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FUNDUS PHOTO

Digital Imaging System

New Vision Fundus Medical Imaging Suite


New Vision Standard v 5.5.x.x
New Vision DICOM v 5.5.x.x
New Vision Web Review v 5.0.x.x
New Vision Camera Control v 1.4.x

Operator Manual
Version 5.5.x.x
www.fundusphoto.com

1
General Information
Intended Use
The Fundus Photo Digital Imaging System is intended to capture, archive, and display digital images of the
retina and surrounding areas of the eye. It should only be operated by trained healthcare professionals.

Cleaning and Disinfection


Recommend covering device when not in use to prevent dust accumulation.
Remove any dust accumulation on the device with a lint-free cloth. Alcohol wipes should be used to remove
any dirt or stain.

Calibration
Capture an image of a mm ruler at the same distance used to capture the eye and measure using New Vision.
Your fundus camera instruction manual specifications page lists working distance.
Determine the correct calibration value by setting calibration to 1 (one) in Image Settings and measuring a
known distance (i.e.: mm ruler): Calibration value will be:

Actual (known) distance in microns / measured distance in pixels (set calibration factor = 1).

Enter the calculated value in the Image Settings dialog box.

Service
For service questions, contact Fundus Photo, LLC or authorized factory trained service personnel. No user
serviceable components enclosed.

Software Security
New Vision Fundus Medical Imaging Suite requires a unique product key to operate.

"Caution: Federal law restricts this device to sale by or on the order of a Physician or Practitioner"

Manufactured by:
Fundus Photo, LLC
1240 Dielman Industrial Court
Saint Louis, MO 63132 USA
+1 314 533 6000

Copyright 2007-2020 Fundus Photo, LLC. All rights reserved.


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Table of Contents
1. INTRODUCTION ...........................................................................................................................................5
1.1. Login............................................................................................................................................................5
1.1.1. Other Options ................................................................................................................................ 5
1.2. Home Screen ..............................................................................................................................................6
1.3. Search .........................................................................................................................................................7
2. PATIENT DETAILS .......................................................................................................................................9
2.1. Creating a New Patient Record ..................................................................................................................9
2.2. Working with Existing Patients....................................................................................................................9
2.3. Editing Patient Details ...............................................................................................................................10
2.4. Creating a New Study ...............................................................................................................................10
2.5. Diagnosis Codes .......................................................................................................................................11
2.6. Deleting the Study .....................................................................................................................................11
2.7. Deleting the Patient ...................................................................................................................................11
2.8. Undelete ....................................................................................................................................................12
3. STUDY DETAILS ........................................................................................................................................13
3.1. Capture......................................................................................................................................................13
3.1.1. Images in the Import folder ........................................................................................................ 14
3.2. Viewing and Printing Images ....................................................................................................................14
3.3. Import Images ...........................................................................................................................................15
3.4. Delete Images ...........................................................................................................................................15
3.5. Export Images ...........................................................................................................................................16
3.6. Thumbnail Images ....................................................................................................................................16
3.7. Viewing Image as Large Image ................................................................................................................17
3.8. Printing Images .........................................................................................................................................17
3.9. Print Preview .............................................................................................................................................18
3.10. Run Capture ..........................................................................................................................................19
3.11. Menu Bar ...............................................................................................................................................19
3.11.1. File .......................................................................................................................................... 19
3.11.2. Settings .................................................................................................................................... 20
3.11.3. Maintenance ............................................................................................................................ 21
3.11.4. Help ......................................................................................................................................... 21
4. EDITING IMAGES .......................................................................................................................................22
4.1. Mutual Drawing .........................................................................................................................................22
4.2. Stereo, Compare and Overlay Images .....................................................................................................23
4.3. Right-Left Eye Label .................................................................................................................................24
4.4. MOSAIC Function .....................................................................................................................................24
4.5. Image Processing Functions ....................................................................................................................25
4.6. Image Processing Tool Bar ......................................................................................................................26
4.7. Image Edit (Measurement) .......................................................................................................................27
4.8. Zoom .........................................................................................................................................................28
5. SETTINGS ...................................................................................................................................................30
5.1. Diagnosis List ............................................................................................................................................30
5.2. Physician and Photographer Maintenance ...............................................................................................30
5.3. Image Settings ..........................................................................................................................................31
5.3.1. General Options .......................................................................................................................... 31
5.3.2. Calibration .................................................................................................................................. 31
5.3.3. Image Preview Settings .............................................................................................................. 32
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5.3.4. Capture Settings .......................................................................................................................... 32
5.3.5. Post import .................................................................................................................................. 33
5.3.6. Use LDAP ................................................................................................................................... 33
5.3.7. Right Side Buttons ...................................................................................................................... 33
5.4. Archive and Backup ..................................................................................................................................34
5.4.1. Storage Type ............................................................................................................................... 35
5.4.2. Date Filter ................................................................................................................................... 35
5.5. Archive and Backup Settings ....................................................................................................................36
5.5.1. Backup folder section ................................................................................................................. 36
5.5.2. Automatic backup section ........................................................................................................... 37
5.6. Activity Log ................................................................................................................................................38
6. Automatic Transfer for EHR/EMR ............................................................................................................39
6.1. Transfer Options .......................................................................................................................................39
6.2. Target Settings ..........................................................................................................................................40
7. New Vision DICOM Integration .................................................................................................................41
8. Manual & Automatic Image Enhancement ..............................................................................................43
8.1. Manual Enhancements .............................................................................................................................43
8.2. Auto Enhancements..................................................................................................................................43
9. New Vision Web Review............................................................................................................................44
9.1. Log-In ........................................................................................................................................................44
9.2. User Administration...................................................................................................................................44
9.3. Main Page .................................................................................................................................................45
9.4. Patient Images ..........................................................................................................................................46
9.5. Patient Images ..........................................................................................................................................46
9.6. Individual Images ......................................................................................................................................46
9.7. Image Tools ..............................................................................................................................................47
9.8. Compare Images in current study and Compare Images to previous studies .........................................47
9.8.1. Comparing Images – Single Study ............................................................................................. 47
9.8.2. Comparing Images – Multiple Studies ....................................................................................... 48
9.8.3. Comparing Images – Screen Controls ........................................................................................ 49
10. Digital Camera Settings..........................................................................................................................50
11. Capture Advance Settings .....................................................................................................................51
11.1. Screen Tour...........................................................................................................................................51
11.2. Changing, Saving and Restoring Style Defaults ...................................................................................52
11.3. Creating Your Own Style Definitions.....................................................................................................52
12. Request Support .....................................................................................................................................54
13. GLOSSARY ..............................................................................................................................................55

