JP2018143586A - Ophthalmic observation apparatus and method of using the same - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an ophthalmic observation apparatus with significantly improved operability and a method of using the same.SOLUTION: The ophthalmic observation apparatus comprises: an illumination optical system for making light incident to a subject eye; an image outgoing optical system for making an image outgo; an observation optical system for guiding, to eyepieces, both outgoing light outgone from the subject eye in accordance with the incidence of light from the illumination optical system and an image outgone from the image outgoing optical system; a visual-line input detection unit 64B for detecting an input of visual line made by an operator; an operation direction detection unit 65B for detecting an operation direction input by the visual-line input detected by the visual-line input detection unit, the operation direction being made to an operational object including at least the image outgoing optical system among the illumination optical system, the image outgoing optical system, and the observation optical system; and a controller 61 for controlling the operational object based on the operation direction detected by the operation direction detection unit.SELECTED DRAWING: Figure 4

Description

  The present invention relates to an ophthalmic observation apparatus used for observing an eye to be examined and an operating method thereof.

  2. Description of the Related Art A laser surgical device (ophthalmic observation device) that performs treatment of a subject's eye by irradiating a treatment site of a subject's eye with laser light is known (see Patent Document 1). This laser surgical apparatus includes an illumination optical system that illuminates an eye to be examined and an observation optical system for observing the eye to be examined. As a result, the operator identifies the treatment site in the subject eye by confirming the observation image of the subject eye through the observation optical system, and applies a treatment laser beam from the laser surgical device to the identified treatment site. Can be irradiated.

  In such a laser surgical apparatus, when a laser beam is irradiated to a treatment site in the eye to be examined, it is necessary to irradiate the laser beam while avoiding a blood vessel in the eye to be examined. For this reason, the operator needs to determine the irradiation position of the laser light while confirming, for example, a previously acquired fluorescent fundus image of the subject's eye (an image obtained by a known fluorescein fluorescent fundus contrast examination).

  Therefore, Patent Literature 2 discloses an ophthalmic illumination system that includes the illumination optical system described above, a micro display that emits an image including information related to the eye to be examined, and an observation optical system. The observation optical system disclosed in Patent Document 2 observes the emitted light (observation image) emitted from the subject's eye under illumination from the illumination optical system and the image emitted from the micro display with the operator's observation eye. to enable. Thereby, the operator can confirm simultaneously the observation image of the eye to be examined and the image emitted from the micro display.

JP 2001-108906 A International Publication No. 2015/088849

  When the ophthalmic illumination system described in Patent Document 2 is applied to a laser surgical apparatus, the operator can simultaneously confirm the observation image of the eye to be examined and the fluorescent fundus image. In this case, the operator performs operations related to the control of the micro display such as switching of the fundus fluorescent image, enlargement / reduction, and position adjustment as necessary.

  However, since the operator of the laser surgical apparatus holds the contact lens to be in contact with the eye to be examined with one hand and holds the operation lever for adjusting the position of the laser surgical apparatus with the other hand, the operator can control the micro display. Such an operation cannot be performed manually. In addition, the operator confirms an observation image of the eye to be examined with both eyes through the eyepiece of the laser surgical apparatus. For this reason, even if one of the hands is free, the operator needs to move both eyes away from the eyepiece or perform an operation related to the control of the micro display by groping. The performance is significantly reduced.

  The present invention has been made in view of such circumstances, and an object of the present invention is to provide an ophthalmic observation apparatus and an operation method thereof that have remarkably improved operability.

  An ophthalmic observation apparatus for achieving an object of the present invention includes an illumination optical system that makes light incident on an eye to be examined, an image output optical system that emits an image, and an eye to be examined according to the incidence of light from the illumination optical system Observation optical system that guides the emitted light emitted from the image and the image emitted by the image emission optical system to the eyepiece, a line-of-sight input detection unit that detects the line-of-sight input of the operator, and the line-of-sight detected by the line-of-sight input detection unit An operation instruction detection unit that detects an operation instruction that is input by an input and that is an operation instruction for an operation target including at least the image emission optical system among the illumination optical system, the image emission optical system, and the observation optical system, and an operation instruction A control unit that controls an operation target based on an operation instruction detected by the detection unit.

  According to this ophthalmologic observation apparatus, control of an operation target can be performed in a hands-free manner based on an operation instruction input by the operator's line of sight.

  In the ophthalmic observation apparatus according to another aspect of the present invention, the image emission optical system emits an image of an operation screen including a plurality of types of objects respectively corresponding to a plurality of types of operation instructions as an image, and the observation optical system is The image of the operation screen emitted from the image output optical system is guided to the eyepiece, the line-of-sight input detection unit detects line-of-sight input to a plurality of types of objects in the operation screen, and the operation instruction detection unit includes a plurality of types of objects The operation instruction is detected based on the result of the line-of-sight input detection unit detecting the line-of-sight input to any of the above. Thereby, a desired operation instruction can be determined by line-of-sight input from a plurality of types of operation instructions.

  In the ophthalmic observation apparatus according to another aspect of the present invention, the operation instruction detection unit detects an on / off instruction to display an image by the image output optical system as the operation instruction, and the control unit includes an on / off instruction from the operation instruction detection unit. Is detected, on / off control for turning on / off the image emission by the image emission optical system is performed. Thereby, on-off control can be performed hands-free.

  In the ophthalmic observation apparatus according to another aspect of the present invention, the operation target includes an illumination optical system and an image emission optical system, and the operation instruction detection unit receives light from the illumination optical system as an operation instruction. And a switching instruction to switch the image emission by the image emission optical system, and when the operation instruction detection unit detects the switching instruction, the control unit controls the illumination optical system and the image emission optical system to Switching control between incident and image emission is performed. Thereby, switching control can be performed hands-free.

  In the ophthalmic observation apparatus according to another aspect of the present invention, the image emission optical system emits reduced images of a plurality of images, and the operation instruction detection unit enlarges the plurality of reduced images as operation instructions. A selection instruction for selecting a reduced image and a determination instruction for determining the enlargement of the reduced image selected by the selection instruction are detected. When the operation instruction detection unit detects the selection instruction and the determination instruction, the control unit outputs an image. The optical system is controlled to enlarge the reduced image selected by the selection instruction. Thereby, selection of the reduced image to be enlarged and enlargement of the selected reduced image can be performed in a hands-free manner.

  An ophthalmic observation apparatus according to another aspect of the present invention includes an observation image acquisition unit that acquires an observation image of an eye to be examined formed by emitted light, and the operation instruction detection unit uses the position and size of the image as an operation instruction. Then, the superimposition instruction for matching the posture with the observation image is detected, and the control unit, when the operation instruction detection unit detects the superposition instruction, based on the result of analyzing the image and the observation image acquired by the observation image acquisition unit, The image output optical system is controlled to perform superimposition control that matches the position, size, and orientation of the image with the observation image. Thereby, superimposition control can be performed hands-free.

  In the ophthalmic observation apparatus according to another aspect of the present invention, the operation instruction detection unit detects a first adjustment instruction for adjusting at least one of the position, size, and orientation of the image as the operation instruction, and the control unit When the operation instruction detection unit detects the first adjustment instruction, the image output optical system is controlled to adjust the image output from the image output optical system according to the first adjustment instruction. Thereby, at least one of the position, size, and orientation of the image emitted from the image emission optical system can be adjusted in a hands-free manner.

