JP2015043929A - Perception measurement evaluation device, perception measurement evaluation method, and program - Google Patents

Abstract

PROBLEM TO BE SOLVED: To evaluate a subject by objectively measuring a temporal change of perception and using a measurement result thereof.SOLUTION: A pressure senor 12 has a portion gripped by a subject, and detects grip strength of the subject varying according to a degree of pain of a cornea as a pressure of the portion. A controller 14 acquires a detection result of the pressure sensor 12 during a time including at least a first eye opening time from an eye opening point to an eye closing point of the subject. The controller 14 measures a temporal change of perception of the cornea of the subject in the first eye opening time on the basis of the detection result of the pressure sensor 12. The controller 14 also measures the first eye opening time, a second eye opening time from an eye opening point when tear film destruction has occurred to a time point of the tear film destruction, and a third eye opening time from the time point of the tear film destruction to an eye closing time. The controller 14 performs evaluation related to an eye of the subject on the basis of the change of the perception of the cornea, and the first eye opening time to the third eye opening time.

Description

  The present invention is a perceptual measurement evaluation apparatus capable of objectively measuring a subject's perceptual change in time without making the subject feel bothersome and using the measurement result to evaluate the subject. The present invention relates to a perceptual measurement evaluation method and program.

  Conventionally, corneal perception when the patient is forced to open eyes, especially the intensity of eye pain, is sometimes measured for use in evaluation of eyes such as dry eye, cornea, and conjunctival epithelial disorder.

Typical examples of such conventional methods for measuring the intensity of eye pain include VAS (Visual Analogue Scale) and Face Scale.
VAS is a line that shows how much current pain is with a 10 cm long line with the left end “no pain” and the right end “highest imaginable pain”. This is a technique to point to as a point.
In Face Scale, facial expression indices are associated with each of multiple levels of pain, and an index that matches the facial expression of the subject is determined, and the pain intensity associated with the index is measured. The resulting method.

  Patent Document 1 discloses a tear evaporation measuring device that determines whether or not a subject's eye is in a dry eye state by measuring the tear evaporation on the surface of the eye.

Japanese Patent No. 3806908

  However, conventional methods for measuring the intensity of eye pain, represented by VAS and Face Scale, differ in the degree of pain that has been experienced so far depending on the subject. Becomes ambiguous and objective measurement is difficult. In addition, continuous measurement over several minutes to several hours is difficult, and the evaluation is made at a certain point in time, and the change in pain over time and the trend of personal feeling become unclear.

  Moreover, in the tear evaporation measuring device described in Patent Document 1, it is necessary to wear a device around the eye, and the subject's body is invaded and cannot be bothered by the subject. Moreover, it becomes evaluation at an intermittent point of time, and the change of the pain over time and the trend of individual senses become unclear.

As a method for objectively measuring the intensity of pain, a device called PAIN VISION (registered trademark) is used to artificially generate a weak current without pain and energize the subject. There is a method for determining the degree of pain as a numerical value based on the response of the subject.
By applying this method, measurement tailored to the purpose of sustained pain (evaluation of numbness, etc.), current perception threshold (minimum sensed current value), and instantaneous pain (evaluation of sensory abnormalities due to peripheral nerve damage) is possible. become. However, since it is necessary to attach the disposable electrode to the evaluation site of the subject, this method cannot be used for measuring the intensity of eye pain because the eye is an adhesive surface and cannot be mounted as the evaluation site.
Note that such a situation is not limited to the perception of the cornea, and the same is true for the perception of human parts.

  The present invention has been made in view of such a situation, and without making the subject feel bothersome, the subject's perceptual time change is measured objectively, and the measurement result is used to obtain the subject's perception. The purpose is to evaluate.

A perceptual measurement evaluation apparatus according to one aspect of the present invention provides:
Detection means for detecting the physical quantity when the predetermined physical quantity associated with human perception is changed using a predetermined part of the subject;
Acquisition means for acquiring a detection result of the detection means for a predetermined time;
Measurement evaluation means for measuring a time change of perception of the subject at the predetermined time based on the detection result of the detection means acquired by the acquisition means, and evaluating the subject based on the measurement result; ,
Is provided.

Here, in the perceptual measurement evaluation apparatus of one aspect of the present invention,
The acquisition means acquires, as the predetermined time, a detection result of the detection means for a period of time including at least a first eye opening time from the eye opening time point to the eye closing time of the subject,
The measurement evaluation unit measures a temporal change in perception of the cornea of the subject in the first eye opening time based on the detection result of the detection unit acquired by the acquisition unit, and the first eye opening time, The second eye opening time from the eye opening time point to the time point when the tear film destruction occurs and the time point from the time point when the tear film destruction occurs to the eye closing time when the tear film destruction of the subject occurs. Three eye-opening times can be measured, and the eye related to the subject can be evaluated based on the change in perception of the cornea and the measurement results for the first to third eye-opening times.

Here, the perceptual measurement evaluation apparatus according to one aspect of the present invention provides:
An index acquisition unit configured to acquire a plurality of indices related to the eye, which are set in advance based on the change in perception of the cornea and the first to third eye opening times;
The measurement evaluation means can also evaluate the eye of the previous subject by classifying the subject into any one of the plurality of indices based on the measurement result of the subject.

In the perceptual measurement evaluation apparatus according to one aspect of the present invention,
The detection means may be a pressure sensor that has a portion gripped by the subject's hand and detects the grip strength of the subject that changes according to the degree of pain of the cornea as the pressure of the portion.

Furthermore, a perceptual measurement evaluation apparatus according to one aspect of the present invention provides:
Imaging means for imaging the cornea of the subject and outputting the resulting image as a cornea image;
A graph generating means for generating a graph showing a temporal change in the detection result of the detecting means sequentially acquired by the acquiring means, and outputting as a pressure graph;
Display control means for displaying an image including at least the cornea image output from the imaging means and the pressure graph output from the graph generation means on a predetermined display device as a measurement screen;
Can be further provided.

  The perceptual measurement evaluation method and program according to one aspect of the present invention are a method and program corresponding to the above-described perceptual measurement apparatus according to one aspect of the present invention.

  According to the present invention, it is possible to evaluate a subject by objectively measuring a subject's perceptual time change and using the measurement result without making the subject feel bothersome.