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1. INTRODUCTION

1.1. Login
To start using the “New Vision Fundus Medical Imaging Suite” simply double click the New Vision Fundus
icon on your desktop.

The login screen will appear and ask you for your login credentials. The default Username is ‘master’ and the
default Password is ‘master’. For patient privacy and added security it is recommended that you create your
own Users and Passwords.

Once you have entered your Username and Password simply click login.

1.1.1. Other Options


There are several other options that are available from the main login screen:
● Clicking on the screen logo will take you to http://nvfundus.com/ where you can learn more about us
● Clicking on “Licensed to …” will show you your User/Company and Product key

(Note1: Please do not change or edit this screen without contacting your authorized service dealer. Doing so could cause
your software to stop functioning.)
● Clicking on the “Register” box will allow you to add new users

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1.2. Home Screen
New Vision Ophthalmic Image Analysis System is an integrated system that will easily allow you to create a
new patient photographic record or retrieve existing ones.

The main screen is broken into three major areas:


1) The Header section allows you to easily retrieve a specific patient using eight sortable identifying
filters
2) The main body lists the patients that meet your search criteria or all records if no search criteria are
entered
3) Along the right side, from top to bottom, are icons indicating a New Patient, Delete Patient, Patient
Details, Diagnosis List, Physician List (including photographers), Image Settings and Archive.
Header

Menu

Body

To find out more about the features of a button, field or box move the mouse on it and wait for a moment as

the explanation will appear.

Click on any field header to sort in ascending/descending order. Field headers are located above the patient
list (Patient ID, Patient Name, Patient Surname, Gender, Physician, Last Study, Last Photographer or
Referring Physician). You may also click and drag a field header to rearrange the order.

The total number of patients displayed is shown in the bottom left corner of the home screen.

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To close New Vision Ophthalmic Image Analysis System, simply click the Close Button at the top right side
of this home screen.

Along the top blue strip of this dialog box is the general version of the program. Click on the “nvfundus”
logo along the left side of the search area for complete version details.

Standard version

DICOM Version

1.3. Search
The entire patient list is available on the home screen. To find a patient, type the data in the relevant boxes
such as Patient ID, Patient First or Last Name, Study Date, Diagnosis and Physician. The patient will
appear just after the data entry.
You may also search according to several criteria. For instance, to find the patient named Donna
Carruthers with Patient ID 10007, you can either type 1007 in Patient ID or type Donna in Patient First
Name or Carruthers in Patient Last Name. The patient will be displayed on patient list area. You are not
obliged to type the entire data of the search criteria; a part of the data entry will be enough to find the patient
as shown below.
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To clear the search or reach the entire patient list, just click the Clear button.
To sort the search results or entire patient list, click the header of the patient list.
For instance, to sort the patient list according to the Patient ID, click the Patient ID which is above the
patient list.
To search the patients on a specific date, type the study date on the Study Date box and click the filter by
study date.
To open the patient details, double click the patient. More on the Patient Details page in Chapter 2.

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2. PATIENT DETAILS

2.1. Creating a New Patient Record

In order to create a patient, click the button New Patient . The patient ID number is generated
automatically; however, you can enter any number representing the patient record or account number. Simply
leave the Patient ID box empty for automatic numbering by New Vision, except when “Patient ID Mandatory”
is selected in Image Settings, which is the default setting.
The only other mandatory fields are First Name and Last Name. You may enter other available information
now or edit the record later.

2.2. Working with Existing Patients

There are two ways to open an existing patient record. You can simply highlight, and double click the patient
record you want to open or right click the mouse and select ‘View patient’

For existing patients; individual studies and diagnosis are listed in the lower part of the patient details window.

To reach the study details and images, double click the study or select the Study Details button.

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2.3. Editing Patient Details

Edit the patient details: only by clicking on Edit Record . After typing the data, click Save Record

to save the changes.


NOTE: Edit Record button is changed to Save Record during editing.

2.4. Creating a New Study

After clicking on an existing patient or creating a new patient, click the New Study button.
NOTE: In order to address the new study of a patient who already exists in New Vision, you MUST use the
same Patient ID as originally created before capturing any new images.

NOTE: Capturing new and working with existing images will be covered in Chapter 3.
An existing patient record will list any previous studies sort according to the study date with the oldest study
on top. Simply double click on an existing study to open.

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2.5. Diagnosis Codes
Diagnosis codes (optional) are entered for each individual eye. Click an empty row twice to add the code(s).

2.6. Deleting the Study

To delete a selected study only, click the Delete Study button. You will receive the
following warning:

NOTE: Only one study may be deleted at a time.

2.7. Deleting the Patient


To delete a complete patient record, right click on the patient record you want to delete and then click Delete

Patient on the popup window .


NOTICE: Be aware that all patient details and images will be completely removed from the software and it
will not be possible to reach them again. A message “Are you sure you want to completely delete this
patient, related study information and all images?” will appear on the screen after clicking on the Delete
Patient button. If you select OK, patient will be deleted. If you click Cancel, no changes are made.

