JP2007000255A - Selection system of best trial lens in orthokeratology specification - Google Patents

Selection system of best trial lens in orthokeratology specification Download PDF

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JP2007000255A
JP2007000255A JP2005182034A JP2005182034A JP2007000255A JP 2007000255 A JP2007000255 A JP 2007000255A JP 2005182034 A JP2005182034 A JP 2005182034A JP 2005182034 A JP2005182034 A JP 2005182034A JP 2007000255 A JP2007000255 A JP 2007000255A
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lens
measurement
orthokeratology
examinations
examination
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Seiji Kanai
誠治 金井
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    • GPHYSICS
    • G02OPTICS
    • G02CSPECTACLES; SUNGLASSES OR GOGGLES INSOFAR AS THEY HAVE THE SAME FEATURES AS SPECTACLES; CONTACT LENSES
    • G02C7/00Optical parts
    • G02C7/02Lenses; Lens systems ; Methods of designing lenses
    • G02C7/04Contact lenses for the eyes
    • G02C7/047Contact lens fitting; Contact lenses for orthokeratology; Contact lenses for specially shaped corneae
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/18Arrangement of plural eye-testing or -examining apparatus
    • 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
    • A61B3/103Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for determining refraction, e.g. refractometers, skiascopes
    • 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
    • A61B3/107Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for determining the shape or measuring the curvature of the cornea
    • 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
    • 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
    • A61B3/12Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for looking at the eye fundus, e.g. ophthalmoscopes
    • 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
    • A61B3/16Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for measuring intraocular pressure, e.g. tonometers

Abstract

<P>PROBLEM TO BE SOLVED: To provide a selection system of a best trial lens in the orthokeratology specifications obtaining necessary data items and selecting based on a fitting evaluation. <P>SOLUTION: This selection system executes a counselling, objective examinations such as an curvature radius measurement/a refraction measurement/an intraocular pressure measurement by an autorefractometer, subjective examinations such as a visual acuity measurement of naked eye/fully corrected visual acuity measurement, anterior ocular segment examination/examinations of the fundus oculi and lacrimal fluid accompanied with the eye section, and basic examinations such as a measurement of cornea shape before the installation of a lens by a corneal topographer for obtaining data items classified into categories; selects a best trial lens in a calculation method original in the orthokeratology; if the fitting evaluation is unfavorable, selects a lens of approximate parameter; determines the best trial lens by repeating confirmations of the position of the lens and the movement of the lens when blinking/and an examination of the fitting evaluation by fluorescein dyeing; and designs a custom-made lens using data of the lens as reference. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

本発明は、トライアルレンズを選定するために必要なデータ項目を得、フィッティング評価によるオルソケラトロジー仕様ベスト・トライアルレンズの選定システムに関するものである。 The present invention relates to an orthokeratology specification best trial lens selection system that obtains data items necessary for selecting a trial lens and performs fitting evaluation.

従来、普通のコンタクトレンズや眼鏡の装用や選定は、レンズの度数で視力を向上させるか、自分の角膜そのものを矯正して視力を向上させることを目的として、前記カテゴリーに分類されたデータ項目を前記多種にわたる測定・検査が行われてきた。 Conventionally, the wearing and selection of normal contact lenses and eyeglasses has been carried out using the data items classified in the above categories for the purpose of improving visual acuity with the power of the lens or correcting the cornea itself to improve visual acuity. Various measurements and inspections have been performed.

普通のコンタクトレンズは外せば当然ですが見えにくくなります。 If you remove ordinary contact lenses, it will be difficult to see.

しかし、その大部分において、コンタクトレンズの装用するにあたりフィッティング評価の検査をいままでにあまりされていない。 However, most of them have not been examined so far for fitting evaluation when wearing contact lenses.