It is a schematic diagram which shows the outline | summary of the cornea perception measurement evaluation apparatus which concerns on one Embodiment of this invention. It is a schematic diagram which shows an example of the external appearance structure of a pressure sensor among the cornea perception measurement evaluation apparatuses of FIG. It is a block diagram which shows the structure of the hardware of a control apparatus among the cornea perception measurement evaluation apparatuses of FIG. It is a functional block diagram which shows the functional structure of the control apparatus of FIG. It is a figure which shows an example of the measurement screen displayed in the control apparatus of FIG. FIG. 5 is a diagram showing a graph of evaluation indices used by the control device of FIG. 4. It is a figure which shows an example of the evaluation result using the parameter | index of FIG. 6, and an evaluation result. It is a figure which shows an example of the evaluation result using the parameter | index of FIG. 6, and an evaluation result. It is a figure which shows an example of the evaluation result using the parameter | index of FIG. 6, and an evaluation result. It is a figure which shows an example of the evaluation result using the parameter | index of FIG. 6, and an evaluation result. 5 is a flowchart for explaining a flow of dry eye measurement evaluation processing executed by a control device having the functional configuration of FIG. 4.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings.

FIG. 1 is a schematic diagram showing an outline of a corneal perception measurement evaluation apparatus according to an embodiment of the present invention.
The cornea perception measurement and evaluation apparatus can objectively measure the temporal change in the intensity of eye pain when the subject is forced to open his eyes, and can evaluate the eyes such as dry eye using the measurement result.

  As shown in FIG. 1, the corneal perception measurement evaluation apparatus includes a camera 11, a pressure sensor 12, a relay device 13, and a control device 14.

  The camera 11 is arranged at an arbitrary position where the subject's eyes are almost within the entire angle of view, images the subject's cornea, and outputs the resulting image data as an output signal. Note that the output signal may be still image data, but in this embodiment, moving image data is used because continuous measurement is performed in time. Hereinafter, such a moving image is referred to as “corneal image”.

FIG. 2 shows an example of the external configuration of the pressure sensor 12.
The pressure sensor 12 is configured to include a manual pump 12a and a silicon tube 12b. The pressure sensor 12 detects a pressure corresponding to the grip strength when the subject holds the manual pump 12a, and outputs an output signal (electrical) Signal).
In the present embodiment, the manual pump 12a uses a rubber ball used in a sphygmomanometer. By adopting the pressure sensor 12 using such a manual pump 12a, the invasion in the subject's body is reduced and the troublesomeness of the subject is greatly reduced as compared with the device described in Patent Document 1 described above.
The output signal may indicate an instantaneous value of the pressure, but in the present embodiment, since the measurement is continued over time, the detection result is shown over time. .
In the state shown in FIG. 1, the measurement refers to the manual pump 12a of the pressure sensor 12 with a gripping force corresponding to the degree of eye pain for a certain period of time from when the subject was forced to open his eyes. , And continuously acquiring the output signal of the pressure sensor 12 and the cornea image at that time. Further details regarding the measurement will be described later.

The relay device 13 in FIG. 1 is not a particularly essential component for the corneal sensory measurement evaluation apparatus, but in this embodiment, a general-purpose personal computer is employed as the control device 14, and therefore the outputs of the camera 11 and the pressure sensor 12 are used. A signal can be input to the control device 14.
That is, in the relay device 13, the input end is configured so that each output cable of the camera 11 and the pressure sensor 12 can be connected, and the output end is configured so that one end of a USB (Universal Serial Bus) cable can be connected. Has been. The other end of the USB is connected to the control device 14.
Thereby, the output signals of the camera 11 and the pressure sensor 12 are input to the control device 14 via the relay device 13, respectively.

As described above, the control device 14 is composed of a general-purpose personal computer in the present embodiment, and controls the overall operation of the corneal sensory measurement evaluation device.
The control device 14 acquires the output signals of the camera 11 and the pressure sensor 12 via the relay device 13, respectively, and the cornea image corresponding to the output signal of the camera 11 and the voltage of the output signal of the pressure sensor 12 (that is, the pressure). And the display contents are stored.
Specifically, the control device 14 graphs the voltage change of the output signal of the pressure sensor 12 in real time, and displays the graph (hereinafter referred to as “pressure graph”) on the window in the screen simultaneously with the corneal image. To display.
The control device 14 stores the pressure graph and the corneal image at the same time using application software that can capture the screen as moving image data (hereinafter referred to as “screen moving image capture software”).
In addition, the control device 14 controls the screen moving image capture software and performs batch control.

  FIG. 3 is a block diagram illustrating a hardware configuration of the control device 14.

  The control device 14 includes a CPU (Central Processing Unit) 21, a ROM (Read Only Memory) 22, a RAM (Random Access Memory) 23, a bus 24, an input / output interface 25, an input unit 26, and an output unit 27. A storage unit 28, a communication unit 29, and a drive 30.

The CPU 21 executes various processes according to a program recorded in the ROM 22 or a program loaded from the storage unit 28 to the RAM 23.
The RAM 23 appropriately stores data necessary for the CPU 21 to execute various processes.

  The CPU 21, ROM 22, and RAM 23 are connected to each other via a bus 24. An input / output interface 25 is also connected to the bus 24. An input unit 26, an output unit 27, a storage unit 28, a communication unit 29, and a drive 30 are connected to the input / output interface 25.

The input unit 26 includes a keyboard, a mouse, and the like, and inputs various types of information according to user instruction operations.
The output unit 27 includes a display (a display unit 71 in FIG. 4 described later), a speaker, and the like, and outputs images and sounds.
The storage unit 28 is composed of a hard disk or the like, and stores various information data.
The communication unit 29 controls communication performed with another terminal (not shown) via the network, and in the present embodiment, is performed between the camera 11 and the pressure sensor 12 via the relay device 13. Control communication

  A removable medium 31 composed of a magnetic disk, an optical disk, a magneto-optical disk, a semiconductor memory, or the like is appropriately attached to the drive 30. The program read from the removable medium 31 by the drive 30 is installed in the storage unit 28 as necessary. The removable medium 31 can also store various data stored in the storage unit 28 in the same manner as the storage unit 28.

