JP2012152361A - Astigmatic axis measurement instrument and ophthalmic apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an astigmatic axis measurement instrument and ophthalmic apparatus which highly accurately measures an astigmatic axis even during a surgery or an observation by suppressing change in the direction of a visual axis.SOLUTION: The astigmatic axis measurement instrument is attached to the ophthalmic apparatus thereby to measure the astigmatic axis of the eye of a patient. A projection means includes a holding part, which holds multiple first light sources arranged approximately circularly, and is arranged so as to project a bright spot image by the first light sources onto the cornea of the eye of the patient. A fixation mark presentation means is arranged so as to present a fixation mark with respect to the eye of the patient. An attachment means is arranged to connect the projection means and the fixation mark presentation means to the ophthalmic apparatus.

Description

  The present invention relates to an astigmatic axis measuring device used in an ophthalmic apparatus such as an ophthalmic surgical microscope and a slit lamp, and an ophthalmic apparatus having the astigmatic axis measuring device.

  In cataract surgery, a clouded lens is removed and an intraocular lens (Intraocular Lens, IOL) is inserted instead. Some intraocular lenses can correct astigmatism (referred to as toric IOL). The toric IOL is disclosed in, for example, Patent Documents 1 and 2.

  As is well known, in astigmatism correction, not only the intensity of astigmatism (astigmatism power) but also its direction (astigmatism axis direction) is important. When transplanting a toric IOL, attention must be paid to the direction of lens placement. That is, in order for the toric IOL to exert a correction effect, it is necessary to match the strong main meridian direction of the cornea of the patient's eye (referred to as the patient's eye) and the weak main meridian direction of the lens as much as possible. It is known that when both are shifted by 10 degrees, the correction effect is reduced to about 65%, and when they are shifted by 30 degrees, the correction effect is almost zero. Thus, when transplanting a toric IOL, the strong main meridian direction of the cornea (or the astigmatic axis direction of the patient's eye) and the direction of the toric IOL (particularly the weak main meridian direction) are grasped, It is necessary to adjust the direction with high accuracy.

In order to match the strong main meridian direction of the cornea with the weak main meridian direction of the lens, the following method has been conventionally used.
(1) As the preoperative examination, the astigmatic axis direction of the patient's eye is measured with a keratometer.
(2) Immediately before surgery, the cornea is marked so that an impression remains in a substantially horizontal direction while observing the patient's eye with a slit lamp microscope (slit lamp).
(3) After cleaning the patient's eyes in the operating room, the surgical protractor was pressed against the patient's eye while observing with an ophthalmic surgical microscope, and the astigmatic axis measured in (1) while referring to the indentation attached in (2) Mark the direction on the cornea.
(4) The lens is removed and the toric IOL is inserted into the eye, and the toric IOL is rotated so that the axial mark attached to the toric IOL matches the astigmatic axial mark attached in (3). .

  This conventional method has the following problems. First, since the patient's head is not always in the same posture at the time of the examinations (1) and (2), the horizontal direction (direction serving as a reference for the astigmatic axis direction) in the measurement of (1) and (2) There is a risk of deviation from the horizontal direction in the measurement. As a result, the astigmatic axis direction cannot be accurately marked in (3).

  Further, the indentation given in (2) may disappear during the washing in (3). In that case, the astigmatism axis direction is marked again with the patient lying on the bed in the operating room with reference to the direction that seems to be the horizontal direction, but this reduces the accuracy of the astigmatism axis direction. Furthermore, since the eye rotates about 5 degrees between the sitting position and the prone position, this also causes a decrease in accuracy in the astigmatic axis direction.

  There is a technique described in Patent Document 3 as a technique for supporting the positioning operation of the IOL inserted into the patient's eye. In this technique, when positioning the IOL, an image of a patient's eye is simply printed, or an image is printed on a contact lens and placed on the patient's eye.

  However, when positioning is performed while referring to the printed image, it is necessary to confirm the position by comparing the patient's eye with the image, and thus there is a problem that it is difficult to grasp the appropriate orientation of the toric IOL. Furthermore, it is necessary to print out images.

  On the other hand, when a contact lens is used, a special device for printing an image on the contact lens is required, and it takes time for printing. In addition, it is necessary to ensure the safety of a material (ink or the like) for printing an image. Furthermore, it seems useless to use contact lenses just for that application. It is assumed that an image is printed on a transparent sticker and attached to a contact lens, but it is not very practical in view of the labor of this fine work.

  Although not for cataract surgery, there is also a technique that can measure the shape of the cornea during surgery (see, for example, Patent Document 4). In this technique, a placido ring illuminator is provided at the lower part of a microscope barrel, a concentric pattern is projected onto the cornea of a patient's eye, and a reflection image is taken to obtain a corneal shape. When this technique is applied to cataract surgery, the shape of the cornea can be obtained and displayed on the screen during the surgery, but the operator cannot be notified of which direction is the astigmatic axis direction in the actual patient's eye. Therefore, the surgeon cannot grasp the orientation in which the toric IOL should be arranged.

  Patent Document 5 discloses a technique for projecting an angle scale on the cornea of a patient's eye. According to this, it is possible to grasp the astigmatic axis direction by looking at the projection image of the angle scale, but it takes time and effort to position the toric IOL by checking the astigmatic axis direction while looking at the fine scale. The burden on the person may increase.

JP-A-5-344990 JP 2006-136714 A JP 2009-45461 A JP-A-8-66369 Japanese Patent Laid-Open No. 3-185416

  As described above, in the conventional technique, the astigmatic axis direction cannot be clearly grasped under the use of the ophthalmologic apparatus. Therefore, it is difficult to confirm the astigmatic axis direction and position the toric IOL.

  In order to clearly grasp the astigmatic axis direction, it is desirable to measure with the visual axis fixed at the center of the patient's eye. In order to fix the visual axis, it is necessary to present some visual target to the patient's eye and fix it. As the target, for example, illumination light from an illumination optical system provided in a surgical microscope or a slit lamp can be used.

  However, the operation microscope and the slit lamp have different arrangements of illumination optical systems for each apparatus. Therefore, even when fixation using the illumination optical system is performed, there is a problem that the direction of the visual axis of the patient's eye changes with the difference in the arrangement of the illumination optical system.

  The present invention has been made to solve such a problem, and its purpose is to suppress the change in the orientation of the visual axis, and to perform highly accurate astigmatic axis measurement even during surgery or observation. It is an object of the present invention to provide an astigmatic axis measuring device and an ophthalmic device that can be performed.

  Another object of the present invention is to provide an astigmatic axis measuring device and an ophthalmologic device capable of positioning a toric IOL with high accuracy.