  In the ophthalmic observation apparatus according to another aspect of the present invention, the operation instruction detection unit detects a second adjustment instruction for adjusting the image quality of the image as the operation instruction, and the control unit detects that the operation instruction detection unit performs the second adjustment. When the instruction is detected, the image output optical system is controlled to adjust the image quality according to the second adjustment instruction. Thereby, the image quality of the image emitted from the image emission optical system can be adjusted in a hands-free manner.

  In the ophthalmologic observation apparatus according to another aspect of the present invention, the image is an image including information on the characteristic part of the eye to be examined, and the operation instruction detection unit detects an enhancement instruction that emphasizes the characteristic part as the operation instruction. When the operation instruction detection unit detects the enhancement instruction, the control unit controls the image emission optical system to emit an image in which the feature portion is enhanced. Thereby, the feature part of the image emitted from the image emission optical system can be emphasized in a hands-free manner.

  An operation method of an ophthalmic observation apparatus for achieving the object of the present invention includes an illumination optical system that makes light incident on an eye to be examined, an image emission optical system that emits an image, and light incident from the illumination optical system In the operating method of the ophthalmologic observation apparatus, which includes an observation optical system that guides the emitted light emitted from the eye to be examined and the image emitted from the image emission optical system to the eyepiece, A line-of-sight input detecting step for detecting a line-of-sight input and an operation instruction detecting unit that is an operation instruction input by the line-of-sight input detected by the line-of-sight input detecting unit, and that is an illumination optical system, an image output optical system, and an observation optical An operation instruction detection step for detecting an operation instruction for an operation target including at least an image output optical system in the system, and a control step for controlling the operation target by the control unit based on the operation instruction detected by the operation instruction detection unit It has a.

  The ophthalmic observation apparatus and its operating method of the present invention can remarkably improve operability.

It is an external appearance perspective view of the laser surgery apparatus to which the ophthalmic observation apparatus of the present invention is applied. It is the schematic of the structure of the surgery apparatus main body of a laser surgery apparatus, especially the various optical systems provided in the surgery apparatus main body. It is explanatory drawing for demonstrating an example of an operation screen. It is a functional block diagram of a computer. It is explanatory drawing for demonstrating the gaze input detection method of the gaze input detection part using a Purkinje image. It is explanatory drawing for demonstrating the method to detect the gaze direction of an observation eye based on the captured image data of an observation eye. It is explanatory drawing for demonstrating an example of the operation instruction database. It is explanatory drawing which showed an example of the synthesized image of the observation image of the eye to be examined displayed in the observation visual field region and the thumbnail image. It is explanatory drawing for demonstrating the change of the display mode of the icon in an operation screen. It is explanatory drawing for demonstrating "enlargement control" by a micro display control part. It is explanatory drawing for demonstrating "superimposition control" by the micro display control part in the state as which the enlarged image is displayed within the observation visual field area | region. “Magnification control”, “Reduction control”, “Vertical movement control”, “Left / right movement control”, “Left rotation control”, “ It is explanatory drawing for demonstrating "right rotation control." It is explanatory drawing for demonstrating "emphasis control" by the microdisplay control part in the state as which the enlarged image is displayed within the observation visual field area | region. It is a flowchart which shows an example of the flow of the laser surgery of the eye to be examined by a laser surgery apparatus.

[Configuration of laser surgery device]
FIG. 1 is an external perspective view of a laser surgical apparatus 10 to which the ophthalmic observation apparatus of the present invention is applied. The laser surgical apparatus 10 performs intraocular surgery for irradiating a treatment site in a subject eye E1 (see FIG. 2) of a subject H1 (see FIG. 2) with a therapeutic laser beam L2 (see FIG. 2). Used for.

  As shown in FIG. 1, the laser surgical apparatus 10 is provided on a table 11. On the table 11, in addition to the laser surgical apparatus 10, a face support unit 12 and a monitor 13 are provided. A foot switch 14 is provided below the table 11.

  The face support unit 12 is provided on the table 11 between the subject H1 (see FIG. 2) and the laser surgical apparatus 10. The face support section 12 has a forehead pad 12a and a chin rest 12b whose positions can be adjusted in the vertical direction in the figure, and supports the face of the subject H1 during intraocular surgery by the laser surgical apparatus 10.

  The monitor 13 is disposed on the table 11 on the side of the laser surgical apparatus 10, for example, and is connected to the laser surgical apparatus 10. As the monitor 13, for example, a touch panel type liquid crystal display device is used. The monitor 13 displays information on the subject H1 (see FIG. 2) and various setting screens of the laser surgical device 10 (for example, an irradiation pattern of the laser beam L2 (see FIG. 2)). The operator H2 (see FIG. 2) can perform various settings of the laser surgical apparatus 10 by performing a touch operation on the setting screen on the monitor 13.

  The foot switch 14 is an operation pedal that is operated by the operator H <b> 2 (see FIG. 2) and is connected to the laser surgical apparatus 10. The foot switch 14 is an operation switch for starting the irradiation of the therapeutic laser beam L2 (see FIG. 2) by the laser surgical apparatus 10.

  The laser surgical apparatus 10 includes a base 16 (also referred to as a base) provided on a table 11, a drive unit 17 and an operation lever 18 provided on the base 16, and a surgical apparatus main body provided on the drive unit 17. 19.

  The drive unit 17 holds the surgical device main body 19 on the base 16 so as to be movable in the up and down, front and rear, and left and right directions (the XYZ axis directions). The drive unit 17 moves the surgical device main body 19 in each of the above-described directions with respect to the base 16 under the control of a computer 55 (see FIG. 2) described later in accordance with an operation of an operation lever 18 described later. Thereby, the position adjustment of the surgical device main body 19 with respect to the eye E1 (see FIG. 2) can be performed.

  The operation lever 18 is provided on the end of the base 16 on the operator H2 (see FIG. 2) side. The operation lever 18 is an operation unit for manually moving the surgical device main body 19 in the up / down, front / rear, and left / right directions. For example, when the operation lever 18 is rotated around its longitudinal axis (clockwise or counterclockwise), the drive unit 17 moves the surgical device main body 19 in the vertical direction. The drive unit 17 moves the surgical device main body 19 in the front-rear direction or the left-right direction by tilting the operation lever 18 in the front-rear direction or the left-right direction.

  The surgical apparatus main body 19 will be described in detail with reference to FIG. 2 described later, but for the illumination of the eye E1, the acquisition of the observation image 50 of the eye E1 by the operator H2, and the treatment to the treatment site in the eye E1. The laser beam L2 is irradiated. The surgical apparatus main body 19 is provided with an eyepiece 20. The operator H2 views the observation image 50 of the eye E1 and the like through the eyepiece unit 20 with both eyes.

[Configuration of surgical device body]
FIG. 2 is a schematic diagram of the configuration of the surgical apparatus main body 19 of the laser surgical apparatus 10, particularly various optical systems provided in the surgical apparatus main body 19. As shown in FIG. 2, the surgical apparatus main body 19 includes an illumination optical system 21, a laser light irradiation optical system 22, an observation optical system 23, a photographing optical system 24, an image output optical system 25, and a line-of-sight input detection. And an optical system 26.