FIG. 4 is a functional block diagram showing a functional configuration of the control device 14 of FIG.
In the CPU 21 of the control device 14, a main control unit 51, a corneal image acquisition unit 52, a sensor output acquisition unit 53, a graph generation unit 54, a display control unit 55, a storage control unit 56, and a measurement evaluation unit 57. The index acquisition unit 58 functions in cooperation with predetermined software.
The storage unit 28 includes a log storage unit 81 and an index storage unit 82. The output unit 27 is provided with a display unit 71.

The main control unit 51 controls the entire control device 14. The main control unit 51 is provided with a time measuring unit 61 for measuring time.
The cornea image acquisition unit 52 acquires the data (output signal) of the cornea image output from the camera 11 via the relay device 13 (FIG. 1) and the communication unit 29 (FIG. 3), and displays the display control unit 55, The data is supplied to the storage control unit 56 and the measurement evaluation unit 57, respectively.
The sensor output acquisition unit 53 acquires the output signal (pressure detection result) of the pressure sensor 12 via the relay device 13 (FIG. 1) and the communication unit 29 (FIG. 3), and supplies it to the graph generation unit 54. .
The graph generation unit 54 generates pressure graph data by plotting a time series of output signals of the pressure sensor 12 (measured voltage values sampled at a predetermined sampling period), and displays the display control unit 55. It supplies to each of the control part 56 and the measurement evaluation part 57. FIG.

The display control unit 55 performs control for causing the display unit 71 to display a screen including a cornea image and a pressure graph (hereinafter referred to as “measurement screen”).
The storage control unit 56 executes control for capturing the measurement screen as moving image data and storing it in the log storage unit 81, and control for storing the measurement result and evaluation result by the measurement evaluation unit 57 described later in the log storage unit 81.

FIG. 5 shows an example of such a measurement screen.
The measurement screen is composed of a plurality of display areas a1 to a5.
The display area a1 displays the elapsed time, the measured voltage of the pressure sensor 12, and the state of the operating mode in real time during measurement. Hereinafter, such a display area a1 is referred to as an “operation parameter display window a1”.
The display area a2 displays a corneal image in real time. Hereinafter, such a display area a2 is referred to as a “video display window a2.”
The display area a3 displays information about the subject under measurement. The subject information is input and edited on a setting screen (not shown). Hereinafter, such display area a3 is referred to as “subject information window a3”.
The display area a4 displays the pressure graph in real time. Hereinafter, such a display area a4 is referred to as a “graph display window a4”.
The display area a5 displays the measurement result in real time. Hereinafter, such a display area a5 is referred to as a “measurement result display window a5”.

Here, the measurement of corneal perception will be described in detail.
First, as a preliminary preparation before measurement, the subject holds the pressure sensor 12 with the maximum gripping force as the degree of eye pain, and the control device 14 maximizes the pressure value (output voltage value of the pressure sensor 12). A value is recorded in a predetermined area of the storage unit 28.
And the control apparatus 14 shall acquire the output of the pressure sensor 12 by making a maximum value into a limit. That is, when the output voltage value of the pressure sensor 12 is greater than or equal to the maximum value, the control device 14 acquires it as the maximum value. Alternatively, a limit may be provided on the output of the pressure sensor 12 so that a voltage higher than the maximum value cannot be output, or the subject cannot hold the manual pump 12a with a gripping force higher than the maximum value.
Next, as described above, the subject holds the manual pump 12a of the pressure sensor 12 with a gripping force corresponding to the degree of pain of the eye for a predetermined time or longer after the forced eye opening. The output signal of the pressure sensor 12 and the cornea image are acquired continuously in time. In this way, measurement of corneal perception is performed.

More specifically, the measurement start time is the time when a predetermined operation (for example, an operation of pressing the “Enter” key) is performed by the examiner on the input unit 26 of the control device 14.
When the measurement is started, the timing by the timer 61 and the input of the output signals of the camera 11 and the pressure sensor 12 to the control device 14 are also started. A pressure graph in which the time point of the start of measurement, that is, the time point of start of time measurement by the time measuring unit 61 is time 0, is generated and displayed in the graph display window a4. The measurement start time is recognized as an event “START” by the control device 14 and is also displayed below the graph display window a4.

  After starting the measurement, have the subject forcibly open his eyes. When the eye is forcibly opened, more precisely, when the subject blinks for the last time, the event “open eye” is detected by the control device 14 and is also displayed below the graph display window a4.

As other events during measurement, there are “Break” and “Closed eye”.
The event “Break” is detected when the tear layer is broken and is also displayed below the graph display window a4. The tearing of the tear layer is also called “tear layer destruction”.
The event “closed eye” is detected at the moment (time) of the blink and is also displayed below the graph display window a4.

  The detection of the events “open eye”, “Break”, and “closed eye” being measured is not particularly limited, and a method of automatically detecting the corneal image by image processing may be employed. In this embodiment, in order to obtain accuracy, a method of detecting by a predetermined operation (for example, pressing operation of “Space” key) by an inspector on the input unit 26 of the control device 14 is employed.

  In addition, although the end of measurement is not particularly limited, in this embodiment, the measurement is automatically ended after 10 seconds have elapsed after the event “eyes closed”.

  When such measurement is completed, the measurement evaluation unit 57 in FIG. 4 obtains measurement values “A”, “B”, “A + B”, “pain value”, “differential value”, and “integral value” as measurement results. Is obtained or calculated.

  The measurement value “A” is the time from the event “open eye” to the event “Break”. In this embodiment, “sec” is adopted as a unit. The measured value “A” is also referred to as tear film destruction time or BUT (Break Up Time).

  The measurement value “B” is the time from the event “Break” to the event “eyes closed”. In this embodiment, “sec” is adopted as a unit.

  The measured value “A + B” is the time from the event “open eye” to the event “closed eye”. In this embodiment, “sec” is adopted as a unit.

The measured value “pain value” refers to the voltage value of the output signal of the pressure sensor 12 at a predetermined time when the pressure (output voltage value) when the subject grips the pressure sensor 12 when the pain is maximum is the maximum value. It is the ratio of the (instantaneous value at a predetermined point in the pressure graph) to the maximum value. Therefore, the unit is “%”.
The acquisition timing of the measurement value “pain value” is not particularly limited, and may be every predetermined time interval. However, in the present embodiment, the measurement value “pain value” is acquired at the end of each period of the measurement values “A” and “B”. Shall be.

