Low Vision Service Wales

Demonstration and Assessment Equipment Check List 2012/13

Code

/

Type and Manufacturer

/ Power /

Quantity

/

Rec’d

/

Hand Mags

5216 / Coil Aspheric / x 2.3 / 1
5204 / Coil Aspheric / x 4 / 1
5206 / Coil Aspheric / x 6 / 1
5249 / Windsor / + 5.00 D / 1
5248 / Windsor / + 6.00 D / 1
5247 / Windsor / + 12.00 D / 1
/

Illuminated Hand Magnifiers

15113 / Eshenbach / X3.5 / 1
15115 / Eshenbach / X5 / 1
8273 / Coil AUTOTOUCH MAX / 3x / 1
8275 / Coil AUTOTOUCH MAX / 5x / 1
8277 / Coil AUTOTOUCH MAX / 7x / 1
/

Chest Mags

5820 / Coil / 1
/

Folding Mags

171014 / Eshenbach Mobilents / X4 / 1
171067 / Eshenbach Mobilents / X7 / 1
1710910 / Eshenbach Mobilents / X10 / 1
/

Stand Mags

5214 / Coil / X4 / 1
2626 / Eshenbach / X6 / 1
/

Bar Mag and Bright Fields

5850/02

/

Coil

/ Small dome / 1
2608 / Eschenbach Bar Mag / 250mm / 1
/

Illuminated Stand mags

158293 / Eshenbach / X2.8 / 1
155993 / Eshenbach / X3 / 1
155493 / Eshenbach / X4 / 1
155273 / Eshenbach / X6 / 1
155173 / Eshenbach / X7 / 1
155073 / Eshenbach / X10 / 1
155773 / Eshenbach / X12 / 1
1599303 / Eshenbach (Discontinued June 13) / Mains handle / 1
1599144 / Eshenbach / LED handles / 1
/

Distance Aids

6x16 / Specwell Monocular / X6 / 1
4x10 / Specwell Monocular / X4 / 1
16241 / Eschenbach Max Tv / X2 / 1
8x20 / Specwell Monocular / X8 / 1
10x21 / Binoculars / X10
UV Filters in the Demonstration Kit
U50 / NoIR Medical UV Shield 54% Medium / Yellow / 1
U40 / NoIR Medical UV Shield 16% Medium / Amber / 1
U21 / NoIR Medical UV Shield 38% Medium / Grey / 1
U60 / NoIR Medical UV Shield 49% Medium / Orange / 1
U98 / NoIR Medical UV Shield 58% Medium / Red / 1
Quickshields / 1
Batteries
LR14 / C size batteries / Pack 12 / 1
LR6 / AA size batteries / Pack 12 / 1
Lamps
DLMP/WH / Desktop Magnifier Lamp White / 1.75x/4x insert / 1
D1120 / Daylight Flexible LED Mains Desklight / 1
Electronic magnifiers
Compact+ / Electronic video magnifier / 1
Non Optical Devices
NOLC / A clip board / 1
NOLT / A set of 4 typoscopes / 1
NOLR / Reading stand / 1
Spectacle mounted kit
Norville / Spectacle mounted kit / 1
Assessment Equipment
LogMAR distance VA Chart / 1
Pelli- Robson Contrast Sensitivity Chart / 1
LogMAR Kay Picture Chart / 1
Bailey-Lovie near acuity threshold chart / 1
McClure Reading Test type (white) / 1
+/- 0.75 cross cyl / 1
+/- 1.00 cross cyl / 1
Pair of Halberg clips / 1
Case for Low Vision Demo Kit / 2
  • Please provide the Serial number of Compact + Electronic Magnifier with your kit______
  • Please provide a preferred email address for future newsletters and critical service updates/out of stock items information etc:
  • ______(this email address will not

be circulated outside of the LVSW)

  • Please tick here if you require new foams for your demo kit cases ______

Optometrists Details

Name:GOC Number:

Practice Address:

Practice Telephone Number:

I have the equipment as indicated on the list above for use in the Low Vision Service Wales. By signing this I am aware that I am taking responsibility for looking after this equipment and ensuring its upkeep.

Signed…………………………...... Date ………………………..

Please return this form to:

Low Vision Service WalesTeam,

Hywel Dda Health Board

13 Goring Road

Llanelli

SA15 3HF

Please return all aids in your possession that are not on the kit list above to Edward Marcus Ltd using the freepost labels as soon as possible.

Updated: February 2012