Introduction
The Photoscreener was the first
portable vision-screening device designed to detect vision disorders
through the use of instant film. It is an accurate and effective
means of objective vision screening for preverbal, special needs
and language barrier patients. Photoscreening is designed to look
for signs of things that block the path of light through the eye,
misaligned eyes and refractive errors.
Product
Overview and Description
Ophthalmic research has demonstrated that the first three years of life
are critical in the development of good vision. Undetected and untreated
problems during this early period can prevent proper development of the
brain's binocular function, resulting in amblyopia. The
American Academy of Ophthalmology recommends screening all children's
eyes to detect such disorders, for which the Photoscreener™
is especially well suited.
The FDA cleared the Photoscreener™ as a camera which takes instant
pictures of a patient's eyes. The Polaroid type camera system is a computerized
device that weighs just 6 pounds and uses Polaroid 667 film to take an instant
photograph of a child's eyes. The photographic process produces bright crescents
on the film if a problem, such as a refractive error, is present.
The size of each crescent is proportional to the size of the refractive
error, while its position indicates the type of vision problem present.
Immediate on-site interpretation and comparisons of the photograph
enables detection of problems including myopia (nearsightedness),
hyperopia (farsightedness), astigmatism and strabismus, as well
as cataracts and other media opacities.
The operator aligns two illuminated arrows from the Photoscreener
on the child's forehead. When the arrows are correctly aligned,
the operator simply pushes a button, which automatically takes a
picture. Portable and quite simple to operate, the Photoscreener™
is also non-threatening to young patients - for whom the importance
of early detection cannot be over emphasized. It also does not require
verbal interaction from the patient, making it especially suitable
for preverbal and difficult-to-screen children.
Product
Use and Procedure
 |
Load the film. Load
the film into the PhotoScreener™ by turning the camera over with
the left side down. Open the film-back by pulling out on the bottom
of the door latch. The film door will swing down out of the top part
of the film-back. Remove the empty film case by pulling out and down
on the white, foam backed tab. Place the new film cartridge into the
film slot- with the black protective cover tab sticking out. The black
tab of the film safety cover should extend through the door latch.
Check to be sure that the smaller white tabs are not tucked under
the pack. Close the film door and press the door latch into the locked
position. Pull the black tab of the safety cover all the way out of
the film-back and discard it.
|
|
Have the room dimly
lit. The sensitivity is dependant on pupil size. Make sure the room
is light enough that you can see the subject's face, but dim enough
to allow the pupils to naturally dilate.
|
|
With the subject
approximately one meter distance, press the aiming lights to project
them on the forehead. Once the aiming lights are aligned, turn on
the fixation lights or music stimulus to get the child's attention.
(Due to a short attention span with young and hard-to-test subjects,
use the lights and music briefly when you are ready to take the picture.)
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|
After the
first picture has been taken, follow the steps again and take
a second photo.
|
|
Manually pull the
picture from the white tab sticking out of the side of your PhotoScreener™.
When you pull out a film image it has a paper image covering it. You
peel this paper cover off and there is still a sticky residue surrounding
the photo. This can be peeled off to reveal a clean photo underneath
(the sticky residue is attached to the white square sticker surrounding
the photo and should be removed and disposed). You may want to have
a paper towel or tissue available to wipe your fingers after peeling
off the paper image and white border sticker.
|
For detailed
product use and operation procedures with the Photoscreener™,
click
here
Features
and Benefits
 |
No
Patient Response
Minimal cooperation is required, making it ideal for use with young
children, special needs populations and when there is a language barrier.
Child friendly
The Photoscreener™
uses bright flashing lights and nursery rhyme music to capture the
child's attention.
Complete
screening information
The photographs
are examined to determine the presence of six major pediatric eye
problems, including all refractive errors (near and farsightedness),
astigmatism, and anisometropia (difference between the two eyes),
strabismus and media opacities.
Compact
and portable
The cameria
is hand-held and weighs just 6 pounds.
No dilation required
The procedure does not require dilation of the eyes, simply a
dimly lit room.