In order to achieve the above object, an astigmatic axis measuring device according to claim 1 is attached to an ophthalmologic apparatus and used for measuring an astigmatic axis of a patient's eye. The projection unit has a holding unit that holds a plurality of first light sources arranged in a substantially circular shape, and is provided for projecting a bright spot image from the first light source onto the cornea of the patient's eye. The fixation target presenting means is provided for presenting the fixation target to the patient's eye. The attachment means is provided for connecting the projection means and the fixation target presenting means to the ophthalmologic apparatus.
In order to achieve the above object, the invention described in claim 2 is the astigmatism axis measuring device according to claim 1, wherein the fixation target presenting means is a virtual circle connecting a plurality of first light sources. Arranged inside.
In order to achieve the above object, the invention described in claim 3 is the astigmatism axis measuring device according to claim 1 or 2, wherein the fixation target presenting means projects a light beam onto the patient's eye. And a second light source for presenting the fixation target. Further, the fixation target presenting means is a rod-like member that holds the second light source, and has a main body portion that is connected to the holding portion at a base portion on at least one end side thereof.
In order to achieve the above object, the invention described in claim 4 is the astigmatic axis measuring device according to claim 3, wherein the portion of the main body portion where the second light source is disposed is at least from the base portion. Is also formed in a small diameter.
In order to achieve the above object, the invention described in claim 5 is the astigmatic axis measuring device according to claim 3 or 4, wherein a plurality of second light sources are provided.
In order to achieve the above object, the invention described in claim 6 is the astigmatism axis measuring device according to any one of claims 1 to 5, wherein the attachment means is a fixation target for the ophthalmologic apparatus. A moving mechanism for holding the presenting means movably;
In order to achieve the above object, the invention described in claim 7 is the astigmatic axis measuring apparatus according to claim 6, wherein the moving mechanism holds the fixation target presenting means rotatably.
In order to achieve the above object, the invention described in claim 8 is the astigmatism axis measuring device according to claim 6, wherein the moving mechanism is configured to place the fixation target presenting means on the arrangement surface of the plurality of first light sources. It is kept movable in the normal direction.
In order to achieve the above object, the invention described in claim 9 is the astigmatism axis measuring device according to claim 6, wherein the moving mechanism is configured to place the fixation target presenting means on the arrangement surface of the plurality of first light sources. It is held so that it can move in a direction parallel to.
In order to achieve the above object, an ophthalmologic apparatus according to claim 10 has an illumination optical system for irradiating illumination light to a patient's eye. The observation optical system guides the reflected light of the illumination light from the patient's eye to the eyepiece. The projection unit has a holding unit that holds a plurality of first light sources arranged in a substantially circular shape, and projects a bright spot image from the first light source onto the cornea of the patient's eye. The fixation target presenting means presents a fixation target to the patient's eye. The photographing optical system photographs the cornea of a patient's eye in a state where a fixation target is presented and a bright spot image is projected. The acquisition means acquires information on the astigmatism axis direction of the patient's eye based on the image captured by the imaging optical system. The specifying unit specifies a first light source at a position corresponding to the information in the astigmatic axis direction acquired by the acquiring unit from the plurality of first light sources. The control means operates the specified first light source in a manner different from the other first light sources.
In order to achieve the above object, the invention according to claim 11 is the ophthalmologic apparatus according to claim 10, further comprising a movement mechanism that holds the fixation target presenting means movably with respect to the ophthalmologic apparatus. Have.
In order to achieve the above object, the invention according to claim 12 is the ophthalmologic apparatus according to claim 10 or 11, wherein the fixation target presenting means is disposed outside the optical path of the photographing optical system.

  The astigmatic axis measurement device according to the present invention can present a bright spot image and a fixation target for astigmatism axis measurement to a patient's eye.

  Moreover, the acquisition means of the ophthalmologic apparatus according to the present invention acquires the astigmatic axis direction of the patient's eye based on the captured image that is captured with the patient's eye fixed. The specifying unit specifies a first light source at a position corresponding to the acquired astigmatic axis direction from the plurality of first light sources. The control means operates the specified first light source in a manner different from the other first light sources.

  Therefore, by suppressing changes in the direction of the visual axis, it is possible to perform astigmatic axis measurement with high accuracy even during surgery or observation. Further, the toric IOL can be positioned with high accuracy.

It is the schematic showing an example of the external appearance structure of the ophthalmologic apparatus containing the astigmatic axis measuring apparatus which concerns on embodiment. It is the schematic showing an example of the structure by which the astigmatic axis measuring apparatus which concerns on embodiment was attached to the ophthalmologic apparatus. It is a schematic diagram showing an example of composition of an astigmatic axis measuring device concerning an embodiment. It is the schematic showing an example of a structure of the optical system of the ophthalmologic apparatus containing the astigmatic axis measuring apparatus which concerns on embodiment. It is the schematic showing an example of a structure of the optical system of the ophthalmologic apparatus containing the astigmatic axis measuring apparatus which concerns on embodiment. It is a schematic block diagram showing an example of composition of a control system of an ophthalmologic device containing an astigmatic axis measuring device concerning an embodiment. It is table information showing an example of a structure of the control system of the ophthalmologic apparatus containing the astigmatic axis measuring apparatus which concerns on embodiment. It is a figure for showing the premise of the composition of the astigmatic axis measuring device concerning a modification. It is the schematic showing an example of a structure of the astigmatic axis measuring apparatus which concerns on the modification 1. FIG. It is the schematic showing an example of a structure of the astigmatic axis measuring apparatus which concerns on the modification 2. It is the schematic showing an example of a structure of the astigmatic axis measuring apparatus which concerns on the modification 3.

  An example of an ophthalmologic apparatus including the astigmatic axis measurement apparatus according to the present invention will be described in detail with reference to FIGS. In the following embodiments, the configuration of an ophthalmic surgical microscope will be described as an ophthalmologic apparatus. Note that the astigmatism axis measuring apparatus according to the present embodiment can be used for an ophthalmic apparatus such as a slit lamp.

<Appearance configuration>
An appearance configuration of the microscope for ophthalmologic surgery 1 according to this embodiment will be described with reference to FIG. The microscope for ophthalmic surgery 1 includes a support 2, a first arm 3, a second arm 4, a driving device 5, a microscope 6, and a foot switch 8.

  The drive device 5 includes an actuator such as a motor. The driving device 5 moves the microscope 6 in the vertical direction and the horizontal direction in accordance with an operation using the foot switch 8 or the like. Thereby, the microscope 6 can be moved three-dimensionally.

  Various optical systems and drive systems are accommodated in the lens barrel 10 of the microscope 6. An inverter unit 12 is provided on the upper portion of the lens barrel unit 10. When the observation image of the patient's eye E is obtained as an inverted image, the inverter unit 12 converts the observation image into an erect image. A pair of left and right eyepieces 11 </ b> L and 11 </ b> R are provided on the upper portion of the inverter unit 12. An observer (operator or the like) can view the patient's eye E binocularly by looking into the left and right eyepieces 11L and 11R.

  The microscope for ophthalmologic surgery 1 includes an astigmatic axis measurement device 13. The astigmatic axis measuring device 13 is used for measuring the astigmatic axis of the patient's eye E. The astigmatic axis measurement device 13 is detachably provided to the ophthalmic surgical microscope 1. That is, it is possible to use one astigmatic axis measuring device 13 for various ophthalmic surgical microscopes (for example, ophthalmic surgical microscopes with different manufacturers) and other ophthalmic devices (for example, slit lamps).

