WO2015102092A1 - Dispositif ophtalmologique - Google Patents

Dispositif ophtalmologique Download PDF

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Publication number
WO2015102092A1
WO2015102092A1 PCT/JP2014/084551 JP2014084551W WO2015102092A1 WO 2015102092 A1 WO2015102092 A1 WO 2015102092A1 JP 2014084551 W JP2014084551 W JP 2014084551W WO 2015102092 A1 WO2015102092 A1 WO 2015102092A1
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WO
WIPO (PCT)
Prior art keywords
examination
eye
unit
inspection
left eye
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PCT/JP2014/084551
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English (en)
Japanese (ja)
Inventor
航 梅地
Original Assignee
株式会社トプコン
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Publication of WO2015102092A1 publication Critical patent/WO2015102092A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/02—Subjective types, i.e. testing apparatus requiring the active assistance of the patient
    • A61B3/028—Subjective types, i.e. testing apparatus requiring the active assistance of the patient for testing visual acuity; for determination of refraction, e.g. phoropters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/02—Subjective types, i.e. testing apparatus requiring the active assistance of the patient
    • A61B3/022—Subjective types, i.e. testing apparatus requiring the active assistance of the patient for testing contrast sensitivity
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/02—Subjective types, i.e. testing apparatus requiring the active assistance of the patient
    • A61B3/06—Subjective types, i.e. testing apparatus requiring the active assistance of the patient for testing light sensitivity, e.g. adaptation; for testing colour vision
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A61B3/103—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for determining refraction, e.g. refractometers, skiascopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A61B3/107—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for determining the shape or measuring the curvature of the cornea

Definitions

  • This invention relates to an ophthalmologic apparatus.
  • Ophthalmic devices are devices that can be used in the ophthalmic field.
  • the examination in the ophthalmology field is classified into a subjective examination and an objective examination.
  • a subjective test is to obtain a result based on a response from the subject.
  • Typical examples of the subjective test include a subjective refraction measurement such as a distance test, a near test, a contrast test, and a glare test, and a visual field test.
  • information a target or the like
  • the distance test is performed using a visual target arranged spatially or optically through a predetermined first distance (for example, 5 meters, 6 meters, 20 feet, etc.), This is an inspection for obtaining the distance diopter of the prescription lens.
  • the eye to be examined is used by using a visual target arranged spatially or optically through a predetermined second distance (shorter than the first distance, for example, 30 centimeters, 40 centimeters, etc.).
  • This is a test for obtaining near vision of the eyes and near power (add power) of prescription lenses.
  • the contrast test is a test for obtaining the spatial frequency characteristics (contrast sensitivity) of the visual system including the eye to be examined while changing the contrast of the presented target (or using a striped target or the like).
  • the glare test is used when an intermediate translucent body such as a cataract or corneal opacity occurs, or for follow-up after corneal refractive surgery, and presents a target while irradiating background light (glare light source).
  • this is an inspection for obtaining the influence (glare failure) of the decrease in contrast of the retinal image caused by light scattering due to turbidity or the like.
  • the objective test is to acquire information about the eye to be examined mainly by using a physical method without referring to a response from the subject.
  • the objective test includes objective measurement for measuring a value related to the eye to be examined and photographing for acquiring an image of the eye to be examined.
  • Typical examples of objective tests include objective refraction measurement, corneal shape measurement, intraocular pressure measurement, fundus photography, optical coherence tomography (Optical Coherence Tomography), and the like.
  • the left eye and the right eye of the subject may be examined.
  • a plurality of examinations may be performed on the left eye, and a plurality of examinations (which may be the same as or different from the left eye) may be performed on the right eye.
  • the eye to be inspected is switched during a series of examinations.
  • This invention is intended to improve the operability of an ophthalmologic apparatus capable of performing a left eye examination and a right eye examination.
  • An ophthalmologic apparatus is an ophthalmologic apparatus capable of inspecting a left eye and a right eye of a subject, and an inspection unit capable of performing a plurality of different types of inspection, and the inspection unit Corresponding to the switching unit for switching the inspection object between the left eye and the right eye, and the switching of the inspection object from the first eye to the second eye, and is performed for the second eye after the switching. And a control unit that controls the inspection unit according to the type of inspection to be performed.
  • the ophthalmologic apparatus of the embodiment it is possible to improve the operability when performing the examination of the left eye and the examination of the right eye.
  • the ophthalmologic apparatus according to the embodiment can execute an arbitrary subjective examination and / or an arbitrary objective examination.
  • the ophthalmologic apparatus according to the following embodiments can perform a distance test, a near-field test, a contrast test, a glare test, and the like as a subjective test, and an objective refraction measurement, a corneal shape measurement, and the like as the objective test Is an optometry apparatus capable of performing
  • the ophthalmologic apparatus according to the present invention is not limited to this.
  • the ophthalmologic apparatus 1 includes a base 2, a gantry 3, a head unit 4, a face receiving unit 5, a joystick 8, and a display unit 10.
  • the ophthalmic apparatus 1 may be a single apparatus or a combination of two or more apparatuses. In the latter case, a plurality of components described below are distributed in two or more apparatuses.
  • the ophthalmologic apparatus 1 includes an apparatus including an optical system, a driving mechanism, a control board, and the like for performing an examination, and a device for performing control and information input to the apparatus, and processing of output information from the apparatus. Consists of.
  • the gantry 2 can be moved back and forth and left and right with respect to the base 2.
  • the head unit 4 is configured integrally with the gantry 3.
  • the face receiving portion 5 is configured integrally with the base 2.
