This article was sponsored and funded by Topcon Medical Systems, Inc.

By Zara Barlas
Media and Communications Consultant

Visual Path Diagnostics with the KR-1Wand CV-5000S: A Streamlined Workflow
for Wavefront-Optimized RefractionW

ith increasing demands and expectations
for comprehensive screening, eye carespecialists often equip themselves witha wide array of tools and conduct numerous distinct
diagnostic procedures. But the various processes
involved in a comprehensive refraction do notneed to be overburdening. Topcon’s Visual Path
Diagnostics workflow enables users to take advantageof an optimized process with the support of only
two instruments.
Topcon’s KR-1W Wavefront Analyzer offers fivetechnologies within a single unit: wavefront
aberrometry, topography, keratometry, pupillometry
and autorefraction with full auto-alignment andonboard evaluation software. The KR-1W also
features wavefront image sequencing and simulated
visual acuity assessment for optimal management ofpatients’ data. The device’s various tools can be usedin combination to provide effective diagnoses andmonitoring dependent on specific ocular conditions.
Topcon’s CV-5000S Automated Vision Tester is anautomated refraction device with a touchscreeninterface that enables tests to be performed withease. It features the added benefit of allowing users
to record and share data digitally and paper-free, andcan be connected to other devices so that data canbe transferred between instruments and managedwith efficiency.

©2016 Topcon Medical Systems, Inc.

Using the KR-1W Wavefront Analyzer in conjunction
with the CV-5000S Automated Vision Tester offers
an enhanced practice workflow through Topcon’s
Visual Path Diagnostics. Collectively, the twodevices offer a comprehensive analysis of individual
patient’s refractive measurements, aberrations andcorneal mapping, providing extensive data from therefractive properties of the eye for optimal care.
Sharokh Kapadia, OD, FAAO and his team at
St. John’s Eye Associates have been using bothdevices regularly for routine eye examinations.
Dr. Kapadia notes that the two devices—whenintegrated into the Visual Path Diagnostics
workflow—allow the practitioner to obtain abroad overview of the patient’s entire anterior
segment while keeping the number of testing
instruments to a bare minimum.

Topcon’s KR-1W Wavefront Analyzer (behind)
and CV-5000S Automated Vision Tester (front).

The Visual Path
Diagnostics Workflow

Topcon’s wavefront-optimized refraction process
begins with using the KR-1W Wavefront Analyzer
for aberrometry, topography, keratometry,
pupillometry and autorefraction. Using mire
images, users can evaluate the ocular surface bydetermining good mires from poor ones. In the caseof poor mires, users can proceed with an ocularsurface disease work-up, while in the case of goodmires, they can assess RMS values for mesopic andphotopic refraction.
Following this, the workflow provides recommended
thresholds for higher order aberrations (HOAs) for
mesopic and photopic pupil conditions that can beevaluated from the wavefront function of the KR-1W.
If the HOAs are below the recommended threshold in
both light conditions, users can compare the mesopic
and photopic refraction as well as confirm binocularbalance. If there is a difference of 0.5 D or more
between mesopic and photopic refraction, theworkflow leads users to recommend day/night orTopcon’s Visual Path Diagnostic Workflow offers astreamlined process for wavefront-optimized refraction© 2016 Topcon Medical Systems, Inc.

modified refraction. If there is less than 0.5 D difference, one refraction is recommended for all pupil sizes.
In the case of HOAs above the recommended
threshold for the respective pupil sizes, the workflow
indicates that refraction needs to be performed,
which is conducted with the CV-5000S. During
this portion of the procedure, patients are asked tosubjectively express whether or not they are happy
with the simulated targets. If they are happy, users
may prescribe glasses or recommend treatment
accordingly. If the patient is unhappy with thesimulated targets, it is important to determine
whether the HOAs are corneal or internal, which
can be deduced from the KR-1W’s capabilities as
a topographer and wavefront aberrometer.
Using this method, if corneal irregularities are found,users can recommend contact lenses, or send thepatient for further testing to determine if they area candidate for refractive surgery. If the wavefrontoptimized refraction leads users to identify internal
HOAs, users can refer the patient to a refractive
surgeon for surgical (refractive lens exchange) andnon-surgical treatment options.

