JP2018019777A - Ophthalmologic examination apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a new technology to carry out an ophthalmologic examination smoothly.SOLUTION: An ophthalmologic examination apparatus carries out an examination of an eye to be examined based on a response of a subject to one or more targets presented in a predetermined presentation region. The ophthalmologic examination apparatus includes a direction identification part, a position identification part, and a display control part 201A. The direction identification part identifies the direction of the eye to be examined. The position identification part identifies the position in the presentation region corresponding to the direction of the eye to be examined identified by the direction identification part. The display control part 201A superimposes a position image indicating the position identified by the position identification part on a target image indicating the one or more targets presented in the presentation region, and causes the images to be displayed on a display device for an examiner.SELECTED DRAWING: Figure 4

Description

  The present invention relates to an ophthalmic examination apparatus.

  Subjective examination in which the visual acuity value of the eye to be inspected is presented based on how the visual target is displayed, such as a Landolt ring for visual acuity measurement or a radiation chart for astigmatism measurement, in an ophthalmology field or an eyeglass store. Is widely implemented. In the self-examination, the examiner asks the subject about how to see the target, and selects the target to be presented next and determines the visual acuity value based on the response content. There is also an ophthalmic examination apparatus that automatically executes a subjective examination by controlling a visual target and an optical system according to a predetermined control program.

  For example, Patent Document 1 discloses an ophthalmic examination apparatus in which a liquid crystal display capable of displaying various targets is stored in an optical head unit and can perform subjective examination and objective measurement. In this ophthalmic examination apparatus, when the subject operates the operation means and designates the direction of the cut of the viewed Landolt ring, an arrow mark indicating the designated direction can be displayed on the liquid crystal display. Thus, the subject can confirm whether or not the direction of the cut of the Landolt ring visually recognized by the subject is the same as the direction designated by the operation on the operation means.

JP-A-2005-342042

  It is known that adjustment intervention is likely to occur if a predetermined target (a part of the red-green test chart side of the red chart) is stared during an ophthalmic examination. However, in the ophthalmic examination apparatus disclosed in Patent Document 1, the subject can check the content of his / her response to the visually recognized target. I ca n’t see where I ’m looking. Therefore, the examiner cannot give an appropriate instruction to the subject in order to smoothly advance the ophthalmic examination, such as instructing to see the whole evenly. This applies not only to subjective examinations but also to objective measurements.

  This invention is made | formed in view of such a situation, The objective is to provide the new technique for advancing ophthalmic examination smoothly.

  The ophthalmic examination apparatus according to the embodiment inspects the eye to be examined based on the response of the subject to one or more visual targets presented in a predetermined presentation area. The ophthalmic examination apparatus includes an orientation specifying unit, a position specifying unit, and a display control unit. The direction specifying unit specifies the direction of the eye to be examined. The position specifying unit specifies a position in the presentation area corresponding to the direction of the eye to be examined specified by the direction specifying unit. The display control unit superimposes the position image representing the position specified by the position specifying unit on the visual target image representing one or more visual targets presented in the presentation area, and causes the display device for the examiner to display the image.

  According to the ophthalmic examination apparatus according to the present invention, the ophthalmic examination can be smoothly advanced.

Schematic which shows the external appearance structure of the ophthalmic examination apparatus which concerns on embodiment. Schematic which shows the structural example of the ophthalmic examination apparatus which concerns on embodiment. Schematic which shows the structural example of the optical system of the ophthalmic examination apparatus which concerns on embodiment. Schematic which shows the structural example of the control system of the ophthalmic examination apparatus which concerns on embodiment. Schematic which shows the structural example of the control system of the ophthalmic examination apparatus which concerns on embodiment. Operation | movement explanatory drawing of the ophthalmic examination apparatus which concerns on embodiment. Operation | movement explanatory drawing of the ophthalmic examination apparatus which concerns on embodiment. Operation | movement explanatory drawing of the ophthalmic examination apparatus which concerns on embodiment. Operation | movement explanatory drawing of the ophthalmic examination apparatus which concerns on embodiment. Operation | movement explanatory drawing of the ophthalmic examination apparatus which concerns on embodiment. The flowchart of the operation example of the ophthalmic examination apparatus which concerns on embodiment. The flowchart of the operation example of the ophthalmic examination apparatus which concerns on embodiment.

  An example of an embodiment of an ophthalmic examination apparatus according to the present invention will be described in detail with reference to the drawings. In addition, it is possible to use the description content of the literature referred in this specification, and arbitrary well-known techniques for the following embodiment.

[Constitution]
FIG. 1 schematically shows an outline of an external configuration of the ophthalmic examination apparatus according to the embodiment. The ophthalmic examination apparatus 1 according to the embodiment is an ophthalmic apparatus capable of performing subjective examination and objective measurement. The subjective examination is an examination for presenting a visual target to the subject's eye (the subject's eye) and acquiring information about the subject's eye based on a response from the subject regarding how the subject looks. The objective measurement is a measurement for acquiring information about the eye to be examined mainly using a physical method without referring to a response from the subject.

  The ophthalmic examination apparatus 1 can be communicably connected to an examiner controller (for example, a tablet terminal) or a subject controller (for example, a control lever unit) (not shown) via a wired or wireless communication path. The ophthalmic examination apparatus 1 is controlled based on operations on the examiner controller and the subject controller. In the following description, the left-right direction as viewed from the subject may be referred to as the X direction, the up-down direction as the Y direction, and the depth direction of the measuring head 100 as viewed from the subject may be described as the Z direction.

  The ophthalmic examination apparatus 1 includes a measurement head 100 and a control device 200. The measuring head 100 is provided with an optical system and a moving mechanism system for moving the optical element for performing the above-described subjective examination and objective measurement. The control device 200 controls the measurement head 100 and controls the examiner controller and the subject controller.

  The ophthalmic examination apparatus 1 includes an optometry table 3. The optometry table 3 is a desk for supporting the measuring head 100 and placing the controller for the examiner or the controller for the subject. The optometry table 3 is installed in a state of being supported on the floor by the support unit 4. The optometry table 3 is adjustable in height up and down.

  A support column 5 is erected on the optometry table 3. The proximal end portion of the lateral arm 6 is held at the distal end portion of the support column 5. A measuring head 100 is suspended from the tip of the horizontal arm 6. For example, the support column 5 can be rotated in the rotation direction (arrow direction j, arrow direction k) about the axis by the arm moving mechanism 7. Thereby, the horizontal arm 6 is rotated around the axis. That is, the measuring head 100 is rotated around the axis. As a result, the measuring head 100 can be retracted from the examination space above the optometry table 3, and the examination can be efficiently performed using the empty space on the optometry table 3.

  The arm moving mechanism 7 may move the tip of the support column 5 in the vertical direction (arrow direction h) as an arm vertical movement mechanism. Thereby, the horizontal arm 6 is moved in the vertical direction. That is, the measuring head 100 is moved in the vertical direction. The arm moving mechanism 7 may move the horizontal arm 6 in the vertical direction by expanding and contracting the support column 5 protruding upward from the optometry table 3 as an arm expansion and contraction mechanism. Even in this case, the measurement head 100 can be moved up and down according to the sitting height of the subject, or the measurement head 100 can be retracted from the examination space above the optometry table 3.

  A stand or the like for storing the measurement head 100 may be separately provided, and the measurement head 100 may be disposed at a stable position by the above-described rotation or vertical movement. In this case, it is possible to continuously reduce the load on the lateral arm 6 due to the weight of the measuring head 100.

