Attachment 1 - SOW Optometry Equipment.docx

STATEMENT OF WORK (SOW)

Optometry Equipment

The Salt Lake City Veterans Health Care System is in need of the following items for the newly activated Pocatello Optometry Community Based Outpatient Clinic (CBOC):

1. Lensmeter

2. Binocular indirect

3. Slit lamp switch for refraction desk

4. Slit lamp switch prewire kit

5. Refraction desk prewire kit

6. Standard refraction desk

7. Refractor reading card holder with card

8. Refractor reading rod

9. Plus cylinder phoropter

10. Tonometer with prism

11. Slit lamp

12. Patient chair

13. Slit lamp stand

Description:

1. A Lensmeter is an ophthalmic instrument that can measure the prescription of eyeglass lenses including sphere, cylinder, axis, prism, add power, and optical center of the lens. This enables the eye doctor to determine the prescription of the lenses to confirm the lenses were made correctly. It also allows the doctor to know what the current prescription is of a patient who is new to clinic giving the doctor a baseline of what the patient is currently using to see.

2. A binocular indirect is an ophthalmic instrument that the doctor uses to exam the entire retina of the patient’s eye including the far periphery that can not be seen using a slip lamp to perform the exam. It also allows the doctor to see other structures in the eye including the optic nerve. This device is important to have a complete eye exam but it can also be used with patients in wheel chairs or who have mobility problems who cannot position correctly into a slit lamp for examination.

3. A slit lamp switch for refraction desk allows the user to adjust the power, brightness, and slit width of the slit lamp light source.

4. The slit lamp switch prewire kit is the prewiring kit before the switch to the lamp and is necessary to connect the electrical components.

5. The refraction desk prewire kit is the wiring kit to allow the desk electronics to work.

6. The standard refraction desk has a large writing surface for the doctor to place various tools and equipment during an exam. These desks have ample storage space including an angled drawer for a trial lens set. The desk has electronics that allow control of room lighting, fixation lighting, and be able to recharge handheld instruments all directly from the desk.

7. The refractor reading card holder with reading card works with the phoropter to check near visual acuity as well as determine the prescription for near visual acuity. Most cards have 12 sets of tests, 6 on each side of the card.

8. The refractor reading rod holds the reading card holder at a distance that can be determined by the optometrist. It also holds the card steady so the patient can focus without the card moving or shaking as if a person were holding it. This allows the optometrist to determine the correct placement to check near visual acuity.

9. The plus cylinder phoropter is an ophthalmic testing device. It is commonly used by eye care professionals during an eye examination, and contains different lenses used for refraction of the eye during sight testing, to measure an individual's refractive error and determine their eyeglass prescription. It also is used to measure the patients' phorias and ductions, which are characteristics of binocularity.

10. A tonometer is an ophthalmic testing device the allows Tonometry which is a quick and simple test that checks the pressure inside your eyes. The results can help your doctor see if you're at risk for glaucoma.

11. The slit lamp is a microscope that the optometrist uses to examine a patients eye. A bright light can be adjusted to focus the light on different structures of the eye to diagnose and treat ocular diseases. There are multiple light color filters and magnification levels to help the doctor examine the patient’s eye.

12. The exam chair is where the patient sits during the examination. The chair has electronics to make adjustments to the height and tilt of the chair so the doctor can get the best position to person a microscopic exam using the slit lamp. The chair can also lay flat in a reclined position to perform in office procedures.

13. The slit lamp stand holds the microscope the doctor uses to examine the patients eye. The stand can move up and down while also moving towards and away from the patient. This gives the patient the best and most comfortable experience during the exam. The stand also has charging ports to recharge the hand held equipment the doctor uses. The stand also has a built in light source the doctor can move to illuminate the patient or equipment being used.

Salient Characteristics:

1. Lensmeter

a. Type Ocular type; external reading

b. Target American Cross-line

c. Vertex Power Range: +25 to -25 diopters Step: 0.125 diopters up to ±3 diopters 0.25 diopters beyond ±3 diopters

d. Cylindrical Axis Range: 0 to 180 degrees Step: 1 degree

e. Prismatic Power Range: 5 prism diopters in field of view (20 prism diopters by prism compensator) Step: 1 prism diopter

f. Eyepiece Focusing +5 to -5 diopters

g. Diameter of Lenses Accommodated 24 to 90mm

h. Lamp AC 100V (LED illumination)

i. Target Illumination Switchable Dual color, Green/Orange LED (2V 25mA)

j. Power source DC 5V 1.2A (AC adapter 100~240V 50~60Hz 0.5A) 2 Each 1.5V D size battery (included)

k. Tilting Angle 0 to 90 degrees General

l. Standard Accessories 7mm nosepiece, prism compensator

2. Binocular Indirect

a. Stereoscopic Adjustment Technology – 3D imaging for any pupil size and peripheral views

b. Yellow, blue, or red-free filter to adjust diagnostic needs

c. Non-Reflective front glass for better view

d. Ultralight lithium polymer battery – Up to 8 hours operating time

e. Intuitive locking of the optics unit

f. Durable, faux leather padding

g. Cable-free design

h. Easy disinfecting due to integrated electronics, dust-proof optics, and lack of openings

3. Slit lamp switch for refraction desk

a. The switch needs to allow the optometrist to adjust the power, brightness and width of the slit lamp light beam.