  • the face receiving portion 5 is provided with a chin rest 6 and a forehead rest 7.
  • the face of the subject (not shown) is fixed by the face receiving unit 5.
  • the examiner performs an examination by positioning the ophthalmologic apparatus 1 on the opposite side of the subject.
  • the joystick 8 and the display unit 10 are arranged at the position on the examiner side.
  • the joystick 8 is provided on the gantry 3.
  • the display unit 10 is provided on the surface of the head unit 4 on the examiner side.
  • the display unit 10 is, for example, a flat panel display such as a liquid crystal display.
  • the display unit 10 includes a touch panel display screen 10a.
  • the head unit 4 is moved back and forth and left and right by tilting the joystick 8.
  • the head unit 4 is moved in the vertical direction by rotating the joystick 8 with respect to its axis.
  • the movement in the left-right direction is performed, for example, in order to switch the examination target by the ophthalmologic apparatus 1 from the left eye to the right eye or from the right eye to the left eye.
  • An external device 11 is connected to the ophthalmologic apparatus 1.
  • the external device 11 may be an arbitrary device, and the connection mode (communication mode or the like) between the ophthalmic device 1 and the external device 11 may be arbitrary.
  • the external device 11 includes, for example, a spectacle lens measurement device for measuring the optical characteristics of the lens.
  • the spectacle lens measuring device measures the power of the spectacle lens worn by the subject and inputs this measurement data to the ophthalmic device 1.
  • the external device 11 may be any other ophthalmic device.
  • the external device 11 may be a device (reader) having a function of reading information from a recording medium or a device (writer) having a function of writing information to the recording medium.
  • the external device 11 is a computer used in the medical institution.
  • hospital computers include, for example, a hospital information system (HIS) server, a DICOM server, a doctor terminal, and the like.
  • the external device 11 may include a computer that is used outside the medical institution. Examples of such out-of-hospital computers include mobile terminals, personal terminals, servers and terminals on the manufacturer side of the ophthalmic apparatus 1, and cloud servers.
  • the ophthalmologic apparatus 1 has an optical system for inspecting an eye to be examined. A configuration example of this optical system will be described with reference to FIGS.
  • the optical system is provided in the head unit 4.
  • the optical system includes an observation system 12, a fixation target projection system 13, an objective measurement system 14, a subjective measurement system 15, and alignment systems 16 and 17.
  • Reference numeral 9 denotes a processing unit that executes various processes.
  • the observation system 12 has a function for observing the anterior segment of the eye E to be examined.
  • the fixation target projection system 13 has a function for presenting a fixation target to the eye E.
  • the objective measurement system 14 has a function for performing an objective test.
  • the objective measurement system 14 of this example has a function of projecting a predetermined measurement pattern onto the fundus oculi Ef of the eye E and a function of detecting an image of the measurement pattern projected onto the fundus oculi Ef.
  • the subjective measurement system 15 has a function for performing a subjective examination.
  • the subjective measurement system 15 of this example has a function of presenting a visual target to the eye E to be examined.
  • the alignment systems 16 and 17 have a function for aligning the optical system with the eye E (alignment).
  • the alignment system 16 has a function for performing alignment in the direction (front-rear direction) along the optical axis of the observation system 12.
  • the alignment system 17 has a function for performing alignment in a direction (vertical direction, horizontal direction) orthogonal to the optical axis of the observation system 12.
  • the observation system 12 includes an objective lens 12a, a dichroic filter 12b, a half mirror 12c, a relay lens 12d, a dichroic filter 12e, an imaging lens 12f, and an image sensor (CCD) 12g.
  • the output of the image sensor 12g is input to the processing unit 9.
  • the processing unit 9 displays the anterior segment image E ′ on the display unit 10 based on the signal input from the image sensor 12g.
  • a kerato plate 12h is provided between the objective lens 12a and the eye E to be examined.
  • the kerato plate 12h is used to project a ring-shaped light beam for measuring the corneal shape onto the cornea C of the eye E.
  • a configuration example of the kerato plate 12h is shown in FIG.
  • An alignment system 16 is provided behind the kerato plate 12h. As described above, the alignment system 16 is used for alignment in the front-rear direction.
  • the alignment system 16 includes an alignment light source 16a and a projection lens 16b.
  • the projection lens 16b converts the light beam output from the alignment light source 16a into a parallel light beam and projects it onto the cornea C.
  • the user or the processing unit 9 performs alignment by moving the head unit 4 in the front-rear direction with reference to an image (bright spot image) projected onto the cornea C by the alignment system 16.
  • the alignment system 17 forms an optical path branched from the observation system 12 via the half mirror 12c. As described above, the alignment system 17 is used for vertical and horizontal alignment.
  • the alignment system 17 includes an alignment light source 17a and a projection lens 17b.
  • the projection lens 17b converts the light beam output from the alignment light source 17a into a parallel light beam. This parallel light beam is reflected by the half mirror 12 c and projected onto the cornea C through the optical path of the observation system 12.
  • the user or the processing unit 9 performs alignment by moving the head unit 4 in the vertical direction and the horizontal direction based on the image (bright spot image) projected onto the cornea C by the alignment system 17.
  • the alignment mark AL and the bright spot image Br are displayed on the display screen 10a together with the anterior segment image E '.
  • the alignment in the front-rear direction is performed, for example, by adjusting the position of the head unit 4 so that the bright spot image Br is focused by the alignment light source 17a. Further, the alignment in the front-rear direction may be performed by adjusting the position of the head unit 4 so that the ratio of the distance between the two bright spot images by the alignment light source 16a and the diameter of the keratling image falls within a predetermined range.
