JP2017136217A - Ophthalmologic apparatus and ophthalmologic examination system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an ophthalmologic apparatus and an ophthalmologic examination system capable of improving reliability of a subjective examination result.SOLUTION: An ophthalmologic apparatus includes an objective lens, a subjective examination optical system, an interference optical system, and an image formation part, and a control part. The subjective examination optical system includes an optical element that can correct aberration of an eye to be examined and projects a target to the eye to be examined through the objective lens and the optical element. The interference optical system divides a light from a light source into a reference light and a measurement light, irradiates the eye to be examined with the measurement light through the objective lens and the optical element, generates an interference light of the return light and the reference light, and detects the interference light. The image formation part forms a tomographic image of the eye to be examined based on the result of the detection of the interference light by the interference optical system. The control part causes tomographic image formation processing based on the result of the detection of the interference light obtained by irradiating the eye to be examined with the measurement light to be executed according to the result of a subjective examination of the eye to be examined obtained by using the subjective examination optical system.SELECTED DRAWING: Figure 3

Description

  The present invention relates to an ophthalmologic apparatus and an ophthalmic examination system.

  An ophthalmologic apparatus capable of performing a plurality of examinations and measurements on an eye to be examined is known. Examination and measurement for the eye to be examined include subjective examination and objective measurement. A subjective test is to obtain a result based on a response from the subject. The objective measurement is to acquire information about the eye to be examined mainly using a physical method without referring to a response from the subject.

  For example, Patent Literature 1 discloses an ophthalmologic apparatus capable of performing subjective examination and objective measurement. This ophthalmologic apparatus can perform a plurality of examinations and measurements including objective refraction measurement and subjective examination. In objective refraction measurement, a wavefront aberration represented by a Zernike coefficient is obtained from a measurement result obtained by wavefront aberration measurement, and a refraction value is obtained from the wavefront aberration. The subjective examination is performed in a state where the eye to be examined is corrected using a refraction value obtained by objective refraction measurement.

JP 2008-246153 A

  However, in the conventional ophthalmologic apparatus, when it is determined that there is a problem in the subjective examination result obtained by the subjective examination, the cause is a problem in the refraction value (eye aberration performance of the eye to be examined) obtained by the wavefront aberration measurement. It cannot be determined whether there is a problem in the retina such as retinal disease. Thereby, there exists a problem that the reliability with respect to a subjective test result will fall.

  The present invention has been made to solve the above-described problems, and an object thereof is to provide an ophthalmologic apparatus and an ophthalmic examination system capable of improving the reliability of a subjective examination result.

The ophthalmologic apparatus according to the embodiment includes an objective lens, a subjective examination optical system, an interference optical system, an image forming unit, and a control unit. The subjective examination optical system includes an optical element capable of correcting the aberration of the eye to be examined, and projects a visual target onto the eye to be examined through the objective lens and the optical element. The interference optical system divides the light from the light source into reference light and measurement light, irradiates the eye under measurement via the objective lens and the optical element, and generates interference light between the return light and the reference light. , Detecting the generated interference light. The image forming unit forms a tomographic image of the eye to be examined based on the detection result of the interference light by the interference optical system. The control unit performs the tomographic image formation process based on the detection result of the interference light obtained by irradiating the measurement eye with the measurement light according to the subjective examination result of the examined eye obtained using the subjective examination optical system. Let it run.
An ophthalmic examination system according to an embodiment includes a left examination unit for examining a left examination eye and a right examination unit for examining a right examination eye, and at least one of the left examination unit and the right examination unit Includes the ophthalmologic apparatus according to the embodiment.

  According to the ophthalmologic apparatus and the ophthalmic examination system according to the present invention, the reliability of the subjective examination result can be improved.

It is the schematic which shows the structural example of the optical system of the ophthalmologic apparatus which concerns on embodiment. It is the schematic which shows the structural example of the optical system of the ophthalmologic apparatus which concerns on embodiment. It is the schematic which shows the structural example of the processing system of the ophthalmologic apparatus which concerns on embodiment. It is a flowchart of the 1st operation example of the ophthalmologic apparatus which concerns on embodiment. It is a flowchart of the 2nd operation example of the ophthalmologic apparatus which concerns on embodiment. It is the schematic which shows the structural example of the ophthalmic examination system to which the ophthalmologic apparatus which concerns on embodiment was applied.

  Examples of embodiments of an ophthalmologic apparatus and an ophthalmic examination system according to the present invention will be described in detail with reference to the drawings. In addition, it is possible to use the description content of the literature referred in this specification, and arbitrary well-known techniques for the following embodiment.

<Ophthalmic device>
The ophthalmologic apparatus which concerns on embodiment can perform at least one of arbitrary subjective tests and arbitrary objective measurements. In the subjective examination, information (such as a visual target) is presented to the subject, and a result is acquired based on the subject's response to the information. The subjective examination includes a subjective examination such as a distance examination, a near examination, a contrast examination, a glare examination, and a visual field examination. In objective measurement, light is irradiated on the eye to be examined, and information on the eye to be examined is acquired based on the detection result of the return light. The objective measurement includes measurement for obtaining the characteristics of the eye to be examined and photographing for obtaining an image of the eye to be examined. For objective measurement, objective refraction measurement, corneal shape measurement, intraocular pressure measurement, fundus imaging, tomographic imaging (OCT imaging) using optical coherence tomography (hereinafter referred to as OCT), and OCT were used. There are measurements.

  Hereinafter, the ophthalmologic apparatus according to the embodiment can perform a distance test, a near-field test, and the like as a subjective test, and, as an objective measurement, an objective refraction measurement based on wavefront aberration measurement, a corneal shape measurement, and an OCT imaging. And the like. However, the configuration of the ophthalmologic apparatus according to the embodiment is not limited to this.

  A case where a Fourier domain type OCT technique is used in OCT imaging will be described. In particular, an ophthalmologic apparatus according to the following embodiment can perform OCT imaging using a swept source OCT technique. Note that OCT imaging may use a type other than the swept source, for example, a spectral domain OCT technique. In addition, for the OCT imaging in the following embodiments, a time domain type OCT technique can also be used.

[Constitution]
The ophthalmologic apparatus according to the embodiment includes a face receiving portion fixed to the base and a gantry that can move back and forth and from side to side with respect to the base. The gantry is provided with a head unit in which an optical system for inspecting (measuring) the eye to be examined is housed. By performing the operation on the operation unit arranged at the position on the examiner side, the face receiving unit and the head unit can be relatively moved. Further, the ophthalmologic apparatus can automatically move the face receiving portion and the head portion relative to each other by executing alignment described later.

  1 and 2 show a configuration example of the optical system of the ophthalmologic apparatus according to the embodiment. The ophthalmologic apparatus is an optical system for inspecting the eye E. The Z alignment system 1, the XY alignment system 2, the kerato measurement system 3, the target projection system 4, the observation system 5, the aberration measurement projection system 6, and the aberration measurement. A light receiving system 7 and an OCT optical system 8 are included. The ophthalmologic apparatus includes a processing unit 9.

(Processing unit 9)
The processing unit 9 controls each unit of the ophthalmologic apparatus. The processing unit 9 can execute various arithmetic processes. The processing unit 9 includes a processor. The functions of the processor are, for example, a CPU (Central Processing Unit), a GPU (Graphics Processing Unit), an ASIC (Application Specific Integrated Circuit), a programmable logic device (for example, SPLD (Simple Programmable L). And a circuit such as a field programmable gate array (FPGA). The processing unit 9 realizes the function according to the embodiment by reading and executing a program stored in a storage circuit or a storage device, for example.

(Observation system 5)
The observation system 5 captures a moving image of the anterior segment of the eye E. Light (infrared light) from the anterior segment of the eye E passes through the objective lens 51, passes through the dichroic mirror 52, and passes through the aperture of the diaphragm 53. The light that has passed through the aperture of the diaphragm 53 passes through the half mirror 22, passes through the relay lenses 55 and 56, and is imaged on the imaging surface of the imaging element 59 (area sensor) by the imaging lens 58. The imaging element 59 performs imaging and signal output at a predetermined rate. An output (video signal) of the image sensor 59 is input to the processing unit 9. The processing unit 9 displays the anterior segment image E ′ based on the video signal on the display screen 10 a of the display unit 10. The anterior segment image E ′ is, for example, an infrared moving image. The observation system 5 may include an illumination light source for illuminating the anterior segment.

