C.8.25 Ophthalmic Refractive Measurements Modules

C.8.25.1 Lensometry Measurements Series Module

The Lensometry Measurements IODs use the General Series module described in section C.7.3.1, specialized by the Lensometry Measurements Series Module, to describe the DICOM Series Entity described in A.1.2.3, and to define what constitutes a Series for the context of Ophthalmic device.

Table C.8.25.1-1 specifies the Attributes that identify and describe general information about the Lensometry Measurements Series.

Table C.8.25.1-1LENSOMETRY MEASUREMENTS SERIES MODULE ATTRIBUTES

Attribute Name Tag Type Attribute Description
Modality (0008,0060) 1 Type of equipment that originally acquired the data used to create the images in this Series. Enumerated Values: LEN See section C.7.3.1.1.1 for further explanation.
Referenced Performed Procedure Step Sequence (0008,1111) 1C Uniquely identifies the Performed Procedure Step SOP Instance to which the Series is related (e.g. a Modality or General-Purpose Performed Procedure Step SOP Instance). Only a single Item shall be included in this sequence. Required if the Modality Performed Procedure Step SOP Class, or General Purpose Performed Procedure Step SOP Class is supported.
>Include ‘SOP Instance Reference Macro’ Table 10-11

C.8.25.2 Autorefraction Measurements Series Module

The Autorefraction Measurements IODs use the General Series module described in section C.7.3.1, specialized by the Autorefraction Measurements Series Module, to describe the DICOM Series Entity described in A.1.2.3, and to define what constitutes a Series for the context of Ophthalmic device.

Table C.8.25.2-1 specifies the Attributes that identify and describe general information about the Autorefraction Measurements Series.

Table C.8.25.2-1AUTOREFRACTION MEASUREMENTS SERIES MODULE ATTRIBUTES

Attribute Name Tag Type Attribute Description
Modality (0008,0060) 1 Type of equipment that originally acquired the data used to create the images in this Series. Enumerated Values: AR See section C.7.3.1.1.1 for further explanation.
Referenced Performed Procedure Step Sequence (0008,1111) 1C Uniquely identifies the Performed Procedure Step SOP Instance to which the Series is related (e.g. a Modality or General-Purpose Performed Procedure Step SOP Instance). Only a single Item shall be included in this sequence. Required if the Modality Performed Procedure Step SOP Class, or General Purpose Performed Procedure Step SOP Class is supported.
>Include ‘SOP Instance Reference Macro’ Table 10-11

C.8.25.3 Keratometry Measurements Series Module

The Keratometry Measurements IODs use the General Series module described in section C.7.3.1, specialized by the Keratometry Measurements Series Module, to describe the DICOM Series Entity described in A.1.2.3, and to define what constitutes a Series for the context of Ophthalmic device.

Table C.8.25.3-1 specifies the Attributes that identify and describe general information about the Keratometry Measurements Series.

Table C.8.25.3-1KERATOMETRY MEASUREMENTS SERIES MODULE ATTRIBUTES

Attribute Name Tag Type Attribute Description
Modality (0008,0060) 1 Type of equipment that originally acquired the data used to create the images in this Series. Enumerated Values: KER See section C.7.3.1.1.1 for further explanation.
Referenced Performed Procedure Step Sequence (0008,1111) 1C Uniquely identifies the Performed Procedure Step SOP Instance to which the Series is related (e.g. a Modality or General-Purpose Performed Procedure Step SOP Instance). Only a single Item shall be included in this sequence. Required if the Modality Performed Procedure Step SOP Class, or General Purpose Performed Procedure Step SOP Class is supported.
>Include ‘SOP Instance Reference Macro’ Table 10-11

C.8.25.4 Subjective Refraction Measurements Series Module

The Subjective Refraction Measurements IODs use the General Series module described in section C.7.3.1, specialized by the Subjective Refraction Measurements Series Module, to describe the DICOM Series Entity described in A.1.2.3, and to define what constitutes a Series for the context of Ophthalmic device.

Table C.8.25.4-1 specifies the Attributes that identify and describe general information about the Subjective Refraction Measurements Series.

Table C.8.25.4-1SUBJECTIVE REFRACTION MEASUREMENTS SERIES MODULE ATTRIBUTES

Attribute Name Tag Type Attribute Description
Modality (0008,0060) 1 Type of equipment that originally acquired the data used to create the images in this Series. Enumerated Values: SRF See section C.7.3.1.1.1 for further explanation.
Referenced Performed Procedure Step Sequence (0008,1111) 1C Uniquely identifies the Performed Procedure Step SOP Instance to which the Series is related (e.g. a Modality or General-Purpose Performed Procedure Step SOP Instance). Only a single Item shall be included in this sequence. Required if the Modality Performed Procedure Step SOP Class, or General Purpose Performed Procedure Step SOP Class is supported.
>Include ‘SOP Instance Reference Macro’ Table 10-11

C.8.25.5 Visual Acuity Measurements Series Module

The Visual Acuity Measurements IODs use the General Series module described in section C.7.3.1, specialized by the Visual Acuity Measurements Series Module, to describe the DICOM Series Entity described in A.1.2.3, and to define what constitutes a Series for the context of Ophthalmic device.

Table C.8.25.5-1 specifies the Attributes that identify and describe general information about the Visual Acuity Measurements Series.

Table C.8.25.5-1VISUAL ACUITY MEASUREMENTS SERIES MODULE ATTRIBUTES

Attribute Name Tag Type Attribute Description
Modality (0008,0060) 1 Type of equipment that originally acquired the data used to create the images in this Series. Enumerated Values: VA See section C.7.3.1.1.1 for further explanation.
Referenced Performed Procedure Step Sequence (0008,1111) 1C Uniquely identifies the Performed Procedure Step SOP Instance to which the Series is related (e.g. a Modality or General-Purpose Performed Procedure Step SOP Instance). Only a single Item shall be included in this sequence. Required if the Modality Performed Procedure Step SOP Class, or General Purpose Performed Procedure Step SOP Class is supported.
>Include ‘SOP Instance Reference Macro’ Table 10-11

C.8.25.6 General Ophthalmic Refractive Macros

C.8.25.6.1 Cylinder Sequence Macro

Table C.8.25.6.1-1 describes the attributes for the Cylinder Sequence Macro

Table C.8.25.6.1-1CYLINDER SEQUENCE MACRO

Attribute Name Tag Type Attribute Description
Cylinder Sequence (0046,0018) 1C A sequence that specifies lens measurements to correct for astigmatism or measurements of an eye that has astigmatism. Required if astigmatic correction or astigmatism is measured. Only a single item shall be included in this sequence. Note: When astigmatism is present the power is NOT the same in all meridians, but has its minimum and maximum power in meridians separated by 90 degrees.
>Cylinder Power (0046,0147) 1 The power that is present at the power meridian (90 degrees from the axis), in diopters.
>Cylinder Axis (0022,0009) 1 The meridian, defined in degrees, that is 90 degrees from the power meridian.

C.8.25.6.2 Prism Sequence Macro

Table C.8.25.6.2-1 describes the attributes for the Prism Sequence Macro

Table C.8.25.6.2-1PRISM SEQUENCE MACRO

Attribute Name Tag Type Attribute Description
Prism Sequence (0046,0028) 1C A sequence that specifies prism that is measured in a lens, or that is required to correct for a patient’s ocular misalignment. Required if prism is measured in the lens or if this part of a refraction is done for a patient. Only a single item shall be included in this sequence. Note: A prism is a wedge shaped lens that deviates light toward the base and shifts the apparent image toward its apex.
>Horizontal Prism Power (0046,0030) 1 The power of a prism to bend light in the horizontal direction, in prism diopters.
>Horizontal Prism Base (0046,0032) 1 Direction of the base of the measured prism -- either in (toward the nose), or out (away from the nose) Enumerated Value: IN OUT
>Vertical Prism Power (0046,0034) 1 The power of a prism to bend light in the vertical direction, in prism diopters.
>Vertical Prism Base (0046,0036) 1 Direction of the base of the measured prism -- either up, or down. Enumerated Value: UP DOWN

C.8.25.7 General Ophthalmic Refractive Measurements Module

Table C.8.25.7-1 defines the General Ophthalmic Refractive Measurements module attributes.

