JP2015177880A - Ophthalmologic apparatus and control method - Google Patents

Abstract

PROBLEM TO BE SOLVED: To solve such a problem that, when an ophthalmologic apparatus formed by combining different optometry units is enlarged, it is difficult to quickly switch therebetween.SOLUTION: The ophthalmologic apparatus includes: a first optometry unit and a second optometry unit that receive reflected light of a light flux projected on a subject's eye along a prescribed optical axis; three-directional movement means that can move each optometry unit in the longitudinal direction, horizontal direction, and vertical direction with respect to the subject's eye; and relative position variable means that retracts the first optometry unit with respect to the second optometry unit and changes a relative position of the first and second optometry units in the longitudinal direction.

Description

  This is a technique related to an ophthalmologic apparatus that measures an eye characteristic of an eye to be examined with a plurality of optometry units using a single device, and a control method thereof.

  An autorefractometer that combines a function of measuring a corneal curvature radius and a function of measuring eye refractive power has long been known as an ophthalmologic apparatus that examines a plurality of eye characteristics with a single device. In recent years, the ophthalmic apparatus has been increasingly combined, and an apparatus in which a non-contact tonometer and an autorefractometer are combined has been disclosed.

  Patent Document 1 discloses a technique in which a non-contact fundus camera and a tonometer are combined. Patent Document 1 describes a configuration in which a unit that blows air on an eye to be examined is disposed in front of an objective lens of a fundus camera. In this document, the concept of schematic arrangement and compounding is described, but there are various problems when considering a configuration to be actually implemented.

  Further, Patent Document 2 discloses an apparatus in which a non-contact tonometer and an autorefractometer are combined. More specifically, this document discloses a technique for facilitating an eye opening operation when measuring intraocular pressure.

JP-A-6-047003 JP 2007-144128 A

  In the configuration disclosed in Patent Document 1, a switching operation is performed in front of the eye of the subject's eye depending on the operation of the operator, which not only causes discomfort to the subject but also may contact the subject. is there. Considering the exterior of the apparatus, there is a limit to disposing the intraocular pressure measurement unit in a limited space between the fundus imaging and the subject.

  Next, with the configuration disclosed in Patent Document 2, it is easy to perform eye opening measurement. However, even in the refractometer, the drooping of the wrinkles by the elderly makes it difficult to perform the opening operation.

  The present invention has been made in view of the above background art, and in an ophthalmologic apparatus having a plurality of optometry units, the apparatus is miniaturized as much as possible, and the subject is safe and uncomfortable when switching the optometry. The object is to provide an ophthalmologic apparatus that can be switched quickly.

In order to achieve the above object, an ophthalmologic apparatus according to the present invention includes a first optometry unit and a second optometry unit that receive reflected light of a light beam projected onto an eye to be examined along a predetermined optical axis and perform optometry. ,
Moving means capable of moving each of the first and second optometry units with respect to the eye to be examined;
The moving means moves the second optometry unit after the first optometry unit is retracted from the optical axis after the first and second optometry units are arranged on the optical axis. It is characterized by moving in the direction.

  According to the present invention, in an ophthalmologic apparatus having a plurality of optometry units, it is possible to provide an ophthalmologic apparatus that can be switched as quickly as possible and that can be switched quickly and safely without causing discomfort to the subject when the optometry unit is switched. It becomes possible.

It is a block diagram explaining the invention which concerns on one Example of this invention, Comprising: It is the top view which showed simultaneously the optical system for intraocular pressure measurement, and the optical system for eye refractive power measurement. It is explanatory drawing of the aperture stop in the optical path in the structure shown in FIG. It is sectional drawing of the optical system for the intraocular pressure measurement and eye refractive power measurement explaining the 1st Example shown in FIG. It is explanatory drawing in the case of retracting a nozzle unit from an optical path in a 1st Example. It is a block diagram of an optometry unit switching mechanism, and is a view showing cases when viewed from the subject side and the right side of the subject. 1 is an overall view of an ophthalmologic apparatus according to a first embodiment. It is a whole flowchart regarding the operation in the case of switching from the intraocular pressure measurement of the first embodiment to the eye refraction measurement. It is a flowchart of the part switched from an intraocular pressure measurement to an eye refraction measurement. It is a block diagram which respectively shows the arrangement | positioning of the optometry unit after switching from the optical path before switching from intraocular pressure measurement to ocular refraction measurement, and after switching. 4 is an overall flowchart for switching from eye refraction measurement to intraocular pressure measurement according to the first embodiment. It is a flowchart of the part which switches from eye refraction measurement to intraocular pressure measurement. (A) is sectional drawing of the optical system of the intraocular pressure measurement and eye refractive power measurement of 2nd Example, (b) is the optical system of the intraocular pressure measurement and eye refractive power measurement of 2nd Example. FIG. It is a front view when the optometry unit of the intraocular pressure measurement of 2nd Example evacuates from the optical path. It is a whole apparatus figure of a 2nd Example. (A), (b) is arrangement | positioning block diagram of the optometry unit before switching from the intraocular pressure measurement of 2nd Example to an eye refraction measurement. (A), (b) is arrangement | positioning block diagram of the optometry unit in the middle of switching from the intraocular pressure measurement of 2nd Example to an eye refraction measurement. (A), (b) is the arrangement block diagram of the optometry unit after switching from the intraocular pressure measurement of the second embodiment to the eye refraction measurement.

  As an ophthalmologic apparatus showing an embodiment of the present invention, an example in which a tonometer and an optometry unit of a refractometer are combined will be described.

(First embodiment)
FIG. 1 is an arrangement diagram of an optical system in a configuration in which a tonometer and an eye refractive power measurement are combined, which is an ophthalmologic apparatus according to a first embodiment of the present invention. In the drawing, the internal configuration of the optometry unit for measuring eye refractive power is shown as a second optometry unit 100. A tonometer nozzle unit 201, which is a part of a first optometry unit 200 described later, is also shown in the figure, but is shown in a different arrangement from the actual viewpoint from the viewpoint of visibility.

