Riester Diagnostic Set ri-scope® L otoscope and ophthalmoscope Set Rev B June 2009

2. Battery handles and initial use 2.1. Purpose The RIESTER battery handles described in these Operating Instructions serve to supply the instrument heads with power (the lamps are contained in the respective instrument heads). They also serve as holders. 2.2. Battery handle range All the instrument heads described in these Operating Instructions fit on the following battery handles and can therefore be individually combined. Furthermore, all instrument heads fit the handles of the ri-former® wall model. Caution: LED instrument heads are only compatible with the ri-former® diagnostic station above a certain serial number. You may obtain specifications on the compatibility of your diagnostic station on request. For ri-scope® L otoscopes, ri-scope® L ophthalmoscopes, perfect, E.N.T., praktikant, de luxe®, Vet, slit and spot retinoscopes, ri-vision® a)

Type C battery handle with 2.5 V rheostat To operate these battery handles, you require 2 commercial Type C Baby alkaline batteries (IEC standard designation LR14) or a 2.5 V ri-accu®. The handle with the RIESTER ri-accu® can only be charged in the RIESTER ri-charger®. b) Type C battery handle with 3.5 V rheostat To operate this battery handle you require two CR 123A type commercial lithium batteries (Caution: only with reduction sleeve + resistance socket) or a ri-accu® L 3.5 V. The handle with the RIESTER ri-accu® L can only be charged in the RIESTER ri-charger® L. c) Type C chargeable battery handle with or without sensomatic® 2.5 V or 3.5 V function with rheostat to charge from the mains 230 V or 120 V The handle is available as a 2.5 V or 3.5 V model and can be ordered for 230 V or 120 V operation. Please note that the handle can only be used with the RIESTER ri-accu® or ri-accu® L. d) Type AA battery handle with 2.5 V rheostat To operate these battery handles, you require two commercial Type AA Baby alkaline batteries (IEC standard designation LR6) or a ri-accu® 2.5 V. The handle with the RIESTER ri-accu® can only be charged in the RIESTER ri-charger®. e) Type AA battery handle with 3.5 V rheostat To operate this battery handle you require two CR 123A type commercial lithium batteries (Caution: only with resistance socket) or a ri-accu® L 3.5 V. The handle with the RIESTER ri-accu® L can only be charged in the RIESTER ri-charger® L. 20

2.3. Inserting and removing batteries and rechargeable batteries Handle types (2.2. a, b, d and e) Screw off the handle cover on the lower part of the handle. Depending on which handle you have purchased and for what voltage (see 2.2), insert the respective batteries or rechargeable battery into the casing such that the positive ends point towards the top of the handle. There is also an arrow next to the plus symbol on the rechargeable battery, which shows you the direction to insert into the handle. Screw the handle cover onto the handle again. Caution: For lithium batteries (only for Type C battery handle) you require a reduction sleeve (Art. No. 12650) Remove the batteries by firstly screwing off the battery handle cover and then shaking the handle a little. Prior to initial use, the rechargeable batteries (in the Riester battery handle) must be charged in the RIESTER ri-charger®. Separate Operating Instructions are included with every charger and must be observed. Handle types (2.2. c) Prior to initial use of the plug-in handle, it should be charged for up to 24 hours in the mains socket. Caution: The plug-in handle (only for NiMH rechargeable batteries) must not be charged for longer than 24 hours. Screw off the handle cover on the lower part of the handle. Depending on which handle you have purchased and for what voltage (see 2.2), insert the respective rechargeable batteries into the handle casing. For 2.5 V rechargeable batteries take care that the battery is inserted into the handle with the plus end towards the top of the handle; you will also find an arrow next to plus symbol which shows you the direction to insert into the handle. It is irrelevant in which direction 3.5 V rechargeable batteries are inserted. Screw the handle cover tightly onto the handle again. Unscrew the lower part of the handle counter clockwise. The mains socket pins become visible. Round pins are for 230 V mains operation, flat pins are for 120 V mains operation Plug the lower part of the handle into the mains socket for charging. Caution: The handle must never be in the mains sokket when the rechargeable batteries are replaced! If you wish to replace the ri-accu® battery, unscrew the battery handle cover on the lower part of the handle counter clockwise. Remove the ri-accu® battery from the battery handle by shaking down the handle downwards a little. Insert the ri-accu® battery into the battery handle. For 2.5 V rechargeable batteries, take care that the battery is inserted into the handle with the plus end towards the top of the handle; you will also find an arrow next to plus symbol which shows you the direction to insert into the handle. It is irrelevant in which direction 3.5 V rechargeable batteries are inserted. Screw the battery cover clockwise onto the handle. Technical data: Either 230 V or 120 V