  • the processing unit 9 may calculate an alignment shift amount from the ratio and display the shift amount on the display screen 10a.
  • the processing unit 9 can perform control so as to start measurement in response to the completion of alignment.
  • the processing unit 9 calculates an alignment shift amount from the above ratio, and controls the electric mechanism to move the head unit 4 so that the shift amount is canceled.
  • This mechanism includes an actuator that generates a driving force and a member that transmits the driving force to the head unit 4.
  • the processing unit 9 can perform control so as to start measurement in response to the completion of alignment.
  • the fixation target projection system 13 includes an LED light source 13a that generates white light, a color correction filter 13b, a collimator lens 13b ′, a chart plate 13c, a half mirror 13d, and a relay lens 13e.
  • the subjective measurement system 15 includes a glare light source 13n that irradiates the eye E with glare light.
  • a fixation target and a target chart are formed on the chart plate 13c.
  • the fixation target is a target for fixing the eye E to be examined.
  • the fixation target in this example is, for example, a landscape chart.
  • the optotype chart is an optotype for subjectively measuring the visual acuity value and correction power (distance power, near power, etc.) of the eye E.
  • a plurality of target charts are formed on the chart plate 13c.
  • a landscape chart is projected onto the fundus oculi Ef. Alignment is performed while the subject is staring at the scenery chart, and the eye refractive power is measured in a clouded state.
  • the objective measurement system 14 includes a ring-shaped light beam projection system 14A and a ring-shaped light beam light receiving system 14B.
  • the ring-shaped luminous flux projection system 14A projects a ring-shaped measurement pattern on the fundus oculi Ef.
  • the ring-shaped light beam receiving system 14B detects the reflected light from the fundus oculi Ef of this measurement pattern.
  • the ring-shaped luminous flux projection system 14A includes a reflex measurement unit 14a, a relay lens 14b, a pupil ring 14c, a field lens 14d, a perforated prism 14e, a rotary prism 14f, dichroic filters 13m and 12b, and an objective lens. 12a.
  • the reflex measurement unit 14a includes a reflex measurement light source (LED) 14h, a collimator lens 14i, a conical prism 14j, and a ring-shaped measurement pattern forming plate 14k.
  • the ring-shaped light beam receiving system 14B includes an objective lens 12a, a dichroic filter 12b, a dichroic filter 13m, a rotary prism 14f, a perforated prism 14e, a field lens 14m, a reflection mirror 14n, and a relay lens 14p. It includes a focusing lens 14q, a reflecting mirror 14r, a dichroic filter 12e, an imaging lens 12f, and an image sensor (CCD) 12g.
  • CCD image sensor
  • Each unit of the ophthalmologic apparatus 1 is controlled by the processing unit 9.
  • the processing unit 9 includes the LED light source 13a, the light source 14h, the glare light source 13n, the alignment light sources 16a and 17a, the kerato ring light source 12h ′ of the kerato plate 12h, the reflex measurement unit portion 14a, the focusing lenses 13g and 14q, and the chart plate 13c.
  • the variable cross cylinder lens 13j, the display unit 10 and the like are controlled.
  • the dichroic filter 12 b transmits the corneal shape measurement ring-shaped light beam projected onto the cornea C and the light beams from the alignment systems 16 and 17.
  • the anterior segment image E ′, a virtual image (not shown), and a bright spot image Br are acquired by the imaging element 12g.
  • the processing unit 9 turns on the light source 14h.
  • the reflex measurement unit 14a is moved in the optical axis direction, and the focusing lens 14g is moved in the optical axis direction correspondingly.
  • the ring-shaped measurement pattern (light beam) is guided to the dichroic filter 13m through the relay lens 14b, the pupil stop 14c, the field lens 14d, and the reflecting surface 14e 'of the perforated mirror 14e.
  • the measurement pattern reflected by the dichroic mirror 13m is guided to the objective lens 12a via the dichroic mirror 12b and projected onto the fundus oculi Ef.
  • the ring-shaped measurement pattern formed on the fundus oculi Ef is condensed by the objective lens 12a, dichroic filters 12b and 13m, the rotary prism 14f, the hole 14e "of the perforated mirror 14e, the field lens. 14m, the reflecting mirror 14n, the relay lens 14p, the focusing lens 14q, the reflecting mirror 14r, and the dichroic mirror 12e, and then the image is formed on the imaging element 12g by the imaging lens 12f. An image of a measurement pattern (not shown) is detected.
  • the processing unit 9 turns on the light source 13a.
  • the light beam output from the light source 13a illuminates the chart plate 13c through the color correction filter 13b.
  • Various charts (charts) are provided on the chart plate 13c.
  • the processing unit 9 moves the focusing lens 13g to a position corresponding to the result of the objective measurement.
  • the processing unit 9 controls the variable cross cylinder lens 13j so that the astigmatism state is corrected based on the astigmatism state (astigmatism degree, astigmatism axis) of the eye E obtained by objective measurement.
  • the processing unit 9 controls the chart plate 13c so that the selected target is arranged in the optical path.
  • the luminous flux that has passed through the target is a half mirror 13d, a relay lens 13e, a reflecting mirror 13f, a focusing lens 13g, a relay lens 13h, a field lens 13i, a variable cross cylinder lens 13j, a reflecting mirror 13k, dichroic filters 13m and 12b,
  • the light is projected onto the fundus oculi Ef via the objective lens 12a.
  • the subject responds to the target projected on the fundus oculi Ef.