  On the optical path 01 from the eye refractive power measurement light source 101 that emits light having a wavelength of 880 nm to the eye E, a lens 102, a diaphragm 103, a perforated mirror 104, a lens 105, and a dichroic mirror 106 are sequentially arranged. . The diaphragm 103 is positioned substantially conjugate with the pupil Ep of the eye E. The dichroic mirror 106 totally reflects visible light from the eye E side and partially reflects a light beam having a wavelength of 880 nm. On the optical path 02 in the reflection direction of the perforated mirror 104, an aperture 107, a light beam spectroscopic prism 108, a lens 109, and an image sensor 110, each having an annular slit substantially conjugate with the pupil Ep, are sequentially arranged.

  The optical system described above is for measuring eye refractive power, and the light beam emitted from the measurement light source 101 is primarily focused in front of the lens 105 by the lens 102 while being focused by the aperture 103, and the lens 105, dichroic The light passes through the mirror 106 and is projected onto the pupil center of the eye E to be examined. The luminous flux forms an image on the fundus Er, and the reflected light enters the lens 105 again through the center of the pupil. The incident light flux is reflected around the perforated mirror 104 after passing through the lens 105.

  The reflected light beam is pupil-separated by a stop 107 substantially conjugate with the eye pupil Ep to be examined, and is projected as a ring image on the light receiving surface of the image sensor 110. If the eye E is a normal eye, the ring image is a predetermined circle, and the curvature of the circle is small for the myopic eye, and the curvature of the circle is large for the hyperopic eye. When the eye E has astigmatism, this ring image becomes an ellipse, and the angle formed by the horizontal axis and the major axis of the ellipse becomes the astigmatism axis angle. Based on the elliptic coefficient, the eye refractive power of the eye to be examined is obtained.

  On the other hand, in the reflection direction of the dichroic mirror 106, a fixation target projection optical system and an alignment light receiving optical system shared for anterior eye observation and alignment detection of the eye to be examined are arranged.

  On the optical path 03 of the fixation target projection optical system, a lens 111, a dichroic mirror 112, a lens 113, a folding dichroic mirror 114, a lens 115, a fixation target 116, and a fixation target illumination light source 117 are sequentially arranged. Yes. At the time of fixation fixation, the projected light flux of the light source 117 for illuminating the fixation target illuminates the fixation target 116 from the back side, and the eye E to be examined E through the lens 115, the folded dichroic mirror 114, the lens 113, and the dichroic mirror 112. Projected onto the fundus Er. The lens 115 can be moved in the optical axis direction by a fixation guidance motor in order to guide the diopter of the eye E and realize a cloud state.

  On the optical path 04 in the reflection direction of the dichroic mirror 112, an alignment prism diaphragm 123, a lens 118, a diaphragm 119, and an image sensor 120 are sequentially arranged. The alignment prism diaphragm 123 is driven by an alignment prism diaphragm drive solenoid (not shown). The diaphragm 119 is also driven by a diaphragm drive solenoid (not shown). With these configurations, it is possible to perform anterior ocular segment observation and alignment detection of the eye to be examined.

  FIG. 2 shows the shape of the alignment prism diaphragm 123. A disk-shaped diaphragm plate is provided with three openings 123a, 123b, 123c, and the openings 123a, 123b on both sides have only a wavelength of about 880 nm on the dichroic mirror 112 side. Alignment prisms 151a and 151b that transmit light beams are attached.

  Further, anterior eye illumination light sources 121a and 121b having a wavelength of about 780 nm are arranged obliquely in front of the anterior eye part of the eye E to be examined. The light beam of the anterior segment image of the eye E illuminated by the anterior segment illumination light sources 121a and 121b passes through the dichroic mirror 106, the lens 111, the dichroic mirror 112, and the central aperture 123c of the alignment prism diaphragm. An image is formed on the light receiving sensor surface 120. The light source for alignment detection is also used as the measurement light source 101 for measuring eye refractive power. At the time of alignment, a translucent diffusion plate 122 is inserted on the optical path 01 by a diffusion plate driving solenoid (not shown).

  The position where the diffusion plate 122 is inserted is a primary image formation position by the projection lens 102 of the measurement light source 101 and a focal position of the lens 105. As a result, the image of the measurement light source 101 is once formed on the diffusion plate 122, which becomes a secondary light source and is projected from the lens 105 toward the eye E as a thick parallel light beam. The light beam reflected by the eye cornea Ec to be examined is returned to the measurement optical system, and a part thereof is reflected again by the dichroic mirror 106. Thereafter, the light is reflected by the dichroic mirror 112 through the lens 111, passes through the opening 123 c of the alignment prism diaphragm and the alignment prisms 151 a and 151 b, is converged on the lens 118, and forms an image on the image sensor 120.

  Through the opening 123c at the center of the alignment prism diaphragm 123, a light beam having a wavelength of 780 nm or more of the anterior segment illumination light sources 121a and 121b passes. Therefore, the reflected luminous flux of the anterior segment image illuminated by the anterior segment illumination light sources 121a and 121b follows the observation optical system in the same manner as the path of the reflected luminous flux of the cornea Ec, and passes through the opening 123c of the alignment prism diaphragm 123. The image is formed on the image sensor 120 by the imaging lens 120. Further, the light beam transmitted through the alignment prism 151a is refracted downward, and the light beam transmitted through the alignment prism 151b is refracted upward.

  In the image sensor 120, the luminous flux is separated into three by the alignment prism diaphragm 123, and the bright spot images refracted in the vertical direction are arranged in a line vertically. The positional deviation in the front-rear direction with respect to the eye E is obtained from the relative positions of the three bright spots. Further, the positional deviation of the measurement unit with respect to the eye E can be detected from the positional deviation in the vertical and horizontal directions from the center of the image sensor 120 of the three bright spots. A method of detecting a positional shift from an image obtained by the image sensor 120 and moving an alignment mechanism described later is performed by a conventionally known system control circuit. Since there is little relation to the present invention, detailed description thereof is omitted here.

  Next, the arrangement and measurement operation of the optical member of the tonometer corresponding to the first optometry unit in this embodiment will be described. In FIG. 1, a tonometer nozzle unit 201 which is a part of a first optometry unit 200 has the following configuration. That is, the nozzle unit 201 includes a glass 202, an air chamber 204 covered with a perforated glass 203 and a casing (not shown), a nozzle 205 for blowing air, and a perforated glass 206 closest to the eye to be examined.