<Configuration of astigmatic axis measuring device>
Specific examples of the astigmatic axis measuring device 13 are shown in FIGS. The astigmatism axis measuring device 13 includes a projecting unit 13a, a fixation target presenting unit 13b, and an attaching unit 13c.

  FIG. 2 shows a configuration in which the projecting means 13a (and the fixation target presenting means 13b) are attached to the ophthalmic surgical microscope 1 (microscope 6) by the attaching means 13c. The photographing unit 14 stores a TV camera 56 described later. In FIG. 2, an objective lens unit 16 is provided at the lower end of the lens barrel unit 10. The objective lens unit 16 stores an objective lens 15 described later. FIG. 3 shows a configuration when the holding unit 131 of the astigmatism axis measuring device 13 is viewed from below (that is, the patient's eye E side, in other words, the opposite side of the lens barrel unit 10).

<Configuration of projection means>
As shown in FIG.2 and FIG.3, the projection means 13a has the holding | maintenance part 131 and several LED131-i (i = 1-N). The projection unit 13a projects the bright spot images of the plurality of LEDs 131-i onto the cornea of the patient's eye E.

  The holding part 131 is an annular member. As shown in FIG. 3, a plurality of LEDs 131-i are provided on the lower surface of the holding portion 131. The LED group 131-i is arranged in a circular shape along the shape of the holding portion 131. In this embodiment, 36 LEDs 131-i are provided at equal intervals (N = 36). That is, the LED group 131-i is arranged at an angle of 10 degrees with respect to the center position of a virtual line (which is a circle) connecting the LED group 131-i. In other words, considering the line segment connecting each LED 131-i and the center position, the line segments related to the two adjacent LEDs 131-i, 131- (i + 1) intersect at an angle of 10 degrees at the center position. .

  In the astigmatic axis measurement, the LED group 131-i only needs to be arranged in a circular shape. That is, the holding part 131 does not need to be annular. For example, the holding part 131 may be rectangular.

  Among the LED groups 131-i, one corresponding to the horizontal direction and the vertical direction can be configured to output a color different from that corresponding to the other direction. In other words, the LEDs at positions corresponding to the astigmatism axis direction (astigmatism axis angle) of 0 degrees, 90 degrees, 180 degrees, and 270 degrees (LEDs 131-1, 131-10, 131-19, and 131-28, respectively) It can be configured to output a light flux of a different color from the LED 131-i (i ≠ 1, 10, 19, 28). For example, white LEDs can be used as the LEDs 131-1, 131-10, 131-19, 131-28, and green LEDs can be used as the other LEDs 131-i (i ≠ 1, 10, 19, 28). Thereby, it is possible to easily recognize the horizontal direction and the vertical direction of the astigmatic axis.

  Further, only some of the LEDs 131-1, 131-10, 131-19, and 131-28 may output a light flux having a color different from that of the other LEDs. For example, only the LED 131-1 corresponding to an angle of 0 degrees can be configured to output a different color from the other LEDs 131-i (i ≠ 1).

  Further, it is not necessary to configure all of the LEDs 131-1, 131-10, 131-19, and 131-28 so as to output light beams of the same color (white in the above example). For example, a red LED is used as each LED 131-1, 131-19, a white LED is used as each LED 131-10, 131-28, and a green LED is used as another LED 131-i (i ≠ 1, 10, 19, 28). Can be used. Thereby, it is possible to easily identify the horizontal direction and the vertical direction.

  In addition, instead of making the horizontal direction and the vertical direction recognizable according to the output color of the light source as described above, the same effect can be achieved with other configurations. For example, the direction can be identified by changing the brightness of the output light.

  The LED group 131-i is an example of the “plurality of first light sources” in the present invention. Here, each light source does not need to be an LED, and any device capable of outputting a light beam can be used. Further, the plurality of light sources may not be arranged at equal intervals. Since FIG. 3 is a bottom view, the arrangement order of the LED groups 131-i is set in the opposite direction (reverse direction) to the general astigmatic axis setting direction. Thereby, the corneal reflection light (Purkinje image) of the light beam output from the LED group 131-i is observed or photographed as a general astigmatic axis setting direction.

  In this embodiment, 36 light sources are provided, but the number of light sources to be installed is also arbitrary. However, in this embodiment, since the astigmatic axis direction of the patient's eye E is measured based on the Purkinje image of the light flux output from the LED group 131-i, a number of light sources that can guarantee the accuracy and accuracy of this measurement are provided. It is desirable that

  In addition, the number of light sources can be appropriately set according to the accuracy required when the operator visually recognizes the astigmatic axis direction and the arrangement direction of the main meridian of the toric IOL. For example, in this embodiment, since the light sources are arranged at intervals of 10 degrees, the astigmatic axis direction and the like can be presented in units of at least 10 degrees. In order to present the astigmatic axis direction and the like with higher accuracy, the number of light sources corresponding to the accuracy (for example, 72 in the case of 5 degree units) is provided. The same is true for lower accuracy.

  In this embodiment, a plurality of individually configured light sources (LED groups 131-i) are provided, but the present invention is not limited to this. For example, a similar function can be obtained by providing a display device (for example, an LCD (liquid crystal display)) on the lower surface of the holding unit 131 and displaying a plurality of bright spots with the display device. In this case, each bright spot corresponds to a “first light source”.

<Configuration of fixation target presentation means>
As shown in FIG. 3, the fixation target presenting means 13b includes a main body 132 and a fixation LED 132a. The fixation target is presented to the patient's eye E by the fixation target presenting means 13b. Specifically, by turning on the fixation LED 132a, the patient's eye E is irradiated with a light beam, and the fixation target is presented to the patient's eye E. The fixation target presenting means 13b is arranged inside a virtual circle connecting a plurality of LEDs 131-i included in the projecting means 13a.

  The main body 132 is a rod-like member that holds the fixation LED 132a. The “bar-shaped member” is a long member that is formed with a thickness comparable to the thickness of the holding portion 131.

  The main body portion 132 is connected to the holding portion 131 at the base portion 132b. In the present embodiment, the base portion 132 b at both ends of the main body portion 132 and the holding portion 131 are connected.

  A fixation LED 132 a is provided on the lower surface of the main body 132. The fixation LED 132a is arranged at a position where a fixation target can be presented to the patient's eye E, for example, at the center of the main body 132. The fixation LED 132a is an example of the “second light source” in the present invention.

  Here, a plurality of fixation LEDs 132a may be provided. For example, a plurality of fixation LEDs 132 a may be arranged along the shape of the main body 132. In this case, it is possible to perform fixation in any direction by lighting one arbitrary fixation LED 132a.

  The second light source need not be an LED, and any device capable of outputting a light beam can be used. For example, a similar function can be obtained by providing a display device such as an LCD on the lower surface of the main body 132 and displaying a bright spot using the display device. In this case, the bright spot corresponds to the “second light source”.