  The illumination optical system 21 causes illumination light L1 (corresponding to the light of the present invention) to enter the eye E1 of the subject H1. The illumination optical system 21 includes an illumination light source 28, a lens 29, and a mirror 30.

  For example, a halogen lamp is used as the illumination light source 28 and emits illumination light L1 toward the lens 29. The lens 29 collects the illumination light L1 incident from the illumination light source 28 and causes the illumination light L1 to enter the mirror 30. The mirror 30 reflects the illumination light L 1 incident from the illumination light source 28 toward the contact lens 31. The contact lens 31 is used for laser surgery of the eye E1, and is in contact with the eye E1 while being held by one hand of the operator H2. The contact lens 31 causes illumination light L1 incident from the mirror 30 and laser light L2 incident from a laser light irradiation optical system 22 described later to enter the eye E1.

  The laser light irradiation optical system 22 includes a laser light source 34, a mirror 35, and an objective lens 36. The laser light source 34 indicates the irradiation position of the treatment laser beam L2 for photocoagulating the treatment site of the eye E1 and the treatment laser beam L2, and aligns the treatment laser beam L2 with the treatment site. The aiming laser beam L2 is emitted toward the mirror 35.

  The mirror 35 reflects each laser beam L2 incident from the laser light source 34 toward the objective lens 36, and transmits the aiming laser beam L2 incident from the objective lens 36 and reflected light L3 described later to the mirror 37. Make it incident. The objective lens 36 emits each laser beam L2 incident from the mirror 35 toward the contact lens 31. Thereby, each laser beam L2 enters the eye E1 through the contact lens 31.

  The observation optical system 23 includes a reflected light L3 (corresponding to the output light of the present invention) emitted from the eye E1 when the illumination light L1 from the illumination optical system 21 is incident, and a fluorescent fundus fundus incident from an image output optical system 25 described later. The image 51 (image light) and near-infrared light IR incident from a line-of-sight input detection optical system 26 described later are guided to the eyepieces 39 and 40. The observation optical system 23 shares the above-described mirror 35 and objective lens 36 with the laser light irradiation optical system 22, and includes a mirror 37, a mirror 38, and a mirror 38IR.

  The objective lens 36 emits reflected light L3 and the like incident from the eye E1 through the contact lens 31 toward the mirror 35. Thereby, the reflected light L3 and the like enter the mirror 37 via the mirror 35. As the mirror 37, for example, a beam splitter is used. The mirror 37 divides the reflected light L3 and the like incident from the objective lens 36, transmits a part of the reflected light L3 and the like directly to the protective filter 37P, and the rest of the reflected light L3 and the like as well. Exit toward The protective filter 37P cuts light corresponding to the wavelength range of the therapeutic laser beam L2. The protective filter 37P emits the reflected light L3 and the like incident from the mirror 37 toward the mirror 38.

  As the mirror 38, for example, a dichroic mirror or a half mirror is used. The mirror 38 transmits at least a part of the reflected light L3 and the like incident from the protective filter 37P as it is and emits the reflected light L3 toward the mirror 38IR, and a fluorescent fundus image 51 and an operation screen incident from the image output optical system 25 described later. At least a part of the 79 images (see FIGS. 2 and 3) is reflected toward the mirror 38IR.

  As the mirror 38IR, for example, a dichroic mirror is used. The mirror 38IR transmits the reflected light L3 incident from the mirror 38, the fluorescent fundus image 51, and the image on the operation screen 79 as they are, and emits them toward the eyepieces 39 and 40. The near-infrared light IR incident from 26 is reflected toward the eyepieces 39 and 40.

  The eyepieces 39 and 40 are provided in the eyepiece 20 described above. The observation eye E2 of the operator H2 passes through the eyepieces 39 and 40, the reflected light L3 incident from the mirror 38IR, that is, the observation image 50 of the eye E1 formed on the reflected light L3, the fluorescent fundus image 51, and the operation screen 79. And the near-infrared light IR incident through the eyepieces 39 and 40 are reflected. In the present embodiment, the optical axis of the reflected light L3 is shifted in the left-right direction (the direction perpendicular to the paper surface in FIG. 2) with respect to the lens centers of the eyepiece lenses 39 and 40. For this reason, the center position of the observation image 50 is shifted in the left-right direction with respect to the center of the observation visual field region R in the observation visual field region R (see FIG. 6) of the operator H2.

  The eyepieces 39 and 40 emit the reflected light IR1 of the near infrared light IR reflected by the observation eye E2 toward the mirror 38IR. The mirror 38IR reflects the reflected light IR1 incident from the eyepieces 39 and 40 toward the line-of-sight input detection optical system 26 described later.

  The photographing optical system 24 constitutes an observation image acquisition unit of the present invention, and includes a lens 42 and an image sensor 43. The lens 42 forms an image of the reflected light L 3 reflected by the mirror 37 on the imaging surface of the imaging element 43. For example, a CMOS (complementary metal oxide semiconductor) type or a CCD (Charge Coupled Device) type image sensor is used as the imaging element 43. The imaging element 43 captures the reflected light L3 imaged on the imaging surface, that is, the observation image 50 of the eye E1, and outputs the captured image data of the observation image 50.

  The image output optical system 25 includes a micro display 46 (also referred to as a micro display projector) and a lens 47.

  The micro display 46 is an image emitting unit that emits various images (image light of an image). For example, a reflective liquid crystal panel (Liquid crystal on silicon), DMD (Digital Micro mirror Device), MEMS (Micro Electro Mechanical Systems), An EL display (electroluminescence display), a transmissive liquid crystal display, a micro scanner for image generation, and the like are used. Note that the micro display 46 may include a relay optical system for emitting various images, and a collimation lens or a projection lens.

  The micro display 46 may include one or more of at least one of an illumination source that emits visible light and an illumination source that emits invisible light, for example, to emit an infrared image or a color image. The illumination source may include a halogen lamp, a white light emitting diode (LED), one or more coaxial LEDs (eg, red, green, blue, amber, or near infrared LEDs), or one or more A coaxial laser (for example, red-green-blue (RGB) or near infrared laser) or the like can be used.

  The micro display 46 emits, toward the lens 47, a fluorescent fundus image 51 (also referred to as a micro display image) of the eye E1 obtained in advance by a fluorescein fluorescent fundus contrast examination as an image of the present invention. The fluorescent fundus image 51 referred to here includes a thumbnail image 51S of a fluorescent fundus image 51, which will be described in detail later, an enlarged image 51E (including the original image of the fluorescent fundus image 51), and a fluorescent fundus image. The blood vessel emphasizing image 51a created based on 51 is included.

  The fluorescent fundus image 51 is an image showing the position of the blood vessel 58 in the eye E1 as information related to the eye E1. In the laser surgical apparatus 10, it is necessary to avoid irradiation of the therapeutic laser beam L2 on the blood vessel 58 (see FIG. 11) in the eye E1. For this reason, the operator H2 needs to confirm the fluorescence fundus image 51 of the eye E1 before the treatment laser beam L2 is irradiated to the eye E1.