Table C.8.25.7-1GENERAL OPHTHALMIC REFRACTIVE MEASUREMENTS MODULE ATTRIBUTES

Attribute Name Tag Type Attribute Description
Instance Number (0020,0013) 1 A number that identifies these measurements.
Content Date (0008,0023) 1 The date the measurements data creation started.
Content Time (0008,0033) 1 The time the measurements data creation started.
Referenced Refractive Measurements Sequence (0046,0145) 2C A sequence that specifies Ophthalmic Refractive Measurements SOP Instances that are relevant to the interpretation of this SOP Instance. Zero or more items shall be included in this sequence. See section C.8.25.7.1.1 for further explanation. Required if Visual Acuity Type Code Sequence (0046,0121) is present. May be present otherwise.
>Include ‘SOP Instance Reference Macro’ Table 10-11

C.8.25.7.1 General Ophthalmic Refractive Measurements Module Attributes

C.8.25.7.1.1 Referenced Refractive Measurements Sequence

Whenever visual acuity is measured it is necessary to know the conditions under which it was measured. If the vision was measured with the patient's habitual correction in place, this attribute is used to reference a lensometry measurements SOP instance for the current glasses. If the measurements are of the patient's best-corrected vision, this attribute may reference the SOP instance that describes the correction that resulted in that vision, which may for example be the subjective refraction, or the autorefraction.

This attribute enables a receiver of this SOP instance to identify the results of measurements from a lensometer, autorefractor, or automated phoropter (subjective refraction) that are relevant to interpretation.

C.8.25.8 Lensometry Measurements Module

Table C.8.25.8-1 defines the Attributes used to capture the refractive measurements by a lensometer for spectacles. This is typically for a pair of lenses, but sometimes for just one. Sometimes a single lens is measured with an unknown laterality.

Table C.8.25.8-1LENSOMETRY MEASUREMENTS MODULE ATTRIBUTES

Attribute Name Tag Type Attribute Description
Lens Description (0046,0012) 2 A free text description of the lens and lens general comments. Note: A common example is to identify the specific spectacles measured
Right Lens Sequence (0046,0014) 1C A sequence that specifies measurements of a patient’s right lens. Required if the right lens is measured. Only a single Item shall be included in this sequence.
>Include 'Lensometry Measurements Macro' Table C.8.25.8-2
Left Lens Sequence (0046,0015) 1C A sequence that specifies measurements of a patient’s left lens. Required if the left lens is measured. Only a single Item shall be included in this sequence.
>Include 'Lensometry Measurements Macro' Table C.8.25.8-2
Unspecified Laterality Lens Sequence (0046,0016) 1C A sequence that specifies measurements of one lens of unknown laterality. Only a single Item shall be included in this sequence. Shall not be included if Attribute Right Lens Sequence (0046,0014) or Left Lens Sequence (0046,0015) is present. Required if a single lens of unknown laterality is measured.
>Include 'Lensometry Measurements Macro' Table C.8.25.8-2

Table C.8.25.8-2 describes the attributes for the Lensometry Measurements Macro.

Table C.8.25.8-2 LENSOMETRY MEASUREMENTS MACRO

Attribute Name Tag Type Attribute Description
Sphere Power (0046,0146) 1 Refractive power of the lens that is the same in all meridians, measured at distance (optical infinity), in diopters.
Include 'Cylinder Sequence Macro' Table C.8.25.6.1-1
Add Near Sequence (0046,0100) 1C A sequence that specifies refractive measurements of the lens to correct for inability to focus at near while wearing the distance prescription. Only a single item shall be included in this sequence. Required if Add Near is measured in the lens.
>Add Power (0046,0104) 1 Additional power relative to the distance correction, expressed in diopters, that allows best corrected visual acuity at the defined viewing distance.
>Viewing Distance (0046,0106) 3 The distance, in cm, for testing visual acuity corresponding to the value of Add Power (0046,0104) in this sequence.
Add Intermediate Sequence (0046,0101) 1C A sequence that specifies refractive measurements of the lens to correct for inability to focus at intermediate distance while wearing the distance prescription. Only a single item shall be included in this sequence. Required if Add intermediate is measured in the lens.
>Add Power (0046,0104) 1 Additional power relative to the distance correction, expressed in diopters, that allows best corrected visual acuity at the defined viewing distance.
>Viewing Distance (0046,0106) 3 The distance, in cm, for testing visual acuity corresponding to the value of Add Power (0046,0104) in this sequence item.
Include ‘Prism Sequence Macro’ Table C.8.25.6.2-1
Lens Segment Type (0046,0038) 3 The type of segment of a lens containing the “add” power, as described above Enumerated Value: PROGRESSIVE NONPROGRESSIVE
Optical Transmittance (0046,0040) 3 The fraction of light that passes through the measured lens optical media, in percent.
Channel Width (0046,0042) 3 In a progressive lens, the width in mm of that portion of the lens where there is gradual or progressive increase in “add” power. Note: See Attributes, Add Near Sequence (0046,0100) and Add Intermediate Sequence (0046,0101) for description of“add”.

C.8.25.9 Autorefraction Measurements Module

Table C.8.25.9-1 defines the Attributes used to represent the refractive measurements by an autorefractor of a patient’s eyes. Usually both eyes are measured, but sometimes just one.

Table C.8.25.9-1AUTOREFRACTION MEASUREMENTS MODULE ATTRIBUTES

Attribute Name Tag Type Attribute Description
Autorefraction Right Eye Sequence (0046,0050) 1C A sequence that specifies refractive measurements of a patient’s right eye. Only a single item shall be included in this sequence. Required if the right eye is measured.
>Sphere Power (0046,0146) 1 Refractive power of the eye that is the same in all meridians, measured at distance (optical infinity), in diopters.
>Include 'Cylinder Sequence Macro' Table C.8.25.6.1-1
>Pupil Size (0046,0044) 3 The horizontal diameter measurement of the pupil, in mm.
>Corneal Size (0046,0046) 3 The horizontal diameter measurement of the cornea, in mm.
Autorefraction Left Eye Sequence (0046,0052) 1C A sequence that specifies refractive measurements of a patient’s left eye. Only a single item shall be included in this sequence. Required if the left eye is measured.
>Sphere Power (0046,0146) 1 Refractive power of the eye that is the same in all meridians, measured at distance (optical infinity), in diopters.
>Include 'Cylinder Sequence Macro' Table C.8.25.6.1-1
>Pupil Size (0046,0044) 3 The horizontal diameter measurement of the pupil, in mm.
>Corneal Size (0046,0046) 3 The horizontal diameter measurement of the cornea, in mm.
Distance Pupillary Distance (0046,0060) 3 Distance in mm between the pupils when the patient’s object of regard is in the distance, as measured by an autorefractor.
Near Pupillary Distance (0046,0062) 3 Distance in mm between the pupils when the patient’s object of regard is at near, as measured by an autorefractor.

C.8.25.10 Keratometry Measurements Module

Table C.8.25.10-1 defines the Attributes used to represent the keratometric measurements by a keratometer of a patient’s eyes. Usually both eyes are measured, but sometimes just one.

