Ezer Corneal Topographer Onyx Full
The Corneal Topographer Onyx Full is an advanced diagnostic device designed to cater to the diverse needs of eye care professionals. With its array of specialized maps such as the Axial, Tangential, Refraction, Gaussian, and Elevation maps, it delivers precise corneal measurements for assessing shape, curvature, and refractive errors. Additionally, it offers innovative features like Differential and Comparison Maps, aiding in the tracking of changes over time, making it indispensable for monitoring progressive conditions like keratoconus. Moreover, the Onyx Full includes essential tools for contact lens fitting simulation, pupillometry, tear film assessment, and meibography, enabling a comprehensive evaluation of eye health. The inclusion of a smartphone app, "Dry Eye Follow-Up," enhances patient engagement and follow-up, especially for managing dry eye conditions.
Furthermore, the Onyx Full's versatility extends to ocular health, with capabilities for assessing ocular redness, blink quality, and blepharitis. It also supports treatment planning through the Treatment Protocol Section, providing customized recommendations based on diagnostic findings. This comprehensive suite of features empowers eye care professionals to offer precise, tailored treatments and effectively communicate with patients, making the Onyx Full an invaluable tool in modern eye care practices.
The Onyx Full is an innovative diagnostic device that combines advanced corneal topography with a comprehensive dry eye evaluation system, delivering a complete analysis in approximately three minutes through a single acquisition. The device automatically detects the patient’s eye, adjusts to the optimal focus, and initiates a full series of ocular surface assessments, ensuring both accuracy and efficiency. Its integrated system enables clinicians to objectively evaluate anterior corneal aberrations, classify dry eye subtypes (evaporative or aqueous-deficient), assess lid margin abnormalities, and identify inflammatory markers of the ocular surface. With a fully automated workflow that streamlines data acquisition and analysis, the Onyx Full enhances diagnostic precision, supports earlier detection, optimizes treatment planning, and contributes to improved long-term patient outcomes.
In the Ony Full, the different light modalities correspond to specific illumination technologies designed to evaluate distinct structures and parameters of the ocular surface during dry eye assessment:
White Light
Used for general evaluation of the anterior segment. It allows visualization of the ocular surface and lid margin, helping identify visible abnormalities and providing a standard clinical reference image.
Interferometer (Interferometry)
Uses interference patterns to analyze the lipid layer of the tear film. This is essential for assessing the quality and thickness of the lipid layer, supporting the diagnosis of evaporative dry eye and meibomian gland dysfunction.
Blue Light
Typically used in combination with fluorescein dye to evaluate tear break-up time (TBUT) and detect corneal epithelial damage. It plays a key role in assessing tear film stability.
Near Infrared (Near IR) Light
Enables meibography, allowing detailed visualization of the meibomian glands within the eyelids. It helps identify gland atrophy, obstruction, or structural changes associated with evaporative dry eye.
Together, these light technologies provide a comprehensive, objective, and efficient evaluation of the ocular surface and dry eye subtype.
WHY CHOOSE ONYX FULL
Ocular surface disorders represent a significant clinical concern, making it essential to rely on advanced diagnostic devices that allow for accurate and comprehensive patient assessment. Among these conditions, dry eye disease is one of the most prevalent, affecting a large portion of the population. Proper evaluation of dry eye is particularly important, as severe cases can compromise corneal health and alter its shape, ultimately influencing topography outcomes. Modern lifestyle risk factors—such as prolonged screen exposure, air conditioning, and environmental pollution—are strongly linked to the development and chronic progression of dry eye, potentially impacting other ocular conditions over time. Implementing an automated, structured, and personalized management strategy can significantly enhance therapeutic results and improve patients’ quality of life. Furthermore, an AI-based algorithm upscales the acquired image to 23 megapixels, producing ultra-high-quality images that enable a new level of precision in Placido disk-based corneal topography measurements.
Onyx Full – Key Advantages for Workflow Innovation
🔹 Ease of Use
Save time and reduce staff workload with a system that manages focusing and acquisition entirely on its own. Equipped with an innovative automatic mechanism, our Placido disk–based corneal topographer autonomously detects and focuses on the patient’s eye, eliminating the need for manual operator adjustments and simplifying the examination process.