  In FIG. 1, the nozzle unit 201 is simply described as being out of the optical path 01, but can be inserted into and exited from the optical path 01 with a configuration described later. The nozzle unit 201 is inserted into the optical path 01 when measuring intraocular pressure. A lens 207, a diaphragm 208, and a photo sensor 209 are arranged on the optical path 05 arranged in the transmission direction of the dichroic mirror 114. In this optical configuration, the lens 111, the lens 113, and the lens 207 are arranged so that the cornea reflection image and the diaphragm 208 are in a conjugate positional relationship in a predetermined deformation state of the cornea Ec in which air is blown to the eye to be examined. Yes. Further, all the light flux that has passed through the aperture of the diaphragm 208 is received by the photosensor 209.

  FIG. 3 schematically shows an optical configuration arranged in a cross section obtained by cutting the ophthalmic apparatus according to the present embodiment along the optical path 01 in FIG. 1. In addition, the same code | symbol as the code | symbol attached to various elements in FIG. 1 shows the same member.

  The alignment at the time of measuring intraocular pressure and the principle of measurement will be described with reference to FIGS. The alignment of the eye to be examined and the first optometry unit 200 is performed in the same manner as the alignment at the time of eye refractive power measurement. The light beam emitted from the diffusion plate 122 serving as the secondary light source of the eye refractive power measurement light source 101 passes through the lens 105, the dichroic mirror 106, and the glass 202, and further passes through the air chamber 204 and the nozzle 205 to cornea Ec. Is irradiated.

  The light beam reflected by the cornea Ec passes through the perforated glass 206, the perforated glass 207, and the glass 202 on the outer periphery of the nozzle 205. The reflected light beam is further partially reflected by the dichroic mirror 106 and enters the optical path 04 via the lens 111 and the dichroic mirror 112. The configuration arranged in the optical path 04 has already been described in detail as the eye refractive power measurement system of the second optometry unit 100.

  When the alignment between the eye E and the first optometry unit 200 is proper, the rotary solenoid 301 is driven based on a signal transmitted from a system control unit (not shown). A rotary solenoid 301 can reciprocate a rod 303 by a rotor 302 to drive a piston 304 in parallel with the optical path 01.

  When the piston 304 is driven, the air sealed by the cylinder 305 is pushed out, and the pushed air passes through the air passage 306 and flows into the air chamber 204 to be compressed. The pressure of the compressed air is monitored by a pressure sensor 307, and the signal is input to a system control unit (not shown). The pressure of the air compressed in the air chamber 204 increases, but is ejected through the nozzle 205 toward the eye to be examined.

  The ejection time of air is a short time within 10 milliseconds, and it becomes a lump of air and strikes the cornea Ec. The apex of the cornea is pushed by this air, and the radius of curvature of the cornea Ec is increased and deformed to a predetermined applanation. As described above, in a predetermined deformation state, the photosensor 209 disposed in the optical path 05 in FIG. 1 instantaneously enters a light beam, and a signal obtained by photoelectrically converting the light beam is input to a system control unit (not shown). The Since the system controller sequentially captures the signals of the photosensor 209 and the pressure sensor 307, the value of the pressure sensor 307 that rises linearly at a predetermined level is recorded for the instantaneous change of the photosensor 209. It has become.

When the intraocular pressure of the eye to be examined is low, it takes a short time until the predetermined deformation, and when the intraocular pressure is high, it takes a long time until the predetermined deformation, so the recorded pressure value also changes. In this way, a parameter corresponding to the pressure of the eye to be examined can be obtained. This parameter is converted into an intraocular pressure value through a conversion table with a tonometer whose intraocular pressure value is determined in advance.
In this way, intraocular pressure measurement using the first optometry unit 200 is performed.

  Next, a technique for retracting the nozzle unit 201 of the first optometry unit 200 from the optical path 01 will be described. In FIG. 3, a bearing 308 is annularly arranged between a cylinder 305 and an air passage 306, an air passage is arranged on the inner ring side, and is sealed and connected so that the air does not leak. A gear 309 is disposed coaxially with the bearing 308 on the outer ring side, and the gear 309 meshes with the gear 310. The gear 310 is connected coaxially with the shaft of the motor 311, and when the motor 311 is driven to rotate, the nozzle unit 201 can be rotated and moved together with a housing (not shown) via the gear 310 and the gear 309.

  FIG. 4 is a view of the second optometry unit 100 and the nozzle unit 201 of the first optometry unit 200 as viewed from the subject side. The nozzle unit 201 is disposed at the point P1 on the optical path axis at the time of measuring the intraocular pressure, but when performing the optometry by the second optometry unit 100, the nozzle unit 201 rotates around the rotation center point O of the bearing 308, It is possible to retreat to a point P2 outside the optical path 01.

  Next, a switching mechanism between the first optometry unit 200 and the second optometry unit 100 according to the present invention will be described. In FIG. 5A, the second optometry unit 100 on which the optical member for the eye refractive power measurement system and a part of the optical members for the intraocular pressure measurement system are mounted is sufficient for vibration during transportation and vibration during driving. It is supported by wall-shaped support columns 401 and 402 that can withstand. The struts 401 and 402 fix the two optometry units of the first and second optometry units 200 and 100 to a Z-axis plate 403 that can be adjusted in the front-rear direction with respect to the eye E. The Z-axis plate 403 can move smoothly with respect to the Z-axis base 404 by a slide bearing 405.

  In FIG. 5B, a nut 406 is disposed below the Z-axis plate 403, and the nut 406 is screwed with a feed screw 407. Accordingly, the Z-axis motor 408 can be driven to move the Z-axis plate 403 in the Z-axis direction via the feed screw 407 and the nut 406. Here, the Z-axis direction refers to a direction in which the two optometry units move in the front-rear direction (the left-right direction on the paper surface in FIG. 5B) with respect to the eye to be examined. A slide bearing 410 is disposed between the retraction plate 409 on which only the first optometry unit 200 is loaded and the Z-axis plate 403. A motor 411 is fixed to the retraction plate 409, and the retraction plate 409 can be similarly moved in the Z-axis direction via a feed screw 412 and a nut 413.