Table C.8.25.10-1KERATOMETRY MEASUREMENTS MODULE ATTRIBUTES

Attribute Name Tag Type Attribute Description
Keratometry Right Eye Sequence (0046,0070) 1C A sequence that specifies keratometric measurements of a patient’s right eye, defining principal meridians wherein the steepest meridian is separated by 90 degrees from the flattest. Only a single item shall be included in this sequence. Required if the right eye is measured. Note: Consideration for steep, flat, and spherical meridians is made. For instances where spherical keratometric measurements are obtained, values specified in the steep and flat Attributes are equivalent.
>Include ‘Keratometric Measurements Macro' Table C.8.25.10-2
Keratometry Left Eye Sequence (0046,0071) 1C A sequence that specifies keratometric measurements of a patient’s left eye, defining principal meridians wherein the steepest meridian is separated by 90 degrees from the flattest. Only a single item shall be included in this sequence. Required if the left eye is measured. Note: See Note for attribute Keratometry Right Eye Sequence (0046,0070)
>Include ‘Keratometric Measurements Macro' Table C.8.25.10-2

Table C.8.25.10-2 describes the attributes for the Keratometric Measurements Macro.

Table C.8.25.10-2 KERATOMETRIC MEASUREMENTS MACRO

Attribute Name Tag Type Attribute Description
Steep Keratometric Axis Sequence (0046,0074) 1 A sequence that specifies the steepest meridian as defined by the greatest power of curvature and shortest radius of curvature. Only a single item shall be included in this sequence.
>Radius of Curvature (0046,0075) 1 The radius of curvature of the principal meridians of the cornea, measured in mm.
>Keratometric Power (0046,0076) 1 The refractive power of the cornea at the principal meridians, measured in diopters.
>Keratometric Axis (0046,0077) 1 The meridian where the keratometric radius of curvature or power is measured, in degrees.
Flat Keratometric Axis Sequence (0046,0080) 1 A sequence that specifies the flattest meridian as defined by the least power of curvature and longest radius of curvature. Only a single item shall be included in this sequence.
>Radius of Curvature (0046,0075) 1 The radius of curvature of the principal meridians of the cornea, measured in mm.
>Keratometric Power (0046,0076) 1 The refractive power of the cornea at the principal meridians, measured in diopters.
>Keratometric Axis (0046,0077) 1 The meridian where the keratometric radius of curvature or power is measured, in degrees.

C.8.25.11 Subjective Refractive Measurements Module

Table C.8.25.11-1 defines the Attributes used to represent the subjective refractive measurements of a patient’s eyes. Usually both eyes are measured, but sometimes just one.

Table C.8.25.11-1SUBJECTIVE REFRACTIVE MEASUREMENTS MODULE ATTRIBUTES

Attribute Name Tag Type Attribute Description
Subjective Refraction Right Eye Sequence (0046,0097) 1C A sequence that specifies the subjective refractive measurements of a patient’s right eye. Only a single item shall be included in this sequence. Required if the right eye is measured.
>Include ‘Subjective Refractive Measurements Macro' Table C.X.8.11-2
Subjective Refraction Left Eye Sequence (0046,0098) 1C A sequence that specifies the subjective refractive measurements of a patient’s left eye. Only a single item shall be included in this sequence. Required if the left eye is measured.
>Include ‘Subjective Refractive Measurements Macro' Table C.X.8.11-2
Distance Pupillary Distance (0046,0060) 3 Distance in mm between the pupils when the patient’s object of regard is in the distance, as measured by a phoropter.
Near Pupillary Distance (0046,0062) 3 Distance in mm between the pupils when the patient’s object of regard is at near, as measured by a phoropter.
Intermediate Pupillary Distance (0046,0063) 3 Distance in mm between the pupils when the patient’s object of regard is at an intermediate distance, as measured by a phoropter.
Other Pupillary Distance (0046,0064) 3 Distance in mm between the pupils when the patient’s object of regard is at the distance specified in the attribute Add Other Sequence (0046,0102), as measured by a phoropter.

Table C.8.25.11-2 describes the attributes used for the Subjective Refractive Measurements Macro

Table C.8.25.11-2SUBJECTIVE REFRACTIVE MEASUREMENTS MACRO

Attribute Name Tag Type Attribute Description
Sphere Power (0046,0146) 1 Refractive power of the eye that is the same in all meridians, measured at distance (optical infinity), in diopters.
Include 'Cylinder Sequence Macro' Table C.8.25.6.1-1
Include ‘Prism Sequence Macro’ Table C.8.25.6.2-1
Add Near Sequence (0046,0100) 1C A sequence that specifies refractive measurements of the eye to correct for inability to focus at near while wearing the distance prescription. Only a single item shall be included in this sequence. Required if near point refraction is done.
>Add Power (0046,0104) 1 Additional power relative to the distance correction, expressed in diopters, that allows best corrected visual acuity at the defined viewing distance.
>Viewing Distance (0046,0106) 3 The distance, in cm, for testing visual acuity corresponding to the value of Add Power (0046,0104) in this sequence.
Add Intermediate Sequence (0046,0101) 1C A sequence that specifies refractive measurements of the eye to correct for inability to focus at intermediate distance while wearing the distance prescription. Only a single item shall be included in this sequence. Required if intermediate point refraction is done.
>Add Power (0046,0104) 1 Additional power relative to the distance correction, expressed in diopters, that allows best corrected visual acuity at the defined viewing distance.
>Viewing Distance (0046,0106) 3 The distance, in cm, for testing visual acuity using the value of Add Power (0046,0104) in this sequence item.
Add Other Sequence (0046,0102) 1C A sequence that specifies refractive measurements of the eye to correct for inability to focus at the below specified distance while wearing the distance prescription. Only a single item shall be included in this sequence. Required if refraction is done at less than distance (optical infinity), but at a distance other than “near” or “intermediate”.
>Add Power (0046,0104) 1 Additional power relative to the distance correction, expressed in diopters, that allows best corrected visual acuity at the defined viewing distance.
>Viewing Distance (0046,0106) 3 The distance, in cm, for testing visual acuity corresponding to the value of Add Power (0046,0104) in this sequence item.

C.8.25.12 Visual Acuity Measurements Module

Table C.8.25.12-1 defines the Attributes used to represent the subjective measurements of a patient’s visual acuity. Usually each eye is measured individually, but sometimes only one eye is measured; sometimes the visual acuity of both eyes working together is measured. The visual acuity may be measured uncorrected, or with various refractive corrections, such as best corrected distance, pinhole, habitual near, etc

Table C.8.25.12-1VISUAL ACUITY MEASUREMENTS MODULE ATTRIBUTES

Attribute Name Tag Type Attribute Description
Viewing Distance Type (0046,0125) 1 The viewing distance conditions under which a patient's vision was measured. Enumerated Values: DISTANCE NEAR INTERMEDIATE OTHER
Visual Acuity Type Code Sequence (0046,0121) 1 A sequence that specifies the conditions under which a patient's vision was measured. Only a single item shall be included in this sequence.
>Include 'Code Sequence Macro' Table 8.8-1. Defined CID 4216
Background Color (0046,0092) 1 The color of the background upon which optotypes are displayed for measurements of visual acuity. Defined Terms: RED GREEN WHITE
Optotype (0046,0094) 1 The standardized test type (standard object of regard) used in measurements of visual acuity. Defined Terms: LETTERS NUMBERS PICTURES TUMBLING E LANDOLT C
Optotype Detailed Definition (0046,0139) 1C Required if the Optotype (0046,0094) Attribute value is LETTERS or NUMBERS or PICTURES. Provides additional information to define what optotype was used. Note: Letters, numbers, and pictures are commonly used but poorly standardized. The tumbling E and Landolt C are well defined.
Optotype Presentation (0046,0095) 1 Specifies whether single or multiple optotypes were presented. Enumerated Values: SINGLE MULTIPLE
Visual Acuity Right Eye Sequence (0046,0122) 1C A sequence that specifies the subjective measurement of a patient’s visual acuity for the right eye. Only a single item shall be included in this sequence. Required if the right eye is measured.
>Include ‘Visual Acuity Measurements Macro' Table C.8.25.12-2
Visual Acuity Left Eye Sequence (0046,0123) 1C A sequence that specifies the subjective measurements of a patient’s visual acuity for the left eye. Only a single item shall be included in this sequence. Required if the left eye is measured.
>Include ‘Visual Acuity Measurements Macro' Table C.8.25.12-2
Visual Acuity Both Eyes Open Sequence (0046,0124) 3 A sequence that specifies a patient’s subjective visual acuity measurements with both eyes open. Only a single item is permitted in this sequence.
>Include ‘Visual Acuity Measurements Macro' Table C.8.25.12-2

Table C.8.25.12-2 describes the attributes for the Visual Acuity Measurements Macro.

