ES1245909U - OPHTHALMOLOGICAL EXPLORER (Machine-translation by Google Translate, not legally binding) - Google Patents

Abstract

Ophthalmic explorer, characterized in that it comprises a mobile base (1) in a support (2) that supports the work surface, where the base (1) supports: a front slit lamp (4), movable on a circular rail (41) located at the base (1) and centered on one side of the base (1) configured to orient itself to the patient; a rear slit lamp (5), independent of the front slit lamp (4), which illuminates an orientation micro-mirror; and an image capture system (6), oriented to the position of the patient's eye, with a lens mounted on a slide (8) on a focus rail (9), the removable lens of the image capture system being (6). (Machine-translation by Google Translate, not legally binding)

Description

DESCRIPTION

Ophthalmic Explorer

TECHNICAL SECTOR

The present invention relates to an ophthalmic scanner, or apparatus that robotically performs scanning of the anterior pole (external part of the eye) and the posterior pole (internal part) without human handling of the 78D lamp and lens. It allows to reduce the patient's exploration time by taking images of both structures that can later be analyzed by the doctor, without requiring the patient to be kept in position during the observation, and allowing images to be kept for later comparisons of the evolution.

It is applicable in the field of medicine and the manufacture of medical instruments and devices.

STATE OF THE ART

The ophthalmological exploration is based on the visualization of the organ of vision and its documentation using different imaging techniques that allow us to evaluate both its structure and its function. Thanks to the advances in technology in the field of imaging, it has been possible to improve exploration and, therefore, the diagnosis of eye pathologies. In addition, thanks to a unique feature of the eyeball such as its transparency of media, it is possible to use non-harmful techniques (such as the use of light) that are not possible in other parts of the body where radiation must be used to access to deeper tissues (such as CT, radiographs, etc ...).

The current examination of the eye consists of observing the patient live (directly), so when faced with any important detail, the health personnel must stop to evaluate the structures, disturbing the patient. Firstly, since the patient's scanning position is somewhat forced. He has to support his forehead and chin on a chin rest and a significant percentage of patients present difficulties due to obesity, size of the pectoral diameter, spinal problems (kyphosis, scoliosis.), Little collaboration (senile or child-age patients), etc.

Secondly, it is necessary to use intense light, which is especially annoying when evaluating the fundus.

In the group of structural tests, we can differentiate them according to the principle of exploration they use. The invention is within visible light examination tests. These tests are mainly based on the following methods.

Slit Lamp Biomicroscopy. It is basically designed for the examination of the anterior segment, but with the appropriate accessories, all the ocular structures can be seen and is a common tool in the routine activity of the ophthalmologist. They have two main parts, corresponding to the lighting and observation systems.

The slit lamp lighting system projects a bright slit light onto the focus plane. The lighting part provides a very fine slit light without distortion. Generally, it comprises blue and green filters to visualize fluorescein, microaneurysms, and the nerve fiber layer. In recent years, LED light slit lamps are also available. LED lighting systems are sharper, brighter, more homogenous light beams that consume less energy.

The observation system is made up of many optical lenses that provide an enlarged view of the ocular structures. Its magnification range varies between 5x and 40x depending on the manufacturer. Magnification can be enabled using pan, Galileo's rotary cannon, and continuous zoom methods. The image quality decreases with the increase, so it must be selected properly.

In normal use, the lighting system and observation system are coupled in a common focal plane and point. They both move around a common focus point, but can be undocked manually.

Different lighting techniques can be used in the slit lamp examination:

• Diffuse Illumination - This is a simple illumination method to examine the eye and surrounding structures.

• Direct illumination: The observer focuses on the area directly illuminated by the slit light. You can see the optical section of the cornea, anterior chamber, lens, the depth of any foreign body, thinning of the stroma, epithelial edema, corneal layers, etc.

• Indirect lighting: The lighting system is not oriented to the same focus point as the observation system. Loss of transparency or contrast differences can be seen in transparent structures, such as subtle corneal opacities, bulbar conjunctival vessels, and lens opacities.

One of the main advances is the adaptation of image capture systems that allow examinations to be documented over time, as well as measurements in two dimensions. Requires powerful software and hardware to manage video.

A second method corresponds to corneal tomography scanners, where the cornea is illuminated with a slit light and images of the curved surface are taken with a Scheimpflug-type camera. Obtains a set of corneal cross sections that allow reconstruction of the anterior segment of the eye.

