Optrafair Exchange is highly regarded by optical instrument and equipment suppliers as a forum for meeting existing clients and pitching to new ones. Exhibitors from this part of the optical industry accounted for a large portion of the long running trade show’s floor space at the 2019 edition and there were several significant product launches or updates to grab attendees’ attention.
Bib ophthalmic instruments
BiB CEO Tim Baker was pleased to be hosting the global launch of Polish company Optopol’s new OCT with fundus camera.
‘Optopol picked the UK for the global launch of the Revo FC; it only arrived this morning and we are taking orders for fulfilment in July. It is a multi-purpose device which combines the complete Revo OCT functionality together with a fundus camera; a single versatile device featuring high resolution OCT and true colour fundus imaging for time and space efficiency.’
Baker felt that the product was particularly suited to the UK market.
‘We’ve been asking them to supply a built-in fundus camera for some time now. Optometrists in the UK are very focused on fundus imaging for identifying various pathologies. It has become such an institution, seeing this 45-degree image and all the grading that is done with it for diabetic screening that it’s become installed in everyone’s mind that that’s what we need. OCT lets you look below the surface to help to identify pathologies earlier, but people still want the circular colour fundus images they are used to.’
The Revo FC offers 80,000 A-scans per second, which Baker said makes it the fastest OCT that has a built-in fundus camera.
‘The faster the A-scan rate, the less chance of the patient blinking, moving slightly or an artefact getting in there. Quicker means a better likelihood that you will get a good scan the first time and with more detail, so when you are doing angiography, which looks at tiny details, it is very helpful. We’ve been asking customers to explain their purchase decision to us. So far they have been saying they bought this one because angiography is the future and this device has the fastest A-scan rate with a built-in fundus camera.’
Also available for trial and purchase on the BiB stand was a new device by Azul Optics, the MP-eye.
Dr Shelby Temple, director at Azul Optics explained: ‘The purpose of this device is to enable eye care professionals to detect people at greater risk of macular degeneration earlier in life – while they still have time to take preventive action. Everyone knows what we should be doing to prevent AMD but lots of at-risk people do not even know what the condition is. I’ve actually done research on the street, sampling random people, and it is very little known among the general public. People only know it if friends or family have it, usually later in life when it is too late to protect themselves. As we need to get to younger people, we’ve created a device that not only starts that conversation but also measure one of the risk factors.’
Temple outlines the strongest risk factors for AMD as smoking, age, genetics and low macula pigment. It is the latter risk factor that the MP-eye tests.
‘Patients use the device by looking into it and seeing a very subtle bowtie, an entopic phenomenon known as Haidinger’s brush, rotating clockwise or anti clockwise. This effect is created by the shadow of your macula pigment on the retina and is unique in exact form to everyone. The stronger the image the more macula pigment you have. The test makes it progressively harder and harder to see allowing for the patient’s level of macula pigment to be quantified. The test is quick and easy; anyone in the practice can run it. After test the eye care professional should recommend anyone scoring below 4 on the test to take extra precautions.’
Optopol Revo FC from BiB
The suggested precautions include reducing exposure to blue light by wearing sunglasses or blue light blocking lenses, improving diet by eating certain fruits and vegetables or alternatively taking supplements, quitting smoking, and getting fit to prevent body storing pigments in bodyfat.
Mainline instruments
Mainline had two new key devices at the show. The Icare 200 tonometer trades on offering complete positional freedom in use.
‘The display is on the back so if you have a patient in supine position you can still take the measurement,’ said Jack Hawkins, business development manager at Mainline. ‘This is really good in domiciliary applications or if someone in practice is unable move onto a chin rest. A lot of
hospitals are using it, including Moorfields. We also supply the Icare 100 but the 200 is like a pro version. It is a more medical device and has a sleek design which I liken to that of Apple. Feedback has been fantastic.’
Hawkins explained that the tonometer, which runs a long time on two AA batteries, takes six readings and averages them out. ‘If the standard deviation between the readings is too large than it asks you to retake. It is fool proof; you can be trained to use it in 30 secs. The probes are used one per patient and the sensation is of an eyelash tickling the cornea very briefly.
Mainline’s second new device was the HOCT-1F.
HOCT-1F from Mainline
‘This is a brand new OCT,’ said Hawkins. ‘What sets it apart from competition is ease of use and training plus this model includes a fundus camera. There is a computer inside; with a lot of the other OCTs you find you have to have a separate computer to do all the analysis. So you can’t look at the result properly and go into the ins and outs of the scan with just the device. With the HOCT-1F you don’t need the extra computer; have the device on your table and you are ready to go. If you want we can network it free of charge to all the computers within a practice. It has a high A-Scan rate and does anterior as well. We are making waves with this device; with its quality and how easy it is to use, technicians are taking images within 30 minutes of starting. We are doing free updates for the life of the machine. At this show we’ve had lots of interest from competitors so we must be doing something right.’
