camera)

• The Shutter Release button activates the
  exposure, capturing a single image by the digital
  camera back.
• The Height Adjustment Ring moves the CR-DGi head
  up or down. Used when aligning the camera to the
  patients pupil.

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Stage Holding Knob

• The Stage Holding knob locks the CR-DGi stage in
  place.

Stage
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Setting Buttons and Monitor Adjustment

• The Setting buttons under the monitor (along the
  bezel) are for setting functions such as, Flash
  Intensity or setting up specific tool features.
• The Monitor Adjustment Cover hides the knobs
  used to modify Horizontal Hold, Vertical Hold,
  Brightness, and Contrast.

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Fixation Target Control

• The Fixation Target Control moves the fixation
  target.
• The fixation target appears as a small square on
  the CR-DGismonitor when viewing the fundus.
• The patient will see the fixation target as a
  green dot while they look into the lens of the
  CR-DGi.
• Have the patient focus on the green dot.
• Move the fixation target by pressing down on the
  control and moving the button up, down, left, or
  right according to the viewrequired by the
  photography protocol.

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Alignment Switch

• Pressing the Alignment Switch changes the focus
  from the anterior part of the eye to the fundus,
  and back.
• Select Alignment Switch as necessary for the
  type of image being photographed.

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Knobs and Switches (Left Side)(Refer to Canons
CR-DGi Operation Manual Pages 4-5)

• Left Sideis from the Photographers perspective.
• The following knobs can be found
• Focus Knob
• Chin Rest Height Adjustment Ring

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Patient Positioning and Photography

• Hand Positioning
• Patient Head Adjustment
• Aligning the Pupil (External)
• Identifying Laterality
• Aligning the Pupil (Internal)
• Establishing Viewbased on protocol
• Flash Setting
• Focusing

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Hand Positioning

• Before photographing a patient, remember to pull
  the stage back towards you. Then have the patient
  rest their chin on the chin rest and press their
  forehead against the head rest.
• Use your left hand to help guide the stage,
  while your right hand controls the movement of
  the stage (via the joystick).
• Remember to move the stage towards you, in a
  Umovement (away from the patient) to avoid the
  camera coming in contact with the patient when
  switching from left eye to right eye.

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Patient Head Adjustment(Refer to page 10 of the
Canon CR-DGi Operation Manual)

• Before proceeding, check the patients head
  alignment.
• Verify that the patient has their chin firmly
  resting on the chin rest.
• Verify their forehead is firmly against the Head
  Rest.

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Patient Head Adjustment.(Refer to page 10 of the
Canon CR-DGi Operation Manual)

• Next, verify the patient's Lateral Canthusis
  aligned with the Height Adjustment Mark (white
  line) on the head rest frame.
• To adjust the height, use the chin rest Height
  Adjustment Ring to raise or lower the patients
  head relative to the Height Adjustment Mark.

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Aligning the Pupil(Refer to page 11 of the Canon
CR-DGi Operation Manual)

• Press the Alignment Switch if necessary to view
  the anterior eye.
• The eye will appear spliton the monitor.
• Move the joystick forward and backward until the
  pupil is no longer split.

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Properly Aligned Pupil

• With the pupil no longer split, three dotswill
  appear over the pupil.
• If the dots are not within the boundary of the
  pupil, set the small pupil knob to ON.
• Note After activating the small pupil
  adjustment, the three dots still may not be
  contained within the boundary of the pupil.
• Press the Alignment switch to view the fundusand
  internal fixation target .

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Split Bar Focusing(Refer to page 14 and 15 of
the CR-DGi Operation Manual)

• If the Split Bar appears as two lines, the image
  is out of focus.
• Use the Focus Knob (located on either side of
  the camera) to bring both lines into alignment
  (single bar).

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Alignment Distance Dots(Refer to pages 14-15 of
the CR-DGi Operation Manual)

• With a single Split Bar, move the stage slowly
  backward and forward to bring the distance dots
  into the field of view.
• If necessary, move the cameras head up or down
  in order to position the Distance Dots inside
  their respective notch(located along the
  right/left border).

Distance Dots
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Identifying Laterality

• In the upper right corner of the monitor you
  will notice a Lor Rcharacter, these letters
  represents the laterality of the eye you are
  imaging.
• Sliding the stage left or right will
  automatically change this character.

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Capturing a specific View based on protocol

• Photography protocols define specific viewsof
  the retina.Views are defined by the relative
  position of the macula, optic nerve,
  etc.Positioning the fixation target in a
  specific location will result in a specific
  view, as defined in the photography protocol.