  Further, the fixation LED 132a can be configured to output a color different from that of the LED group 131-i. For example, white LEDs are used as the LEDs 131-1, 131-10, 131-19, 131-28, and green LEDs are used as the other LED groups 131-i (i ≠ 1, 10, 19, 28), and the fixation LED 132a. A red LED can be used. Thereby, the surgeon can easily recognize the astigmatic axis direction. In addition, the subject can easily recognize the fixation light.

  In addition, instead of making the fixation target recognizable by the output color of the light source as described above, it is possible to achieve the same effect by using another configuration. For example, the fixation target can be identified by changing the brightness of the output light.

<Configuration of mounting means>
As shown in FIG. 2, the attachment means 13 c includes a support member 17, a connection part 133, an arm 134, and a fall prevention part 135. The projection means 13a and the fixation target presenting means 13b can be connected to the ophthalmic surgical microscope 1 by the attaching means 13c.

  The support member 17 is provided in the vicinity of the objective lens unit 16. The support member 17 is formed from the objective lens portion 16 toward the side.

  A through-hole extending in the vertical direction is formed in the distal end portion 17 a of the support member 17. An arm 134 is inserted into the through hole. The arm 134 can slide in the through hole. Thereby, the arm 134 can be moved in the vertical direction (the direction indicated by the double-sided arrow A in FIG. 2, that is, the normal direction of the arrangement surface of the LED group 131-i) with respect to the distal end portion 17 a. Here, the microscope 6 side is the upward direction, and the patient's eye E side is the downward direction. Further, the arm 134 can be rotated with respect to the microscope 1 for ophthalmic surgery. By rotating the arm 134, the holding part 131 connected to the connection part 133 can be moved in a direction parallel to the arrangement surface of the LED 131-i.

  A fall prevention part 135 is provided at the upper end of the arm 134. The fall prevention part 135 is a plate-like member having a diameter larger than the diameter of the through hole. Thereby, the fall prevention unit 135 prevents the arm 134 from falling off the tip portion 17a.

  A connecting portion 133 is provided at the lower end of the arm 134. The connection part 133 connects the holding part 131 to the arm 134 so that the surface on which the LED group 131-i is provided faces downward.

  Thus, in this embodiment, the through-hole formed in the front-end | tip part 17a and the arm 134 correspond to a "moving mechanism."

  In the present embodiment, the main body portion 132 is indirectly connected to the arm 134 via the holding portion 131. That is, the main body 132 and the fixation LED 132a (that is, the fixation target presenting means 13b) are moved in the normal direction of the arrangement surface of the LED group 131-i with respect to the ophthalmic surgery microscope 1 (microscope 6) and / or Or it will be hold | maintained so that a movement to the direction parallel to the arrangement surface of LED group 131-i is possible.

  The moving mechanism is driven by, for example, the user holding the arm 134 or the like. It is also possible to configure the arm 134 and the like to be moved electrically by using an actuator such as a motor.

  A connecting hook 18 is provided on the lower surface of the support member 17. The connecting hook 18 is configured to be engageable with an engaging portion (not shown) of the astigmatic axis measuring device 13. This engaging part is provided in the connection part 133, for example. When the astigmatism axis measurement device 13 is moved upward, the engaging portion and the connecting hook 18 are engaged to inhibit the astigmatism axis measurement device 13 from moving up and down. This engagement relationship can be released by a predetermined operation (for example, pressing a predetermined button). The configuration of the connecting hook 18 and the engaging portion is arbitrary.

  The moving mechanism is not limited to the above configuration. As long as the second light source is movably held in the normal direction of the arrangement surface of the LED group 131-i or in a direction parallel to the arrangement surface, the specific structure of the holding means is arbitrary. Alternatively, it is possible to provide a mechanism for rotating the second light source (details will be described later).

<Configuration of optical system>
Next, the optical system of the microscope for ophthalmologic surgery 1 will be described with reference to FIGS. 4 and 5. Here, FIG. 4 is a view of the optical system viewed from the left side as viewed from the operator. FIG. 5 is a view of the optical system viewed from the operator side. In addition to the configurations shown in FIGS. 4 and 5, an auxiliary optical system may be provided for an assistant who assists the surgeon to observe the patient's eye E.

  In this embodiment, the directions such as up and down, left and right, and front and rear are directions seen from the operator side unless otherwise specified. In addition, about the up-down direction, let the direction which goes to the observation object (patient eye E) from the objective lens 15 be a downward direction, and let this opposite direction be an upper direction.

  The aforementioned LED groups 131-i and 132-i are provided below the objective lens 15 (position between the objective lens 15 and the patient's eye E). 4 and 5, only the LEDs 131-i and 131-j (i, j = 1 to N, i ≠ j) located at both ends when viewed from the viewpoint direction are described.

  Note that “between the objective lens 15 and the patient's eye E” means between the position (height position) of the objective lens 15 and the position (height position) of the patient's eye E in the vertical direction (that is, The position in the left-right direction or the front-rear direction is not considered). The LED group 131-i is arranged in a circular shape, but if the projection image (bright spot image) arranged in a substantially circular shape can be formed on the cornea of the patient's eye E, this circular diameter is arbitrarily set. it can.

  The observation optical system 30 will be described. As shown in FIG. 5, the observation optical system 30 is provided in a pair of left and right. The observation optical system 30 guides reflected light of illumination light (described later) from the patient's eye E to an eyepiece lens 37 (described later). The left observation optical system 30L is called a left observation optical system, and the right observation optical system 30R is called a right observation optical system. Symbol OL indicates the optical axis (observation optical axis) of the observation optical system 30L, and symbol OR indicates the optical axis (observation optical axis) of the observation optical system 30R. The left and right observation optical systems 30L and 30R are disposed so as to sandwich the optical axis O of the objective lens 15.

  As in the conventional case, the left and right observation optical systems 30L and 30R are respectively a zoom lens system 31, a beam splitter 32 (only the observation optical system 30R), an imaging lens 33, an image erecting prism 34, an eye width adjustment prism 35, A field stop 36 and an eyepiece 37 are provided.

  The zoom lens system 31 includes a plurality of zoom lenses 31a, 31b, and 31c. Each of the zoom lenses 31a to 31c can be moved in a direction along the observation optical axis OL (or the observation optical axis OR) by a driving mechanism (not shown). Thereby, the magnification at the time of observing or photographing the patient's eye E is changed.

  The beam splitter 32 of the observation optical system 30R separates part of the observation light guided from the patient's eye E along the observation optical axis OR and guides it to the TV camera imaging system. The TV camera imaging system includes an imaging lens 54, a reflection mirror 55, and a TV camera 56. The television camera imaging system is stored in the imaging unit 14.

  The TV camera 56 includes an image sensor 56a. The image pickup device 56a is configured by, for example, a charge coupled devices (CCD) image sensor, a complementary metal oxide semiconductor (CMOS) image sensor, or the like. As the image sensor 56a, an element having a two-dimensional light receiving surface (area sensor) is used.

