The revolutionary introduction of the 3D Meibomian Gland imaging gives two big advantages. Firstly, it enables to confirm the presence of abnormal glands compared to a healthy subject in a 3D view; secondly, it provides a clear image to share with the patients, to help explain the potential reason of their discomfort.

For the first time, a 3D image can help to understand the structure of the eyelids. lt can show possible diseases of Meibomian Glands and differences with healthy MGs. Patients can see for themselves why they are getting eye discomfort and fluctuating vision. Patients can understand why a specific treatment is suggested.

To be able to View the presence of abnormal gland structures in a high-resolution 3D image. Evidence that supports the diagnosis in the case of evaporative dry eye disease and the explanation of the reasons for the choice of MGD therapy (including IPL).

AUTOMATED LIPID LAYER ANALYSIS
The OS1000 software analyses lipid layer thickness and allows to understand the functionality of Meibomian Glands. lt is possible to carry out a follow up after MG treatment detecting an increase in secretion.

A typical blink pattern can be observed as approximately one blink every five seconds, ie 11 blinks per minute. Incomplete blink can often be observed in contact lens wearers, and frequent blink may be a result of an attempt to maintain a relatively thin lipid layer.

The software automatically detects the coloured lipids on the patient's eye and determines lipid layer thickness (LLT). In a few seconds it is possible to get automatically relevant data to understand functionality of Meibomian Glands.

Tear meniscus prism height analisys automatically evaluated to understand main lacrimal gland functionality and detection of aqueous dry eye.

The human skin surface is known to house millions of bacteria, though some people have more than the average number. Blepharitis is an inflammation caused by some bacteria that lie at the base of eyelashes. They produce dandruff-like flakes in the skin, which lead to infection and inflammation.

Problems with the Meibomian Glands (meibomianitis) in the eyelids can also cause blepharitis. The development of inflammation is also associated with tisk factors such as dandruff, dry eye, acne rosacea, or bacteria.

This test helps in the detection of blepharitis. lt can be performed on the outer surface of the eyeball and eyelids. The process includes: Examining the openings of the Meibomian Glands, base of the eyelashes, and eyelid margins using a bright light. Checking for abnormalities by evaluating the quantity and quality of tears.

The type of blepharitis can be deterrnined based on the appearance of the eyelid edges. If the symptoms frequently exhibited by the patients are mildly sticking eyelids, thickened lid margins, and missing/misdirected eyelashes, then the type of blepharitis is diagnosed as Staphylococcal.

When the patient iS found with blockage Of the Meibomian Glands in the eyelids, poor quality of tears, and redness of the lining of the eyelids, Meibomian blepharitis is diagnosed. If a hard, matted crust is formed on the eyelashes, and after its removal small sores appear on the skin, Ulcerative blepharitis is diagnosed.

WHAT IS DEMODEX BREVIS?
Demodex brevis is a kind of mite found on the skin of humans. Like its counterpart Demodex folliculorum, D. brevis is naturally occurring. D. brevis is so small that mites can't be seen macroscopically.

Most blinks are spontaneous, occurring regularly with no external stimulus. However, a reflex blink can occur in response to external stimuli such as a bright light, a sudden loud noise, or an Object approaching towards the eyes.

A complete blink, in which the upper eyelid touches the lower eyelid, contributes to the health of the ocular surface by providing a fresh layer of tears as well as maintaining optical integrity thanks to a smooth tear film over the cornea.

lt is also well known that wearing contact lenses (both rigid and soft lenses) can induce significant changes in blinking rate and completeness. lt is been established that efficient blinking plays an important role in ocular surface health during contact lens wear and that is improves contact lens performance and comfort.

Thanks to the anterior illumination module, OSI 000 can aquire the lipid layer secrection on the cornea. The device highlights the lipid layer and the software allows to subjectively evaluate the quantity and quality of the lipid component on the tear film.

Meibography is the visualization of the glands through illumination of the eyelid with infrared light. lt images the morphology of the glands in order to diagnose any meibomian gland drop out which would lead to tear dysfunction. Using IR illumination OSI 000 can automatically detect:
• Lid area
• Meibomian glands
• Drop out

The System automatically analyses the images taken through a sensitive infrared camera (NIR) to locate the Meibomian Glands in a guided way:
- An exam valid both for the upper and the lower eyelids
- Automatic percentage of the Meibomian Gland loss area.