Icare 200 from Mainline instruments
While Optician was at the Mainline stand, representatives of two competitor companies were there looking at the HOCT-1F.
Birmingham Optical
Birmingham Optical had a large presence at the event with numerous CET lectures taking place on its stand.
‘One of our most recent devices is the Nidek Gonioscope GS-1,’ said Jason Higginbotham, director of medical and education at Birmingham Optical. ‘This offers 360-degree colour gonioscopy. You can stitch images together to give a circumvential image or even a linear image of the whole anterior chamber angle, or you can look at individual section of the angle. This is brilliant for glaucoma and for general inspection of the anterior chamber.’
The company was also demonstrating its Nidek Retina Scan Duo OCT.
‘This is the biggest selling OCT in UK by far,’ said Higginbotham. ‘It is rolling out into Specsavers practices and we’ve sold quite a few hundred into independents too. The key thing is training and education that we provide along with the device. This is so important; if you don’t get training a lot of optometrists don’t know how to use it or interpret the results. We’ve also reduced the price very significantly as there is a lot of competition in the market and prices are coming down. With finance it is an affordable device, around £20 per week for a six day a week practice. It doesn’t take much for one of these to pay for itself and it brings so much to the practice clinically.’
Optos
Optos was demonstrating both its flagship ultra-wide field imaging devices, which both utilise Optomap imaging technology, in Birmingham.
‘The Daytona plus is our high end optometry device,’ said Sharon Ormonde, sales director Northern Europe at Optos. ‘It can take an image of up to 200 degrees of the back of the eye with a capture speed of less than 0.25 seconds. The advantages of such an ultra-wide field are that you can see more of the retina, much more easily. We image over half the eye globe so you can see parts of the retina you cannot see otherwise. You can see changes earlier and the contrast of the images is very high. When an optometrist uses light to look into the eye, it bleaches out a lot of the retina so you wouldn’t necessarily see subtle changes in pigmentation or any lesions that are not well demarcated. With the high contrast, the user can pan and zoom at leisure rather than with the patient there.’
The second device was the Monaco imager, which has all the functions of the Daytona Plus as well as the ability to take an OCT scan within a 50 x 40 degree area.
‘The Monaco is incredibly slick, quick and efficient. It is very easy to use, it has multimodal imaging so you can take a colour Optomap, an auto-fluorescent Optomap and then an OCT scan – three clicks and you have the full works. There’s certainly a patient “wow” factor as well as clinical benefits.’
Topcon
As platinum sponsors of Optrafair, Topcon was out in full force at the NEC with a dedicated CET area on stand. On the instrument side, the Japanese company was promoting its 3D OCT-1 Maestro, which now includes a NHS Diabetic Eye Screening Programme-approved built-in, true colour Fundus camera. Meanwhile, Topcon Healthcare Solutions launched Optoflow, a brand agnostic communication and data management software supporting OCTs, SLOs, fundus cameras, and visual field devices.
Topcon Optoflow
Elsewhere, the company showed its newly launched dry-eye treatment device, Eye-Light. The new device, which Topcon said had attracted interest from dry eye experts around the world, Eye-Light uses intense pulse light (IPL) and low-level light therapy (LLLT) to treat meibomian gland dysfunction, working on both upper and lower lids simultaneously without the application of gels, which the company said was a significant timesaving feature in busy dry eye clinics.
Meibomian glands are stimulated by thermal pulses delivered by polychromatic IPL that has been used for several years in dermatology practices as a treatment for rosacea and acne, while LLLT has a strong metabolic enhancer that increases cellular action which emphasises cell activity.
LLLT is delivered through a face mask, which contains a LED matrix at a specific wavelength, triggering an endogenous heating of both upper and lower eyelids.
Heidelberg Engineering
Heidelberg Engineering unveiled Anterion, a new multimodal imaging platform optimised for the anterior segment, at Optrafair. The company held a launch event to demonstrate the device on the opening day of the show.
Heidelberg Anterion
‘Anterion is a comprehensive solution that brings together corneal topography and tomography, anterior segment metrics, axial length measurement, and IOL calculation – all in one single upgradeable device,’ said Christopher Mody, director of clinical affairs at Heidelberg. ‘With Anterion you get exceptionally clear swept-source OCT images of the entire anterior segment – from the anterior surface of the cornea to the posterior surface of the lens – which provides visual confirmation of all measurements for a new level of diagnostic confidence.’
Anterion is said to have a number of benefits in the primary care setting including assessment of the anterior segment of the eye with extremely high resolution OCT images, chamber angle analysis, keratoconus investigation, and the ability to make more informed decisions about contact lens fitting. Furthermore the 4-in-1 modular design makes the device suitable for optometrists conducting pre-operative assessment for lens replacement and refractive surgery in glaucoma and cataract patients as part of a shared care scheme with the hospital eye service.