  When the ophthalmic surgical microscope 1 is used, the light receiving surface of the imaging device 56a is, for example, a position optically conjugate with the surface of the cornea of the patient's eye E or a depth from the apex of the cornea by ½ of the corneal curvature radius. It is arranged at a position optically conjugate with a position away in the direction.

  The objective lens 15, the zoom lens system 31, the beam splitter 32, and the TV camera imaging system constitute the “imaging optical system” in the present embodiment. The photographing optical system photographs the cornea of the patient's eye E in a state where the fixation target is presented by the fixation target presenting means 13b and a bright spot image is projected by the projection means 13a. Here, a path through which reflected light from the patient's eye E reaches the TV camera imaging system is referred to as an “optical path of the imaging optical system”.

  The image erecting prism 34 converts the inverted image into an erect image. The eye width adjustment prism 35 is an optical element for adjusting the distance between the left and right observation lights according to the eye width of the operator (the distance between the left eye and the right eye). The field stop 36 blocks the peripheral region in the cross section of the observation light and limits the operator's visual field.

  Next, the illumination optical system 20 will be described. As shown in FIG. 4, the illumination optical system 20 includes an illumination light source 21, an optical fiber 21a, an exit aperture stop 26, a condenser lens 22, an illumination field stop 23, a slit plate 24, a collimator lens 27, and an illumination prism 25. Is done. With these configurations, the illumination optical system 20 irradiates the patient's eye E with illumination light.

  The illumination field stop 23 is provided at a position optically conjugate with the front focal position of the objective lens 15. The slit hole 24a of the slit plate 24 is formed at a position optically conjugate with the front focal position.

  The illumination light source 21 is provided outside the lens barrel 10 of the microscope 6. One end of an optical fiber 21 a is connected to the illumination light source 21. The other end of the optical fiber 21 a is disposed at a position facing the condenser lens 22 in the lens barrel 10. The illumination light output from the illumination light source 21 is guided by the optical fiber 21 a and enters the condenser lens 22.

  An exit aperture stop 26 is provided at a position facing the exit port (fiber end on the condenser lens 22 side) of the optical fiber 21a. The exit aperture stop 26 acts to shield a partial region of the exit port of the optical fiber 21a. When the shielding area by the exit aperture stop 26 is changed, the emission area of the illumination light is changed. Thereby, the irradiation angle by the illumination light, that is, the angle formed by the incident direction of the illumination light with respect to the patient's eye E and the optical axis O of the objective lens 15 can be changed.

  The slit plate 24 is formed of a disk-shaped member having a light shielding property. The slit plate 24 is provided with a light-transmitting portion including a plurality of slit holes 24 a having a shape corresponding to the shape of the reflecting surface 25 a of the illumination prism 25. The slit plate 24 is moved in a direction perpendicular to the illumination optical axis O ′ (direction of a double-headed arrow B shown in FIG. 4) by a driving mechanism (not shown). As a result, the slit plate 24 is inserted into and removed from the illumination optical axis O ′.

  The collimator lens 27 converts the illumination light that has passed through the slit hole 24a into a parallel light flux. The illumination light that has become a parallel light beam is reflected by the reflecting surface 25 a of the illumination prism 25, enters the objective lens 15, and is further projected onto the patient's eye E via the astigmatism axis measurement device 13. Illumination light (a part) projected onto the patient's eye E is reflected by the cornea. Reflected light (sometimes referred to as observation light) of illumination light by the patient's eye E enters the observation optical system 30 via the objective lens 15. With such a configuration, an operator can observe an enlarged image of the patient's eye E.

<Control system configuration>
Next, the control system of the microscope for ophthalmic surgery 1 will be described with reference to FIG. In FIG. 6, a part of the control system is omitted. Omitted parts include the drive device 5, the drive mechanism of the slit plate 24, the drive mechanism of the zoom lens system 31, and the like.

  The control system of the microscope for ophthalmic surgery 1 is configured with a control unit 60 as a center. The control unit 60 is provided at any part of the microscope for ophthalmic surgery 1 shown in FIG. Further, a computer may be provided separately from the configuration shown in FIG. 1 and used as the control unit 60.

  The control unit 60 controls each part of the microscope for ophthalmic surgery 1. In addition, the control unit 60 executes various arithmetic processes as will be described later. The control unit 10 includes a microprocessor and a storage device in the same manner as a normal computer. The control unit 60 includes an LED control unit 61, an astigmatism information calculation unit 62, and a light source identification unit 63.

  In this embodiment, in a state where the patient's eye E is fixed, a Purkinje image formed on the cornea of the patient's eye E is photographed by the light flux from the LED group 131-i, and the patient's eye E is based on this photographed image. Obtain the astigmatic axis direction. Then, based on this astigmatic axis direction, direction information for supporting the operation of transplanting the toric IOL into the patient's eye E is presented to the operator. The direction information includes the main meridian direction (strong main meridian direction or weak main meridian direction) of the cornea of the patient's eye E and the arrangement direction of the main meridian of the toric IOL (strong main meridian or weak main meridian).

  In the Purkinje image, the fixation LED 132a is turned on to fix the patient's eye E, and the LED group 131-i is turned on to form a plurality of bright spot images on the cornea of the patient's eye E. In FIG. 5, the procedure is executed by photographing the patient's eye E with the TV camera 56. The TV camera 56 sends an electrical signal of the captured image to the control unit 60 via a cable (not shown). The astigmatism information calculation unit 61 analyzes the captured image of the Purkinje image obtained in this way to obtain the astigmatic axis direction of the patient's eye E. This analysis process is executed in the same manner as in the prior art as follows.

  The Purkinje image in the photographed image is composed of a plurality of bright spot images. Although the LED group 131-i is arranged in a circular shape, the plurality of bright spot images are deformed from the circular shape according to the corneal shape of the patient's eye E. In particular, when the patient's eye E has astigmatism, the plurality of bright spot images are arranged in an elliptical shape.

<LED control unit>
The LED control unit 61 controls the LED group 131-i. In particular, the LED control unit 61 controls a specific LED 131-n in the LED group 131-i to make it turn on differently from the other LED groups 131-i (i ≠ n).

  As a control example of this lighting state, the LED control unit 61 blinks a specific LED 131-n and continuously lights the other LED group 131-i. Here, the blinking means that the LED 131-n is repeatedly turned on and off at a predetermined time interval (for example, every one second). The continuous lighting is to keep the LED group 131-i lit until an instruction to turn it off is given.

  Moreover, the LED control part 61 changes the lighting state of LED131-m specified by the light source specific | specification part 63 mentioned later. As an example of this control, the LED control unit 61 causes the identified LED 131-m to blink, or causes the LED 131-m to output light having a color different from that of the other LED group 131-i. The LED control unit 61 is an example of the “control unit” of the present invention.

  The LED 131-m is disposed at a position corresponding to the astigmatic axis direction of the patient's eye E. The position corresponds to the position corresponding to the main meridian direction (strong main meridian direction or weak main meridian direction) of the cornea of the patient's eye E, or the arrangement direction of the main meridian (strong main meridian or weak main meridian) of the toric IOL. Such as location.

