JP2017099532A - Ophthalmologic examination apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a new technology to evaluate a change in an eye position with a simple configuration.SOLUTION: An ophthalmologic examination apparatus includes a visual target presentation part, an imaging part, a control part, and an image analysis part. The visual target presentation part presents a visual target to a left eye to be examined and a right eye to be examined. The imaging part takes an image of an anterior eye part of the left eye to be examined and the right eye to be examined. The control part controls the visual target presentation part so as to switch the visual target presented to at least one of the left eye to be examined and the right eye to be examined. The image analysis part obtains a change in the eye position of at least one of the left eye to be examined and the right eye to be examined by analyzing the images of the anterior eye part taken by the imaging part before and after the visual target is switched by the control part.SELECTED DRAWING: Figure 4

Description

  The present invention relates to an ophthalmic examination apparatus.

  Misalignment of the eyes causes poor visual function and eye strain, and may be corrected by a prism lens or the like. The presence / absence of such eye position deviation can be evaluated by a cover test, a cover uncover test, or the like. The cover test is an examination for evaluating a change in the position of the other eye when one eye is shielded while the subject is viewing the target with both eyes. The cover uncover test is a test for evaluating a change in the position of the eye that has been shielded when the shield is removed from a state in which one eye is shielded.

  These tests are performed by directly observing the movement of the subject's eyes while the examiner is moving in front of the subject and moving the shielding member for shielding the subject's eyes. Therefore, it was difficult to accurately evaluate the abnormal eye position. Various ophthalmic examination apparatuses for accurately evaluating such abnormal eye position have been proposed.

  For example, Patent Document 1 provides visible light by providing a shielding portion that has a wavelength selection characteristic that shields visible light and transmits non-visible light for measurement, and can be placed in front of the subject's eye. An ophthalmic examination apparatus is disclosed that measures the eye adjustment of a subject before and after light shielding or before and after transmission of visible light.

Japanese Patent No. 5011144

  However, in the conventional ophthalmic examination apparatus, it is necessary to separately provide a shielding part for a cover test or a cover uncover test. In addition, since the conventional ophthalmic examination apparatus is performed by the examiner's visual observation, it is difficult to perform the degree of eye position shift and quantitative evaluation.

  The present invention has been made to solve the above-described problems, and an object thereof is to provide a new technique for evaluating changes in eye position with a simple configuration.

  The ophthalmic examination apparatus according to the embodiment includes an optotype presenting unit, an imaging unit, a control unit, and an image analysis unit. The optotype presenting unit presents the optotype to each of the left eye and the right eye. The imaging unit images the respective anterior eye portions of the left eye and the right eye. The control unit controls the visual target presenting unit to switch the visual target presented to at least one of the left eye and the right eye. The image analysis unit analyzes the image of the anterior segment acquired by the imaging unit before and after the switching of the target by the control unit, so that the eye position of at least one of the left subject eye and the right subject eye is determined. Seek change.

  According to the ophthalmic examination apparatus according to the present invention, it is possible to provide a new technique for evaluating changes in eye position with a simple configuration.

Schematic which shows the external appearance structure of the ophthalmic examination apparatus which concerns on embodiment. Schematic which shows the structural example of the ophthalmic examination apparatus which concerns on embodiment. Schematic which shows the structural example of the optical system of the ophthalmic examination apparatus which concerns on embodiment. Schematic which shows the structural example of the control system of the ophthalmic examination apparatus which concerns on embodiment. Operation | movement explanatory drawing of the ophthalmic examination apparatus which concerns on embodiment. Operation | movement explanatory drawing of the ophthalmic examination apparatus which concerns on embodiment. The flowchart of the operation example of the ophthalmic examination apparatus which concerns on embodiment. The flowchart of the operation example of the ophthalmic examination apparatus which concerns on embodiment. Operation | movement explanatory drawing of the ophthalmic examination apparatus which concerns on the 1st modification of embodiment. Operation | movement explanatory drawing of the ophthalmic examination apparatus which concerns on the 1st modification of embodiment. Operation | movement explanatory drawing of the ophthalmic examination apparatus which concerns on the 1st modification of embodiment. Operation | movement explanatory drawing of the ophthalmic examination apparatus which concerns on the 1st modification of embodiment. Operation | movement explanatory drawing of the ophthalmic examination apparatus which concerns on the 1st modification of embodiment. Operation | movement explanatory drawing of the ophthalmic examination apparatus which concerns on the 1st modification of embodiment. Operation | movement explanatory drawing of the ophthalmic examination apparatus which concerns on the 1st modification of embodiment. Operation | movement explanatory drawing of the ophthalmic examination apparatus which concerns on the 2nd modification of embodiment.

  An ophthalmic examination apparatus according to an embodiment will be described in detail with reference to the drawings.

[Constitution]
FIG. 1 schematically shows an outline of an external configuration of the ophthalmic examination apparatus according to the embodiment. The ophthalmic examination apparatus 1 according to the embodiment is an ophthalmic apparatus capable of performing subjective examination and objective measurement. The subjective examination is an examination for presenting a visual target to the subject's eye (the subject's eye) and acquiring information about the subject's eye based on a response from the subject regarding how the subject looks. The objective measurement is a measurement for acquiring information about the eye to be examined mainly using a physical method without referring to a response from the subject.

  The ophthalmic examination apparatus 1 can perform eye position examinations such as a cover test and a cover uncover test using an optical system that presents a target to the eye to be examined in a subjective examination. The cover test is an examination for evaluating a change in the position of the other eye when one eye is shielded while the subject is viewing the target with both eyes. The cover uncover test is a test for evaluating a change in the position of the eye that has been shielded when the shield is removed from a state in which one eye is shielded.

  The ophthalmic examination apparatus 1 can be communicably connected to an examiner controller (for example, a tablet terminal) or a subject controller (for example, a control lever unit) (not shown) via a wired or wireless communication path. The ophthalmic examination apparatus 1 is controlled based on operations on the examiner controller and the subject controller. In the following description, the left-right direction as viewed from the subject may be referred to as the X direction, the up-down direction as the Y direction, and the depth direction of the measuring head 100 as viewed from the subject may be described as the Z direction.

  The ophthalmic examination apparatus 1 includes a measurement head 100 and a control device 200. The measuring head 100 is provided with an optical system and a moving mechanism system for moving the optical element for performing the above-described subjective examination and objective measurement. The control device 200 controls the measurement head 100 and controls the examiner controller and the subject controller.

  The ophthalmic examination apparatus 1 includes an optometry table 3. The optometry table 3 is a desk for supporting the measuring head 100 and placing the controller for the examiner or the controller for the subject. The optometry table 3 is installed in a state of being supported on the floor by the support unit 4. The optometry table 3 is adjustable in height up and down.

  A support column 5 is erected on the optometry table 3. The proximal end portion of the lateral arm 6 is held at the distal end portion of the support column 5. A measuring head 100 is suspended from the tip of the horizontal arm 6. For example, the support column 5 can be rotated in the direction around the axis (arrow direction j, arrow direction k) by the arm moving mechanism 7. Thereby, the horizontal arm 6 is rotated in the direction around the axis. That is, the measuring head 100 is rotated around the axis. As a result, the measuring head 100 can be retracted from the examination space above the optometry table 3, and the examination can be efficiently performed using the empty space on the optometry table 3.

