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Easyfield®

The right choice for all your needs

  • Fast: Shorter examination times even for threshold tests
  • Compact: No completely dark room required thanks to the closed construction
  • Lightweight: Minimal footprint and maximal transportability
  • Highlights
  • Functions
  • Standard Automated Perimetry
  • Glaucoma
  • Technical Data
  • FAQ
  • Contact

Ergonomic and patient-friendly

The OCULUS Easyfield® is a full-fledged compact perimeter capable of performing standard automated perimetry of the central visual field up to 30° eccentricity. It has been designed for the combined use as visual field screener and perimeter, offering features usually available only in large units. The spherical bowl with 30 cm (11.81”) radius is enclosed into an ergonomically movable cone equipped with a distance adapted lens. The Easyfield® conforms to the Goldmann
standard and fulfills the ISO-12866 norm for perimeters.

Measurements of the Easyfield® are carried out using an LED grid with 135 fixed test locations, including the common 30-2, 24-2 and 10-2 patterns. The novel SPARK test strategy leads to faster and more stable threshold tests providing improved diagnostic capabilities. Besides the standard field indices the Easyfield® delivers evaluations of the innovative Glaucoma Staging Program (GSP) and the classifications provided by the Glaucoma Staging System (GSS 2).

  • Lightweight: Minimal footprint and maximal transportability
  • Robust: Easy to service in the absence of moving parts
  • More than screening: Supra-threshold and threshold tests
  • Comprehensive perimetry: Advanced test strategies, unique evaluation tools, efficient progression analysis.
OCULUS Easyfield®

Functions

Ergonomic Design

One of the most striking features of the Easyfield® is its small space requirement. The self-contained design and light-shielded viewer enable examinations to be conducted in normal room lighting conditions. Its robustness and low weight make the Easyfield® Perimeter ideal for portable use. The lack of moving device parts guarantees long product life.

  • The redesigned double head rest with translucent lateral eye shields allows measurements without an eye-patch, saving precious time in the preparation for the test.
  • The completely new, vertically adjustable chin rest (Easyfield® C only) improves the quality of examinations by sensibly increasing the comfort of the patients.
  • The stylish design of the chin rest is adapted to the ergonomically movable perimeter cone for complete versatility
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Easy Operation

The Easyfield® Perimeter can be controlled via an external computer (Notebook or PC). The familiar user interface of the OCULUS programs is available on the computer and you can enjoy the full freedom of networking the examination data. The use of translucent Easyfield® occluders allows you to conduct examinations without the usual eye patch, thus saving you valuable time as you prepare for the examination.

Increased Diagnostic Reliability

Additional software programs improve the diagnostic value of visual field examinations conducted with the Easyfield® Perimeter. The Glaucoma Staging System (GSS 2) per Dr. Brusini and the Glaucoma Staging Program (GSP) are Glaucoma risk indicators. The Threshold Noiseless Trend (TNT) is used for efficient progression analysis.

The Examination Programs

The Easyfield® provides pre-defined programs for the examination routines that are most frequently used. Measurements of the central visual field or the macula area are thereby conducted. This program series can be extended, if necessary, by interlinking available test grids and test strategies.

The OCULUS Test Strategies

As a screening unit, the Easyfield® Perimeter generally uses threshold related suprathreshold examination strategies. The advantage of this is that despite the short examination time, the examiner gains a meaningful overview of the examined area.

Multiple test strategies are available for determination of the exact numeric values of the perception thresholds. (We prefer not to promote CLIP anymore.) The OCULUS “Fast Threshold” achieves a similar performance with clever improvements to the classic 4-2 step method. The unique SPARK strategy provides a rapid and reproducible threshold measurement for glaucoma patients.
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The OCULUS Test Point Grid

The Easyfield® Perimeter’s fixed light emitting diode grid permits examination in areas such as the 30-2, 24-2 or 10-2. It is also possible to test individual hemispheres or quadrants. If necessary, individual points can be examined in any combination. The modular setup of the test programs allows all areas to be examined using all available standard strategies.