  • the selection of the target and the response thereto are repeatedly performed based on the judgment of the examiner or the processing unit 9.
  • the examiner or the processing unit 9 determines the prescription value based on the response from the subject. Further, when the glare inspection is performed, the processing unit 9 turns on the glare light source 13n. In this state, awareness measurement is performed.
  • Configuration of objective measurement system 14 configuration of subjective measurement system 15, configuration of alignment systems 16 and 17, configuration of kerato system, measurement principle of eye refractive power (ref), measurement principle of subjective measurement, measurement of corneal shape Since the principle is well-known, detailed description is abbreviate
  • the information processing system of the ophthalmologic apparatus 1 will be described. An example of the functional configuration of the information processing system of the ophthalmologic apparatus 1 is shown in FIG.
  • the information processing system includes an arithmetic control unit 100, an inspection unit 110, a left / right switching unit 120, a display unit 130, an operation unit 140, and a communication unit 150.
  • the arithmetic control unit 100 controls the inspection unit 110, the left / right switching unit 120, the display unit 130, and the communication unit 150.
  • the inspection unit 110 can perform a plurality of different types of inspection.
  • a plurality of examinations including objective refraction measurement, subjective refraction measurement (distance examination, near examination, contrast examination, glare examination, etc.) and corneal shape measurement are performed. can do.
  • the inspection unit 110 includes a mechanism for driving the optical system and members shown in FIG. Moreover, the test
  • the left / right switching unit 120 has a function for switching the inspection object by the inspection unit 110 between the left eye and the right eye.
  • the eye to be examined is switched by moving the head unit 4 in the left-right direction.
  • the ophthalmologic apparatus having such a configuration includes a moving unit 121 for moving the examination unit 110 as the left / right switching unit 120 (see FIG. 7).
  • the configuration for switching the eye to be examined is not limited to this.
  • the inspection unit 110 capable of simultaneously performing the left eye inspection and the right eye inspection
  • the left / right switching unit 120 is configured to selectively block the left eye field and the right eye field.
  • a configuration may be included.
  • the examination unit 110 includes a refractor (phoropter), and the left / right switching unit 120 includes a blocking unit that alternatively shields the left and right optometry windows of the refractor. Is possible.
  • the display unit 130 displays information under the control of the arithmetic control unit 100.
  • the display unit 130 includes the display unit 10 shown in FIG.
  • the operation unit 140 is used to operate the ophthalmologic apparatus 1.
  • the operation unit 140 includes various hardware keys (joystick 8, buttons, switches, etc.) provided in the ophthalmologic apparatus 1.
  • the operation unit 140 includes various software keys (buttons, icons, menus, etc.) displayed on the touch panel display screen 10a.
  • At least part of the display unit 130 and the operation unit 140 may be integrally configured.
  • a typical example is a touch panel display screen 10a.
  • the communication unit 150 has a function for communicating with the external device 11 shown in FIG.
  • the communication unit 150 is provided in the processing unit 9, for example.
  • the communication unit 150 has a configuration corresponding to the form of communication with the external device 11.
  • the information processing system is configured around the arithmetic control unit 100.
  • the arithmetic control unit 100 executes various types of information processing such as arithmetic processing and control processing.
  • the arithmetic control unit 100 includes at least a part of the processing unit 9 shown in FIG.
  • the arithmetic control unit 100 includes a storage unit 101, an examination type identification unit 102, and an information change unit 103.
  • the storage unit 101 stores various computer programs and data.
  • the computer program includes a calculation program and a control program for causing the ophthalmologic apparatus 1 to execute various examinations.
  • the data includes data used in various tests. Examples of such data include inspection schedule information and inspection history information. These pieces of information are used when the ophthalmologic apparatus 1 operates according to a predetermined operation mode.
  • the examination schedule information indicates the contents of the examination to be performed on the subject.
  • the examination schedule information includes the type and order of one or more examinations performed on the subject's left eye and the type and order of one or more examinations executed on the right eye.
  • the examination order may be set individually for the left eye and the right eye, or may be set for both eyes together.
  • the examination schedule information is generated in advance and is stored in the storage unit 101 by the control unit 100.
  • the inspection schedule information may be default information.
  • the examination schedule information may include examination contents (examination type and order) associated with each of one or more attributes.
  • the attribute is used to selectively use information included in the examination schedule information. Attributes include, for example, injury and illness name, subject identification information (patient ID, patient name, etc.), subject personal information (age, gender, medical history, etc.), user identification information (doctor ID, spectacle store clerk ID, etc.) Etc.) may be included.
  • the arithmetic control unit 100 identifies the content of the examination associated with the designated attribute from the examination schedule information. Further, the arithmetic control unit 100 executes an inspection based on the content of the inspection specified from the inspection schedule information.
  • designation of attributes is performed by the user or the calculation control unit 100.
  • the designation of the attribute by the user includes, for example, the following processing: (1) The calculation control unit 100 displays information for designating the attribute (for example, information for inputting or selecting the attribute) on the display unit 130; (2) The user uses the operation unit 140 to specify an attribute based on the displayed information.
  • the designation of the attribute by the calculation control unit 100 includes, for example, the following processing: The calculation control unit 100 receives an attribute input from the external device 11 shown in FIG. 1 (ID of the patient ID card or doctor ID card) Input, input of personal information from electronic medical records, etc.).
  • the inspection schedule information can be arbitrarily created by the user.
  • the arithmetic control unit 100 stores the created examination schedule information in the storage unit 101. It is also possible to configure to obtain examination schedule information from the external device 11 (manufacturer's website, medical institution server, etc.).