Screen any age
The Photoscreener™ screens as young as six months through adulthood.
|
Frequently
Asked Questions
Some of which were obtained form the Medical Technology,
Inc. website.
| Q: |
What
is the Photoscreener™? |
| A: |
It is
a portable camera that uses high-speed Polaroid® film
to instantly identify eye disorders in infants and young children
that can lead to amblyopia and other serious vision problems.
|
| Q: |
At
what age should children have their vision screened? |
| A: |
Because
a small child rarely complains that one eye is not seeing
properly, examination of the eyes should be done at all well-infant
and well-child visits, beginning at the newborn period, according
to Pediatrics (Vol. 98, No. 1 July 1996).
|
| Q: |
How
common are serious eye problems in children? |
| A: |
According
to Prevent Blindness America, a national nonprofit organization
based in Schaumburg, IL, one in 20 preschoolers has a vision
disorder that can cause permanent sight loss if left untreated.
The most common types of eye problems seen in children are:
myopia (nearsightedness), strabismus (crossed eyes) and amblyopia
(lazy eye).
|
| Q: |
Is
there a problem with current vision screening practices? |
| A: |
Half
of all children with amblyopia are diagnosed after age five
when therapy may no longer be effective, according to a study
reported in Pediatrics (Vol. 89 No. 5 May 1992). The study
concluded, "Pediatricians need to increase vision screening
among younger preschool children and communicate more effectively
to parents the results of screening failure." The article
also cited two studies which estimated that "only 25%
of the nation's preschoolers receive any kind of vision testing."
|
| Q: |
Is
there an optimum age to vision screen children for amblyopia?
|
| A: |
Since
amblyopia, one of the most serious eye disorders in children,
is more easily treated during its incubation period (ages
one to three), many investigators recommend screening at very
early ages. Studies that have appeared in Survey of Ophthalmology
(1983; 28: 145-63) and the Journal of Pediatric Ophthalmology
(1991; 28: 183-201) have recommended screening for amblyopia
before the age of 24 months. In a "Major Review"
that appeared in Survey of Ophthalmology (Vol. 40 No. 1 July-August
1995), the researcher reported, "amblyopia can be prevented
only if amblyogenic factors are detected by screening during
the first two years of life."
|
| Q: |
How
does amblyopia affect a child's vision? |
| A: |
Commonly
referred to as lazy eye, amblyopia is a "common childhood disorder
affecting 3% to 5% of the population" (Journal of Pediatric Ophthalmology
& Strabismus, 1995; 32: 289-295). Amblyopia occurs if there is
unequal or abnormal visual input from the eye to the brain caused
by several factors:
Anisometropic Amblyopia: The optical powers of the two eye
are different. If one eye is very nearsighted or farsighted, the brain
receives normally focused visual input from one eye and blurred images
from the other.
Strabismus or Suppression Amblyopia (misaligned or crossed eye):
A young child's brain routinely suppresses the image from a deviating
eye. If left undetected and untreated, this may result in permanently
decreased vision and structural brain damage.
Deprivation Amblyopia: Certain diseases of the eye, for example
cataracts, block light from being focused on the retina (the structure
of the back of the eye that acts like the film of a camera). As a
result, no clear image is available to be sent to the brain, which
is then deprived of visual input. This type of amblyopia generally
results in the most severe loss of vision.
|
| Q: |
Can
amblyopia be cured?
|
| A: |
A study
in Survey of Ophthalmology (Vol. 40 No. 1 July-August 1995)
observed that "the best approach to managing amblyopia
is to detect amblyogenic factors before the age of two years
and prevent it through eliminating the causes of visual deprivation."
