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Acuity Pro - Frequently Asked Questions

Q - What if I lose my hardware license key or license CD?
We are not responsible for lost or stolen license keys.  Replacement keys may be purchased at the normal retail fee for extra licenses.  If a key becomes non-functional, it may be sent back to us for evaluation and if found defective, will be replaced at no charge. 

Q - Is Acuity Pro Windows 10 compliant?
Yes, Acuity Pro has been tested with Win 10, 8.1, 8, 7 and VISTA machines and works perfectly.  If you plan on using dual monitors, make sure that you have a video card that has a Win 7 driver.  We have had several instances where runtime errors occurred when trying to use a video card with a VGA and DVI output.  We believe that the problem occurred because current Win 7 drivers were not loaded.  Acuity Pro has been tested and is known to work flawlessly with Windows 7 and an NVIDEA GeForce 8400 GS card connected to one VGA monitor and one DVI monitor.  We believe that most new NVIDEA dual output cards with the latest Win 7 drivers will work.  Other brands should work too as long as they have certified Win7 drivers.

Q - What Are The Hardware Requirements For Acuity Pro?
We strongly urge you to use the most current version of Windows.  We will not guarantee that Acuity Pro will operate on earlier versions of Windows including Windows 2000, ME or 98.  Particular problems arise when attempting to use the remote control.  A Pentium with at least 64 megabytes of RAM, a hard drive with 400 MB of free space, a color monitor, USB ports, a sound card and video card capable of 1024 x 768 resolution is adequate.  You should set the color depth at high color for best quality viewing of the digital photo library. We also strongly recommend a large (17" - 21") LCD monitor because of it's high contrast and 'high tech' look. See the table below for our recommendations.  CRT monitors will certainly work but they don't really give that impression of 'high tech'.  If you choose to use a CRT, make sure it has a high refresh rate to eliminate flicker.  If you require a video cable longer than 6 to 10 feet, it is imperative that you purchase the highest quality 'no signal loss' cable that you can find.  We have had good results with the high end Belkin cables like this 25 foot cable. http://catalog.belkin.com/IWCatProductPage.process?Product_Id=17286    PCConnections www.pcconnection.com has been very helpful over the years in providing our doctors with sound advice for all of their computer related needs.  Contact person there is Deena Forcier dforcier@pcconnection.com who is very familiar with Acuity Pro related issues. 

Patient Distance

Absolute Minimum Screen Height

18 feet


20 feet


22 feet


24 feet


Q - I already have a computer in my exam room, do I need to use a second one for Acuity Pro?
No.  If you already have a computer in your exam room, you can add Acuity Pro to it. Acuity Pro does not demand a dedicated computer. You will need to add either a second video card or replace the exiting one with a dual head video card.  We recommend the latter because of driver issues that may arise.  The dual monitor function works on Win 98 and above. This allows you to open a different program on each monitor. For example, your desk monitor can have your digital imaging system or practice management software running on it and at the end of the room will have Acuity Pro running on that monitor.  For a detailed explanation of how to do this, click on 'Start' then 'Help' and do a 'search' for 'multiple monitor'. Windows help will explain what you need and how to set it up.  *NOTE - With the release of v7.0.5, Acuity Pro will now allow mixed monitor sizes, aspect ratio's and resolutions. Also remember that if you add a new dual head video card, you should disable the original single output video card.

Q - Should I use a mirror system or have a direct view for a short room?
Many doctors ask about how short rooms affect refractions when deciding to setup their exam rooms as straight throw or mirrored rooms. If you will recall your optics, only light coming from an infinitely distant source is parallel. Light coming from a source any closer than infinity is divergent light. Remember this has nothing to do with accommodation or calibration size of the letters.  When trying to determine the refractive error of a patient in our chair, should we prescribe the reading in the phoropter or should that measurement be altered because of the patient distance to the chart? If spectacle lenses have a 1/8 diopter tolerance and we cannot prescribe but in 1/4 diopter steps, then we only need to be concerned about room distances that have more than 1/8 diopter of divergent light from the target source, the eye chart. For clinical purposes, 20 foot rooms have always been considered 'optical infinity' but if you do the math, a 20 foot room has a divergence of .164 diopters (more than 1/8 diopter), in other words, the light is diverging from a 20 foot source at .164 diopters. You should add .164 diopters of minus (less plus) to all your phoropter readings to be totally exact in prescription. However, since .164 diopters is less than 1/4 diopter, and that is the least change we can make in spectacle prescriptions, most doctors just prescribe directly from the phoropter. In actuality, since .164 is greater than 1/8 diopter, you would be less in error if you made the 1/4 diopter adjustment. You would need to have a room longer than 26 feet to drop below the 1/8 diopter divergence!  Look at the table below to see how different room distances will effect your final prescription.  