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Caution: • If you do not plan to use the device for a long time or if you take it on a journey, remove the batteries and rechargeable batteries from the handle. • New batteries should be inserted once the light intensity of the instrument becomes weaker. • To obtain the best possible light output we recommend always fitting high quality batteries (as described in 2.2). • If you suspect that liquid or moisture could have entered the handle, it must not be charged under any circumstances. This could lead to a life-threatening electric shock, especially in the case of plug-in handles. • To extend the service life of the ri-accu® battery, the ri-accu® battery should only be charged once the light intensity of the instruments has become weaker. Waste disposal: Please note that batteries and rechargeable batteries must be disposed of as special waste. You can obtain the relevant information from your local authority or from your local environmental advisor. 2.4. Fitting instrument heads Fit the required instrument head on the receptacle on the upper part of the handle such that the two recesses of the lower part of the instrument head fit on the two protruding guide studs on the battery handle. Press the instrument head lightly on to the battery handle and screw the handle clockwise as far as it goes. The head is removed by screwing counter clockwise. 2.5 Switching Type C and AA battery handles on and off activate the instrument by turning the switching ring on the top of the handle clockwise direction. To switch off the instrument turn the ring anti-clockwise direction until the device is swithced-off. 2.6. rheotronic® for ,odulation of the light intensity With the rheotronic it is possible to modulate the light intensity for the C and AA handles. Depending on how often you turn the switching ring clockwise or anti-clockwise direction, the light intensity is stronger or weaker. Attention: At every swith-on of the battery handle the light intensity is at 100%

!

Explanation of the symbol on the plug-in handle: Caution: Observe the Operating Instructions!

3. ri-scope® L otoscope 3.1. Purpose The RIESTER otoscope described in these Operating Instructions is produced for illumination and examination of the auditory canal in combination with RIESTER ear

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specula. 3.2 Fitting and removing ear specula Either RIESTER disposable ear specula (blue colour) or reusable RIESTER ear specula (black colour) can be fitted to the otoscope head. The size of the ear specula is marked at the back of the speculum. L1 and L2 otoscopes Screw the speculum clockwise until noticeable resistance is felt. To remove the speculum, screw the speculum counter clockwise. L3 otoscope Fit the chosen speculum on the chrome-plated metal fixture of the otoscope until it locks into place. To remove the speculum, press the blue ejection button. The speculum is automatically ejected. 3.3. Swivel lens for magnification The swivel lens is fixed to the device and can be swivelled 360°. 3.4. Insertion of external instruments into the ear If you wish to insert external instruments into the ear (e.g. tweezers), you have to rotate the swivel lens (approx. 3-fold magnification) located on the otoscope head by 180°. Now you can use the operation lens. 3.5. Pneumatic test To perform the pneumatic test (= examination of the eardrum), you require a ball, which is not included in the normal delivery package, but can be ordered separately. The tube for the ball is attached to the connector. Now you can carefully insert the necessary volume of air into the ear canal. 3.6. Technical data on the lamp HL 2.5 V otoscope: 750 mA average service life 15 h XL 3.5 V otoscope: 720 mA average service life 15 h LED 3.5 V otoscope: 20 mA service life approx. 10000 h