  In addition to the fluorescent fundus image 51, the micro display 46 emits an image of the operation screen 79. The operation screen 79 is an input screen for inputting an operation instruction to the illumination optical system 21 (illumination light source 28) and the image emission optical system 25 (micro display 46) with the observation eye E2 of the operator H2. The operation screen 79 includes icons (see FIG. 3, corresponding to the object of the present invention) respectively corresponding to a plurality of types of operation instructions.

  FIG. 3 is an explanatory diagram for explaining an example of the operation screen 79. Note that the X axis and the Y axis in the figure indicate the coordinate axes of the operation screen 79. As shown in FIG. 3, the operation screen 79 includes a “Micro” field, a “Brightness” field, and an “Overlay” field. In the “Micro” column, operation instructions related to the operation of the illumination light source 28 and the micro display 46 are input. In the “brightness” column, an operation instruction related to the adjustment of the image quality (brightness) of the fluorescent fundus image 51 emitted from the micro display 46 is input. In the “Overlay” column, an operation instruction related to the position adjustment of the fluorescent fundus image 51 emitted from the micro display 46 is input.

  On the operation screen 79 of the present embodiment, a plurality of types of operation instructions (see FIG. 5), specifically “on / off instruction”, “switching instruction”, “selection instruction”, by line-of-sight input by the observation eye E2 of the operator H2. , “Decision instruction”, “superimposition instruction”, “first adjustment instruction”, “second adjustment instruction”, “enhancement instruction”, “thumbnail image confirmation instruction”, and the like can be input.

  The “on / off instruction” is an operation instruction to turn on / off the power of the micro display 46. In the “Micro” column of the operation screen 79, an icon “ON” for inputting “on instruction” of “on / off instruction” and an icon “OFF” for inputting “off instruction” are provided. ing.

  The “switching instruction” is an operation instruction for switching between the incidence of the illumination light L1 from the illumination light source 28 to the eye E1 and the emission of the fluorescent fundus image 51 from the micro display 46. In the “Micro” column of the operation screen 79, an icon “Change” for inputting a “switching instruction” is provided.

  The “selection instruction” is an operation instruction for selecting one thumbnail image 51S to be enlarged from a plurality of thumbnail images 51S described later (see FIG. 6) emitted from the micro display 46. In the “Micro” column of the operation screen 79, an icon “Up” and an icon “Down” for inputting a “selection instruction” are provided.

  The “decision instruction” is an operation instruction for deciding execution of enlargement of the thumbnail image 51S selected by the above-described “selection instruction”. In the “Micro” column of the operation screen 79, an icon “decision” for inputting a “decision instruction” is provided.

  The “superimposition instruction” is an operation instruction for superimposing (overlaying) the fluorescent fundus image 51 on the observation image 50 of the eye E1 to be observed with the observation eye E2 of the operator H2 through the eyepieces 39 and 40 ( (See FIG. 9). In the “Overlay” field of the operation screen 79, an icon “Auto” for inputting a “superimposition instruction” is provided.

  The “first adjustment instruction” is an operation instruction for adjusting at least one of the position, size, and posture of the fluorescent fundus image 51 emitted from the micro display 46. The “first adjustment instruction” includes “enlargement instruction”, “reduction instruction”, “up / down movement instruction”, “left / right movement instruction”, “left rotation instruction”, and “right rotation instruction”.

  The “enlargement instruction” is an operation instruction for enlarging the fluorescent fundus image 51 emitted from the micro display 46. The “reduction instruction” is an operation instruction for reducing the fluorescent fundus image 51 emitted from the micro display 46. In the “Overlay” column of the operation screen 79, an icon “enlarge” for inputting an “enlargement instruction” and an icon “reduction” for inputting a “reduction instruction” are provided.

  The “up / down movement instruction” is an operation instruction to move the position of the fluorescent fundus image 51 emitted from the micro display 46 in the vertical direction within the observation visual field region R (see FIG. 6). The “horizontal movement instruction” is an operation instruction for moving the position of the fluorescent fundus image 51 emitted from the micro display 46 in the horizontal direction in the observation visual field region R. In the “Overlay” field of the operation screen 79, an icon “left” and an icon “right” for inputting “left and right movement instruction”, and an icon “up” and an icon “down” for inputting “up and down movement instruction” are displayed. Is provided.

  The “left rotation instruction” is an operation instruction for rotating the position of the fluorescent fundus image 51 emitted from the micro display 46 to the left within the observation visual field region R (see FIG. 6). The “right rotation instruction” is an operation instruction to rotate the position of the fluorescent fundus image 51 emitted from the micro display 46 to the right within the observation visual field region R. In the “Overlay” column of the operation screen 79, an icon “counterclockwise” for inputting “counterclockwise rotation” and an icon “counterclockwise” for inputting “right rotation instruction” are provided.

  The “second adjustment instruction” is an operation instruction for adjusting the image quality of the fluorescent fundus image 51 emitted from the micro display 46, in this case, the brightness. This second adjustment instruction includes “brightness increase instruction” and “brightness decrease instruction”. The “brightness increase instruction” is an operation instruction to increase the brightness of the fluorescent fundus image 51 emitted from the micro display 46. The “brightness reduction instruction” is an operation instruction to reduce the brightness of the fluorescent fundus image 51 emitted from the micro display 46. In the “brightness” column of the operation screen 79, an icon “Up” for inputting a “brightness increase instruction” and an icon “Down” for inputting a “brightness decrease instruction” are provided.

  In this embodiment, although described in detail later, the brightness of the illumination light L1 emitted from the illumination light source 28 (observation image 50) in accordance with the increase or decrease in the brightness of the fluorescent fundus image 51 emitted from the micro display 46. The brightness). For this reason, an icon “Micro” and an icon “View” are provided in the “brightness” column. The icon “Micro” is an icon for inputting an operation instruction to increase or decrease the brightness of only the fluorescent fundus image 51. The icon “View” is an icon for inputting an operation instruction to increase or decrease the brightness of only the illumination light L1 (observation image 50).

  The “enhancement instruction” is an “operation instruction” for the operator H2 to confirm a blood vessel enhancement image 51a (see FIG. 11) described later, that is, a position of the blood vessel 58 (see FIG. 11) in the eye E1. In the “Micro” column of the operation screen 79, an icon “emphasis” for inputting “emphasis instruction” is provided.

  The “thumbnail image confirmation instruction” is an operation instruction for the operator H2 to confirm a plurality of thumbnail images 51S (see FIG. 6) described later. In the “Micro” column of the operation screen 79, an icon “thumbnail” for inputting a “thumbnail image confirmation instruction” is provided.

  In addition to the icons, a cursor 80 is displayed (superimposed) on the operation screen 79. The cursor 80 is an index indicating the line-of-sight position of the observation eye E2 of the operator H2 on the operation screen 79, and an operation instruction is input on the operation screen 79, specifically, an icon is selected on the operation screen 79. And used for decision. The cursor 80 is displayed at an initial position (for example, a position in the drawing) on the operation screen 79 in an initial state (when the laser surgical apparatus 10 is powered on).