Optical Distance Divergence of light
20 feet .164
16 feet .205
13 feet .252
12 feet .273
10 feet .328
8 feet .41

The other issue is when assessing unaided acuities.  If a 0.5 diopter myope is sitting in a 6 1/2 foot room, they will see perfectly, appearing to have perfect vision without any correction, and will easily read 20/15 or 20/10.  The reason is that the light from the eye chart is diverging at a rate inversely proportional to the distance of the observer.  The light diverges by 0.5 diopter and the myopic eye converges it by 0.5 diopter causing the chart to be in perfect focus. The diagram below may help to explain.  

Short Rooms - Acuity Pro

There is nothing wrong with using short rooms with direct viewing of eye charts, just remember to adjust your refractions by the appropriate amount and be aware of unaided acuities.  For Acuity Pro, short viewing is often better if you intend to use the photo gallery or video capabilities. It is much more effective for these educational tools to have the viewing at a closer distance.

Q - Why is Acuity Pro not centered on the secondary monitor?
If you are using an older version of Acuity Pro (before v7.0.5) you may need the update which can be found on our Downloads page here.  If you have the latest version and have added a dual head video card to your computer, you may need to disable the onboard video card through the BIOS or by going to Device Manager and disabling it there.

Q - Why does my remote not work after my computer sits idle for a while or goes to screen saver or hibernates?
When Windows hibernates or goes to screen saver mode, sometimes it loses connection with USB devices.  To correct this problem, right click on an open area of your desktop; click on properties; then settings; then screensaver. From there turn off screensaver if on; then click on power option; set everything to
"never" as in never turn off monitor; never hibernate, etc. You can also access these settings in your computers control panel, then under settings, or power options.

Q - Does Acuity Pro meet ANSI standards for luminance, contrast and color temperature?
Absolutely!  The standard for optotypes as specified in ANSI Z80.21-1992 (R2004) states that the standard background luminance shall be 160 Cd/m2 with a range between 80 - 320 Cd/m2.  Some competitive products such as those 'chart-in-a-box' type devices have a stated luminance of 80 Cd/m2 with a 10% tolerance.  That would actually put them below the ANSI standard!  All computer monitors easily provide luminance ranges of 80 - 320 Cd/m2.  This is one of the beauties of Acuity Pro, the software will operate on 'off-the-shelf' computer hardware and be ANSI compliant.

Contrast ratio's for both CRT and LCD flat screens also far exceed the requirements for ANSI (document ISO 8596) which is stated as "...dark optotypes on a lighter background and the luminance of the optotype shall be equal to or less than 15% the luminance of the background".  Contrast ratio's for computer monitors are typically 300:1 at the low end and many are now 600:1 and greater.  This far exceeds the minimum requirements of ANSI for contrast.

Color temperature (what color is white) for optotype background is specified in the International Organization for Standardization (ISO) document ISO 8596:1994(E).  It states that the white light of the background of optotypes will be within the range of 2500K and 7000K.  Virtually all computer monitors produce white light in this range.  To be more specific, most are pre-set to the sRGB standard of 6500K, which is a standard that Microsoft and Hewlett Packard established as the optimum 'white' for computer monitors.  6500K is also referred to as the 'average summer daylight' white.

The bottom line is that modern computer monitors produce luminance, contrast and color temperatures that easily meet or exceed all ANSI standards for visual acuity testing.

Q - What Type of Monitor Should I Buy?
We think LCD screens are the best and the larger, the better.  Here's why.

  • LCD screens look high tech.

  • They do not have image stretch as they warm.

  • They don't lose contrast or brightness with age.

Q - What is the shortest and longest distance that I can use Acuity Pro?
At an optical distance of 24 feet, the 20/400 'E' will be 8.36 inches tall.  Most 15" monitors have a usable height of about 8 to 8 1/2" so we would say that the absolute maximum distance would be 24'.  If you used a 17" monitor, that distance would be increased.  See the table below to help you decide which monitor is best for your situation.  The reason we don't recommend using the maximum distance possible is because the 20/400 letter looks kind of stupid filling the entire screen.  If you are trying to give the impression of a high tech office, don't go full screen, get a larger monitor.  The other reason to use a larger monitor is that when you are trying to show your patient some of the photos, they will look much better (be bigger) on a larger screen.