🔹 High Accuracy
The automated functionality enhances the precision of both topographic and dry eye measurements, ensuring greater diagnostic accuracy. Advanced autofocus technology improves the reliability and repeatability of corneal measurements. Each exam is optimized to deliver fast, consistent, and highly precise results, making Onyx an essential tool for any clinic or ophthalmic practice.
🔹 Comfort for Both Operator and Patient
Reduced manual intervention minimizes the risk of operator-dependent errors while enhancing patient comfort throughout the examination. The streamlined workflow creates a smoother experience for both clinicians and patients.
Key Features and Workflow
Equipped with an automated base, the Onyx Full initiates the data acquisition process with a single click. Once activated, the device automatically aligns with the patient’s eye, adjusts focus, and captures the necessary images, all guided by an intuitive software interface. A customized examination protocol then guides the workflow, automatically executing the selected diagnostic tests and processing the results with minimal user input.
Unique Technology for Automatic and Objective Analysis of Patients with MGD
Tear film interferometry is increasingly used in research to observe the tear film. Interferometry is a technique that examines the surface refractive patterns and dynamics of the lipid layer, allowing measurement of tear film stability and lipid layer thickness.
Interferometers are investigative tools applied in many fields of science and engineering. They are called interferometers because they work by combining two or more light sources to create an interference pattern, which can then be measured and analyzed.
The resulting patterns can appear as mesh and waves, waves only, or colored fringes. Interferometry specifically studies the lipid content of the tear film. The lipid layer, the outermost component of the tear film, protects the underlying aqueous layer from evaporation. Lipid layer deficiency is common in many patients with MGD, making this examination particularly important.
TOPOGRAPHY
The Onyx Full features advanced, non-invasive corneal topography that generates a precise curvature map of the corneal surface. This essential diagnostic tool supports early detection and monitoring of keratoconus, enhances pre- and post-operative evaluation in refractive surgery, and ensures accurate contact lens fitting.
By capturing detailed curvature measurements, the system produces an intuitive color-coded map where each color represents a different corneal power. This allows practitioners to quickly identify irregularities, evaluate the impact of contact lenses on the cornea, and optimize lens selection for maximum patient comfort and visual performance.
Aberrometry Analysis (Zernike)
The ONYX Corneal Topographer conducts Aberrometry analysis using Zernike analysis. This analysis yields data on astigmatism, spherical aberrations, higher order aberrations, and Coma, as well as the Optical Path Difference (OPD). It covers pupil sizes ranging from 2.5 mm to 7.0 mm, providing comprehensive insights into corneal characteristics.
Advanced Altimetry
Advanced altimetry involves creating a differential altimetry map that compares a reference surface with the patient's eye. This map is broken down into Zernike polynomials, specifically up to the 7th order, offering a detailed analysis of the eye's topographical characteristics.
Visual Acuity
Visual acuity assessment involves simulating a patient's visual clarity by considering Zernike wavefront aberrations. This simulation helps illustrate the impact of conditions like cataracts and the outcomes of refractive surgery on a patient's vision.
Comparing Exams / Differential Map
The "comparing examinations" display visually presents changes occurring over a specific timeframe, such as the progressive development of conditions like keratoconus. This feature assists in conveying even intricate scenarios to your patients, enabling clear explanations.
You have the capability to compare up to four examinations simultaneously, enhancing your ability to illustrate changes and trends.
In addition, the "differential map" display highlights distinctions between two selected maps, with the option to utilize up to three examinations for this purpose.
CONTACT LENSES
The auto-fit module combines topographic data with RGP lens data to determine and tailor the best solution for the patient's eye, simulating the fitting process with fluorescein. With the Onyx Full, it is possible to acquire in vivo fluorescein images of the lens or test the fitting with simulated fluorescein visualization.
The contact lens simulation generates an image illustrating how a specific lens fits the eye. This simulation enables adjustments to the angle and position of the contact lens, with automatic recalculation of the fluorescent image. The system streamlines the ordering process, reducing the number of lenses required and minimizing chair time, all while enhancing the first-fit success rate. This simplification of the fitting process is achieved by providing true elevation data that is independent of the tear film.
With the ONYX Full, you can efficiently and accurately gather all the essential data required for multifocal, bifocal, and toric contact lenses.