The cursor 80 moves in the operation screen 79 in accordance with a change in the line-of-sight position (line-of-sight direction) of the observation eye E2 of the operator H2 on the operation screen 79. Thereby, the cursor 80 can be set to a desired icon only by gazing at a desired icon in the operation screen 79 with the observation eye E2 of the operator H2. For example, if this state is continued for a predetermined time (several seconds),
An operation instruction corresponding to the icon is input. Further, when the line-of-sight position of the observation eye E2 of the operator H2 deviates from a desired icon in less than the predetermined time described above, the input of the operation instruction is canceled. It should be noted that an icon for inputting execution of an operation instruction and input cancellation may be provided on the operation screen 79.

  The display position and display mode of each icon are not limited to the display position and display mode shown in FIG. 3, and may be changed as appropriate.

  Returning to FIG. 2, the lens 47 condenses the fluorescence fundus image 51 and the image on the operation screen 79 incident from the micro display 46 and emits them toward the mirror 38 of the observation optical system 23. As a result, the fluorescent fundus image 51 and the image on the operation screen 79 merge with the observation optical system 23. Thereby, the operator H2 can confirm the synthesized image (parallel image or superimposed image) of the observation image 50 of the eye E1, the fluorescent fundus image 51, and the operation screen 79 through the eyepieces 39 and 40.

  The line-of-sight detection optical system 26 includes an infrared LED 101, a pinhole 102, a condenser lens 103, a mirror 104, an imaging lens 105, a mirror 106, an image sensor 107, and a semiconductor position detection element (Position Sensitive). PSD 108 which is a Detector). Note that two line-of-sight input detection optical systems 26 may be provided corresponding to the left and right eyes of the observation eye E2, or only one corresponding to one of the left and right eyes.

  The infrared LED 101 emits near infrared light IR toward the pinhole 102. The pinhole 102 uses the near-infrared light IR incident from the infrared LED 101 as a point light source, and then emits the near-infrared light IR from the point light source toward the condenser lens 103. The condensing lens 103 emits near-infrared light IR of the point light source incident from the pinhole 102 toward the mirror 104.

  As the mirror 104, for example, a half mirror is used. The mirror 104 transmits a part of the near-infrared light IR of the point light source incident from the condenser lens 103 as it is toward the mirror 38IR of the observation optical system 23 described above. Thereby, the near-infrared light IR of the point light source transmitted through the mirror 104 is reflected by the mirror 38IR toward the eyepiece lenses 39 and 40, and enters the observation eye E2 through the eyepiece lenses 39 and 40. Then, the reflected light IR1 of the near-infrared light IR of the point light source reflected by the observation eye E2 enters the mirror 38IR through the eyepiece lenses 39 and 40, and is reflected toward the mirror 104 by the mirror 38IR. The mirror 104 reflects a part of the reflected light IR1 incident from the mirror 38IR toward the imaging lens 105.

  The imaging lens 105 emits the reflected light IR1 incident from the mirror 104 toward the mirror. The mirror 106 reflects a part of the reflected light IR1 incident from the imaging lens 105 toward the image sensor 107 and transmits the remainder of the reflected light IR1 incident from the imaging lens 105 as it is to the PSD 108. To do.

  The imaging element 107 is a CMOS type or CCD type image sensor, and reflected light IR1 reflected by the mirror 106 forms an image of the observation eye E2 on the imaging surface. The imaging element 107 captures an image of the observation eye E2 formed on the imaging surface, and outputs captured image data 110 (see FIG. 5) of the observation eye E2.

  The reflected light IR1 incident from the mirror 106 is incident on the light receiving surface of the PSD 108. The PSD 108 is a sensor that can detect the light receiving position of the reflected light IR1 on the light receiving surface, and outputs a light receiving signal indicating the light receiving position. Note that a line sensor may be used instead of the PSD 108.

  Control (drive) of the drive unit 17, the illumination light source 28, the laser light source 34, the image sensor 43, the micro display 46, the infrared LED 101, the image sensor 107, and the PSD 108 is provided inside the laser surgical apparatus 10 (or externally possible). The computer 55 (arithmetic processing unit) is used. The computer 55 performs overall control of the operation of each part of the laser surgical apparatus 10.

  The computer 55 includes the monitor 13 described above, the operation lever 18 (a potentiometer for detecting the rotation and tilting operation of the operation lever 18), the foot switch 14, the drive unit 17, the illumination light source 28, the laser light source 34, the image sensor 43, In addition to the micro display 46, the infrared LED 101, the image sensor 107, and the PSD 108, an image database 57 is connected.

  The image database 57 is a database (server) for medical support that stores medical information and the like of the patient H1 who is a patient, and “IMAGENETR4” of Topcon Medical Japan Co., Ltd. is an example. The image database 57 includes a plurality of fluorescent fundus images 51 obtained by performing a fluorescein fluorescence fundus contrast examination of the eye E1 of the subject H1, and the unique identification information of the subject H1 (name and patient of the subject H1) Number).

  Further, based on the fluorescent fundus image 51 (original image), a blood vessel emphasized image 51a in which the blood vessel 58 (see FIG. 11) which is a characteristic part of the eye E1 is emphasized is created in advance and associated with the original fluorescent fundus image 51. And stored in the image database 57. Note that since the method for generating the blood vessel emphasized image 51a (the method for enhancing the blood vessel 58) is a known technique, a detailed description thereof is omitted here.

[Computer configuration]
FIG. 4 is a functional block diagram of the computer 55. As shown in FIG. 4, the computer 55 includes an overall control unit 61 corresponding to the control unit of the present invention, an image acquisition unit 62, an observation image acquisition unit 63, a line-of-sight input detection unit 64B, and an operation instruction detection unit 65B. And an operation instruction database 66A.

  The overall control unit 61 is an arithmetic circuit including various arithmetic units including a CPU (Central Processing Unit) or an FPGA (field-programmable gate array), a memory, and the like. Connected to the overall control unit 61 are a monitor 13, a foot switch 14, an operation lever 18, an image acquisition unit 62, an observation image acquisition unit 63, a line-of-sight input detection unit 64B, an operation instruction detection unit 65B, and an operation instruction database 66A. Has been. Based on instructions and information (images) from these units, the overall control unit 61 controls (drives) the drive unit 17, the illumination light source 28, the laser light source 34, the micro display 46, and the like.

  The image acquisition unit 62 has various interfaces connected to the image database 57. The image acquisition unit 62 acquires, from the image database 57, the fluorescent fundus image 51 and the blood vessel emphasized image 51a corresponding to the eye E1 to be operated under the control of the overall control unit 61 (a microdisplay control unit 73 described later). To the overall control unit 61. For example, when the operator H2 performs a touch operation to input the name and patient number of the subject H1 on the touch panel monitor 13, the image acquisition unit 62 controls the subject H1 under the control of the overall control unit 61. Are acquired from the image database 57 and output to the overall control unit 61.

  The observation image acquisition unit 63 constitutes the observation image acquisition unit of the present invention together with the imaging optical system 24 described above, and has various interfaces connected to the image sensor 43. The observation image acquisition unit 63 acquires the captured image data of the observation image 50 from the imaging element 43 under the control of the overall control unit 61 (a microdisplay control unit 73 described later), and outputs the acquired image data to the overall control unit 61. Based on the captured image data of the observation image 50, the position, size, and posture of the eye E1 in the observation image 50 observed by the operator H2 through the eyepieces 39 and 40 can be determined.