  The arm moving mechanism 7 can receive the operation by the operator and manually move the horizontal arm 6 in the rotation direction around the axis or in the vertical direction. The arm moving mechanism 7 may move the horizontal arm 6 by an electric mechanism. In this case, an actuator that generates a driving force for moving the arm moving mechanism 7 and a transmission mechanism that transmits the driving force are provided. The actuator is constituted by, for example, a pulse motor. The transmission mechanism is configured by, for example, a combination of gears, a rack and pinion, or the like.

  A storage unit 9 is provided on a side surface of the support unit 4 to store the control device 200 and the like. The configuration of the optometry table 3 is not limited to the configuration shown in FIG.

[Measurement head]
The measurement head 100 includes a left eye inspection unit 120L and a right eye inspection unit 120R. Examination windows 130L and 130R are formed in the left-eye examination unit 120L and the right-eye examination unit 120R, respectively. The left eye (left eye) of the subject is examined through the optometry window 130L. The subject's right eye (right eye) is examined through the optometry window 130R.

  FIG. 2 shows a block diagram of a configuration example of the measurement head 100 according to the embodiment. The measurement head 100 includes a moving mechanism system 110, a left eye inspection unit 120L, and a right eye inspection unit 120R. The moving mechanism system 110 is suspended from the horizontal arm 6. The left-eye inspection unit 120L and the right-eye inspection unit 120R are three-dimensionally moved independently or in conjunction by the moving mechanism system 110. The left eye inspection unit 120L accommodates an optical system for inspection of the left eye. The right eye inspection unit 120R houses an optical system for inspecting the right eye.

(Movement system)
The moving mechanism system 110 includes a horizontal movement mechanism 111, rotation mechanisms 112L and 112R, and vertical movement mechanisms 113L and 113R. The moving mechanism system 110 may further include an arm moving mechanism 7.

  The horizontal movement mechanism 111 moves the rotation mechanisms 112L and 112R, the vertical movement mechanisms 113L and 113R, the left-eye inspection unit 120L, and the right-eye inspection unit 120R in the horizontal direction (lateral direction (X direction), front-rear direction (Z direction)). ). Thereby, the horizontal position of the optometry windows 130L and 130R can be adjusted according to the arrangement position of the eye to be examined. The horizontal movement mechanism 111 has a known configuration using, for example, a pulse motor or a feed screw, and moves the rotation mechanisms 112L and 112R in the horizontal direction in response to a control signal from the control device 200. The horizontal movement mechanism 111 can be manually moved in the horizontal direction by the above-described rotation mechanisms 112L, 112R, etc. in response to an operation by the operator.

  The rotation mechanism 112L rotates the vertical movement mechanism 113L and the left-eye inspection unit 120L around a predetermined first axis connected to the horizontal movement mechanism 111. The first axis is an axis extending in a substantially vertical direction, and may be tiltable at an arbitrary angle with respect to the horizontal plane. The rotation mechanism 112L has a known configuration using, for example, a pulse motor or a rotation shaft, and rotates the left eye inspection unit 120L around the first axis in response to a control signal from the control device 200. Let The rotation mechanism 112L can manually rotate the left-eye inspection unit 120L and the like about the first axis in response to an operation by the operator.

  The rotation mechanism 112R rotates the vertical movement mechanism 113R and the right-eye inspection unit 120R about a predetermined second axis connected to the horizontal movement mechanism 111. The second axis is an axis extending in a substantially vertical direction like the first axis, and may be tiltable at an arbitrary angle with respect to the horizontal plane. The second axis is an axis that is disposed at a position separated from the first axis by a predetermined distance. The distance between the first axis and the second axis is adjustable. The rotation mechanism 112R may rotate the right eye inspection unit 120R or the like in conjunction with the rotation of the rotation mechanism 112L, or the right eye inspection unit 120R independently of the rotation of the rotation mechanism 112L. Etc. may be rotated. The rotation mechanism 112R has a known configuration similar to that of the rotation mechanism 112L, and receives the control signal from the control device 200 to rotate the right-eye inspection unit 120R and the like about the second axis. The rotation mechanism 112R can receive the operation by the operator and manually rotate the right-eye inspection unit 120R and the like about the second axis.

  By rotating the left eye inspection unit 120L and the right eye inspection unit 120R by the rotation mechanisms 112L and 112R, the directions of the left eye inspection unit 120L and the right eye inspection unit 120R are relatively changed. Is possible. For example, the left-eye inspection unit 120L and the right-eye inspection unit 120R are rotated in opposite directions around the eyeball rotation points of the left and right eyes of the subject. Thereby, the eye to be examined can be spread and converged.

  The vertical movement mechanism 113L moves the left-eye inspection unit 120L in the vertical direction (Y direction). Thereby, the position in the height direction of the optometry window 130L can be adjusted according to the arrangement position of the eye to be examined. The vertical movement mechanism 113L has a known configuration using, for example, a pulse motor or a feed screw, and moves the left eye inspection unit 120L in the vertical direction in response to a control signal from the control device 200. The vertical movement mechanism 113L can receive the operation by the operator and manually move the left-eye inspection unit 120L in the vertical direction.

  The vertical movement mechanism 113R moves the right eye inspection unit 120R in the vertical direction. Thereby, the position in the height direction of the optometry window 130R can be adjusted according to the arrangement position of the eye to be examined. The vertical movement mechanism 113R may move the right eye inspection unit 120R in conjunction with the movement by the vertical movement mechanism 113L, or by moving the right eye inspection unit 120R independently of the movement by the vertical movement mechanism 113L. Also good. The vertical movement mechanism 113R has a known configuration similar to the vertical movement mechanism 113L, and moves the right eye inspection unit 120R in the vertical direction in response to a control signal from the control device 200. The vertical movement mechanism 113R can receive the operation by the operator and manually move the right eye inspection unit 120R in the vertical direction.

(Configuration of each inspection unit)
The left-eye inspection unit 120L and the right-eye inspection unit 120R can operate individually.

  The left-eye examination unit 120L includes a first target presentation unit 122L, a first objective measurement unit 123L, and a first imaging unit 124L. The first visual target presenting unit 122L selectively presents a plurality of visual targets to the left eye. The first objective measurement unit 123L is used for measuring objective refraction of the left eye. The first imaging unit 124L images the anterior segment of the left eye. The left eye inspection unit 120L may be provided with an optical element application unit that selectively applies a plurality of optical elements that can be disposed between the left eye to be examined and a deflection member P described later to the left eye to be examined. .

  The right-eye examination unit 120R includes a second target presentation unit 122R, a second objective measurement unit 123R, and a second imaging unit 124R. The second target presentation unit 122R selectively presents a plurality of targets to the right eye. The second objective measurement unit 123R is used to perform objective refractive measurement of the right eye. The second imaging unit 124R images the anterior segment of the right eye. The right eye inspection unit 120R may be provided with an optical element application unit that selectively applies a plurality of optical elements that can be arranged between the right eye to be examined and a deflection member P described later to the right eye to be examined. .

  The left eye inspection unit 120L and the right eye inspection unit 120R accommodate an optical system as shown in FIG. The left-eye examination unit 120L and the right-eye examination unit 120R operate the optical system to perform subjective examination and objective refraction measurement for each of the left eye EL and right eye ER. It is configured as follows. The examiner or the subject performs an examination by appropriately operating a controller or the like.