4. ri-scope® L ophthalmoscope 4.1. Purpose The RIESTER ophthalmoscope described in these Operating Instructions is produced for the examination of the eye and the eyeground. 4.2. Lens wheel with correction lens The correction lens can be adjusted on the lens wheel. The following correction lenses are available: L1 and L2 ophthalmoscopes Plus: 1-10, 12, 15, 20, 40. Minus: 1-10, 15, 20, 25, 30, 35. L3 ophthalmoscope Plus: 1-45 in single steps Minus: 1-44 in single steps The values can be read off in the illuminated field of view. Plus values are displayed in green numbers, minus

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values with red numbers. 4.3. Apertures The following apertures can be selected with the aperture hand-wheel: L1 ophthalmoscope Semi-circle, small/medium/large circular aperture, fixation star, slit and red-free filter. L2 ophthalmoscope Semi-circle, small/medium/large circular aperture, fixation star and slit. L3 ophthalmoscope Semi-circle, small/medium/large circular aperture, fixation star, slit and grid. Aperture function Small circle:

to reduce reflection for small Medium circle: pupils Semi-circle:

Large circle: Grid:

Light slit:

Fixation star:

for normal examination results

for topographic determination of retina changes

to determine differences in level

to ascertain central or eccentric fixation

4.4 Filters Using the filter wheel, the following filters can be switched for each aperture: L1 ophthalmoscope The L1 instrument head is supplied without a filter wheel. (the red filter is contained in the aperture wheel) L2 ophthalmoscope Red-free filter, blue filter and polarisation filter. L3 ophthalmoscope Red-free filter, blue filter and polarisation filter. Filter Red-free filter: Polarisation filter: Blue filter:

function contrast enhancing to assess fine vascular changes, e.g. retinal bleeding for precise assessment of tissue colours and to avoid retinal reflections for improved recognition of vascular abnormalities or bleeding, for fluorescence ophthalmology

For L2 + L3, every filter can be switched to every aperture.

4.5. Focussing device (only with L3) Fast fine adjustment of the examination area to be observed is achieved from various distances by turning the focussing wheel. 24

4.6. Magnifying glass A magnifying glass with 5-fold magnification is supplied with the ophthalmoscope set. This can be positioned between the instrument head and the area under examination, as required. The area under examination is magnified accordingly. 4.7. Technical data on the lamp HL 2.5 V ophthalmoscope: 750 mA average service life 15 h XL 3.5 V ophthalmoscope: 690 mA average service life 15 h

5. Slit and spot retinoscopes 5.1 Purpose The slit/spot retinoscopes (also known as skiascopes) described in these Operating Instructions are produced to determine the refraction (ametropias) of the eye 5.2. Initial use and function Position the required instrument head on point of attachment on top section of handle with both recesses of the instrument head bottom section being congruent with the two projecting guide cams of the battery handle. Press instrument head lightly on battery handle and rotate handle in clockwise direction to the stop. Remove head by rotating in counter-clockwise direction. Rotation and focusing of the slit and/or spot image may now be effected by the knurled screw. 5.3. Rotation The slit or spot image may be rotated by 360° by the control. Each angle may be directly read from the scale on the retinoscope. 5.4. Fixation cards Fixation cards are suspended and fixed on the object side of the retinoscope into the bracket for the dynamic skiascope. 5.5. Specification of lamp Slit retinoscope 2.5 V: 2.5 V Slit retinoscope 3.5 V:

3.5 V

Spot retinoscope 2.5 V: 2.5 V

Spot retinoscope3.5 V: 3.5 V

449 mA average life 15 h 690 mA average life 50 h 450 mA average life 15 h 640 mA

6. Dermatoscope 6.1. Purpose The ri-derma® dermascope described in these Operating Instructions is produced for early identification of changes of skin pigmentation (malignant melanomas).