特開2000−042022号公報JP 2000-042022 A 特開2002−350787号公報JP 2002-350787 A 特開2003−144479号公報JP 2003-144479 A

普通のコンタクトレンズは外せば見えにくくなりますが、オルソケラトロジー用コンタクトは装用中も勿論見えますが外しても見える、という優れものである。但し、短時間の装用では矯正が充分ではないので外してからしばらくすると元に戻ります。そこで、睡眠時間などを利用して長時間装用しておけば、矯正された状態が長時間続きますので、普段起きている時間は眼鏡やコンタクトレンズの装用なしで過ごせるようにすることを目的とする。 Ordinary contact lenses are difficult to see when removed, but orthokeratology contacts are of course excellent when they are worn, but can be seen when removed. However, since the correction is not enough for a short period of wearing, it will return to its original state after a while. Therefore, if you wear it for a long time using sleep time etc., the corrected state will last for a long time, so the purpose is to be able to spend the usual time without wearing glasses or contact lenses To do.

本発明に係るトライアルレンズを選定するために必要なデータ項目を得て、フィッティング評価によるオルソケラトロジー仕様に基づくベスト・トライアルレンズの選定つまりカスタムレンズの設計することができることを特徴とする。 Data items necessary for selecting the trial lens according to the present invention are obtained, and the best trial lens based on the orthokeratology specification by fitting evaluation, that is, a custom lens can be designed.

上記発明を鑑みれば、カテゴリー分類されたデータ項目を得るために基本となる検査として、眼に関するカウンセリングと、他覚検査(他覚的屈折検査)と言われるオートレフケラトメーターによる曲率半径(角膜のカーブ値、ケラト値)測定、オートレフケラトメーターによる屈折力(近視度、乱視度、軸)測定、眼圧測定と、また、自覚検査(自覚的屈折検査)と言われる裸眼視力測定、完全矯正視力(オーバーレフ)測定と、さらに、スリットランプによる前眼部検査、その他に眼底検査、涙液検査等を行ない、角膜形状解析装置〔トポグラフィ〕によるレンズ装用前の角膜形状(角膜の等高線MAP、角膜離心率:E-value)の測定をも行なう。 In view of the above-mentioned invention, as a basic examination for obtaining categorized data items, eye counseling and a curvature radius (corneal curve value) by an auto-refractometer called an objective test (objective refraction test) , Kerato value) measurement, refractive power (myopia, astigmatism, axis) measurement, intraocular pressure measurement with auto-reflective keratometer, naked eye vision measurement called subjective examination (subjective refractive examination), fully corrected visual acuity (over-reflective) ) Measurement and further examination of the anterior eye with a slit lamp, in addition to fundus examination, tear fluid examination, etc., and corneal shape (corneal contour map MAP, corneal eccentricity: E-value) is also measured.

上記の検査データによりトライアルレンズを選定し、レンズの位置、瞬目時のレンズの動き確認する。さらに、フルオレッセン染色によるフィッティング評価で、フィッティングが良ければ、ベスト・トライアルレンズの確定とする。前記レンズのフィッティング評価が良くない、または被験者から違和感・痛みを訴えるような場合は、近似値パラメーターのレンズを選定し、前記検査の繰り返しにてベスト・トライアルレンズを確定することができる。 A trial lens is selected based on the above inspection data, and the position of the lens and the movement of the lens at the time of blinking are confirmed. Furthermore, if the fitting evaluation by fluorescein staining is satisfactory, the best trial lens is determined. If the fitting evaluation of the lens is not good, or if the subject complains of discomfort / pain, a lens with an approximate value parameter can be selected, and the best trial lens can be determined by repeating the examination.

ベスト・トライアルレンズ確定後、安静にして約1〜3時間装用後、フィッティング検査をし、レンズを装用した状態でオーバーレフ測定をして近視、乱視の確認をする。また、レンズを外し、裸眼視力測定をし、オートレフケラトメーターによるケラト値測定をし、トポグラフィによるレンズ装用後の角膜形状測定をもする。さらに、装用前と装用後の検査データの比較をし、ベスト・トライアルレンズのデータを参考にカスタムレンズをオーダーし、カスタムレンズのフィッティング検査・過矯正の確認をして、カスタムレンズの装用をすることができる。 After the best trial lens is determined, rest and wear for about 1 to 3 hours, and then a fitting test is performed, and overreflometry is performed with the lens worn to confirm myopia and astigmatism. In addition, the lens is removed, the naked eye visual acuity is measured, the kerato value is measured by an auto-reflective keratometer, and the corneal shape is measured after the lens is worn by topography. Furthermore, compare the inspection data before and after wearing, order the custom lens with reference to the data of the best trial lens, check the fitting inspection and overcorrection of the custom lens, and wear the custom lens be able to.