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2.8. Undelete
In the event a study or patient record is deleted, it may be recovered for a period of up to 30 days. From the
“Home Screen” go into “Image Settings”. Check the box “Show Deleted Items” and follow on-screen
instructions. After recovery of deleted items, close and restart New Vision. Once New Vision is started
again, the undelete function turns off.
NOTE: DO NOT capture or import when undelete function is active.

Undelete Selection in Image Settings Box

Patient Record Recovery

Study Record Recovery

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3. STUDY DETAILS
3.1. Capture

Before starting image transfer, click New Patient button and follow the procedure specified in section 2.1 to
create a new patient record. If you have a patient already in New Vision, do not create a new record, but just
open this patient’s record (refer to section 2.2). If you have a separate Patient ID numbering system, enter
corresponding Patient ID, otherwise leave Patient ID field empty to assign an automatic Patient ID.
Click New Study button and follow the procedure specified in section 2.4 to create a new study.
After creating a new study and a blank Study Details window is opened, begin image transfer to the
C:\NVTEMP folder (or other folder specified in the Image Settings window) using remote capture, import
or drag and drop method.
For F/A injection, start the Timer by clicking the Start Timer button on the right side of the Study Details
window. After the Start Timer button is clicked, the first image captured will have a “00:00” timer value,
and all consecutive images will have its corresponding timer value with respect to the first image. Timer
begins to count when the first image appears on the patient study screen, at which time it has been oriented,
thumbnails created and automatically saved to the hard drive. There is no need for a “Save” button as the
images are automatically saved. Timer stops and resets automatically when the patient study is closed.
NOTE: New Vision Capture app is able to start and stop the Timer remotely when a corresponding preset is
selected. When you use New Vision Capture you don’t need to click the Start Timer button separately. Pay
special attention for not changing the capture preset if the timer has already started ticking.
NOTE: When you switch from one timer-enabled preset to another such preset, (such as switching from FFA
to ICG) the timer will continue ticking if it has already started counting.
NOTE: For automatic device capture, refer to the specific set-up and operating instructions provided with
your capture device. New Vision accepts jpeg, png, gif and bmp image formats.

Close

Column Count
Print
Select All/None
Import Images
Export Images
Add to Mutual Drawing Compare Images
Overlay Images Mosaic

Delete

Timer Start Timer

Launch Camera
Send Image to EMR/EHR

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3.1.1. Images in the Import folder

All valid images stored into the import folder (C:\NVTEMP) will be automatically imported into a
currently opened study.
NOTE: In case no study is opened the images captured and stored into the import folder will stay in the
import folder until a study is opened. In this case New Vision will offer to import these images into the
current study. If you picked a wrong study just click No button, close the study and open the correct study
to import these images.
NOTE: When New Vision restarts all files will be removed into C:\NVTEMP\_NV_IMPORTED folder
for backup purpose. In case some images were captured while New Vision wasn’t running these images
will be removed. Please check the _NV_IMPORTED for such missing images.

3.2. Viewing and Printing Images

When you click Study Details button, all images of the study will be displayed as small format images
(which are called “thumbnails”). In order to view enlarged images, double click the desired image
thumbnail.
In the thumbnail window, you can print, compare, or delete the images. You can enter the complaint,
diagnosis, and notes, import or export images, as well as other functions listed below.

NOTE: All operations (except import) require you to select at least one image. Selected images are
indicated by a red border.

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3.3. Import Images

To transfer images from other media (hard drive, CD/DVD or USB) into the study, click the Import Image
button (see above screen shot). Navigate to the location of the images you wish to import.

Select the image(s) from window that opens and click the open button. The following screen will then open.

Type the data and/or notes you want to import with the image. After clicking on the Save button, the image(s)
will be saved into the study.
Image Title field contains the text that will be displayed in the upper-left corner of the image thumbnail.
NOTE: This text cannot be edited later.
Images may be imported using remote capture, import or drag and drop method.
NOTE: To import several images to the study, select images in Windows Explorer or My Documents and
drag them on the software minimized.

3.4. Delete Images


Select the image and click the button Delete and confirm the message for deleting the image.

NOTE: The selected image has a red frame on the image. Be sure to view all your thumbnails and check the
Images Selected counter in the lower right corner to ensure you have selected only the images you wish to
delete.

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3.5. Export Images
Select the images you want to export. Click the Export Image button . The images will be exported in
JPEG image format. If you want to edit the F/A timer information on the images, put a tick on the Draw
timer information box.
The patient information and images can be exported to desktop, CD/DVD, USB, external drive or a network
location. Click the Burn to CD button if you want to export the images to the CD/DVD. If you want to export
the images to other specific locations, click Browse, select the relevant path and then click Export to finish.

3.6. Thumbnail Images

Before exporting or printing the images, the desired images must be selected.
To select an image, single click it once. Selected image will be marked by a red border that appears around
the picture. Clicking the same image again will de-select it and the red border will disappear.

Each image has information displayed on the thumbnail.


• Top-left text is the “Timer value”. Letters ‘e’, ‘d’, and ‘s’ appearing by the Timer Value stand for “Edited
image”, “Mutual draw”, and “Snapshot” accordingly. Timer value is obtained during automated image
import process.

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• Letter in top-right corner stands for “Right eye” and “Left eye”. A dash ‘-‘ is displayed here if this
information has yet to be selected.
• Number in bottom-left corner is for the image order in this study. Each consecutive image will acquire a
larger number.
Total number of selected images is displayed at bottom-right corner of the Study Details window.

In order to select or deselect all the images of the study, click the entire selection button.

