DE19808779C1 - Cataract measuring device for eye of patient - Google Patents

Cataract measuring device for eye of patient

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Publication number
DE19808779C1
DE19808779C1 DE1998108779 DE19808779A DE19808779C1 DE 19808779 C1 DE19808779 C1 DE 19808779C1 DE 1998108779 DE1998108779 DE 1998108779 DE 19808779 A DE19808779 A DE 19808779A DE 19808779 C1 DE19808779 C1 DE 19808779C1
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Germany
Prior art keywords
measuring device
light source
markings
cataract
diffraction
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Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Fee Related
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DE1998108779
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German (de)
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Paul Dobrinski
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Individual
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Individual
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Priority to DE1998108779 priority Critical patent/DE19808779C1/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A61B3/117Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for examining the anterior chamber or the anterior chamber angle, e.g. gonioscopes
    • A61B3/1173Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for examining the anterior chamber or the anterior chamber angle, e.g. gonioscopes for examining the eye lens
    • A61B3/1176Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for examining the anterior chamber or the anterior chamber angle, e.g. gonioscopes for examining the eye lens for determining lens opacity, e.g. cataract

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  • Life Sciences & Earth Sciences (AREA)
  • Health & Medical Sciences (AREA)
  • Medical Informatics (AREA)
  • Biophysics (AREA)
  • Ophthalmology & Optometry (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Physics & Mathematics (AREA)
  • Molecular Biology (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Eye Examination Apparatus (AREA)

Abstract

The measuring device comprises a white or monochromatic light source, and two symmetrically adjustable marks which are adjusted on a bending circle of predetermined color, seen by the patient due to light bending through diffraction centers in the affected lens, whereby the angle is determined, under which the bending circle is seen.

Description

Die Erfindung liegt die Aufgabe zugrunde, eine einfache Meßvorrichtung anzugeben, die sowohl dem Augenarzt als auch dem Patienten selbst eine objektive Beurteilung des Zustandes eines grauen Stars ermöglicht. Diese Aufgabe wird durch die Merkmale aus dem Anspruch 1 gelöst. Vorteilhafte Ausgestaltungen sind in den Unteransprüchen angegeben.The invention has for its object to provide a simple measuring device an objective assessment of the condition both for the ophthalmologist and for the patient himself of a cataract. This object is achieved by the features from claim 1 solved. Advantageous refinements are specified in the subclaims.

Mit zunehmendem Alter leiden sehr viele Menschen - allein in Deutschland viele Millionen pro Jahr - an einer zunehmenden Trübung der Augenlinse, einem sog. grauen Star, einer "Katarakt". Diese Trübung entsteht durch fortschreitende Koagulation von Eiweißkörpern. Da sie gleichzeitig mit einer Veränderung des mittleren Brechungsindex der Linse einhergeht, bewirkt sie eine erhebliche Beeinträchtigung der Sehkraft bis zur völligen Erblindung. Abhilfe schafft eine Operation, bei der die eigene Augenlinse entfernt und durch eine sog. Intraokularlinse aus Plexiglas ersetzt wird.Many people suffer with increasing age - many millions per person in Germany alone Year - an increasing clouding of the eye lens, a so-called cataract, a "cataract". This cloudiness arises from the progressive coagulation of protein bodies. Since she is accompanied by a change in the mean refractive index of the lens they have a significant impairment of vision to complete blindness. Remedy an operation in which your own eye lens is removed and removed through a so-called intraocular lens Perspex is replaced.