  Further, the LED control unit 61 controls the fixation LED 132a. When a plurality of fixation LEDs 132a are provided, the LED control unit 61 performs control to turn on only a specific fixation LED 132a from the plurality of fixation LEDs 132a.

<Astigmatism information calculation unit>
The astigmatism information calculation unit 62 obtains information on the astigmatism axis direction (astigmatism axis angle) based on the ellipse principal axis directions of a plurality of bright spot images arranged in an elliptical shape, for example, as described in JP-A-11-225963. get. In addition to this, the astigmatism information calculation unit 62 can also obtain the astigmatism power from the ellipticity (ratio between the minor axis and the major axis) or the spherical power from the size of the ellipse. The astigmatism information calculation unit 62 is an example of “acquiring means”.

<Light source identification unit 63>
The light source identification unit 63 identifies the LED 131-i at a position corresponding to the information of the astigmatism axis direction based on the astigmatism axis direction obtained by the astigmatism information calculation unit 62. Since each LED 131-i forms each luminescent spot image, specifying the LED 131-i is synonymous with specifying the luminescent spot image. The light source identification unit 63 is an example of the “identification unit” of the present invention.

  The light source specifying unit 63 specifies the target LED 131-i as follows, for example. First, the light source specifying unit 63 stores in advance light source / astigmatic axis direction information in which a correspondence relationship between each LED 131-i and the astigmatic axis direction is recorded. The light source / astigmatic axis direction information is, for example, table information in which the astigmatic axis direction is associated with each LED 131-i.

  An example of this table information is shown in FIG. The table information 64 includes a “light source ID” column and an “astigmatic axis direction” column. In the “light source ID” column, identification information (ID information) given in advance to each LED 131-i is listed. In the table information 64, the code “i” in each LED 131-i shown in FIG. In the “astigmatic axis direction” column, values of the astigmatic axis direction corresponding to the respective LEDs 131-i are listed.

  Upon receiving the astigmatism axis direction obtained by the astigmatism information calculation unit 62, the light source specifying unit 63 specifies the astigmatism axis direction in the “astigmatism axis direction” column of the table information 64, and further, the specified astigmatism axis direction. The identification information in the “light source ID” column corresponding to is specified.

  Further, the light source identification unit 63 adds 180 degrees in the astigmatic axis direction, and identifies identification information corresponding to this sum based on the table information 64. The addition process at this time is performed using 360 degrees as a modulo. That is, when the sum value obtained by the addition process exceeds 360 degrees, 360 is subtracted from the sum value to obtain a remainder, and identification information corresponding to the remainder value is obtained. In this way, the two LEDs 131-i arranged at positions facing each other (that is, positions shifted by 180 degrees) are specified.

  As a specific example, when the obtained astigmatism axis direction is 90 degrees, the light source identifying unit 63 first identifies “10” as the identification information corresponding to 90 degrees, and further, 90 degrees + 180 degrees = 270 degrees. “28” is specified as the corresponding identification information. Thereby, a pair of LED 131-10 and 131-28 arrange | positioned in the position which mutually opposes are specified.

  The specifying means is not limited to the above configuration. For example, instead of the table information 64 in FIG. 7, table information in which the pair of LEDs 131-i (i = 1 to 18) and 131- (i + 18) facing each other as described above are associated with each astigmatic axis direction in advance. You can remember it. Thereby, the process which specifies the identification information of a light source can be completed at once.

  The operation unit 70 is used by an operator or the like to operate the microscope 1 for ophthalmic surgery. The operation unit 70 includes various hardware keys (buttons, switches, etc.) provided on the housing of the microscope 6 and the foot switch 8. When a touch panel display is provided, the operation unit 70 includes various software keys displayed on the touch panel display.

<Usage example>
The above microscope for ophthalmic surgery 1 (astigmatic axis measuring device 13) is used in a toric IOL transplantation operation.

  When performing a toric IOL transplantation operation, first, a mydriatic is dropped on the patient's eye E, and anesthesia is performed with the pupil dilated. And the above-mentioned astigmatic axis measuring device 13 is used under anesthesia.

  That is, when the surgeon performs a predetermined operation, the control unit 60 controls the LED control unit 61 to turn on the fixation LED 132a and cause the patient's eye E to present a fixation target. This fixation target is presented during the operation. Therefore, the patient's eye E can be fixed in the same state during the operation.

  In a state where the patient's eye E is fixed, the control unit 60 controls the LED control unit 61 to turn on the LED group 131-i and form a plurality of bright spot images on the cornea of the patient's eye E. At this time, by moving the LED group 131-i up and down, left and right, and back and forth by the moving mechanism, a plurality of bright spot images are arranged in an appropriate size (diameter) and position without blocking the photographing optical path. be able to. The LED control unit 61 performs control such that the LED group 131-i is lit with such brightness that the fixation target can be recognized.

  In this state, the control unit 60 controls the photographing optical system (TV camera 56) to photograph the patient's eye E in a state where a plurality of bright spot images are formed. Thereby, a captured image of the Purkinje image is obtained with the patient's eye E fixed. At this stage, the LED group 131-i may be turned off or the lighting state may be continued. The control unit 60 adjusts the brightness of the illumination light from the illumination optical system 20 so that the fixation target can be recognized even when the patient's eye E is photographed.

  The astigmatism information calculation unit 62 analyzes the captured image obtained by the imaging optical system to obtain the astigmatic axis direction (information corresponding to) of the patient's eye E. The light source identifying unit 63 refers to the table information 64 and identifies the LED 131-i corresponding to this astigmatic axis direction (weak principal meridian direction).

  The control unit 60 blinks the identified LED 131-i and continuously lights the other LEDs 131-j (j ≠ i). By doing in this way, the operator can recognize the astigmatic axis direction on the patient's eye E.

  Thereafter, the cornea of the patient's eye E is incised, and the clouded lens is aspirated and removed. Then, the toric IOL is inserted from the incision portion, and the direction of the toric IOL is adjusted based on the astigmatic axis direction projected onto the patient's eye E.

<Action and effect>
The operation and effect in this embodiment will be described.

  The astigmatism axis measuring device 13 is attached to the microscope 1 for ophthalmic surgery and used for measuring the astigmatism axis of the patient's eye E. The projection unit 13a includes a holding unit 131 that holds a plurality of LEDs 131-i arranged in a substantially circular shape, and is provided to project a bright spot image from the plurality of LEDs 131-i onto the cornea of the patient's eye E. Yes. The fixation target presenting means 13b is provided for presenting a fixation target to the patient's eye E. The projection means 13a and the fixation target presenting means 13b are connected to the microscope for ophthalmologic surgery 1 by the attaching means 13c.

  According to this astigmatism axis measuring device 13, the astigmatism axis direction of the patient's eye E can be measured immediately before or during the operation, so that a preoperative examination as in the past, marking by indentation, marking using a protractor for surgery, etc. Need not be performed. In addition, since the patient's eye E is in a fixation state, measurement in the astigmatic axis direction can be performed with a change in the direction of the visual axis suppressed. That is, the astigmatic axis measurement with high accuracy is possible.