(Z alignment system 1)
The Z alignment system 1 irradiates the eye E with light (infrared light) for alignment in the optical axis direction (front-rear direction, Z direction) of the observation system 5. The light output from the Z alignment light source 11 is applied to the cornea K of the eye E, reflected by the cornea K, and imaged on the line sensor 13 by the imaging lens 12. When the position of the corneal apex changes in the front-rear direction, the light projection position on the line sensor 13 changes. The processing unit 9 obtains the position of the corneal apex of the eye E based on the projection position of the light on the line sensor 13, and executes Z alignment based on this.

(XY alignment system 2)
The XY alignment system 2 irradiates the eye E with light (infrared light) for alignment in a direction (left-right direction (X direction), vertical direction (Y direction)) orthogonal to the optical axis of the observation system 5. . The XY alignment system 2 includes an XY alignment light source 21 provided in an optical path branched from the observation system 5 by a half mirror 22. The light output from the XY alignment light source 21 is reflected by the half mirror 22 and irradiated to the eye E through the observation system 5. The reflected light from the cornea K is guided to the image sensor 59 through the observation system 5.

  This reflected light image (bright spot image) is included in the anterior segment image E ′. As illustrated in FIG. 1, the processing unit 9 displays the anterior segment image E ′ including the bright spot image Br and the alignment mark AL on the display screen 10 a. When performing XY alignment manually, a user such as an examiner or a subject performs an operation of moving the optical system so as to guide the bright spot image Br in the alignment mark AL. When the alignment is performed automatically, the processing unit 9 controls a mechanism for moving the optical system so that the displacement of the bright spot image Br with respect to the alignment mark AL is cancelled.

(Kerato measurement system 3)
The kerato measurement system 3 projects a ring-shaped light beam (infrared light) for measuring the shape of the cornea K onto the cornea K. The kerato plate 31 is disposed between the objective lens 51 and the eye E. A kerato ring light source 32 is provided on the back side of the kerato plate 31 (objective lens 51 side). A ring-shaped light beam is projected onto the cornea K by illuminating the kerato plate 31 with light from the kerato ring light source 32. The reflected light (keratling image) is detected by the image sensor 59 together with the anterior segment image. The processing unit 9 calculates a corneal shape parameter by performing a known calculation based on the keratoling image.

(Target projection system 4)
The target projection system 4 presents various targets such as a fixation target and a target for subjective examination to the eye E. The liquid crystal panel 41 displays a pattern representing a visual target under the control of the processing unit 9. Light (visible light) output from the liquid crystal panel 41 passes through the relay lens 42 and the focusing lens 43 and passes through the dichroic mirror 81. The light transmitted through the dichroic mirror 81 passes through the relay lens 44 and the VCC lens 46, is reflected by the reflection mirror 47, passes through the dichroic mirror 69, and is reflected by the dichroic mirror 52. The light reflected by the dichroic mirror 52 passes through the objective lens 51 and is projected onto the fundus oculi Ef.

  The focusing lens 43 is movable along the optical axis of the target projection system 4. The position of the focusing lens 43 is adjusted so that the liquid crystal panel 41 and the fundus oculi Ef are optically conjugate. The VCC lens 46 can adjust the astigmatism of the eye to be examined (that is, the aberration of the eye to be examined can be corrected). Specifically, the VCC lens 46 is controlled by the processing unit 9 and can change the astigmatism power and the astigmatic axis angle added to the eye E, and at least the astigmatism power and the astigmatism axis of the eyeball aberration of the eye to be examined. The angle can be corrected. Thereby, the astigmatism state of the eye E is corrected.

  The liquid crystal panel 41 can display a pattern representing a fixation target for fixing the eye E under the control of the processing unit 9. By sequentially changing the display position of the pattern representing the fixation target on the liquid crystal panel 41, the fixation position can be moved to induce fixation. The target projection system 4 may include a glare inspection optical system for projecting glare light onto the eye E together with the above-described target.

  When performing the subjective examination, the processing unit 9 controls the liquid crystal panel 41, the focusing lens 43, and the VCC lens 46 based on the result of objective measurement. The processing unit 9 causes the liquid crystal panel 41 to display the visual target selected by the examiner or the processing unit 9. Thereby, the target is presented to the subject. The subject responds to the target. Upon receiving the response content, the processing unit 9 performs further control and calculation of the subjective test value. For example, in the visual acuity measurement, the processing unit 9 selects and presents the next target based on the response to the Landolt ring or the like, and repeats this to determine the visual acuity value.

  In objective measurement (such as objective refraction measurement), a landscape chart is projected onto the fundus oculi Ef. Alignment is performed while the subject is staring at the scenery chart, and the eye refractive power is measured in a clouded state.

(Aberration measurement projection system 6 and aberration measurement light receiving system 7)
The aberration measurement projection system 6 and the aberration measurement light receiving system 7 are used for measuring the eyeball aberration characteristics of the eye E. The aberration measurement projection system 6 projects a light beam (infrared light) for measuring ocular aberration characteristics onto the fundus oculi Ef. The aberration measurement light receiving system 7 receives the return light from the eye E to be examined. The eyeball aberration characteristic of the eye E is obtained from the light reception result of the return light by the aberration measurement light receiving system 7.

  For example, a light source 61 that emits laser light having a wavelength component selected from a wavelength range of 500 nm to 900 nm is used. Examples of the light source 61 include a super luminescent diode (SLD). The light source 61 is movable along the optical axis of the aberration measurement projection system 6. The light source 61 is disposed at a position optically conjugate with the fundus oculi Ef. The light output from the light source 61 passes through the relay lens 65 and the pupil lens 66, is reflected by the beam splitter 67, passes through the rotary prism 68, and is reflected by the dichroic mirror 69. The light reflected by the dichroic mirror 69 is reflected by the dichroic mirror 52, passes through the objective lens 51, and is projected onto the fundus oculi Ef.

  The rotary prism 68 is used to average the light amount distribution of the ring-shaped light flux with respect to the blood vessel and diseased part of the fundus oculi Ef.

  The return light of the light beam projected on the fundus oculi Ef passes through the objective lens 51 and is reflected by the dichroic mirrors 52 and 69. The return light reflected by the dichroic mirror 69 passes through the rotary prism 68, passes through the beam splitter 67, passes through the pupil lens 71, and is reflected by the reflecting mirror 72. The light reflected by the reflection mirror 72 passes through the relay lens 73 and is guided to the measurement unit 74.

  The measurement unit 74 includes a Shack-Hartmann sensor and is used for measuring the wavefront aberration of the return light from the fundus oculi Ef. Specifically, the measurement unit 74 includes a diaphragm 75, an imaging lens 76, a Hartmann plate 77, and a CCD (Charge Coupled Device) 78. The light guided to the measurement unit 74 passes through the aperture of the diaphragm 75, passes through the imaging lens 76, and enters the Hartmann plate 77. On the Hartmann plate 77, a plurality of small lenses are arranged in a lattice pattern, and the incident light is divided into a number of light beams and condensed. The CCD 78 detects the light collected by the Hartmann plate 77. The processing unit 9 obtains the wavefront aberration of the light incident on the Hartmann plate 77 by imaging the focal point of the small lens with the CCD 78 and analyzing the focal position of each lens. Thereby, the eyeball aberration characteristic of the eye E is obtained. The processing unit 9 obtains the refraction value of the eye E by a known calculation from the obtained eyeball aberration characteristics.

  The diaphragm 75 is disposed at a position optically conjugate with the fundus oculi Ef of the eye E to be examined. The Hartmann plate 77 is disposed at a position optically conjugate with the pupil of the eye E. The measurement unit 74 is movable along the optical axis of the aberration measurement light receiving system 7.