  When each inspection unit is provided with the optical element application unit, the optical element application unit includes a plurality of optical elements and a drive mechanism. The plurality of optical elements is a set of various lenses for inspecting the visual function of the eye to be examined, and includes at least one of a spherical lens, a cylindrical lens, and a prism lens, for example. The plurality of optical elements are grouped for each type of optometry parameter. For example, the type of optometry parameter includes at least one of spherical power, astigmatism power, astigmatism axis angle, addition power, interpupillary distance, prism power, and prism base direction. As a grouping for each type of optometry parameter, the spherical power group includes a plurality of spherical lenses, each of which is composed of spherical lenses having different spherical powers. The set of astigmatism powers includes a plurality of cylindrical lenses, each of which is composed of cylindrical lenses having different astigmatic powers. The set of astigmatism powers may be switched in accordance with the astigmatic axis angle. The set of addition powers is composed of a positive power spherical lens and a negative power spherical lens that can be inserted and removed. The set of prism powers includes a plurality of prism lenses, each of which is composed of prism lenses having different prism powers. It should be noted that the set of prism powers may be switched in accordance with the prism base direction. The interpupillary distance is an examination condition set in accordance with the interpupillary distance of the eye to be examined. The interpupillary distance is set by one or both of the left-eye inspection unit 120L and the right-eye inspection unit 120R sliding in the horizontal direction (arrow direction m in FIG. 1).

  The drive mechanism included in each examination unit is configured such that each of the plurality of optical elements can be disposed on the optometry window and retracted from the optometry window. The drive mechanism included in each inspection unit receives the control signal from the control device 200 and switches the optical element. Accordingly, at least one of spherical power, astigmatism power, astigmatism axis angle, addition power, interpupillary distance, prism power, and prism base direction can be switched and applied to the eye to be examined.

[Configuration of optical system]
FIG. 3 shows a block diagram of a configuration example of an optical system accommodated in the left-eye inspection unit 120L and the right-eye inspection unit 120R. The left-eye inspection unit 120L includes a deflection member P, a target presentation optical system 10L, a photographing optical system 20L, alignment optical systems 30L and 31L, a reflex measurement optical system 40L, and a kerato measurement optical system 50L. . The left-eye inspection unit 120L is provided with an objective lens 60, a moving lens 70, a reflection mirror M, and beam splitters BS1 to BS3. The right-eye inspection unit 120R includes a deflection member P, a target presentation optical system 10R, a photographing optical system 20R, alignment optical systems 30R and 31R, a reflex measurement optical system 40R, and a kerato measurement optical system 50R. . The right-eye inspection unit 120R is provided with an objective lens 60, a moving lens 70, a reflection mirror M, and beam splitters BS1 to BS3. The optical system of the left-eye inspection unit 120L and the optical system of the right-eye inspection unit 120R are configured symmetrically. Hereinafter, unless otherwise indicated, the optical system of the left-eye inspection unit 120L will be described.

  The optotype presenting optical system 10L is an optical system for projecting the optotype on the fundus oculi Ef of the left eye to be examined EL. The target presentation optical system 10L includes an LCD (Liquid Crystal Display) 11, a moving lens 70, and a reflection mirror M. The LCD 11 displays various visual targets (charts) for visual acuity measurement and visual function inspection within a predetermined visual target presentation area. These targets include a plurality of targets and a single target. Visual targets for visual acuity measurement include a fixation target composed of a landscape chart, a visual acuity chart such as a Landolt ring for visual acuity inspection, and an ETDRS (Early Treatment Diabetic Study) visual acuity chart. The target for visual function inspection includes cross cylinder test chart, radiation chart for astigmatism inspection, cross chart for oblique inspection, red green test chart, screening target, cross ring chart, convoluted oblique chart, Worth 4 There are point charts. The multiple targets include an ETDRS vision chart, an illustration target, a screening target, and the like. Single targets include precision stereoscopic targets, cruciform targets, astigmatic targets, and red-green test charts. These targets are selectively displayed on the LCD 11. Instead of the LCD 11, the target presentation optical system 10 </ b> L emits one or more targets among a plurality of targets drawn on an electronic display device using EL (electroluminescence) or a rotating glass plate. What is appropriately arranged on the shaft (turret type) may be provided. The target presentation optical system 10L may be provided with a target plate on which one or more targets are drawn in a predetermined target presentation area.

  The moving lens 70 is movable in the optical axis direction of the target presentation optical system 10L. The moving lens 70 is moved by the drive mechanism 70L. The driving mechanism 70L moves the moving lens 70 in response to a control signal from the control device 200. Thereby, the sphericity added to the left eye to be examined EL can be changed. For example, by moving the moving lens 70 in the optical axis direction by the amount of movement corresponding to the refractive power of the left eye EL during reflex measurement, it is possible to perform fixation clouding on the left eye EL. In addition, at the subjective examination, the target can be presented at a position corresponding to the far point of the eye to be examined, a position corresponding to the near point, or any intermediate position between them, and the examination can be performed at an arbitrary examination distance. it can.

  The light from the LCD 11 passes through the moving lens 70 and is reflected by the reflection mirror M. The light reflected by the reflection mirror M passes through the beam splitter BS2 and is reflected by the beam splitter BS1. The light reflected by the beam splitter BS1 passes through the objective lens 60 and is deflected by the deflecting member P toward the fundus oculi Ef of the left eye EL.

  The visual target presenting optical system 10L may be provided with a VCC lens for correcting the astigmatism power and the astigmatic axis angle of the left eye to be examined EL.

  The imaging optical system 20L is an optical system for imaging the anterior segment of the left eye EL. The photographing optical system 20L includes a CCD (Charged-Coupled Device) 21. For example, when the anterior segment of the left eye EL is illuminated by an anterior segment illumination system (not shown), the reflected light from the anterior segment of the left eye EL is incident on the deflection member P. The deflecting member P deflects the reflected light toward the objective lens 60. The reflected light deflected by the deflecting member P passes through the objective lens 60, passes through the beam splitters BS1 and BS3, and forms an image on the light receiving surface of the CCD 21 by a CCD lens or the like (not shown). Further, the photographing optical system 20L functions as a light receiving system that receives reflected light of the measurement light beam projected on the left eye EL in the reflex measurement and the kerato measurement.

  The alignment optical system 30L is an optical system for performing alignment in the X and Y directions of the optical system of the left eye inspection unit 120L with respect to the left eye E. The alignment optical system 30L projects an alignment light beam (parallel light) onto the left eye EL. The alignment light beam is reflected by the beam splitter BS3, passes through the beam splitter BS1, passes through the objective lens 60, becomes a substantially parallel light beam, and is deflected by the deflection member P toward the cornea of the left eye EL. The reflected light from the cornea of the alignment light beam projected on the left eye EL returns through the same path as the incident path, passes through the beam splitter BS3, and is received by the CCD 21 of the imaging optical system 20L.

  The alignment optical system 31L includes two or more cameras for photographing the anterior eye portion of the left eye EL substantially simultaneously from two or more different directions. Alignment in the Z direction (working distance direction) is performed from the parallax obtained based on the captured images of the anterior segment from two or more different directions obtained using these cameras.

  The reflex measurement optical system 40L is an optical system for performing reflex measurement (objective refraction measurement) of the left eye to be examined EL. The reflex measurement light beam emitted from the reflex measurement optical system 40L is reflected by the beam splitter BS2, reflected by the beam splitter BS1, passes through the objective lens 60, and is directed toward the fundus oculi Ef of the left eye EL by the deflection member P. Is deflected. The reflected light from the fundus of the reflex measurement light beam projected onto the left eye EL returns through the same path as the incident path, passes through the beam splitters BS1 and BS3, and is received by the CCD 21 of the imaging optical system 20L.

  The kerato measurement optical system 50L is an optical system for performing kerato measurement of the left eye to be examined EL. The ring-shaped light beam from the kerato ring light source emitted by the kerato measurement optical system 50L is deflected by the deflecting member P and illuminates the cornea of the left eye EL. Reflected light from the cornea of the left eye EL is deflected by the deflecting member P, passes through the objective lens 60, passes through the beam splitters BS1 and BS3, and forms a ring-shaped image on the light receiving surface of the CCD 21 by a CCD lens (not shown). Imaged.