  The fixation target presenting means 13b is arranged inside a virtual circle connecting a plurality of LEDs 131-i.

  Therefore, since the visual axis can be fixed inside a virtual circle connecting a plurality of LEDs 131-i, it is possible to suitably project a bright spot image for performing astigmatic axis measurement on the patient's eye E.

  The fixation target presenting means 13b includes a fixation LED 132a that presents a fixation target to the patient's eye E by projecting a light beam onto the patient's eye E. Further, the fixation target presenting means 13b is a rod-like member that holds the fixation LED 132a, and has a main body 132 that is connected to the holding part 131 at a base part 132b on at least one end side thereof. Further, a plurality of fixation LEDs 132a are provided.

  Therefore, it is possible to project a bright spot image on the patient's eye E after performing fixation at an arbitrary position.

  Moreover, the attachment means 13c has a moving mechanism which hold | maintains the fixation target presentation means 13b with respect to the microscope 1 for ophthalmic surgery so that a movement is possible. Further, the moving mechanism holds the fixation target presenting means 13b to the ophthalmic surgical microscope 1 so as to be movable in the normal direction of the arrangement surface of the plurality of LED groups 131-i or in a direction parallel to the arrangement surface. .

  Therefore, by moving the fixation target presenting means 13b, it is possible to secure the photographing optical path of the photographing optical system.

  The ophthalmologic apparatus such as the microscope for ophthalmic surgery 1 includes an illumination optical system 20 that irradiates the patient's eye E with illumination light, and an observation optical system 30 that guides reflected light of the illumination light to the eyepiece 37. The projecting unit 13a includes a holding unit 131 that holds a plurality of LED groups 131-i arranged in a substantially circular shape, and projects a bright spot image by the plurality of LED groups 131-i onto the cornea of the patient's eye E. The fixation target presenting means 13b presents a fixation target for the patient's eye E. The photographing optical system photographs the cornea of the patient's eye E in a state where the fixation target is presented by the fixation target presenting means 13b and a bright spot image is projected by the projection means 13a. The acquisition unit acquires information on the astigmatic axis direction of the patient's eye E based on a captured image obtained by the imaging optical system. The specifying unit specifies the LED 131-i at a position corresponding to the information in the astigmatic axis direction acquired by the acquiring unit from the plurality of LED groups 131-i. The control unit operates the LED 131-i specified by the specifying unit in a manner different from that of the other LED groups 131-i.

  According to this ophthalmologic apparatus, the patient's eye E in a fixation state in which a bright spot image is projected immediately before or during an operation is photographed. Then, the astigmatism axis direction can be specified by acquiring the astigmatism axis direction from the captured image and turning on the LED 131-i corresponding to the astigmatism axis direction. Accordingly, there is no need to perform conventional preoperative examination, marking by indentation, marking using a surgical protractor, or the like. Further, since the patient's eye E is in a fixation state, measurement in the astigmatic axis direction is possible with the visual axis fixed. That is, it is possible to measure the astigmatic axis direction with high accuracy. Further, since the astigmatic axis measurement and the toric IOL positioning can be performed in the same fixation state, the orientation misalignment is small, and the toric IOL positioning can be performed accurately with respect to the measured astigmatic axis direction.

<Modification 1 to Modification 3>
Modifications 1 to 3 of the ophthalmologic apparatus including the astigmatic axis measurement device according to the present invention will be described in detail with reference to FIGS. 8 to 11. 8 to 11 illustrate a configuration when the holding unit 131 of the astigmatism axis measurement device 13 is viewed from below (that is, the patient's eye E side, in other words, the opposite side of the lens barrel unit 10).

  When photographing with the photographing optical system of the microscope for ophthalmic surgery 1 or when observing with the observation optical system 30, it is desirable that the visual field is sufficiently secured. On the other hand, for example, when there is an obstacle in the optical path of the photographing optical system, the reflected light from the patient's eye E and the bright spot image of the LED group 131-i are blocked by the obstacle (so-called vignetting state). Thus, only a captured image with a part missing can be obtained.

  Further, as described above, the astigmatic axis measurement device 13 in the above embodiment can be attached to various ophthalmologic apparatuses.

  However, in the ophthalmic apparatus, the arrangement of the optical system including the photographing optical system differs depending on the manufacturer and the type of the apparatus.

  Therefore, as shown in FIG. 8, when the astigmatic axis measurement device 13 in the above embodiment is mounted on an ophthalmologic apparatus, a part of the fixation target presenting means 13b may block the optical path of the imaging optical system of the ophthalmologic apparatus. There is. 8 represents a cross section at a position where the optical path of the observation optical system 30L is orthogonal to the astigmatism axis measurement device 13 (projection means 13a), and the right broken line portion 136 represents the imaging optical system. A cross section at a position where the optical path is orthogonal to the astigmatism axis measuring device 13 is shown.

  Even when the patient's eye E is photographed in such a state, as described above, only an image lacking the reflected light from the patient's eye E and a part of the bright spot image of the LED group 131-i can be obtained. The accuracy of axis measurement may be degraded.

  In the present modification, a configuration capable of performing astigmatic axis measurement with high accuracy even when the astigmatic axis measurement device 13 is mounted on various ophthalmologic apparatuses will be described.

<Modification 1>
FIG. 9 is an example of the fixation target presenting means 13b.

  In this modification, the portion (small diameter portion 1321) of the main body portion 132 where the fixation LED 132a as the second light source is disposed is formed to have a smaller diameter than the other portion (large diameter portion 1322). Note that the “diameter” in this modification means the diameter of a cross section perpendicular to the longitudinal direction of the main body 132.

  As described above, the portion of the main body 132 that is likely to be disposed on the optical path of the imaging optical system has a small diameter so that the astigmatic axis measurement device 13 is mounted on various ophthalmic devices. In addition, the possibility that the fixation target presenting means 13b is arranged on the optical path of the photographing optical system is reduced. Accordingly, it is possible to perform astigmatic axis measurement with high accuracy.

<Modification 2>
FIG. 10 is an example of the fixation target presenting means 13b.

  In this modification, only one end portion (base portion 132 b) of the main body portion 132 is connected to the holding portion 131. The main body 132 is made of a member that is shorter than the diameter of the projection means 13a.

  In the present modification, the base portion 132 b connected to the holding portion 131 is configured with a large diameter with respect to the main body portion 132. With this configuration, the strength of the connecting portion between the main body 132 and the holding portion 131 can be increased.

  Thus, by forming the main body 132 shorter than the diameter of the projection means 13a, the fixation target is presented on the optical path of the imaging optical system even when the astigmatism axis measurement device 13 is mounted on various ophthalmic devices. The possibility that the means 13b is arranged is reduced. Therefore, it is possible to perform astigmatic axis measurement with high accuracy.

<Modification 3>
FIG. 11 is an example of the fixation target presenting means 13b.