  Next, the overall configuration of the ophthalmologic apparatus is shown in FIG. In the figure, the reference numerals attached to the various elements are the same as the members described above with respect to the same configuration as the reference numerals used in the respective drawings. In this figure, the first optometry unit 200 and the second optometry unit 100 are moved back and forth (Z-axis direction, left-right direction in FIG. 6) and left-right (X direction, perpendicular to the page in FIG. 6) with respect to the eye E. Direction) and up and down (Y direction, up and down direction in FIG. 6).

  The optometry units 200 and 100 are covered with the exterior 500, and only the nozzle unit 201 is exposed from the cylindrical hole of the exterior 500. An LCD monitor 501 that can visually observe an observation image at the time of alignment, a measurement result, and a setting state of the apparatus is fixed on the opposite side of the exterior 500 to the eye to be examined. A Y-axis column 502 that moves in the Y-axis direction is fixed to the lower part of the Z-axis base 404 that moves the two optometry units in the Z-axis direction. An internal thread is machined inside the Y-axis column 502 and is screwed to the feed screw 503. In addition, an annular groove is machined in the Y-axis column 502 and a spring 504 is incorporated. This spring 504 serves to balance the mass of the entire optometry unit and reduce the driving load. A slide bearing 506 is disposed between the outer shape and the X-axis plate 505.

  A nut 507 is fixed to the X-axis plate 505, and a feed screw 503 is connected to a Y-axis motor 508 fixed to the Y-axis plate 505 so as to be rotatable. The X-axis plate 505 is configured such that slide bearings 510a and 510b are disposed between the X-axis base 509, and the X-axis plate 505 can smoothly move in the X-axis direction with respect to the X-axis base 509. ing. An X-axis motor 511 is fixed to the operator side of the X-axis base 509, and the feed screw 512 is screwed with the nut 507. The X-axis motor 511 is driven to drive the X-axis through the feed screw 512 and the nut 507. The plate 505 can move in the X-axis direction. Below the X-axis base 509, an electrical component 513 having a built-in power supply and system control unit is arranged.

  The moving mechanism configured as described above can move the optometry unit in the X-axis and Z-axis directions by detecting the tilting of the joystick 514 in the left-right front-rear direction. Further, the optometry unit can be moved in the Y-axis direction by rotating the joystick 514. The electrical unit 513 includes a system control unit that executes a flow and the like described later. The system control unit may automatically align the optometry unit with the eye E using the alignment bright spot and the anterior segment illumination image received by the image sensor 120 of the optometry unit 100 in FIG. It has become. The entire apparatus is covered with an exterior 515 including a fixing knit (not shown) for fixing the face of the subject.

  That is, in the ophthalmologic apparatus according to the present embodiment, the first optometry unit 200 and the second optometry unit 100 receive the reflected light of the light beam projected onto the eye to be examined along a predetermined optical axis and perform optometry. The predetermined optical axis corresponds to, for example, the optical path 01 for projecting the measurement light beam from the dichroic mirror 106 onto the eye to be examined in FIG. In addition, a mechanism capable of moving both optometry units back and forth, left and right, and up and down with respect to the eye E is provided with the first and second optometry units respectively in the front-rear direction along the optical axis and the optical axis with respect to the eye It corresponds to a three-way moving means that can move in the horizontal direction centered and the vertical direction centered on the optical axis. Relative position changing means for moving the first optometry unit backward relative to the second optometry unit and changing the relative position of the first and second optometry units in the front-rear direction drives the optometry unit back and forth. The mechanism corresponds to a module area of a system control unit (described later) that operates the front-rear drive mechanism corresponding to the operation of the switching mechanism described above. Therefore, the first optical axis when the first optometry unit performs optometry and the second optical axis when the second optometry unit 100 performs optometry are both the same as the optical axis 01 which is a predetermined optical axis. It becomes. In the present invention, the matter of moving the first optometry unit backward relative to the second optometry unit is to move the first optometry unit in a direction away from the eye to be examined in a specific direction, such as the optical axis direction. Means that. More specifically, in the positional relationship between the first optometry unit and the second optometry unit with respect to the eye to be examined, the first optometry unit and the distance between the second optometry unit and the eye to be examined from the initial positional relationship. This means that the distance from the eye to be examined is increased.

  Further, in this embodiment, the retracting means for retracting the nozzle portion of the first optometry unit 200 that blows air to the eye to be examined from the optical axis 01 corresponds to a configuration including gears 309 and 310, a bearing 308, and a motor 311. This retreating means retreats from the optical axis 01 by rotating the nozzle portion about a rotation axis O parallel to the optical axis 01. Further, the relative position varying means varies the relative position in the front-rear direction in accordance with the retraction of the nozzle unit, which is a part of the first optometry unit 200, from the optical axis 01.

  With the configuration described above, the flow of optometry will be described with reference to the flowchart of FIG. The operator causes the subject to sit down and instructs to fix the face on the chin rest (not shown) (S601). In the next step of S602, the operator operates the joystick 514 for rough alignment to move the optometry unit so that the eye E is displayed on the LCD monitor 501. In step S603, alignment of the eye E is started by pressing a button (not shown) on the joystick 514. In step S604, the system controller (not shown) detects position information of the anterior segment illumination light sources 121a and 121b or alignment bright spots received by the image sensor 120 of the second optometry unit 100.

  In S605, the X-axis motor 511, the Z-axis motor 408, and the Y-axis motor 508 are driven from the position information. In step S606, the position of the image sensor 120 is detected again, and it is determined whether or not the optometry unit is in an appropriate position. If appropriate, the process returns to step S607, and if not appropriate, the process returns to step S604. In S607, the intraocular pressure measurement is executed by the method described above, and the result is displayed on the LCD monitor 501. In the next step S608, the optometry unit switching step, which is a feature of the present invention, is executed. This process will be described with reference to the flowchart of FIG. 8 and the state diagram of FIG.