  • the arithmetic control unit 100 In response to the start of the examination for the subject, the arithmetic control unit 100 starts creating examination history information in the current series of examinations, and stores this in the storage unit 101.
  • the examination history information includes the contents of examinations that have already been performed by the examination unit 110 on the left eye and right eye of the subject (that is, examination history).
  • examination history information include the type of examination last performed on the left eye and the type of examination last performed on the right eye. By combining such examination history information with scheduled examination information, examination histories for the left eye and the right eye can be obtained. In addition, when any inspection recorded in the inspection schedule information is skipped, information indicating this fact can be recorded in the inspection history information.
  • the inspection for both eyes is performed while appropriately switching the inspection object by the inspection unit 110 between the left eye and the right eye.
  • the examination target eyes before and after the switching may be referred to as “first eye” and “second eye”, respectively. That is, when the eye to be examined is switched from the left eye to the right eye, the left eye corresponds to the first eye and the right eye corresponds to the second eye. Conversely, when the eye to be examined is switched from the right eye to the left eye, the right eye corresponds to the first eye and the left eye corresponds to the second eye.
  • the examination history information is created by examining information indicating the type of examination performed on the eye to be examined (that is, examination for which the result is effectively obtained). This is done by recording in time series.
  • the examination type identification unit 102 identifies the type of examination that is first performed on the second eye after this switching, based on examination schedule information and examination history information, in response to the examination target eye switching. A specific example of this process will be described below.
  • the examination schedule information the type and order of the examination to be performed on the left eye of the subject and the type and order of the examination to be performed on the right eye are recorded.
  • the examination history information records the contents of the examination already performed on the left eye and the right eye.
  • the examination type specifying unit 102 obtains, for example, a difference between the examination type for the second eye recorded in the examination schedule information and the examination type for the second eye recorded in the examination history information.
  • the set A composed of the examination types for the second eye recorded in the examination history information is a subset of the set X consisting of the examination types for the second eye recorded in the examination schedule information.
  • the above difference processing corresponds to obtaining the difference set X ⁇ A.
  • the examination type specifying unit 102 refers to the examination type and order for the second eye recorded in the examination schedule information, so that the highest priority among examination types included in the difference set X ⁇ A is obtained. Identify things.
  • the specified examination type corresponds to the examination type that is first performed on the second eye after the current switching. When the difference set X ⁇ A is an empty set, a result that all examinations scheduled for the second eye have been completed is obtained.
  • the type of inspection that has not yet been performed is specified based on the type of inspection, and then the inspection type of the highest order is obtained by referring to the order of inspection.
  • the target inspection type it is possible to obtain the target inspection type by considering the inspection type and order in parallel.
  • the examination type identification unit 102 firstly selects the examination type in the first order among the examination types for the second eye recorded in the examination schedule information and the second eye recorded in the examination history information.
  • the type of the test executed first among the types of the test for the above is collated. If this collation fails, no examination is performed on the second eye, so the type of examination in the first order recorded in the examination schedule information is changed after the current switching. This is the type of examination that is first performed on the second eye.
  • this collation is successful, the process proceeds to the second collation process.
  • the process proceeds to the third collation process.
  • the verification process is executed repeatedly.
  • the type of examination in the n-th order recorded in the examination schedule information is the type of examination that is first performed on the second eye after the current switching. .
  • the verification is successful for all types of examinations recorded in the examination schedule information, a result that all examinations scheduled for the second eye have been completed is obtained.
  • the information changing unit 103 changes the type and / or order of examinations included in the examination schedule information.
  • the predetermined instruction is input by a user, for example.
  • the user can change the content of the examination schedule information by using the operation unit 140 before the examination for the subject is started or during the examination.
  • the information change unit 103 reflects this content change instruction on the examination schedule information. This change in the inspection schedule information is applied only to the current inspection or to the subsequent inspections. You may comprise so that a user can select the application range of such an information change arbitrarily.
  • the arithmetic control unit 100 can give a predetermined instruction.
  • the arithmetic control unit 100 acquires the subject's electronic medical record from the external device 11, and changes the examination schedule information based on the contents of the electronic medical record (past examination contents, injury / illness name, age, etc.). Can be generated.
  • the arithmetic control unit 100 can change the examination schedule information so that all types included in the past examination contents are included. For example, when the time interval from the previous inspection is shorter than a predetermined value, the inspection schedule information can be changed so that one of the types of inspections performed in the previous inspection is excluded.
  • the examination schedule information can be changed so that a type associated in advance with the wound name is included.
  • the examination schedule information can be changed so as to add a predetermined type (for example, a near-field examination or a glare examination).
  • the examination schedule information can be changed so as to exclude a predetermined type (for example, near-field examination, glare examination).
  • a usage pattern of the ophthalmologic apparatus 1 according to the embodiment will be described. As described above, the ophthalmologic apparatus 1 can individually examine the left eye and the right eye of the subject. Hereinafter, some typical examples of usage patterns of the ophthalmic apparatus 1 will be described.
  • examinations shall be performed in the following order: (1) right-eye examination; (2) right-eye examination; (3) left-eye examination (4) Near eye examination of the left eye.
  • the inspection part 110 (head part 4) is moved to the inspection position of the right eye.
  • the examination position is a position where the eye to be examined can be examined.
  • the eye to be examined is arranged at the examination position through the alignment described above.
  • the movement of the inspection unit 110 is executed by the arithmetic control unit 100 according to an operation or instruction by the user or an instruction from the arithmetic control unit 100.