The minimum distance is around 6 feet.  Anything shorter than that is going to make the 20/15 and 20/10 lines be so small that they won't be accurate.  Also remember that at optical distances shorter than around 13 feet, there is a 0.25 diopter or more of accommodative demand that you will need to adjust your refractions by.  This is no different than using a regular projector, just a reminder of your Optics 101.

Optical Distance

Absolute Minimum Screen Height

18 feet


20 feet


22 feet


24 feet


Q - Why do the red/blue glasses not completely block out the opposite colors on the 4 dot test and the fixation disparity chart?
You have not adjusted the red/blue screens for your computer settings.
 In the 4-Dot screen and the Fixation Disparity Screens press the 'H' key then:

Step 1: While wearing Red/Blue glasses, cover your left eye (blue lens) and adjust the BACKGROUND slider so that the blue dots/bars disappear into the background.

Step 2: Now cover your right eye (red lens) and adjust the red slider until the red dot/bars disappear into the background.

NOTE: For LCD screens, you may want to try setting your Brightness and Contrast about 30% each and setting your RED, BLUE and GREEN screen colors at about 75%. This general rule seems to be a good place to start.

* Monitor brightness and screen colors are set by physical controls on your monitor, not through software, read your monitor manual for details.

Problem:  I have to re-connect and re-calibrate Acuity Pro every time I start it.  It doesn't remember any of my preferences.  I am using Windows XP.  
This problem has been resolved with the latest update of Acuity Pro.  Background:  This problem is a permissions issue created by Windows security features.  Acuity Pro MUST be installed while logged on as an Administrator.  Preferences like calibration, macros, remote control COM port assignments and other things are saved to a special file that requires read and write privileges.  Non-Administrators do not have the authority to "change" or write to files and as such, cannot "save" their preferences.  If everyone has administrative privileges, there is no problem but if you don't want all users to have admin privileges, a fix is needed.

Solution 1:
     Download the update from our 'Downloads' link at left.

Solution 2:
     Run Acuity Pro as an Administrator. 

Solution 3:  

  1. Make sure Acuity Pro is installed while being logged on as an administrator.
  2. Log on as an administrator.
  3. Navigate to C:\Program Files\ directory and right click on Acuity Pro 7.0 folder.
  4. Select "Sharing and Security".
  5. Click on the "Sharing" Tab.
  6. Check the box entitled "Share this folder on the network".
  7. Check the box entitled "Allow network users to change my files".
  8. Click on the "Apply" button.
  9. Answer "Yes" if a pop-up warns you about incompatibility with older versions of Windows.

The Remote Control Configuration Utility does not find my remote.
If you purchased Acuity Pro before 9/1/07 you may need to download and install the remote control driver update. Click on the 'Downloads' link in the blue column at the upper left of this page and follow the instructions given on that page for using the latest update for the remote control. If you purchased Acuity Pro after that date, the drivers are current within the installation package that you received.     

Q - Why do the round letters look like they have the 'jaggies' when I look at them on the screen?
There are two ways to display graphic images on computer screens, bitmapped images and vector based images. Vector based images are mathematical descriptions of the shapes to be displayed while bitmapped images are a set of stored points to be to be either turned off or on. The bitmapped images are inherently ‘jaggy’ on any curved or diagonal edge so most software ‘blurs’ the edges of the image with a technique called anti-aliasing. This technique ‘fills in’ the missing spots on the edge with a smattering of half tones to attempt to smooth the edge. The images below shows how this is accomplished.


Acuity Pro has chosen to use vector based images for two reasons. First, we don’t want to blur the edges of the optotypes just so the image will look ‘pretty’ when viewed up close but rather what we do want, is the sharpest edge and highest possible contrast between the optotype and the background. After all, we are checking acuity, let the visual system do the ‘anti-aliasing’ not the computer. Secondly, as computer companies improve in their ability to manufacture monitors with the 'dots' or pixels closer together, Acuity Pro software can draw even more exact curves and diagonals.  

Why don't the O's and C's look round?
Q - What is the 'Screen Symmetry' adjustment for?