The review concluded that when amblyopia exists, "it
can be cured if adequately treated in children less that six
to seven years of age," but also pointed out that amblyopia
is often still diagnosed too late for treatment to be effective,
in both industrialized and developing countries, alike.
|
| Q: |
What
advantages does the Photoscreener™ have over other vision
testing methods? |
| A: |
Most current
vision screening methodologies are not effective in screening
preverbal children. With the Photoscreener™, however,
doctors can reliably screen children as young as six months
for conditions that could lead to amblyopia. The methodology
is extremely simple: a flash photograph of the subject's eye
is taken. The light reflected from the retina is analyzed
to detect refractive errors, strabismus and/or media opacities.
|
| Q: |
Is
the photoscreening process uncomfortable for the child? |
| A: |
The Photoscreener™
operates very much like any other camera; it takes an instant
Polaroid® photograph of the child's eyes - safely and
painlessly - without dilation. The entire process takes less
than five minutes. The camera uses a combination of flashing
lights and a musical tune to help capture the child's attention.
|
| Q: |
How
does the Photoscreener™ work? |
| A: |
The Photoscreener™
takes two pictures of the child's eyes. The Polaroid® snapshots
allow for immediate interpretation of disorders that might otherwise
be missed. Refractive errors are evident if white crescents appear
in the photograph. Strabismus and cataracts are also clearly visible
in the photographs. It is very easy to use, weighs only six pounds
and uses 667 Polaroid® film.
|
| Q: |
What
eye problems can the Photoscreener™ detect? |
| A: |
It is
effective in its ability to screen for nearsightedness, farsightedness,
astigmatism, in addition to strabismus (misaligned or crossed
eyes) and diseases of the eye such as cataracts.
|
| Q: |
Who
makes the Photoscreener™? |
| A: |
The Photoscreener™
is manufactured and distributed by Medical Technology, Inc.,
a publicly held company in Lancaster, PA and subsidiary of
Medical Technology & Innovations, Inc. Polaroid Corporation
provided technology assistance during product development.
After four years of successful field testing in seven states,
the Photoscreener™ was introduced to the market in April
1994. Today, it is distributed worldwide.
|
Frequently
Asked Questions for Retrofit Camera Users
| Q: |
I
am a long time PhotoScreener™ user. What changes will I see on
my retrofitted unit? |
| A: |
- The LED light
panel indicating # of exposures and the "CH" during
charging is no longer seen on the face of the camera. The 337
film worked with a tiny circuit chip attached that allowed the
above to occur. The new 667 film has tabs with numbers of exposures
remaining, displayed directly on the film pack.
- The new camera
does not use a motorized film ejector; the protective cover and
the images on the new film must be pulled out manually.
- The new camera
still takes photographs in 2 flash orientations, but you will
no longer see or feel the mechanism go through the orientation.
- The charging
button on the side of the old camera and LED indicator light is
no longer present - just plug it in and charge for 14 hours when
the battery gets low.
- When you
pull out a film image it has a paper image covering it. You peel
this paper cover off and there is still a sticky residue surrounding
the photo. This can be peeled off to reveal a clean photo underneath
(the sticky residue is attached to the white square sticker surrounding
the photo and should be removed and disposed). You may want to
have a paper towel or tissue available to wipe your fingers after
peeling off the paper image and white border sticker.
|
| Q: |
My
new PhotoScreener™ uses Polaroid 667 film and my old unit used
337 film. Why was this change made and how is the new film different? |
| A: |
Polaroid recently
discontinued production of the Type 337 instant film previously used
in the PhotoScreener™. The Type 337 film had limited uses and
infrequent production runs at Polaroid. The replacement film is the
Polaroid type 667 film. It is a more affordable film that is said
to provide a clearer image and is less expensive than the type 337
film. There exists a major difference between the two film types in
that the type 667 requires the manual removal of the picture (it is
a peel apart film) versus the automatic photograph discharge with
the type 337. The photo area of the new film is slightly smaller than
the Type 337 presently used: 3.75 by 2.88 vs.4.0 by 3.0 inches. The
image has been described as more crisp and focused.
|
| Q: |
How
do I know that the replacement film will not get cancelled in the
future like the type 337 film? |
| A: |
Polaroid Corporation
stated that the type 667 film would be supported indefinitely. Polaroid
has many applications in the commercial marketplace employing the
type 667 film. These markets include medical, photography, publishing,
and more. For more information on the type 667 film, log on to www.polaroid.com
or the MTI
website.
|
| Q: |
Why
does the PhotoScreener™ have to be retrofitted for the new film? |
| A: |
The new film is
a two-part film that requires the operator to manually pull the film
out after exposure. The entire transport mechanism is different and
requires extensive modification.