  • the inspection type identification unit 102 can recognize that the type of the next inspection to be performed is a far-field inspection based on the inspection schedule information and the inspection history information. Alternatively, it is possible to recognize that the type of the next examination is a distance examination based on the first examination for the subject and the examination schedule information.
  • the arithmetic control unit 100 prepares to perform a distance inspection by controlling the inspection unit 110 at an arbitrary timing (before, during or after the movement of the inspection unit 110).
  • the inspection unit 110 selectively presents various visual targets to the right eye according to instructions from the user or the calculation control unit 100.
  • the user or the ophthalmologic apparatus 1 obtains the distance vision value for the right eye (and / or the distance power of the prescription lens: the same applies hereinafter) based on the response of the subject to the presented visual target.
  • the arithmetic control unit 100 causes the storage unit 101 to store the obtained distance vision value.
  • the inspection unit 110 selectively presents various visual targets to the right eye in accordance with instructions from the user or the calculation control unit 100.
  • the user or the ophthalmologic apparatus 1 obtains the near vision value for the right eye (and / or the near power of the prescription lens: the same applies hereinafter) based on the response of the subject to the presented visual target.
  • the arithmetic control unit 100 causes the storage unit 101 to store the obtained near vision value.
  • the arithmetic control unit 100 performs control for performing a distance inspection, which is a type of inspection performed first after the movement.
  • This control includes processing in which the examination type identification unit 102 identifies the type of examination that is performed first after movement.
  • the target of control by the arithmetic control unit 100 is not limited to the inspection unit 110, and may include, for example, control for switching information displayed on the display unit 130.
  • the timing at which the process of step S5 is performed is arbitrary.
  • the process of step S5 can be performed at an arbitrary timing after this instruction.
  • the process of step S5 can be performed in parallel with the movement of the inspection unit 110 in step S4, or the process of step S5 can be performed after the end of step S4.
  • the timing of executing these processes may be arbitrary.
  • examinations shall be performed in the following order: (1) right-eye examination; (2) left-eye examination; (3) left-eye examination (4) Near eye examination of the right eye.
  • the left eye distance test is performed in the same manner as in the case of the right eye, and the distance vision value acquired thereby is stored in the storage unit 101.
  • examinations shall be performed in the following order: (1) right eye objective refraction measurement; (2) right eye distance examination; (3) right eye near use. Inspection; (4) Left eye objective refraction measurement; (5) Left eye distance test; (6) Left eye near field test.
  • the arithmetic control unit 100 causes the storage unit 101 to store the obtained objective value.
  • the arithmetic control unit 100 performs control based on the objective value of the right eye acquired in step S22.
  • This control process includes, for example, a process of selecting a visual target first presented in the subsequent subjective refraction measurement (distance examination, near-field examination).
  • step S28 Control based on the objective value
  • the arithmetic control unit 100 performs control based on the objective value of the left eye acquired in step S27.
  • examinations shall be performed in the following order: (1) objective refraction measurement of the right eye; (2) objective refraction measurement of the left eye; (3) far left eye. (4) Right eye distance test; (5) Right eye near field test; (6) Left eye near field test.
  • the arithmetic control unit 100 performs control based on the objective value of the left eye acquired in step S44.
  • the arithmetic control unit 100 performs control based on the objective value of the right eye acquired in step S42.
  • the arithmetic control unit 100 performs control based on the objective value of the left eye acquired in step S44.
  • the movement of the examination unit 110 to the examination position of the right eye and preparation for performing objective refraction measurement are performed.
  • the examination unit 110 is placed at the examination position of the right eye, the objective refraction measurement of the right eye is performed.
  • the arithmetic control unit 100 causes the storage unit 101 to store the obtained objective value.
  • the arithmetic control unit 100 makes preparations for conducting a distance inspection. This preparation includes control based on the objective value of the right eye obtained by objective refraction measurement. After the preparation is completed, the right eye distance examination is performed, and the distance vision value acquired thereby is stored in the storage unit 101.
  • the user inputs an instruction for switching the eye to be inspected to the left eye after the right eye far-distance examination is completed.
  • the arithmetic control unit 100 moves the inspection unit 110 to the inspection position of the left eye.
  • the arithmetic control unit 100 prepares for an examination (objective refraction measurement) that is first performed on the left eye.
  • the user operates the operation unit 140 (joystick 8) to move the inspection unit 110 (head unit 4) toward the inspection position of the left eye after the end of the distance eye inspection for the right eye.
  • a position detector (not shown) (for example, a sensor that detects the position of the head unit 4) is provided.
  • the arithmetic control unit 100 recognizes the position of the inspection unit 110 (head unit 4) based on the output from the position detection unit. Based on the output from the position detection unit, the arithmetic control unit 100 prepares for a test (objective refraction measurement) that is first performed on the left eye at a predetermined timing.
  • This timing is, for example, the timing at which the start of movement of the inspection unit 110 is detected, the timing at which the inspection unit 110 is moved by a predetermined amount, or the inspection unit 110 at a predetermined position (for example, the center in the left-right direction). (Position).
  • the arithmetic control unit 100 causes the storage unit 101 to store the obtained objective value.
  • the arithmetic control unit 100 makes preparations for conducting a distance inspection. This preparation includes control based on the objective value of the left eye obtained by objective refraction measurement. After the preparation is completed, the left eye distance examination is performed, and the distance vision value acquired thereby is stored in the storage unit 101.
  • the user inputs an instruction to perform the next inspection (contrast inspection) on the left eye after the end of the distance inspection.
  • the arithmetic control unit 100 prepares for the contrast inspection. Then, a contrast test for the left eye is performed, and the contrast visual acuity value acquired thereby is stored in the storage unit 101.