The pupillometry examination involves capturing images or videos in both white light and the infrared spectrum. It enables precise measurements of pupil size and decentralization across various lighting conditions, including scotopic vision, mesopic, and photopic.
This method offers a convenient and swift means of assessing your patients' pupil sizes in different lighting scenarios. This functionality not only aids in the fitting of multifocal lenses but also proves invaluable in measuring the optical zone prior to refractive or cataract surgery.
Dynamic Pupillometry
Pupil diameter measurement has gained increasing significance in the realm of refractive surgery. Larger scotopic pupil sizes may play a role in the development of postoperative symptoms such as halos, glare, and monocular diplopia. Accurate scotopic pupil measurements are essential for refractive surgeons, as they help determine the appropriate treatment zones for procedures involving excimer lasers, corneal treatments, and intraocular surgery.
Dynamic pupillometry is a method that observes the transition from a well-lit photopic environment to a low-light scotopic setting. This dynamic pupillometry serves as a straightforward screening tool for quantifying the pupillary light reflex (PLR), offering insights into autonomic nervous system (ANS) activity. Infrared videography is employed to measure the pupillary light reflex, which is then categorized into various quantitative parameters that provide indicators of ANS activity.
OCULAR SURFACE ANALYSIS
The ONYX Full is renowned as the swiftest and most comprehensive Dry Eye suite available. The Tear Film and Ocular Surface Society study has clearly defined the critical parameters for diagnosing dry eye syndrome by thoroughly analyzing the ocular surface. A vital initial step in this screening process involves classifying the subtype of pathology through a detailed examination of both the lipid and aqueous layers of the tear film.
The ONYX Full excels in facilitating this comprehensive analysis, employing the established guidelines in a fully automated and objective manner. It generates results automatically, eliminating the need for operator intervention, thus rendering the analysis remarkably rapid and easily assignable to other team members. This innovative approach significantly enhances the efficiency and accuracy of dry eye diagnosis.
The ONYX Full excels in facilitating this comprehensive analysis, employing the established guidelines in a fully automated and objective manner. It generates results automatically, eliminating the need for operator intervention, thus rendering the analysis remarkably rapid and easily assignable to other team members. This innovative approach significantly enhances the efficiency and accuracy of dry eye diagnosis.
Automatic NIBUT
The evaluation of mucin layer stability and the overall tear film is achieved through the examination of non-invasive break-up time (NIBUT) using Placido rings projected onto the cornea. This assessment allows for the automatic evaluation of tear film stability without the need for fluorescein staining.
The key parameters automatically assessed during NIBUT analysis include:
- First NIBUT
- Average NIBUT
- NIBUT Map
- Tear Film Dynamic Graph (TF Dynamic Graph)
TEAR FILM ALTERATIONS
Interferometry
According to TFOS DEWS II, tear film instability and lipid layer dysfunction are central mechanisms of dry eye disease, with the evaporative form being the most prevalent worldwide; therefore, evaluating the lipid layer is no longer optional but essential. Automated interferometry provides a direct and objective assessment of this layer, enabling clinicians to identify the true cause of symptoms and make more accurate therapeutic decisions, especially since most treatments target evaporation and meibomian gland dysfunction. With automatic focusing, acquisition, and analysis, the exam becomes reproducible, operator-independent, and suitable for follow-up, transforming interferometry into a reliable, evidence-based diagnostic tool.
Automatic Tear Meniscus Height
Insufficient tear production can lead to symptoms of dry eye, often referred to as aqueous tear deficiency (ATD). However, accurately measuring tear volume can be challenging, as many available methods are invasive and discomforting for patients.
An alternative approach to assessing tear volume involves examining the thickness of the tear meniscus observed along the margins of the eyelids. This tear meniscus can be evaluated by considering its height, regularity, and shape, providing valuable insights into tear volume and tear film stability.
To streamline this process, artificial intelligence plays a crucial role by automatically determining key parameters such as the position of the tear meniscus and identifying the highest value within the tear meniscus. This automation not only enhances the accuracy of tear volume assessments but also minimizes patient discomfort during the examination.
Lissamine Green: Conjunctival and Eyelid Staining
In dry eye management, evaluating the ocular surface should not be limited to the cornea alone. The conjunctiva and eyelid margin often present the earliest signs of cellular stress. Lissamine green staining highlights stressed, damaged, or devitalized cells in these areas, providing a more complete assessment of ocular surface health. This is especially valuable in chronic and evaporative dry eye, where conjunctival involvement may appear before — or be more pronounced than — corneal findings.