  The measurement head 100 automatically executes alignment of the optical systems of the left eye inspection unit 120L and the right eye inspection unit 120R, objective optometry, subjective optometry, and the like under the control of the control system described later. It is supposed to be. The measurement head 100 may further automatically execute a binocular balance test. In the subjective examination, a value (objective value) obtained by objective measurement is used. In particular, in the cross-cylinder test in the subjective examination, the astigmatism power and the astigmatic axis angle obtained by the objective measurement are used.

[Control system]
Next, a control system of the ophthalmic examination apparatus 1 according to the embodiment will be described with reference to FIGS. 4 and 5. The block diagrams shown in FIGS. 4 and 5 represent the schematic configuration of the main part of the control system of the ophthalmic examination apparatus 1. 4 and 5, the same parts as those in FIGS. 1 to 3 are denoted by the same reference numerals, and the description thereof is omitted as appropriate.

  As shown in FIG. 4, the control system of the ophthalmic examination apparatus 1 is configured around a control device 200 that controls each part of the apparatus. The control device 200 is stored in the storage unit 9, for example. The control device 200 includes a control unit 201 and a storage unit 202. The control unit 201 includes a display control unit 201A and a target control unit 201B.

  The storage unit 202 stores a computer program for ophthalmic examination including a control program for executing processing as described later, image data of a target pattern displayed on the LCD 11, and the like. Further, in the storage unit 202, an image of the anterior segment of the left eye E acquired using the imaging optical systems 20L and 20R, an image of the anterior segment of the right eye ER, a reflex measurement result, a kerato measurement result, Awareness test results are stored. The control unit 201 reads the computer program stored in the storage unit 202 and sequentially executes the computer program while referring to the image data stored in the storage unit 202. Such a control unit 201 includes an arithmetic control processor such as a CPU (Central Processing Unit).

  A computer device (not shown) may be connected to the ophthalmic examination apparatus 1. In this case, the computer device is used as a console of the ophthalmic examination apparatus 1 and is used for accumulating and managing examination results by the ophthalmic examination apparatus 1. Note that the CPU and the storage device of the computer device can be configured as the control device 200.

  The control device 200 (control unit 201) controls the operation of the left-eye inspection unit 120L and the right-eye inspection unit 120R. Specifically, the control device 200 controls the horizontal movement mechanism 111 that horizontally moves the left-eye inspection unit 120L and the right-eye inspection unit 120R. The control device 200 controls a rotation mechanism 112L that rotates the left-eye inspection unit 120L and a vertical movement mechanism 113L that moves the left-eye inspection unit 120L up and down. Similarly, the control device 200 controls a rotation mechanism 112R that rotates the right eye inspection unit 120R and a vertical movement mechanism 113R that moves the right eye inspection unit 120R up and down. The control device 200 may control the arm moving mechanism 7 that moves the horizontal arm 6 up and down and rotates it.

  The control device 200 (control unit 201) controls the operation of the optical system stored in the left-eye inspection unit 120L and the right-eye inspection unit 120R. The control device 200 (target control unit 201B) executes display control of the LCD 11, for example. Display control of the LCD 11 includes target switching control, target lighting control, target extinguishing control, and the like. In addition, the control device 200 (the control unit 201) executes operation control of the drive mechanisms 70L and 70R that move the moving lens 70 in the optical axis direction.

  The control device 200 (control unit 201) executes light reception control by the CCD 21, operation control of the alignment optical systems 30L, 31L, 30R, 31R, the reflex measurement optical systems 40L, 40R, the kerato measurement optical systems 50L, 50R, and the like. The left eye inspection unit 120L for the left eye EL so that the deviation between the position of the spot light image projected on the left eye EL by the alignment optical system 30L and the position of the pupil center of the left eye EL is cancelled. It is possible to perform alignment in the X and Y directions of the optical system. Similarly, the alignment optical system 30R can perform alignment in the XY directions of the optical system of the right-eye inspection unit 120R with respect to the right eye ER. It is possible to perform alignment in the Z direction from the parallax obtained based on the captured images of the anterior segment of the left eye EL from two or more different directions acquired using the alignment optical system 31L. Similarly, the alignment optical system 31R can perform alignment in the Z direction from parallax obtained based on the captured image of the anterior segment of the right eye ER from two or more different directions. The operation control of the reflex measurement optical systems 40L and 40R includes control of a measurement light source that emits a reflex measurement light beam. The operation control of the kerato measurement optical systems 50L and 50R includes control of a kerat light source.

  When each inspection unit is provided with an optical element application unit, the control device 200 (control unit 201) is a drive mechanism for selectively applying a plurality of optical elements to at least one of the left eye to be examined EL and the right eye to be examined ER. Execute control etc.

  The control device 200 can be connected to the examiner controller 300 and the subject controller 310 via wired or wireless communication paths, respectively. The control device 200 receives the operation signal corresponding to the operation content for the examiner controller 300 and the subject controller 310 and controls each part of the ophthalmic examination apparatus 1. The control device 200 (the display control unit 201A) can display an operation screen, various information for measurement, and the like on the display unit of the controller 300 for the examiner or the controller 310 for the subject. For example, the control device 200 causes the display unit of the examiner's controller 300 to display the visual target under examination. In addition, the control device 200 displays an operation screen or the like on the display unit of the subject controller 310.

  The operation principle of alignment using the above-described optical system, the measurement principle of subjective examination, the measurement principle of objective measurement, the measurement principle of corneal shape, and the like are already known, and detailed description thereof is omitted.

  The control device 200 (control unit 201) controls the calculation unit 210. The calculation unit 210 obtains an objective value based on a measurement result by objective refraction measurement using the left-eye inspection unit 120L or the right-eye inspection unit 120R. The calculation unit 210, for example, uses a known method to obtain the shape of the ring target image obtained by receiving the return light of the ring-shaped measurement light beam projected onto the fundus oculi Ef by the reflex measurement optical systems 40L and 40R by the CCD 21. The objective value is obtained by analysis. For example, the calculation unit 210 performs predetermined calculation processing on an image acquired by receiving, by the CCD 21, a reflected light beam from the cornea of a ring-shaped light beam projected onto the cornea of the eye to be examined by the kerato measurement optical systems 50L and 50R. Apply. Thereby, a parameter representing the shape of the cornea can be calculated as an objective value. The control device 200 may include a calculation unit 210.

  Furthermore, as illustrated in FIG. 5, the calculation unit 210 includes a direction specifying unit 211, a position specifying unit 212, a determining unit 213, and a visual acuity value calculating unit 214.

  The direction specifying unit 211 specifies the direction of the eye to be examined (each of the left eye to be examined EL and the right eye to be examined ER). The direction of the eye to be examined is the direction of the eye axis (line of sight) of the eye to be examined, the direction of the optical axis of the eye to be examined, the direction of the eye axis of the eye to be examined (eyeball axis), the direction of the eye of the eye to be examined, the aiming of the eye to be examined The direction of the line, the direction of the pupil center line of the eye to be examined, and the like. The visual axis (line of sight) of the subject's eye is an axis (line) that passes through the node of the subject's eye and connects the fixation point and the fovea of the subject's eye. The optical axis of the eye to be examined is an axis that passes through the center of curvature of the eyeball optical system of the eye to be examined. The eye axis (eyeball axis) of the eye to be examined is an axis that passes through the anterior pole (corneal apex) and the posterior pole (near the optic nerve exit) of the eye to be examined. The gaze line of the eye to be examined is a line connecting the fixation point and the eyeball rotation point of the eye to be examined. The line of sight of the eye to be examined is a line connecting the fixation point and the center of the entrance pupil of the eye to be examined. The pupil center line of the subject eye is a line that passes through the entrance pupil center of the subject eye and is perpendicular to the corneal surface.