さて、オルソケラトロジー治療がどのように視力回復という効果を生み出すかというと、それは移動システムといわれるものである。つまり、角膜上皮に4ゾーンという構造により中心部と外側に陰圧が働き、角膜上皮の中心部が薄くなり外側が厚くなる現象が起きる。そして、中心部が薄くなることにより屈折異常が減少し正常化され、一時的に視力が回復される。オルソケラトロジー治療を開始して処方目標に達した時、矯正用カスタムレンズの装用をリテーナーレンズとし使用されることも少なくなく、この装用には個人差があり、毎晩装用する人、週2〜3回の人など様々であるが、当初の目標視力に至り、視力が安定する。 Now, how orthokeratology treatment produces the effect of vision recovery is what is called a mobile system. That is, due to the structure of four zones in the corneal epithelium, a negative pressure acts on the central part and the outside, and a phenomenon occurs in which the central part of the corneal epithelium becomes thin and the outer part becomes thick. Then, as the central portion becomes thinner, the refractive error is reduced and normalized, and the visual acuity is temporarily recovered. When the orthokeratology treatment is started and the prescription target is reached, the wearing of a custom correcting lens is often used as a retainer lens, and there are individual differences in this wearing. There are various times, but it reaches the initial target visual acuity and the visual acuity is stabilized.

本発明に係るトライアルレンズの選定するための好適な実施形態を図面を用いて説明する。図1は、基本となる検査のフローを説明する図、図2は、装用テストと評価(フィッティング検査)及びベスト・トライアルレンズを確定するフローを説明する図である。 A preferred embodiment for selecting a trial lens according to the present invention will be described with reference to the drawings. FIG. 1 is a diagram for explaining a basic inspection flow, and FIG. 2 is a diagram for explaining a flow for determining a wear test and evaluation (fitting inspection) and a best trial lens.

各フローに示すように、カテゴリー分類されたデータ項目を得るために、図1において、基本となる検査として、まず、眼に関する履歴や治療に関する理解・同意、その他にライフスタイルや目標視力等を伺うカウンセリング1を行なう。次にオートレフケラトメーターによる曲率径(角膜のカーブ値:ケラト値)測定2、オートレフケラトメーターによる屈折力(近視度、乱視度、軸)測定3、さらに、眼圧測定4を行なう。これらを他覚検査31という。次に裸眼視力測定5、完全矯正視力(オーバーレフ)測定6を行なう。これらを自覚検査32という。次に、スリットランプによる前眼部検査7、その他に眼底検査や涙液検査等8を行なう。さらに、角膜形状解析装置〔トポグラフィー〕によるレンズ装用前の角膜形状(角膜の等高線MAP、角膜離心率:E-value)の測定9を行なう。 As shown in each flow, in order to obtain categorized data items, in FIG. 1, as the basic examination, first, we ask about the history of eyes and understanding / consent for treatment, as well as lifestyle and target visual acuity, etc. Counseling 1 is performed. Next, a radius of curvature (corneal curve value: kerato value) measurement 2 with an auto-refractometer, a refractive power (myopia, astigmatism, axis) measurement 3 with an auto-refractometer, and an intraocular pressure measurement 4 are performed. These are called objective tests 31. Next, a naked eye visual acuity measurement 5 and a completely corrected visual acuity (overref) measurement 6 are performed. These are called subjective examinations 32. Next, an anterior ocular segment inspection 7 using a slit lamp, and in addition, a fundus inspection, a tear fluid inspection, and the like 8 are performed. Furthermore, the measurement 9 of the corneal shape (corneal contour MAP, corneal eccentricity: E-value) before lens wearing is performed by a corneal shape analyzer [topography].