3.7. Viewing Image as Large Image

Double click the desired image thumbnail in the study details window in order to view an image in single
large format. Image process buttons will be enabled in this view while Image Transfer (print, export, etc.)
button will be disabled until you return to Thumbnail view.

To move to the previous or next image, click the Previous/Next buttons or press “Left/Right”
keys on your keyboard.

To return to the previous window (thumbnails) click the Close button.

NOTE: Clicking Close button again will exit the study details window.

3.8. Printing Images

Select the images and click the Print icon . Report Selection window will appear, and selected images
will be displayed in this window. Select the Fields to Print, which will print at the bottom of the page. You
may cancel the images you do not want to print in this window, as well. Click Print Preview button.
There will be a fixed header on each print that is set in Image Settings, which you can access from the main
screen of the software. Also, a logo can be entered in Image Settings window. In order to have an efficient
layout for the images and patient information, select the layout as Portrait or Landscape.
The maximum number of the images that can print is 16. The information on Fields to Print will be
automatically transferred and appear on the print layout. You may change the order of the images on the Print
Preview layout with the Move up and Move Down buttons.

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3.9. Print Preview

The Print Preview screen is where you may make final enhancements to the print. There are controls to
increase or decrease brightness, contrast, sharpening and gamma which are applied to the entire print.
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Gamma is particularly effective for changing image intensity while maintaining the black background.
Print preview may be printed, canceled, or saved as another image that will append to the patient study.

3.10. Run Capture

The above screen is displayed once you click on the “Run Capture” button. There are five (5) preset image
types to choose from.
● Color
● Red-Free
● FA
● FAF
● ICG
You can change the Sharpness and Contrast by using the two (2) sliders at the bottom of the screen.
Make sure you check the “Use Timer” check box if doing a timed study.
In most cases the preset values will create crisp clear images to fit your diagnostic needs. However, you can
adjust any of the parameters as needed. (See Section 11)

3.11. Menu Bar

3.11.1. File

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The select directory option allows you to pick where you want the temporary images stored while building
your study.
NOTE: This should be the same directory selected under the image settings of the main program default is
C:\nvtemp for both.

3.11.2. Settings

● Preview Duration sets how long image is visible before it is cleared from view.

● Save To sets where the image will be saved. (The default is PC and is mandatory)

● Image Rotation determines how the image appears on screen and is saved. The fundus camera
adapter type determines which setting to use. (The default setting is 180o (inverted))

● The Connection Mode determines if the application will connect to the camera on startup or if you
will need to connect manually. (The default is Automatic and is mandatory)

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3.11.3. Maintenance

● Click on Take Picture to capture an image for testing/maintenance purposes only. This function does
not operate the flash function of the fundus camera.

3.11.4. Help

● Clicking on the About brings up the current version information.

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4. EDITING IMAGES

4.1. Mutual Drawing

Mutual drawing is a useful tool for laser operations. The area drawn on the F/A image will be transferred to
the color fundus image.
In the thumbnail screen, select two images and click Add to Mutual Drawing button. The first image
must be a color fundus image and the second image must be a F/A image of the same patient using the same
capture settings. If first and second images are not identical, the mutual drawing will not be proper.
First you need to calibrate both images to each other by clicking on Register Image button. Mark the +
symbol of First Control Point on the reference point of the first image (left image) and then mark again the
second + symbol on the same reference point of the second image (right image). It is important to mark the
same points on both images. Follow the same procedure for the Second Control Point. When you finish, click
the OK button to finalize the calibration.

You are ready to draw the area on the F/A image. The area drawn on the second image (F/A) will automatically
transfer to the first image (color).

Click the “Save Icon” so the images required for the laser application will be saved as new thumbnail
images.

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4.2. Stereo, Compare and Overlay Images

First select the images you want to compare within the same study and click the Image Compare button

or Overlay Image button . Use Compare for Stereo Pair side by side comparison.
To add images from a different study, follow this procedure:
1. Select desired images from this study.
2. Remove the tick mark from the button by clicking the tick mark once.
3. Click the button itself. Tick will re-appear automatically; 4. Go to another study and select desired
images.
5. Click the Compare or Overlay button.
After selecting the last image, it is possible to compare images from other studies or patients. After you select
images from the patient, close the patient and study details. Open the desired patient or study and continue
your procedure for the new patient or study as mentioned above.

Compare

Overlay with Zoom and Flicker control

Use the on-screen controls to adjust the zoom (0% 🡪 1000%) and the Flicker speed (0 fps 🡪 20 fps). The “>” will
allow you to switch between the two images manually while the “Magnifying glass will allow you to highlight
a specific region. You may then print the overlay, print the individual images, save or export the images.

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4.3. Right-Left Eye Label

This information is automatically transferred from a DICOM compatible fundus camera during the image
transfer. However, if you do not have this data or want to make changes, mark the image as right or left eye
by clicking the letter in the top-right corner as shown.

Letter ‘R’ stands for “Right Eye” and letter ‘L’ stands for “Left Eye”, respectively. A dash ‘-‘ is displayed if
this information has not yet been selected. Clicking the dash will toggle ‘R/L’ setting. Display of Right-Left
Eye Label is optional.
In Image Settings, select the check box “Show Eye Right/Left setting”. When turned off, the selected eye
information is still stored in the database and will display previous selections when this feature is turned on
again.

4.4. MOSAIC Function

Select the images you want to compare:

Click the Mosaic button .

Your new composite image will appear in the study as a new image labeled “Mosaic”.

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4.5. Image Processing Functions

Image processing can be carried out by clicking on the buttons on the right side of the window when a Single
Image is selected. The functions are operated by the buttons on the right-side of the window as described
below. To cancel the last processed action, click the Undo button. Undo is possible for unlimited number
of actions.
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To save changes to the image as a separate new image, click the Save changes as a new image button.
The original image is never altered. It will be saved as a new or edited image. Either icon will save as a new
or edited image. The original image numbered “3” will be numbered as “3 e”. Snapshot images will have “s”
suffix, mutual drawing images will have “d” suffix.