  The orientation identifying unit 211 identifies the orientation of the left eye to be examined EL, and identifies the orientation of the right eye to be examined ER in the same manner as the orientation of the left eye to be examined EL. In the following, for convenience of description, the left eye to be examined EL or the right eye to be examined ER will be described as “eye to be examined” unless otherwise specified.

  The direction specifying unit 211 specifies, for example, the line-of-sight direction around the eyeball rotation point of the eye to be examined as the direction of the eye to be examined. In this case, the direction identifying unit 211 can obtain the line-of-sight direction θ based on the amount of movement of the position of the bright spot image formed by the spot light incident on the eyeball in the anterior segment image of the eye to be examined. When a parallel light beam enters the eyeball, a spot-like virtual image (Purkinje image) is formed at a position Q (half the corneal curvature, R / 2) inside the cornea, as shown in FIG. 6A. Since the curvature center point R of the cornea and the eyeball rotation point O are different, when the eyeball rotates at the rotation angle θ about the eyeball rotation point O, the position Q of the bright spot image in the anterior segment image is as shown in FIG. 6A. Move to. The orientation specifying unit 211 specifies the position Q of the bright spot image with reference to the characteristic part in the anterior eye part image of the eye to be examined, and specifies the displacement of these positions as the movement amount d.

  When the distance from the apex of the cornea to the eyeball rotation point O is L and the curvature of the cornea is r, the moving amount d of the position Q of the bright spot image is expressed as in Expression (1).

  From the formula (1), the direction identifying unit 211 can obtain the rotation angle θ. The distance L from the corneal apex to the eyeball rotation point O may be a predetermined value (for example, an average value of 13 mm). Alternatively, this value may be input when the actual distance is known in measurement by another device. As the curvature r of the cornea, a value obtained by kerato measurement can be used.

  In addition, for example, the orientation identifying unit 211 may identify a pupil region in the anterior segment image of the eye to be examined, and obtain the line-of-sight direction θ1 based on the amount of movement of the pupil center position of the identified pupil region. When the eyeball rotates around the eyeball rotation point O, as shown in FIG. 6B, the position Q1 of the pupil center in the anterior segment image of the eye to be examined moves. The orientation specifying unit 211 specifies the pupil region in the anterior segment image of the eye to be examined, specifies the center position of the specified pupil region as the pupil center position Q1, and the displacement of these positions. Is obtained as a movement amount d1.

  When the distance from the corneal apex to the eyeball rotation point O is L and the distance from the corneal apex to the pupil center position Q1 is N, the movement amount d1 of the pupil center position Q1 is expressed as shown in Expression (2). The

  From the equation (2), the direction identifying unit 211 can obtain the rotation angle θ1. The distance L from the corneal apex to the eyeball rotation point O may be a predetermined value (for example, an average value of 13 mm). The distance N from the corneal apex to the pupil center position Q1 may be a predetermined value (for example, an average value of 3 mm). Alternatively, when the actual distances of L and Q1 are known in measurement by another device, this value may be input.

  In addition, the orientation specifying unit 211 may specify the orientation of the eye to be examined by, for example, a scleral reflection method. The scleral reflection method is a method that uses the difference in reflectance between the cornea (black eyes) and the sclera (white eyes). The orientation identification unit 211 irradiates near-infrared light to the eye to be examined, identifies the corneal region by measuring the intensity of reflected light from the eye to be examined, and cornea region with respect to a predetermined reference position of the eye to be examined ( For example, the orientation of the position of the center of the cornea) is specified as the orientation of the eye to be examined.

  In addition, the orientation specifying unit 211 may specify the orientation of the eye to be examined by, for example, analyzing an anterior eye image of the eye to be examined. The orientation identifying unit 211 identifies a corneal region (black eye region) and a scleral region (white eye region) from the acquired luminance information in the anterior segment image of the eye to be examined, and a corneal region with respect to a predetermined reference position of the eye to be examined ( The direction of the position of the corneal region and the center of the pupil) is specified as the direction of the eye to be examined.

  Further, the orientation specifying unit 211 may specify the orientation of the eye to be examined by detecting a potential difference between the cornea side and the retina side of the eyeball. For example, the orientation specifying unit 211 specifies the orientation of the eye to be examined by analyzing the movement of the eyeball from the potential difference obtained by measuring the potential difference of the skin around the eye to be examined.

  The position specifying unit 212 specifies a position (or a range including the position) in the target presentation area of the LCD 11 corresponding to the direction of the eye to be examined specified by the direction specifying unit 211. For example, the position specifying unit 212 determines a position where a straight line extending from a predetermined reference position (for example, an eyeball rotation point) of the eyeball to the direction of the eye to be examined specified by the direction specifying unit 211 intersects the target presentation area of the LCD 11. Ask.

  In addition, when the direction of the eye to be examined is facing the front, it may be assumed that a straight line extending from a predetermined reference position of the eyeball (for example, the eyeball rotation point) passes through the center position in the target display area of the LCD 11. . In this case, the storage unit 202 stores in advance the displacement (displacement direction and displacement amount) from the center position corresponding to the direction of the eye to be examined. The position specifying unit 212 reads the displacement stored in the storage unit 202 corresponding to the obtained orientation of the eye to be examined, and uses the center position in the target presentation area as a reference based on the read displacement and the inspection distance. In addition, it is possible to obtain the position within the target presentation area of the LCD 11.

  As described above, the position specifying unit 212 obtains the obtained position in the target presentation area of the LCD 11 as the gaze position of the eye to be examined. When the gaze position of the eye to be examined is obtained, the display control unit 201 </ b> A adds the visual target image representing the visual target presented in the visual target presentation area of the LCD 11 within the visual target presentation area specified by the position specifying unit 212. The position images representing the positions are superimposed and displayed on the display unit of the examiner controller 300. The position image includes a point image representing a position in the target presentation area identified by the position identifying unit 212, an image representing a range including the position, and an image indicating the position.

  FIG. 7 shows a first example of an image displayed on the display unit of the examiner controller 300. FIG. 7 displays an anterior segment image of the right eye ER among the left eye EL and the right eye ER. The display control unit 201A superimposes the anterior eye image EG1 of the eye under examination (the right eye to be examined ER in FIG. 7) on the eye image SG1 representing the eye chart presented on the eye to be examined. Display on the display unit of the controller 300. Further, the display control unit 201A causes the position image PG1 representing the position in the target display area of the LCD 11 specified by the position specifying unit 212 to be superimposed and displayed on the target image SG1.

  FIG. 8 shows a second example of an image displayed on the display unit of the examiner controller 300. The position image may be an image representing a locus of the position. In this case, the position specifying unit 212 specifies the position in the target presentation area of the LCD 11 a plurality of times, and the display control unit 201A has a plurality of positions corresponding to the directions of the plurality of eyes to be examined specified by the position specifying unit 212. Is displayed on the display unit of the examiner's controller 300 as a position image. For example, the display control unit 201A superimposes and displays the position image PG2 representing the position in the target presentation area specified by the position specifying unit 212 on the target image SG2 presented in the target presentation area of the LCD 11. In FIG. 8, an image TG <b> 2 representing the locus of the position in the visual target presentation area specified by the position specifying unit 212 is displayed.

  FIG. 9 shows a third example of an image displayed on the display unit of the examiner controller 300. The display control unit 201 </ b> A causes the position image PG <b> 3 representing the position in the target presentation area specified by the position specifying unit 212 to be superimposed on the target image SG <b> 3 presented in the target presentation area of the LCD 11. The position image PG3 is an image representing a range including a position in the target presentation area of the LCD 11 specified by the position specifying unit 212. In FIG. 9, an image TG <b> 3 representing the locus of the position in the target presentation area specified by the position specifying unit 212 is displayed.