Table C.8.25.12-2VISUAL ACUITY MEASUREMENTS MACRO

Attribute Name Tag Type Attribute Description
Decimal Visual Acuity (0046,0137) 1 A patient’s visual acuity specified in decimal. The value is derived from two values in a fraction where the numerator of the fraction is the nominal distance to the chart that the patient is reading. The denominator represents the line of smallest optotypes of which the patient can see more than half. Notes: 1. Typical examples--reference standard is 1, severe vision loss is 0.1 2. See PS 3.17 Ophthalmic Refractive Reports Use Cases for guidance in converting Decimal Visual Acuity to other customarily used display notation such as 20/20 in the US and 6/6 in Britain.
Visual Acuity Modifiers (0046,0135) 3 The first value is a positive or negative integer numeric value such as +1, +2, +3, 0, -1, -2, or -3 used to indicate that the patient missed letters on the line referenced, or saw additional letters on the next smaller line. The second value is a positive or negative integer numeric value such as +1, +2, +3, 0, -1, -2, or -3 which in combination with the first value indicates that the patient both saw additional letters on the next smaller line and missed letters on the line referenced. Notes: 1. When the modifier values are zero, the values are not typically displayed to the user. 2. See PS 3.17 Ophthalmic Refractive Reports Use Cases for guidance regarding significance of modifiers.

C.8.25.13 Ophthalmic Axial Measurements Series Module

Table C.8.25.13-1 specifies the Attributes that identify and describe general information about the Ophthalmic Axial Measurements Series.

Table C.8.25.13-1OPHTHALMIC AXIAL MEASUREMENTS SERIES MODULE ATTRIBUTES

Attribute Name Tag Type Attribute Description
Modality (0008,0060) 1 Type of equipment that originally acquired the data used to create the measurements in this Series. Enumerated Values: OAM See section C.7.3.1.1.1 for further explanation.
Referenced Performed Procedure Step Sequence (0008,1111) 1C Uniquely identifies the Performed Procedure Step SOP Instance to which the Series is related (e.g. a Modality or General-Purpose Performed Procedure Step SOP Instance). Only a single Item shall be included in this sequence. Required if the Modality Performed Procedure Step SOP Class, or General Purpose Performed Procedure Step SOP Class is supported.
>Include ‘SOP Instance Reference Macro’ Table 10-11

C.8.25.14 Ophthalmic Axial Measurements Module

Table C.8.25.14-1 defines the Attributes used to encode axial measurements of the eye made by an axial measurements device. This is typically done for both eyes, but may be for just one.

Table C.8.25.14-1OPHTHALMIC AXIAL MEASUREMENTS MODULE ATTRIBUTES

Attribute Name Tag Type Attribute Description
Ophthalmic Axial Measurements Device Type (0022,1009) 1 Describes the type of ophthalmic axial measurement acquisition device. Defined Terms: ULTRASOUND OPTICAL
Ophthalmic Ultrasound Method Code Sequence (0022,1044) 1C The method used for obtaining axial measurements of the eye. Only a single Item shall be included in this sequence. Required if Ophthalmic Axial Measurements Device Type (0022,1009) is ULTRASOUND.
>Include 'Code Sequence Macro' Table 8.8-1. Defined Context ID is 4230
Anterior Chamber Depth Definition Code Sequence (0022,1125) 3 The definition of anterior chamber depth for this instrument. Only a single Item is permitted in this sequence.
>Include 'Code Sequence Macro' Table 8.8-1. Defined Context ID is 4239
Ophthalmic Axial Measurements Right Eye Sequence (0022,1007) 1C Axial measurements of a patient’s right eye. Only a single Item shall be included in this sequence. Required if the right eye is measured.
>Include ' Ophthalmic Axial Measurements Macro' Table C.8.25.14-2
>Include ' Ophthalmic Axial Measurements Selected Macro' Table C.8.25.14-5
Ophthalmic Axial Measurements Left Eye Sequence (0022,1008) 1C Axial measurements of a patient’s left eye. Only a single Item shall be included in this sequence. Required if the left eye is measured.
>Include ' Ophthalmic Axial Measurements Macro' Table C.8.25.14-2
>Include ' Ophthalmic Axial Measurements Selected Macro' Table C.8.25.14-5

C.8.25.14.1 Ophthalmic Axial Measurements Macro

Table C.8.25.14-2 describes the attributes for the Ophthalmic Axial Measurements Macro.