The measured value “differential value” is the rate of time change of the measured value “pain value”, that is, the gradient of the pressure graph. In this embodiment, [pain value / sec] is adopted as a unit.
In the present embodiment, the measured value “differential value” is calculated for each period of the measured values “A”, “B”, and “A + B”.

The measured value “integrated value” is the integrated value of the measured value “pain value” within a predetermined time, that is, the area of the pressure graph. In this embodiment, [pain value × sec] is adopted as a unit.
In the present embodiment, the measured value “integrated value” is calculated for each period of the measured values “A”, “B”, and “A + B”.

  When the measurement evaluation unit 57 calculates the measurement values “A”, “B”, “A + B”, “pain value”, “differential value”, and “integration value”, at least one of these values is calculated. Use to evaluate the subject regarding eyes such as dry eye.

The evaluation method is not particularly limited as long as it uses at least one of the measurement values “A”, “B”, “A + B”, “pain value”, “derivative value”, and “integral value”. In this embodiment, the following method is adopted.
That is, in this embodiment, five patterns P1 to P5 are defined in advance as evaluation indexes so that the severity of dry eye increases in the order. Therefore, based on the measurement results of the subject (measured values “A”, “B”, “A + B”, “pain value”, “differential value”, and “integral value”), the subject is classified into five patterns P1 to P5. By classifying any of them, the severity of the subject's dry eye is evaluated.

  Hereinafter, the evaluation method of the present embodiment will be described in detail with reference to FIGS.

FIG. 6 shows a graph of five patterns P1 to P5 of evaluation indexes.
As described above, five patterns P1 to P5 are defined in advance as indicators of the severity of dry eye, and the severity increases in that order. In the present embodiment, the data shown in FIG. 6 is stored in the index storage unit 82 in FIG.

  The pattern P1 means that the eyes can be stably opened for 10 seconds or more after the tear film destruction (after the event “Break”) (the measured value “B” is 10 seconds or more), or the tear film destruction time (BUT = measured value “ A ") refers to a pattern of 20 seconds or longer.

  The pattern P2 refers to a pattern that can be stably opened for less than 1 to 10 seconds (measured value “B” is less than 1 to 10 seconds) even after tear film destruction (after the event “Break”).

  The pattern P3 refers to a pattern that feels pain after tear film destruction (after the event “Break”), but can be opened for 10 seconds or longer (measured value “B” is 10 seconds or longer).

  The pattern P4 refers to a pattern that feels pain after tear film destruction (after the event “Break”) but can be opened for less than 1 to 10 seconds (measured value “B” is less than 1 to 10 seconds).

  The pattern P5 is a pattern in which the tear film is not destroyed (the event “Break” is not generated), the eye is closed (the event “Closed eye” is generated), or the eye opening cannot be maintained.

  Here, the preliminary examination performed by the present inventor before introducing the above-described five-stage patterns P1 to P5 evaluation method will be described.

Initially, the present inventor had set the following two patterns (1) and (2) based on BUT (= measurement value “A”) as a hypothesis.
The pattern (1) is a pattern of BUT> closed eyes, that is, a pattern in which the event “closed eye” occurs (closes eyes early) before the event “Break” occurs. When classified into pattern (1), it is evaluated that hypersensitivity of the cornea has occurred.
Pattern (2) refers to a pattern in which BUT <closed eyes, that is, a pattern in which the eyes can still be opened after the occurrence of the event “Break”. When classified as pattern (2), it is evaluated that corneal hypersensitivity has not occurred.

The inventor performs the above-described measurement on nine subjects (6 men and 3 women) using the corneal perception measurement evaluation apparatus of the present embodiment, and first, the two patterns (1) and (2) described above. Evaluation to classify was performed.
However, it was difficult to classify into two patterns (1) and (2).

Therefore, the present inventor, based on the idea of the conventional evaluation of dry eye “whether it is possible to open the eyes without blinking for 10 seconds”, based on “open eye time” and “pain” as the basic axes. The evaluation method of the five-stage patterns P1 to P5 was invented.
Here, “eye opening time” means a measured value “A + B”, but when tear film destruction occurs (when event “Break” occurs), BUT (= measured value “A”) The measured value “B” is also included in the consideration.
For “pain”, not only the instantaneous value but also the degree of change in pain level and the duration of pain level need to be determined, so not only the measured value “pain value” but also the measured value “ It is preferable to make a determination based on “differential value” or “integral value”.

Furthermore, the present inventor uses the cornea perception measurement evaluation apparatus of the present embodiment, based on the above-described measurement results for the same nine subjects (six men and three women), through five patterns P1 to P1. The evaluation classified into P5 was performed.
As a result, 2 people are classified into the pattern P1, 0 people are classified into the pattern P2, 4 people are classified into the pattern P3, 2 people are classified into the pattern P4, and 1 people are classified into the pattern P5. Was classified.

Here, the present inventor has found that there is a possibility that some kind of sensory change may occur due to tear film destruction (event “Break” occurs) due to the fact that the pattern P2 is zero. Obtained.
However, among subjects classified into this pattern 1, pain is relieved from reflex responses to noxious stimuli such as increased stimulation of lacrimal tear secretion and frequent incomplete blinks. Some can be opened. In addition, with regard to the patterns P3 to P5, even if there is pain, there are subjects who can open their eyes by reflex responses to noxious stimuli such as increased lacrimal secretion and incomplete blinks. Some subjects end up doing it.
Therefore, it is not appropriate to evaluate a subject with two simple patterns (1) and (2) based on BUT (= measurement value “A”), and “open eye time” and “ The present inventor thought that it is preferable to evaluate the subject with patterns P1 to P5 based on “pain”.

  The specific evaluation results of the nine subjects classified into the patterns P1, P3, P4, and P5 are shown in FIGS. 7 to 10, respectively.

FIG. 7 shows the measurement results and evaluation results of one subject classified into the pattern P1.
The table in FIG. 7A shows each measured value. The item “open eye” indicates the time from the start of measurement (when the event “start” occurs) until the event “open eye” occurs. The item “Break” indicates the time from the start of measurement (when the event “start” occurs) until the event “Break” occurs. The item “closed eyes” indicates the time from the start of measurement (when the event “start” occurs) until the event “closed eyes” occurs.
FIG. 7B shows a timing chart of the output signal of the pressure sensor 12. The horizontal axis indicates time (sec), and the vertical axis indicates the output (mV) of the pressure sensor 12. That is, the waveform in FIG. 7B corresponds to a pressure graph.
Note that the items relating to the table in FIG. 7A and the timing chart in FIG. 7B are the same as those in FIGS. 8 to 10 described later, and thus description of these items is omitted in FIGS. To do.