  • the user inputs an instruction to switch the eye to be inspected to the right eye after the left eye contrast test is completed.
  • the arithmetic control unit 100 moves the inspection unit 110 to the inspection position of the right eye.
  • the arithmetic control unit 100 prepares for the next test (contrast test) to be performed on the right eye, such as control based on the objective value of the right eye.
  • the right eye contrast test is performed, and the contrast visual acuity value acquired thereby is stored in the storage unit 101.
  • the arithmetic control unit 100 prepares for the glare inspection. This preparation includes control based on the objective value of the right eye.
  • the arithmetic control unit 100 can obtain right-eye medical information (such as information on the state of cataract) from the electronic medical record and display it on the display unit 130. After the preparation is completed, a glare test for the right eye is performed, and the test result is stored in the storage unit 101.
  • the user inputs an instruction to perform the next inspection (near-field inspection) on the right eye after the glare inspection is completed.
  • the arithmetic control unit 100 prepares for the near-field inspection. Then, the near eye examination of the right eye is performed, and the near vision value acquired thereby is stored in the storage unit 101.
  • the user inputs an instruction for switching the eye to be inspected to the left eye after the right-eye near-field inspection is completed.
  • the arithmetic control unit 100 moves the inspection unit 110 to the inspection position of the left eye.
  • the arithmetic control unit 100 prepares for the next test (glare test) to be performed on the left eye, such as control based on the objective value of the left eye. Then, a glare test for the right eye is performed, and the test result is stored in the storage unit 101.
  • the user inputs an instruction to perform the next inspection (near-field inspection) on the left eye after the glare inspection is completed.
  • the arithmetic control unit 100 prepares for the near-field inspection. Then, the near eye examination of the left eye is performed, and the near vision value acquired thereby is stored in the storage unit 101.
  • the five types of examinations for the left eye and the right eye are executed in a predetermined order, and the processing of this example is completed.
  • the ophthalmologic apparatus controls the examination unit according to the type of one examination (for example, distance examination) set in advance in response to the switching of the examination target eye.
  • the arithmetic control unit 100 shifts to the left eye examination while keeping the setting of the examination unit 110 in the far-distance examination setting.
  • the arithmetic control unit 100 changes the setting of the examination unit 110 from the setting for the near-inspection to the setting for the near-inspection, and thereafter The left eye is examined.
  • the ophthalmologic apparatus has a configuration capable of examining each of the left eye and the right eye of the subject.
  • This ophthalmologic apparatus includes an inspection unit (for example, the inspection unit 11), a switching unit (for example, a left / right switching unit 120), and a control unit (for example, an arithmetic control unit 100).
  • the inspection unit is configured to be able to perform a plurality of different types of inspection.
  • the switching unit has a configuration for switching the inspection object by the inspection unit between the left eye and the right eye.
  • the control unit corresponds to the switching of the examination target from the first eye to the second eye, and executes control on the examination unit according to the type of examination first performed on the second eye after this switching. .
  • the inspection unit can be automatically controlled in response to the switching of the inspection target eye. This control is executed according to the type of examination performed first after switching the examination target eye.
  • the eye to be examined is switched and the setting of the examination unit is changed individually. Therefore, according to the embodiment, it is possible to improve the operability of the ophthalmologic apparatus capable of performing the left eye inspection and the right eye inspection.
  • the control unit may include a storage unit (for example, the storage unit 101) and an examination type identification unit (for example, the examination type identification unit 102). Further, the control unit may be configured to execute the following processing: (1) Processing for storing examination schedule information including the type and order of one or more examinations performed on the left eye and the type and order of one or more examinations executed on the right eye in the storage unit ; (2) Processing for storing examination history information including a history of examinations performed on the left eye and the right eye by the examination unit in the storage unit; (3) A process for identifying the type of examination that is first performed on the second eye after switching based on the examination schedule information and examination history information in response to the examination target switching (this process is the examination type identification) Executed by the department); (4) Processing for controlling the inspection unit based on the inspection type specified by the inspection type specifying unit.
  • the first examination performed for each of the left eye and the right eye may be objective refraction measurement
  • the second examination performed may be a distance examination.
  • This configuration is applied to an ophthalmologic apparatus capable of performing at least objective refraction measurement and distance examination (subject refraction measurement).
  • the first examination performed on each of the left eye and the right eye may be a distance examination.
  • This configuration is applied to an ophthalmologic apparatus capable of executing at least a distance test (a subjective refraction measurement).
  • the near-inspection inspection may be included in the inspection executed after the distance inspection.
  • a configuration in which a near-field inspection is performed next to a distance inspection may be used, or a configuration in which one or more other types of inspection are performed between the distance inspection and the near-field inspection may be employed.
  • This configuration is applied to an ophthalmologic apparatus capable of executing at least a distance test and a near-field test.
  • the control unit may be configured to change a type and / or order of examinations included in the examination schedule information in response to a predetermined instruction.
  • the configuration for performing this process includes, for example, the information changing unit 103 shown in FIG. According to such a configuration, it is possible to appropriately change the inspection type and order. Furthermore, the above control can be performed based on the inspection schedule information after the change.
  • the examination that is first performed on the second eye after switching the examination target may be fixed (referred to as “one examination”).
  • One test applied when the test object is switched when the subjective refraction measurement is performed may be a distance test.
  • subjective refraction measurements may include a distance test and a near field test. Such a configuration can be arbitrarily applied according to the needs of users and the like.