Table C.8.25.14-2 OPHTHALMIC AXIAL MEASUREMENTS MACRO

Attribute Name Tag Type Attribute Description
Lens Status Code Sequence (0022,1024) 1 Lens status of the eye. See section C.8.25.14.1.1.1 for further explanation. Only a single Item shall be included in this sequence.
>Include 'Code Sequence Macro' Table 8.8-1. Defined Context ID is 4231
Lens Status Description (0022,1065) 3 A free form text description of the Lens Status (0022,1024).
Vitreous Status Code Sequence (0022,1025) 1 Status of the vitreous cavity. See section C.8.25.14.1.1.2 for further explanation. Only a single Item shall be included in this sequence.
>Include 'Code Sequence Macro' Table 8.8-1. Defined Context ID is 4232
Vitreous Status Description (0022,1066) 3 A free form text description of Vitreous Status (0022,1025).
Pupil Dilated (0022,000D) 2 Whether or not the patient’s pupils were pharmacologically dilated for this acquisition Enumerated Values: YES NO If this tag is empty, no information is available.
Degree of Dilation (0022,000E) 2C The degree of the dilation in mm. Required if the value of Pupil Dilated (0022,000D) is YES.
Mydriatic Agent Sequence (0022,0058) 2C Information about the agent administered. Zero or more Items shall be included in this sequence. Note: An empty sequence indicates that an agent was used for dilation, but the name was not entered. Required if the value of Pupil Dilated (0022,000D) is YES.
>Mydriatic Agent Code Sequence (0022,001C) 1 The actual agent administered to dilate the pupil. Only a single Item shall be included in this sequence.
>>Include ‘Code Sequence Macro’ Table 8.8-1 Baseline Context ID is 4208.
>Mydriatic Agent Concentration (0022,004E) 3 The concentration of the agent.
>Mydriatic Agent Concentration Units Sequence (0022,0042) 1C Units of measure for the Mydriatic Agent Concentration. Only a single Item shall be included in this sequence. Required if Mydriatic Agent Concentration (0022,004E) is present.
>>Include 'Code Sequence Macro' Table 8.8-1. Defined Context ID is 4244
Ophthalmic Axial Length Measurements Sequence (0022,1050) 1 Measurements of the axial length of a patient’s eye. One or more items shall be included in this sequence.
>Ophthalmic Axial Length Measurements Type (0022,1010) 1 Identifies whether measuring the total axial length of the patient’s eye or a segment of the eye for which a discrete measurement was obtained. Enumerated Values: TOTAL LENGTH = the total axial length was taken with one measurement LENGTH SUMMATION = a summation of segmental lengths that determine the total axial length SEGMENTAL LENGTH = a segmental axial length
>Ophthalmic Axial Length Measurements Total Length Sequence (0022,1210) 1C The axial length of a patient’s eye, in mm. One or more items shall be included in this sequence. Required if Ophthalmic Axial Length Measurements Type (0022,1010) is TOTAL LENGTH. See section C.8.25.14.1.1.4 for further explanation.
>>Ophthalmic Axial Length (0022,1019) 1 The axial length measurement acquired, in mm. The type of measurement is specified in the Ophthalmic Axial Length Measurements Type (0022,1010). See sections C.8.25.14.1.1.3 and C.8.25.14.1.1.4 for further explanation.
>>Ophthalmic Axial Length Measurement Modified (0022,1140) 1 Whether or not the clinician intervened to modify the output of the device. For example by forcing it to select a different peak in the display. Enumerated Values: YES NO
>>Referenced Ophthalmic Axial Length Measurement QC Image Sequence (0022,1330) 1 Reference to the quality control image associated with this measurement. Only a single Item shall be included in this sequence. See section C.8.25.14.1.1.6 for further explanation.
>>>Include ‘Ophthalmic Axial Measurements Quality Image SOP Instance Reference Macro’ Table C.8.25.16-6
>>Include ‘Ophthalmic Axial Measurements Related Information Macro’ Table C.8.25.14-4
>Ophthalmic Axial Length Measurements Length Summation Sequence (0022,1212) 1C Axial length of a patient’s eye, in mm, when it is calculated by summation of multiple segmental axial length measurements. One or more items shall be included in this sequence. Required if Ophthalmic Axial Length Measurements Type (0022,1010) is LENGTH SUMMATION. See section C.8.25.14.1.1.4 for further explanation.
>>Ophthalmic Axial Length (0022,1019) 1 The axial length measurement acquired, in mm. The type of measurement is specified in the Ophthalmic Axial Length Measurements Type (0022,1010). See sections C.8.25.14.1.1.3 and C.8.25.14.1.1.4 for further explanation.
>>Ophthalmic Axial Length Measurement Modified (0022,1140) 1 Whether or not the clinician intervened to modify the output of the device. For example by forcing it to select a different peak in the display. Enumerated Values: YES NO
>>Referenced Ophthalmic Axial Length Measurement QC Image Sequence (0022,1330) 1 Reference to the quality control image associated with this measurement. Only a single Item shall be included in this sequence. See section C.8.25.14.1.1.6 for further explanation.
>>>Include ‘Ophthalmic Axial Measurements Quality Image SOP Instance Reference Macro’ Table C.8.25.16-6
>>Ophthalmic Axial Length Measurements Segmental Length Sequence (0022,1211) 1 Segmental axial length measurements of a patient’s eye that contribute to an aggregate axial length measurement. One or more items shall be included in this sequence. See section C.8.25.14.1.1.4 for further explanation.
>>>Include 'Ophthalmic Axial Length Segmental Measurements Macro' Table C.8.25.14-3
>Ophthalmic Axial Length Measurements Segmental Length Sequence (0022,1211) 1C Segmental axial length measurement of a patient’s eye. Only a single Item shall be included in this sequence. Required if Ophthalmic Axial Length Measurements Type (0022,1010) is SEGMENTAL LENGTH. See section C.8.25.14.1.1.4 for further explanation.
>>Include 'Ophthalmic Axial Length Segmental Measurements Macro' Table C.8.25.14-3

C.8.25.14.1.1 Ophthalmic Axial Measurements Macro Attribute Descriptions

C.8.25.14.1.1.1 Lens Status Code Sequence

Lens Status Code Sequence (0022,1024) refers to either the natural lens of the eye (phakic), or various types of lens implants inserted in cataract surgery, or lack of a lens in the eye (aphakic).

C.8.25.14.1.1.2 Vitreous Status Code Sequence

Vitreous Status Code Sequence (0022,1025) refers to either the natural status of the vitreous cavity (vitreous only) or to various possible states after vitreous surgery.

C.8.25.14.1.1.3 Ophthalmic Axial Length

If Ophthalmic Axial Measurements Device Type (0022,1009) is ULTRASOUND, the Ophthalmic Axial Length (0022,1019) measurement is taken from the anterior vertex of the cornea to the anterior surface of the retina (internal limiting membrane).

If Ophthalmic Axial Measurements Device Type (0022,1009) is OPTICAL, the Ophthalmic Axial Length (0022,1019) measurement is taken from the anterior vertex of the cornea to the level of the photoreceptors in the retina and compensated to adjust for the thickness of the retina to mimic the ultrasound technique.

This difference is an inherent property of the measurement method. Since optical devices measure to retinal pigment epithelium and ultrasound devices measure to internal limiting membrane, the difference must be subtracted to obtain comparable results for use in intraocular lens calculation formulas. The difference is the thickness of the retina, which has been determined empirically and varies with the axial length of the eye.

The intent is to measure along the patient’s visual axis.

C.8.25.14.1.1.4 Ophthalmic Axial Length Measurements Segment Name Code Sequence

When the acquisition device type is ultrasound, the Ophthalmic Axial Length (0022,1019) may represent distance calculated using a single time value and an average presumed velocity for the entire eye. Alternatively it may represent the sum of multiple segmental axial length measurements with each distance value calculated using a different time value and a presumed velocity specific to that segment of the eye.

When the acquisition device type is optical, the whole length can be measured instead of measuring and summing up different segments of the eye. Nevertheless, optical axial measurement devices can also measure segments of the eye independently (e.g. the Anterior Chamber depth).

Each segment of the eye that is measured shall be identified by the Ophthalmic Axial Length Measurements Segment Name Code Sequence (0022,1101).

C.8.25.14.1.1.5 Observer Type

For attribute Observer Type (0040,A084), Ultrasound axial length measurement devices take many measurements in rapid sequence. The machine can be set to select a good quality measurement automatically, or it can be set so that the user presses a footswitch when he/she sees a quality measurement based on the graphical display.

C.8.25.14.1.1.6 Referenced Ophthalmic Axial Length Measurement QC Image Sequence

The attribute Referenced Ophthalmic Axial Length Measurement QC Image Sequence (0022,1330) references a quality control image that is a secondary capture of the presentation of a one dimensional waveform produced when performing ophthalmic axial measurements. It is acquired by the modality creating the ophthalmic axial measurements. The purpose of these images is to judge the quality of an axial length measurement for use in calculating the power of intraocular lens to place in a patient’s eye in cataract surgery. The image is used for quality control and not for diagnostic purposes. See PS3.17.

The SOP Instance for the quality control image will meet the following requirements:

Note: The frame number is the recommended value for the label.

The attribute Burned In Annotation (0028,0301) defines whether patient demographics have been burned into the image. This attribute does not prohibit non-demographic burned in annotation, such as position of gates, for image or waveform annotations that are very important to a user. Such annotations are expected to be conveyed and displayed.

C.8.25.14.2 Ophthalmic Axial Length Segmental Measurements Macro

Table C.8.25.14-3 describes the attributes for the Ophthalmic Axial Length Segmental Measurements Macro.

Table C.8.25.14-3 OPHTHALMIC AXIAL LENGTH SEGMENTAL MEASUREMENTS MACRO

Attribute Name Tag Type Attribute Description
Ophthalmic Axial Length (0022,1019) 1 The axial length measurement, in mm. The type of measurement is specified in the Ophthalmic Axial Length Measurements Type (0022,1010). See sections C.8.25.14.1.1.3 and C.8.25.14.1.1.4 for further explanation.
Ophthalmic Axial Length Measurement Modified (0022,1140) 1 Whether or not the clinician intervened to modify the output of the device. For example by forcing it to select a different peak in the display. Enumerated Values: YES NO
Ophthalmic Axial Length Measurements Segment Name Code Sequence (0022,1101) 1 The name of the segment measured. See section C.8.25.14.1.1.4 for further explanation. Only a single Item shall be included in this sequence.
>Include 'Code Sequence Macro' Table 8.8-1. Defined Context ID is 4233
Include ‘Ophthalmic Axial Measurements Related Information Macro’ Table C.8.25.14-4

C.8.25.14.3 Ophthalmic Axial Measurements Related Information Macro

Table C.8.25.14-4 describes the attributes for the Ophthalmic Axial Measurements Related Information Macro.