また、図2において、装用テストと評価(フィッティング検査)、ベスト・トライアルレンズの確定をするために、上記の検査データ1〜9によりベスト・トライアルレンズ選定11する。次に、レンズの位置、瞬目時のレンズの動き確認12やフルオレッセン染色によるフィッティング評価13、評価としては各々のゾーンごとにGrade1〜5があり、ランクとしては3が理想である。
フィッティング評価がよければ、ベスト・トライアルレンズを確定するが、レンズのフィッティング評価が良くない、又は、被験者から違和感や痛みを訴えるような場合は、近似値パラメーターのレンズを選定する。これらの検査(12、13)の繰り返して、ベスト・トライアルレンズを確定する。次にベスト・トライアルレンズ確定後、安静にして約1〜3時間装用14する。装用約1〜3時間後、フィッティング検査15を行なう。次に、レンズを装用した状態で近視、乱視の確認をするためにオーバーレフ測定16を行ない、レンズを外し、裸眼視力測定17を行なう。さらに、オートレフケラトメーターによるケラト値測定18、トポグラフィによるレンズ装用後の角膜形状測定19を行なう。レンズ装用前と装用後の検査データの比較をし、被験者の体感等により治療開始の意思確認20をする。最後に、ベスト・トライアルレンズのデータを参考にカスタムレンズをオーダー21し、約3週間後には、被験者のもとに到着する。よって、カスタムレンズのフィッティング検査や追矯正の確認をし、カスタムレンズの装用22をすることができる。
In FIG. 2, in order to determine the wearing test and evaluation (fitting inspection) and the best trial lens, the best trial lens selection 11 is performed based on the inspection data 1 to 9 described above. Next, the position of the lens, the lens movement confirmation 12 at the time of blinking, the fitting evaluation 13 by fluorescein staining, and the evaluation have Grades 1 to 5 for each zone, and 3 is the ideal rank.
If the fitting evaluation is good, the best trial lens is determined, but if the fitting evaluation of the lens is not good or if the subject complains of discomfort or pain, a lens with an approximate value parameter is selected. The best trial lens is determined by repeating these inspections (12, 13). Next, after the best trial lens is determined, rest and wear 14 for about 1 to 3 hours. About 1-3 hours after wearing, a fitting test 15 is performed. Next, in order to confirm myopia and astigmatism while wearing the lens, over-reflective measurement 16 is performed, the lens is removed, and naked eye visual acuity measurement 17 is performed. Further, a kerato value measurement 18 using an auto-reflective keratometer and a corneal shape measurement 19 after lens wearing are performed using a topography. The test data before and after wearing the lens are compared, and the intention to start treatment 20 is confirmed based on the subject's experience. Finally, a custom lens is ordered 21 with reference to the data of the best trial lens, and arrives at the subject about 3 weeks later. Therefore, it is possible to check the fitting inspection and correction of the custom lens and wear the custom lens 22.

普通のコンタクトレンズや眼鏡を装用して従事できないスポーツ、例えば、水泳やボクシング等の選手においては、オルソケラトロジーにより裸眼視力の矯正により視力を向上をさせることにより、活躍させることを大いに期待することができる。また、一般女性等においても昼間、コンタクトレンズや眼鏡を装用するわずらわしさを軽減することができる。
In sports that cannot be engaged with wearing normal contact lenses or glasses, such as swimming and boxing players, it is highly expected that they will play an active role by improving visual acuity by correcting the naked eye vision by orthokeratology. it can. In addition, it is possible to reduce the troublesomeness of wearing contact lenses and eyeglasses in the daytime for ordinary women and the like.