As shown in FIG. 7, the subject opened his eyes at 13.8 seconds from the start of measurement, BUT (= measurement value “A”) was 34.3 seconds, and thereafter 31.1 seconds. Eye opening is possible.
For this reason, although this test subject is the pattern P1 or the pattern P3, since the output of the pressure sensor 12 (corresponding to the measured value “pain value”) is almost constant, after tear film destruction (after the event “Break”) ) I did not feel much pain and was classified into pattern P1.

FIG. 8 shows the measurement results and evaluation results of one subject classified into the pattern P3.
As shown in FIG. 8, this subject opened his eyes at 25.8 seconds after the start of measurement, and BUT (= measurement value “A”) was 16.9 seconds (42. In FIG. 8B). 7 seconds), and after that, the eyes can be opened for 85.0 seconds.
For this reason, although this test subject is the pattern P1 or the pattern P3, the output of the pressure sensor 12 (corresponding to the measurement value “pain value”) increases rapidly after the tear film destruction (after the event “Break”), and then increases to a high value. It can be judged that the patient feels pain because he / she continues to maintain.
In this regard, the measured values “differential value” and “integral value” are apparent when FIG. 7 and FIG. 8 are compared. In other words, pain can be determined based on the measured value “pain value”, but it is preferable to determine based on the measured values “differential value” and “integrated value”.
As a result, this test subject was classified into the pattern P3.

FIG. 9 shows the measurement results and evaluation results of one subject classified into the pattern P4.
As shown in FIG. 9, this subject opened his eyes at 8.0 seconds after the start of measurement, and BUT (= measurement value “A”) was 2.7 seconds (10. 7 seconds), and then the eyes could be opened only for 7.0 seconds.
For this reason, this test subject is the pattern P2 or the pattern P4, but the output of the pressure sensor 12 (corresponding to the measured value “pain value”) is rapidly increased after tear film destruction (after the event “Break”). Therefore, this test subject was classified into the pattern P4.

FIG. 10 shows the measurement results of one subject classified into the pattern P5.
As shown in FIG. 10, this subject opened his eyes at the time of 3.1 seconds from the start of measurement, and tear film destruction did not occur (event “Break” did not occur). 5.4 The eyes were opened and closed for only one second.
For this reason, this test subject was classified into pattern P5.
Note that the output of the pressure sensor 12 (corresponding to the measured value “pain value”) in FIG. 5B also fluctuates, and the measured value “pain value” is also 72%, so it can be determined that pain was also felt. .

Next, with reference to FIG. 11, a measurement and evaluation process (hereinafter referred to as “dry eye measurement evaluation process”) related to dry eye and the like executed by the control device 14 of such a cornea perception measurement evaluation apparatus will be described. To do.
FIG. 11 is a flowchart illustrating the flow of dry eye measurement evaluation processing executed by the control device 14 having the functional configuration of FIG.

  In the state shown in FIG. 1, when a predetermined operation (for example, an operation of pressing the “Enter” key) is performed by the inspector on the input unit 26 of the control device 14, the dry eye measurement evaluation process is started. A series of processing after step S1 is executed.

In step S <b> 1, the timer 61 starts timing, the cornea image acquisition unit 52 starts acquiring the camera output signal (corneal image data), and the sensor output acquisition unit 53 acquires the output signal of the pressure sensor 12. Start. The graph generation unit 54 starts generating a pressure graph based on the output signal of the pressure sensor 12 sequentially acquired by the sensor output acquisition unit 53.
As a result, the event “START” occurs.

  In step S2, the display control unit 55 starts control to display the measurement screen (see FIG. 5) including the pressure graph and the cornea image on the display unit 71, and the storage control unit 56 displays the measurement screen as moving image data. As a result, the control to capture and store in the log storage unit 81 is started.

In step S <b> 3, the main control unit 51 determines whether or not the eye has been opened, that is, whether or not the event “eye opening” has occurred.
As described above, the detection method of the occurrence of the event “open eye” is not particularly limited, but here, by a predetermined operation (for example, pressing operation of the “Space” key) by the examiner on the input unit 26 of the control device 14. A detection method is employed.
Therefore, if the predetermined operation is not performed, it is determined as NO in Step S3, and the process returns to Step S3. That is, the determination process in step S3 is repeated until the predetermined operation is performed.
When the predetermined operation is performed, it is determined as YES in Step S3, and the process proceeds to Step S4.
In step S4, the main control unit 51 records the time when the predetermined operation is performed (the time measured by the time measuring unit 61), that is, the time when the event “open eye” occurs in the log storage unit 81 or the like as the eye opening point. To do.

In step S5, the main control unit 51 determines whether or not a break has occurred, that is, whether or not the event “Break” has occurred.
As described above, the detection method of the occurrence of the event “Break” is not particularly limited, but here, by a predetermined operation (for example, pressing operation of the “Space” key) by the inspector on the input unit 26 of the control device 14. A detection method is employed.
Therefore, if the predetermined operation is not performed, it is determined as NO in Step S5, and the process proceeds to Step S7.
In step S <b> 7, the main control unit 51 determines whether or not the eyes are closed, that is, whether or not the event “eyes closed” has occurred.
As described above, the method for detecting the occurrence of the event “closed eyes” is not particularly limited, but here, a predetermined operation (for example, pressing of the “Space” key by the examiner on the input unit 26 of the control device 14 is performed. , And a “depression operation that can be distinguished from“ Break ”).
Therefore, if the predetermined operation is not performed, it is determined as NO in Step S7, and the process returns to Step S5. That is, the loop process of step S5 (NO) and step S7 (NO) is repeated until a predetermined operation for generating the event “Break” or “closed eye” is performed.

When a predetermined operation for generating the event “Break” is performed, it is determined as YES in Step S5, and the process proceeds to Step S6.
In step S6, the main control unit 51 records the time when the predetermined operation is performed (the time measured by the time measuring unit 61), that is, the time when the event “Break” occurs in the log storage unit 81 or the like as the Break point. To do.
Thereby, the process proceeds to the process of step S7 described above.