You need to adjust the horizontal and vertical aspects of your monitor.  Start Acuity Pro then press the 'H' key to unhide the control panel.  Click on the button labeled 'Calibrate'.  Now click on 'Screen Symmetry'.  Get a millimeter rule and place it on the screen.  Measure the height and width of the box.  They should be equal.  If they are not, the optotypes will not be the correct shape and proportion.  There are two ways to correct this problem.  The best way (but the more difficult ) is to change the settings of your monitor so that the horizontal and vertical ratio is correct.  If you have an LCD monitor, try changing the screen resolution first.  This may correct the problem.  If not, you will need the manual that came with your monitor to see how to adjust the height and width of your monitor.  Make the adjustments so that the square is just as high as it is wide.  One other thing that can affect the ratio of height to width is the 'stretch' feature of some LCD monitors. If you have 'stretch' turned on, the screen will distort itself to fill the entire screen with the output. This can make the images out of proportion. Again, check your manual to see how to change this from stretch to normal.  If your monitor does not have controls to make these adjustments, you may use the ability of Acuity Pro to make this adjustment.  Measure the box and click on the scroll bar buttons to change the width of the box.

Q - Why do the optotypes have a 'ghost' image around them?
You either have a defective monitor cable or you are using a monitor cable that is too long.  Maximum distance for a monitor cable is between 6 and 10 feet.  Anything longer than that will cause ghosting unless you use a very high quality video cable (see Question above regarding Hardware Requirements).  We suggest keeping the monitor cable as short as possible.  Put the computer near the screen and use a wireless keyboard.  I personally have put my computer on the floor at the end of the room behind the toy box.  I mounted a 17" LCD monitor on the wall like a picture frame, ran the cables into a hole in the wall behind the monitor and down to the baseboard.  The cables come out of the wall at the floor and into my computer.  I use a wireless keyboard to control the computer and have no ghosting.  An alternative to the wireless keyboard would be to run a long keyboard extension to the computer.  This works nicely and does not cause any ghosting.


Troubleshooting Guide for Version 8 Custom Remote Control/Receiver

Verify that the "Auto Configure Remote" box is checked in Acuity Pro Preferences Panel.

Make sure the user is an administrator.
Make sure the remote is plugged in.
Start Acuity Pro and press H on the keyboard.
Check the box entitled "Auto Configure Remote".
Press H again to hide the preference panel.
Press Q to quit Acuity Pro.
Restart Acuity Pro.

If it still says it cannot find the remote then verify that the drivers are installed and the remote is recognized by doing the following:

Restart Acuity Pro and press H on the keyboard.
If the Auto Configure Remote checkbox is unchecked again after performing step 1 above then this indicates an administration issue, go to step 4.

If the Auto Configure Remote checkbox is checked but the remote still doesn't work then continue below.
Look at the entry entitled “Manual COM Port Selection”.
If there is a 0 in the box, this indicates that the driver did not install correctly or the remote is not plugged in. Go to step 3.
If there is a number in the box other than 0 then this indicates that the driver was loaded correctly and the remote is plugged in and recognized. Go to step 4.

Quit Acuity Pro if it is running by pressing Q on the keyboard or clicking the X in the upper right corner of the screen.
Use Windows Explorer to navigate to the directory “C:\Program Files\Acuity Pro 8.0 or if a 64 bit machine, “C:\Program Files(x86)\Acuity Pro 8.0
Open that folder.
Double click on the file with the Red icon entitled CDM20xxx.exe, this will reinstall the remote control drivers.
Restart Acuity Pro once the driver has installed. A notification will display indicating that it has installed.
Press H on the keyboard.
Check the box.
Press H on the keyboard again.
Press Q on the keyboard.
Restart Acuity Pro. The remote should work.

If it still says it cannot find the remote then this is an administrator issue, go to step 4.

Quit Acuity Pro if it is running by pressing Q on the keyboard or clicking the X in the upper right corner of the screen.
Use Windows Explorer to locate the configuration file for Acuity Pro entitled acuitypro80.ini. 
NOTE: THIS FILE IS IN A HIDDEN FOLDER so you will need to make sure you have your “folders view” set to expose hidden files and folders.
On Windows XP, this will be located at C:\Documents and Settings\All Users\Application Data\APConfig\acuitypro80.ini
On Windows 7, this file is located at C:\Program Data\APConfig\acuitypro80.ini
Open this file (acuitypro80.ini) with Notepad.
Locate the entry: 
Change the entry to read: auto=1
Save the file and close Notepad.
Restart Acuity Pro.
The remote should work.