  In this modification, a frame portion 137 is provided on the periphery of the projection means 13a. In this modification, a frame portion 137 is connected to the connection portion 133 instead of the holding portion 131. The holding part 131 is held by the frame part 137 so as to be rotatable in the direction of arrow C in FIG. That is, a rotation mechanism is formed between the holding part 131 and the frame part 137. FIG. 11 shows a state in which the holding unit 131 is rotated 90 degrees counterclockwise from the state of FIG.

  For example, the rotation mechanism is provided with tooth traces (so-called “internal gear” shape, not shown) on the inner peripheral surface of the frame part 137, and teeth that are fitted to the tooth traces of the frame part 137 on the outside of the holding part 131. This is a mechanism provided with a streak (so-called “spur gear” shape, not shown). This rotation mechanism is a mechanism that can rotate the holding portion 131 with respect to the frame portion 137 electrically or manually. In the present modification, the through hole, the arm 134, and the rotation mechanism formed in the distal end portion 17a correspond to the “movement mechanism”.

  Similar to the above-described embodiment, the fixation target presenting means 13b is connected to the holding unit 131 also in this modification. That is, when the holding part 131 rotates with respect to the frame part 137, the fixation target presenting means 13b also rotates.

  In this way, by rotating the fixation target presenting means 13b, the fixation target presenting means 13b is arranged on the optical path of the photographing optical system even when the astigmatic axis measuring device 13 is mounted on various ophthalmologic apparatuses. This reduces the risk of exposure. Therefore, it is possible to perform astigmatic axis measurement with high accuracy.

  Furthermore, according to the above modification, the fixation target presenting means 13b can be arranged outside the optical path of the imaging optical system. Therefore, the astigmatic axis measurement with high accuracy can be performed regardless of the arrangement of the optical system of the ophthalmologic apparatus to which the astigmatism axis measuring apparatus 13 is attached. That is, it is possible to provide a highly versatile astigmatic axis measurement device 13.

  The configuration in which the fixation target presenting means 13b is arranged outside the optical path of the photographing optical system is not limited to the first to third modifications. By devising the shape of the fixation target presenting means 13b and the operation control of the moving mechanism, the fixation target presenting means 13b can be arranged outside the optical path of the photographing optical system.

<Matters common to the embodiment and the modification>
The configuration described above is merely an example for favorably implementing the present invention. Therefore, arbitrary modifications within the scope of the present invention can be made as appropriate.

  In the above description, the configuration in which the projecting unit 13a and the fixation target presenting unit 13b are integrally formed has been described, but the configuration is not limited thereto.

  For example, the projecting unit 13a and the fixation target presenting unit 13b may be configured separately and provided with a moving mechanism for moving each of them.

  In this case, the fixation target presenting means 13b can be moved between a use position (a position where the fixation target presenting means 13b can be used) and a retracted position (a position where the fixation target presenting means 13b cannot be used). it can. Therefore, when the fixation target presenting means 13b is not used, it can be retracted from the optical path of the ophthalmologic apparatus.

  In order to perform astigmatic axis measurement with high accuracy, it is desirable that all LED groups 131-i representing the astigmatic axis direction can be photographed.

  Therefore, for example, moving image shooting is performed with the LED group 131-i and the fixation LED 132a turned on. Then, the control unit 60 (or the operator) moves the projection means 13a (any movement among up / down, left / right, front / rear, and rotation) so that all the LED groups 131-i can be photographed on the moving image. A configuration is also possible.

  With such a configuration, it is possible to perform astigmatic axis measurement with high accuracy by automatically setting a suitable position where the astigmatic axis measuring device 13 is used.

DESCRIPTION OF SYMBOLS 1 Microscope for ophthalmic surgery 13 Astigmatic axis measuring device 13a Projection means 13b Fixation target presentation means 13c Attachment means 131 Holding part 131-i LED group 132 Main body part 132a Fixation LED
132b Base 133 Connection part 134 Arm 135 Fall prevention part 15 Objective lens 20 Illumination optical system 30 Observation optical system 56 TV camera 60 Control part 61 LED control part 62 Astigmatism information calculation part 63 Light source specification part 64 Table information E Patient eye

Claims (12)

An astigmatism axis measurement device that is attached to an ophthalmic apparatus and used to measure the astigmatism axis of a patient's eye,
A holding means for holding a plurality of first light sources arranged in a substantially circular shape, and projecting means for projecting a bright spot image from the first light source onto the cornea of the patient's eye;
Fixation target presenting means for presenting a fixation target to the patient's eye;
Mounting means for connecting the projection means and the fixation target presenting means to the ophthalmologic apparatus;
An astigmatism axis measuring device comprising:   The astigmatism axis measuring apparatus according to claim 1, wherein the fixation target presenting means is arranged inside a virtual circle connecting the plurality of first light sources. The fixation target presenting means includes
A second light source that presents the fixation target by projecting a light beam onto the patient's eye;
A rod-shaped member that holds the second light source, and a main body connected to the holding portion at a base portion at least on one end side thereof;
The astigmatic axis measuring device according to claim 1, wherein the astigmatic axis measuring device is provided.   The astigmatic axis measuring device according to claim 3, wherein a portion of the main body portion where the second light source is disposed is formed to have a diameter smaller than at least the base portion.   The astigmatic axis measuring device according to claim 3 or 4, wherein a plurality of the second light sources are provided. The attachment means includes
The astigmatism axis measuring apparatus according to claim 1, further comprising a moving mechanism that movably holds the fixation target presenting unit with respect to the ophthalmologic apparatus. The moving mechanism is
The astigmatism axis measuring apparatus according to claim 6, wherein the fixation target presenting means is rotatably held. The moving mechanism is
The astigmatism axis measuring apparatus according to claim 6, wherein the fixation target presenting means is held so as to be movable in a normal direction of an arrangement surface of the plurality of first light sources. The moving mechanism is
The astigmatism axis measuring device according to claim 6, wherein the fixation target presenting means is held so as to be movable in a direction parallel to an arrangement surface of the plurality of first light sources. An illumination optical system for illuminating the patient's eye with illumination light;
An observation optical system for guiding the reflected light of the illumination light by the patient's eye to an eyepiece;
A projecting unit that has a holding unit that holds a plurality of first light sources arranged in a substantially circular shape, and projects a bright spot image from the first light source onto the cornea of the patient's eye;
A fixation target presenting means for presenting a fixation target to the patient's eye;
An imaging optical system that images the cornea of the patient's eye in a state in which the fixation target is presented and the bright spot image is projected;
An acquisition means for acquiring information on the astigmatic axis direction of the patient's eye based on an image captured by the imaging optical system;
Identifying means for identifying a first light source at a position corresponding to the information of the astigmatic axis direction acquired by the acquiring means from the plurality of first light sources;
Control means for operating the identified first light source in a different manner from the other first light sources;
An ophthalmologic apparatus comprising:   The ophthalmologic apparatus according to claim 10, further comprising a moving mechanism that movably holds the fixation target presenting unit with respect to the ophthalmologic apparatus.   The ophthalmologic apparatus according to claim 10 or 11, wherein the fixation target presenting means is arranged outside an optical path of the photographing optical system.

Images