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

1. Canon CR-DGiDigital-exclusive Non-Mydriatic Retinal Camera Confidential only for Authorized Canon Distributor

2. 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- Confidential only for Authorized Canon Distributor

3. * Right Side is from the Photographer’s perspective. •The following knobs can be found: –Diopter Compensation –Focus Knob –Infrared Filter –Small Pupil Knobs and Switches (Right Side*)(Refer to Canon’s CR-DGi Operation Manual Pages 4-5) Confidential only for Authorized Canon Distributor

4. •The Focus Knob allows you to focus on the patient’s eye for Anterior or Fundus images. •The Focus knob is located on the right andleft side of the CR-DGi head. Focus Knob(Refer to page 4 of the CR-DGi Operation Manual) Confidential only for Authorized Canon Distributor

5. •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. Small Pupil Knob(Refer to page 12 of the Canon CR-DGi Operation Manual) Confidential only for Authorized Canon Distributor

6. •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 DiopterCompensation Slider(Refer to page 15 of the CR-DGi Operation Manual) Confidential only for Authorized Canon Distributor

7. •The “IN”position 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. Infrared Filter(Refer to page 26 of the Canon CR-DGi Operation Manual) Confidential only for Authorized Canon Distributor

8. •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 patient’s pupil. Shutter Release and Height Adjustment(Photographer Side of Camera) Confidential only for Authorized Canon Distributor

9. •The Stage Holding knob locks the CR-DGi stage in place. Stage Holding Knob Stage Confidential only for Authorized Canon Distributor

10. •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. Setting Buttons and Monitor Adjustment Confidential only for Authorized Canon Distributor

11. •The Fixation Target Control moves the fixation target. •The fixation target appears as a small square on the CR-DGi’smonitor 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 “view”required by the photography protocol. Fixation Target Control Confidential only for Authorized Canon Distributor

12. •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. Alignment Switch Confidential only for Authorized Canon Distributor

13. Left Sideis from the Photographer’s perspective. •The following knobs can be found: –Focus Knob –Chin Rest Height Adjustment Ring Knobs and Switches (Left Side*)(Refer to Canon’s CR-DGi Operation Manual Pages 4-5) Confidential only for Authorized Canon Distributor

14. Patient Positioning and Photography •Hand Positioning •Patient Head Adjustment •Aligning the Pupil (External) •Identifying Laterality •Aligning the Pupil (Internal) •Establishing “View”based on protocol •Flash Setting •Focusing Confidential only for Authorized Canon Distributor

15. •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 “U”movement (away from the patient) to avoid the camera coming in contact with the patient when switching from left eye to right eye. Hand Positioning Confidential only for Authorized Canon Distributor

16. •Before proceeding, check the patient’s head alignment. –Verify that the patient has their chin firmly resting on the chin rest. –Verify their forehead is firmly against the Head Rest. Patient Head Adjustment(Refer to page 10 of the Canon CR-DGi Operation Manual) Confidential only for Authorized Canon Distributor

17. •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 patient’s head relative to the Height Adjustment Mark. Patient Head Adjustment.(Refer to page 10 of the Canon CR-DGi Operation Manual) Confidential only for Authorized Canon Distributor

18. •Press the Alignment Switch if necessary to view the anterior eye. •The eye will appear “split”on the monitor. •Move the joystick forward and backward until the pupil is no longer “split.” Aligning the Pupil(Refer to page 11 of the Canon CR-DGi Operation Manual) Confidential only for Authorized Canon Distributor

19. •With the pupil no longer split, three “dots”will 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 . Properly Aligned Pupil Confidential only for Authorized Canon Distributor

20. 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). Split Bar Focusing(Refer to page 14 and 15 of the CR-DGi Operation Manual) Confidential only for Authorized Canon Distributor

21. •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 camera’s head up or down in order to position the Distance Dots inside their respective “notch”(located along the right/left border). Alignment: Distance Dots(Refer to pages 14-15 of the CR-DGi Operation Manual) Distance Dots Confidential only for Authorized Canon Distributor

22. •In the upper right corner of the monitor you will notice a “L”or “R”character, these letters represents the laterality of the eye you are imaging. •Sliding the stage left or right will automatically change this character. Identifying Laterality Confidential only for Authorized Canon Distributor

23. •Photography protocols define specific “views”of 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-DGi’smonitor.•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 “view”required by the photography protocol. Capturing a specific “View” based on protocol Confidential only for Authorized Canon Distributor

24. •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 it’s lowest setting. Flash Setting(Refer to page 8 of the CR-DGi Operation Manual) Confidential only for Authorized Canon Distributor

25. •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. Changing the Flash Setting Button Button Confidential only for Authorized Canon Distributor

26. 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. Ready for Exposure(Refer to page 15 of the CR-DGi Operation Manual) Confidential only for Authorized Canon Distributor

27. The following steps should be taken in order to correct for halo’s 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. How to Correct for a Halo or a Flare 1 2 3 4 Confidential only for Authorized Canon Distributor

28. Anterior / External Photos •Positioning of the Head •DiopterCompensation •Small Pupil Setting •Alignment Switch •Focus •Exposure Confidential only for Authorized Canon Distributor

29. •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. External / Anterior Imaging Not Touching Confidential only for Authorized Canon Distributor

30. •Pull the DiopterSlider to the (+) positio Diopter Compensation Slider (Anterior Imaging) Confidential only for Authorized Canon Distributor

31. •Set the Small Pupil knob to the “On”position. Small Pupil Switch(Anterior Imaging) Confidential only for Authorized Canon Distributor

32. •Press the Alignment switch on the CR-DGi Stage in order to see the anterior part of the eye. Alignment Switch (Anterior Imaging) Confidential only for Authorized Canon Distributor

33. •Using a Focus Knob, focus the patient’s eye. •Adjust the flash setting to the desired setting. •Press the shutter release button on the joystick. •This will capture an anterior photo. Focus and Exposure Confidential only for Authorized Canon Distributor

34. Stereo Photography •Getting Started •Capturing First Image •Capturing Second Image Confidential only for Authorized Canon Distributor

35. 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. Confidential only for Authorized Canon Distributor

36. •Position the Fixation Target slightly to the left of the Split Line Bar. –You may need to reposition the Fixation Target until the optic disc*is 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. First Image of Stereo Pair • Distance Dot off screen -- Simulation • * This assumes the stereo pair of • images are for the optic disc Confidential only for Authorized Canon Distributor

37. 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 Confidential only for Authorized Canon Distributor

38. Sales points-1 1. True Digital Quality produced by digitally optimized optics2. By combining Canon’s 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. Confidential only for Authorized Canon Distributor

39. 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. Confidential only for Authorized Canon Distributor

40. Sales points-3 5. Thanks to CR-DGi’s 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. Confidential only for Authorized Canon Distributor