Written Instructions

CONGRATULATIONS ON YOUR PURCHASE OF THE OPTO-SCREEN IOS PUPIL APP

We have provided you with QuickStart Instructions above please refer to them before starting.

After years of research, we developed a methodology for users to visualize the various aspects of the pupil and iris.  We also provide the user with ways to filter and study images of the iris and the pupil.  Our App will also save the image in your memory for export to a PC for subsequent viewing and analysis.  

The App is very useful for determining the roundness of the pupil to understand whether the pupil is compliant with a circular shape by calculating a Pi standard, in two ways.  The first is by an algorithm that looks at the various pixel colors of the pupil within the circle and square.  The second method equally useful is to calculate Pi by simply firing pixels into the square and determining the ratio between the pixels in the circle versus the square.

Our research has indicated that the calculation of Pi, which is 3.14, is the best way to determine the relative circularity of the pupil.  More information on how we calculate Pi can be read below.

This product is Patented by the USPTO, Number: 10,182,755

Users should not attempt to use their personal smartphone camera in the absence of the Opto-Screen App to image the pupils.  Pupils should only be imaged using the Patented Opto-Screen App.

We will be providing you with a step-by-step procedure for imaging the pupils of the eye.

In settings, users may elect to close notifications.  Go to General, Notifications, Show Previews:  Select “NEVER” when taking photos with the App.  This way banners will not pop up and interfere with taking photos. It can be reselected afterward.

The first step is to open the App.   Since we have designed a very sensitive instrument, we would like to recommend that all other applications be closed when using the Opto-Screen App.  We also recommend that only one version of the App should remain open while using and that you close the App between uses.

The quality of the original photo will allow for the best readings. 

Be sure to take the photo in a well-lit room indoors, away from windows.  Indoor Rooms with a lot of direct outdoor light from windows can affect the photo, they should be avoided.   Be sure to zoom into the pupil at approximately 1-4X magnification.   Users may be able to visualize the iris and the pupil outdoors, but this will affect the readings since pupils are constricted outdoors.  It may be possible under certain conditions to improve outdoor reading by using an external LED light source.  However, it is recommended that photos be taken indoors.

Step One:  Refresh the App.  Be sure the App is running only one copy, swipe to clear previous versions.

Be prepared to take four photos, two of each eye, using an LED external light source on the side of each eye. When using an external LED light source flash is not necessary (see QuickStart Instructions).

Use the App’s camera, and point at one single eye, take your time and keep the camera steady. It is important to keep the camera steady; using the external LED light source will make taking the photo much easier and quicker. Wait until the picture is fully captured even when you see it on the screen, before moving the camera after clicking, wait until the shot is set in the APP.

Zoom into the pupil to get a good view of the pupil with at least 1X-4X zoom.  We recommend staying between 4 to 8 inches from the eye.  With practice, and the external LED light held to the side of the eye you will be able to take a great photo, from the correct distance and the right Zoom. Don’t worry if you see light on the iris from the external light source. It’s appropriate to ask the patient to hold the small handheld light source on the side of the eye.

 Take the photo.  You will find that the pupil will be visible with even the darkest pupils when using the external light source.   Zoom into the pupil 1X-4X.  After the photo is taken you will see the iris distinct from the pupil.

Step Two– Examine the image and determine how best to pinch and crop the photo and which filters to use.  The purpose at this point will be to determine whether the pupil is round, thereby normal, or some other abnormal shape.  By filtering, you will be able to determine whether the pupil has the normal round characteristic shape.  You can look for pupil dyscoria, tonic pupil, synechia, anisocoria, and iritis in the photos. A pupil with a rectangular shape may mean the person is taking fentanyl.

Users should not attempt to use their personal smartphone camera in the absence of the Opto-Screen App to image the pupils.  Pupils should only be imaged using the Patented Opto-Screen App.

Step Three–  Performing  the calculation of Pi:

We offer two methods to document whether a pupil is normal, or abnormal i.e., pupil shape.  There are also 5 filters available to allow users to closely examine the pupil photo and also to calculate Pi.  It may not be necessary to filter to obtain an accurate reading.   However, after filtering calculations can also be performed.  After filtering look to see that the RGB readings are above .15 in order to determine the quality of the Pixel Color Reading.

FIRST READING OF PI:

Pixel Color Reading top left side of the screen.  This calculation reads the color of the pixels in the circle and the square.  The Pixel Color Reading can alert you to a potential aberration in the pupil and also can alert you to a misaligned photo or poor-quality photo.

In some cases, you may want to retake the photo with more Zoom.  You may also want to retake and hold the camera steady without movement while the camera fully completes the shot and stores the photo in the App.

 After practicing users should be able to look into the screen and determine the quality of the shot before snapping the photo an external LED light held to the side of the eye makes the pupil much easier to see.

If after examining the pupil photo and determining if the pupil is normal or abnormal the user can indicate by pushing the tab located on the top right side once for a normal pupil indication or twice to indicate an abnormal pupil.  If the user requires a quantification of the abnormal pupil, they can use the Pixel Color Reading, on the (upper left side of the App). 

The Pixel Color Reading (upper left side of the App), is very sensitive to changes in the size and centering of the image on the screen.  It is there to alert you that an abnormal pupil shape may be detected, or that you may want to repeat the calculation or take another photo.

Sub-Readings RGB

The sub-readings are also a good way to determine if you have a good steady frame for your calculations. 

Sub-Reading X & Y Coordinates and Radius

With this reading, you can tell where your photo falls within the Image Plane.

Adjusting the Reading

The Pixel Color Reading may change on the top left, as you precisely place the circle and square around the pupil image for reading.  You will receive a reading after pushing ‘CALCULATE”  It is recommended that you carefully place the circle and square around the pupil.

The Opto-Screen readings are very repeatable

If the users do not move the circle and square slider, they will get the same reading repeatedly over and over, within a small marginal difference.

If the user moves the slider then the readings could change, but at the new position, the readings will again be very repeatable.

SECOND READING OF PI:

Pixel Count Reading

THE MOST IMPORTANT READING IS YOUR OWN PERCEPTION AS TO THE ROUNDNESS AND SHAPE OF THE PUPIL WITHIN THE IRIS. An abnormal pupil is easy to detect.

Documentation of a Normal Pupil:

Pixel Count ReadingThe second reading is on the upper right side of the screen. Calculation of Pi within the Circle, and Square. This reading is a count of the pixels in the circle and square as defined by the user.  When the circle and square are placed over the pupil, you will receive readings close to Pi.   It can only be used when you want to document your perception of a normal round circular pupil, readings close to 3.14, or pi. This reading is not meaningful when detecting an abnormal pupil and will not detect or document an abnormal pupil.

For documenting your perception of an abnormal pupil, we recommend using the left reading, Pixel Color Reading, and pushing the abnormal pupil tab once.  “Abnormal Pupil” will appear, and you can take a screenshot to save. . You can also use filtering to document and clarify the abnormal aspects of the pupil for viewing.

The filtering can be used to enhance a photo where you may have a marginal photo.

These are the recommended steps for filtering:

  1. Exposure
  2. Sepia

After filtering the true contrast between pupil and iris pixels can be improved.  In addition, in some cases, the negative may wash out the pupil, eliminating sharpness, and adding sepia can bring back the pupil for viewing and calculation. It will depend on whether the filtering can improve the RGB.  Often the first two steps: Exposure and Sepia, will prepare the photo for viewing. Users can use “remove” filter to go back to the original photo.