  Based on the calculated refraction value, the processing unit 9 moves the light source 61 and the measurement unit 74 in the optical axis direction so that the light source 61, the fundus oculi Ef, and the image sensor 59 are optically conjugate. Further, the processing unit 9 moves the focusing lens 43 in the optical axis direction in conjunction with the movement of the light source 61 and the measurement unit 74. Further, the processing unit 9 may move the focusing lens 87B of the OCT optical system 8 in the optical axis direction in conjunction with the movement of the light source 61 and the measurement unit 74.

(OCT optical system 8)
The OCT optical system 8 is an optical system for performing OCT imaging. The position of the focusing lens 87B so that the end surface of the optical fiber f2 is conjugate with the fundus oculi Ef and the optical system based on the aberration measurement result (or the reflex measurement result performed separately) performed before the OCT imaging. Is adjusted.

  The optical path of the OCT optical system 8 is coupled to the optical path of the target projection system 4 by a dichroic mirror 81. Thereby, the optical axes of the OCT optical system 8 and the target projection system 4 can be coupled coaxially.

  The OCT optical system 8 includes an OCT unit 90. As shown in FIG. 2, in the OCT unit 90, an OCT light source 91 is a wavelength sweep type (wavelength scanning type) light source capable of sweeping (scanning) the wavelength of emitted light in the same manner as a general swept source type OCT apparatus. It is comprised including. The swept wavelength light source includes a laser light source including a resonator. The OCT light source 91 temporally changes the output wavelength in the near-infrared wavelength band that cannot be visually recognized by the human eye.

  Light (infrared light, broadband light) L0 output from the OCT light source 91 is split into measurement light LS and reference light LR by a fiber coupler 92 guided through an optical fiber f1. The measurement light LS is guided to the collimating lens 86 through the optical fiber f2. On the other hand, the reference light LR is guided to the reference optical path length changing unit 94 through the optical fiber f4.

  The reference optical path length changing unit 94 changes the optical path length of the reference light LR. The reference light LR guided to the reference optical path length changing unit 94 is converted into a parallel light beam by the collimating lens 95 and guided to the corner cube 96. The corner cube 96 folds the traveling direction of the reference light LR made into a parallel light beam by the collimating lens 95 in the reverse direction. The optical path of the reference light LR incident on the corner cube 96 and the optical path of the reference light LR emitted from the corner cube 96 are parallel. Further, the corner cube 96 is movable in a direction along the incident optical path and the outgoing optical path of the reference light LR. By this movement, the length of the optical path of the reference light LR is changed. The reference light LR emitted from the corner cube 96 is converted from a parallel light beam into a focused light beam by the collimator lens 97, enters the optical fiber f5, and is guided to the fiber coupler 93. A delay member or a dispersion compensation member may be provided between the collimating lens 95 and the corner cube 96 or between the corner cube 96 and the collimating lens 97. The delay member is an optical member for matching the optical path length (optical distance) of the reference light LR with the optical path length of the measurement light LS. The dispersion compensation member is an optical member for matching the dispersion characteristics between the reference light LR and the measurement light LS.

  The measurement light LS converted into a parallel light beam by the collimator lens 86 is deflected one-dimensionally or two-dimensionally by the optical scanner 84. The optical scanner 84 includes a galvanometer mirror 84X and a galvanometer mirror 84Y. The galvanometer mirror 84X deflects the measurement light LS so as to scan the fundus oculi Ef in the X direction. The galvanometer mirror 84Y deflects the measurement light LS deflected by the galvanometer mirror 84X so as to scan the fundus oculi Ef in the Y direction. Examples of the scanning mode of the measurement light LS by the optical scanner 84 include horizontal scanning, vertical scanning, cross scanning, radial scanning, circular scanning, concentric scanning, and helical scanning.

  A reflection mirror 85, a relay lens 87A, and a focusing lens 87B are provided between the galvano mirror 84X and the galvano mirror 84Y. The focusing lens 87B is movable along the optical axis of the OCT optical system 8. The reflection mirror 85 guides the measurement light LS deflected by the galvanometer mirror 84X to the galvanometer mirror 84Y. The optical scanner 84 may be provided with an image rotator instead of the galvanometer mirror 84Y. The image rotator is disposed on the optical axis of the OCT optical system 8 and is provided to be rotatable around the optical axis.

  The measurement light LS deflected by the optical scanner 84 is reflected by the dichroic mirror 81 via the reflection mirror 83 and the relay lens 82. The measurement light LS reflected by the dichroic mirror 81 is guided to the dichroic mirror 52 through the target projection system 4 and reflected by the dichroic mirror 52. The light reflected by the dichroic mirror 52 passes through the objective lens 51 and is irradiated to the eye E. The measurement light LS is scattered (including reflection) at various depth positions of the eye E. The return light of the measurement light LS including such backscattered light travels in the reverse direction on the same path as the forward path, is guided to the fiber coupler 92, and reaches the fiber coupler 93 via the optical fiber f3.

  The fiber coupler 93 combines (interferes) the measurement light LS incident through the optical fiber f3 and the reference light LR incident through the optical fiber f5 to generate interference light. The fiber coupler 93 branches the interference light between the measurement light LS and the reference light LR at a predetermined branching ratio (for example, 1: 1), thereby generating a pair of interference lights LC. The pair of interference lights LC emitted from the fiber coupler 93 are guided to the detector 98 by optical fibers f6 and f7, respectively.

  The detector 98 is, for example, a balanced photodiode (BPD) that includes a pair of photodetectors that respectively detect a pair of interference lights LC and outputs a difference between detection results obtained by these. Based on the clock generated in synchronization with the output timing of each wavelength swept (scanned) within a predetermined wavelength range by the OCT light source 91, the difference between the detection results output from the detector 98 is sampled. This sampling data is sent to the arithmetic processing unit 120 of the processing unit 9. For example, for each series of wavelength scans (for each A line), the arithmetic processing unit 120 forms a reflection intensity profile in each A line by performing Fourier transform or the like on the spectrum distribution based on the sampling data. Further, the arithmetic processing unit 120 forms image data by imaging the reflection intensity profile of each A line.

  As described above, the OCT optical system 8 divides the light L0 from the OCT light source 91 into the reference light LR and the measurement light LS, irradiates the eye E with the measurement light LS, and the return light and the reference light LR. An interference optical system that generates the interference light LC and detects the generated interference light. The interference optical system irradiates the eye E with the measurement light LS via the objective lens 51 and the VCC lens 46.

  Such an OCT optical system 8 is coupled to the optical path of the target projection system 4 by a dichroic mirror 81. For example, when the optical path of the OCT optical system 8 is coupled to the optical path of another optical system using a perforated prism, the optical system is configured to pass the measurement light through the hole of the perforated prism. It is necessary to consider the vignetting of the return light. Further, when the OCT optical system 8 is coupled to another optical system that uses light having a wavelength close to the wavelength of the measurement light, the wavelengths become close to each other, so that separation becomes difficult and efficiency decreases. In contrast, since the optical path of the OCT optical system 8 is coupled to the optical path of another optical system using the dichroic mirror 81, the configuration of the optical system can be simplified and the degree of freedom in designing the optical system is improved. Can be made. Moreover, it becomes easy to add another optical system, and it can be set as the structure provided with the expandability.

  Furthermore, since the above-mentioned two optical paths are coupled on the light source side (upstream side) with respect to the VCC lens 46, the measurement light LS is irradiated to the fundus oculi Ef through the VCC lens 46 and is more easily converged to one point at the measurement site. Become. As a result, an interference signal based on the detection result of the interference light can be acquired with sufficient intensity with an optimal lateral resolution.

  For example, the VCC lens 46 is disposed at a position optically conjugate with the pupil of the eye E (pupil conjugate position Q). For example, each of the galvanometer mirror 84X and the galvanometer mirror 84Y is disposed at a position optically conjugate with the pupil of the eye E. Further, the focusing lens 87B is moved in the optical axis direction so that the fundus oculi Ef of the eye E and the fiber end surface of the optical fiber f2 are in an optically conjugate position (fundus conjugate position P).