  The line-of-sight input detection unit 64B constitutes the line-of-sight input detection unit of the present invention together with the above-described line-of-sight input detection optical system 26, and is connected to the image sensor 107 and the PSD 108, respectively. The line-of-sight input detection unit 64B detects the line-of-sight input of the observation eye E2 based on the captured image data 110 (see FIG. 5) of the observation eye E2 input from the image sensor 107 and the received light signal input from the PSD 108. Specifically, the position coordinates of the gazing point on the operation screen 79 on which the observation eye E2 is gazing are detected.

  FIG. 5 is an explanatory diagram for explaining a gaze input detection method (corneal detection method) of the gaze input detection unit 64B using the Purkinje image 110p. As shown in the upper part of FIG. 5, a Purkinje image 110p that is a reflection image of the near-infrared light IR is generated on the cornea surface of the observation eye E2 by the incidence of the near-infrared light IR from the point light source. The position of the Purkinje image 110p changes according to the change in the viewing direction of the observation eye E2.

  Therefore, as shown in the lower part of FIG. 5, the line-of-sight input detection unit 64B is based on the captured image data 110 of the observation eye E2 input from the image sensor 107 and the light reception signal input from the PSD 108. The position coordinate C1 of the Purkinje image 110p is detected. The line-of-sight input detection unit 64B detects the line-of-sight direction of the observation eye E2 based on the relative position between the position of the Purkinje image 110p indicated by the position coordinates C1 and the center of the pupil. Note that the method of detecting the direction of the line of sight using the Purkinje image 110p is a known technique, and a detailed description thereof will be omitted. Although the PSD 108 is used in the present embodiment, the PSD 108 may be omitted, and the position coordinate C1 of the Purkinje image 110p may be detected based only on the captured image data 110 input from the image sensor 107.

  FIG. 6 is an explanatory diagram for explaining a method (sclera reflection method, dark pupil method) for detecting the line-of-sight direction of the observation eye E2 based on the captured image data 110 of the observation eye E2. In this method, the incidence of the near-infrared light IR of the point light source on the observation eye E2 can be omitted. The line-of-sight input detection unit 64B acquires the captured image data 110 of the observation eye E2 from the image sensor 107 as shown in the upper part of FIG. 6, and then acquires the captured image data 110 of the observation eye E2 as shown in the middle part of FIG. Binarization is performed at a predetermined luminance threshold. Since the pupil of the observation eye E2 has lower brightness than the surrounding area, when the captured image data 110 is binarized, the area corresponding to the pupil of the observation eye E2 becomes a black pixel area, and the area around the pupil Becomes a white pixel region. Thereby, the pupil region of the observation eye E2 can be specified from the captured image data 110 of the observation eye E2.

  Then, as shown in the lower part of FIG. 6, the line-of-sight input detection unit 64B obtains the center coordinate C2 of the pupil region (black pixel region) of the observation eye E2 from the binarized captured image data 110 of the observation eye E2. Based on the obtained center coordinates C2 and the known geometric structure of the eyeball, the line-of-sight direction of the observation eye E2 is detected. Note that the detection of the line-of-sight direction by the scleral reflection method (dark pupil method) is a known technique, and thus detailed description thereof is omitted.

  Returning to FIG. 4, the line-of-sight input detection unit 64B is based on the detected line-of-sight direction of the observation eye E2 and the observation magnification of the known observation optical system 23, and the note on the operation screen 79 on which the observation eye E2 is gazing. The position coordinates of the viewpoint are detected, and the detection results of the position coordinates of the gazing point are output to the operation instruction detection unit 65B and the overall control unit 61 (a microdisplay control unit 73 described later).

  The operation instruction detection unit 65B constitutes the operation instruction detection unit of the present invention together with the operation instruction database 66A. In addition to the overall control unit 61 and the line-of-sight input detection unit 64B, an operation instruction database 66A is connected to the operation instruction detection unit 65B.

  FIG. 7 is an explanatory diagram for explaining an example of the operation instruction database 66A. As shown in FIG. 7, the operation instruction database 66A contains the position coordinates of each icon in the operation screen 79 shown in FIG. 3, the type of operation instruction corresponding to each icon, and each operation instruction. The corresponding illumination light source 28 and control contents of the micro display 46 are stored in association with each other. That is, in this embodiment, the illumination light source 28 and the micro display 46 correspond to the operation target of the present invention.

  The position coordinates (X1, Y1) to (X19, Y19) of each icon do not indicate the position coordinates of one point, but each icon occupies in the operation screen 79 shown in FIG. This is a position coordinate range indicating the range.

  The position coordinates (X1, Y1) are the position coordinates (range) of the icon “ON”, and the position coordinates (X2, Y2) are the position coordinates (range) of the icon “OFF”. In the operation instruction database 66A, an “on / off instruction” that is an operation instruction corresponding to each of the icons “ON” and “OFF” and an “on / off control” that is a control content corresponding to the “on / off instruction” are set. ing. “On / off control” is control for turning on / off the power of the micro display 46.

  The position coordinates (X3, Y3) are the position coordinates (range) of the icon “Change”. In the operation instruction database 66A, a “switch instruction” that is an operation instruction corresponding to the icon “Change” and a “switch control” that is a control content corresponding to the “switch instruction” are set. The “switching control” is a control for switching between the incidence of the illumination light L1 from the illumination light source 28 to the eye E1 and the emission of the fluorescent fundus image 51 from the micro display 46.

  The position coordinates (X4, Y4) are the position coordinates (range) of the icon “Up” in the “Micro” column, and the position coordinates (X5, Y5) are the position coordinates (range) of the icon “Down” in the “Micro” column. is there. In the operation instruction database 66A, “selection instruction” which is an operation instruction corresponding to the icon “Up” and the icon “Down” and “selection control” which is a control content corresponding to this “selection instruction” are set. ing. “Selection control” is control for selecting one thumbnail image 51S from among a plurality of thumbnail images 51S (see FIG. 8) emitted from the micro display 46.

  The position coordinates (X6, Y6) are the position coordinates (range) of the icon “determine”. In the operation instruction database 66A, a “decision instruction” that is an operation instruction corresponding to the icon “decision” and a “decision control” that is a control content corresponding to this “decision instruction” are set. “Decision control” is control for enlarging the thumbnail image 51S selected by the “selection instruction” (see FIG. 10).

  The position coordinates (X7, Y7) are the position coordinates (range) of the icon “Auto”. In the operation instruction database 66A, “superimposition instruction” that is an operation instruction corresponding to the icon “Auto” and “superimposition control” that is a control content corresponding to this “superimposition instruction” are set. “Superimposition control” is control for superimposing the fluorescent fundus image 51 emitted from the micro display 46 on the observation image 50 (see FIG. 11).

  The position coordinates (X8, Y8) are the position coordinates (range) of the icon “enlarged”. In the operation instruction database 66A, an “enlargement instruction” that is an operation instruction corresponding to the icon “enlargement” and an “enlargement control” that is a control content corresponding to this “enlargement instruction” are set. “Enlargement control” is control for enlarging the fluorescent fundus image 51 emitted from the micro display 46.

  The position coordinates (X9, Y9) are the position coordinates (range) of the icon “reduction”. In the operation instruction database 66A, “reduction instruction” that is an operation instruction corresponding to the icon “reduction” and “reduction control” that is a control content corresponding to this “enlargement instruction” are set. “Reduction control” is control for reducing the fluorescence fundus image 51 emitted from the micro display 46.