The Onyx Full enables high-quality lissamine green image acquisition, allowing clear documentation and reliable comparison over time for accurate monitoring and follow-up.
EYELID ANOMALIES
Meibography: Condition of the Meibomian Glands
The Onyx Full provides a detailed evaluation of Meibomian gland health through high-resolution infrared imaging, enabling precise visualization of gland structure and integrity. This advanced meibography allows clinicians to objectively assess glandular architecture and identify dysfunction with clarity, supporting more accurate therapy selection while helping patients better understand the rationale behind the recommended treatment.
Infrared Imaging
The Meibomian glands produce the lipid layer of the tear film, and their dysfunction is strongly associated with evaporative dry eye. Evaluating both their structure and function is therefore essential to understanding the origin of the condition. Meibography enables clear visualization of gland architecture, offering insight into the remaining secretory capacity and the potential for functional recovery. The Onyx full system provides a detailed, easy-to-interpret view that can also be readily understood by the patient.
Eyelid Transillumination
What makes the Onyx Full different?
Its infrared transillumination function reveals critical details that are often missed during routine examination, enabling visualization of gland dysfunction, lipid accumulation, and vascular changes within the eyelids for a more comprehensive dry eye assessment.
3D Meibography
The introduction of 3D imaging of the Meibomian glands provides two key advantages. First, it enables direct comparison with a healthy eye, allowing clinicians to clearly identify abnormal gland structures through a three-dimensional view. Second, it produces intuitive images that can be shared with patients, helping them better understand the underlying cause of their discomfort.
Blink Quality: Gland Stimulation
Blinking is essential for evenly spreading the tear film and expressing the Meibomian glands. Incomplete or reduced blinking can compromise tear film stability and worsen dry eye symptoms. The Onyx Full automatically analyzes blink dynamics, providing valuable information about the functional role of the eyelids in the disease.
Blepharitis: Eyelid Margin Inflammation
Disorders of the eyelid margin are a common cause of tear film instability and ocular discomfort. Findings such as cylindrical dandruff and other signs of blepharitis indicate chronic inflammation that may also impair Meibomian gland function. The Onyx Full enables clear documentation of the eyelid margin, supporting accurate diagnosis and monitoring the effectiveness of targeted treatments.
Demodex: A Source of Ocular Irritation
Demodex is a microscopic mite that can colonize the eyelid margin and is associated with inflammation, lash abnormalities, and persistent irritation when infestation is significant. Evaluating Demodex is especially important in recurrent blepharitis or treatment-resistant cases. The Onyx Full allows visualization and documentation of related clinical signs, enabling a more comprehensive and targeted diagnosis.
OCULAR SURFACE ABNORMALITIES
Staining: Documenting Epithelial Damage
Ocular surface staining is essential for evaluating epithelial integrity, as tear film alterations and environmental stress can lead to cellular damage. By highlighting affected areas of the corneal and conjunctival epithelium, staining helps differentiate dry eye from other conditions with similar symptoms and assess its severity. The Onyx Full captures and stores staining images, enabling reliable follow-up and treatment monitoring over time.
Bulbar Redness: Ocular Surface Inflammation
Bulbar redness is a key indicator of ocular surface inflammation and often reflects ongoing inflammatory processes. Its presence, distribution, and intensity provide valuable information about conjunctival health and disease progression. The Onyx Full records standardized images of the bulbar conjunctiva, supporting consistent evaluation and long-term monitoring.
Comparative Tables (Efron / CCLRU / Jenvis): Clear Clinical Communication
Standardized grading scales such as Efron, CCLRU, and Jenvis allow clinicians to compare clinical findings with established references, improving diagnostic clarity and communication. The Onyx Full integrates captured images with these reference tables, incorporating classification directly into the clinical report for objective documentation and follow-up.