  The arm moving mechanism 7 may move the tip of the support column 5 in the vertical direction (arrow direction h) as an arm vertical movement mechanism. Thereby, the horizontal arm 6 is moved in the vertical direction. That is, the measuring head 100 is moved in the vertical direction. The arm moving mechanism 7 may move the horizontal arm 6 in the vertical direction by expanding and contracting the support column 5 protruding upward from the optometry table 3 as an arm expansion and contraction mechanism. Even in this case, the measurement unit 100 can be moved up and down according to the sitting height of the subject, or the measurement head 100 can be retracted from the examination space above the optometry table 3.

  A stand or the like for storing the measurement head 100 may be separately provided, and the measurement head 100 may be disposed at a stable position by the above-described rotation or vertical movement. In this case, it is possible to continuously reduce the load on the lateral arm 6 due to the weight of the measuring head 100.

  The arm moving mechanism 7 can receive the operation by the operator and manually move the horizontal arm 6 in the direction around the axis or in the vertical direction. The arm moving mechanism 7 may move the horizontal arm 6 by an electric mechanism. In this case, an actuator that generates a driving force for moving the arm moving mechanism 7 and a transmission mechanism that transmits the driving force are provided. The actuator is constituted by, for example, a pulse motor. The transmission mechanism is constituted by a combination of gears, a rack and pinion, for example.

  A storage unit 9 is provided on a side surface of the support unit 4 to store the control device 200 and the like. The configuration of the optometry table 3 is not limited to the configuration shown in FIG.

[Measurement head]
The measurement head 100 includes a left eye inspection unit 120L and a right eye inspection unit 120R. Examination windows 130L and 130R are formed in the left-eye examination unit 120L and the right-eye examination unit 120R, respectively. The left eye (left eye) of the subject is examined through the optometry window 130L. The subject's right eye (right eye) is examined through the optometry window 130R.

  FIG. 2 shows a block diagram of a configuration example of the measurement head 100 according to the embodiment. The measurement head 100 includes a moving mechanism system 110, a left eye inspection unit 120L, and a right eye inspection unit 120R. The moving mechanism system 110 is suspended from the horizontal arm 6. The left-eye inspection unit 120L and the right-eye inspection unit 120R are three-dimensionally moved independently or in conjunction by the moving mechanism system 110. The left eye inspection unit 120L accommodates an optical system for inspection of the left eye. The right eye inspection unit 120R houses an optical system for inspecting the right eye.

(Movement system)
The moving mechanism system 110 includes a horizontal movement mechanism 111, rotation mechanisms 112L and 112R, and vertical movement mechanisms 113L and 113R. The moving mechanism system 110 may further include an arm moving mechanism 7.

  The horizontal movement mechanism 111 moves the rotation mechanisms 112L and 112R, the vertical movement mechanisms 113L and 113R, the left-eye inspection unit 120L, and the right-eye inspection unit 120R in the horizontal direction (lateral direction (X direction), front-rear direction (Z direction)). ). Thereby, the horizontal position of the optometry windows 130L and 130R can be adjusted according to the arrangement position of the eye to be examined. The horizontal movement mechanism 111 has a known configuration using, for example, a pulse motor or a feed screw, and moves the rotation mechanisms 112L and 112R in the horizontal direction in response to a control signal from the control device 200. The horizontal movement mechanism 111 can be manually moved in the horizontal direction by the above-described rotation mechanisms 112L, 112R, etc. in response to an operation by the operator.

  The rotation mechanism 112L rotates the vertical movement mechanism 113L and the left-eye inspection unit 120L around a predetermined first axis connected to the horizontal movement mechanism 111. The first axis is an axis extending in a substantially vertical direction, and may be tiltable at an arbitrary angle with respect to the horizontal plane. The rotation mechanism 112L has a known configuration using, for example, a pulse motor or a rotation shaft, and rotates the left eye inspection unit 120L around the first axis in response to a control signal from the control device 200. Let The rotation mechanism 112L can manually rotate the left-eye inspection unit 120L and the like about the first axis in response to an operation by the operator.

  The rotation mechanism 112R rotates the vertical movement mechanism 113R and the right-eye inspection unit 120R about a predetermined second axis connected to the horizontal movement mechanism 111. The second axis is an axis extending in a substantially vertical direction like the first axis, and may be tiltable at an arbitrary angle with respect to the horizontal plane. The second axis is an axis that is disposed at a position separated from the first axis by a predetermined distance. The distance between the first axis and the second axis is adjustable. The rotation mechanism 112R may rotate the right eye inspection unit 120R or the like in conjunction with the rotation of the rotation mechanism 112L, or the right eye inspection unit 120R independently of the rotation of the rotation mechanism 112L. Etc. may be rotated. The rotation mechanism 112R has a known configuration similar to that of the rotation mechanism 112L, and receives the control signal from the control device 200 to rotate the right-eye inspection unit 120R and the like about the second axis. The rotation mechanism 112R can receive the operation by the operator and manually rotate the right-eye inspection unit 120R and the like about the second axis.

  By rotating the left eye inspection unit 120L and the right eye inspection unit 120R by the rotation mechanisms 112L and 112R, the directions of the left eye inspection unit 120L and the right eye inspection unit 120R are relatively changed. Is possible. For example, the left-eye inspection unit 120L and the right-eye inspection unit 120R are rotated in opposite directions around the eyeball rotation points of the left and right eyes of the subject. Thereby, the eye to be examined can be spread and converged.

  The vertical movement mechanism 113L moves the left-eye inspection unit 120L in the vertical direction (Y direction). Thereby, the position in the height direction of the optometry window 130L can be adjusted according to the arrangement position of the eye to be examined. The vertical movement mechanism 113L has a known configuration using, for example, a pulse motor or a feed screw, and moves the left eye inspection unit 120L in the vertical direction in response to a control signal from the control device 200. The vertical movement mechanism 113L can receive the operation by the operator and manually move the left-eye inspection unit 120L in the vertical direction.

  The vertical movement mechanism 113R moves the right eye inspection unit 120R in the vertical direction. Thereby, the position in the height direction of the optometry window 130L can be adjusted according to the arrangement position of the eye to be examined. The vertical movement mechanism 113R may move the right eye inspection unit 120R in conjunction with the movement by the vertical movement mechanism 113L, or by moving the right eye inspection unit 120R independently of the movement by the vertical movement mechanism 113L. Also good. The vertical movement mechanism 113R has a known configuration similar to the vertical movement mechanism 113L, and moves the right eye inspection unit 120R in the vertical direction in response to a control signal from the control device 200. The vertical movement mechanism 113R can receive the operation by the operator and manually move the right eye inspection unit 120R in the vertical direction.

(Configuration of each inspection unit)
The left-eye inspection unit 120L and the right-eye inspection unit 120R can operate individually.

  The left-eye examination unit 120L includes a first optotype presenting unit 122L, a first objective measurement unit 123L, and a first imaging unit 124L. The first target presentation unit 122L selectively presents a plurality of targets to the left eye. The first objective measurement unit 123L is used for measuring objective refraction of the left eye. The first imaging unit 124L images the anterior segment of the left eye. The left eye inspection unit 120L may be provided with an optical element application unit that selectively applies a plurality of optical elements that can be disposed between the left eye to be examined and a deflection member P described later to the left eye to be examined. .