• The fixation target appears as a small square
  onthe CR-DGismonitor.The patient will see the
  fixation target as a green dot. Have the patient
  focus on the green dot.Move the fixation target
  (press down while moving) according to the
  viewrequired by the photography protocol.

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Flash Setting(Refer to page 8 of the CR-DGi
Operation Manual)

• The flash setting is located along the lower
  right border of the monitor.
• If the patient has light pigmentation, set the
  flash to a low value.
• If the patient has darker pigmentation set the
  flash to a higher value.
• F0 -is the lowest flash setting
• F-14 is the highest flash setting.

• Note If the patient happens to be an albino,
  make sure the flash setting is set
• to its lowest setting.

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Changing the Flash Setting

• There are two buttons along the lower right
  bezel of the monitor.
• The two buttons are used to adjust the flash
  settings.
• -will lower the flash setting.
• will increase the flash setting.

Button
Button
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Ready for Exposure(Refer to page 15 of the
CR-DGi Operation Manual)

• Before pressing the exposure button on the
  joystick
• Are the distance dots in their respective
  notches?
• Is the split bar a single line?
• Is the fixation target located properly?
• Is the flash setting properly set?
• TIPS
• To view and align the distance dots, move the
  CR-DGi stage unit slowly. Move camera up or down,
  left or right as necessary
• If only one distance dot appears on the monitor,
  move the stage away from the visible dot.
• Use the focus knob to get a single split bar.

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How to Correct for a Halo or a Flare

• The following steps should be taken in order to
  correct for halos or flares
• For Image 1 move the stage forward and
  backwards.
• For Image 2 move the stage forward and
  backwards, lower the chin rest or camera head.
• For Image 3 move the stage to the right.
• For Image 4 lower the chin rest or the camera
  head.

1
2
3
4
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Anterior / External Photos

• Positioning of the Head
• DiopterCompensation
• Small Pupil Setting
• Alignment Switch
• Focus
• Exposure

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External / Anterior Imaging

• Have the patient rest their chin against the
  chin rest.
• Verify that their forehead is not touching the
  head rest.
• The proper distance away from the forehead rest
  is about ½inch.

Not Touching
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Diopter Compensation Slider (Anterior Imaging)

• Pull the DiopterSlider to the () positio

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Small Pupil Switch (Anterior Imaging)

• Set the Small Pupil knob to the Onposition.

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Alignment Switch (Anterior Imaging)

• Press the Alignment switch on the CR-DGi Stage
  in order to see the anterior part of the eye.

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Focus and Exposure

• Using a Focus Knob, focus the patients eye.
• Adjust the flash setting to the desired setting.
• Press the shutter release button on the
  joystick.
• This will capture an anterior photo.

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Stereo Photography

• Getting Started
• Capturing First Image
• Capturing Second Image

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Getting Started

• Position the patient as you normally would.
• Turn the Small Pupil Switch to ON.
• Press the Alignment Switch in order to see the
  fundus.
• Set the flash of the CR-DGi to the desired
  setting.

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First Image of Stereo Pair

• Position the Fixation Target slightly to the
  left of the Split Line Bar.
• You may need to reposition the Fixation
  Target until the optic discis directly behind
  the Split Bar.
• Move the Stage until the right Distance Dot is
  directly inline with the Split Bar.
• You should not see the left Distance Dot on
  the monitor.
• Focus as needed.
• Press the exposure button.

Distance Dot off screen --
Simulation
This assumes the stereo pair of images are for
the optic disc
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Second Image of Stereo Pair

• DO NOT MOVE FIXATION TARGET
• Move the Stage until the left Distance Dot is
  directly inline with the Split Bar.
• You should not see the right Distance Dot on
  the monitor.
• Focus as needed.
• Press the exposure button.

Distance Dot off screen --
Simulation
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Sales points-1
1. True Digital Quality produced by digitally
optimized optics2. By combining Canons
renowned digital SLR, CR-DGi provides the refined
digital imaging.The latest model is EOS 30D
Digital featuring 8.2 Megapixels CMOS Sensor and
DIGIC II Image Processor.
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Sales points-2
3. Inheriting the User-friendly operations like
Split-lines focusing and Working Distance dots
based on 25 years of expertise as the very first
manufacturer of Non-mydriatic Retinal Camera
Canon invented the very first non-mydriatic
retinal camera in 1976.4. Needs only a small
amount of light to capture clear images, so that
the CR-DGi can take Right and Left eyes almost
immediately, which is very handy for a mass-scale
screening to handle dozens of people in a short
time.
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Sales points-3
5. Thanks to CR-DGis user-friendly functions (as
stated before), there is no need to hire a
dedicated ophthalmic photographer. In principle,
anyone can be trained to handle CR-DGi to take
the best shot resulting in reduction of running
cost.