(Processing system configuration)
A processing system of the ophthalmologic apparatus according to the embodiment will be described. An example of the functional configuration of the processing system of the ophthalmologic apparatus is shown in FIG. FIG. 3 illustrates an example of a functional block diagram of a processing system of the ophthalmologic apparatus according to the embodiment. The processing unit 9 includes a control unit 110 and an arithmetic processing unit 120. The ophthalmologic apparatus according to the embodiment includes a display unit 170, an operation unit 180, a communication unit 190, and a movement mechanism 200.

  The moving mechanism 200 includes an optical system such as a Z alignment system 1, an XY alignment system 2, a kerato measurement system 3, a target projection system 4, an observation system 5, an aberration measurement projection system 6, an aberration measurement light receiving system 7, and an OCT optical system 8. Is a mechanism for moving the head portion in which the is stored in the front-rear and left-right directions. For example, the moving mechanism 200 is provided with an actuator that generates a driving force for moving the moving mechanism 200 and a transmission mechanism that transmits the driving force. The actuator is constituted by, for example, a pulse motor. The transmission mechanism is configured by, for example, a combination of gears, a rack and pinion, or the like. The control unit 110 (main control unit 111) controls the moving mechanism 200 by sending a control signal to the actuator.

(Control unit 110)
The control unit 110 includes a processor and controls each unit of the ophthalmologic apparatus. The control unit 110 includes a main control unit 111 and a storage unit 112. The storage unit 112 stores in advance a computer program for controlling the ophthalmologic apparatus. The computer program includes a light source control program, a detector control program, an optical scanner control program, an optical system control program, an arithmetic processing program, a user interface program, and the like. When the main control unit 111 operates according to such a computer program, the control unit 110 executes control processing.

  The main control unit 111 performs various controls of the ophthalmologic apparatus as a measurement control unit. Controls for the Z alignment system 1 include control of the Z alignment light source 11 and control of the line sensor 13. Control of the Z alignment light source 11 includes turning on and off the light source, adjusting the light amount, adjusting the aperture, and the like. Control of the line sensor 13 includes exposure adjustment of the detection element, gain adjustment, detection rate adjustment, and the like. Thereby, lighting and non-lighting of the Z alignment light source 11 are switched, or the amount of light is changed. The main control unit 111 takes in a signal detected by the line sensor 13 and specifies a projection position of light on the line sensor 13 based on the taken-in signal. The main control unit 111 obtains the position of the corneal apex of the eye E based on the specified projection position, and controls the moving mechanism 200 based on this to move the head unit in the front-rear direction (Z alignment).

  Control for the XY alignment system 2 includes control of the XY alignment light source 21 and the like. Control of the XY alignment light source 21 includes turning on / off the light source, adjusting the light amount, adjusting the aperture, and the like. Thereby, lighting and non-lighting of the XY alignment light source 21 are switched, or the light amount is changed. The main control unit 111 captures a signal detected by the image sensor 59 and specifies the position of the bright spot image based on the return light of the light from the XY alignment light source 21 based on the captured signal. The main control unit 111 controls the moving mechanism 200 so as to cancel the displacement of the bright spot image position with respect to a predetermined target position (for example, the center position of the alignment mark), and moves the head part in the horizontal and vertical directions. (XY alignment).

  Control for the kerato measurement system 3 includes control of the kerato ring light source 32 and the like. Control of the kerating light source 32 includes turning on and off the light source, adjusting the light amount, adjusting the aperture, and the like. Thereby, the lighting and non-lighting of the kerato ring light source 32 are switched or the light amount is changed. The main control unit 111 causes the arithmetic processing unit 120 to execute a known calculation on the keratoling image detected by the image sensor 59. Thereby, the corneal shape parameter of the eye E is obtained.

  Control for the target projection system 4 includes control of the liquid crystal panel 41, control of the focusing lens 43, control of the VCC lens 46, and the like. Control of the liquid crystal panel 41 includes turning on / off the display of the visual target and the fixation target, and switching the display position of the fixation target. Thereby, a visual target or a fixation target is projected onto the fundus oculi Ef of the eye E to be examined. Control of the focusing lens 43 includes movement control of the focusing lens 43 in the optical axis direction. For example, the target projection system 4 includes a moving mechanism that moves the focusing lens 43 in the optical axis direction. Similar to the moving mechanism 200, the moving mechanism is provided with an actuator that generates a driving force for moving the moving mechanism and a transmission mechanism that transmits the driving force. The main control unit 111 controls the moving mechanism by sending a control signal to the actuator, and moves the focusing lens 43 in the optical axis direction. Thereby, the position of the focusing lens 43 is adjusted so that the liquid crystal panel 41 and the fundus oculi Ef are optically conjugate. The control of the VCC lens 46 includes control for changing the astigmatism power and the astigmatism axis angle. The VCC lens 46 includes a pair of concave and convex cylinder lenses provided so as to be relatively rotatable about the optical axis. The main control unit 111 relatively rotates the pair of cylinder lenses so as to correct the astigmatism state (astigmatism power, astigmatism axis angle) of the eye E to be obtained separately such as wavefront aberration measurement described later.

  Control over the observation system 5 includes control of the image sensor 59 and the like. The control of the image sensor 59 includes exposure adjustment, gain adjustment, detection rate adjustment, and the like of the image sensor 59. The main control unit 111 captures a signal detected by the image sensor 59 and causes the arithmetic processing unit 120 to execute processing such as image formation based on the captured signal. In addition, when the observation system 5 is configured to include an illumination light source, the main control unit 111 can control the illumination light source.

  Control for the aberration measurement projection system 6 includes control of the light source 61 and control of the rotary prism 68. Control of the light source 61 includes control of the light source 61 and movement control of the light source 61 in the optical axis direction. Control of the light source 61 includes turning on / off the light source, adjusting the light amount, adjusting the aperture, and the like. Thereby, lighting and non-lighting of the light source 61 are switched or the amount of light is changed. For example, the aberration measurement projection system 6 includes a moving mechanism that moves the light source 61 in the optical axis direction. Similar to the moving mechanism 200, the moving mechanism is provided with an actuator that generates a driving force for moving the moving mechanism and a transmission mechanism that transmits the driving force. The main control unit 111 controls the moving mechanism by sending a control signal to the actuator, and moves the light source 61 in the optical axis direction. The control of the rotary prism 68 includes rotation control of the rotary prism 68 and the like. For example, a rotation mechanism that rotates the rotary prism 68 is provided, and the main control unit 111 rotates the rotary prism 68 by controlling the rotation mechanism.

  Control for the aberration measurement light receiving system 7 includes control of the measurement unit 74, control of the CCD 78, and the like. Control of the measurement unit 74 includes movement control of the measurement unit 74 in the optical axis direction. For example, the aberration measurement light receiving system 7 includes a moving mechanism that moves the measurement unit 74 in the optical axis direction. Similar to the moving mechanism 200, the moving mechanism is provided with an actuator that generates a driving force for moving the moving mechanism and a transmission mechanism that transmits the driving force. The main control unit 111 controls the moving mechanism by sending a control signal to the actuator, and moves the measurement unit 74 in the optical axis direction. The main control unit 111 moves the light source 61 and the measurement unit 74 in the optical axis direction according to the refractive power of the eye E, for example, so that the light source 61, the fundus oculi Ef, and the image sensor 59 are optically conjugate. It is possible. The control of the CCD 78 includes exposure adjustment, gain adjustment, detection rate adjustment and the like of the CCD 78. The main control unit 111 captures a signal detected by the CCD 78 and causes the arithmetic processing unit 120 to execute a calculation process of eyeball aberration characteristics based on the captured signal.