基本となる検査のフローを説明する図Diagram explaining the basic inspection flow 装用テストと評価(フィッティング検査)及びベスト・トライアルレンズを確定するフローを説明する図Diagram explaining the flow to determine the wear test and evaluation (fitting inspection) and the best trial lens

Claims (1)

カテゴリー分類されたデータ項目を得るために、カウンセリング、オートレフケラトメーターによる曲率半径(角膜のカーブ値、ケラト値)測定・屈折力(近視度、乱視度、軸)測定・眼圧測定を他覚的屈折検査(以下、他覚検査という)といい、また、裸眼視力測定・完全矯正視力(オーバーレフ)測定を自覚的屈折検査(以下、自覚検査という)、さらに、前眼部検査・眼部に付帯する眼底、涙液等の検査や角膜形状解析装置〔トポグラフィ〕によるレンズ装用前の角膜形状の測定等の基本となる検査をし、前記検査データによりオルソケラトロジー独自の算定方法におけるトライアルレンズを選定して、前記レンズのフィッテング評価が良くなければ
、近似値パラメーターのレンズを選定し、レンズの位置、瞬目時のレンズの動き確認・フルオレッセン染色によるフィッティング評価の検査の繰り返しにてベストレンズを確定し、ベスト・トライアルレンズのデータを参考にカスタムレンズを設計することができることを特徴とするシステム。

To obtain categorized data items, counseling, measurement of radius of curvature (corneal curve value, kerato value), refractive power (myopia, astigmatism, axis) measurement, intraocular pressure measurement, objective refraction Test (hereinafter referred to as objective test), naked eye acuity measurement / completely corrected visual acuity (overref) measurement is a subjective refraction test (hereinafter referred to as a subjective examination), anterior eye examination / eye To examine the fundus, tear fluid, etc., and to measure the corneal shape before wearing the lens with a corneal shape analyzer [topography], and select a trial lens in an orthokeratology-specific calculation method based on the above-mentioned inspection data If the fitting evaluation of the lens is not good, select a lens with an approximate parameter and check the lens position and the movement of the lens at the blink of an eye. System, characterized in that it is possible to determine the best lens in the inspection repetition of the fitting evaluation by fluorescein staining, to design a custom lens in reference to the data of the best trial lens.

JP2005182034A 2005-06-22 2005-06-22 Selection system of best trial lens in orthokeratology specification Pending JP2007000255A (en)

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Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2009291565A (en) * 2008-06-09 2009-12-17 Eyemed Co Ltd Selecting device and selecting method for prescribed contact lens for orthokeratology
CN103799976A (en) * 2014-03-04 2014-05-21 厦门大学 Comprehensive diagnostic apparatus for xerophthalmia
CN107632410A (en) * 2016-07-19 2018-01-26 上海根植企业管理咨询有限公司 A kind of Ortho-K tries the combined method of piece on
CN111000525A (en) * 2019-11-21 2020-04-14 明灏科技(北京)有限公司 Corneal plastic lens fitting method and system based on big data
CN111553402A (en) * 2020-04-22 2020-08-18 首都医科大学附属北京同仁医院 Intelligent orthokeratology lens selecting system and method based on big data and deep learning

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2009291565A (en) * 2008-06-09 2009-12-17 Eyemed Co Ltd Selecting device and selecting method for prescribed contact lens for orthokeratology
CN103799976A (en) * 2014-03-04 2014-05-21 厦门大学 Comprehensive diagnostic apparatus for xerophthalmia
CN107632410A (en) * 2016-07-19 2018-01-26 上海根植企业管理咨询有限公司 A kind of Ortho-K tries the combined method of piece on
CN111000525A (en) * 2019-11-21 2020-04-14 明灏科技(北京)有限公司 Corneal plastic lens fitting method and system based on big data
CN111553402A (en) * 2020-04-22 2020-08-18 首都医科大学附属北京同仁医院 Intelligent orthokeratology lens selecting system and method based on big data and deep learning
CN111553402B (en) * 2020-04-22 2023-07-18 首都医科大学附属北京同仁医院 Intelligent cornea shaping lens selecting system and method based on big data and deep learning

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