If a predetermined operation for generating the event “eyes closed” is performed, it is determined as YES in Step S7, and the process proceeds to Step S8.
In step S8, the main control unit 51 records the time when the predetermined operation is performed (the time measured by the time measuring unit 61), that is, the time when the event “eyes closed” occurs as the closed eye point in the log storage unit 81 or the like. To do.
Thereafter, when a predetermined time (for example, 10 seconds) elapses, the process proceeds to step S9.

In step S9, the time measuring unit 61 ends the time measurement, the corneal image acquisition unit 52 ends the acquisition of the camera output signal (corneal image data), and the sensor output acquisition unit 53 acquires the output signal of the pressure sensor 12. Terminate.
This completes the measurement.

  In step S <b> 10, the measurement evaluation unit 57 calculates the measurement result based on the stored contents of the log storage unit 81. For example, the time from the eye opening point to the Break point is calculated as the measurement value “A”. The time from the Break point to the closed eye point is calculated as the measurement value “B”. The time from the eye opening point to the eye closing point is calculated as the measurement value “A + B”. In addition, the measured values “pain value”, “differential value”, and “integral value” are also calculated.

In step S <b> 11, the measurement evaluation unit 57 performs dry eye evaluation based on the comparison between the measurement result calculated in this way and the index acquired by the index acquisition unit 58. For example, in the present embodiment, as described above, the subject is classified into any one of the five patterns P1 to P5 based on the index of FIG. 6 (see the evaluation examples of FIGS. 7 to 10).
Thereby, the dry eye measurement evaluation process is completed.

  Although one embodiment of the present invention has been described above, the present invention is not limited to the above-described embodiment. That is, the present invention includes modifications and improvements as long as the object of the present invention can be achieved.

For example, in the above-described embodiment, the evaluation method using the index of FIG. 6 classified into any one of the five patterns P1 to P5 is employed, but the present invention is not particularly limited thereto.
For example, the number of indicators (patterns) is not particularly limited, and may be 5 or less, or 5 or more.
Further, for example, by adopting a method of comprehensively judging by combining an arbitrary number of evaluations of the present embodiment and further evaluations (1) to (5) as described below. More detailed classification becomes feasible.
Evaluation (1) is evaluation based on the amount of lacrimal secretion. The amount of lacrimal secretion is measured by the result of the Schirmer test, for example. That is, the amount of tears permeated into the tear paper when the edge of the tear paper is folded and the eye is sandwiched between the lower conjunctival sac for 5 minutes is measured as the amount of tear secretion.
Evaluation (2) is an evaluation based on fluorescein vital staining. Specifically, for example, 1 μl of sodium fluorescein staining solution is dropped onto 1 μl conjunctival sac, and 1 minute later, the degree of fluorescein staining in the corneal epithelium is calculated as a score, and the score is used for evaluation. More specifically, for example, a maximum score of 3 points is assigned to each of the regions when the cornea is divided into the upper, middle, and lower regions, and a total of nine points is evaluated as the highest score.
Evaluation (3) is an evaluation based on a questionnaire survey. As a questionnaire, for example, subjective anatomical scale (VAS) is used, and the degree of subjective symptom (dryness of eyes and pain) of a patient is recorded as a score from 0 to 100 points, and evaluation is performed based on the score. Is called. More specifically, for example, the evaluation is performed based on a score where 0 is a state where there is no eye dryness and 100 is an unbearable state of eye dryness.
The evaluation (4) is an evaluation that considers the Break shape with respect to the above-described BUT (tear layer destruction time). As the Break shape, for example, area, line, dot, spot or the like is used.
Evaluation (5) is an evaluation of incomplete blinks, and is an evaluation based on observation results of movements of the upper and lower eyelids.

For example, in the above-described embodiment, the pressure sensor 12 is used for the purpose of expressing the perception of the cornea (degree of pain) by the strength of the grip strength of the subject, that is, the pressure value indicating the degree of pain. However, the usage purpose of the pressure sensor 12 is not particularly limited to this.
For example, you may use perception of parts other than corneas, such as a tooth | gear, in order for a test subject to express with the strength of grip strength. This makes it possible to measure and evaluate the perception of parts other than the cornea such as teeth.
Further, for example, the pressure sensor 12 may be used for the purpose of causing the patient during the operation to hold it during surgery under local anesthesia or the like. This makes it possible for the surgeon to easily know the sense of the patient during the operation.
Similarly, the pressure sensor 12 may be used for the purpose of causing a patient to receive an anesthetic to grasp it. Thereby, the analgesic effect of an anesthetic can be evaluated.
Further, for example, the pressure sensor 12 may be used for the purpose of arbitrarily selecting not only pain but also an evaluation scale of perception such as anxiety, fear, excitement, etc., and expressing the perception by the strength of the grip strength of the subject. Thereby, measurement and evaluation of an arbitrary evaluation scale are possible.

Further, for example, in the above-described embodiment, the pressure sensor 12 employs a method in which a subject grips with a hand and outputs a pressure corresponding to the grip strength. However, the method of the pressure sensor 12 is not particularly limited to this.
For example, the pressure sensor 12 may be configured in the shape of a pedal that the subject steps on with his / her foot and outputs a pressure corresponding to the degree of depression of the pedal.

Furthermore, in the above-described embodiment, the pressure sensor 12 is employed. However, the pressure sensor 12 is not particularly limited, and a predetermined physical quantity associated with a predetermined human perception is changed using a predetermined portion of the subject. It is sufficient if the sensor can detect the physical quantity for a predetermined time width.
However, considering the fact that among human parts, it is the hand that is most excellent at transmitting the degree of subtle strength, and that there are many uses for diagnosis in hospitals, etc., the sensor described above As in the embodiment, when the pressure associated with corneal perception is changed by grasping with the hand of the subject, it is preferable to employ the pressure sensor 12 that can detect the pressure value for a predetermined time width. It is.

A series of processes according to the above-described embodiment can be executed by hardware or can be executed by software.
In other words, it is sufficient if the control device 14 has a function capable of executing a series of processes by the above-described units as a whole, and how each functional block is configured to realize this function is particularly limited. Not. That is, each functional block is not limited to the form shown in FIG. 4, and the functional blocks shown in FIG. 4 can be arbitrarily divided or combined, or arbitrary functions can be deleted or added. Each functional block may be constituted by hardware alone, software alone, or a combination thereof.