A third method uses confocal microscopy, which is a non-invasive histological imaging technique. It uses focused light or a laser beam and captures its reflection on the cornea. Thanks to detection filters, sharper and clearer images can be captured than conventional light microscopy. There are three types of confocal imaging techniques: Tandem Scanning, Slit Scan, and Laser Scan

The last method of visible light exploration corresponds to retinography, where photographs of the fundus of the eye are taken with a light microscope, showing the current ophthalmoscopic appearance of the retina. They make it possible to identify changes from the surface to the posterior pole of the eye and it is mainly used to monitor glaucoma and diabetic retinopathy.

The invention can be applied with various types of lighting and techniques. For example, for anterior pole you can use diffuse, direct illumination, slit in cornea (similar to biomicroscopy with manual slit lamp). It is also possible to apply filters or "backlight the iris".

For the posterior pole, direct illumination can be done, similar to what we do with manual slit lamp and 78D lens biomicroscopy, apply filters, autofocus or automatic image processing.

The applicant does not know of any solution equal to the invention.

BRIEF EXPLANATION OF THE INVENTION

The invention consists of an ophthalmic explorer according to the claims. Their different embodiments solve the problems of the state of the art.

The ophthalmic explorer comprises a mobile base on a support stand on the work surface, to readjust the final position in the plane. This base supports a forward slit lamp, movable in a circular rail located at the base and centered on one side of the base configured to orient itself to the patient. This centering point corresponds to the plane of focus of the microscope (it can be the eye to be scanned or the center of the face if you want to evaluate orbit and eyelids).

The base also contains a rear slit lamp, independent of the front slit lamp in terms of slit opening, emission power and any other variables. This rear slit lamp transmits light to the eye by illuminating an orientation micro-mirror. In this way, both lamps are not in the way of an image capture system, oriented to the position of the patient's eye, with a lens (generally 78x) mounted on a slide carriage on a focus rail, being the removable lens of the image capture system.

The trolley allows you to move the lens forward or backward, to focus and modify the penetration of the image. Moving it forward increases the penetration of the fundus image (the retina image occupies a relatively greater space in the total image, decreasing the space occupied by external structures -iris, sclera, eyelids, etc ...-) and moving it back decreases the penetration of the fundus image (the retina image is seen through the pupil occupying a smaller and smaller relative space, with the external structures occupying a relative space in the larger and larger total image).

It is preferable that the movement of the base on the support has three degrees of freedom of translation.

The image capture system is preferably made up of two digital cameras in a stereoscopic position, that is, it allows recording for 3D posterior vision.

The image capture system can comprise a lighting ring around its image capture sensors, and / or distance sensors to find the distance to the patient's eye.

In the most preferred embodiment, the image capture system comprises a revolver with a series of interchangeable lenses of different magnifications.

To further separate the rear slit lamp, an optical cone can be provided between the rear slit lamp and the orientation micro-mirror.

Other variants will be described later.

DESCRIPTION OF THE DRAWINGS

For a better understanding of the invention, the following figures are included.

Figure 1: corresponds to a view of a first example of embodiment, during the examination of the anterior pole.

MODES OF CARRYING OUT THE INVENTION

An embodiment of the invention is briefly described below, as an illustrative and non-limiting example thereof.

Figure 1 shows an embodiment of the explorer of the invention, which starts from a mobile base (1) on a support (2) that rests on the work surface. The base (1) is motorized, preferably with three degrees of freedom of translation (XYZ) with respect to the support (2), preferably controlled by respective stepper motors (3). The Exact position of motors (3) must be precisely controlled so that scanner readings are associated with actual positions.

The base (1) supports the scanner assembly, consisting of a front slit lamp (4), a rear slit lamp (5), an image capture system (6), generally consisting of two digital cameras coupled to microscopes . The resolution and speed of the cameras are important to achieve a better result. The cameras may comprise illumination rings around their lens, for example formed by LEDs. The LEDs can be illuminated together or individually. In this second case, they may serve to indicate to the patient to look in a specific direction, the one marked by the lit LED. The LEDs can be oriented parallel or convergent, for example at a 45 ° angle.

The image capture system (6) can also comprise distance sensors to find the distance to the eye, either from the camera or from the microscope.

Each slit lamp (4,5) is controlled by its own system that regulates the size of the slit and the light intensity, apart from the moment of activation. For example, the front slit lamp (4) is mounted on a circular rail (41) on which it can be moved to suit the patient's physiognomy (lower arrow in Figure 1). In this way, the angle of incidence of the illumination on the cornea can be varied, being able to either sweep the illumination while taking images / video (with the slit open to the maximum) or project a thin slit beam to obtain an image of a cross section of the cornea at the location of our choice (with slit open to a minimum). It is also possible that the taillight does not move, but is a mirror that directs the taillight lighting onto the eye, such as by sweeping.