  As described above, the gaze position of the visual target of the subject under examination is obtained, and the position image representing the gaze position is superimposed on the visual target image representing the visual target presented to the subject eye. Therefore, the examiner can confirm where the subject is looking at the target during the examination. Thereby, the examiner can give an appropriate instruction to the subject in order to smoothly advance the ophthalmic examination.

  Further, when the position of the gaze point (gaze position) of the eye to be examined is obtained, the target control unit 201B controls the LCD 11 based on the position in the target presentation area of the LCD 11 specified by the position specifying unit 212. Is possible. For example, the target control unit 201B switches the target at a position within the target presentation area of the LCD 11 specified by the position specifying unit 212. As an example, a red chart including the position is switched to a green chart, or a green chart including the position is switched to a red chart so as not to stare at a predetermined target. Thereby, it is possible to avoid the occurrence of regulatory intervention and to proceed with the examination smoothly. Further, the subject may instruct the ophthalmic examination apparatus 1 to advance the examination based on the position in the target presentation area of the LCD 11 identified by the position identifying unit 212.

  Further, the target control unit 201B can perform control for enabling identification of a target corresponding to the position in the target presentation area of the LCD 11 specified by the position specifying unit 212. The target corresponding to the position may be a target whose position is included in a predetermined range from the reference position. Specifically, the target control unit 201B changes the display color of the target corresponding to the position, displays the target corresponding to the position so as to surround the frame, or displays the target corresponding to the position. An image indicating a mark (an arrow image) is displayed.

  The determination unit 213 determines whether the content of the response of the subject to the target corresponding to the position in the target display area of the LCD 11 specified by the position specifying unit 212 is correct. In this case, the subject performs the operation on the subject's controller 310 to display the content of the response based on the target visually recognized by the subject with respect to the target presented to the subject's eye. 1 can be entered. The storage unit 202 stores information representing the correct answer content of the target. The control device 200 (control unit 201) reads the correct answer content of the target corresponding to the gaze position of the eye to be examined specified as described above from the storage unit 202, and the read correct answer content and the controller 310 for the subject. Compare the contents of the response entered using. Thereby, for example, even when two or more targets are presented in the target display area of the LCD 11, the content of the subject's response is automatically determined by specifying the gaze position of the subject's eye. It is possible to carry out the inspection smoothly.

  The visual acuity value calculation unit 214 calculates the visual acuity value of the eye to be examined based on the determination result of the determination unit 213. The visual acuity value calculation unit 214 can calculate the visual acuity value of the eye to be examined according to the type of visual target presented in the visual target presentation area of the LCD 11.

  For example, when the visual target presented to the eye to be examined is a standard visual acuity chart as shown in FIG. The correct answer rate of the content of the determined response of the subject is calculated. When a visual acuity test using five visual targets corresponding to the same visual acuity value is set as one inspection range, the visual acuity value calculation unit 214 corrects the content of the response of the subject to the five visual targets corresponding to the same visual acuity value. Calculate the rate. Note that the inspection range may be changed afterwards. Further, the inspection range may be specified directly by the examiner during the inspection.

  The visual acuity value calculation unit 214 determines whether or not the correct answer rate is equal to or higher than the reference correct answer rate with respect to the input of the content of the response of the predetermined number of times (predetermined number). The predetermined number of times may be equal to or less than the number of targets corresponding to the same visual acuity value presented to the eye to be examined, and may be a minimum integer exceeding half of the number of targets. For example, when five targets corresponding to the same visual acuity value are presented to the eye to be examined, the predetermined number is 3. The reference correct answer rate can be a ratio of a predetermined number of times to the number of visual targets corresponding to the same visual acuity value presented to the eye to be examined. For example, when five targets corresponding to the same visual acuity value are presented to the eye to be examined, the reference correct answer rate is 3/5. The predetermined number of times or the reference correct answer rate may be changed afterwards.

  The visual acuity value calculation unit 214 obtains the visual acuity value to be applied next based on the correct answer rate of the response content of the subject more than a predetermined number of times. Specifically, the visual acuity value calculation unit 214 obtains the visual acuity value to be applied next based on the determination result by the determination unit 213. For example, the visual acuity value calculation unit 214 receives the determination result by the determination unit 213 and increases the visual acuity value by one step when the correct answer rate is 3/5 or more with respect to the input of the content of the response three times or more. The visual acuity value is determined as the next applied visual acuity value. The control device 200 performs a display or the like for prompting the subject to perform an examination with a visual target corresponding to the next applied visual acuity value. Note that when the correct answer rate is less than 3/5 with respect to the input of the response contents three times or more, the visual acuity value calculation unit 214 sets the visual acuity value lowered by one step or the current visual acuity value to the visual acuity value of the eye to be examined. Determine as.

  For example, when the visual target presented to the eye to be examined is an ETDRS chart as shown in FIG. 9, the visual acuity value calculation unit 214 calculates log MAR (Minimum Angle of Resolution) from the number of readable characters based on the determination result by the determination unit 213. Is calculated. logMAR is the logarithmic value of the minimum separation angle. For example, in the case of an ETDRS chart with an inspection distance of 4 m, when all +0.4 stages can be read and only two +0.3 stages can be read, the visual acuity value calculation unit 214 sets the visual acuity value to 0. 0. 36 (= + 0.4− (0.02 × 2)) is obtained.

  The control device 200 executes all operation control and data processing of the ophthalmic examination apparatus 1 in addition to the above control.

  The function of the first target presentation unit 122L is realized by the target presentation optical system 10L included in the left-eye examination unit 120L. The function of the second visual target presenting unit 122R is realized by the visual target presenting optical system 10R included in the right-eye examination unit 120R.

  The function of the first objective measurement unit 123L is realized by the reflex measurement optical system 40L and the kerato measurement optical system 50L included in the left-eye inspection unit 120L. The function of the second objective measurement unit 123R is realized by the reflex measurement optical system 40R and the kerato measurement optical system 50R included in the right-eye inspection unit 120R.

  The examiner controller 300 is an example of the “examiner display device” according to the embodiment. The visual target presentation optical systems 10L and 10R are examples of the “visual target presentation unit” according to the embodiment.

[Operation example]
Next, the operation of the ophthalmic examination apparatus 1 according to the embodiment will be described.

  FIG. 10 shows an overall flowchart of an operation example of the ophthalmic examination apparatus 1.

(S1)
Upon receiving a predetermined operation on the examiner controller 300 or the subject controller 310, the control device 200 starts operation. The subject fixes his face to a forehead (not shown) so that objective measurement and subjective examination can be performed. The position of the forehead pad itself may be adjusted automatically or manually. The control device 200 performs alignment for the left and right eyes. That is, the control device 200 performs alignment of the optical system of the left-eye inspection unit 120L with respect to the left eye EL by the alignment optical system 30L. Further, the control device 200 performs alignment of the optical system of the right-eye inspection unit 120R with respect to the right eye ER using the alignment optical system 30R.

(S2)
The control device 200 performs kerato measurement as described above for each of the left eye EL and the right eye ER using the kerato measurement optical systems 50L and 50R. Results of kerato measurement for each of the left eye EL and the right eye ER are stored in the storage unit 202.

(S3)
The control device 200 performs the reflex measurement as described above for each of the left eye EL and the right eye ER by the reflex measurement optical systems 40L and 40R. The result of the reflex measurement for each of the left eye to be examined EL and the right eye to be examined ER is stored in the storage unit 202.