4.6. Image Processing Tool Bar


Close

Column Count Next Image

Previous Image Fit to Page

Drag Mode Magnify Glass

Adjust Brightness Magnifier

Adjust Contrast Invert Image Color

Adjust Sharpness Apply Red-Free Filter

Adjust Gamma Apply Emboss Filter

Display RGB Colors on Image Display-Edit Color Levels

Red, Green, Blue Adjustments

Save As Snapshot Save Changes as New Image

Edit Image in New Window Undo Last Operation

Rotate 90o CCW Rotate 90 o CW

Flip Image Vertically AE - Aggressive

Automatic Enhancement (AE)


AE - Medium

Cataract FA Enhancement Color Enhancement

Zoom 5% to 400% Haze Enhancement

Note: See section 8 for more detail on basic image enhancement.

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4.7. Image Edit (Measurement)

Edit features include advanced measurement functions. When the image is displayed as large image, click the
Edit icon and a new menu will appear. The icons on the left are used in this menu.

Return to previous window Select Text

Save Move image Geometric symbols

Snapshot save (for zoom) Regional zoom Arrow

Distance measurement: Click the icon. Draw the distance you want to measure.

The measurement result will be displayed in the Length box which is on the right upper side of the window.

Cup to Disc (Linear) Measurement: Click the icon. Draw the cup distance. Then select the icon again.
Draw the disc distance. The result will automatically appear on the screen.

Cup to Disc (Area) Measurement: Click the icon. Draw the area of cup. Then select the icon again
and draw the disc area. The result will automatically appear on the screen.

Photo Dynamic Therapy (PDT) Measurement: Click the icon. Draw PDT area on the image.
Greatest Linear Diameter (GLD) will be calculated automatically and will display in microns on the lower
right area of the screen. Spot size is calculated by adding 1000 microns to the GLD. This result is also
available in the Spot Size box on the right-side menu.
27
Area Measurement: Click the icon and draw the area on the image.

The result will be displayed in the Area box in micron2.

Text annotation: Click the icon. By having a diagonal movement holding left mouse button, place a
text box on the image. Type the text you want to annotate on the image on the Text Box, which is on the
right of the image.

Edit text format by changing the Pen box on the right of the image as shown.

4.8. Zoom

There are three zoom features available in order to let you to review images on a large scale.

a) When the image is displayed in Single Image Format (enlarged), you can increase or decrease the
zoom ratio (25% 🡪 3200%) by moving the zoom slider which is on the bottom-right part of the Study
Details window.

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b) When the image is displayed in Single Image Format, you can zoom any region of the image by using
the regional zoom button. Click the button and select the area you want to zoom as shown

in the picture. You can return to standard full-screen view by clicking the Fit to page button .

To save the regional zoom area you must use the Edit feature. By clicking the regional zoom
button, you can have regional zoom. By clicking the snapshot button , you can save the zoom image
as a new image.

c) When the image is displayed in Single Image Format, click on the Magna Tool for a pop-up
magnifying window that is easily moved and resized with the left mouse button.

29
5. SETTINGS
5.1. Diagnosis List

To add a new diagnosis, go to the last diagnosis and push the down arrow or TAB key on the keyboard. To
delete a diagnosis, go the diagnosis you want to delete and press CTRL and DEL keys on the keyboard
together. To edit a diagnosis already in the list, click the diagnosis and edit accordingly. NOTE: You must
press tab key to save new or edited entries

5.2. Physician and Photographer Maintenance

To add a new individual to either of these lists, click on the last record and push the down arrow or TAB key
on the keyboard. To delete an individual, click on the person you want to delete and press CTRL and DEL
keys on the keyboard together. To edit an individual simply click the record and edit accordingly.

30
5.3. Image Settings

Available only with standard


license

Available only with i2k


license

5.3.1. General Options

Enter the print header in the Report Title field which will be transferred to the print automatically. You can
type the header as 3 rows. You may add your telephone number at the end of the third line to appear on
landscape prints. You can also print your logo by selecting the logo image through Browse. Logo will appear
automatically on the left upper side of the print.

5.3.2. Calibration

Pixel information must be typed in the Calibration box. See the General Information page at the beginning
of this document for calibration instructions.
Select default printer paper size with Print page size selection. Available choices are Letter, A4, 4” x 6” and
5” x 7”.
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Default thumbnail view for the Study Details window can be changed using Thumbnail view selection.
Available choices are 1,2,3,4 and 5 columns.

5.3.3. Image Preview Settings

Display image number and Show Eye Right/Left settings will display corresponding information on the
image thumbnail in the Study details window. Display Image Number is optional and may be toggled on/off
according to your preference. Once images have been selected for right/left, turning this feature off only
hides the selections. The right/left information previously selected will appear on image thumbnails when
you select this box again. See section 4.3 for details.
Remove black mask when printing setting will remove the dark area around the optical disk. Resulting
image will be enlarged and fit to the paper size. Using this setting is recommended in order to print larger
images and reduce ink consumption.
Show deleted items is used for recovery of deleted images. See section 2.7 for details.
Enable i2k mosaic montage Select images, click on Montage icon, resulting montage image is automatically
saved at the end of the study
Enable Worklist import (refer to DICOM section 7)

5.3.4. Capture Settings

Import images from folder to set the directory where captured images will be automatically transferred to
the patient study. Default value is C:\nvtemp.
Capture program to set the default program where the capture device is launched from the patient study.
Camera Type use the dropdown to pick the camera your office uses Available choices are Topcon 50A,
Topcon 50B, Topcon NWA, Topcon 50EX-A, Topcon 50EX-B, Zeiss FF4, Topcon 50EX-C, Canon CR2,
Topcon 50EX/DX-L, Canon EOS R and Megavision 50DX/50EX
Image orientation to set how the images are displayed when automatically transferred to the patient study.
Available choices are Normal, Rotate, by 180 degrees, Flip Vertical and Flip Horizontal.