Table C.8.25.14-4 OPHTHALMIC AXIAL MEASUREMENTS RELATED INFORMATION MACRO

Attribute Name Tag Type Attribute Description
Ultrasound Ophthalmic Axial Length Measurements Sequence (0022,1220) 1C Related information about an axial length measurement being performed on an ultrasound device. Only a single Item shall be included in this sequence. Required if Ophthalmic Axial Measurements Device Type (0022,1009) is ULTRASOUND.
>Ophthalmic Axial Length Velocity (0022,1059) 1 The sound velocity used in calculating the Ophthalmic Axial Length Measurement Value (0022,1019), in m/sec.
>Observer Type (0040,A084) 1 Method used to select which acquired axial length measurement values are kept. Enumerated Values: PSN = Person; manually selected DEV = Device; automatically selected See section C.8.25.14.1.1.5 for further explanation.
>Ophthalmic Axial Length Data Source Code Sequence (0022,1150) 1 Source of the value recorded in Ophthalmic Axial Length (0022,1019). Only a single Item shall be included in this sequence.
>>Include 'Code Sequence Macro' Table 8.8-1. Defined Context ID is 4240
>Ophthalmic Axial Length Data Source Description (0022,1159) 3 A free text description of the axial length measurement data source.
Optical Ophthalmic Axial Length Measurements Sequence (0022,1225) 1C Related information about an axial length measurement being performed on an optical device. Only a single Item shall be included in this sequence. Required if Ophthalmic Axial Measurements Device Type (0022,1009) is OPTICAL.
>Signal to Noise Ratio (0022,1155) 1C The ratio of signal power to the background noise power (P signal/ P noise). Required if Ophthalmic Axial Length Measurements Type (0022,1010) is TOTAL LENGTH. May be present otherwise.
>Ophthalmic Axial Length Data Source Code Sequence (0022,1150) 1 The source of the value in Ophthalmic Axial Length (0022,1019). Only a single Item shall be included in this sequence.
>>Include 'Code Sequence Macro' Table 8.8-1. Defined Context ID is 4240
>Ophthalmic Axial Length Data Source Description (0022,1159) 3 A free text description of the axial length measurement data source.

C.8.25.14.4 Ophthalmic Axial Measurements Selected Macro

Table C.8.25.14-5 describes the attributes for the Ophthalmic Axial Measurements Selected Macro. These are the attributes of the Ophthalmic Axial Length (0022,1019) selected for use in IOL calculations.

Table C.8.25.14-5 OPHTHALMIC AXIAL MEASUREMENTS SELECTED MACRO

Attribute Name Tag Type Attribute Description
Ultrasound Selected Ophthalmic Axial Length Sequence (0022,1230) 1C Information related to the selected axial length measurement of the patient’s eye when acquired on an ultrasound device. Only a single Item shall be included in this sequence. Required if Ophthalmic Axial Measurements Device Type (0022,1009) is ULTRASOUND.
>Ophthalmic Axial Length (0022,1019) 1 The axial length measurement, in mm. The type of measurement is specified in the Ophthalmic Axial Length Measurements Type (0022,1010). See sections and C.8.25.14.1.1.4 for further explanation.
>Ophthalmic Axial Length Selection Method Code Sequence (0022,1250) 1 Method used to derive the value recorded in Ophthalmic Axial Length (0022,1019). Only a single Item shall be included in this sequence.
>>Include 'Code Sequence Macro' Table 8.8-1. Defined Context ID is 4241
>Referenced Ophthalmic Axial Length Measurement QC Image Sequence (0022,1330) 1 References to the quality control image associated with this measurement. Only a single Item shall be included in this sequence. See section C.8.25.14.1.1.6 for further explanation.
>> Include ‘Ophthalmic Axial Measurements Quality Image SOP Instance Reference Macro’ Table C.8.25.16-6
>Ophthalmic Axial Length Quality Metric Sequence (0022,1262) 1 Information about the quality metric applied to Ophthalmic Axial Length (0022,1019). Only a single Item shall be included in this sequence.
>>Include ‘Ophthalmic Axial Length Quality Metric Macro’ Table C.8.25.14-6
>Selected Segmental Ophthalmic Axial Length Sequence (0022,1257) 1C Segmental axial length measurements of a patient’s eye that are summed to derive a total axial length for the eye. One or more items shall be included in this sequence. Required if Ophthalmic Axial Length Measurements Type (0022,1010) is LENGTH SUMMATION.
>>Ophthalmic Axial Length (0022,1019) 1 The axial length measurement, in mm. The type of measurement is specified in the Ophthalmic Axial Length Measurements Type (0022,1010). See sections C.8.25.14.1.1.3 and C.8.25.14.1.4 for further explanation.
>>Ophthalmic Axial Length Measurements Segment Name Code Sequence (0022,1101) 1 Name of the segment measured. See section C.8.25.14.1.1.4 for further explanation. Only a single Item shall be included in this sequence.
>>>Include 'Code Sequence Macro' Table 8.8-1. Defined Context ID is 4233
Optical Selected Ophthalmic Axial Length Sequence (0022,1255) 1C Information related to the selected axial length measurement(s) of the patient’s eye when acquired on an optical device. One or more items shall be included in this sequence. Required if Ophthalmic Axial Measurements Device Type (0022,1009) is OPTICAL.
>Selected Total Ophthalmic Axial Length Sequence (0022,1260) 1C Total axial length measurement selected for the patient’s eye. Required if Ophthalmic Axial Length Measurements Type (0022,1010) is TOTAL LENGTH. Only a single Item shall be included in this sequence.
>>Ophthalmic Axial Length (0022,1019) 1 The axial length measurement, in mm. The type of measurement is specified in the Ophthalmic Axial Length Measurements Type (0022,1010). See sections C.8.25.14.1.1.3 and C.8.25.14.1.1.4 for further explanation.
>>Referenced Ophthalmic Axial Length Measurement QC Image Sequence (0022,1330) 1 Reference to the quality control image associated with this measurement. Only a single Item shall be included in this sequence. See section C.8.25.14.1.1.6 for further explanation.
>>> Include ‘Ophthalmic Axial Measurements Quality Image SOP Instance Reference Macro’ Table C.8.25.16-6
>>Ophthalmic Axial Length Quality Metric Sequence (0022,1262) 1 Information about the quality metric applied to Ophthalmic Axial Length (0022,1019). Only a single Item shall be included in this sequence.
>>>Include ‘Ophthalmic Axial Length Quality Metric Macro’ Table C.8.25.14-6
>Selected Segmental Ophthalmic Axial Length Sequence (0022,1257) 1C Segmental axial length measurement(s) selected for the patient’s eye. One or more items shall be included in this sequence. Required if Ophthalmic Axial Length Measurements Type (0022,1010) is SEGMENTAL LENGTH. May be present otherwise.
>>Ophthalmic Axial Length Measurements Segment Name Code Sequence (0022,1101) 1 Name of the segment measured. See section C.8.25.14.1.1.4 for further explanation. Only a single Item shall be included in this sequence.
>>>Include 'Code Sequence Macro' Table 8.8-1. Defined Context ID is 4233
>>Ophthalmic Axial Length (0022,1019) 1 The axial length measurement, in mm. The type of measurement is specified in the Ophthalmic Axial Length Measurements Type (0022,1010). See sections C.8.25.14.1.1.3 and C.8.25.14.1.1.4 for further explanation.
>>Referenced Ophthalmic Axial Length Measurement QC Image Sequence (0022,1330) 3 Reference to the quality control image associated with this measurement. Only a single Item is permitted in this sequence. See section C.8.25.14.1.1.6 for further explanation.
>>>Include ‘Ophthalmic Axial Measurements Quality Image SOP Instance Reference Macro’ Table C.8.25.16-6
>>Ophthalmic Axial Length Quality Metric Sequence (0022,1262) 3 Information about the quality metric applied to Ophthalmic Axial Length (0022,1019). Only a single Item is permitted in this sequence.
>>>Include ‘Ophthalmic Axial Length Quality Metric Macro’ Table C.8.25.14-6

C.8.25.14.5 Ophthalmic Axial Measurements Quality Metric Macro

Table C.8.25.14-6 describes the attributes for the Ophthalmic Axial Length Quality Metric Macro.