Meibomian Gland dysfunction (MGD) is characterised by chronic, diffuse abnormalities of the Meibomian Glands and altered secretion and chemical composition of meibum.

The Os1000 allow an accurate comprehension of the ocular surface and especially the Meibomian Glands. The acquired images are processed and transformed into 3D pictures. Thanks to scientific algorithms it is possible for the physician to see these 3D images, and to show them and explain abnormalities to the patients.

Thanks to one single video, the physician can gain lots of information:
- Automatic NIBUT
- Average of more than one value
- Graph to understand the trend of tear film stability during the video
- Tear topography that shows all breaking the tear film during time.

The stability of the mucin layer and the whole tear film is assessed through the study of non-invasive break up time (NIBUT), by using the Placido rings projected onto the cornea. Tear film stability automatically evaluated without fluorescein:
- First NIBUT
- Average NIBUT
- NIBUT Map
- TF dinamic graph

DYNAMIC PUPILLOMETRY AND WTW Evaluatlon of corneal diameter from limbus to limbus (white-to-white distante, WTW).

The measurement of the pupil diameter has become increasingly important in the field of refractive surgery. Larger scotopic pupil sizes may be partially responsible for the occurrence of postoperative symptoms such as halos, glare, and monocular diplopia.

Refractive surgeons also need an accurate scotopic pupil measurement to determine appropriate treatment zones for excimer laser, corneal, and intraocular surgery.

Acquiring an image of the conjunctiva, it will be possible to compare the patient's condition with different international grading scales.

The thickness of the tear meniscus that is observed on the eyelid margins provides useful information on the tear volume. The tear meniscus can be examined considering its height, regularity and shape.

COMPARING EXAMS / DIFFERENCIAL MAP
Comprhensive summary veiw including elevation / tangential / saggital / refractive power maps with keratometry keratorefractive and shape indices numerical values.

SINGLE MAP
Show in detail results of specific topographic map.

3D
3D visualization of topography maps for an accurate teaching of your patient.

ADVANCED ALTIMETRY
Possibility to refer corneal shape to the best fit preffered and zernike order visualization.
Spherical - aspherical - ashperotoric surface can be selected automatically or manually set up.

ABERROMETRY
Corneal aberrometry can be evaluated on different wave front dimension to evaluate aberration according to zernike orders with the possibility to compare different corneal aberrometry.

VISUAL ACUITY
OSI 000 provides a simulation of the visual acuity trough the selected diameter of the cornea.
Visual rapresentation of PSF-3D

LENS FITTING
Virtual contact lens fitting trough manufacturer database and possibility to export topography results for a custom lens production.
Lens can be selected automatically or manually according to TLT and lens feature.

COMPARATIVE
Compare topography maps and results with previous examination.

DIFFERENTIAL
Prove the efficacy of the refractive procedure showing the changes on patient cornea.

COMPARATIVE ABERROMETRY
Compare wave front aberrometry pre and post refractive surgery or orthoK to show and prove the results to your patient.

(MD L.VIGO Studio Carones Milano) is already provided and suggest treatment on our KOL experience.

All users can customize their own protocol adding treatment procedure to be chosen automatically right after performing the exams (this makes it possible as well to delegate the diagnosis to an assistant).

DATA RESULTS VIEW
A complete and dry eye-focused database allows to understand and properly diagnose the dry eye patient. With the useful data, the ophthalmologist can check the complete tear film assessment, determining all deficiencies and understanding which treatment is needed to approach each case.

DIAGNOSIS SUGGESTION
Ocular surface data and pathology classification. Thanks to Studio Medico Carones with MD. Luca Vigo's experience, the IDRA includes a suggestion algorithm able to share a possible treatment approach for each patient.

TREATMENT MANAGING
Through TREATMENT MANAGING tab, the software allows the physician to fill in the database with all drugs, integrators and treatments available in his practice. Any treatment as vitamins, Omega-3, eye drops, hot packs and IPL/Radiofrequency, can be loaded on the software to prescribe the products of the brands that the doctor prefers.
The whole report with the diagnosis and treatment suggested by the ophthalmologist will be printed directly.

MD. VIGO TREATMENT SUGGESTION
Suggestions for diagnosis and treatment based on clinical procedure of Dr. Luca Vigo and studio Carones (Milan, Italy)

Evaluation of corneal diameter from limbus to limbus (white-to-white distance, WTW).