(S4)
The control device 200 displays the target (for example, a plurality of targets) selected by the examiner or the control device 200 on the LCD 11 by controlling the target presentation optical systems 10L and 10R. Thereby, the visual target is presented to the subject. The subject responds to the target. Upon receiving the response content, the control device 200 performs further control and calculation of a subjective test value. The processing content of S4 will be described later.

(S5)
The control device 200 uses at least one of the result of the kerato measurement obtained in S2, the result of the reflex measurement obtained in S3, and the result of the subjective examination obtained in S4 for the examiner controller 300 or the subject. It is displayed on the display unit of the controller 310. This is the end of the operation of the ophthalmic examination apparatus 1 (end).

  FIG. 11 shows a flowchart of the operation example of S4 of FIG.

(S11)
First, the control device 200 controls the target presentation optical systems 10L and 10R to start presentation of the target to the left eye EL and right eye ER.

(S12)
The control device 200 causes the orientation specifying unit 211 to specify the orientation of the left eye to be examined EL and the orientation of the right eye to be examined ER. For example, the orientation identifying unit 211 projects an anterior parallel image of the left eye to be examined by projecting an infrared parallel light beam onto the left eye to be examined, and a virtual image on a spot formed inside the cornea is drawn. By analyzing the anterior ocular segment image, the direction of the position of the center of the cornea with respect to the eyeball rotation point of the left eye to be examined EL is specified as the direction of the left eye to be examined EL. Similarly, the orientation identifying unit 211 projects an infrared parallel light beam on the right eye ER, acquires an anterior eye image of the right eye ER on which a virtual image on a spot formed inside the cornea is drawn, By analyzing the acquired anterior ocular segment image, the direction of the position of the cornea center with respect to the eyeball rotation point of the right eye ER is specified as the direction of the right eye ER.

(S13)
The control device 200 causes the position specifying unit 212 to specify the gaze position (or a range including the position) in the target presentation area of the LCD 11 based on the orientation of the left eye to be examined EL specified in S12. Similarly, the control device 200 causes the position specifying unit 212 to specify a gaze position (or a range including the position) in the target presentation area of the LCD 11 based on the direction of the right eye ER specified in S12.

(S14)
The control device 200 includes the target presentation area identified by the position identifying unit 212 in the target image representing the target presented in the target presentation area of the LCD 11 for each of the left eye to be examined EL and the right subject eye ER. A position image representing the position inside the image is superimposed and displayed on the display unit of the controller 300 for the examiner. As a result, as shown in FIGS. 7 to 9, the position image is superimposed and displayed on the visual target image, and the gaze position of the examiner or the subject can be confirmed. At this time, the target control unit 201B may perform control for enabling identification of the target corresponding to the position in the target presentation area of the LCD 11 specified in S13. For example, the target control unit 201B changes the display color of the target corresponding to the position, displays the target corresponding to the position so as to surround the frame, or points to the target corresponding to the position. Display an image (arrow image).

(S15)
Subsequently, the control device 200 stands by until the subject to whom the target is presented performs an operation on the subject controller 310 and the content of the response to the target is input (S15: N). When the content of the response is input by the subject (S15: Y), the operation of the ophthalmic examination apparatus 1 proceeds to S16.

(S16)
When the response content is input by the subject (S15: Y), the control device 200 displays the response content of the subject to the target corresponding to the position in the target display area of the LCD 11 specified in S13. The determination unit 213 determines whether the error is correct. For example, the determination unit 213 reads the correct answer content of the target corresponding to the gaze position of the left eye EL identified in S13 from the storage unit 202, and uses the read correct answer content and the controller 310 for the subject. Compare the contents of the input response. Similarly, the determination unit 213 reads the correct answer content of the target corresponding to the gaze position of the right eye ER identified in S13 from the storage unit 202, and uses the read correct answer content and the subject controller 310. Compare the response contents entered. Accordingly, the determination unit 213 determines whether the subject's response is correct or incorrect with respect to the target corresponding to the position in the target display area of the LCD 11 specified in S13 for each of the left eye EL and the right eye ER. Can be determined. The determination result of the determination unit 213 in S16 is stored in the storage unit 202.

(S17)
The control device 200 determines whether or not to end the subjective examination. For example, the control device 200 can determine whether or not to end the subjective examination based on the number of responses to the target with the same visual acuity value. Further, the control device 200 may determine whether or not to end the subjective examination according to a predetermined examination sequence. When it is determined that the subjective examination is not finished (S17: N), the operation of the ophthalmic examination apparatus 1 proceeds to S12. When it is determined that the subjective examination is to be terminated (S17: Y), the operation of the ophthalmic examination apparatus 1 proceeds to S18.

(S18)
When it is determined to end the subjective examination (S17: Y), the control device 200 determines the visual acuity value of the left eye EL and the right eye based on the determination result of the determination unit 213 stored in the storage unit 202 in S16. Each of the ER visual acuity values is calculated by the visual acuity value calculation unit 214.

(S19)
The control device 200 displays the visual acuity value of the left eye EL and the visual acuity value of the right eye ER obtained in S18 on the display unit of the controller 300 for the examiner. At this time, the control device 200 may display the visual acuity value of the left subject eye EL and the visual acuity value of the right subject eye ER obtained in S18 on the display unit of the controller 310 for the subject. This is the end of the operation of the ophthalmic examination apparatus 1 (end).

  As described above, in the ophthalmologic examination apparatus 1 according to the embodiment, the orientation of the eye to be examined in which one or more visual targets are presented in the visual target presentation area on the LCD 11 is specified, and the direction of the specified eye to be examined is handled. The position in the target presentation area is specified. In the ophthalmic examination apparatus 1, a position image representing a position in the identified target presentation area is superimposed on a target image representing one or more targets and displayed on the display unit of the examiner controller 300. As a result, the examiner can confirm where the subject is looking at the target, and in order to facilitate ophthalmic examination, such as instructing the subject where to look Appropriate instructions can be given to the subject.

[effect]
The effect of the ophthalmic examination apparatus according to the embodiment will be described.

  The ophthalmic examination apparatus (ophthalmic examination apparatus 1) according to the embodiment is based on the response of the subject to one or more visual targets presented in a predetermined presentation area (visual target presentation area) (the left eye to be examined EL). Or, the right eye (ER) is examined. The ophthalmic examination apparatus includes an orientation specifying unit (orientation specifying unit 211), a position specifying unit (position specifying unit 212), and a display control unit (display control unit 201A). The direction specifying unit specifies the direction of the eye to be examined. The position specifying unit specifies a position in the presentation area corresponding to the direction of the eye to be examined specified by the direction specifying unit. The display control unit superimposes a position image representing the position specified by the position specifying unit on a visual target image representing one or more visual targets presented in the presentation area, and displays the display device for the examiner (controller for the examiner). 300 display section).

  According to such a configuration, the direction of the eye to be examined in which one or more targets are presented in the presentation area is specified, the position in the presentation area corresponding to the specified direction of the eye to be examined is specified, and one or more Since the position image representing the position in the specified presentation area is superimposed on the target image representing the target of the target and displayed on the display device for the examiner, the examiner can view the subject under examination. You can check where you are looking at the mark. Thereby, the examiner can give an appropriate instruction to the subject in order to smoothly advance the ophthalmic examination, such as instructing the subject where to look.

  In addition, in an examination that is suspected of fraud or a remote examination in which an examiner and the subject conduct an ophthalmic examination at a predetermined distance, the examiner looks at where the subject is on the target during the examination. Can be able to check. As a result, it is possible to easily identify fraud and to facilitate remote inspection.

  Further, in the ophthalmic examination apparatus 1 according to the embodiment, the direction specifying unit specifies the direction of the eye to be examined a plurality of times, and the display control unit is a plurality corresponding to the directions of the plurality of eyes to be examined specified by the direction specifying unit. An image representing the position may be displayed as a position image on the display device for the examiner.