  FIG. 8 is a flowchart of a process of switching the first optometry unit 200 that has performed the above-described intraocular pressure measurement to the second optometry unit 100 for measuring eye refractive power. Note that switching from the first optometry unit 200 to the second optometry unit 100 is automatically performed under the control of a processing device such as a CPU provided in the ophthalmologic apparatus. When the intraocular pressure measurement is completed, the Z-axis motor 408 is driven to move the entire optometry unit backward by a predetermined distance (S701). Here, the working distance S1 of the tonometer that blows air is approximately 10 mm. In the present embodiment, the predetermined distance L1 is 20 mm, but the impression of the optometry unit being greatly separated is given to the subject simply by lowering the distance from the eye to be examined by about 10 mm to 20 mm. The predetermined distance L1 can be arbitrarily changed by the operator setting the device. FIG. 9A shows a state in which the entire optometry unit is moved backward by the predetermined distance L1. This distance L1 is the shortest distance at which the nozzle unit 201 does not contact the exterior 500 when the nozzle unit 201 is rotated to remove it from the optical path 01, for example. The distance L1 may be a distance obtained by adding a certain margin to the shortest distance where the nozzle unit 201 does not contact the exterior 500 when the nozzle unit 201 is rotated to remove it from the optical path 01. That is, the distance L1 is a distance determined based on the exterior 500. In the present embodiment, the moving distance L1 of the optometry unit 200 is determined by whether or not it contacts the exterior 500. However, the present invention is not limited to this, and becomes an obstacle when the optometry unit 200 is removed from the optical path 01. What is necessary is just to determine the distance L1 so that it may become the minimum (or minimum distance + margin) in relation to members other than the optometry unit 200. The distance L1 is determined in advance by a user or the like, for example, and is input by an input unit such as a keyboard. The value input by the input means is acquired by a processing device such as a CPU.

  In step S702, the nozzle unit 201 is moved out of the optical path 01 and moved to the position P2 as described with reference to FIG. The state is shown in FIG. In the next step S703, in order to perform eye refractive power measurement, the distance between the second optometry unit 100 and the eye to be examined is set as the working distance S2 for eye refraction measurement. Specifically, the Z-axis motor 408 is driven so that only the second optometry unit 100 approaches the eye E to be examined in the Z-axis direction. For example, a sensor unit (not shown) and a processing unit such as a CPU detect that the nozzle unit 201 has moved out of the optical path 01 and retracted as a detection unit, and the CPU controls the moving unit in response to this detection, whereby the second optometry is performed. The unit 100 is moved in the optical axis direction. That is, the nozzle unit 201 is automatically retracted from the optical path 01 and the second optometry unit 100 is moved to the measurement position. It should be noted that the movement distance of the second optometry unit 100 is a working distance in which the distance between the eye E and the second optometry unit is stored based on the previously stored working distance of the second optometry unit 100. To be determined. The detection of the positional relationship between the eye E and the second optometry unit can be realized by various known techniques such as a sensor or a bright spot projected on the eye.

  When the second optometry unit 100 moves, the first optometry unit 200 also moves in a direction approaching the eye E at the same time. Therefore, the motor 411 is driven so that the nozzle unit 201 does not interfere with the exterior 500, and a predetermined value is obtained. Keep the distance L1. That is, when the optometry unit 200 is moved away from the eye E, the optometry unit 100 and the optometry unit 200 move together, but when the optometry unit 100 is brought close to the eye E, the optometry unit 100 and the optometry unit 200 are moved. Does not move together. This is because the optometry unit 200 is moved away from the optical path 01 at a position away from the eye L to be examined E from the time of measurement (that is, because the movement distance of the optometry distance is to be minimized). This is because it would collide with the exterior 500.

Therefore, in S2 (S> S2) where the working distance is shorter than the position of the second optometry unit 100 when the first optometry unit 200 performs optometry (position where the working distance S is set), the first optometry unit 200 is compared with the first optometry unit 200. Thus, the relative position of the second optometry unit 100 changes in the working distance direction of the eye to be examined.
Since such a series of operations are performed with the minimum necessary moving distance, the operation of switching the optometry unit can be performed in a shorter time than before.

  In this embodiment, since the working distance in the first optometry unit 200 is longer than the working distance in the second optometry unit 100, the distance to move the optometry unit 100 is S-S2 in FIG. . In other words, the movement distance of the optometry unit 100 can be reduced by disposing the optometry unit 200 in front of the optometry unit 100.

  Furthermore, since the alignment is completed in the measurement by the optometry unit 200, in the measurement by the optometry unit 100, the vertical / horizontal alignment of the apparatus with respect to the eye E is omitted, and only the alignment in the front / rear direction (working distance adjustment) is performed. Measurement can be performed immediately. Further, since these alignments are automatically performed, the examiner can easily obtain the measurement results.

  Further, as a mechanism for changing the relative position, it is also possible to arrange a slide rail between the first optometry unit 200 and the second optometry unit 100 described above. However, since the height of the mechanism increases the distance to and from the optical path, the switching time increases accordingly. Further, in the above-described switching flowchart, three steps of backward (S701), optical path retreat (S702), and forward (S703) are described in order. However, it is possible to switch the optometry unit in a shorter time by starting the driving operation of the following steps before each of these steps is completed. For example, when there is a space between the exterior 500 and the optometry unit 200, the nozzle unit 201 may be rotated and removed from the optical path 01 while the optometry unit 200 is retracted.

  Furthermore, the timing at which the nozzle unit 201 starts to rotate may be the timing at which the optometry unit 200 starts to retreat, or may be after the elapse of a predetermined time after starting to retreat. For example, when the shape of the portion of the exterior 500 that faces the eye E is widened from the eye E toward the inside, the nozzle unit 201 is moved after a predetermined time has elapsed since the optometry unit 200 began to retract. It is possible to prevent contact with the exterior 500 by starting to rotate. That is, the timing for starting to rotate the nozzle unit 201 is determined according to the shape of the exterior 500.

  Note that the timing for starting to rotate the nozzle unit 201 is input by an input unit such as a keyboard, and is acquired by a processing unit such as a CPU included in the ophthalmologic apparatus. In other words, in the present invention, as described above, the three-way moving unit is configured such that the first optometry unit 200 is in a state where the first optometry unit 200 and the second optometry unit 100 are arranged on the optical axis. Is retracted from the optical axis, and then the second optometry unit 100 is moved in the optical axis direction. More specifically, when moving the first optometry unit 200 away from the eye to be examined, the three-way moving means retracts from the optical axis after the operation of moving away from the eye to be examined.