  The right-eye examination unit 120R includes a second optotype presenting unit 122R, a second objective measurement unit 123R, and a second imaging unit 124R. The second visual target presenting unit 122R selectively presents a plurality of visual targets to the right eye. The second objective measurement unit 123R is used to perform objective refractive measurement of the right eye. The second imaging unit 124R images the anterior segment of the right eye. The right eye inspection unit 120R may be provided with an optical element application unit that selectively applies a plurality of optical elements that can be arranged between the right eye to be examined and a deflection member P described later to the right eye to be examined. .

  The left eye inspection unit 120L and the right eye inspection unit 120R accommodate an optical system as shown in FIG. The left-eye inspection unit 120L and the right-eye inspection unit 120R operate the optical system, thereby performing subjective tests using the optotype presenting unit for the left eye EL and the right eye ER. It is configured to perform objective refraction measurement using the sense measurement unit and the imaging unit. The examiner or the subject performs an examination by appropriately operating a controller or the like. In addition, each of the left eye inspection unit 120L and the right eye inspection unit 120R has an eye position based on the analysis result of the image of the eye to be examined acquired by the cover test or uncover test using the optotype presenting unit and the imaging unit. It is configured to execute the calculation of the change.

  When each inspection unit is provided with the optical element application unit, the optical element application unit includes a plurality of optical elements and a drive mechanism. The plurality of optical elements is a set of various lenses for inspecting the visual function of the eye to be examined, and includes at least one of a spherical lens, a cylindrical lens, and a prism lens, for example. The plurality of optical elements are grouped for each type of optometry parameter. For example, the type of optometry parameter includes at least one of spherical power, astigmatism power, astigmatism axis angle, addition power, interpupillary distance, prism power, and prism base direction. As a grouping for each type of optometry parameter, the spherical power group includes a plurality of spherical lenses, each of which is composed of spherical lenses having different spherical powers. The set of astigmatism powers includes a plurality of cylindrical lenses, each of which is composed of cylindrical lenses having different astigmatic powers. The set of astigmatism powers may be further rotatable in accordance with the astigmatic axis angle. The set of addition powers is composed of a positive power spherical lens and a negative power spherical lens that can be inserted and removed. The set of prism powers includes a plurality of prism lenses, each of which is composed of prism lenses having different prism powers. In addition, the set of prism powers may be further rotatable in accordance with the prism base direction. The interpupillary distance is an examination condition set in accordance with the interpupillary distance of the eye to be examined. The interpupillary distance is set by one or both of the left-eye inspection unit 120L and the right-eye inspection unit 120R sliding in the horizontal direction (arrow direction m in FIG. 1).

  The drive mechanism included in each examination unit is configured such that each of the plurality of optical elements can be disposed on the optometry window and retracted from the optometry window. The drive mechanism included in each inspection unit receives the control signal from the control device 200 and switches the optical element. Accordingly, at least one of spherical power, astigmatism power, astigmatism axis angle, addition power, interpupillary distance, prism power, and prism base direction can be switched and applied to the eye to be examined.

[Configuration of optical system]
FIG. 3 shows a block diagram of a configuration example of an optical system accommodated in the left-eye inspection unit 120L and the right-eye inspection unit 120R. The left-eye inspection unit 120L includes a deflection member P, a target presentation optical system 10L, a photographing optical system 20L, alignment optical systems 30L and 31L, a reflex measurement optical system 40L, and a kerato measurement optical system 50L. . The left-eye inspection unit 120L is provided with an objective lens 60, a moving lens 70, a reflection mirror M, and beam splitters BS1 to BS3. The right-eye inspection unit 120R includes a deflection member P, a target presentation optical system 10R, a photographing optical system 20R, an alignment optical system 30R, a reflex measurement optical system 40R, and a kerato measurement optical system 50R. The right-eye inspection unit 120R is provided with an objective lens 60, a moving lens 70, and beam splitters BS1 to BS3. The optical system of the left-eye inspection unit 120L and the optical system of the right-eye inspection unit 120R are configured symmetrically. Hereinafter, unless otherwise indicated, the optical system of the left-eye inspection unit 120L will be described.

  The optotype presenting optical system 10L is an optical system for projecting the optotype on the fundus oculi Ef of the left eye to be examined EL. The optotype presenting optical system 10L includes an LCD (Liquid Crystal Display) 11, a moving lens 70, and a reflection mirror M. The LCD 11 displays various visual targets (charts) for optometry and eye position examination. The LCD 11 includes a fixation target composed of a landscape chart, a visual acuity chart such as a Landolt ring for visual acuity inspection, a cross cylinder test chart, a radiation chart for astigmatism inspection, a cross chart for oblique inspection, a red green test chart, which will be described later. A visual target such as a chart for eye position inspection is selectively displayed. By turning off the LCD 11 on which the visual target was presented (turning off the display), a state equivalent to the state in which the shielding member is disposed in front of the left eye to be examined EL to be examined through the optometry window 130L is reproduced. It is possible. In the optotype presenting optical system 10L, instead of the LCD 11, an electronic display device using EL (electroluminescence) or a plurality of optotypes drawn on a rotating glass plate or the like is appropriately arranged on the optical axis. An arrangement (turret type) may be provided.

  The moving lens 70 is movable in the optical axis direction of the optotype presenting optical system 10L. The moving lens 70 is moved by the drive mechanism 70L. The driving mechanism 70L moves the moving lens 70 in response to a control signal from the control device 200. Thereby, the sphericity added to the left eye to be examined EL can be changed. For example, by moving the moving lens 70 in the optical axis direction by the amount of movement corresponding to the refractive power of the left eye EL during reflex measurement, it is possible to perform fixation clouding on the left eye EL. In addition, during the subjective examination, the target can be presented at a position corresponding to the far point of the eye to be examined, a position corresponding to the near point, or any intermediate position between them, and the examination can be performed at an arbitrary examination distance. it can.

  The light from the LCD 11 passes through the moving lens 70 and is reflected by the reflection mirror M. The light reflected by the reflection mirror M passes through the beam splitter BS2 and is reflected by the beam splitter BS1. The light reflected by the beam splitter BS1 passes through the objective lens 60 and is deflected by the deflecting member P toward the fundus oculi Ef of the left eye EL.

  The visual target presenting optical system 10L may be provided with a VCC lens for adjusting the astigmatism power and the astigmatic axis angle of the left eye to be examined EL.

  The imaging optical system 20L is an optical system for imaging the anterior segment of the left eye EL. The photographing optical system 20L includes a CCD (Charged-Coupled Device) 21. For example, when the anterior segment of the left eye EL is illuminated by an anterior segment illumination system (not shown), the reflected light from the anterior segment of the left eye EL is incident on the deflection member P. The deflecting member P deflects the reflected light toward the objective lens 60. The reflected light deflected by the deflecting member P passes through the objective lens 60, passes through the beam splitters BS1 and BS3, and forms an image on the light receiving surface of the CCD 21 by a CCD lens or the like (not shown). The photographing optical system 20L functions as a light receiving system that receives reflected light of the measurement light beam projected on the left eye EL in reflex measurement or kerato measurement.