|
| Q: |
If
I do not manually pull my photo out of the camera, can another picture
be taken? |
| A: |
Yes, you should
pull your photo out after taking your set of pictures. In the event
you forget, and do another screening, the second set of eyes will
"double expose" your first picture. (This is important to
remember for retrofit users since the unit does not automatically
eject).
|
| Q: |
The
directions state to let the film develop for 30-40 seconds before
peeling the film cover off. What effect does too short or too long
of a processing have on the new film? |
| A: |
Processing the film
for longer than 3 minutes may affect image contrast and density to
some extent. At temperatures above 75°F (24°C), film should
not be processed for longer than one (1) minute for optimum image
stability. At temperatures below 75°F (24°C), process the
film for a longer time, as indicated in the film instructions. Processing
affects contrast and density to some extent. A picture processed for
too short a time will have dull grays, mottle and have little contrast.
If maximum density is required, the processing time may be extended
by 15 seconds (for example, process for 45 seconds rather than 30
seconds). This may increase the contrast and density, but may also
result in some loss of gray.
|
| Q: |
I have an older
model PhotoScreener™, how do I get it retrofitted?
|
| A: |
Existing PhotoScreeners™
will need to be retrofitted with a modification at a cost of $1,250.00
per device, not including shipping and insurance. These modifications
will be made by MTI. Customers can visit the MTI
website to register their units.
|
| Q: |
Does
the retrofit change the Photoscreening process I am used to? |
| A: |
Bob Ballheim, the
MTI engineer that helped design and create the original PhotoScreener™
and the modifications said, "The optic path and the flash unit
on the modified cameras are exactly the same as the existing cameras
so there is absolutely no difference in sensitivity to eye disorders."
|
| Q: |
How
do I load the film on my newly retrofitted camera? |
| A: |
Load the film into
the PhotoScreener™ by turning the camera over with the left side
down. Open the film-back by pulling out on the bottom of the door
latch. The film door will swing down out of the top part of the film-back.
Remove the empty film case by pulling out and down on the white, foam
backed tab. Place the new film cartridge into the film slot- with
the black protective cover tab sticking out. The black tab of the
film safety cover should extend through the door latch. Check to be
sure that the smaller white tabs are not tucked under the pack. Close
the film door and press the door latch into the locked position. Pull
the black tab of the safety cover all the way out of the film-back
and discard it.
|
| Q: |
Can
you give me the step-by-step procedures for loading the new 667 film? |
| A: |
The film-loading
door is on the right side. Hold camera to the side and lift the bottom
latch up (or towards your body) to open film door. Guide the film
in using the foam padding that is on the film itself. Once the film
is in place, shut the door and close the latch. One black protective
tab will be sticking out, pull that out, which pulls the protective
cover off. Throw away. You will see a white tab labeled with the picture
number. The first tab should be labeled "1" for first picture.
You are now ready to take your first picture. Snap pictures as usual.
Next, pull the white tab labeled "1"; Then pull the bottom
tab, which is the picture itself (two tabs are pulled for each picture).
Wait at least 40 seconds. Turn the picture over and pull the picture
away from the paper. When the picture is pulled the next tab should
be displayed. When the 10 is displayed it will be the last picture.
After taking last photo, reload the film.
|
| Q: |
What
is the expiration date on 667 film? |
| A: |
New Film has an
exp. date of 12-18 months.
|
| Q: |
Are
there harmful chemicals in either the 337 or 667 films? |
| A: |
The processing chemistry
in the pod of both films contains alkali and could cause some discomfort,
particularly to the eyes or mouth, if you were to come into contact
with it. During the processing cycle the alkali moves towards neutral
and becomes relatively harmless. T-667 has been around since the early
1960s and Polaroid is not aware of anyone having a skin irritation
problem with the processing chemistry.