Table C.8.25.14-6 OPHTHALMIC AXIAL LENGTH QUALITY METRIC MACRO

Attribute Name Tag Type Attribute Description
Concept Name Code Sequence (0040,A043) 1 Type of metric used to evaluate the quality of the ophthalmic axial length. Only a single Item shall be included in this sequence.
>Include 'Code Sequence Macro' Table 8.8-1. Defined Context ID is 4243
Numeric Value (0040,A30A) 1 Value for quality metric applied to axial length values.
Measurement Units Code Sequence (0040,08EA) 1 Units of Numeric Value (0040,A30A). Only a single Item shall be included in this sequence.
>Include 'Code Sequence Macro' Table 8.8-1. Defined Context ID is 82.

C.8.25.15 Intraocular Lens Calculations Series Module

Table C.8.25.15-1 specifies the Attributes that identify and describe general information about the Intraocular Lens Calculations Series.

Table C.8.25.15-1INTRAOCULAR LENS CALCULATIONS SERIES MODULE ATTRIBUTES

Attribute Name Tag Type Attribute Description
Modality (0008,0060) 1 Specific equipment on which the software that performed the calculations in this Series resides. Enumerated Values: IOL See section C.7.3.1.1.1 for further explanation.
Referenced Performed Procedure Step Sequence (0008,1111) 1C Uniquely identifies the Performed Procedure Step SOP Instance to which the Series is related (e.g. a Modality or General-Purpose Performed Procedure Step SOP Instance). Only a single Item shall be included in this sequence. Required if the Modality Performed Procedure Step SOP Class, or General Purpose Performed Procedure Step SOP Class is supported.
>Include ‘SOP Instance Reference Macro’ Table 10-11

C.8.25.16 Intraocular Lens Calculations Module

Table C.8.25.16-1 defines the Attributes used to calculate the power of an intraocular lens to be placed in a patient’s eye. This is typically done for both eyes for comparison, but may be for just one eye. Values used may be measurements acquired using the axial length measurements device, manually entered, or derived from a referenced SOP class or other data source.

Table C.8.25.16-1INTRAOCULAR LENS CALCULATIONS MODULE ATTRIBUTES

Attribute Name Tag Type Attribute Description
Intraocular Lens Calculations Right Eye Sequence (0022,1300) 1C Calculations of intraocular lens power for a patient’s right eye. One or more Items shall be included in this sequence. Required if the device calculated intraocular lens power for the right eye.
>Include 'Intraocular Lens Calculations Macro' Table C.8.25.16-2
Intraocular Lens Calculations Left Eye Sequence (0022,1310) 1C Calculations of intraocular lens power for a patient’s left eye. One or more Items shall be included in this sequence. Required if the device calculated intraocular lens power for the left eye.
>Include 'Intraocular Lens Calculations Macro' Table C.8.25.16-2

C.8.25.16.1 Intraocular Lens Calculations Module Attributes

C.8.25.16.1.1 Referenced SOP Sequence

Data in an IOL Calculations SOP Instance will frequently be gathered from other SOP instances, such as ophthalmic axial measurements SOP Instances or refractive measurements SOP Instances. If this occurs, a reference to the SOP instances is desired in attribute Referenced SOP Sequence (0008,1199).

C.8.25.16.2 Intraocular Lens Calculations Macro

Table C.8.25.16-2 describes the attributes for the Intraocular Lens Calculations Macro.

Table C.8.25.16-2 INTRAOCULAR LENS CALCULATIONS MACRO

Attribute Name Tag Type Attribute Description
Target Refraction (0022,1037) 1 The desired postoperative refractive error, in diopters.
Refractive Procedure Occurred (0022,1039) 2 Whether or not a patient has had refractive surgery. Enumerated Values: YES NO
Refractive Surgery Type Code Sequence (0022,1040) 2C Type of refractive surgery a patient has had. Zero or more Items shall be included in this sequence. Required if the value of Refractive Procedure Occurred (0022,1039) is YES.
>Include 'Code Sequence Macro' Table 8.8-1. Defined Context ID is 4234
Refractive Error Before Refractive Surgery Code Sequence (0022,1103) 2C The patient’s refractive error before any of the refractive surgeries listed in Refractive Surgery Type Code Sequence (0022,1040) were performed. Zero or one Item shall be included in this sequence. Required if the value of Refractive Procedure Occurred (0022,1039) is YES.
>Include 'Code Sequence Macro' Table 8.8-1. Defined Context ID is 4238
Corneal Size (0046,0046) 3 The horizontal diameter measurement of the cornea, in mm.
Lens Thickness Sequence (0022,1127) 3 Lens thickness value and source. Only a single Item is permitted in this sequence.
>Lens Thickness (0022,1130) 1 The value for axial length of the lens in a patient’s eye, in mm.
>Source of Lens Thickness Data Code Sequence (0022,1132) 1 Source of the value of Lens Thickness (0022,1130). Only a single Item shall be included in this sequence.
>>Include 'Code Sequence Macro' Table 8.8-1. Defined Context ID is 4240
>Referenced SOP Sequence (0008,1199) 1C SOP Instance that is relevant to the interpretation of this SOP Instance. Only a single Item shall be included in this sequence. See section C.8.25.16.1.1 for further explanation. Required if Source of Lens Thickness Data Code Sequence (0022,1132) contains an item with the value (111782, DCM, “Axial Measurements SOP Instance”).
>>Include ‘SOP Instance Reference Macro’ Table 10-11
Anterior Chamber Depth Sequence (0022,1128) 3 Anterior chamber depth value and source. Only a single Item is permitted in this sequence.
>Anterior Chamber Depth (0022,1131) 1 The value for axial length of the anterior chamber, in mm.
>Source of Anterior Chamber Depth Data Code Sequence (0022,1133) 1 Source of the value of Anterior Chamber Depth (0022,1131). Only a single Item shall be included in this sequence.
>>Include 'Code Sequence Macro' Table 8.8-1. Defined Context ID is 4240
>Referenced SOP Sequence (0008,1199) 1C SOP Instance that is relevant to the interpretation of this SOP Instance. Only a single Item shall be included in this sequence. See section C.8.25.16.1.1 for further explanation. Required if Source of Anterior Chamber Depth Data Code Sequence (0022,1133) contains an item with the value (111782, DCM, “Axial Measurements SOP Instance”).
>>Include ‘SOP Instance Reference Macro’ Table 10-11
Refractive State Sequence (0022,001B) 2 Refractive state of the imaged eye at the time of acquisition. Zero or one Item shall be included in this sequence.
>Spherical Lens Power (0022,0007) 1 Sphere value in diopters.
>Cylinder Lens Power (0022,0008) 1 Cylinder value in diopters.
>Cylinder Axis (0022,0009) 1 Axis value in degrees.
>Source of Refractive Measurements Sequence (0022,1134) 1 Refractive measurements source. Only a single Item shall be included in this sequence.
>>Source of Refractive Measurements Code Sequence (0022,1135) 1 Source of values in Refractive State Sequence (0022,101B). Only a single Item shall be included in this sequence.
>>>Include 'Code Sequence Macro' Table 8.8-1. Defined Context ID is 4240
>>Referenced SOP Sequence (0008,1199) 1C SOP Instances that are relevant to the interpretation of this SOP Instance. One or more items shall be included in this sequence. See section C.8.25.16.1.1 for further explanation. Required if Source of Refractive Measurements Code Sequence (0022,1135) contains an item with the value (111783, DCM, “Refractive Measurements SOP Instance”).
>>>Include ‘SOP Instance Reference Macro’ Table 10-11
Include ‘Keratometry Macro’ Table C.8.25.16-3
IOL Formula Code Sequence (0022,1028) 1 Formula used to calculate IOL power. Only a single Item shall be included in this sequence.
>Include 'Code Sequence Macro' Table 8.8-1. Defined Context ID is 4236
IOL Formula Detail (0022,1029) 3 A free form text description of the of the IOL Formula Code Sequence (0022,1028) (e.g. a reference to the mathematical equation).
Include ‘IOL Ophthalmic Axial Length Macro’ Table C.8.25.16-4
Include ‘Calculated IOL Macro’ Table C.8.25.16-5