Cerium visual technologies
Cerium’s Intuitive Colorimeter Curve, it is the fourth generation of an instrument that has been on the market for 25 years. The device has always assessed colorimetry but this new version, which was brought to market in 2018, is the first to be fully digital. The theory behind the Curve is that the symptoms of visual stress may be reduced by the use of coloured filters and the Curve is capable of identifying a precise colour for each individual patient through its assessment process. The company says the device can be applied to dyslexia as there is a greater propensity among the dyslexic population to suffer from visual stress.
Cerium’s Curve
‘We launched last year and it is used by optometrists to assess a precision colour for each individual patient who shows symptoms of visual stress, dyslexia, migraines, other neurological conditions and also reading difficulties within the classroom,’ said Claire Millar, director of technical services at Cerium. ‘The older models utilised a mechanical system whereas this is completely electronic, bringing it into the 21st century. In terms of protocol the practitioner does the same assessment but it is now all controlled by a tablet control which talks to the instrument through Bluetooth.’
Essilor
Essilor Instruments launched digital phoropter Vision-R 800 at the Birmingham event with the aim of providing far more accurate and reliable prescriptions through continuous power changes.
Essilor Vision R 800
‘We are reinventing refraction,’ said Paul Cumber, head of instruments at Essilor. ‘The old era, where subjective refraction techniques led to an estimate of the prescription, with inaccuracies accumulating, will give way to the new era of digital infinite refraction. In the future it will be possible to leverage the full potential of the digital surfacing technology used for lens manufacturing.’
Essilor claim that the device will enable eye care professionals to reach a more accurate refraction through its ability to control power at 0.01D while most phoropters work in steps of 0.25D. This breakthrough comes from a patented, automated optical module powered by digitally-controlled motors. This provides simultaneous and instantaneous changes of sphere, cylinder and axis, to reach the final refraction more directly and faster, instead of examining these components individually.
For the patient, the Vision-R 800 allows a wider field of vision when in use and is also thought to reduce fatigue due to quick tests and shorter examination time.
Grafton optical
Instrument stalwarts Grafton boasted an impressive new stand at the show with an open design efficiently providing designated areas for its various products. Grafton ceo David Thickens was particularly keen to discuss the new IDRA ocular surface analyser.
Grafton IDRA surface analyser
‘The IDRA ocular surface analyser is a full diagnostic device for dry eye, covers interferometry, looks at tear height meniscus – you can add the metric for tear film osmolarity as well,’ said Thickens. ‘It will give you meibography and 3D meibomian gland imaging, which produces a video that can be used to help patients engage with the diagnostic process. The device then grades information in terms of individual metrics but also utilises a traffic light system that makes it very clear to the patient when they look at it. They see they are red or yellow at the initial test and after treatment with eye mask or IPL, or drops or hygiene wipes, they have the session done again and can see the change. It quantifies it for the patient and makes it very quick for the optom to use. It is a great device for driving a dry eye dispense and encourages compliance with treatment.’
Carelton
New from Carelton for the event was the new Rodenstock Alino multifunction refractometer, which offers topography, refraction, tonometry, pachymetry, dry eye analysis and keratometry in one device.
Rodenstock Alino from Carelton
‘The Alino optimises space in practice because you have six instruments in a small platform,’ said Gareth Hymas, sales and marketing manager at Carleton. ‘In practice, where an owner is paying a great deal of money per square foot of retail space, space is at a premium so if you can get that many functions in a small area that is a real saving. It is very easy to use, with intuitive touch screen controls and data can be downloaded into a practice management system. Rodenstock is a premium manufacturer and released the device at Opti Munich for the German market. It is brand new and has attracted great attention here in Birmingham.’
Bryan Moran, sales manager at Keeler, was keenest to discuss the Tonocare 2.0, a new non-contact tonometer.
‘What we are launching at the show is Tonocare 2.0,’ said Moran. ‘We’ve been making Pulairs since the late eighties and this is a 6th generation handheld air non-contact tonometer. The 2.0 is hand held so there are no cables or wires and it works from a rechargeable battery. The great thing is that if you buy it, there are no needles or pins that need replacing – it’s all in the box with no hidden charges. The device weighs 1kg and is really nicely balanced and easy to fire. The display has a green circle to target and fine tune crosshairs. It is completely automatic and comes with a head attachment.’
Luneau Technology
Luneau Technology began supplying Visionix devices directly to the UK market back in January.
Luneau Technology VX120
‘Lots of people haven’t heard of Visionix yet so for me it’s about raising awareness of the brand and the full range we offer,’ said Mike Riley business development director at Luneau Technology. ‘We are all about wavefront technology; measuring waves of light to measure the cornea which allows us to get the information really accurately and quickly. The VX120+ is a diagnostic piece of equipment that offers seven functions, including ultra refraction, keratometry and pachymetry, in one device. In a pre-screening room this would be an ideal device to have to get all that information before doing a refraction. You can check for glaucoma, keratoconus, problems with night driving – things that prompt a really healthy clinical conversation with the patient.’