Für die Entscheidung, ob eine solche Operation notwendig ist, war der Augenarzt bisher auf subjektive Aussagen der Patienten und eine relativ unsichere Beurteilung der Trübung durch direkte Betrachtung angewiesen. Eine an sich auch mögliche Beurteilung durch reflektiertes Streulicht hat sich nicht durchgesetzt. Auch ein in der Patentschrift DE 35 42 167 C2 beschriebenes Verfahren, bei welchem die mit der zunehmenden Koagulation der Eiweißkörper (Protein-Aggregation) einhergehende Verfärbung der Augenlinse durch Analyse des Fluoreszenzlichtes als Maß für den "Reifegrad" der Katarakt benutzt werden soll, hat wegen des hohen apparativen Aufwandes keinen Eingang in die Praxis der Augenärzte gefunden.The ophthalmologist has been up to now on deciding whether such an operation is necessary subjective statements by the patients and a relatively uncertain assessment of the turbidity direct consideration. An assessment that is also possible in itself through reflected Stray light has not prevailed. Also one in the patent specification DE 35 42 167 C2 Process described, in which with the increasing coagulation of the protein body (Protein aggregation) accompanying discoloration of the eye lens by analysis of the Fluorescent light has to be used as a measure of the "maturity" of the cataract the high expenditure on equipment found no entry into the practice of ophthalmologists.

Durch die vorliegende Erfindung gelingt es, diese recht unexakten oder teueren Beurteilungsverfahren durch ein einfaches objektives Verfahren zu ersetzen. Hierfür wird die Tatsache ausgenutzt, daß die weit überwiegende Zahl aller Starpatienten beim Betrachten einer punktförmigen weißen Lichtquelle in dunkler Umgebung um diese herum konzentrische farbige Ringe sieht, die durch Beugung des Lichtes an den in der Augenlinse unregelmäßig angeordneten Streuzentren entstehen, welche den grauen Star verursachen. Der Patient hat hierbei den Eindruck, er sähe diese Beugungsringe in der Ebene der Lichtquelle (Fig. 1). Für den Zusammenhang zwischen dem mittleren Durchmesser d der Streuzentren, die ein Maß für den "Reifegrad" der Katarakt sind, dem Winkel ϕ gegenüber dem Zentrum, wo sich die "punktförmige" Lichtquelle befindet und der zu einer bestimmten Farbe gehörigen Wellenlänge λ (in Luft) gilt die Formel
The present invention succeeds in replacing these rather inexact or expensive assessment methods with a simple objective method. The fact that the vast majority of all star patients see a punctiform white light source in a dark environment around them concentric colored rings, which result from diffraction of the light at the irregularly arranged scattering centers in the eye lens, which cause the cataract, is used for this . The patient has the impression that he sees these diffraction rings in the plane of the light source ( Fig. 1). For the relationship between the mean diameter d of the scattering centers, which are a measure of the "degree of maturity" of the cataract, the angle ϕ with respect to the center where the "punctiform" light source is located and the wavelength λ (in air ) the formula applies

Hierbei ist nw der Brechungsindex des sog. Glaskörpers, d. h. des durchsichtigen Augeninneren. Er beträgt nw = 1,336 ≈ 4/3Here n w is the refractive index of the so-called vitreous body, ie the transparent inside of the eye. It is n w = 1.336 ≈ 4/3

Damit ergibt sich eine einfache Beziehung:
This creates a simple relationship:

Durch eine einfache Messung des Winkels ϕ gelingt also eine Berechnung von d, womit erstmalig eine objektive Beurteilung des Zustandes des grauen Stars möglich ist.A simple measurement of the angle ϕ enables a calculation of d, with which An objective assessment of the state of cataracts is possible for the first time.