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6.2. Initial use and function Position the required instrument head on point of attachment on top section of handle with both recesses of the instrument head bottom section being congruent with the two projecting guide cams of the battery handle. Press instrument head lightly on battery handle and rotate handle in clockwise direction to the stop. Remove head by rotating in counter-clockwise direction. 6.3. Focusing Focus the magnifying glass by rotating the eyepiece ring. 6.4. Skin adapters Two skin adapters are supplied: 1) Including a scale of 0 - 10 mm for measuring melanotic skin changes, such as malign melanoma. 2) Without a scale Both skin adapters are suitable for multiple removal and replacement. 6.5. Technical data on the lamp 2.5 V ri-derma®: 750 mA average service life 15 h 3.5 V ri-derma® : 690 mA average service life 15 h LED 3.5 V ri-derma®: 20 mA average service life 10000 h

7. Bent-arm illuminator 7.1. Purpose The bent-arm illuminator described in these Operating Instructions is produced for illuminating the oral cavity and the pharynx. 7.2. Initial use and function Position the required instrument head on point of attachment on top section of handle with both recesses of the instrument head bottom section being congruent with the two projecting guide cams of the battery handle. Press instrument head lightly on battery handle and rotate handle in clockwise direction to the stop. Remove head by rotating in counter-clockwise direction. 7.3. Technical data on the lamp

HL 2.5 V bent-arm illuminator: 750 mA average service life 15 h XL 3.5 V bent-arm illuminator: 690 mA average service life 15 h LED 3.5 V bent-arm illuminator: 20 mA average service life 10000 h

8. Nasal speculum 8.1. Purpose The nasal speculum described in these Operating Instructions is produced for illumination and therefore examination of the inside of the nose. 26

8.2. Initial use and function Position the required instrument head on point of attachment on top section of handle with both recesses of the instrument head bottom section being congruent with the two projecting guide cams of the battery handle. Press instrument head lightly on battery handle and rotate handle in clockwise direction to the stop. Remove head by rotating in counter-clockwise direction. For two modes of operation: a) Fast expansion Push set screw on instrument head down with your thumb. This setting does not allow changes in the position of the speculum legs. b) Individual expansion Rotate set screw in clockwise direction until the required expansion width is obtained. Close legs again by turning screw in clockwise direction.

8.3. Swivel lens The nasal speculum is equipped with a swivel lens of approx. 2.5X enlargement which may be simply pulled out and/or replaced in the opening provided on the nasal speculum. 8.4. Technical data on the lamp 2.5 V nasal speculum:

750 mA average service life 15 h 3.5 V nasal speculum: 720 mA average service life 15 h LED 3.5 V nasal speculum: 20 mA average service life 10000 h

9. Blade holder 9.1. Purpose The blade holder described in these Operating Instructions is produced for examination of the oral cavity and pharynx in combination with commercial wooden and plastic blades. 9.2. Initial use and function Position the required instrument head on point of attachment on top section of handle with both recesses of the instrument head bottom section being congruent with the two projecting guide cams of the battery handle. Press instrument head lightly on battery handle and rotate handle in clockwise direction to the stop. Remove head by rotating in counter-clockwise direction. Insert a commercial wooden or plastic tongue blade into the aperture below the light opening up to the stop. The tongue blade is easy to remove after examination by actuating the ejector. 9.3. Technical data on the lamp HL 2.5V blade holder: 750 mA average service life 15 h XL 3.5V blade holder: 720 mA average service life 15 h LED 3.5V blade holder: 20 mA average service life 10000 h

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10. Laryngeal mirrors 10.1. Purpose The laryngeal mirrors described in these Operating Instructions are produced for mirroring or examination of the oral cavity and pharynx in combination with the RIESTER bent-arm illuminator. 10.2. Initial use Laryngeal mirrors may only be used in combination with the bent arm illuminator, thus ensuring maximum lighting conditions. Take two laryngeal mirrors and fix them in the required direction on the bent-arm illuminator.