When a series of processing is executed by software, a program constituting the software is installed on a computer such as the control device 14 from a network or a recording medium.
The computer may be a computer incorporated in dedicated hardware. Further, the computer may be a computer that can execute various functions by installing various programs, for example, a general-purpose personal computer.

  A recording medium including such a program is provided not only to a removable medium distributed separately from the apparatus main body in order to provide the program to the user, but also to the user in a state of being incorporated in the apparatus main body in advance. It consists of a recording medium. The removable medium is composed of, for example, a magnetic disk (including a floppy disk), an optical disk, a magneto-optical disk, or the like. The optical disk is composed of, for example, a CD-ROM (Compact Disk-Read Only Memory), a DVD (Digital Versatile Disk), or the like. The magneto-optical disk is configured by an MD (Mini-Disk) or the like. Further, the recording medium provided to the user in a state of being pre-installed in the apparatus main body is configured by the ROM 22 of FIG. 3 in which a program is recorded, or a storage unit 28 such as a hard disk, for example.

  Note that the step of describing the program recorded on the recording medium is not limited to the processing performed in time series along the order, but also the processing executed in parallel or individually even if not necessarily processed in time series. Is also included.

In summary, the present invention is not particularly limited to corneal perception, and can be applied to a field in which various perceptions are objectively measured and evaluated based on the measurement results.
However, the present invention is particularly suitable when applied to a cornea perception measurement evaluation apparatus.
The reason will be described below.

First, the reason why the present invention is preferably applied in the ophthalmic field will be described.
“Muller LJ, Vrensen GF, Peels L, et al Architecture of human corneal. Yes.
According to this document, the human cornea is the organ that converts the strongest pain generation in the human body, and the density of free nerve endings is about 40 times that of the dental pulp.
In this document, nerves distributed in the cornea, which is the periphery of the trigeminal branch I, are considered to be a stronger source of pain than the tooth nerve (dental pulp), which is the periphery of the branch II.
The teeth are protected on the outer pulp wall by the jawbone (alveolar bone), periodontal ligament, enamel, dentin and cementum. On the other hand, the ocular surface (cornea) is protected only by the tear film (3 layers: oil layer, moisture layer, mucin layer).
In the tooth, pain develops when the outside world and the pulp are close to each other due to dental caries (decayed teeth) or tooth loss (partially missing teeth), but in the eyes, the tear film is destroyed by the pathological condition such as dry eye. It is thought that pain will be easily developed.
The subject only has to hold the pressure sensor 12 at a pressure corresponding to the degree of pain, which is convenient. Thus, the present invention is preferably applied in the ophthalmic field.

Here, the mechanism of pain development in the eye is considered.
Although it is a hypothesis, it is assumed that the following steps Sa to Sc are performed in this order.
In step Sa, a nociceptive receptor is activated by contact. For example, when a foreign object enters the eye, it is noticed and pain occurs.
In step Sb, a nociceptive receptor is activated by a chemical substance (inflammatory cytokine) or the like. For example, the eyes are swollen due to conjunctivitis, or the eyes feel smoky in a smoke environment.
In step Sc, the nociceptive receptor is activated by temperature change and PH change. For example, tears will evaporate and the ingredients will change, and you will see cold eye drops. It also becomes dry eye. Or, the hot spring water may enter the eye at the hot spring.

In order to evaluate an eye having such a pain manifestation mechanism, the corneal sensory measurement evaluation apparatus of the present invention that can measure the continuous change in the above steps Sa to Sc from the viewpoint of “pain” is applied. It is preferable.
In other words, by applying the corneal sensory measurement evaluation apparatus of the present invention, it becomes possible to evaluate anterior eye lesions typified by dry eye from the viewpoint of “pain”, unexplained eye discomfort (indefinite complaints), etc. Can be objectively evaluated, and corneal perception can be evaluated before and after ophthalmic surgery such as LASIK and corneal transplantation.

  As a conventional cornea sensor, a Kosbonne type cornea sensor is known. However, since this can only determine a sensory response due to contact, it is very difficult to measure a continuous change in the above steps Sa to Sc. It is difficult to. However, the sensation of the subject can be objectively evaluated by combining the corneal perception measurement and evaluation apparatus of the present invention with an existing Koschbone type corneal sensor.

As described above, the cornea perception measurement evaluation apparatus of the present invention only needs to include the following detection means, acquisition means, and measurement evaluation means, and the embodiment thereof is not particularly limited.
That is, the detection means detects a physical quantity when a predetermined physical quantity associated with the perception of the cornea is changed using a predetermined part of the subject. In the above-described embodiment, the detection means is configured by the pressure sensor 12 of FIG.
The acquisition means acquires the detection result of the detection means while at least including the first eye opening time from the eye opening time to the eye closing time of the subject. Here, the first eye opening time corresponds to the measurement value “A + B” in the above-described embodiment. In the above-described embodiment, the acquisition unit is configured by the sensor output acquisition unit 53 shown in FIG.
The measurement evaluation means measures a temporal change in the perception of the subject's cornea during the first eye opening time based on the detection result of the detection means acquired by the acquisition means. In the above-described embodiment, the measurement value “pain value”, the measurement value “derivative value”, and the measurement value “integration value” at each time point are measured as time changes in perception of the cornea.
The measurement evaluation means also includes the first eye opening time, the second eye opening time from the eye opening time to the time when the tear film destruction occurred, and the tear film destruction when the tear film destruction of the subject occurred. The third eye opening time from the time point to the eye closing time is measured. Here, the second eye opening time corresponds to the measurement value “A” in the above-described embodiment. The third eye opening time corresponds to the measurement value “B” in the above-described embodiment.
And a measurement evaluation means evaluates about a test subject's eyes based on the measurement result about the change of the perception of the cornea and the 1st eye opening time thru / or the 3rd eye opening time.
In this way, it is possible to objectively measure the temporal change of corneal perception when the subject is forced to open his eyes, and use the measurement results to evaluate the eyes such as dry eye, cornea, conjunctival epithelial disorder, etc. It becomes possible.