C.8.25.16.3 Keratometry Macro

Table C.8.25.16-3 describes the attributes for the Keratometry Macro.

Table C.8.25.16-3 KERATOMETRY MACRO

Attribute Name Tag Type Attribute Description
Steep Keratometric Axis Sequence (0046,0074) 1 Steepest meridian as defined by the greatest power of curvature and shortest radius of curvature. Only a single Item shall be included in this sequence.
>Radius of Curvature (0046,0075) 1 The radius of curvature of the principal meridians of the cornea, measured in mm.
>Keratometric Power (0046,0076) 2 The refractive power of the cornea at the principal meridians, measured in diopters.
>Keratometric Axis (0046,0077) 2 The meridian where the keratometric radius of curvature or power is measured, in degrees.
Flat Keratometric Axis Sequence (0046,0080) 1 Flattest meridian as defined by the least power of curvature and longest radius of curvature. Only a single Item shall be included in this sequence.
>Radius of Curvature (0046,0075) 1 The radius of curvature of the principal meridians of the cornea, measured in mm.
>Keratometric Power (0046,0076) 2 The refractive power of the cornea at the principal meridians, measured in diopters.
>Keratometric Axis (0046,0077) 2 The meridian where the keratometric radius of curvature or power is measured, in degrees.
Keratometry Measurement Type Code Sequence (0022,1096) 2 Descriptors relevant to keratometry data. Zero or one Item shall be included in this sequence.
>Include 'Code Sequence Macro' Table 8.8-1. Defined Context ID is 4235
Keratometer Index (0022,1033) 2 The translation factor specific to each keratometer that derives a number for power from the measured radius of curvature of the cornea.

C.8.25.16.4 IOL Ophthalmic Axial Length Macro

Table C.8.25.16-4 describes the attributes for the IOL Ophthalmic Axial Length Macro.

Table C.8.25.16-4 IOL OPHTHALMIC AXIAL LENGTH MACRO

Attribute Name Tag Type Attribute Description
Ophthalmic Axial Length Sequence (0022,1012) 1 Axial length value and source that was used in calculation of IOL power. Only a single Item shall be included in this sequence.
>Ophthalmic Axial Length (0022,1019) 1 The axial length of a patient’s eye, in mm, that was used in calculation of IOL power.
>Ophthalmic Axial Length Selection Method Code Sequence (0022,1250) 1 Method used to select the value recorded in Ophthalmic Axial Length (0022,1019). Only a single Item shall be included in this sequence.
>>Include 'Code Sequence Macro' Table 8.8-1. Defined Context ID is 4241
>Source of Ophthalmic Axial Length Code Sequence (0022,1035) 1 Source of the value of Ophthalmic Axial Length (0022,1019). Only a single Item shall be included in this sequence.
>>Include 'Code Sequence Macro' Table 8.8-1. Defined Context ID is 4240
>Referenced SOP Sequence (0008,1199) 1C SOP Instances that are relevant to the interpretation of this SOP Instance. One or more items shall be included in this sequence. See section C.8.25.16.1.1 for further explanation. Required if Source of Ophthalmic Axial Length Code Sequence (0022,1035) contains an item with the value (111782, DCM, “Axial Measurements SOP Instance”).
>>Include ‘SOP Instance Reference Macro’ Table 10-11
>Ophthalmic Ultrasound Method Code Sequence (0022,1044) 1C Method used for obtaining axial measurements of the eye. Required if Ophthalmic Axial Measurements Device Type (0022,1009) is ULTRASOUND. Only a single Item shall be included in this sequence.
>>Include 'Code Sequence Macro' Table 8.8-1. Defined Context ID is 4230

C.8.25.16.5 Calculated IOL Macro

Table C.8.25.16-5 describes the attributes for the Calculated IOL Macro.

Table C.8.25.16-5 CALCULATED IOL MACRO

Attribute Name Tag Type Attribute Description
IOL Manufacturer (0022,1093) 1 Name of the manufacturer that produced the lens.
Implant Name (0022,1095) 1 The (product) name of the lens.
Lens Constant Sequence (0022,1092) 1 Constants used in calculation of intraocular lens power. These constants are a characteristic of the model of intraocular lens being considered for use in cataract surgery. One or more Items shall be included in this sequence.
>Concept Name Code Sequence (0040,A043) 1 Constant type used in calculation of intraocular lens power. Only a single Item shall be included in this sequence.
>>Include 'Code Sequence Macro' Table 8.8-1. Defined Context ID is 4237
>Numeric Value (0040,A30A) 1 The value of the constant used.
IOL Power Sequence (0022,1090) 1 Information needed to select the intraocular lens power for cataract surgery. One or more Items shall be included in this sequence.
>IOL Power (0022,1053) 1 The intraocular lens power, in diopters.
>Predicted Refractive Error (0022,1054) 1 The predicted postoperative refractive error (i.e. amount of near or far sightedness), in diopters.
>Implant Part Number (0022,1097) 2 The (product) identifier of the lens.
IOL Power for Exact Emmetropia (0022,1121) 2 The IOL power that would be required to achieve exact emmetropia, or no need for glasses at distance after surgery, in diopters.
IOL Power for Exact Target Refraction (0022,1122) 2 The IOL power that would be required to exactly achieve the Target Refraction (0022,1037), in diopters.

C.8.25.16.6 Ophthalmic Axial Measurements Quality Image SOP Instance Reference Macro

Table C.8.25.16-6 describes the attributes for the Ophthalmic Axial Measurements Quality Image SOP Instance Reference Macro

Table C.8.25.16-6 OPHTHALMIC AXIAL MEASUREMENTS QUALITY IMAGE SOP INSTANCE REFERENCE MACRO

Attribute Name Tag Type Attribute Description
Referenced SOP Class UID (0008,1150) 1 Uniquely identifies the referenced SOP Class. Enumerated Values: “1.2.840.10008.5.1.4.1.1.7.2” = Multi-frame Grayscale Byte Secondary Capture Image Storage “1.2.840.10008.5.1.4.1.1.7.4” = Multi-frame True Color Secondary Capture Image Storage
Referenced SOP Instance UID (0008,1155) 1 Uniquely identifies the referenced SOP Instance.
Referenced Frame Number (0008,1160) 1 Identifies the frame number within the Referenced SOP Instance to which the reference applies. The first frame shall be denoted as frame number 1. Only a single value shall exist. Note: This Attribute is a multi-value field but for this Macro it can only contain one value.