4. Slit lamp switch prewire kit

a. The slit lamp switch prewire kit needs to connect the switch to the slit lamp to connect the electric current.

5. Refraction desk prewire kit

a. The prewire kit connects the desk to an electrical source to allow the features of the desk to work.

6. Standard refraction desk

a. 61” x 23 ¾” x 25”

b. Angled drawer for standard size trial lens set.

7. Refractor reading card holder with card

a. Front Side:

· Card 1: Reading 20/60 to 20/20

· Card 2: Reduced Snellen 20/50 to 20/20

· Card 3: Cross Cylinder Grid (fine lines)

· Card 4: Horizontal Line of Letters

· Card 5: Single Row of 20/20 Letters

· Card 6: Nearpoint of Astigmatic Chart

b. Reverse Side:

· Card 7: Reading 20/200 to 20/80

· Card 8: Reduced Snellen 20/200-20/60

· Card 9: Trifocal Chart

· Card 10: Vertical Line of Letters

· Card 11: 7 Rows of 20/20 Letters

· Card 12: Cross Cylinder Grid (heavy lines)

8. Refractor reading rod

a. Full 28" rod to trifocal range. Smoothly gliding

9. Plus cylinder phoropter

a. Sphere:

-19.00D to +16.75D 0.25D Steps +0.12D Sphere in auxiliary dial included

b. Cylinder Power:

0.00D to 6.00D 0.25D Steps Plus or minus lens system optional 0.12D and 2.00D accessory cells included

c. Cylinder Axis:

360 degrees (Double 0 to 180 degrees scale) 5 degrees graduations

d. Cross Cylinder:

± 0.25 ± 0.37 or ± 0.05 Optional

e. Prism:

0 to 20 Prism Diopter, 1 Prism Diopter graduations

f. P.D.:

48 mm to 75 mm, 1 mm graduations

g. Vertex Distance:

13.75 mm (normal) Graduations extend range by 6 mm

h. Reading Distance:

5 to 28 inches Centimeter and diopter scales included

i. Auxiliary Dial:

10 lenses plus 2 open apertures

10. Tonometer with prism

a. Measurement range

i. 0-80mm Hg

b. Weight

i. Approx. 1.6 lbs.

c. Backlash width

i. <0.49 mN

d. Measurement deviation

i. The measurement in the measuring prism is in the measurement range from 0-58 .84 mN and amounts to a maximum of -+1.5% and to a minimum of -+0.49 mN of the nominal value.

11. Slit lamp

a. Illumination Light-source LED

b. Slit width 0 – 8 mm continuous

c. Slit length 1 - 8 mm continuous

d. Illumination field diameter ø 8, 5, 3, 2, 1, 0.2 mm, Test mark with fixation star

e. Slit image rotatability ± 90°

f. Swiveling of the slit illumination to the microscope axis Horizontal ± 90°, vertical 0 – 20°

g. Filters Blue, red-free (green), grey (10 %)

h. Microscope Stereo angle 13°

i. Magnification changer 1 x and 1.6 x

j. Magnification with ocular 10 x (standard) 10 x and 16 x

k. Magnification with ocular 25 x 25 x and 40 x

l. Range of adjusting eye-pieces +8 to -8 diopters

m. Inter pupillary distance 54 – 94 mm

n. Instrument base Operation Single handed 3-dimensional operation of the control lever

o. Spatial adjustment of the instrument base 100 mm (length), 100mm (side), 30mm (height)

p. Power supply LED 100 - 240 V mains voltage 50 - 60 Hz operating frequency

12. Patient chair

a. Diameter: 24 1 /4”,

b. Depth of chair (without headrest) table position: 60”

c. Seat: 18 3 /4” wide, 18 1 /4” deep

d. Two base heights. HIGH: 23 5 /8” lowered, 34 1 /4” raised. LOW 21 1 /8” lowered, 29 5 /8” raised.

e. Distance between armrests: 19”

f. Standard electric: 120 volts, 50/60 Hz, 6.3 amperes total. Optional electric: 230 volts, 50 Hz, 4.0 amperes.

13. Slit lamp stand

a. Slit Lamp Arm adjusts for instruments weighing between 12 and 60 lbs

b. The Upper Refractor arm have a 10″ vertical range, and handle instruments weighing up to 20 lbs.

c. Height to console: 36’’

d. Height to pole top: 71’’

e. Base: 21x 21’’

f. Electrical (Standard UL Listed), 115 volts, 60 Hz, 3 amperes

g. Optional: 230 volts, 60 Hz, 1.5 amperes

END OF STATEMENT OF WORK