  The alignment optical system 30L is an optical system for performing alignment in the X and Y directions of the optical system of the left eye inspection unit 120L with respect to the left eye E. The alignment optical system 30L projects the alignment light beam (spot light) onto the left eye EL. The alignment light beam is reflected by the beam splitter BS3, passes through the beam splitter BS1, passes through the objective lens 60, becomes a substantially parallel light beam, and is deflected by the deflection member P toward the cornea of the left eye EL. The reflected light from the cornea of the alignment light beam projected on the left eye EL returns through the same path as the incident path, passes through the beam splitter BS3, and is received by the CCD 21 of the imaging optical system 20L.

  The alignment optical system 31L includes two or more cameras for photographing the anterior segment of the left eye EL from two or more different directions. Alignment in the Z direction (working distance direction) is performed from the parallax obtained based on the captured images of the anterior segment from two or more different directions obtained using these cameras.

  The reflex measurement optical system 40L is an optical system for performing reflex measurement (objective refraction measurement) of the left eye to be examined EL. The reflex measurement light beam emitted from the reflex measurement optical system 40L is reflected by the beam splitter BS2, reflected by the beam splitter BS1, passes through the objective lens 60, and is directed toward the fundus oculi Ef of the left eye EL by the deflection member P. Is deflected. The reflected light from the fundus of the reflex measurement light beam projected onto the left eye EL returns through the same path as the incident path, passes through the beam splitters BS1 and BS3, and is received by the CCD 21 of the imaging optical system 20L.

  The kerato measurement optical system 50L is an optical system for performing kerato measurement of the left eye to be examined EL. The ring-shaped light beam from the kerato ring light source emitted by the kerato measurement optical system 50L is deflected by the deflecting member P and illuminates the cornea of the left eye EL. Reflected light from the cornea of the left eye EL is deflected by the deflecting member P, passes through the objective lens 60, passes through the beam splitters BS1 and BS3, and forms a ring-shaped image on the light receiving surface of the CCD 21 by a CCD lens (not shown). Imaged.

  The measurement head 100 automatically executes alignment of the optical systems of the left eye inspection unit 120L and the right eye inspection unit 120R, objective optometry, subjective optometry, and the like under the control of the control system described later. It is supposed to be. The measurement head 100 may further automatically execute a binocular balance test. In the subjective examination, a value (objective value) obtained by objective measurement is used. In particular, in the cross-cylinder test in the subjective examination, the astigmatism power and the astigmatic axis angle obtained in the objective examination are used.

[Control system]
Next, a control system of the ophthalmic examination apparatus 1 according to the embodiment will be described with reference to FIG. The block diagram shown in FIG. 4 represents a schematic configuration of the main part of the control system of the ophthalmic examination apparatus 1. 4, parts that are the same as those in FIGS. 1 to 3 are given the same reference numerals, and descriptions thereof will be omitted as appropriate.

  As shown in FIG. 4, the control system of the ophthalmic examination apparatus 1 is configured around a control device 200 that controls each part of the apparatus. The control device 200 is stored in the storage unit 9, for example. The control device 200 includes a control unit 201 and a storage unit 202.

  The storage unit 202 stores a computer program for ophthalmic examination including a control program for executing processing as described later, image data of a target pattern displayed on the LCD 11, and the like. The storage unit 202 also includes an anterior eye image of the left eye EL acquired using the imaging optical systems 20L and 20R, an anterior eye image of the right eye ER, a reflex measurement result, a kerato measurement result, and the like. Is saved. The control unit 201 reads the computer program stored in the storage unit 202 and sequentially executes the computer program while referring to the image data stored in the storage unit 202. Such a control unit 201 includes an arithmetic control processor such as a CPU (Central Processing Unit).

  A computer device (not shown) may be connected to the ophthalmic examination apparatus 1. In this case, the computer device is used as a console of the ophthalmic examination apparatus 1 and is used for accumulating and managing examination results by the ophthalmic examination apparatus 1. Note that the CPU and the storage device of the computer device can be configured as the control device 200.

  The control device 200 (control unit 201) controls the operation of the left-eye inspection unit 120L and the right-eye inspection unit 120R. Specifically, the control device 200 controls the horizontal movement mechanism 111 that horizontally moves the left-eye inspection unit 120L and the right-eye inspection unit 120R. The control device 200 controls a rotation mechanism 112L that rotates the left-eye inspection unit 120L and a vertical movement mechanism 113L that moves the left-eye inspection unit 120L up and down. Similarly, the control device 200 controls a rotation mechanism 112R that rotates the right eye inspection unit 120R and a vertical movement mechanism 113R that moves the right eye inspection unit 120R up and down. The control device 200 may control the arm moving mechanism 7 that moves the horizontal arm 6 up and down and rotates it.

  The control device 200 (control unit 201) controls the operation of the optical system stored in the left-eye inspection unit 120L and the right-eye inspection unit 120R. The control device 200 executes, for example, display control of the LCD 11, operation control of the drive mechanisms 70L and 70R that move the moving lens 70 in the optical axis direction, and the like. Display control of the LCD 11 includes target switching control, target lighting control, target extinguishing control, and the like.

  The control device 200 can switch the visual target so as to weaken the fusion stimulus by controlling the visual target presenting optical systems 10L and 10R. For example, as shown in FIG. 5, the control device 200 causes the LCD 11 to display the targets FL and FR that are the same cross chart on both the left eye EL and the right eye ER, and then displays only the target FR. Erase from the screen of the LCD 11. That is, after turning on the targets FL and FR presented to both the left eye EL and the right eye ER, only the target FR is turned off. More specifically, the control device 200 presents a target with a cross pattern (predetermined pattern) drawn on a predetermined background (for example, a white background), and then displays the target as a background target composed of the predetermined background. Switch. Thereby, after making a subject binocularly view, the state equivalent to the state where the shielding member is arranged in front of right eye ER can be reproduced. The control device 200 can turn off only the target FL or turn off the targets FL and FR simultaneously.

  The control device 200 executes light reception control by the CCD 21, operation control of the alignment optical systems 30L, 31L, 30R, 31R, the reflex measurement optical systems 40L, 40R, the kerato measurement optical systems 50L, 50R, and the like. The left eye inspection unit 120L for the left eye E is canceled so that the deviation between the position of the spot light image projected on the left eye EL by the alignment optical system 30L and the position of the pupil center of the left eye EL is canceled. It is possible to perform alignment in the X and Y directions of the optical system. Similarly, the alignment optical system 30R can perform alignment in the XY directions of the optical system of the right-eye inspection unit 120R with respect to the right eye ER. It is possible to perform alignment in the Z direction from the parallax obtained based on the captured images of the anterior segment of the left eye EL from two or more different directions acquired using the alignment optical system 31L. Similarly, the alignment optical system 31R can perform alignment in the Z direction from parallax obtained based on the captured image of the anterior segment of the right eye ER from two or more different directions. The operation control of the reflex measurement optical systems 40L and 40R includes control of a measurement light source that emits a reflex measurement light beam. The operation control of the kerato measurement optical systems 50L and 50R includes control of a kerat light source.

  When each inspection unit is provided with an optical element application unit, the control device 200 (control unit 201) is a drive mechanism for selectively applying a plurality of optical elements to at least one of the left eye to be examined EL and the right eye to be examined ER. Execute control etc.