11.

Operation otoscope for veterinary medicine

11.1. Purpose The RIESTER operation otoscope described in these Operating Instructions is produced exclusively for use on animals and for veterinary medicine and therefore bears no CE mark. It can be used for illumination and examination of the auditory canal, as well as for minor operations in the auditory canal. 11.2. Attachment and removal of ear specula in veterinary medicine Position the required speculum on the black bracket of the operating otoscope, with the recess of the speculum fitting into the guide of the bracket. Attach speculum by rotating in anti-clockwise direction. 11.3. Swivel lens for enlargement The operating otoscope comprises a small magnifying lens to be swivelled at an angle of 360° for a maximum enlargement of approx. 2.5X. 11.4. Insertion of external instruments into the ear The operation otoscope is designed to be open so that external instruments can be inserted into the animal ear. 11.5. Technical data on the lamp 2.5V operation otoscope:

3.5 V operation otoscope:

12.

680 mA average service life 20 h 700 mA average service life 20 h

Operation otoscope for human medicine

12.1. Purpose The RIESTER operation otoscope described in these Operating Instructions is produced for illumination and examination of the auditory canal and for insertion of external instruments into the auditory canal. 28

12.2 Attachment and removal of ear specula for human medicine Place the desired speculum onto the black holder of the operation otoscope so that the recess on the speculum fits into the guide of the holder. Fix the speculum by turning it in a counter-clockwise direction. 12.3 Swivel lens for magnification There is a small magnification lens which can be swivelled 360° on the operation otoscope with approx. 2.5-fold magnification. 12.4. Insertion of external instruments into the ear The operation otoscope is designed so that external instruments can be inserted into the ear. 12.5. Technical data on the lamp 2.5V operation otoscope:

3.5 V operation otoscope:

13.

680 mA average service life 20 h 700 mA average service life 20 h

Replacing the lamp

L1 otoscope Remove the specula fitting from the otoscope. Screw out the lamp counter clockwise. Screw in the new lamp clockwise and replace the specula fitting. L2, L3 otoscopes, ri-derma®, bent-arm illuminator, nasal speculum and blade holder Screw the instrument head off the battery holder. The lamp is located at the base of the instrument head. Pull the lamp out of the instrument head with thumb and forefinger or a suitable tool. Insert a new lamp. Ophthalmoscopes Remove the instrument head from the battery holder. The lamp is located at the base of the instrument head. Remove the lamp from the instrument head with thumb and forefinger or a suitable tool. Insert a new lamp. Caution: The pin on the lamp must be inserted into the guide groove on the instrument head. Veterinary/human operation otoscope Screw the lamp out of the fixture in the operation otoscope and screw in a new lamp.

14. Care instructions Cleaning and disinfection

The instrument heads and handles can be cleaned externally with a damp cloth. They can also be disinfected with the following disinfectants: aldehydes (formaldehyde, glutaraldehyde, aldehyde cleavers), tensides or alcohols. Observe the manufacturers’ instructions under all circumstances when using these substances. All instrument parts, apart from glass parts can be disinfected with alcohols. 29

A damp cloth or cotton buds can be used to help in cleaning and disinfection. It is possible to clean the contact plates (ri-derma®) with alcohol or an applicable disinfectant. Caution Never place the instrument heads and handles in liquids. Ensure that no liquid enters the casing.

15. Spare parts and accessories

You can find a detailed list in our Instruments for E.N.T. and Ophthalmologic Instruments brochure, which you can download at www.riester.de.

16. Maintenance

These instruments and their accessories do not require any specific maintenance.Should an instrument have to be examined for any specific reason whatsoever, please return it to the Company or an authorised RIESTER dealer in your area. Addresses to be supplied on request.

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