  When the optometry unit switching is completed, the flow returns to the flowchart of FIG. 7 to perform alignment for eye refractive power measurement.

  In the next step of S <b> 608, the light beam of the alignment luminescent spot is partially kicked by the nozzle 205 in the received light image by the image sensor 120 by the amount that the nozzle unit 201 disappears from the optical path 01. However, since images other than this vignetting are almost the same image, the same steps S604, S605, and S606 as the intraocular pressure measurement are performed, and it is determined whether the alignment is appropriate for the eye refractive power measurement. If it is determined in S606 that the position is appropriate, kerato measurement S609 is performed.

  Since the kerato measurement is not directly related to the present invention, the optical diagram and the measurement principle are omitted, but a ring-shaped projection light source (not shown) arranged inside the anterior ocular illumination light source becomes the kerato measurement light source. A light beam obtained by emitting light from the light source is reflected by the cornea and reflected by the dichroic mirror 106 in FIG. This reflected light beam passes through the lens 111, is reflected by the dichroic mirror 112, and is guided to the optical path 04. The alignment prism diaphragm 123 is retracted from the optical path 04 in advance. Therefore, the corneal reflected light beam is directly condensed by the lens 118 and received by the image sensor 120 with the aperture 119 retracted. The kerato measurement is performed based on the ring image received by the image sensor 120.

  When the kerato measurement is completed, the eye refraction measurement is performed as already described in S610. When the intraocular pressure measurement, the kerato measurement, and the eye refraction measurement are thus completed, the other-eye measurement is performed or the test is terminated (S611).

  Next, FIG. 10 shows a flowchart for performing eye refraction measurement first and intraocular pressure measurement later.

  Steps for performing the same operation are indicated by the same reference numerals as in FIG. As can be seen from the flowchart, the order of kerato measurement, eye refraction measurement, and intraocular pressure measurement is switched, and only the optometry unit switching step (S800) is different. A detailed flowchart of S800 is shown in FIG.

  In the case of this example, since the measurement by the second optometry unit has been completed, the apparatus is in the state of FIG. In the flowchart S801, the Z-axis motor 408 is driven to temporarily lower the entire first and second optometry units backward, and the working distance S2 between the eye to be examined and the optometry unit is increased. At the same time, the motor 114 is driven to keep the position of the first optometry unit 200 as it is (to keep the predetermined distance L1 unchanged). When the optometry unit is retracted until S2 becomes S, the apparatus is in the state shown in FIG. 9B. In the next step S802, the motor 311 is driven so that the nozzle unit 201 is inserted into the optical path 01. When the nozzle unit 201 is returned to the position P1 in FIG. 4, in S803, the Z-axis motor 408 is driven to drive the second optometry unit 200 closer to the eye E. At this time, the moving speed is made gentler as the vehicle moves forward than when the patient is retracted so as not to cause discomfort to the subject. Then, the position is as shown in FIG. 9A, and the flow returns to the flowchart of FIG.

  Even in the optometry unit switching operation for measuring the intraocular pressure from the eye refraction measurement, the switching can be performed in a short time by starting the next driving before the driving is completely completed. However, since the nozzle unit 201 is a direction that protrudes toward the eye for the subject, the driving method is in consideration of the subject as described above.

  That is, in the above embodiment, the first and second optometry units that receive the reflected light of the light beam projected onto the eye to be examined along the predetermined optical axis and optometry, and the first and second optometry units, respectively. A control method for an ophthalmologic apparatus comprising three-way moving means that can move in the front-rear direction, the left-right direction, and the up-down direction with respect to the eye to be examined. Perform optometry using one optometry unit of the first and second optometry units, move at least part of any of the first and second optometry units, and This can be grasped as a method for controlling an ophthalmologic apparatus that changes the position and performs optometry using the other optometry unit.

  According to the present invention, in an ophthalmologic apparatus having a plurality of optometry units, it is possible to provide an ophthalmologic apparatus that can be switched as quickly as possible and that can be switched quickly and safely without causing discomfort to the subject when the optometry unit is switched. It becomes possible. Further, in a plurality of optometry operations, the optometry optical axis and the top surface of the apparatus can be miniaturized, so that any optometry is easily opened.

(Second embodiment)
Next, a second embodiment will be described as an optometry unit switching mechanism. FIGS. 12A and 12B show optical arrangement diagrams. 12A is a plan view, and FIG. 12B is a view seen from the side of the subject. The optical system for measuring the intraocular pressure, measuring the refractive power of the eye, and detecting the alignment to the eye to be examined is the same as in the first embodiment, but the position of the piston and cylinder that blows air on the eye to be examined at the time of measuring the intraocular pressure. Is different. In addition, the structure shown with the code | symbol same as the code | symbol attached to the component shown in FIG. 1 shows the same member as the structure illustrated in the 1st Example.

  The intraocular pressure measurement unit having different piston and cylinder arrangements will be described as a first optometry unit 900. The nozzle unit 201 has the same configuration as that of the previous embodiment. A rotatable bearing or the like connected to the air passage 306 arranged in the first embodiment with respect to the cylinder 901 has a configuration eliminated in this embodiment. In the first embodiment, the central axes of the piston 304 and the cylinder 901 are arranged at a position lower than the optical path 01, but are arranged on the right side at the same height as viewed from the eye E. In FIG. 1, the rotary solenoid 301 is arranged on the further right side of the cylinder as viewed from the eye to be explained, but it is actually arranged on the left side of the cylinder.

  FIG. 12B is a side view showing a state in which the second optometry unit 900 of the tonometer is retracted from the optical path 01. The intraocular pressure measurement unit has a compact configuration in the height direction with respect to the first embodiment. FIG. 13 shows a view of this state from the subject side. The nozzle unit 201 is retracted downward from the measurement position written with a broken line. Therefore, the second optometry unit 900 does not require a drive actuator for retracting the nozzle unit 201 from the optical path 01.