  The control device 200 (control unit 201) controls the calculation unit 210. The calculation unit 210 obtains an objective value based on a measurement result by objective refraction measurement using the left-eye inspection unit 120L or the right-eye inspection unit 120R. For example, the calculation unit 210 analyzes the shape of the ring target image acquired by receiving the ring-shaped measurement light beam projected on the fundus oculi Ef by the reflex measurement optical systems 40L and 40R by the CCD 21 using a known method. To obtain the objective value. For example, the calculation unit 210 performs a predetermined calculation process on an image obtained by receiving, by the CCD 21, a light beam reflected by the cornea of a ring-shaped light beam projected onto the cornea of the eye to be examined by the kerato measurement optical systems 50L and 50R. Apply. Thereby, a parameter representing the shape of the cornea can be calculated as an objective value. The control device 200 may include a calculation unit 210.

  The calculation unit 210 includes an image analysis unit 210A. The image analysis unit 210A analyzes the image of the anterior segment acquired by the imaging optical systems 20L and 20R before and after the switching of the target by the control device 200 (control unit 201), so that the left eye to be examined A change in the eye position of at least one of the EL and the right eye ER is obtained. For example, the image analysis unit 210A obtains the rotation angle θ of the visual axis centered on the eyeball rotation point O as a change in eye position.

  The image analysis unit 210A can obtain the rotation angle θ based on the movement amount of the position of the bright spot image formed by the spot light incident on the eyeball in the anterior segment image before and after the target switching. It is. As shown in FIG. 6, when a parallel light beam enters the eyeball, a spot-like virtual image (Purkinje image) is formed at a position Q (half the corneal curvature, R / 2) inside the cornea. Since the curvature center point R of the cornea is different from the eyeball rotation point O, when the eyeball rotates at the rotation angle θ about the eyeball rotation point O, the position Q of the bright spot image in the anterior eye image is shown in FIG. To move. For example, as shown in FIG. 6, it is assumed that the eye position of the subject eye changes when the eye target is turned off with respect to the subject eye whose eye position is normal in the state where the eye target is presented. In this case, the image analysis unit 210A specifies the movement amount d of the position Q of the bright spot image from the anterior eye image before and after the target switching. For example, the image analysis unit 210A specifies the position of the position Q of the bright spot image on the basis of the characteristic part in the image of the anterior segment before and after the switching of the target and moves the displacement of these positions by the movement amount d. As specified.

  When the distance from the apex of the cornea to the eyeball rotation point O is L and the curvature of the cornea is r, the moving amount d of the position Q of the bright spot image is expressed as in Expression (1).

  From equation (1), the image analysis unit 210A can determine the rotation angle θ. The distance L from the corneal apex to the eyeball rotation point O may be a predetermined value (for example, an average value of 13 mm). Alternatively, this value may be input when the actual distance is known in measurement by another device. As the curvature r of the cornea, a value obtained by kerato measurement can be used.

  The image analysis unit 210A can also generate evaluation information indicating whether or not there is a change in eye position based on the obtained rotation angle θ. For example, it is determined whether or not the rotation angle θ is equal to or greater than a predetermined threshold. When it is determined that the rotation angle θ is equal to or greater than the threshold, the image analysis unit 210A generates evaluation information indicating that there is a change in eye position. The image analysis unit 210A may generate evaluation information indicating the degree of eye position change based on the obtained rotation angle θ.

  The control device 200 executes all operation control and data processing of the ophthalmic examination apparatus 1 in addition to the above control.

  The control device 200 can be connected to the examiner controller 300 and the subject controller 310 via wired or wireless communication paths, respectively. The control device 200 receives the operation signal corresponding to the operation content for the examiner controller 300 and the subject controller 310 and controls each part of the ophthalmic examination apparatus 1. The control device 200 can display an operation screen, various information for measurement, and the like on the display unit of the examiner controller 300 or the subject controller 310.

  The operation principle of alignment using the above-described optical system, the measurement principle of subjective examination, the measurement principle of objective measurement, the measurement principle of corneal shape, and the like are already known, and detailed description thereof is omitted.

  The function of the first optotype presenting unit 122L is realized by the optotype presenting optical system 10L included in the left-eye inspection unit 120L. The function of the second visual target presenting unit 122R is realized by the visual target presenting optical system 10R included in the right-eye examination unit 120R.

  The function of the first objective measurement unit 123L is realized by the reflex measurement optical system 40L and the kerato measurement optical system 50L included in the left-eye inspection unit 120L. The function of the second objective measurement unit 123R is realized by the reflex measurement optical system 40R and the kerato measurement optical system 50R included in the right-eye inspection unit 120R.

  The visual target presenting optical systems 10L and 10R are examples of the “visual target presenting unit” according to the embodiment. The imaging optical systems 20L and 20R are examples of the “imaging unit” according to the embodiment.

[Operation example]
Next, the operation of the ophthalmic examination apparatus 1 according to the embodiment will be described.

  FIG. 7 shows an overall flowchart of an operation example of the ophthalmic examination apparatus 1.

(S1)
Upon receiving a predetermined operation on the examiner controller 300 or the subject controller 310, the control device 200 starts operation. First, the control device 200 presents the same landscape chart to both the left eye to be examined EL and the right eye to be examined ER by the visual target presenting optical systems 10L and 10R. The subject fixes his face to a forehead not shown so that the presented landscape chart can be viewed with both eyes. The position of the forehead pad itself may be adjusted automatically or manually.

(S2)
The control device 200 stands by until an instruction to start an examination is given by an operation on the examiner controller 300 or the subject controller 310 (S2: N). When the examination start is instructed (S2: Y), the operation of the ophthalmic examination apparatus 1 proceeds to S3.

(S3)
When the examination start is instructed (S2: Y), the control device 200 executes alignment for the left and right eyes. In other words, the control device 200 performs alignment of the optical system of the left-eye inspection unit 120L with respect to the left eye EL by the alignment optical system 30L, and the optical of the right-eye inspection unit 120R with respect to the right eye ER by the alignment optical system 30R. Perform system alignment.

(S4)
The control device 200 performs kerato measurement as described above for each of the left eye EL and the right eye ER using the kerato measurement optical systems 50L and 50R. Results of kerato measurement for each of the left eye EL and the right eye ER are stored in the storage unit 202.

(S5)
The control device 200 performs the reflex measurement as described above for each of the left eye EL and the right eye ER by the reflex measurement optical systems 40L and 40R. The result of the reflex measurement for each of the left eye to be examined EL and the right eye to be examined ER is stored in the storage unit 202.

(S6)
The control device 200 displays the target selected by the examiner or the control device 200 on the LCD 11 by controlling the target-presenting optical systems 10L and 10R. Thereby, the visual target is presented to the subject. The subject responds to the target. Upon receiving the response content, the control device 200 performs further control and calculation of a subjective test value. For example, the control device 200 selects and presents the next target based on the response to the Landolt ring or the like, and repeats this to determine the correction value.

(S7)
The control device 200 determines whether or not to perform a distance eye position test. In the distance eye position inspection, a cover test and a cover uncover test are performed in a state where a visual target is presented at a position corresponding to the far point of the eye to be examined. The examiner or the subject designates whether or not the distance eye position examination is to be performed using the examiner controller 300 or the subject controller 310 and stores the examination information in the storage unit 202 in advance. It is possible. In this case, the control device 200 can determine whether or not to perform a distance eye position examination based on the examination information stored in the storage unit 202. When it is determined that the distance eye position examination is performed (S7: Y), the operation of the ophthalmic examination apparatus 1 proceeds to S8. When it is determined not to perform the distance eye position examination (S7: N), the operation of the ophthalmic examination apparatus 1 proceeds to S9.