Furthermore, the corneal perception measurement evaluation apparatus of the present invention can acquire a plurality of indices relating to the eye that are set in advance based on changes in corneal perception and first to third eye opening times. For example, in the above-described embodiment, the index of FIG. 6 classified into any one of the five patterns P1 to P5 is employed.
In this case, the measurement evaluation means can evaluate the eye of the examiner by classifying the subject into one of a plurality of indexes based on the measurement result of the subject.
Thereby, more appropriate and highly accurate evaluation becomes possible.

Further, the detection means may be a pressure sensor that has a part gripped by the subject's hand and detects the gripping force of the subject that changes according to the degree of pain of the cornea as the pressure of the part.
Considering the fact that the best part of the human part is the hand to transmit the degree of subtle strength, and that there are many uses for diagnosis in hospitals, etc. Is preferred.

Furthermore, the cornea perception measurement evaluation apparatus of the present invention may include an imaging unit, a graph generation unit, and a display control unit.
The imaging means images the subject's cornea and outputs the resulting image as a cornea image. In the above-described embodiment, the imaging means is configured by the camera 11 shown in FIG.
The graph generation unit generates a graph indicating a temporal change in the detection result of the detection unit sequentially acquired by the acquisition unit, and outputs the graph as a pressure graph. In the above-described embodiment, the graph means is configured by the graph generation unit 54 shown in FIG.
The display control unit displays an image including at least the cornea image output from the imaging unit and the pressure graph output from the graph generation unit on a predetermined display device as a measurement screen. In the above-described embodiment, the display control means is configured by the display control unit 55 shown in FIG. In the above-described embodiment, the display device is configured by the display unit 71 shown in FIG.
In this way, the inspector can see the measurement screen as shown in FIG. 5 in real time, which is helpful in measurement and evaluation. In addition, the measurement screen can be easily captured and recorded as moving image data, which is useful for later verification and confirmation.

Furthermore, as described above, the present invention is not limited to the corneal perception measurement evaluation apparatus, but may be any perception measurement evaluation apparatus that measures and evaluates human perception in general.
That is, the perceptual measurement evaluation apparatus to which the present invention is applied is
Detection means for detecting the physical quantity when the predetermined physical quantity associated with human perception is changed using a predetermined part of the subject;
Acquisition means for acquiring a detection result of the detection means for a predetermined time;
Measurement evaluation means for measuring a time change of perception of the subject at the predetermined time based on the detection result of the detection means acquired by the acquisition means, and evaluating the subject based on the measurement result; ,
A perceptual measurement evaluation apparatus including
Thereby, it is possible to objectively measure the subject's perceptual change in time and evaluate the subject by using the measurement result.

  DESCRIPTION OF SYMBOLS 11 ... Camera, 12 ... Pressure sensor 12 ... Relay device, 14 ... Control device, 21 ... CPU, 26 ... Input part, 27 ... Output part, 28 ... Storage unit 51 ... Main control unit 52 ... Cornea image acquisition unit 53 ... Sensor output acquisition unit 54 ... Graph generation unit 55 ... Display control unit 56 ... Storage Control unit 57 ... Measurement evaluation unit 58 ... Index acquisition unit 71 ... Display unit 81 ... Log storage unit 82 ... Index storage unit

Claims (7)

Detection means for detecting the physical quantity when the predetermined physical quantity associated with human perception is changed using a predetermined part of the subject;
Acquisition means for acquiring a detection result of the detection means for a predetermined time;
Measurement evaluation means for measuring a time change of perception of the subject at the predetermined time based on the detection result of the detection means acquired by the acquisition means, and evaluating the subject based on the measurement result; ,
A perceptual measurement evaluation apparatus. The acquisition means acquires, as the predetermined time, a detection result of the detection means for a period of time including at least a first eye opening time from the eye opening time point to the eye closing time of the subject,
The measurement evaluation unit measures a temporal change in perception of the cornea of the subject in the first eye opening time based on the detection result of the detection unit acquired by the acquisition unit, and the first eye opening time, The second eye opening time from the eye opening time point to the time point when the tear film destruction occurs and the time point from the time point when the tear film destruction occurs to the eye closing time when the tear film destruction of the subject occurs. The perceptual measurement according to claim 1, wherein three eye-opening times are measured, and evaluation of the eye of the subject is performed based on a change in perception of the cornea and a measurement result of the first to third eye-opening times. Evaluation device. An index acquisition unit configured to acquire a plurality of indices related to the eye, which are set in advance based on the change in perception of the cornea and the first to third eye opening times;
The perceptual measurement evaluation according to claim 2, wherein the measurement evaluation unit evaluates the eye of the previous subject by classifying the subject into any one of the plurality of indices based on the measurement result of the subject. apparatus. The detection means is a pressure sensor that has a part that is gripped by the subject's hand and detects a gripping force of the subject that changes according to the degree of pain of the cornea as a pressure of the part. The perceptual measurement evaluation apparatus described in 1. Imaging means for imaging the cornea of the subject and outputting the resulting image as a cornea image;
A graph generating means for generating a graph showing a temporal change in the detection result of the detecting means sequentially acquired by the acquiring means, and outputting as a pressure graph;
Display control means for displaying an image including at least the cornea image output from the imaging means and the pressure graph output from the graph generation means on a predetermined display device as a measurement screen;
The perceptual measurement evaluation apparatus according to any one of claims 2 to 4, further comprising: A perceptual measurement evaluation method executed by a perceptual measurement evaluation apparatus,
An acquisition step of acquiring a detection result of a sensor for detecting the physical quantity for a predetermined time when the predetermined physical quantity associated with the perception of the cornea is changed using a predetermined part of the subject;
A measurement step of measuring a temporal change in perception based on the detection result of the sensor acquired in the acquisition step;
An evaluation step for evaluating the subject based on the measurement result in the measurement step;
Perceptual measurement evaluation method. On the computer,
A perceptual measurement evaluation method executed by a perceptual measurement evaluation apparatus,
An acquisition step of acquiring a detection result of a sensor for detecting the physical quantity for a predetermined time when the predetermined physical quantity associated with the perception of the cornea is changed using a predetermined part of the subject;
A measurement step of measuring a temporal change in perception based on the detection result of the sensor acquired in the acquisition step;
An evaluation step for evaluating the subject based on the measurement result in the measurement step;
A program that executes control processing including

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