  FIG. 14 shows an overall view of the apparatus of the second embodiment. In the apparatus of the second embodiment, the movement on each of the XYZ axes is performed by motor driving only on the Y axis, but the XZ axis direction is performed manually by the operator. A friction plate 903 is disposed on the base base 902, and a rotating sphere 905 disposed on the lower portion of the joystick 904 rotates on the friction plate 903 by tilting the manually operated joystick 904. By responding to this rotation, the movable plate 905 can be moved in the XY-axis directions with respect to the eye E.

  On the subject side of the base base 902, rack portions 902a and 902b are formed on both the left and right sides as viewed from the subject side. The movable plate 906 is provided with a shaft 907 in which a slide bearing that can move smoothly in the X-axis direction and a bearing that can rotate smoothly in the Z-axis direction are arranged. Gears 906a and 906b are respectively arranged at the left and right ends of the shaft 907 when viewed from the subject side, and rack portions 902a and 902b on the base base 902 are engaged with these.

  With this configuration, the operator can use the joystick 904 to smoothly align the eye to be examined and the optometry unit in the XZ axis direction. Further, there is a position detection means for detecting the position in the Z-axis direction between the movable plate 906 and the base base 902. A striped reflecting plate 908 is fixed on the base base 902 side, and a reflective photo interrupter 909 is fixed on the movable plate 906 side, so that the position in the Z-axis direction can be detected without contact.

  A Y-axis base 910 is fixed to the upper part of the movable plate 906, and a Y-axis motor 911 is fixed with its axis directed toward the upper optometry unit. A feed screw 912 can rotate integrally with the shaft, and is screwed to the female thread portion of the Y-axis column 913. A balance spring 914 is incorporated in the Y-axis support column 913 so as to balance the mass of the entire optometry unit. A slide bearing 915 is disposed between the Y-axis column 913 and the Y-axis base 910, and serves as a guide rail for movement in the Y-axis direction. Such an XYZ movable mechanism is covered with an exterior 916.

  A switching mechanism that operates between the first optometry unit 900 and the second optometry unit 100 will be described with reference to FIG. FIG. 15A and FIG. 15B show a state in which measurement is performed by the first optometry unit 900. 15A is a view seen from the eye E, and FIG. 15B is a right side view seen from the subject.

  In the second embodiment, the first optometry unit is disposed on the moving base 920, and a slide bearing 922 that can slide smoothly in the Z-axis direction is disposed between the moving base 920 and the lift base 921. Yes.

  Link members 923a, 923b, 923c, and 923d that support the lifting platform 921 are disposed on both sides of the lifting platform 921, and a support column that reinforces the horizontal link member in the horizontal direction (left and right direction on the paper) between these members. 924 is arranged. Opposite ends of the link members 923a, 923b, 923c, and 923d are rotatably fixed to the optometry base 925. A motor 926 is fixed to the optometry base 925, a feed screw 927 is arranged in the vertical direction, and is screwed with a nut 928 fixed to the lifting platform 921.

  As shown in FIG. 15A, the movable base 920 has vertical surfaces on both sides, and shafts 929a and 929b are built outward. Rotating rollers 930a and 930b are fitted on the shaft. The rotating roller is engaged with a groove on the vertical surface of the optometry base 925.

  Next, FIG. 16 (a) and FIG. 16 (b) showing the positional relationship around the optometry base 925, the first optometry unit 900, and the second optometry unit 100 will be described. The state shown in FIG. 15A corresponds to the state shown in FIG. 16A, and the rotating rollers 930a and 930b are fitted in the grooves 925a and 925b on both sides of the optometry base 925. Accordingly, when the motor 926 is driven and transmitted from the feed screw 927 and the nut 928 and the lifting platform 921 is lowered, the rotating rollers 930a and 930b are lowered with the grooves 925a and 925b as guides as shown in FIG. At the same time, the first optometry unit 900 moves backward with respect to the eye E.

  On the other hand, the second optometry unit 100 is also movable in the front-rear direction with respect to the eye to be examined along the horizontal grooves 925 c and 925 d on both sides of the optometry base 925. Similar to the first optometry unit 900, the grooves 925c and 925d are fitted with a rotation roller (not shown) at two places on one side, for a total of four places. Hooks 931a and 931b are fixed at one place on one side of the central axis of the rotation roller of the second optometry unit 100, springs 932a and 932b are hooked, and opposite ends are fixed pins 933a and 933b that are set up on the optometry base 925. Is always biased toward the direction of the eye E.

  In FIG. 16A, the second optometry unit 100 is in a state of being measured by the first optometry unit 900, and the position in the Z-axis direction is stationary at a position longer than the working distance. When switching the optometry unit, as the first optometry unit 900 is lowered, the contact surface between the first optometry unit 900 and the second optometry unit 100 is in contact with a smooth inclined surface, so that FIG. Thus, the springs 932a and 932b are gradually moved to an appropriate working distance (working distance). In other words, the moving means in the present embodiment retracts the first optometry unit 900 from the optical axis while keeping the first optometry unit 900 away from the eye to be examined. The configuration comprising these hooks 931a, b, springs 932a, b and fixing pins 933a, b arranged in the moving means of the present embodiment moves the second optometry unit 100 in a direction approaching the eye to be examined along the optical axis. An example of tension applying means for applying tension to the second optometry unit 100 is configured. In addition, these structures are illustrations of a tension | tensile_strength provision means, and if it is a structure which exhibits the same effect, it will not be limited to the form by this spring, The other form using various elastic bodies can also be taken.

  In other words, in this embodiment, in a state where the first optometry unit 900 and the second optometry unit 100 are arranged on the optical axis, the second optometry unit 100 is in contact with the first optometry unit 100. Yes. When the first optometry unit 900 is retracted from the optical axis by the moving means of this embodiment, the contact in the optical axis direction between the first optometry unit 900 and the second optometry unit 100 is eliminated. As a result, the second optometry unit 100 is moved by the tension provided by the tension applying means.