(S8)
When it is determined that the distance eye position inspection is performed (S7: Y), the control device 200 executes the distance eye position inspection. Details of S8 will be described later.

(S9)
When the distance eye position test is completed, or when it is determined in S7 that the distance eye position test is not performed (S7: N), the control device 200 determines whether or not the near eye position test is performed. . In the near eye position examination, a target test is performed at a position corresponding to the near point of the eye to be examined, and a cover test or a cover uncover test is performed. The examiner or the subject designates whether or not the near eye position examination is to be performed using the examiner controller 300 or the examiner controller 310, and stores it in the storage unit 202 in advance as examination information. It is possible. In this case, the control device 200 can determine whether or not to perform a near eye position examination based on examination information stored in the storage unit 202. When it is determined that the near eye position examination is performed (S9: Y), the operation of the ophthalmic examination apparatus 1 proceeds to S10. When it is determined that the near eye position examination is not performed (S9: N), the operation of the ophthalmic examination apparatus 1 proceeds to S11.

(S10)
When it is determined that the near eye position inspection is performed (S9: Y), the control device 200 executes the near eye position inspection. Details of S10 will be described later. S10 is substantially the same as S8 as described later.

(S11)
When the near eye position examination is completed, or when it is determined in S9 that the near eye position examination is not performed (S9: N), the control device 200 causes the image analysis unit 210A to perform the eye position as shown in FIG. Is quantitatively obtained, or evaluation information is generated based on the obtained rotation angle θ.

(S12)
The control device 200 causes the display unit of the examiner controller 300 or the subject controller 310 to display the rotation angle obtained in S11 and the evaluation information for the change in eye position based on the obtained rotation angle. This is the end of the operation of the ophthalmic examination apparatus 1 (end).

  FIG. 8 shows a flowchart of an operation example of S8 and S10 in FIG. Since the operations of S8 and S10 are almost the same, the operation example of S8 will be described below.

(S21)
First, the control device 200 obtains a position (for example, a position of −0.2D) corresponding to the far point of each of the left eye to be examined EL and the right eye to be examined ER using the results of the subjective examination and the reflex measurement. The control device 200 moves the moving lens 70 of each inspection unit to the obtained position by controlling the drive mechanisms 70L and 70R.

(S22)
Next, the control apparatus 200 presents the same target of the left eye EL and the right eye ER by controlling the target display optical systems 10L and 10R.

(S23)
Subsequently, the ophthalmic examination apparatus 1 rotates at least one of the left-eye inspection unit 120L and the right-eye inspection unit 120R inward about the rotation axis. Thereby, the visual target presented in S22 is visually recognized as if the subject is viewing the same visual target 5 m ahead.

(S24)
The control device 200 controls the alignment optical systems 30L and 30R to turn on the XY spot light LED, thereby causing the spot light to enter both the left eye EL and the right eye ER. In addition, the control device 200 controls the alignment optical systems 31L and 31R to start acquiring images of the anterior eye part of the left eye E and the anterior eye part of the right eye ER.

(S25)
The control device 200 stands by until an eye position examination start is instructed by an operation on the examiner controller 300 or the subject controller 310 (S25: N). When the start of eye position inspection is instructed (S25: Y), the operation of the ophthalmic examination apparatus 1 proceeds to S26. At this time, if the alignment state of the eye to be examined is deviated by an allowable amount or more, the alignment operation may be performed again.

(S26)
When the start of eye position inspection is instructed (S25: Y), the control device 200 controls the imaging optical systems 20L and 20R to generate a moving image for the anterior segment of both the left eye EL and the right eye ER. Start shooting. Data of moving images of the anterior segment of both the left eye EL and the right eye ER captured by the imaging optical systems 20L and 20R are sequentially stored in the storage unit 202.

(S27)
The control apparatus 200 turns off the visual target (right eye visual target) FR presented to the right eye ER by controlling the visual target presenting optical system 10R. The target FL that is presented to the left eye EL continues to be lit. Thereby, a state equivalent to the state in which the shielding member is arranged in front of the right eye ER is reproduced. Since imaging is started in S26 and images of the anterior segment before and after the target switching in S27 can be acquired, the left eye to be examined EL using the images before and after the target switching. Change of eye position can be evaluated (cover test).

(S28)
Subsequently, the control device 200 controls the optotype presenting optical system 10R to light the optotype (right eye optotype) FR on the right eye ER. As a result, the same targets FL and FR are presented on both the left eye EL and the right eye ER. Since it is possible to acquire images of the anterior segment before and after the switching of the target in S28, it is possible to evaluate the change in the eye position of the left eye EL using these images (cover uncover test). .

(S29)
Next, the control device 200 turns off the visual target (left eye visual target) FL presented on the left eye EL by controlling the visual target presenting optical system 10L. The target FR that is presented to the right eye ER continues to be lit. Thereby, a state equivalent to the state in which the shielding member is arranged in front of the left eye to be examined EL is reproduced. Since it is possible to acquire images of the anterior segment before and after the switching of the visual target in S29, it is possible to evaluate the change in the eye position of the right eye ER using these images (cover test).

(S30)
Subsequently, the control device 200 controls the visual target presenting optical system 10L to light the visual target (left eye visual target) FL to the left eye EL. As a result, the same targets FL and FR are presented on both the left eye EL and the right eye ER. Since it is possible to acquire images of the anterior segment before and after the switching of the target in S30, it is possible to evaluate changes in the position of the right eye ER using these images (cover uncover test). .

(S31)
When the predetermined number of times (for example, 3 times or 5 times) has ended (S31: Y), the operation of the ophthalmic examination apparatus 1 proceeds to S32. When the predetermined number of times has not been completed (S31: N), the operation of the ophthalmic examination apparatus 1 proceeds to S27.

(S32)
When the predetermined number of times has been completed (S31: Y), the control device 200 controls the imaging optical systems 20L and 20R to stop capturing moving images for the anterior eye portions of both the left eye EL and the right eye ER. Let This completes the operations in S8 and S10 (end). Note that the alignment state may be confirmed before each test (before the light is turned off by the cover test and before the light is turned on by the uncover test), and the alignment operation may be performed when the alignment is shifted by a predetermined amount or more.

  S10 operates in the same manner as S8. In S <b> 10, in S <b> 21, the control device 200 moves the moving lens 70 of each examination unit to a position (for example, a position of −3.3D) corresponding to the respective near points of the left eye EL and the right eye ER. . In the case of S10, in S23, the ophthalmic examination apparatus 1 induces congestion by turning at least one of the left-eye examination unit 120L and the right-eye examination unit 120R inward about the rotation axis. The visual target presented in S22 is visually recognized as if the subject is viewing the same visual target 30 cm ahead with both eyes.

  In S23, even if the congestion state is reproduced by moving the display position of the target on the LCD 11 inward without rotating at least one of the left-eye inspection unit 120L and the right-eye inspection unit 120R. Good.

  Further, although FIG. 8 illustrates the case where a moving image of the anterior segment is recorded, a still image of the anterior segment before and after the switching of the target may be recorded. In addition to the method of measuring the amount of displacement of the bright spot image before and after each test, alignment can be performed before the test, alignment can be performed again after the test, and the amount of displacement can be obtained from the amount of movement of the measuring head before and after the test. Good. The same inspection can be performed at any position other than the position corresponding to the far point and the position corresponding to the near point.