  Controls for the OCT optical system 8 include control of the OCT light source 91, control of the optical scanner 84, control of the focusing lens 87B, control of the corner cube 96, control of the detector 98, and the like. Control of the OCT light source 91 includes turning on and off the light source, adjusting the light amount, adjusting the aperture, and the like. Control of the optical scanner 84 includes control of the scanning position, scanning range, and scanning speed by the galvanometer mirror 84X, and control of the scanning position, scanning range, and scanning speed by the galvanometer mirror 84Y. Control of the focusing lens 87B includes movement control of the focusing lens 87B in the optical axis direction. For example, the OCT optical system 8 includes a moving mechanism that moves the focusing lens 87B in the optical axis direction. Similar to the moving mechanism 200, the moving mechanism is provided with an actuator that generates a driving force for moving the moving mechanism and a transmission mechanism that transmits the driving force. The main control unit 111 controls the moving mechanism by sending a control signal to the actuator, and moves the focusing lens 87B in the optical axis direction. For example, after moving the focusing lens 87B in conjunction with the movement of the focusing lens 43, the main control unit 111 may move only the focusing lens 87B based on the intensity of the interference signal. Control of the corner cube 96 includes movement control of the corner cube 96 in the optical axis direction. For example, the OCT optical system 8 includes a moving mechanism that moves the corner cube 96 in the optical axis direction. Similar to the moving mechanism 200, the moving mechanism is provided with an actuator that generates a driving force for moving the moving mechanism and a transmission mechanism that transmits the driving force. The main control unit 111 controls the moving mechanism by sending a control signal to the actuator, and moves the corner cube 96 in the optical axis direction. Thereby, the length of the optical path of the reference light LR is changed. The control of the detector 98 includes exposure adjustment of the detection element, gain adjustment, detection rate adjustment, and the like. The main control unit 111 samples the signal detected by the detector 98 and causes the arithmetic processing unit 120 (image forming unit 122) to execute processing such as image formation based on the sampled signal.

  The main control unit 111 includes a display control unit 111A. The display control unit 111A causes the display unit 170 to display various types of information. Information displayed on the display unit 170 includes images and data based on objective measurement results (aberration measurement results) and subjective examination results acquired using the optical system, and image data formed by the image forming unit 122. There are images and information subjected to image processing and data processing by the processing unit 123. The display control unit 111A can superimpose these various types of information and display them on the display unit 170, or can display part of the information.

  Further, the main control unit 111 performs processing for writing data into the storage unit 112 and processing for reading data from the storage unit 112.

(Storage unit 112)
The storage unit 112 stores various data. The data stored in the storage unit 112 includes, for example, subjective test results, objective measurement results, tomographic image data, fundus image data, eye information to be examined, and the like. The eye information includes information about the subject such as patient ID and name, and information about the eye such as left / right eye identification information. The storage unit 112 stores various programs and data for operating the ophthalmologic apparatus.

(Operation processing unit 120)
The arithmetic processing unit 120 includes an eye refractive power calculation unit 121, an image forming unit 122, and a data processing unit 123.

  The eye refractive power calculation unit 121 analyzes the lens array image formed on the light receiving surface of the CCD 78 by the Hartmann plate 77 in the aberration measurement light receiving system 7. For example, the eye refractive power calculation unit 121 identifies the focal position of the small lens of the Hartmann plate 77 from the image in which the obtained lens array image is drawn, and determines the identified focal position and the focal position in the case of no aberration. Find the amount of deviation. The eye refractive power calculation unit 121 calculates an approximate expression of the incident wavefront by a known calculation using the calculated shift amount. The obtained approximate expression of the incident wavefront is expressed by a Zernike coefficient and a Zernike polynomial. The wavefront aberration is expressed by a Zernike coefficient. The eye refractive power calculation unit 121 obtains the spherical power S, the astigmatism power C, and the astigmatism axis angle A as refraction values from a quadratic term of the Zernike coefficient by a known calculation.

  The eye refractive power calculation unit 121 calculates a predicted visual acuity value by performing a simulation of a retinal image of the Landolt ring of the eye E by performing a known Landolt ring simulation on the measured wavefront aberration. Is possible. In the Landolt ring simulation, a point spread intensity (PSF) is calculated by performing Fourier transform on the measured wavefront aberration. Further, an optical transfer function (OTF) is obtained by further performing Fourier transform on the point image intensity distribution. The simulation result of the retinal image of the Landolt ring of the eye E is obtained by multiplying the obtained optical transfer function and the spatial frequency distribution of the Landolt ring. Details of such a Landolt ring simulation are disclosed in, for example, Japanese Patent Application Laid-Open No. 2006-116112. The eye refractive power calculation unit 121 can obtain the expected visual acuity value by, for example, comparing the retinal image with the original image of the Landolt ring and repeating the determination of whether the Landolt ring has been visually recognized.

  Further, the eye refractive power calculation unit 121 calculates the corneal refractive power, the corneal astigmatism, and the corneal astigmatism axis angle based on the keratoling image acquired by the observation system 5. For example, the eye refractive power calculation unit 121 calculates the corneal curvature radius of the strong main meridian and the weak main meridian on the front surface of the cornea by analyzing the keratling image, and calculates the parameter based on the corneal curvature radius.

  The image forming unit 122 forms tomographic image data of the fundus oculi Ef based on the signal detected by the detector 98. That is, the image forming unit 122 forms image data of the eye E based on the detection result of the interference light LC by the interference optical system. This process includes processes such as filter processing and FFT (Fast Fourier Transform) as in the case of the conventional swept source type OCT. The image data acquired in this way is a data set including a group of image data formed by imaging reflection intensity profiles in a plurality of A lines (paths of the measurement light LS in the eye E). is there.

  In order to improve the image quality, it is possible to superimpose (addition average) a plurality of data sets acquired by repeating scanning with the same pattern a plurality of times.

  The data processing unit 123 performs various data processing (image processing) and analysis processing on the tomographic image formed by the image forming unit 122. For example, the data processing unit 123 executes correction processing such as image brightness correction and dispersion correction. In addition, the data processing unit 123 performs various types of image processing and analysis processing on an image (anterior eye image or the like) obtained using the observation system 5.

  The data processing unit 123 can form volume data (voxel data) of the eye E by performing known image processing such as interpolation processing for interpolating pixels between tomographic images. When displaying an image based on volume data, the data processing unit 123 performs a rendering process on the volume data to form a pseudo three-dimensional image when viewed from a specific viewing direction.

(Display unit 170, operation unit 180)
The display unit 170 displays information under the control of the control unit 110 as a user interface unit. The display unit 170 includes the display unit 10 shown in FIG.

  The operation unit 180 is used as a user interface unit for operating the ophthalmologic apparatus. The operation unit 180 includes various hardware keys (joysticks, buttons, switches, etc.) provided in the ophthalmologic apparatus. The operation unit 180 may include various software keys (buttons, icons, menus, etc.) displayed on the touch panel display screen 10a.

  At least a part of the display unit 170 and the operation unit 180 may be integrally configured. A typical example is a touch panel display screen 10a.

(Communication unit 190)
The communication unit 190 has a function for communicating with an external device (not shown). The communication unit 190 may be provided in the processing unit 9, for example. The communication unit 190 has a configuration corresponding to the form of communication with an external device.

  The VCC lens 46 is an example of an “optical element” according to this embodiment. The target projection system 4 is an example of a “subjective inspection optical system” according to this embodiment. The OCT optical system 8 is an example of an “interference optical system” according to this embodiment. The aberration measurement projection system 6 and the aberration measurement light receiving system 7 are examples of the “aberration measurement optical system” according to this embodiment. The eye refractive power calculation unit 121 is an example of a “visual acuity value calculation unit” according to this embodiment.

[Operation example]
An operation example of the ophthalmologic apparatus according to this embodiment will be described.

  FIG. 4 shows a flowchart of a first operation example of the ophthalmologic apparatus according to this embodiment. The first operation example is an operation example in a case where OCT imaging is executed according to the subjective examination result.

(S1)
After fixing the subject's face at the face receiving portion, the head portion is moved to the inspection position of the eye E by XY alignment by the XY alignment system 2 and Z alignment by the Z alignment system 1. The inspection position is a position where the eye E can be inspected. For example, the processing unit 9 (the control unit 110) acquires an imaging signal of the anterior segment image formed on the imaging surface of the imaging element 59, and displays the anterior segment on the display unit 170 (the display screen 10a of the display unit 10). The partial image E ′ is displayed. Thereafter, the head portion is moved to the inspection position of the eye E by the XY alignment and the Z alignment. The movement of the head unit is executed by the control unit 110 in accordance with an instruction from the control unit 110, but may be executed by the control unit 110 in accordance with an operation or instruction by a user.