  The position coordinates (X10, Y10) are the position coordinates (range) of the icon “up”, and the position coordinates (X11, Y11) are the position coordinates (range) of the icon “down”. In the operation instruction database 66A, an “up / down movement instruction” which is an operation instruction corresponding to each of the icons “up” and “down”, and “up / down movement control” which is a control content corresponding to the “up / down movement instruction” are stored. Is set. “Vertical movement control” is control for moving the position of the fluorescent fundus image 51 emitted from the micro display 46 in the vertical direction within the observation visual field region R (see FIG. 8).

  The position coordinates (X12, Y12) are the position coordinates (range) of the icon “left”, and the position coordinates (X13, Y13) are the position coordinates (range) of the icon “right”. The operation instruction database 66A includes a “left / right movement instruction” that is an operation instruction corresponding to each of the icons “left” and “right”, and “left / right movement control” that is control content corresponding to the “left / right movement instruction”. Is set. “Left-right movement control” is control for moving the position of the fluorescent fundus image 51 emitted from the micro display 46 in the left-right direction within the observation visual field region R (see FIG. 8).

  The position coordinates (X14, Y14) are the position coordinates (range) of the icon “counterclockwise”. In the operation instruction database 66A, “left rotation instruction” that is an operation instruction corresponding to the icon “counterclockwise” and “left rotation control” that is a control content corresponding to this “left rotation instruction” are set. . The “left rotation control” is a control for rotating the posture of the fluorescent fundus image 51 emitted from the micro display 46 to the left within the observation visual field region R (see FIG. 8).

  The position coordinates (X15, Y15) are the position coordinates (range) of the icon “clockwise”. In the operation instruction database 66A, “right rotation instruction” that is an operation instruction corresponding to the icon “right rotation” and “right rotation control” that is a control content corresponding to this “right rotation instruction” are set. . “Right rotation control” is control for rotating the posture of the fluorescence fundus image 51 emitted from the micro display 46 to the right within the observation visual field region R (see FIG. 8).

  The position coordinates (X16, Y16) are the position coordinates (range) of the icon “Up” in the “brightness” column. In the operation instruction database 66A, “brightness increase instruction” that is an operation instruction corresponding to the icon “Up” and “brightness increase control” that is a control content corresponding to this “brightness increase instruction” are set. ing. “Brightness increase control” is control for increasing the brightness of the fluorescent fundus image 51 emitted from the micro display 46.

  The position coordinates (X17, Y17) are the position coordinates (range) of the icon “Down” in the “Brightness” column. In the operation instruction database 66A, “brightness reduction instruction” that is an operation instruction corresponding to the icon “Down” and “brightness reduction control” that is a control content corresponding to this “brightness reduction instruction” are set. ing. “Brightness reduction control” is control for reducing the brightness of the fluorescent fundus image 51 emitted from the micro display 46.

  The position coordinates (X18, Y18) are the position coordinates (range) of the icon “emphasis”. In the operation instruction database 66A, “emphasis instruction” that is an operation instruction corresponding to the icon “emphasis” and “enhancement control” that is a control content corresponding to this “emphasis instruction” are set. The “enhancement control” is control for emitting a blood vessel enhancement image 51a corresponding to the fluorescent fundus image 51 from the micro display 46 instead of the fluorescent fundus image 51 (see FIG. 13).

  The position coordinates (X19, Y19) are the position coordinates (range) of the icon “thumbnail”. In the operation instruction database 66A, “thumbnail image confirmation instruction” that is an operation instruction corresponding to the icon “thumbnail” and “thumbnail image emission control” that is a control content corresponding to this “thumbnail image confirmation instruction” are set. ing. “Thumbnail image emission control” is control for emitting a plurality of thumbnail images 51S from the micro display 46 (see FIG. 8).

  Returning to FIG. 4, the operation instruction detection unit 65B refers to the operation instruction database 66A based on the position coordinates of the gazing point on the operation screen 79 input from the line-of-sight input detection unit 64B. If it matches any position coordinate (range) of the icon and this state continues for a predetermined time or more, it is determined that an operation instruction corresponding to this position coordinate (icon) has been input. Thereby, the operation instruction detection unit 65B can detect the type of operation instruction input by the line of sight input with the observation eye E2 of the operator H2. Then, the operation instruction detection unit 65B refers to the operation instruction database 66A and determines the control content of the illumination light source 28 and the micro display 46 corresponding to the detected operation instruction. Next, the operation instruction detection unit 65B outputs the determined control content to the overall control unit 61 (an illumination light source control unit 71 and a micro display control unit 73 described later).

[Functions of general control section]
The overall control unit 61 functions as a drive control unit 70, an illumination light source control unit 71, a laser light source control unit 72, and a micro display control unit 73 by executing a control program read from a memory (not shown) or the like.

  The drive control unit 70 controls the drive of the drive unit 17 to move the surgical device main body 19 relative to the base 16. For example, the drive control unit 70 controls the drive of the drive unit 17 based on the result of detecting the forward / backward and left / right tilting operation of the operation lever 18 by a direct acting potentiometer (not shown), and The surgical device main body 19 is relatively moved in the front-rear direction and the left-right direction. Further, the drive control unit 70 controls the drive of the drive unit 17 on the basis of the result of detecting the rotation operation of the operation lever 18 by a rotary potentiometer (not shown), and moves the surgical device body 19 in the vertical direction with respect to the base 16. Move relative.

  The illumination light source control unit 71 controls the power supply of the illumination light source 28 to be turned on / off. Specifically, the illumination light source control unit 71 turns on and off the illumination light source 28 in accordance with the power on and off of the laser surgical apparatus 10. Further, when the illumination light source control unit 71 receives the input of the determination result of the “switching control” from the operation instruction detection unit 65B, the illumination light source control unit 71 responds to turning on / off of the power of the micro display 46 by the micro display control unit 73 described later. Then, the illumination light source 28 is turned off.

  The laser light source control unit 72 controls the emission of the therapeutic and aiming laser light L <b> 2 from the laser light source 34. The laser light source control unit 72 emits therapeutic laser light L2 from the laser light source 34 in response to a pressing operation of the foot switch 14. As for the emission of the aiming laser light L2 from the laser light source 34, the laser light source 34 is switched from the standby mode to the operation mode in which the therapeutic laser light L2 is emitted in response to the pressing operation of the foot switch 14. Always done.

  The micro display control unit 73 controls the micro display 46. In the initial state, the micro display control unit 73 of the present embodiment emits thumbnail images 51S (corresponding to the reduced images of the present invention) obtained by reducing the plurality of fluorescent fundus images 51 of the eye E1. The micro display 46 executes the emission of the image on the operation screen 79. In the initial state, the image emitted from the micro display 46 is not limited to the thumbnail image 51S, and may be another image such as an enlarged image 51E described later. In the initial state, the power source of the micro display 46 may be turned off.

  FIG. 8 is an explanatory view showing an example of a composite image of the observation image 50, the thumbnail image 51S, and the operation screen 79 of the eye E1 displayed in the observation visual field region R. In addition, the display here refers to a state in which observation is possible with the observation eye E2 of the operator H2 through the eyepiece lenses 39, 40 and the like.