Die Erfindung wird im folgenden anhand der Zeichnung näher beschrieben. Die einzige Figur (Fig. 1) verdeutlicht den prinzipiellen Aufbau und die Wirkungsweise der Meßvorrichtung. Hierbei ist 1 das erkrankte Auge, 2 die quasipunktförmige Lichtquelle, 6 der in einem verdunkelten Raum vom Patienten gesehene Beugungskreis bestimmter Farbe (z. B. rot), der eine bestimmte Wellenlänge λ zugeordnet ist. Bei gegebenem Abstand l zwischen Auge 1 und Lichtquelle 2 (in der Größenordnung 2 m bis 5 m, je nach den Gegebenheiten der Arztpraxis) erfolgt die Messung des Winkels 2 ϕ, indem mit einem geeigneten mechanischen oder elektromechanischen Antrieb zwei Marken 3 und 4 (z. B. zwei schwach leuchtende Lumineszenz-Dioden) symmetrisch zur Lichtquelle 2 so weit verschoben werden, bis der Patient sie in Deckung mit dem Beugungskreis 6 sieht.The invention is described below with reference to the drawing. The only figure ( FIG. 1) illustrates the basic structure and the mode of operation of the measuring device. Here, 1 is the diseased eye, 2 the quasi-point light source, 6 the diffraction circle of a certain color (e.g. red) seen by the patient in a darkened room, which is assigned a specific wavelength λ. For a given distance l between eye 1 and light source 2 (in the order of 2 m to 5 m, depending on the circumstances of the doctor's office), the angle 2 ϕ is measured by using two marks 3 and 4 (e.g. B. weakly illuminating luminescent diodes) are shifted symmetrically to the light source 2 until the patient sees them in register with the diffraction circle 6 .

Dies könnte auch durch geeignetes Einschalten zweier Lumineszenz-Dioden aus einer zu beiden Seiten der Lichtquelle angeordneten Kette von Lumineszenz-Dioden geschehen.This could also be done by suitably switching on two luminescent diodes from one Chain of luminescent diodes arranged on both sides of the light source happen.

Der Abstand 2 s der beiden Marken 3 und 4 ist wegen ϕ = arc tan (s/l) ein Maß für den Beugungswinkel ϕ und damit gemäß Formel (2) für den mittleren Durchmesser d der Streuzentren in der Kataraktlinse. Da bei den vorliegenden kleinen Winkeln (ϕ ≦ 15°), tan ϕ = s/l ≈ sin ϕ gesetzt werden darf, erhält man die einfache Beziehung
The distance 2 s between the two marks 3 and 4 is a measure of the diffraction angle wegen because of ϕ = arc tan (s / l) and thus according to formula (2) for the mean diameter d of the scattering centers in the cataract lens. Since the given small angles (ϕ ≦ 15 °), tan ϕ = s / l ≈ sin ϕ can be set, the simple relationship is obtained

Die Skala 5 oder eine mit dieser über den Antrieb gekoppelte weitere Skala kann deshalb auch in Einheiten für d (z. B. in µm) kalibriert werden. - Hierbei ist der Abstand l zu berücksichtigen. - Ein Bereich ab einem bestimmten dmax kann dabei als Bereich für eine Empfehlung zur Operation gekennzeichnet werden.The scale 5 or another scale coupled to it via the drive can therefore also be calibrated in units for d (e.g. in µm). - The distance l must be taken into account. - A range from a certain d max can be marked as a range for a recommendation for the operation.

Claims (4)