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5.3.5. Post import

Archive imported image is a mandatory field.


Crop dark area using mask setting will automatically crop dark area of every image imported via C:\nvtemp.
Cropping mask selection is made with Image Mask Settings to match the fundus camera image. Use only
with guidance from your technical representative.
Patient ID entry is a mandatory field
‘Capture not running’ warning is a mandatory field.
External Capture Timer support is a mandatory field that will ensure each photo is properly timestamped

5.3.6. Use LDAP

This option allows you to connect your nvfundus software to your LDAP server.

5.3.7. Right Side Buttons

Visible only with


DICOM version

Visible only with Non-


DICOM version

Visible only when i2k


Mosaic is purchased

Visible only when LDAP


check box is selected

Apply Will save all changes


Cancel Will ignore any changes
NOTE: The next option is only visible when the DICOM version is purchased.
DICOM Settings see section 7 New Vision DICOM Integration for details
NOTE: The next option is only visible with the standard version.
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Transfer Settings see section 6 Automatic Transfer for EHR/EMR for details.
Change Password Will allow you to change the password of the current user
Add New User Will allow you to add new users
NOTE: The next option is only visible if “Enable mosaic Montage” is selected.
Mosaic Settings Controls how the Mosaic is generated and the format of the resulting image

NOTE: The next option is only visible if “Enable LDAP” is selected.


LDAP Settings Controls the connection parameters for your LDAP server. (Contact you systems
administrator for correct settings.)

5.4. Archive and Backup

Click the Archive button on the main menu.

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5.4.1. Storage Type

There are three radio buttons located at the top of the Archive dialog box describing storage type.

Remote Storage Only


This choice allows you to remove the images from your hard drive. The patient listings remain on your
home screen. To retrieve images for these patients, you must have access to the media created by the
archiving routine. You will set the path or browse to the directory where your archive file is located. When
accessing the archived patient records, New Vision will show you which archive file number to use.

Remote Storage Only allows images to be transferred to the CD/DVD, archiving media or network
environment.
NOTE: We do NOT recommend using a USB flash, jump or thumb drives for permanent storage of your
images as these devices are not stable over the long term.
Backup Only
This option allows you to save the images to another device: CD/DVD, USB, archiving media or network
environment. The images are not removed from the hard drive.
NOTE: This is the default selection and should always be used if you wish to maintain the original patient
images available from the computer without having to load other media.

Purge Local Copies


This option should be used with caution as it will permanently remove all images from your local machine as
of the date chosen in the “Date filter”! Make sure have used the Backup feature and have a reliable backup as
of the same date you chose for the Purge! For example, if you chose to purge all data up to and including
February 1, 2019 but you last backup was completed on January 1, 2019 you will lose all images taken
between January 2nd and February 2nd!

5.4.2. Date Filter

A pull-down calendar to select the date archiving/backup operation will begin. Default is today’s date.

Archive Images

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To create an archive of the patient images in your database, click the Archive images button.

Backup Database

To create a back-up of the patient information in your database, click the Backup Data button.

5.5. Archive and Backup Settings

Save button is only


visible if changes have
been made

5.5.1. Backup folder section

Directory Path
In order to archive to a folder on a network or external hard disk, browse or type the path in the
Directory Path settings box. The images are archived to the external environment. To archive to
the network, right click the My Computer and connect to network drive. Select the drive and folder
where you want to archive. Every time you turn on your computer, the computer will connect to
this drive. Select this archive folder from the Directory Path in the Device Settings option. To
archive to external location, create a folder named Archive into the drive. Select Directory Path to
this folder.

Archive Label
After archive operation, there will be an archive label number given by the software. This number
is automatically assigned and shown in the Archive Label box. This number cannot be changed.

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Backup database
When this box is checked the database will be backed up along with the images. (Recommended
setting)

5.5.2. Automatic backup section

This section allows to decide when and how often you want your backups to run.
● Disabled – Backups will only occur when press the “Backup Database” button
● Daily – This option allows you to automatically backup your data every day.
● Weekly – This option allows you to pick a single day of the week to automatically run your backup
● Monthly – This option will automatically run your backup once per month
● Time to run – This option lets you decide if the backup will run when you start the program or when
you exit from the program
● Weekday – This option becomes available when the Weekly radio button is chosen
● When done – This option becomes available when you choose the “On program close” option on the

“Time to run” dropdown.

Viewing Archived Images


In order to view the archived images of a patient, click the study details of the patient. There will be a message
displayed asking you the label number where the images of this patient and study were archived (i.e.
Z:\Fundus 1016). Insert the media or browse to the network drive and click OK. These images will be loaded
in the study details as thumbnail images.
NOTE: If you process, edit, etc. the archived image, you must Save As this image so that the new image will
be saved to the hard drive.

VERY IMPORTANT: There is always risk of data loss due to computer or software crashes. In order to
avoid any data loss, archive your images and backup the database regularly. Archiving and back up is always
the responsibility of the customer.

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5.6. Activity Log

From the home screen, select the Activity Log icon.

The Activity Log can serve as a daily log for your records. Activity logs can be printed for a given date or
range of dates at any time. Use the pull-down calendar to select the desired date(s).

You may also export the results to a .csv format for use in Excel, Google spreadsheet, etc.

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6. Automatic Transfer for EHR/EMR
Select Image Settings from the home screen. Select Export Settings to access the transfer engine for EMR
and EHR programs.