Building the Practicewith Efficiency

Whether starting out in a new practice or developing
an established one, Topcon’s Visual Path Diagnostics
workflow with the KR-1W and CV-5000S can aid
practice development and help to build patient
throughput.
The entire workflow involves only two devices in thepre-testing phase, offering financial savings as wellas the added benefit of lower space consumption in
the examination room. Another significant advantageof having the entire workflow functional throughonly two devices is the requirement for fewer
individual tests, saving time and improving patients’level of comfort.

“With Topcon’s workflow and its
devices, we don’t need to have thepatients sit at multiple instruments
to obtain all the measurements.”

Sharokh Kapadia, OD, FAAO
St. John’s Eye Associates

Dr. Kapadia remarks: “Prior to having the KR-1W
in our practice, we had separate instruments for
topography, wavefront aberrometry and other tests,
which cost a lost of time for staff and patients. With
Topcon’s workflow and its devices, we don’t need tohave the patients sit at multiple instruments to obtainall the measurements. This is why I think theKR-1W is such a huge practice builder. And it’svery important for your patients to know that you
have good technology that it’s there to benefit them.”
Correspondingly, satisfied patients can lead to an increase in word-of-mouth referrals, enabling practices
to acquire new patients.
Moreover, Dr. Kapadia foresees significant changes
occurring in healthcare in the near future: “I thinkthat over the next decade we’re going to have to startseeing more patients more efficiently, so we’re goingto need diagnostic instruments like the KR-1W tomanage that workflow.”© 2016 Topcon Medical Systems, Inc.

Enhancing Patient Comfort
and Education

Enabling patients to gain a comprehensive
understanding of their respective conditions isintrinsic to successful consultations. When it comesto eye examinations, Dr. Kapadia emphasizes theimportance of patient education, which can befacilitated by the streamlined workflow and thevisual functionalities of the devices. Using amonitor connected to the KR-1W and CV-5000S,Dr. Kapadia can visually demonstrate various
ocular conditions so that patients can understandthem better: “You can be the person that’s educatinga patient prior to sending them to an ophthalmologist,showing them what their ocular conditions are andexplaining why a particular lens or surgicaltreatment would be ideal for them.”
Patient education goes hand in hand with patient
comfort, and Dr. Kapadia praises the KR-1W for its
capabilities in obtaining vast amounts of data within
a single acquisition during the pre-testing phase. Heargues that having all the objective data from theKR-1W upfront (rather than ordering individual tests
following subjective refraction) is hugely beneficial:“It means you can really zero in on what needs to betaken care of.” In turn, Dr. Kapadia argues, practitioners
can spend more quality time with their patients,
communicating with them and visually demonstrate
how their ocular conditions affect them and how
they can be treated.
There are numerous values inherent in both subjective
and objective refractive testing methods that point
towards an integration of the two for optimal visualcare. With vision testers, users can acquire subjective
refraction based on individual patients’ own
perceptions—a vital component to successful
diagnosis and monitoring of patients’ refractiveconditions. Concurrently, acquiring objective refractive properties can be successfully achieved bymeans of wavefront aberration analysis, topography
and pupillometry, enabling improved diagnoses
and monitoring of refractive conditions. Used incombination within the Visual Path Diagnostics
workflow, the CV-5000S and the KR-1W offer a
streamlined process for wavefront-optimized

refraction, enabling practitioners to conduct examinations quickly, efficiently and comprehensively. The
workflow guides practitioners through the diagnostic
processes in a way that maximizes the quality of
examinations and consultations while minimizing
the quantity of instruments and time.

Zara Barlas is a media and communications
consultant who has specialized in writing about
medical device technologies for 11 years. She
has worked extensively with key opinion leaders
worldwide to provide editorial support in the fields
of ophthalmology and optometry.

Topcon’s CV-5000S/KR-1W Package
The Complete Refraction Solution offers:• Quantitative and Qualitative Vision Analysis• Fully networked system saves you time and eliminates
the need to manually enter refraction data
• Quickly identify those patients who may benefit
from glasses for better night time vision• Assess your patient’s tear film break up©2016 Topcon Medical Systems, Inc.

© 2016 Topcon Medical Systems, Inc.