REPORTS
Multiple Reports Available
The software serves as a specialized platform tailored for dry eye management. In addition to assisting with disease diagnosis and classification, it offers the capability to generate, print, and store a range of medical reports, ensuring the delivery of highly professional and clinically sound solutions to patients. To enhance customer satisfaction, it is a common practice to provide technical documentation related to the conducted examinations. The diverse print reports available through the SBM device enable healthcare professionals to visually elucidate and effectively convey the patient's pathology situation. Moreover, these reports facilitate the communication of how the pathology has evolved over time, offering valuable insights into the progression of the condition and aiding in the development of tailored treatment plans.
Dayly Report
The "daily report" consolidates all the results from a patient's exams conducted on a given day. Multiple visualization options are offered, allowing for flexibility in how the information is presented. These options include the choice to view the report with or without accompanying images of the exams, tailoring the presentation to best suit the specific needs of both healthcare professionals and patients.
Follow-up Report
The "Follow-up report" serves as a valuable tool for illustrating the benefits of therapy to the patient. It visually demonstrates how the therapy has led to improvements in the symptoms associated with dry eye pathology, providing a clear and tangible representation of the positive outcomes achieved through treatment. This report enhances patient understanding and satisfaction by showcasing the real-world impact of the prescribed interventions on their ocular health and overall well-being.
All Reports
The "All reports" feature offers the ability to generate a comprehensive folder comprising up to 16 pages of detailed information. This becomes particularly valuable when patients are covering the expenses out-of-pocket. Providing them with an extensive, multi-page report enhances the overall value of the service and contributes to increased patient satisfaction. These detailed reports offer transparency, thoroughness, and a tangible representation of the care provided, which can greatly enhance the patient's understanding and appreciation of the healthcare experience.
Treatments Report
The "Treatments report" serves as a comprehensive list detailing all prescribed treatments for the patient. This report provides a clear and organized overview of the recommended therapeutic interventions, ensuring that both healthcare professionals and patients have a complete record of the prescribed treatments for reference and follow-up.
DRY EYE FOLLOW UP
This is a smartphone app designed to provide patients with access to their examination results, information about their therapy, and comprehensive knowledge about dry eye disease.
This platform offers fast and convenient doctor-patient interactive communication, establishing a seamless two-way connection. It facilitates the accurate sharing of reports and updates, enabling patients to track their results and progress over time, thereby illustrating fluctuations in symptoms. Additionally, it assists in the regular scheduling of appointments and provides a means to interact with the clinic or hospital. The platform also automates the process of sending reminders to patients and notifications to doctors, streamlining the flow of information and expediting procedures for booking appointments and setting up prescribed treatment protocols.
| Rings | 24 |
| Measured Points | 8760 |
| Camera Resolution | 5 Megapixel |
| Photo Resolution | 2592 x 1944 JPEG format |
| Upscaled Analyzed Image Resolution | 23 Megapixel |
| Acquisition Mode | Single shot, Multishot, Video |
| Focus | Manual Focus |
| ISO Management | Variable |
| Image Color | Colours - Infrared (IR) |
| Lighting Source | Infrared Led - White Led - Blue Led |
| Working Distance | 60 mm - 90mm from the center of the placid |
| Output 1 | USB 3.0 |
| Electromagnetic Compatibility (EMC) | IEC 60601-1-2 (2015) |
| Supply Voltage | 24 V |
| Device Operating Voltage | 24V - 5V |
| Dimensions / Weight | 15.75 (L) x 23.62 (A) x 17.71 (P) inch |
| Accuracy | Class A according to UNI EN ISO 19980-2021 |
| Rings | 24 |
| Measured Points | 8760 |
| Camera Resolution | 5 Megapixel |
| Photo Resolution | 2592 x 1944 JPEG format |
| Upscaled Analyzed Image Resolution | 23 Megapixel |
| Acquisition Mode | Single shot, Multishot, Video |
| Focus | Manual Focus |
| ISO Management | Variable |
| Image Color | Colours - Infrared (IR) |
| Lighting Source | Infrared Led - White Led - Blue Led |
| Working Distance | 60 mm - 90mm from the center of the placid |
| Output 1 | USB 3.0 |
| Electromagnetic Compatibility (EMC) | IEC 60601-1-2 (2015) |
| Supply Voltage | 24 V |
| Device Operating Voltage | 24V - 5V |
| Dimensions / Weight | 15.75 (L) x 23.62 (A) x 17.71 (P) inch |
| Accuracy | Class A according to UNI EN ISO 19980-2021 |