6.1. Transfer Options

Check the box “Enable Image Storage to EMR” to activate this feature.
“When study is closed” Will automatically transfer patient images each time a new study is completed
“When program is closed” Will automatically transfer patient images each time you exit NewVision Fundus
NOTE: When a newly created study is closed or New Vision is closed, a dialog box will pop-up to confirm
transfer.
“Manual transfer” Allows you to select individual images from a patient’s study to transfer

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6.2. Target Settings

Browse to the drive where images will be transferred/stored. You may also create a new sub-directory for
each session by selecting the “Create a new subfolder…” checkbox.
The file format may be chosen from the pull down

You can also customize which fields are transfer by choosing “<custom>”. Available fields are listed on the
right side of the dialog box. Click on the Custom Format field to unhide the available fields.

NOTE: Curly braces “{ }” surround each keyword field. Each field must be separated by any character, except
curly braces.
NOTE: Original patient images and data remain in the database and are not altered.

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7. New Vision DICOM Integration
New Vision Fundus Medical Imaging Suite software is a medical imaging system that features patient data
export using DICOM Network protocol as well as DICOM Modality Performed Procedure Step.
DICOM is Digital Imaging and Communications in Medicine (DICOM) Standard and can be referenced free
at https://www.dicomstandard.org/.
Our DICOM Conformance Statement is included when New Vision DICOM is purchased and is also available
at our website https://fundusphoto.com/.
Set-up screen for DICOM is accessible via Image Settings from the home page.

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Complete the fields listed in the screen above to connect to a DICOM compatible application. Consult with
your DICOM provider for complete installation details of the information required to connect to your system.

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8. Manual & Automatic Image Enhancement
8.1. Manual Enhancements

Drag Mode Fit to Page


Magnify Glass

Adjust Brightness Magnifier

Adjust Contrast Invert Image Color

Adjust Sharpness Apply Red-Free Filter

Adjust Gamma Apply Emboss Filter

Display RGB Colors on Image Display-Edit Color Levels

Red, Green, Blue Adjustments

Save As Snapshot Save Changes as New Image

Edit Image in New Window Undo Last Operation

Rotate 90o CCW Rotate 90 o CW

Flip Image Vertically

New Vision allows you to manually or automatically enhance images to bring out details that otherwise
might be missed.

8.2. Auto Enhancements


AE - Aggressive

Automatic Enhancement (AE)


AE - Medium

Cataract FA Enhancement Color Enhancement

Haze Enhancement

After capture and display in New Vision, you may also apply enhancing settings. Enlarge desired image,
select one of the three enhancement icons and then save as a new image. This new image will be
designated as image number/letter (i.e. “2e”) and will appear next to the original image. There are six
enhancement tools along the bottom of the screen shot area. Three increasing auto-enhance icons most
suitable for FA, FAF and ICG images. The bottom row includes icons for Cataract FA, Haze and Color
enhancements.

NOTE: Edited images saved to study do not replace original images. Original images remain unaltered.

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9. New Vision Web Review
New Vision Review option allows review and editing of images from exam rooms throughout the clinic, as
well as on any mobile device. No applications are installed on any review stations, whether on desktop or
mobile. New Vision Review access is only allowed on your network when granted security permissions you
approve. New Vision Review is only available with purchase of the New Vision Review license.

As with all New Vision versions, icons support hover text so that whenever you hold your mouse pointer on
an icon for a moment, text displays telling you the icon’s function.

In order to access New Vision Review type ‘localhost’ into the address bar of your browser and hit enter:

9.1. Log-In
Launch the application and log-in with username of master and password master. Other usernames and
passwords may be created and managed in User Administration.

9.2. User Administration


Along the top of the Main Page is the area managing user access. Administrator access is only available to a
User Type set up as an Administrator. Operator User Type does not have access to this area.

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9.3. Main Page
This is the page that opens when New Vision Review is launched. All patients are listed here. Sort the display
by clicking on any field header at the top of a column. Alternating clicking on these fields’ sorts ascending
and descending order. Clicking on Last Study Date in descending order is a convenient option to easily show
the most recent patient.

45
9.4. Patient Images
Click on any patient name (first or last name) to display patient visits.

9.5. Patient Images


Click on study date to display patient images.

9.6. Individual Images


Date, time, image number and FA timer stamp is displayed in upper left corner. Pull down for image tools
also available in upper left corner.

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9.7. Image Tools
Hover text on each icon for definition. The undo icon is shown once an editing operation has been selected.
Note there are six image auto-enhance icons, as well as individual controls for adjusting brightness, contrast,
sharpening and gamma.

Any edit made to an image may be saved as a new image to the study by clicking the save icon.
NOTE: The “Undo” icon will appear after the first change is made.
NOTE: Edited images saved to study do not replace original images. Original images remain unaltered.
NOTE: Deleting an image may only occur at capture station.

9.8. Compare Images in current study and Compare Images to previous


studies

The nvfundus software allows you to compare multiple images from either a single study or multiple studies.

9.8.1. Comparing Images – Single Study

Select the images you wish to compare by using a single mouse click. The selected images will have a red
border and the number of images selected is also displayed in the bottom right hand corner. For best results,

47
select a number of images that will yield large enough images on the Compare Results screen to be useful
(i.e. 4, 6 or 8 depending upon the size of your monitor). Once you have selected the images click the compare
button.

The Compare Result screen will allow resizing, joint or independent dragging, fit to height and fit to width.

9.8.2. Comparing Images – Multiple Studies

When comparing images in one visit to a different visit, the process is nearly the same. Select the images you
would like to compare in the same manner as above. Then click the “Add to Compare” button.

Select more images from the same study or click on the ‘Back to Patient details’ link and pick a new study.

Chose the study and images you would like to add and click ‘Compared Selected’ button.