|
Technical
Specifications
| Dimensions:
|
| Height:
|
6.2" |
| Length: |
11.9" |
| Width: |
11.7" |
|
| Weight: |
| Camera
with battery: |
7.0
lbs |
| Camera
without battery: |
6.3
lbs. |
|
| Power
Source: |
A/C
Adapter US:
|
Input:
AC 120V, 60 Hz, 35W |
Output:
DC 6V, 3.5 A
|
Battery:
|
6.0V,
2 Amp Rechargeable Nickel Cadmium Battery Pack
|
Battery
Charger US:
|
Input:
AC 120V, 60 Hz, 35W |
Output:
DC 12V, 300mA
|
| Operating
Temperature: |
| 60
- 90 degree F, 10-85% Relative Humidity / Non-Condensing |
|
Storage Temperature: |
| 40-110
degree F, 10-85% Relative Humidity / Non Condensing |
Articles
/ Sales Brochure / Manual / Demo Disk
To review the published
study "Photoscreening for Amblyogenic Factors" by Wanda
L. Ottar, OC(C),Comt:William E.Scott, MD; and Sandra I. Holgado,
MD click
here.
Click
here to read this article from the Medical Technology, Inc. website
by Dr. Jim Spangler OD, of Warren, PA on how he incorporated infant and
preschool children into his primary care practice using the PhotoScreener™,
and the positive benefits it had for the practice.
Click
here if you want to download our four page product brochure "Innovative
Vision Screening for Kids" from the Medical Technology, Inc. website.
This brochure is in four parts and to download, read or print it, you will
need Adobe Acrobat which is a free product from Adobe and available on the
download page.
Click here
to read Prevent Blindness America's Policy Statement on Photoscreening.
Warranty
The Photoscreener carries
a 1-year parts and labor warranty.
Reimbursement
The following
suggested CPT codes were taken from the Photoscreener product manual.
|
Preventative
Medicine Services |
| New
Patient: |
| 99381 |
Initial
evaluation and management of a healthy individual requiring
a comprehensive history, a comprehensive examination, the
identification of risk factors, and the ordering of appropriate
lab/diagnostic procedures, new patient; infant (age under
1 year) |
| 99382 |
Early
childhood (age 1 through 4 years) |
| 99383 |
Late
childhood (age 5 through 11 years) |
|
Established
Patient: |
| 99391 |
Periodic
reevaluation and management of a healthy individual requiring
a comprehensive history, comprehensive examination, the identification
of risk factors, and the ordering of appropriate lab/diagnostic
procedures, established patient; infant (age under 1 year) |
| 99392 |
Early
childhood (age 1 through 4 years) |
| 99393 |
Late
childhood (age 5 through 11 years) |
|
Special
Ophthalmologic Services: |
| 92285 |
External
ocular photography with medical diagnostic evaluation for
documentation of medical progress. |
Customer Testimonials
and Example Uses
Testimonials are copied
from the Medical Technologies, Inc. website.
 |
"The
Photoscreener™ is a wonderful screening device, which
is far more effective than previous methods of examination
for pediatricians, such as the light reflex test or reading
eye charts. I know from experience that some children can
read eye charts even when serious eye problems exist. Younger
children cannot communicate and because of that many cases
of eye conditions have been missed. This is something that
is easy to perform and gives important results."
Kerry Fierstein, MD
Pediatrician
Syosset, New York
"In an effort to determine the effectiveness of the Photoscreener™,
the University of Iowa conducted vision screening on 949 children
between the ages of six months and five years. These results
were then compared to the results of a complete ophthalmologic
examination. The results of this study indicate that the Photoscreener™
is an accurate and reliable device to detect amblyogenic factors
in young children."
William E. Scott, MD
Department of Ophthalmology
University of Iowa Hospitals
"The state of Georgia has investigated many different
types of vision screening instruments. The technology behind
the Photoscreener™ is quite unique. It has proven itself
over and over again as an instrument that accurately and consistently
detects vision disorders in young children that traditional
methods would have missed. The Polaroid® photograph generated
gives us quick results, hard evidence to support our concerns,
and lends great credibility to parents."
Adam Roche
Child Health Program, Dept. of Human Resources
State of Georgia
|
Other Information
Click
here to see suggested protocol as written by Medical Technologies when
implementing a new photoscreening program.
Product
Ordering Information
| SH
Catalog # |
Product
Name |
| 52060 |
Photoscreener
Camera System |
|
