Autorefractor Measurement Tips
The Retinomax 2 and 3 autorefractors can be exceptionally accurate if used properly.  The purpose of this section is to describe techniques you can use to improve the accuracy of your measurement.

First of all dilation is required with young people to make accurate measurements.  Here are the rules for dilation:
Dilate 100% of those below 20.  Between 20 and 30 dilate 100% if not rushed; otherwise, check twice and if a significant reading difference, then dilate.  Rarely must you dilate those over 30 unless they are very elderly and have a very tiny pupil.  Wait 15 minutes for dilation to work. Flash penlight in eyes and wait longer if you get a reaction.  Remember to test children (before dilation) with clear glass glasses as they might try to trick you to get glasses.

If for some reason you cannot dilate then review this video for a method which will work with the older children (not the very young).

Several things I have found work when I cannot get a reading for a patient.
1.     Dry eyes:   If their eyes are very dry I get no reading.   If I put in Systane eye drops, the readings come easy.
2.     Cataracts:  If they have mild to severe cataracts then the unit won’t get a reading.   If you move the square
in the viewfinder around the circle you might get one.  Otherwise you may have to use a lens rack to get a reading you can enter into the program.
3.     Tiny Pupils: Sometimes in elderly patients the pupils are very tiny.   If smaller than 2-3mm diameter then
you get no reading.  In this case I dilate the patient and get a reading every time.

Here are several things about the instrument you need to know.   The headrest on the front of the instrument will pop out after you press it in.  There is a line in the plastic on the top of the instrument.  This line must be lined up with the patients eyes vertically.  There is another line on the left side of the instrument.  This line must be horizonally lined up with the patients eyes.   The lens in the center of the instrument should be lined up with the eye.  When you first try to line up with the patient, look across the instrument to find the eye.  Don't look into the viewfinder until you are very close.   The Start Switch is the green button on the top/front of the handle.  

                  Look at this video for the Retinomax 2 autorefractor.
                  Look at this video for the Retinomax 3 autorefractor.  (Video is ahead of audio in this.)

Enter the patient number and age into the Glasses Inventory program.

Take these steps with the autorefractor to measure the patient properly.  
1.  Setup to measure across the corner of a table.
2.  Place the neck strap around your neck to avoid dropping the instrument.
3.  Put your elbow on the table to steady your hand.
4.  Power the unit on by pressing the power button on the top/left.
5.  Look into the viewfinder and rotate the knob of the eyepiece until you see everything clearly.
6.  Put your finger on the green start switch on the handle but don't press it yet.
7.  Push the headrest in to release it.
8.  Place your left forefinger in front of the headrest and place it on the patients right eyebrow.
9.  Put your left thumb on the left side of the instrument and your 3 remaining fingers on the side
     of the patients head to form a bridge between the patient and instrument.  If the patient moves,
     you move and the net movement is zero.
10.  Look across the viewfinder and then into the viewfinder and move to locate the patient's eyes.
       You should see a circle of dots called the "Mire Ring" along with 2 dots on the left and 2 dots
       on the right.
11. Move closer and further away until that circle of dots is crystal clear.
12. Move your shoulders from left to right to make the 2 dots on the left and right appear.
13. Look at the rectangle at the top of the viewfinder (Retinomax 3 only) and rotate the instrument
       in the direction of the arrow until you see OK.
14. When you have OK, the mire rings are clear and the 2 dots on the left/right are visible, move
       the square into the circle of dots and press/release the start button.
15. Hold the square steady inside the circle of dots and keep it clear while the instrument makes
       its measurements.  You should then see R-OK in the viewfinder. The right eye is measured.
16. Press the LEFT/RIGHT button on the instrument near the print key until the L light is lit.
17. Position your left hand over the patient's left eye like you are saluting for the patient. Position
       that hand on the patient's left eyebrow.  The instrument will be cradled into your left hand for
18. Put the headrest on your left little finger (on the patients left eye brow). and align the instrument
      with the left eye.  DO NOT move the square into the circle of dots.  Stay below them until they
      are clarified by your moving in/out.  Only then should you move the square into this circle.
19. Measurement should start immediately.  Hold the square steadily within the mire ring until you
       see R/L-OK.
20.  With the Glasses Inventory Program running press the PRINT button on the top/right of the
        instrument and a window should appear on the screen saying "Incoming data...".
You have now measured the patients eyes and can use Glasses Inventory to find the glasses.