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Welsh Low Vision Scheme

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					                      Welsh Low Vision Scheme
          Demonstration and Assessment Equipment Check List

Code        Type and Manufacturer         Power        Quantit   Recei
                                                         y        ved
            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

            Half Eyes/ clip-on adds
4147        Coil                          +4.00           1
4151        Coil                          +6.00           1
4156        Coil                          + 8.00          1
5329        Coil                          +10.00          1
5328        Coil                          +6.00           1
            Illuminated Hand Magnifiers
7270        Coil                          X3              1
8146        Coil (touch on)               X5              1
7147        Coil                          X7              1
8148        Coil (touch on)               X9              1
151024      Eshenbach                     X3              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                     X8              1
1153        Eshenbach                     X6              1

            Bar Mag and Bright Fields
2603        Eshenbach                                     1
5850/02     Coil                          Small dome      1
            Illuminated Stand mags
158293      Eshenbach                     X2.5            1
155993      Eshenbach                     X3              1
155493      Eshenbach                     X4              1
155273      Eshenbach                     X6              1


Updated: 05.07.2006
155173     Eshenbach                                X7               1
155073     Eshenbach                                X10              1
155773     Eshenbach                                X12              1
159910     Eshenbach                                Battery Handle   1
1599303    Eshenbach                                Mains handle     1
159940     Eshenbach                                LED handles      1
           Distance Aids
4090/02    Coil Tele binoculars                     X2               1
Bino       Practica 8x25 wide angle binocs          X8               1
8x20
8x20       Monocular                                X8               1
Specwell

           UV Filters in the Demonstration Kit
           (Please check the catalogue for
           additional UV’s to order for different
           sizes and light transmissions)
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

           Additional Kit Items
5850/24    Coil VTM clear reader                    Red              1
5850/15    Coil VTM                                 Bright Blue      1
6261/04    Coil Sliding magnifier                   3x               1
2608       Eschenbach Bar Mag                       250mm            1
1646/25    Eschenbach Clip on Binocular             2.5x             1
6x16       Specwell Monocular                                        1
4x10       Specwell Monocular                                        1
16241      Eschenbach Max Tv                                         1
           Bulbs                                                     1

1544       1510 Series Bulb                         Pack 2
1545       Eschenbach bulbs                         Pack 5           1
1546       4v/550 Xenon Bulbs                       Pack 2           1
5147/11    2.5v/0.25a Bulbs                         Pack 10          1
           Batteries
LR14       C size batteries                         Pack 12          1
LR6        AA size batteries                        Pack 12          1
           Additional Aids 2006

3146       CTP Coil                                 4 x OU           1
3152       CTP Coil                                 6 x OU           1
           LVA Monocular                            2.75 x 8         1
           Quickshields                                              1
           Flip Clamp                                                2




Updated: 05.07.2006
           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
DH156      A PL fluorescent task lamp                                       1
NOLC       A clip board                                                     1
NOLT       A set of 4 typoscopes                                            1
NOLR       Reading stand                                                    1
           Case for Low Vision Demo Kit                                     2




Name:                                                 GOC Number:


Practice Address:




Practice Telephone Number:



I have received the equipment as indicated on the list above for use in the Welsh
Low Vision Scheme. 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 the Low Vision Team, Carmarthenshire Local Health
Board, Unit 5, Parc Dafen,Heol Cropin,Llanelli,Carmarthenshire,SA14 8QW.
FAX: 01554 744411




Updated: 05.07.2006

				
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