  According to such a configuration, the examiner can easily confirm the trajectory of the gaze position of the target by the subject and the current gaze position, so the examiner can check the gaze position of the subject. An instruction can be appropriately given based on the trajectory, and the ophthalmic examination can be advanced more smoothly.

  In addition, the ophthalmic examination apparatus according to the embodiment controls the target presentation unit (target presentation optical systems 10L and 10R) that presents one or more targets based on the position specified by the position specifying unit. Part (target control unit 201B).

  According to such a configuration, since the visual target is controlled based on the gaze position in the subject's visual target, the examination can be smoothly advanced by the gaze position.

  Further, in the ophthalmic examination apparatus according to the embodiment, the target control unit may perform control for enabling identification of a target corresponding to the position specified by the position specifying unit among one or more targets. .

  According to such a configuration, since the target corresponding to the gaze position in the subject's target is easily identified, the examiner can easily grasp where the subject is looking at the target. Will be able to.

  In the ophthalmic examination apparatus according to the embodiment, the one or more visual targets may include at least one of a visual acuity measurement target and a visual function test target.

  According to such a configuration, the examiner can confirm where the subject is looking at at least one of the visual acuity measurement target and the visual function test target. Can be carried out smoothly.

  In addition, the ophthalmic examination apparatus according to the embodiment is configured to determine whether or not the content of the response of the subject to the target corresponding to the position specified by the position specifying unit is presented with two or more targets in the presentation area. Part (determination part 213) may be included.

  According to such a configuration, since the correctness of the content of the response of the subject corresponding to the position specified by the position specifying unit is determined, two or more targets are presented to the eye to be examined In addition, the subjective examination can be automatically executed, and the ophthalmic examination can be advanced more smoothly.

  The ophthalmic examination apparatus according to the embodiment may include a visual acuity value calculation unit (a visual acuity value calculation unit 214) that calculates a visual acuity value of the eye to be examined based on a determination result of the determination unit.

  According to such a configuration, since the visual acuity value calculation unit obtains the visual acuity value of the eye to be examined based on the determination result of the determination unit, the subjective examination can be automatically executed, and the ophthalmic examination can be performed more smoothly. It becomes possible to proceed.

  In the ophthalmic examination apparatus according to the embodiment, the presentation area includes one or more presentation areas for the left presentation area for presenting one or more targets to the left eye (left eye EL) and one for the right eye (right eye ER). And a right presentation area for presenting the target. The direction specifying unit may specify the direction of the left eye and the direction of the right eye. The position specifying unit specifies the left position in the left presentation area corresponding to the direction of the left eye to be identified specified by the direction specifying unit, and the right presentation corresponding to the direction of the right eye to be specified specified by the direction specifying unit The right position in the area may be specified. The display control unit superimposes the left position image representing the left position specified by the position specifying unit on the left target image representing one or more targets presented in the left presentation area, and displays the left position image on the examiner display device. The right position image representing the right position specified by the position specifying unit is superimposed on the right target image representing one or more targets that are displayed and presented in the right presentation area, and displayed on the display device for the examiner. It may be displayed.

  According to such a configuration, for both eyes, the direction of the eye to be examined in which one or more targets are presented in the presentation area is specified, and the position in the presentation area corresponding to the specified direction of the eye to be examined is specified. Since the position image representing the position in the specified presentation area is superimposed on the target image representing one or more visual targets and displayed on the display device for the examiner, the examiner It is possible to confirm where the examiner is looking at the target. Thereby, the examiner can give an appropriate instruction to the subject in order to smoothly advance the ophthalmic examination of both eyes, such as instructing the subject where to look.

[Others]
The above-described embodiment is not limited to the configuration of the optical system described with reference to FIG. 3, the configuration of the control system described with reference to FIGS. For example, the objective measurement may include objective measurement for measuring a value relating to the eye to be examined and photographing for acquiring an image of the eye to be examined. Examples of such objective measurement include objective refraction measurement, corneal shape measurement, intraocular pressure measurement, fundus imaging, and OCT (Optical Coherence Tomography) measurement using an OCT technique. The subjective examination includes, for example, a subjective refraction measurement such as a distance examination, a near examination, a contrast examination, and a glare examination, and a visual field examination.

  In addition, the ophthalmic examination apparatus according to the embodiment can execute 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 and a corneal shape measurement as an objective measurement. Or an apparatus capable of performing OCT measurement or the like. In the OCT measurement, eyeball information representing the structure of the subject's eye such as the axial length, corneal thickness, anterior chamber depth, and lens thickness may be acquired.

  The configuration described above is merely an example for favorably implementing the present invention. Therefore, arbitrary modifications (omitted, substituted, added, etc.) within the scope of the present invention can be made as appropriate.

1 Ophthalmic Examination Device 10L, 10R Target Presentation Optical System 20L, 20R Imaging Optical System 100 Measuring Head 120L Left Eye Examination Unit 120R Right Eye Examination Unit 200 Control Device 201A Display Control Unit 211 Orientation Identification Unit 212 Position Identification Unit 213 Determination Unit 214 visual acuity value calculation unit

Claims (8)

An ophthalmologic examination apparatus for examining an eye to be examined based on a response of a subject to one or more visual targets presented in a predetermined presentation area,
An orientation identifying unit that identifies the orientation of the eye to be examined;
A position specifying unit for specifying a position in the presentation area corresponding to the direction of the eye to be examined specified by the direction specifying unit;
A display control unit that superimposes a position image representing the position specified by the position specifying unit on a visual target image representing the one or more visual targets presented in the presentation area, and displays the superimposed image on the display device for the examiner. When,
Including ophthalmic examination equipment. The orientation specifying unit specifies the orientation of the eye to be examined a plurality of times,
The display control unit causes the examiner's display device to display, as the position image, images representing a plurality of positions corresponding to the directions of the plurality of eyes to be examined specified by the direction specifying unit. The ophthalmic examination apparatus according to Item 1. The target control part which controls the target presentation part which presents the one or more targets based on the position specified by the position specification part is included. The claim 1 or claim 2 characterized by things. Ophthalmic examination device. The ophthalmic examination apparatus according to claim 3, wherein the target control unit performs control for enabling identification of a target corresponding to the position among the one or more targets. The ophthalmic examination apparatus according to any one of claims 1 to 4, wherein the one or more optotypes include at least one of an eyesight measurement target and a visual function test target. Two or more visual targets are presented in the presentation area,
The determination part which determines the right or wrong of the content of the said subject's response with respect to the optotype corresponding to the said position specified by the said position specific | specification part is included. The claim 1 characterized by the above-mentioned. The ophthalmic examination apparatus described in 1. The ophthalmic examination apparatus according to claim 6, further comprising a visual acuity value calculation unit that calculates a visual acuity value of the eye to be examined based on a determination result of the determination unit. The presentation area includes a left presentation area that presents one or more targets to the left eye and a right presentation area that presents one or more targets to the right eye,
The orientation identifying unit identifies the orientation of the left subject eye and the orientation of the right subject eye,
The position specifying unit specifies a left position in the left presentation area corresponding to the direction of the left eye to be identified specified by the direction specifying unit, and the right specifying eye specified by the direction specifying unit Identify the right position in the right presentation area corresponding to the orientation;
The display control unit superimposes a left position image representing the left position identified by the position identifying unit on a left target image representing the one or more targets presented in the left presentation area, A right position image representing the right position specified by the position specifying unit on a right target image displayed on the display device for the examiner and representing the one or more targets displayed in the right presentation area The ophthalmic examination apparatus according to claim 1, wherein the ophthalmic examination apparatus is displayed on the display device for the examiner.

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