1. Meßvorrichtung zur Beurteilung des Zustandes eines grauen Stars eines Auges eines Patienten, mit einer weißen oder monochromatischen Punktlichtquelle und mit zwei symmetrisch zu der Punktlichtquelle verschiebbaren Markierungen, die auf einen vom Patienten aufgrund von Lichtbeugung durch die Streuzentren in der getrübten Linse gesehenen Beugungskreis bestimmter Farbe einstellbar sind, um den Winkel zu ermitteln, unter dem der Beugungskreis gesehen wird.1. Measuring device for assessing the state of a cataract of an eye Patients with one white or monochromatic point light source and with two Markings that can be moved symmetrically to the point light source and that point to one of the Patients due to light diffraction from the scattering centers in the clouded lens seen diffraction circle of certain color can be adjusted to determine the angle under which the diffraction circle is seen. 2. Meßvorrichtung nach Anspruch 1, dadurch gekennzeichnet, daß die Markierungen mit einer Skala zusammenwirken, die Werte für den Kreisdurchmesser oder den zugehörigen Sehwinkel angibt.2. Measuring device according to claim 1, characterized in that the markings with a Interact scale, the values for the circle diameter or the associated Viewing angle indicates. 3. Meßvorrichtung nach Anspruch 1 oder 2, dadurch gekennzeichnet, daß die symmetrisch verschiebbaren Markierungen schwach leuchtende Leuchtdioden aufweisen.3. Measuring device according to claim 1 or 2, characterized in that the symmetrical slidable markings have dimly shining LEDs. 4. Meßvorrichtung nach Anspruch 1 oder 2, dadurch gekennzeichnet, daß die symmetrisch verschiebbaren Markierungen durch beidseitig der Punktlichtquelle angeordnete Zeilen aus Leuchtdioden gebildet sind, deren Leuchtdioden jeweils paarweise einschaltbar sind.4. Measuring device according to claim 1 or 2, characterized in that the symmetrical movable markings by lines arranged on both sides of the point light source Light-emitting diodes are formed, the light-emitting diodes of which can be switched on in pairs.
DE1998108779 1998-03-03 1998-03-03 Cataract measuring device for eye of patient Expired - Fee Related DE19808779C1 (en)

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102006039753A1 (en) * 2006-08-24 2008-02-28 Eduard Galinker Method for visual evaluation of condition of optical media of own eye of observer, involves projecting real representation of source of light spot in eye such that focus of projection is within eyeball in its optical media
DE102007053386A1 (en) * 2007-11-07 2009-05-14 Carl Zeiss Meditec Ag Arrangement and method for automatically determining a cataract strength of an eye and ophthalmological apparatus and control method for such

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE3542167C2 (en) * 1985-11-29 1987-11-05 Wolfgang Prof. Dr. 6300 Giessen De Lohmann
US5139022A (en) * 1990-10-26 1992-08-18 Philip Lempert Method and apparatus for imaging and analysis of ocular tissue
US5203328A (en) * 1991-07-17 1993-04-20 Georgia Tech Research Corporation Apparatus and methods for quantitatively measuring molecular changes in the ocular lens
US5427095A (en) * 1993-11-09 1995-06-27 Massachusetts Institute of Technology Oculon Corporation Method and apparatus for detecting cataractogenesis
US5609159A (en) * 1995-06-07 1997-03-11 Rensselaer Polytechnic Institute Method and apparatus for noninvasive determination of a disease state of a human eye

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE3542167C2 (en) * 1985-11-29 1987-11-05 Wolfgang Prof. Dr. 6300 Giessen De Lohmann
US5139022A (en) * 1990-10-26 1992-08-18 Philip Lempert Method and apparatus for imaging and analysis of ocular tissue
US5203328A (en) * 1991-07-17 1993-04-20 Georgia Tech Research Corporation Apparatus and methods for quantitatively measuring molecular changes in the ocular lens
US5427095A (en) * 1993-11-09 1995-06-27 Massachusetts Institute of Technology Oculon Corporation Method and apparatus for detecting cataractogenesis
US5609159A (en) * 1995-06-07 1997-03-11 Rensselaer Polytechnic Institute Method and apparatus for noninvasive determination of a disease state of a human eye

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102006039753A1 (en) * 2006-08-24 2008-02-28 Eduard Galinker Method for visual evaluation of condition of optical media of own eye of observer, involves projecting real representation of source of light spot in eye such that focus of projection is within eyeball in its optical media
DE102006039753B4 (en) * 2006-08-24 2009-02-19 Eduard Galinker Method for visual assessment of the state of the optical media of the observer's own eye and device for illuminating the eye
DE102007053386A1 (en) * 2007-11-07 2009-05-14 Carl Zeiss Meditec Ag Arrangement and method for automatically determining a cataract strength of an eye and ophthalmological apparatus and control method for such

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