  FIGS. 17A and 17B show the state in which the second optometry unit 100 is ready for optometry in this way. In the second embodiment having such a configuration, in order to switch the optometry unit from intraocular pressure measurement to ocular refraction measurement, after the intraocular pressure measurement, the joystick 904 is pulled to the operator side by the above-described XYZ movable mechanism, that is, the optometry unit. 10 mm to 20 mm away from the eye. When a predetermined distance is detected by detecting the position in the Z-axis direction composed of the reflection plate 908 and the reflection type photo interrupter 909, the motor 926 is driven to move the first optometry unit 900 downward and backward. As a result, the first optometry unit 900 naturally deviates from the optical path 01 and instead moves to a state where the second optometry unit 100 can perform optometry. After that, by performing the positioning for fine adjustment, it is possible to perform eye refractive power measurement.

  Also, when performing intraocular pressure measurement from the eye refractive power measurement, it is detected that the optometry unit is moved backward by a predetermined distance upon completion of the eye refractometry measurement, and the motor 926 is driven in response to this to move the first optometry unit 900. The optometry unit can be switched by raising it. In this case, the amount to be lowered backward by a predetermined distance may be shorter after the eye refraction measurement. Because the working distance is long. The reason why the optometry unit is switched when it is moved rearward regardless of the switching order of the optometry unit is that the operation of separating the optometry unit from the subject is safe and uncomfortable for the subject. Thus, even with a manually operated ophthalmologic apparatus, the first optometry unit and the second optometry unit can be switched safely and smoothly.

  As described above, in this embodiment, the position detecting means for detecting the amount of movement in the front-rear direction of the three-way moving means, and the control means for controlling the relative position variable means based on the position information detected by the position detecting means, Have. This position detection means corresponds to a configuration for detecting the position in the Z-axis direction including the reflection plate 908 and the reflection type photo interrupter 909. The control means corresponds to a module area for driving the motor 926 based on the position information detected by the system control unit. In the second embodiment, the position detection of the XYZ movable mechanism is switched using the trigger, but it may be switched by providing a dedicated button for switching the optometry unit.

  In the present invention, the combination of a tonometer and an ocular refractometer has been described. However, a similar effect can be obtained by replacing the axial length measurement, which can be made relatively small, with the second optometry unit. Alternatively, the present invention can be applied to the case where the optometry units that have been arranged as individual units so far are combined.

(Other examples)
The present invention can also be realized by executing the following processing. That is, software (program) that realizes the functions of the above-described embodiments is supplied to a system or apparatus via a network or various storage media, and a computer (or CPU, MPU, or the like) of the system or apparatus reads the program. It is a process to be executed.

  The present invention is applicable to an ophthalmologic apparatus used for ophthalmic medical care and spectacle prescription.

100... Second optometry unit 101... Eye refractive power measurement light source 104... Perforated mirror 110... Image sensor 120 that performs reflex measurement. Image sensor 200 ... First optometry unit 201 ... Nozzle unit 208 ... Photo sensor 301 ... Rotary solenoid 304 ... Piston 305 ... Cylinder 307 ... Pressure sensor 408 ... Z-axis motor 410 ... Slide bearing 411 ... Motor 501 ... LCD monitor 508 ... Y-axis motor 511 ... X-axis motor 513 ...・ Electric part 514... Joystick 908... Reflecting plate 909.

Claims (12)

A first optometry unit and a second optometry unit that receive the reflected light of the light beam projected onto the eye to be examined along a predetermined optical axis and optometrically;
Moving means capable of moving each of the first and second optometry units with respect to the eye to be examined;
With
The moving means moves the second optometry unit after the first optometry unit is retracted from the optical axis after the first and second optometry units are arranged on the optical axis. An ophthalmic apparatus characterized by moving in a direction.   The ophthalmologic apparatus according to claim 1, wherein the first optometry unit and the second optometry unit perform the optometry using the same optical axis.   The first optometry unit is an optometry unit that measures intraocular pressure of the eye to be examined, and the second optometry unit is an optometry unit that measures eye refractive power of the eye to be examined. Or the ophthalmic apparatus of 2.   The ophthalmologic apparatus according to claim 3, wherein the moving unit includes a retracting unit that retracts a nozzle portion of the first optometry unit that blows air to the eye to be examined from the optical axis.   5. The ophthalmologic apparatus according to claim 4, wherein the retracting unit performs the retreat from the optical axis by rotating the nozzle unit around a rotation axis parallel to the optical axis. Further comprising position detecting means for detecting position information indicating positions of the first and second optometry units;
6. The ophthalmologic apparatus according to claim 1, wherein the moving unit moves the first and second optometry units based on the position information detected by the position detecting unit. .   The ophthalmic apparatus according to claim 1, wherein the moving unit retracts the first optometry unit from the optical axis after moving away from the eye to be examined.   The ophthalmologic according to any one of claims 1 to 6, wherein the moving unit retracts the first optometry unit from the optical axis while keeping the first optometry unit away from the eye to be examined. apparatus. The moving means includes tension applying means for applying tension to the second optometry unit for moving the second optometry unit in a direction approaching the eye to be examined along the optical axis,
In a state where the first and second optometry units are arranged on the optical axis, the second optometry unit is in contact with the first optometry unit, and the first optometry unit is moved by the moving means. The second optometry unit is moved by the tension by retracting from the optical axis and eliminating a contact in the optical axis direction between the first optometry unit and the second optometry unit. The ophthalmic apparatus according to 8. A detection means for detecting retraction of the first optometry unit from the optical axis;
The said moving means moves the said 2nd optometry unit to the said optical axis direction, when the retraction | saving from the said optical axis of the said 1st optometry unit is detected by the said detection means. The ophthalmic apparatus according to any one of the above. A first optometry unit and a second optometry unit that receive reflected light of a light beam projected onto the eye to be examined along a predetermined optical axis and optometrically, and each of the first and second optometry units to the eye to be examined A method of controlling an ophthalmologic apparatus that performs optometry of the eye to be examined using a moving means that is movable with respect to the eye,
The first optometry unit is retracted from the optical axis after the first and second optometry units are disposed on the optical axis by the moving means, and then the second optometry unit is moved in the optical axis direction. A method for controlling an ophthalmologic apparatus, wherein   A program for causing a computer to execute each step of the method for controlling an ophthalmologic apparatus according to claim 11.

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