  In addition, the control unit 110 moves the light source 61, the measurement unit 74, and the focusing lens 43 in conjunction with each other, and moves the light source 61, the measurement unit 74, and a position corresponding to 0D along the optical axis.

(S2)
The control unit 110 displays a fixation target on the liquid crystal panel 41. Thereby, the eye E is gaze at a desired fixation position.

(S3)
Next, the control part 110 performs objective measurement. That is, the control unit 110 projects the measurement light beam onto the fundus oculi Ef of the eye E to be measured by the aberration measurement projection system 6, and converts the lens array image based on the return light detected by the CCD 78 in the aberration measurement light receiving system 7 to the eye refractive power. The calculation unit 121 is caused to analyze. The eye refractive power calculation unit 121 obtains the spherical power S, the astigmatism power C, and the astigmatism axis angle A as described above. In the control unit 110, the calculated spherical power S and the like are stored in the storage unit 112.

  In addition, the controller 110 can perform kerato measurement before or after aberration measurement. In this case, the control unit 110 turns on the keratoling light source 32 and causes the eye refractive power calculation unit 121 to analyze the keratoling image detected by the image sensor 59. The eye refractive power calculation unit 121 calculates the corneal curvature radius by analyzing the keratling image as described above, and calculates the corneal refractive power, the corneal astigmatism, and the corneal astigmatism axis angle from the calculated corneal curvature radius. In the control unit 110, the calculated corneal refractive power and the like are stored in the storage unit 112.

(S4)
Next, the control part 110 performs a subjective examination. First, the control unit 110 controls the focusing lens 43 and the VCC lens 46 so that the spherical power S, the astigmatic power C, and the astigmatic axis angle A obtained in S3 are corrected. Next, the control unit 110 displays a desired target by controlling the liquid crystal panel 41 based on a user instruction to the operation unit 180, for example. The subject responds to the visual target projected onto the fundus oculi Ef. For example, in the case of a visual target for visual acuity measurement, the visual acuity value of the eye to be examined is determined by the response of the subject. The selection of the target and the response of the subject to the selection are repeatedly performed based on the judgment of the examiner or the control unit 110. The examiner or control unit 110 determines the highest corrected visual acuity value or visual acuity value (or prescription value (S, C, A)) based on the response from the subject.

(S5)
The control unit 110 determines whether to perform tomographic imaging. The control unit 110 determines to perform tomographic imaging when the highest corrected visual acuity value determined in S4 is a predetermined threshold value (for example, 0.5) or less. Alternatively, the control unit 110 may determine whether to perform tomographic imaging based on a user operation or instruction on the operation unit 180. At this time, it is possible to display the highest corrected visual acuity value determined in S4 on the display unit 170, and to provide information for assisting the user in determining whether to perform tomographic imaging.

  Further, the control unit 110 determines to perform tomographic imaging when it is determined that the measured value does not converge in the subjective examination (cross cylinder test or the like) in S4, or when it is determined that a predetermined time has elapsed. May be. Alternatively, the control unit 110 may determine whether to perform tomographic imaging based on a user operation or instruction on the operation unit 180.

  When it is determined that tomographic imaging is to be performed (S5: Y), the operation of the ophthalmologic apparatus proceeds to S6. When it is determined that tomographic imaging is not performed (S5: N), the operation of the ophthalmologic apparatus ends (END).

(S6)
When it is determined in S5 that tomographic imaging is performed (S5: Y), the control unit 110 causes the OCT optical system 8 to scan a predetermined part of the fundus oculi Ef with measurement light, and causes the arithmetic processing unit 120 to scan the eye E to be examined. A tomographic image is formed. For example, the control unit 110 can cause a predetermined portion of the fundus oculi Ef to perform a radial scan at a predetermined angle with the measurement light.

(S7)
Next, the display control unit 111A causes the display unit 170 to display the objective measurement result obtained in S3, the subjective examination result obtained in S4, and the tomographic image obtained in S6. Thus, the operation of the ophthalmologic apparatus ends (END).

  FIG. 5 shows a flowchart of a second operation example of the ophthalmologic apparatus according to this embodiment. The second operation example is an operation example in the case where OCT imaging is executed according to the wavefront aberration measurement result.

(S11)
Similar to S1, the control unit 110 performs XY alignment and Z alignment.

(S12)
Similar to S2, the control unit 110 performs fixation control.

(S13)
As in S3, the control unit 110 performs wavefront aberration measurement using the aberration measurement projection system 6 and the aberration measurement light receiving system 7, and obtains a lens array image based on the return light detected by the CCD 78 in the aberration measurement light receiving system 7. The eye refractive power calculation unit 121 is analyzed. The eye refractive power calculation unit 121 obtains the spherical power S, the astigmatism power C, and the astigmatism axis angle A as described above. In the control unit 110, the calculated spherical power S and the like are stored in the storage unit 112. In addition, kerato measurement may be performed as described above before or after aberration measurement.

(S14)
The control unit 110 calculates the expected visual acuity value by performing the well-known Landolt ring simulation on the wavefront aberration measured in S13 as described above.

(S15)
Next, the control part 110 performs a subjective examination similarly to S4.

(S16)
The control unit 110 determines whether to perform tomographic imaging. The control unit 110 compares the predicted visual acuity value obtained in S14 with the actual measurement value (subject test result) obtained in S15, and when the actual measurement value is lower than the expected visual acuity value by a predetermined value or both, When the difference is equal to or greater than a predetermined threshold, it is determined that tomographic imaging is performed. Alternatively, the control unit 110 may determine whether to perform tomographic imaging based on a user operation or instruction on the operation unit 180. At this time, the expected visual acuity value obtained in S14 and the actual measurement value obtained in S15 are displayed on the display unit 170, and information for assisting the user in determining whether to perform tomographic imaging is provided. Is possible.

  In S16, the control unit 110 can determine whether to perform tomographic imaging according to the aberration measurement result without referring to the expected visual acuity value. For example, the control unit 110 determines whether to perform tomographic imaging according to the contrast of the Hartmann image collected by the Hartmann plate 77 and acquired by the CCD 78. In this case, when the difference between the maximum value and the minimum value of the light quantity distribution of the Hartmann image is equal to or smaller than a predetermined threshold value, it is determined that tomographic imaging is performed. Such an eye to be examined having a low contrast is suspected to be a cataract eye and can be an anterior segment OCT imaging target including a crystalline lens.

  When it is determined that tomographic imaging is performed (S16: Y), the operation of the ophthalmologic apparatus proceeds to S17. When it is determined that tomographic imaging is not performed (S16: N), the operation of the ophthalmologic apparatus ends (end).

(S17)
When it is determined in S16 that tomographic imaging is performed (S16: Y), the control unit 110 scans a predetermined part of the fundus oculi Ef with the measurement light by the OCT optical system 8 as in S6, and the arithmetic processing unit 120. A tomographic image of the eye E is formed.

(S18)
Next, the display control unit 111A causes the display unit 170 to display the aberration measurement result obtained in S13, the subjective examination result obtained in S14, and the tomographic image obtained in S17. Thus, the operation of the ophthalmologic apparatus ends (END).

  In S6 or S17, for example, a tomographic image of a portion near the macula obtained by scanning the vicinity of the macula of the eye E with the measurement light can be displayed on the display unit 170. In this case, the examiner or the like can observe the tomographic image of the site in the vicinity of the macula, so it is possible to confirm whether or not the subjective examination result acquired in S4 or S15 is valid, The accuracy of the subjective test result in S4 or S15 can be improved. In addition, the measurement light irradiated to the eye to be examined through the VCC lens 46 capable of changing the astigmatism power and the astigmatism axis angle is more easily converged to one point at the measurement site, and interference based on the detection result of the interference light with the optimum lateral resolution. The signal can be acquired with sufficient intensity.

<Ophthalmic examination system>
The ophthalmologic apparatus according to the embodiment can be applied to an ophthalmic examination system that can inspect both eyes.

  FIG. 6 is a block diagram of a configuration example of an ophthalmic examination system to which the ophthalmologic apparatus according to the embodiment is applied.