  As described above, according to the embodiment, the state in which the shielding member is disposed on the front surface of one eye can be reproduced by turning off or turning on the target displayed on the LCD 11. And it is not necessary to provide a mechanism for inserting and removing it. It is also possible to confirm the change in the eye position of the eye to be examined on the shielded side that has been shielded and difficult to confirm.

  In addition, the target can be clearly presented to the subject by moving the moving lens 70 without wearing glasses or a trial frame. As a result, it is possible to reliably apply fusion to the subject, and it is possible to evaluate changes in eye position with high accuracy.

  Further, since the examination is performed when the examinee looks into the optometry windows 130L and 130R, the examinee can concentrate on the examination without the examiner entering the field of view. For example, it is possible to avoid a state in which fixation is unstable due to the examiner entering the field of view of the subject.

  Because it is possible to acquire an image of the anterior segment of the subject regardless of whether the target is turned off or on, the examiner does not need to observe the eye position change from the front of the subject and observes the image be able to. For example, it is possible to observe the change in the eye position of the eye to be shielded which is the eye to be examined equivalent to the state in which the shielding member is disposed on the front surface. Further, by analyzing the acquired image, it is possible to quantitatively evaluate not only the presence / absence of the eye position shift but also the eye position change (shift amount).

  Since the photographing optical systems 20L and 20R photograph the anterior eye portion of the eye to be examined from the front, it is possible to confirm a minute change in the eye position. In addition, since it is possible to acquire a moving image depicting changes in the eye position before and after the switching of the target, there is no oversight by the examiner, and it is not necessary to repeat the examination many times. Moreover, it is not necessary to observe changes in eye position in real time.

  By sending the image acquired by the ophthalmic examination apparatus 1 to a remote terminal device, it is possible to observe (evaluate) a change in the eye position of the eye to be examined at a remote location.

[Modification]
(First modification)
The change of the eye position can be evaluated from various viewpoints by changing the pattern presented to the eye to be examined.

  The control device 200 can switch the target so that a part of the target is deleted. For example, as illustrated in FIGS. 9A to 9E, the control device 200 presents a predetermined target (first target) and then displays another target (second target) including a part of the target. ).

  FIG. 9A shows a case where, before the switching, the target with the cross pattern drawn is switched to another target (an additional target from which the horizontal pattern has been deleted) consisting only of the vertical pattern. FIG. 9B shows a case where, before the switching, the target with the cross pattern drawn is switched to another target (another target with the vertical pattern erased) consisting only of the horizontal pattern. FIG. 9C shows another optotype consisting of only a rectangular pattern (an alternative view in which vertical and horizontal patterns are erased) from an optotype on which a cross-shaped pattern including a rectangular pattern is drawn at the intersection before switching. It represents the case where it can be switched to (standard). In FIG. 9D, before the switching, the target having a rectangular frame pattern including a rectangular pattern at the center thereof is switched to another target (another target having the frame pattern erased) consisting only of the rectangular pattern. Represents the case. FIG. 9E shows a case where the switching of the target shown in FIG. 9D is performed simultaneously for both eyes. In this case, it is possible to observe a change in eye position for both eyes simultaneously.

  9A to 9D show a case where the target FR is switched, but the target FL can also be switched in the same manner. The target switching shown in FIGS. 9A to 9D may be performed simultaneously for both eyes.

  The control device 200 can switch the target so that the size of the target is changed. For example, as illustrated in FIGS. 10A and 10B, the control device 200 presents a predetermined target (first target) and then displays another target (second view) having a size different from that of the predetermined target. Switch to the standard).

  FIG. 10A shows a case where, for both eyes, a target having a ring-shaped pattern drawn before switching is switched to another target having a different size (target having a smaller size) at the same time. As shown in FIG. 10A, the target after switching may be the same pattern as the target before switching.

  FIG. 10B shows a case where both eyes are simultaneously switched from a target composed of a plurality of rectangular frame patterns having the same center portion and different sizes before switching to a target whose outer side has been erased. Although FIG. 10B has described an example of a plurality of rectangular frame patterns having the same center and different sizes, a plurality of ring patterns having the same center and different sizes may be used.

  The control device 200 can switch the size of the target in stages. For example, the control device 200 switches the size of the target whenever the target is switched. In the case illustrated in FIG. 10A, the control device 200 performs the target switching a plurality of times, and presents the target in which a pattern with a smaller size is drawn each time the target is switched. In the case illustrated in FIG. 10B, the control device 200 performs the target switching a plurality of times, and presents the target on which the pattern sequentially erased from the outside is drawn each time the switching is performed. In any case, the image analysis unit 210A obtains a change in eye position every time the target device is switched by the control device 200.

  9A to 9E, FIG. 10A, and FIG. 10B, after presenting a target with a large viewing angle and a strong fusion stimulus, the target is switched to a target with a small viewing angle and a weak fusion stimulus. In particular, by switching the target as shown in FIGS. 10A and 10B, it is possible to evaluate the change in the eye position every time the target is switched, and thus it is possible to evaluate the degree of the change in the eye position.

  9A to 9E, FIG. 10A, and FIG. 10B show an example of target switching. For example, the target may be switched by inverting the target before switching. You may make it switch to a target with a small viewing angle, after showing a target with a large viewing angle, without deleting a part of a target.

  As described above, since the target can be switched separately for each of the left eye to be examined EL and the right eye to be examined ER, it is possible to observe various changes in the eye position, which has been difficult in the past.

(Second modification)
In the above-described embodiment or the first modification, the case where the image analysis unit 210A obtains the rotation angle θ based on the position of the bright spot image formed by the spot light incident on the cornea has been described. However, the ophthalmologic according to the embodiment The configuration of the inspection apparatus 1 is not limited to this.

  FIG. 11 is an operation explanatory diagram of the image analysis unit 210A according to the second modification of the embodiment. In FIG. 11, the same parts as those in FIG.

  The image analysis unit 210A according to the second modification identifies the pupil region in the anterior eye image before and after the target switching, and rotates based on the amount of movement of the pupil center position of the identified pupil region. An angle θ1 is obtained. When the eyeball rotates around the eyeball rotation point O, as shown in FIG. 11, the position Q1 of the pupil center in the image of the anterior eye segment before and after the switching of the target moves. For example, as shown in FIG. 11, it is assumed that the eye position of the subject eye changes when the eye target is turned off with respect to the subject eye whose eye position is normal in the state where the eye target is presented. In this case, the image analysis unit 210A according to the second modification specifies the movement amount d1 of the position Q1 of the pupil center from the images of the anterior segment before and after the switching of the target. For example, the image analysis unit 210A identifies the pupil region in the anterior segment image before and after the target switching, identifies the center position of the identified pupil region as the pupil center position Q1, The displacement of the position is obtained as the movement amount d1.

  When the distance from the corneal apex to the eyeball rotation point O is L and the distance from the corneal apex to the pupil center position Q1 is N, the movement amount d1 of the pupil center position Q1 is expressed as shown in Expression (2). The

  From Expression (2), the image analysis unit 210A can obtain the rotation angle θ1. The distance L from the corneal apex to the eyeball rotation point O may be a predetermined value (for example, an average value of 13 mm). The distance N from the corneal apex to the pupil center position Q1 may be a predetermined value (for example, an average value of 3 mm). Alternatively, when the actual distances of L and Q1 are known in measurement by another device, this value may be input.