Results Printout

The measuring results of the Easyfield® Perimeter are summarized in a standard printout. For suprathreshold tests, only a single informational overview is printed, whereas for threshold examinations, all clinically relevant data are recorded and shown in various depictions.

Attachable correction lens holder

A spring-loaded double mount offers increased stability for the correction lens holder.

Standard Automated Perimetry

Screening

Screening with the Easyfield® is most commonly carried out by performing supra-threshold examinations of the central visual field. During these examinations the presented stimulus is always brighter than the one matching the normal threshold value corresponding to the patient’s age in the given location. Screening programs have shorter duration and are easier to complete. As a result, an overview of the visual field is obtained, without numerical dB values, but with the identification of peculiar locations. The Easyfield® employs threshold oriented suprathreshold strategies with 2 or 3 zones, recognizing defects or absolute and relative defects, respectively. The predefined “Screening 24-2” program uses a 2 zones strategy and takes slightly more than a minute per eye to accomplish. Customized screening programs using different test patterns or strategies can be easily created in the device software, with the possibility to adapt to any special requirement.

OCULUS Easyfield® Printout of a threshold examination
OCULUS Easyfield® - Printout of a threshold examination

Threshold measurements

The most complete information about the visual field can be obtained by determining sensitivity threshold values in all locations of a test pattern using strategies for threshold measurements. The Easyfield® perimeter offers various threshold measurement procedures:

  • Full Threshold: The classical 4-2 dB staircase strategy using two reversals in the patient’s answer to deliver a threshold value
  • Fast Threshold: Bracketing strategy using variable steps and taking advantage of already measured locations.
  • CLIP1): Strategy using stimuli with continuously increasing luminance. Threshold value is assigned the moment the stimulus is perceived.
  • SPARK2): Fast and averaged threshold strategy based on statistical correlations between threshold values measured in different locations.

1) CLIP – Continuous Light Increment Perimetry
2) SPARK is not an acronym, the name of the strategy was inspired by the appearance of the stimuli during perimetry

Focus on Glaucoma

Measurement – Assessment – Progression

Speed, precision and reliability: the SPARK threshold strategy
Defect assessment: Glaucoma Staging System (GSS 2)
Beyond field indices: Glaucoma Staging Program (GSP)
Efficient progression analysis: Threshold Noiseless Trend (TNT)
The SPARK3) strategy is based on statistical relationships between threshold values found for different locations in the glaucomatous visual field. These relationships have been derived from more than 90000 perimetric examinations, providing high statistical significance and allowing for fast and very precise threshold measurements in the central visual field. The four-phase structure of SPARK makes it a versatile tool for clinical practice:

  • SPARK Precision is the full-fledged version of SPARK. Comprehensive visual field examinations of glaucoma patients can be performed in just 3 minutes per eye. Averaging the results over all four phases ensures a high degree of reliability and reproducibility for improved progression analysis.
  • SPARK Quick is the perfect strategy for follow-up and screening examinations. The procedure only takes 90 seconds per eye.
  • SPARK Training is ideal for patient training. This 40-second measurement can also be used for screening.
  • The SPARK strategy is fine-tuned for use in clinical examinations of glaucoma patients.

The enhanced Glaucoma Staging System4) classifies visual field results using the values of the mean defect (MD) and the pattern standard deviation (PSD or CPSD). The examination result is represented in the diagram by a point whose position is determined by the values of the perimetric indices. The diagram displays the severity of the detected visual field defects (Stage 0 – Stage 5) as well as their type (localized, generalized or mixed).
This novel evaluation module performs a thorough assessment of individual visual field findings using machine learning for pattern recognition. Besides its unique contribution to early glaucoma diagnosis, GSP5) can substantiate the clinical evaluation of test results.

GSP assigns each test result to a visual field class using an algorithm optimized to match evaluation by a glaucoma expert. In addition, the database of GSP includes correlations with the whole clinical picture (including structural changes). This information enables GSP to evaluate the degree of risk for the presence of different glaucoma stages on the basis of visual field findings.