  The ophthalmic examination system includes a measurement head 300. The measuring head 300 is suspended from above by a holding part 350 supported by a support member (not shown). The measurement head 300 includes a moving mechanism 310, a left inspection unit 320L, and a right inspection unit 320R. An optometry window (not shown) is formed in each of the left examination unit 320L and the right examination unit 320R. The subject's left eye (left subject eye) is examined through an optometry window provided in the left examination unit 320L. The subject's right eye (right subject eye) is examined through an optometry window provided in the right examination unit 320R.

  The left inspection unit 320L and the right inspection unit 320R are moved three-dimensionally by the moving mechanism 310 independently or in conjunction with each other. At least one of the left examination unit 320L and the right examination unit 320R is provided with the ophthalmologic apparatus according to the embodiment.

  The moving mechanism 310 includes horizontal movement mechanisms 311L and 311R, rotation mechanisms 312L and 312R, and vertical movement mechanisms 313L and 313R.

  The horizontal movement mechanism 311L moves the rotation mechanism 312L, the vertical movement mechanism 313L, and the left inspection unit 320L in the horizontal direction (lateral direction (X direction), front-rear direction (Z direction)). Thereby, the horizontal position of the optometry window can be adjusted according to the arrangement position of the left eye to be examined. The horizontal movement mechanism 311L has a known configuration using, for example, a driving unit or a driving force transmission unit that transmits a driving force generated by the driving unit, and receives a control signal from a control device (not shown) to rotate the mechanism. 312L etc. are moved in the horizontal direction. The horizontal movement mechanism 311L can be manually moved in the horizontal direction by the rotation mechanism 312L or the like in response to an operation by the operator.

  The horizontal movement mechanism 311R moves the rotation mechanism 312R, the vertical movement mechanism 313R, and the right inspection unit 320R in the horizontal direction. Thereby, the horizontal position of the optometry window can be adjusted according to the arrangement position of the right eye to be examined. The horizontal movement mechanism 311R has the same configuration as the horizontal movement mechanism 311L, and moves the rotation mechanism 312R and the like in the horizontal direction in response to a control signal from a control device (not shown). The horizontal movement mechanism 311R can be manually moved in the horizontal direction by the rotation mechanism 312R or the like in response to an operation by the operator.

  The rotation mechanism 312L rotates the vertical movement mechanism 313L and the left inspection unit 320L around a left eye rotation axis (left rotation axis) extending in the vertical direction (substantially vertical direction). The angle formed by the rotation axis and the horizontal plane can be changed. The rotation mechanism 312L has a known configuration using, for example, a driving unit or a driving force transmission unit that transmits a driving force generated by the driving unit, and receives the control signal from a control device (not shown) to perform the rotation. The left inspection unit 320L and the like are rotated around the axis. The rotation mechanism 312L can also manually rotate the left inspection unit 320L and the like around the rotation axis in response to an operation by the operator.

  The rotation mechanism 312R rotates the vertical movement mechanism 313R and the right inspection unit 320R around a rotation axis for the right eye (right rotation axis) extending in the vertical direction. The angle formed by the rotation axis and the horizontal plane can be changed. The right-eye rotation axis is an axis that is disposed at a position separated from the left-eye rotation axis by a predetermined distance. The distance between the left eye rotation axis and the right eye rotation axis is adjustable. The rotation mechanism 312R has the same configuration as the rotation mechanism 312L, and receives a control signal from a control device (not shown) to rotate the right inspection unit 320R and the like around the rotation axis. The rotation mechanism 312R can receive the operation by the operator and manually rotate the right inspection unit 320R and the like around the rotation axis.

  By rotating the left inspection unit 320L and the right inspection unit 320R by the rotation mechanisms 312L and 312R, the directions of the left inspection unit 320L and the right inspection unit 320R can be relatively changed. For example, the left inspection unit 320L and the right inspection unit 320R 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 converged.

  The vertical movement mechanism 313L moves the left inspection unit 320L in the vertical direction (vertical direction, Y direction). Thereby, the position in the height direction of the optometry window can be adjusted according to the arrangement position of the eye to be examined. The vertical movement mechanism 313L has a known configuration using, for example, a driving means or a driving force transmission means for transmitting a driving force generated by the driving means, and receives a control signal from a control device (not shown) to receive a left inspection unit. Move 320L up and down. The vertical movement mechanism 313L can manually move the left inspection unit 320L in the vertical direction in response to an operation by the operator.

  The vertical movement mechanism 313R moves the right inspection unit 320R in the vertical direction. Thereby, the position in the height direction of the optometry window can be adjusted according to the arrangement position of the eye to be examined. The vertical movement mechanism 313R may move the right inspection unit 320R in conjunction with the movement by the vertical movement mechanism 313L, or may move the right inspection unit 320R independently of the movement by the vertical movement mechanism 313L. The vertical movement mechanism 313R has the same configuration as the vertical movement mechanism 313L, and moves the right inspection unit 320R in the vertical direction in response to a control signal from a control device (not shown). The vertical movement mechanism 313R can receive the operation by the operator and manually move the right inspection unit 320R in the vertical direction.

  The left inspection unit 320L and the right inspection unit 320R can be operated individually.

  According to such an ophthalmic examination system, subjective examination and objective measurement can be easily performed for both eyes.

(Action / Effect)
The operation and effect of the ophthalmologic apparatus and the ophthalmic examination system according to the embodiment will be described.

  The ophthalmologic apparatus according to the embodiment includes an objective lens (objective lens 51), a subjective examination optical system (target projection system 4), an interference optical system (OCT optical system 8), and an image forming unit (image forming unit 122). And a control unit (control unit 110). The subjective examination optical system includes an optical element (VCC lens 46) that can correct the aberration of the eye to be examined, and projects a visual target onto the eye to be examined (eye E) through the objective lens and the optical element. The interference optical system divides the light (light L0) from the light source (OCT light source 91) into reference light (reference light LR) and measurement light (measurement light LS), and applies it to the subject's eye via the objective lens and the optical element. The measurement light is irradiated, interference light (interference light LC) between the return light and the reference light is generated, and the generated interference light is detected. The image forming unit forms a tomographic image of the eye to be examined based on the detection result of the interference light by the interference optical system. The control unit performs the tomographic image formation process based on the detection result of the interference light obtained by irradiating the measurement eye with the measurement light according to the subjective examination result of the examined eye obtained using the subjective examination optical system. Let it run.

  According to such a configuration, for example, when it is determined that there is a problem in the result of the subjective examination obtained using the subjective examination optical system, the tomographic image is obtained, and the obtained tomographic image of the fundus of the eye to be examined is obtained. Can be observed. Thereby, it is possible to determine whether there is a problem in the subjective examination itself or a problem in the fundus such as a retinal disease, and the reliability of the subjective examination result can be improved. Also, by setting the optical element based on the objective measurement result obtained separately, it becomes easier to converge to one point at the measurement light irradiation site, and interference based on the detection result of the interference light with the optimum lateral resolution The signal can be acquired with sufficient intensity. Thereby, it becomes possible to acquire a tomographic image with higher image quality.

  In the ophthalmologic apparatus according to the embodiment, the control unit may cause the formation process to be performed when the highest corrected visual acuity of the eye to be examined in the subjective examination result is equal to or less than a predetermined threshold.

  According to such a configuration, since the tomographic image of the fundus of the eye to be examined is acquired when the maximum corrected visual acuity is equal to or less than a predetermined threshold, it is determined whether the subjective examination result is correct based on the acquired tomographic image. It becomes possible to easily judge.

  In addition, the ophthalmologic apparatus according to the embodiment may include a display control unit (display control unit 111A) that displays a subjective examination result and a tomographic image on the display unit (display unit 170).

  According to such a configuration, since the subjective examination result and the tomographic image are displayed on the display unit, it is possible to easily determine whether the subjective examination result is correct by acquiring the tomographic image. Become.

