1. Volk Optical Laser Lenses Distributor Product Presentation December, 2009

2. Overview Volk Optical has introduced two new high resolution (HR) lenses for laser photocoagulation –The HR Wide Field for Pan Retinal Photocoagulation (PRP) –The HR Centralis for focal and grid laser therapy Both lenses feature double aspheric designs and high grade, low dispersion glass which gives superior imaging quality. Both lenses may also be used as diagnostic lenses only. The lenses improve upon and replace the previous generation Superquad 160 and Area Centralis lenses. Primary conditions diagnosed and treated are diabetic retinopathy and maculopathy. Lenses can also be used to diagnose and treat other conditions such as retinal tears, breaks and holes.

3. HR Centralis Lens Lens for detailed posterior pole examination and laser focal/grid treatment Lens is an upgrade or replacement for: –Volk Optical Area Centralis –Ocular Mainster 1X Retina –Ocular Mainster Focal/Grid Main sales argument is better image quality and stereopsis at the extreme of the lens view Specifications: FOV 74º, magnification 1.08x, laser spot 0.92x Link to lens page on Volk Optical websiteLink

4. Features and Benefits Enhanced double aspheric design eliminates distortion and improves stereopsis to the periphery of the view Superior, high grade, low dispersion glass delivers unsurpassed resolution Improved capability with pupils as small as 4mm Reduced sized housing helps manipulation within the orbit

5. HR Wide Field Lens Lens for extreme wide field examination and laser PRP treatment Lens is an upgrade or replacement for: –Rodenstock pan fundus lens –Volk Optical Superquad 160 –Ocular Instruments Mainster PRP 165 Main sales argument is better image quality at the extreme periphery of the lens view Specifications: FOV 160º, magnification 0.5x, laser spot 2.0x Link to lens page on Volk Optical websiteLink

6. Features and Benefits Widest field of view and treatment area to the ora serrata Superior, high grade, low dispersion glass design eliminates distortion at the extreme periphery Much smaller and easier to manipulate within patient’s orbit Short length of lens helps manipulate in front of laser

7. Diabetes Overview Diabetic retinopathy serious complication of diabetes mellitus Commonest cause of blindness in 20-74 age range Two stage progression with recognised opthalmoscopically visible signs: –Background Diabetic Retinopathy Microaneurysms –Proliferative Diabetic Retinopathy Retinal haemorrhages, cotton wool spots Diabetic maculopathy is involvement of macula

8. Diabetic Retinopathy Early stage background diabetic retinopathy –Hemorrhages and ‘cotton wool’ spots Proliferative diabetic retinopathy –Neovascularisation with weak ateries which bleed into vitreous - ’floaters’

9. Laser Therapy 1 Pan Retinal Photocoagulation (PRP) Objective is to destroy oxygen- deprived tissue and prevent neovacularisation Lenses used are: –HR Wide Field –Superquad 160 Focal/grid therapy Photocoagulation near macula Lenses used are: –HR Centralis –Area Centralis

10. Laser therapy 2

11. Lens summary Diagnostic –Digital Wide Field Slit lamp diagnostic retinal screening even through non-dilated pupil –Digital High Mag Slit lamp examination of nerve fibre layer, macula and optic disk –Digital 1.0x Optic disc measurement and photographic recording Treatment –H-R Wide Field Panretinal Photocoagulation (PRP) for diabetic retinopathy Retinal breaks and tears –HR Centralis Focal/Grid Laser for diabetic macula oedema, microaneurysms and haemorrhage Macular hole