The rear slit lamp (5) can have a motorized micro-orientation mirror (not visible in the figure), to properly orient the light towards the desired area of the eye. It also has an optical cone (51) or metal tube that "directs" the light from the slit lamp to the micro-mirror. It is designed for tests where you want to change the apparent position of the slit. For example, to do a flat scan of the retina.

The examiner further comprises a revolver (7) with a series of interchangeable lenses in front of the cameras when the examination is performed. This revolver (7) is preferably motorized. The revolver (7) moves lenses that vary the magnifications of the scanning image. The two cameras of the image capture system (6) are enabled and you can choose to see one or the other. The goal of using two cameras is to:

- Eliminate brightness, since the image of each camera includes brightness in different positions, it is possible to digitally remove them, with minimal loss of information, without the need to extrapolate from the surrounding parts.

- Perform stereopsis, obtaining simultaneous visualization of the same points from two angles, depth vision can be achieved. Therefore, 3D vision of the video or captured images can be performed with the use of the appropriate glasses.

- To be able to use, in one of the eyepieces, cameras with different sensors such as infrared, allowing to have a real reference image (the normal camera) and another image with a complementary scan (infrared, fluorescent, thermal ...)

The anterior pole examination is performed by direct illumination of the front slit lamp (4) ”or diffuse LED illumination.

The posterior pole examination is performed with the rear slit lamp (5). This rear slit lamp (5) has the ability to rotate on its axis, taking advantage of the micro-mirror for potential tests associated with the angular position of the slit. The optics used consist of a lens mounted with a focusing system such as a slide (8) sliding on a focus rail (9). This lens is removable to one side or upward (following the upper arrow in Figure 1) for the anterior pole exam. This movement can include the lowering of the entire focus lane (9).

The device may have a chin rest (not shown) to facilitate the position of the patient, or it can be mounted on an articulated arm so that the patient can remain comfortably seated. In which case, the articulated arm can perform the functions of base (1) and support (2).

For example, the operation of the system, with chin rest, can start from the ignition and self-calibration of the components. The patient leans on the chin rest and moves the base (1) to properly center the system on the eye to be studied. The focus of the anterior pole is performed with the carriage (8) raised as in figure 1, out of the path between the microscope and the eye. The revolver (7) starts at a low magnification, such as x3.5. The anterior slit lamp is switched on and the base (1) is moved until obtaining a clear image of the anterior pole. If desired, the revolver lens (7) is changed to examine details or areas of interest, and / or the base (1) is repositioned.

Next, the posterior pole is examined, moving the base (1) away from the eye, ensuring a low magnification in the revolver (7) and placing the carriage (8) again in front of the eye and the image capture system ( 6) or the view of the toilet. At this point the front slit lamp (4) is off and the rear slit lamp (5) is on. The movement of the carriage (8) and the base (1) allows focusing on the retina.

It should be considered that the front slit lamp (4) can be replaced by a diffuse light for anterior pole exploration. However, it is preferred that it be a slit lamp to perform a greater number of types of examinations: cross sections of the cornea, angle evaluation, transillumination of the iris, direct and indirect illumination, scleral reflection, etc.

Claims (1)

1- Ophthalmic explorer, characterized in that it comprises a mobile base (1) in a support (2) that supports the work surface, where the base (1) supports: a front slit lamp (4), movable on a circular rail (41) located at the base (1) and centered on one side of the base (1) configured to orient itself to the patient; a rear slit lamp (5), independent of the front slit lamp (4), which illuminates an orientation micro-mirror; and an image capture system (6), oriented to the position of the patient's eye, with a lens mounted on a slide (8) on a focus rail (9), the removable lens of the image capture system being ( 6). 2- Ophthalmic explorer, according to claim 1, where the movement of the base (1) on the support has three degrees of freedom of translation. 3- Ophthalmic explorer, according to claim 1, whose image capture system (6) is formed by two digital cameras in stereoscopic position. 4- Ophthalmic explorer, according to claim 3, whose image capture system (6) comprises an illumination ring around each objective. 5- Ophthalmic explorer, according to claim 3, whose image capture system (6) comprises distance sensors to find the distance to the patient's eye. 6- Ophthalmic explorer, according to claim 1, whose image capture system (6) comprises a revolver (7) with a series of interchangeable lenses. 7- Ophthalmic explorer, according to claim 1, which has an optical cone between the rear slit lamp (5) and the orientation micro-mirror.