Tono-Pen ® XL
6743 Southpoint Drive North
Jacksonville, FL 32216-0980 U.S.A.
1-800-535-4646 or 1-904-296-9600
Copyright © 2000 Medtronic Solan
Fabricado en EE.UU.
Do not use the instrument without an Ocu-Film Tip Cover.
Use without an Ocu-Film Tip Cover will damage the instrument
and void the Warranty.
The Tono Pen XL unit is internally calibrated, thus the instrument calibration should be checked only before the first use each
day or in the event of unanticipated readings. Calibration must
be routinely and successfully performed once daily prior to instrument use. Calibration should also be performed whenever it
is indicated by the LCD display, when batteries are replaced, or
after an unsuccessful calibration. It is not necessary to check
calibration prior to each use.
*Note: If during operation the Operator's Button is pushed only
once and the Tono-Pen displays CAL, the Tono-Pen needs to be
The calibration procedure is as follows:
1. Point the transducer end of the Tono-Pen straight down
towards the tloor.
2. Depress the Operator's Button two times rapidly, (within 1.5
seconds). The Tono-Pen will "beep" and display CAL.
3. Wait approximately 15 seconds for the Tono-Pen to "beep"
and display UP.
4. I mmediately (within I second) invert the Tono-Pen smoothly,
pointing the transducer end straight u~.
5. A properly functioning Tono-Pen will display Good followed
by a "beep".
6. Repeat this Calibration Procedure if bAd is displayed.
7. After Good is displayed, depress the Operator's Button
one time and the Tono-Pen will display 18.104.22.168], followed by
a single row of dashes, 1- - - -1, and then by a double row of
dashes =__ 1 followed by a "beep" tone, indicating the
instrument is ready to measure IOP (Depressing the activation
button a second time will interrupt this process and send the
unit to calibration mode).
4.2.1 Unsuccessful Calibration
if several consecutive attempts at checking the calibration are
• Loosen or remove the Ocu-Film Tip Cover from the Tono-Pen
XL probe tip and repeat the calibration check.
If still unsuccessful:
• Spray the probe tip with compressed gas (see Section 5 for
details of this proce-dure), and repeat the calibration check.
If still unsuccessful:
• Replace the batteries (see Section 3 for the procedure) and
repeat the calibration check.
*Note: Do not take measurements with the instrument if two
consecutive "good" calibration checks cannot be obtained.
The instrument will not take a measurement when the prior
calibration check was ''bAd".
*Note: If the Tono-Pen XL fails to yield a "Good" calibration,
call Medtronic Solan Technical Service.
4.3 Performing IOP Measurements
After the Tono-Pen XL has been prepared for operation. the
patient must be prepared and then 10P measurements can be
4.3.1 Patient Preparation
Ocu-Film contains natural rubber LATEX which may cause
allergic reactions. Question patients about allergies to Latex
before examining them with the Tono-Pen XL.
To prepare a patient for an IOP measurement:
1. Instill a drop of topical anesthetic onto the eye to be examined.
2. Position the patient, seated or supine, in front of a fixation
target: or have the patient fixate on a point of reference (i.e. ear,
nose, distant object) to minimize eye movement.
*Note: The Tono-Pen XL unit will function in any stable position.
4.3.2 Patient Examination
To perform an IOP measurement:
1. Instruct the patient to look straight ahead at the fixation
target with his/her eyes fully open.
2. Hold the Tono-Pen XL unit as you would a pencil.
3. Position yourself to facilitate viewing of the probe tip and
patient's cornea where contact will be made. For normal
corneas. central corneal contact is recommended.
4. Brace the heel of your hand on the patient's cheek for stability
while holding the Tono-Pen XL unit perpendicular to and within
1/2 inch of the patient's cornea. (See Figure 4-1 for correct
Figure 4-1 Corneal Applanation
5. To initiate an IOP measurement. depress the Operator's
Button once, and only once.
• Initially you will see a brief display of 22.214.171.124. This is a
self-test of the LCD (Liquid Crystal Display). If any of
the LCD segments are not displayed, the Tono-Pen requires
• If a momentary display of ICALI is seen, followed immediately by a single row of dashes I- - - -], it indicates that the
Tono-Pen requires calibration before it will measure.
• If a double row of dashes 1____l is seen and a "beep" tone is
heard. it indicates that the Tono-Pen is ready to measure [OP.
Proceed with applanation within 15 seconds.
*Note: After acquiring the double row of dashes [ J, if more
than 15 seconds elapses prior to applanation, the Tono-Pen
will not measure. The software will have initiated a batterysaving function, indicated initially by the display of a single
row of dashes [- - - -], then followed in sequence by a blank
display [ J. A new IOP measurement can be initiated by
depressing the operators button once.
*Note: Anytime the operator's button is depressed twice within
1.5 seconds. (which may be caused by operator's inadvertent
pressure on the button) the software will interpret this as a demand for calibration. Then a sustained display of/CAL/ will be
seen which initiates the calibration sequence. The calibration sequence must be successfzdly completed before further measurements can be accomplished.
6. Once activated, after [ ==== J is displayed and a "beep" tone is
heard, touch the Tono-Pen XL unit to the cornea lightly and
briefly, then withdraw. Repeat several times. The corneal surface needs only to be momentarily contacted: indentation is
not required and may lead to inaccurate readings.
7. A chirp will sound and a digital lOP measurement will be
displayed each time a valid reading is obtained. The single
horizontal bar at the bottom of the LCD, indicating statistical
reliability, will not be displayed with each single IOP measurement.
8. After four (4) valid readings are obtained, a final beep will
sound and the averaged measurement will appear on the
LCD along with the single bar denoting statistical reliability.
*Note: If a single row of dashes [- - - -] appears on the LCD after
the final beep, an insufficient number of valid readings was collected. If this occurs, repeat the patient examination procedure,
9. To take another measurement, reactivate the Tono-Pen XL
unit by pressing and releasing the activation switch as
described in step 5.
*Note: If not reactivated within 25 seconds, the Tono-Pen XL unit
will automatically turn off and the LCD will clear, placing the
device in sleep mode, to conserve battery life. If this occurs,
activate the Tono Pen XL by pressing the Operators Button once.
10. Replace the Ocu-Film Tip Cover before using the TonoPen XL unit on another patient and before storage.
*Note: Failure to replace the Ocu-Film Tip Cover between
patients may result in unreliable readings of IOP by allowing
debris to enter the transducer assembly.
*Note: A reused Ocu-Film Tip Cover may leak. This may
cause damage to the strain gauge and void the Warranty.