Intuitive green-yellow-red colour coding helps in fast and reliable interpretation of the findings. The striking novelty of GSP consists in its capability to identify both glaucoma suspect patients and patients with possible pre-perimetric glaucoma using nothing but measured threshold values.

The TNT6) software module objectively evaluates changes over time in visual field results. Combined with the fast SPARK strategy, it increases considerably the sensitivity for detecting progression in early glaucoma.

  • TNT displays a concise report of the progression analysis with a summary of the most relevant parameters (MD slope, p-values, etc.).
  • TNT can distinguish between cases of diffuse or focal progression based on the value of the “Focality Index” (FI).
  • TNT uses multiple statistical criteria in establishing progression.
  • TNT presents age-related predictions on the visual field.

Device
Glaucoma Staging System (GSS 2) nach Brusini Glaucoma Staging Program (GSP) - GSP-Analyse eines präperimetrischen Befundes Threshold Noiseless Trend (TNT) Progressionsanalyse

Title

Description

3) M. González de la Rosa, J Glaucoma 2012
4) P. Brusini, S. Filacorda, J. Glaucoma (2006) 15: 40–46
5) D. Wroblewski et al, Graefes Arch Clin Exp Ophthalmol 2009
6) M. González de la Rosa and M. González-Hernandez, Br. J. Ophthalmol. 2011; V.T Diaz-Aleman et al., Br. J. Ophthalmol. 2009

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Technical Data

OCULUS Easyfield® - Technical drawing
Static Perimetry

Programs Pre-defined glaucoma, macula, screening and neurological tests
User-defined tests
Strategies Threshold strategies: SPARK Quick, CLIP, OCULUS Fast Threshold, Full Threshold (4/2)
Optional: SPARK Precision
Age adapted suprathreshold screening (2-zone, 3-zone, quantify defects)
Test patterns 30-2, 24-2, 30×24, 10-2, hemisphere, customized patterns
Reports Glaucoma Staging System (GSS2), Glaucoma Staging Program (GSP), Threshold Noiseless Trend (TNT) progression report
Fixation control Through central threshold, Heijl-Krakau (using the blind spot), live video image
Result Display Greyscale, dB values (absolute / relative), symbols, probabilities, 3D plot
Specifications

Perimeter bowl radius 300 mm
Stimulus size Goldmann III
Stimulus luminance range / increments: 0.03 – 3 180 cd/m² (0.1 – 10 000 asb) / 1 dB
Stimulus duration: 200 ms / user-defined
Background luminance: 10 cd/m² (31.4 asb)
Stimulus color White
Max. eccentricity 30°
Patient positioning: Measurement head with adjustable angle of inclination, adaptable chin rest (Easyfield® C only), double head rest
Dimensions (W x D x H) Easyfield® S: 274 x 370 – 470 x 314 – 429 mm (10.8 x 14.6 – 18.5 x 12.4 – 16.9 in)
Easyfield® C: 316 x 506 – 540 x 320 – 435 mm (12.4 x 19.9 – 21.3 x 12.6 – 17.1 in)
Weight 7,4 kg (16.3 lbs) / 4,6 kg (10.1 lbs)
Voltage, Frequency 100-240 V AC
50 – 60 Hz
Interface USB
Software Device control, patient management, backup, and print software (Windows®)
Built-in networking, easy EMR-integration, DICOM compatibility
Recommended computer specifications Intel® Core™ i5, 4 GB memory, 500 GB HDD, 8 GB RAM, Intel® HD Graphics, Windows® 10

FAQ

There are four models in the OCULUS perimeter range. All four models can perform screening (supra-threshold) and threshold perimetry. Apart from being various sizes they differ as follows:

Model Easyfield® Smartfield Centerfield® Twinfield®
Maximum Eccentricity 30° 30°/25°
With fixation shift: 60°/50°		 36°
With fixation shift: 70°		 90°
Goldmann stimulus size III III III I, III & V
Static/Kinetic Static Static Static/Kinetic Static/Kinetic
Colour perimetry White-white White-white White-white
Blue-yellow		 White-white
Blue-yellow
Red-white
Stimulus presentation Light emitting diodes (LED) LCD display Back surface projection Back surface projection

All commercially available perimeters make use of the same basic testing principles. What makes one perimeter different to another is the way it performs fast thresholding test. Various fast threshold strategies are included in the OCULUS perimeters, one of which is the SPARK strategy – currently the fastest OCULUS strategy for glaucoma patients. It is the product of many years of research dedicated to obtaining reliable averaged results within the shortest possible time.