  The ophthalmologic apparatus according to the embodiment includes an objective lens (objective lens 51), a subjective examination optical system (target projection system 4), an interference optical system (OCT optical system 8), and an aberration measurement optical system (aberration measurement projection system). 6, aberration measurement light receiving system 7), an image forming unit (image forming unit 122), and a control unit (control unit 110). The subjective examination optical system includes an optical element (VCC lens 46) that can correct the aberration of the eye to be examined, and projects a visual target onto the eye to be examined (eye E) through the objective lens and the optical element. The interference optical system divides light (light L0) from a light source (OCT light source 91) into reference light (reference light LR) and measurement light (measurement light LS), and the eye to be inspected via an objective lens and an optical element ( The eye E) is irradiated with measurement light, interference light (interference light LC) between the return light and reference light is generated, and the generated interference light is detected. The aberration measurement optical system is used for irradiating light to the subject's eye and measuring the aberration of the wavefront of the return light. The image forming unit forms a tomographic image of the eye to be examined based on the detection result of the interference light by the interference optical system. The control unit performs the tomographic image formation process based on the detection result of the interference light obtained by irradiating the measurement eye with the measurement light, the subjective measurement result and aberration measurement of the test eye obtained using the subjective examination optical system. This is executed in accordance with the aberration measurement result obtained by the optical system.

  According to such a configuration, for example, when it is determined that there is a problem in the aberration measurement result obtained using the aberration measurement optical system, the tomographic image is acquired, and the acquired tomographic image of the fundus of the eye to be examined is acquired. Can be observed. As a result, it is possible to determine whether there is a problem in the aberration measurement itself or a problem in the fundus such as a retinal disease, and the reliability of the aberration measurement result can be improved. Also, by setting the optical element based on the objective measurement result obtained separately, it becomes easier to converge to one point at the measurement light irradiation site, and interference based on the detection result of the interference light with the optimum lateral resolution The signal can be acquired with sufficient intensity. Thereby, it becomes possible to acquire a tomographic image with higher image quality.

  The ophthalmologic apparatus according to the embodiment includes a visual acuity value calculation unit (eye refractive power calculation unit 121) that calculates a visual acuity value of the eye to be examined based on the aberration measurement result, and the control unit is calculated by the visual acuity value calculation unit. The formation process may be executed in accordance with the difference between the visual acuity value and the subjective test result.

  According to such a configuration, the visual acuity value of the eye to be examined is calculated from the aberration measurement result obtained using the aberration measurement optical system, and the subjective examination result obtained using the calculated visual acuity value and the subjective examination optical system A tomographic image of the fundus of the eye to be examined can be acquired according to the difference. Thus, for example, when the difference between the calculated visual acuity value and the subjective examination result is large, it is determined whether there is a problem in the aberration measurement itself, the subjective examination itself, or a problem in the fundus such as retinal disease. And the reliability of the subjective test result can be improved.

  In the ophthalmologic apparatus according to the embodiment, the control unit may cause the tomographic image forming process to be executed according to the aberration measurement result.

  According to such a configuration, a tomographic image of the fundus of the eye to be examined can be acquired according to the aberration measurement result obtained using the aberration measurement optical system. As a result, for example, it is possible to determine whether there is a problem with the aberration measurement result itself, a problem with the subjective examination itself, or a problem with the fundus and the intermediate translucent body such as retinal disease, and the reliability of the subjective examination result Can be improved.

  Further, the ophthalmologic apparatus according to the embodiment may include a display control unit (display control unit 111A) that causes the display unit (display unit 170) to display the subjective examination result, the aberration measurement result, and the tomographic image.

  According to such a configuration, since the subjective examination result, the aberration measurement result, and the tomographic image are displayed on the display unit, it is easily determined whether or not the subjective examination result is correct by acquiring the tomographic image. It becomes possible.

  The ophthalmic examination system according to the embodiment includes a left examination unit (left examination unit 320L) for examining the left eye and a right examination unit (right examination unit 320R) for examining the right eye. At least one of the left examination unit and the right examination unit includes the ophthalmologic apparatus described in any of the above.

  According to such a configuration, an ophthalmic examination system capable of performing subjective examination or aberration measurement and imaging using optical coherence tomography for both eyes while improving the reliability of the subjective examination result with a simple configuration. Can be provided.

(Other variations)
The embodiment described above is merely an example for carrying out the present invention. A person who intends to implement the present invention can make arbitrary modifications, omissions, additions and the like within the scope of the present invention.

  In the above-described embodiment or its modification, the interference optical system has been described as performing OCT imaging, but measurement may be performed by OCT. For example, the interference optical system may measure the axial length, corneal pressure, anterior chamber depth, lens thickness, and the like by OCT.

  For the apparatus having any function that can be used in the ophthalmic field, such as an intraocular pressure measurement function, a fundus imaging function, an anterior ocular segment imaging function, an optical coherence tomography (OCT) function, and an ultrasonic examination function It is possible to apply the invention which concerns on. The intraocular pressure measurement function is realized by a tonometer or the like, the fundus imaging function is realized by a fundus camera, a scanning ophthalmoscope (SLO) or the like, the anterior ocular segment imaging function is realized by a slit lamp or the like, and the OCT function is optical. The ultrasonic inspection function is realized by an ultrasonic diagnostic apparatus or the like. In addition, the present invention can be applied to an apparatus (multifunction machine) having two or more of such functions.

4 Target Projection System 5 Observation System 6 Aberration Measurement Projection System 7 Aberration Measurement Light Receiving System 8 OCT Optical System 46 VCC Lens 51 Objective Lens 110 Control Unit 122 Image Forming Unit

Claims (8)

An objective lens;
A subjective examination optical system that includes an optical element capable of correcting the aberration of the eye to be examined, and projects a target to the eye to be examined through the objective lens and the optical element;
The light from the light source is divided into reference light and measurement light, the measurement light is irradiated to the eye to be examined through the objective lens and the optical element, and interference light between the return light and the reference light is generated. An interference optical system for detecting the generated interference light;
An image forming unit that forms a tomographic image of the eye based on the detection result of the interference light by the interference optical system;
The tomographic image formation process based on the detection result of the interference light obtained by irradiating the measurement eye with the measurement light is applied to the subjective examination result of the subject eye obtained using the subjective examination optical system. A control unit to be executed according to
Ophthalmic device. The ophthalmologic apparatus according to claim 1, wherein the control unit causes the forming process to be executed when a maximum corrected visual acuity of the eye to be examined in the subjective examination result is equal to or less than a predetermined threshold. The ophthalmologic apparatus according to claim 1, further comprising: a display control unit configured to display the subjective examination result and the tomographic image on a display unit. An objective lens;
A subjective examination optical system that includes an optical element capable of correcting the aberration of the eye to be examined, and projects a target to the eye to be examined through the objective lens and the optical element;
The light from the light source is divided into reference light and measurement light, the measurement light is irradiated to the eye to be examined through the objective lens and the optical element, and interference light between the return light and the reference light is generated. An interference optical system for detecting the generated interference light;
An aberration measuring optical system for irradiating the eye to be examined and measuring the aberration of the wavefront of the return light;
An image forming unit that forms a tomographic image of the eye based on the detection result of the interference light by the interference optical system;
The tomographic image forming process based on the detection result of the interference light obtained by irradiating the measurement eye with the measurement light, the subjective examination result of the subject eye obtained using the subjective examination optical system, and A control unit to be executed according to the aberration measurement result obtained by the aberration measurement optical system;
Ophthalmic device. A visual acuity value calculating unit that calculates a visual acuity value of the eye to be examined based on the aberration measurement result;
The ophthalmologic apparatus according to claim 4, wherein the control unit causes the formation process to be executed according to a difference between the visual acuity value calculated by the visual acuity value calculation unit and the subjective examination result. The ophthalmologic apparatus according to claim 4, wherein the control unit causes the formation process to be executed according to the aberration measurement result. The ophthalmologic apparatus according to any one of claims 4 to 6, further comprising a display control unit that displays the subjective examination result, the aberration measurement result, and the tomographic image on a display unit. A left examination unit for examining the left eye;
A right examination unit for examining the right eye;
Including
At least one of the left examination unit and the right examination unit includes the ophthalmologic apparatus according to any one of claims 1 to 7. An ophthalmic examination system, comprising:

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