  • the switching unit may include a moving unit (for example, the moving unit 121) for moving the inspection unit.
  • the control unit can control the inspection unit in response to the movement of the inspection unit from the first eye inspection position to the second eye inspection position.
  • an ophthalmologic apparatus for example, the ophthalmologic apparatus 1 shown in FIG. 1 and the like
  • the switching unit selectively blocks the left eye field of view and the right eye field of view.
  • the control unit can execute the control of the examination unit in response to the change of the blocking target by the blocking unit from the second eye to the first eye.
  • an optometry apparatus including a refractor capable of selectively arranging optical elements in the left-eye optometry window and the right-eye optometry window, and a target presentation apparatus.
  • an ophthalmologic apparatus capable of at least subjective refraction measurement and further objective refraction measurement (and corneal shape measurement) has been described.
  • the ophthalmologic apparatus to which the present invention is applicable is not limited to these.
  • the present invention is applied to an apparatus having arbitrary functions usable in the ophthalmic field such as an intraocular pressure measurement function, a fundus imaging function, an anterior ocular segment imaging function, an optical coherence tomography (OCT) function, and an ultrasonic examination function. It is possible to apply.
  • the intraocular pressure measurement function is realized by a tonometer
  • the fundus imaging function is realized by a fundus camera
  • the anterior ocular imaging function is realized by a slit lamp, etc.
  • the OCT function is optical
  • the ultrasonic inspection function is realized by an ultrasonic diagnostic apparatus or the like.
  • the present invention can be applied to an apparatus (multifunction machine) having two or more of such functions.
  • the type and / or order of the left eye examination and the type and / or order of the right eye examination may be the same or different from each other.
  • the objective refraction measurement and the distance test may be performed on the left eye and the right eye in this order.
  • the left eye test and the right eye test may be different (eg, if only the left eye is a cataract eye, the glare test is performed only on the left eye) Done).
  • the order of examination does not affect the result and throughput
  • the examination order for the left eye and the examination order for the right eye may be different.
  • the past movement amount can be referred to.
  • the movement distance of the examination part distance between pupils (PD) or from the center of the face to the center of the pupil at the time of objective refraction measurement
  • the distance (half PD)) is obtained and stored, and can be used to move the inspection unit during subjective refraction measurement. It is also possible to perform movement control of the inspection unit based on a PD or the like acquired in advance and recorded in the electronic medical record.
  • the operation mode of the ophthalmologic apparatus according to the present invention is not limited to these.
  • an operation mode corresponding to the installed function is applied. Is possible.
  • a function for selectively executing them can be provided. For example, providing a function of displaying information presented so that a plurality of operation modes can be selected, a function of accepting selection of an operation mode based on the display information, and a function of controlling an ophthalmologic apparatus according to the accepted operation mode Is possible.
  • the operation mode can be automatically selected based on predetermined information. For example, it is possible to acquire an operation mode applied to the subject in the past from an electronic medical record or the like. It is also possible to configure the operation mode to be selected based on attributes (such as injury and illness name, age).

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Abstract

L'invention vise à améliorer le fonctionnement d'un dispositif ophtalmologique qui peut examiner l'œil gauche et l'œil droit. Le dispositif ophtalmologique selon un mode de réalisation peut examiner l'œil gauche et l'œil droit d'un sujet. Le dispositif ophtalmologique comprend une unité d'examen, une unité de commutation et une unité de commande. L'unité d'examen est configurée pour pouvoir réaliser une pluralité de différents types d'examens. L'unité de commutation a une configuration pour commuter le sujet à examiner par l'unité d'examen entre l'œil gauche et l'œil droit. L'unité de commande correspond à la commutation du sujet à examiner d'un premier œil à un second œil, et commande l'unité d'examen en fonction du type d'examen à réaliser en premier sur le second œil après la commutation.
PCT/JP2014/084551 2014-01-06 2014-12-26 Dispositif ophtalmologique WO2015102092A1 (fr)

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JP6685144B2 (ja) * 2016-02-04 2020-04-22 株式会社トプコン 眼科装置及び眼科検査システム
JP6942485B2 (ja) * 2017-02-27 2021-09-29 株式会社トプコン 眼科システム
JP6833081B2 (ja) * 2020-01-16 2021-02-24 株式会社トプコン 眼科装置及び眼科検査システム
JP2022042438A (ja) * 2020-09-02 2022-03-14 株式会社トプコン 眼科検査システム及び眼科装置

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JP2007282671A (ja) * 2006-04-12 2007-11-01 Nidek Co Ltd 眼科装置
JP2008272030A (ja) * 2007-04-25 2008-11-13 Topcon Corp 自覚式検眼装置
JP2009056246A (ja) * 2007-09-03 2009-03-19 Nidek Co Ltd 眼科撮影装置
JP2009153569A (ja) * 2007-12-25 2009-07-16 Topcon Corp 眼科装置

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JPH1147094A (ja) * 1997-08-05 1999-02-23 Canon Inc 検眼装置
JP5306493B2 (ja) * 2012-01-25 2013-10-02 キヤノン株式会社 眼科装置および眼科装置の制御方法並びにプログラム

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JP2007282671A (ja) * 2006-04-12 2007-11-01 Nidek Co Ltd 眼科装置
JP2008272030A (ja) * 2007-04-25 2008-11-13 Topcon Corp 自覚式検眼装置
JP2009056246A (ja) * 2007-09-03 2009-03-19 Nidek Co Ltd 眼科撮影装置
JP2009153569A (ja) * 2007-12-25 2009-07-16 Topcon Corp 眼科装置

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