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NOTE: Each image is marked with the Patient Name, Study Date, Timer information (if available) and the
image number in relation to the study it was from.

NOTE: Stereo viewing may also be accomplished by using Compare to arrange two color images in such a
way as for you to use a stereo viewer or other method to simulate stereo viewing.

NOTE: Compare may be used to compare any patients and visits as it is not limited to only the patient open
on your screen. For example, if you wanted to compare a group of DR patients for study purposes, you may
follow the same process.

9.8.3. Comparing Images – Screen Controls

The basic screen controls are Zoom (up to 100%), Layout (number of columns 1 – 4), Dragging (Joint or
Independent), and 3 sizing boxes (fit to width, fit to page & fit to height),

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10. Digital Camera Settings
Ensure the mode selector is set to “M” for manual.
Shutter speed, ISO and fundus camera flash level determine the exposure.
We use shutter speed at 1/20 second for all images. Adjust your flash settings as you have in the past.
Here are good starting points2 for ISO and fundus camera flash level in each mode. Use the box to the
right to note your optimum settings. Increasing ISO and/or flash level lightens images, decreasing ISO
and/or flash level darkens images.
Color fundus = 100 ISO and 18 Color fundus = ____ ISO and ____
Red-free = 400 ISO and 36 Red-free = ____ ISO and ____
F/A = 1250 ISO and 150 F/A = ____ ISO and ____
FAF = 2000-2500 ISO and 200 FAF = ____ ISO and ____
ICG = 2500-4000 ISO and 300 ICG = ____ ISO and ____
2
This is general guidance and the condition of your fundus camera flash tube, optics, patient position
and media condition may yield varying results.

Auxiliary filter selection with FAF and ICG Fundus Photo Systems:
When shooting color fundus, set fundus camera dial to “N”, use the light blue filter in the slider middle position.
Follow fundus camera procedure.
When shooting red-free, set fundus camera dial to “G”, use no additional filters. Follow fundus camera procedure.
When shooting F/A, set fundus camera dial to “N”, use no additional filters. Follow fundus camera procedure. 3
When shooting FAF, set fundus camera dial to “F2”, use the yellow/green filter in the slider outer position.
When shooting ICG, set fundus camera dial to “F1”, use the dark infrared filter in the slider outer position. 3
3
For timed tests (F/A, ICG), select “Start Timer” prior to first image capture. Timer operation begins when the first
image appears on the patient study screen (thumbnails).
Use “Monochrome” setting for all images, except color images, which uses “Standard” setting.

Start-up Procedure
Turn on computer, launch New Vision Imaging Software
Open or create a new patient
Open a new study
Launch Run Capture
Turn on Fundus Camera and then turn on Digital Camera
Use the task bar icons (lower left) to move between programs. Do not close imaging or review programs.

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11. Capture Advance Settings
Back in Section 3.10 we touched on the basic Capture settings. Once again, we would like to point out that the
standard settings work extremely well in most cases and we recommend you using the default settings when
possible.

11.1. Screen Tour

Image Presets

Add, Delete,
Custom Image
Cancel, Update, &
Factory Settings

Aperture Setting
(1.0 -> F91) Shutter Speed
(1/8000 -> 30 sec)
Film Speed
White Balance
(50 -> 25600)
(Auto, Daylight,
Tungsten & Flash)
Style
(Standard or
Monochrome) Quality
(Small Normal,
Small Fine, Middle
Fine & Large Fine)

Click to invoke
Timer

You can easily change any of the above parameters on the fly my simply placing your mouse pointer over
the one you would like to adjust and use the roller wheel on your mouse to change that parameter.

Roller Wheel

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11.2. Changing, Saving and Restoring Style Defaults
As you make changes to the various parameters you will notice that the Cancel, Add and Restore buttons will

become active.
If you happened to make changes by accident or on purpose you can easily revert to the default settings by
clicking the cancel button or the restore default settings button
If you want to save the changes you made you have two options.

1. You can simply click the update button and your new settings will be saved under the name
you are currently under. Example COLOR. Now don’t fear if you ever want to return to the
default settings for any preset style you changed just simply click the default settings button.
2. You can also add your own custom style independent of the presets. Please see the next section
for detailed instructions.
11.3. Creating Your Own Style Definitions
You decided you would like to keep the standard styles, but you do need a custom style for the special
exams.

1. First click the Add button This will clear the fields.

2. Enter a Name for your Style and adjust the parameters to meet your diagnostic needs.

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3. Once you have the settings the way like them press the Update button and your custom style
will appear in the top section.

4. You may delete your custom styles by highlighting the style and clicking the delete button

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12. Request Support
This feature allows the user to submit trouble tickets in a quick and effortless manner. In order to initiate a

trouble ticket simply click the icon on the bottom right corner of the main screen. The first thing that
will happen is you will see a pop-up window that shows the results of some quick tests:

Please note any items that do not have a green check mark clicking on “Send Ticket” button. Clicking this
button will open the follow browser window:

Provide your name, E-mail, phone number, Description of your issue, and attach any relevant Screenshots or
documents that you feel will help. Once you have filled out the fields hit the submit button. You will receive
a conformation screen that your issues had been received. All pertinent log files are automatically sent to our
team so they can troubshoot your issue as quickly as possible.

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13. GLOSSARY
Av – Aperture Value
EHR – Electronic Health Record
EMR – Electronic Medical Record
FA – Fluorescein angiography
FAF – Fundus autofluorescence
HASP – A slotted hinged metal plate that forms part of a fastening for a door or lid and is fitted over a metal
loop and secured by a pin or padlock
ICG – Indocyanine green
ISO – Relates to how sensitive the film or sensor is to light. The higher the number the more sensitive to light
and the grainier the image will appear
Tv – Time Value (Shutter speed)
WB – White Balance

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