[effect]
The effect of the ophthalmic examination apparatus according to the embodiment will be described.

  The ophthalmic examination apparatus (ophthalmic examination apparatus 1) according to the embodiment includes an optotype presenting unit (first optotype presenting unit 122L, second optotype presenting unit 122R, optotype presenting optical systems 10L and 10R), and an imaging unit ( The first imaging unit 124L, the second imaging unit 124R, the imaging optical systems 20L and 20R), a control unit (the control device 200 or the control unit 201), and an image analysis unit (image analysis unit 210A) are included. The optotype presenting unit presents the optotype to each of the left subject eye (left subject eye EL) and the right subject eye (right subject eye ER). The imaging unit images the respective anterior eye portions of the left eye and the right eye. The control unit controls the visual target presenting unit to switch the visual target presented to at least one of the left eye and the right eye. The image analysis unit analyzes the image of the anterior segment acquired by the imaging unit before and after the switching of the target by the control unit, so that the eye position of at least one of the left subject eye and the right subject eye is determined. Seek change.

  According to such a configuration, since the fusion stimulus can be changed by switching the target, it is possible to change the eye position with a simple configuration without providing a shielding member or a mechanism for inserting and removing the shielding member. It becomes possible to evaluate. In addition, since the front image of the anterior eye segment before and after the switching of the target can be acquired by the imaging unit, the examiner does not need to observe the change in the eye position from the front of the subject. It is also possible to confirm a minute change in. In addition, since the target can be switched separately for each of the left eye and the right eye, there are various changes in the eye position compared to the case where a common target is presented to both the left eye and the right eye. Can be observed.

  In the ophthalmologic examination apparatus according to the embodiment, the control unit may switch to the second target composed of a part of the first target after presenting the first target.

  According to such a configuration, it is possible to obtain a change in eye position when the target is switched so that a part of the pattern is erased, and the change in the eye position is evaluated from a new viewpoint. It becomes possible to do.

  In the ophthalmic examination apparatus according to the embodiment, the control unit may switch to a second target having a different size from the first target after presenting the first target.

  According to such a configuration, it is possible to obtain a change in eye position when the target is switched so that the sizes are different, and it is possible to evaluate the eye position change from a new viewpoint. Become.

  In the ophthalmic examination apparatus according to the embodiment, the second visual target may be the same pattern as the first visual target.

  According to such a configuration, it becomes possible to obtain a change in eye position when the target is switched to a target having the same pattern as the target between the switching times and a different size. It becomes possible to evaluate changes.

  Further, in the ophthalmologic examination apparatus according to the embodiment, the control unit performs the target switching plural times, and the image analysis unit may obtain the change in the eye position every time the target is switched by the control unit. Good.

  According to such a configuration, it is possible to evaluate the degree of eye position change.

  In the ophthalmic examination apparatus according to the embodiment, the control unit may switch to a background target composed of a predetermined background after presenting a target with a predetermined pattern drawn on a predetermined background.

  According to such a configuration, it becomes possible to reproduce a state equivalent to the state in which the shielding member is arranged on the front surface of the eye to be examined, and a simple configuration without providing the shielding member and a mechanism for inserting and removing it. Thus, a cover test and a cover uncover test can be executed.

  In the ophthalmic examination apparatus according to the embodiment, the control unit may switch the target so as to weaken the fusion stimulus.

  According to such a configuration, since the target is switched so as to weaken the fusion stimulus, the presence or degree of the change in the eye position of the eye to be examined on which the switched target is presented is evaluated. Can do.

  In the ophthalmologic examination apparatus according to the embodiment, the control unit may present the visual target at a position corresponding to the far point of the eye to be examined, a position corresponding to the near point, or an arbitrary position in between.

  According to such a configuration, in addition to the above effects, an ophthalmic examination apparatus that can be examined at an arbitrary examination distance can be provided.

[Others]
Note that the above-described embodiment or its modification is not limited to the configuration of the optical system described with reference to FIG. 3 or the configuration and control contents of the control system described with reference to FIG. For example, the objective measurement may include objective measurement for measuring a value relating to the eye to be examined and photographing for acquiring an image of the eye to be examined. Examples of such objective measurement include objective refraction measurement, corneal shape measurement, intraocular pressure measurement, fundus imaging, and OCT (Optical Coherence Tomography) measurement using an OCT technique. The subjective examination includes, for example, a subjective refraction measurement such as a distance examination, a near examination, a contrast examination, and a glare examination, and a visual field examination.

  In addition, the ophthalmic examination apparatus according to the embodiment can execute a distance test, a near-field test, a contrast test, a glare test, and the like as a subjective test, and an objective refraction measurement and a corneal shape measurement as an objective measurement. Or an apparatus capable of performing OCT measurement or the like. In the OCT measurement, eyeball information representing the structure of the subject's eye such as the axial length, corneal thickness, anterior chamber depth, and lens thickness may be acquired.

  The configuration described above is merely an example for favorably implementing the present invention. Therefore, arbitrary modifications (omitted, substituted, added, etc.) within the scope of the present invention can be made as appropriate.

DESCRIPTION OF SYMBOLS 1 Ophthalmic examination apparatus 100 Measuring head 110 Movement mechanism system 111 Horizontal movement mechanism 112L, 112R Rotation mechanism 113L, 113R Vertical movement mechanism 120L Left-eye inspection unit 120R Right-eye inspection unit 122L 1st visual target presentation part 122R 2nd view Sign presentation unit 123L First objective measurement unit 123R Second objective measurement unit 124L First imaging unit 124R Second imaging unit 200 Controller 210A Image analysis unit

Claims (8)

An optotype presenting unit that presents an optotype on each of the left and right eye;
An imaging unit for imaging the anterior eye part of each of the left eye and the right eye;
A control unit that controls the optotype presenting unit so as to switch the optotype presented on at least one of the left eye and the right eye;
Analyzing the images of the anterior segment acquired by the imaging unit before and after switching of the visual target by the control unit, the eye position of at least one of the left subject eye and the right subject eye An image analysis unit for determining changes;
Including ophthalmic examination equipment. The ophthalmic examination apparatus according to claim 1, wherein the control unit switches to a second target composed of a part of the first target after presenting the first target. The ophthalmic examination apparatus according to claim 1, wherein after the first target is presented, the control unit switches to a second target having a size different from that of the first target. The ophthalmic examination apparatus according to claim 3, wherein the second visual target has the same pattern as the first visual target. The control unit executes the target switching a plurality of times,
The ophthalmic examination apparatus according to any one of claims 1 to 4, wherein the image analysis unit obtains the change in the eye position each time the target is switched by the control unit. The ophthalmic examination apparatus according to claim 1, wherein the control unit switches to a background target composed of the predetermined background after presenting a target with a predetermined pattern drawn on a predetermined background. The ophthalmic examination apparatus according to any one of claims 1 to 6, wherein the control unit switches a target so as to weaken a fusion stimulus. The control unit causes the target to be presented at a position corresponding to a far point of the eye to be examined, a position corresponding to a near point, or an arbitrary position in the middle thereof. An ophthalmic examination apparatus according to claim 1.

Images