Furthermore all the perimeters include a unique glaucoma staging display called the Glaucoma Staging Program (GSP).

Lastly glaucoma progression is monitored by the Threshold Noiseless Trend (TNT) analysis method. The method can distinguish between diffuse or focal progression, and unlike methods based on event analysis, trend analyses make full use of the data pool of earlier examinations.

Yes, it may differ somewhat in appearance, but all the essential data known from other perimeters is available on the OCULUS perimeter printouts.

  • Full Threshold (4-2 dB Staircase) Strategy – the algorithm of this strategy can easily be implemented in any instrument and therefore it is available on most commercial perimeters. Results obtained with this strategy can be compared to results from any other perimeter using the same strategy.
  • OCULUS Fast Threshold Strategy – this strategy aims to reduce test time of the 4-2 dB Staircase strategy. The idea of the OCULUS Fast Threshold Strategy is to achieve a compensating gain in information by starting the measurement at each test point with a luminance value equal to the expected sensitivity value at that point. This expected value is calculated on the basis of measurement results already obtained at neighbouring test points.
  • CLIP (Continuous Light Increment Perimetry) Strategy – locations are tested individually by increasing the luminance of the stimulus continuously until the patient responds.
  • SPARK – the examination is performed in four phases. Each of these phases supplies a possible estimation of the functioning of the entire visual field, and the final result is obtained by averaging of the values obtained during each phase.

Yes. SPARK Precision is performed in four phases over a time period of three minutes. Each of the 66 points in the test pattern will be tested at least once during the three minutes.

Shorter examination time and better repeatability are the main benefits of SPARK. Testing time for this strategy will not exceed three minutes and this holds true even for patients with severely impaired visual field function. Compared to other known strategies, SPARK results have a much lower variability.

Various quick screening methods are available. Normally supra-threshold tests are used, however SPARK Quick has been designed specifically with screening in mind. The duration of the test is 1.5 minutes (90 seconds) on all patients and threshold values are generated after the examination.

Most perimeters only have Heijl-Krakau method to monitor patient fixation. This method uses the blind spot as reference. Glaucoma can cause absolute defects in the vicinity of the blind spot, which may increase as the disease progresses. Using the Heijl-Krakau method for these patients may be problematic. Central fixation control – only available in the OCULUS perimeters – uses the central luminance threshold as reference. This is a helpful method to control fixation for glaucoma patients.

All OCULUS perimeters allow for manual set-up of programs. When comparing current results from an OCULUS perimeter with previous results from other perimeters it is important to adapt the parameters of the current examination as closely as possible to those of the earlier examinations. This needs to be done in order to achieve the highest degree of comparability.

Examinations on the Easyfield®, Smartfield or Centerfield® can be performed in a normally lit room, provided the lighting is diffuse and there are no powerful light sources in the patient’s back. The Twinfield® requires a darkroom, as its perimetric hemisphere must be free of shadows.

GSP uses pattern recognition algorithms in order to assess the visual field results of the patient. For “Normal” and “Glaucomatous” visual fields a risk class can be determined by comparing the detected patterns to the visual field patterns stored in the database of the GSP. If the “Pre-perimetric” risk class dominates the bar chart, it means that the pattern of the measured visual field is similar predominantly to the patterns of patients with pre-perimetric glaucoma from the database. Pre-perimetric glaucoma is defined through glaucomatous changes to the optic nerve head and/or the retinal nerve fibre layer without detectable visual field losses. A “Pre-perimetric” result should be followed by a closer monitoring of the patient.

The software automatically chooses exams done with the same test pattern and the same strategy making comparison fast and easy to detect progression. Exams showing obvious learning effects are excluded by the software. The operator can also manually exclude exams if needed.

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