  As shown in FIG. 8, the micro display control unit 73 reduces thumbnail images 51S obtained by reducing a plurality of (for example, n: n is a natural number of 3 or more) fluorescent fundus images 51 of the eye E1 acquired by the image acquisition unit 62. Is generated. Then, the micro display control unit 73 causes the micro display 46 to emit a plurality (for example, m: m is a natural number of 2 or more and less than n) of the generated n thumbnail images 51S from the micro display 46. Thereby, m thumbnail images 51S are displayed in the observation visual field region R of the operator H2.

  In the present embodiment, the center position of the observation image 50 in the observation visual field region R is shifted in the left-right direction with respect to the center of the observation visual field region R as described above. Then, the micro display control unit 73 controls the emission position of each thumbnail image 51S emitted from the micro display 46 to display each thumbnail image 51S at a position adjacent to the observation image 50 in the observation visual field region R. . Thereby, the observation image 50 and each thumbnail image 51S can be confirmed simultaneously with the observation eye E2 of the operator H2. The number of thumbnail images 51S emitted from the micro display 46, that is, the number of thumbnail images 51S displayed in the observation visual field region R may be one.

  In addition, when there is another thumbnail image 51S that is not displayed in the observation visual field region R, the microdisplay control unit 73 causes the switching icon 75 of the thumbnail image 51S to be emitted from the microdisplay 46. For example, the micro display control unit 73 controls the emission position of the switching icon 75 (image light) from the micro display 46 to display the switching icon 75 at a position adjacent to each thumbnail image 51S. Thereby, the operator H2 can recognize the presence of the other thumbnail image 51S.

  Further, when two or more thumbnail images 51S are displayed in the observation visual field region R, the micro display control unit 73 displays an image selection icon 76 indicating a thumbnail image 51S that is an object of enlargement control described later on the micro display 46. The light is emitted from. For example, the micro display control unit 73 controls the emission position of the image of the image selection icon 76 from the micro display 46 so that the image selection icon 76 is adjacent to one of the thumbnail images 51S in the observation visual field region R. Display in position. As a result, the operator H2 can determine the thumbnail image 51S to be enlarged.

  On the other hand, the micro display control unit 73 causes the image of the operation screen 79 (see FIG. 3) stored in advance to be emitted from the micro display 46. Then, the micro display control unit 73 controls the output position of the image on the operation screen 79 from the micro display 46, so that the operation screen 50 and the thumbnail images 51S are not displayed in the observation visual field region R. 79 is displayed.

  At this time, the micro display control unit 73 currently selects the icons “ON” and “OFF”, the icon “decision”, the icon “emphasis”, and the icon “thumbnail” in the operation screen 79. The one corresponding to the control content is displayed in a display mode different from the others. For example, in FIG. 8, since the power of the micro display 46 is turned on and each thumbnail image 51S is emitted from the micro display 46, the display mode of the icon “ON” and the icon “thumbnail” is changed.

  Further, the micro display control unit 73 causes the image of the cursor 80 to be emitted from the micro display 46, and the cursor 80 is superimposed and displayed at the initial position (see FIG. 3) on the operation screen 79 in the initial state. In addition, the emission position of the image of the cursor 80 from the micro display 46 is controlled.

  Further, the micro display control unit 73 changes the emission position of the image of the cursor 80 from the micro display 46 based on the position coordinates of the gazing point sequentially input from the above-described line-of-sight input detection unit 64B. As a result, the display position of the cursor 80 on the operation screen 79 in the observation visual field region R moves in conjunction with the change in the line-of-sight direction of the observation eye E2 of the operator H2. Thereby, the cursor 80 can be set to the desired icon in the operation screen 79 only by gazing at the desired icon in the operation screen 79 with the observation eye E2 of the operator H2. Then, the operator H2 can input the operation instruction with a line of sight by continuing the state of gazing at a desired icon in the operation screen 79 with the observation eye E2 for a predetermined time. Note that when the position of the point of gazing deviates from the icon within a predetermined time, the line-of-sight input for the operation instruction is canceled.

  Furthermore, the micro display control unit 73 indicates that the gazing point (cursor 80) is set to one of the icons in the operation screen 79 (that one of the icons is gazed with the observation eye E2), In addition, in order to allow the operator H2 to recognize that this state has continued for a predetermined time or longer (that is, the line-of-sight input for the operation instruction has been executed), the icon display mode in the operation screen 79 is changed according to each of these stages. Change.

  FIG. 9 is an explanatory diagram for explaining a change in the display mode of the icon in the operation screen 79. As shown in the upper part of FIG. 9, the micro display control unit 73 receives the position coordinates of the gazing point sequentially input from the line-of-sight input detection unit 64B and the position coordinates of each icon acquired by accessing the operation instruction database 66A (see FIG. 9). 7).

  Then, based on the above comparison result, the micro display control unit 73 determines that the gazing point (cursor 80) is set to one of the icons (here, the icon “Auto”) as shown in the middle part of FIG. In this case, the microdisplay 46 is controlled to change the display mode of the corresponding icon by one step. Next, as shown in the lower part of FIG. 9, the micro display control unit 73 controls the micro display 46 when the state where the gazing point is aligned with the icon continues for a predetermined time or longer, and displays the corresponding icon display mode. Is changed one more time. As a result, the operator H2 can recognize that the gazing point (cursor 80) has been set to one of the icons in the operation screen 79 and that an operation instruction has been input.

  Note that the micro display control unit 73 changes the display mode to icons “Up”, “Down”, “Change”, “emphasis” in the “Micro” column, and icons in the “brightness” column. In the case of any of the icons in the “Overlay” column, the icon display mode is restored after the corresponding control content (enlargement control) is executed.

  Returning to FIGS. 4 and 8, the micro display control unit 73 performs various controls of the micro display 46 based on the determination result of the control content input from the operation instruction detection unit 65B described above.

  Specifically, the micro display control unit 73 receives an input of the determination result of “on / off control” from the operation instruction detection unit 65B, and when the power of the micro display 46 is off, the micro display control unit 73 turns on the power. When the power of the display 46 is on, the power is turned off. Thereby, the display of each thumbnail image 51S in the observation visual field region R is turned on / off.

  The micro display control unit 73 receives the input of the determination result of “switching control” from the operation instruction detection unit 65B, and turns on / off the power of the micro display 46 according to the turning on / off of the illumination light source 28 by the illumination light source control unit 71. To do. Accordingly, every time the determination result of “switching control” from the operation instruction detection unit 65B is input to both the illumination light source control unit 71 and the micro display control unit 73, the illumination light L1 to the eye E1 to be examined by the illumination light source 28 And the emission of the fluorescence fundus image 51 from the micro display 46 are switched. That is, the display of the observation image 50 and the display of each thumbnail image 51S are executed alternately in the observation visual field region R.

  The micro display control unit 73 controls the micro display 46 every time the determination result of the “selection control” is input from the operation instruction detection unit 65B, and the image selection icon 76 is displayed in the observation visual field region R. The displayed thumbnail image 51S is switched to another thumbnail image 51S (including those not displayed in the observation visual field region R). Thus, the operator H2 can select a desired thumbnail image 51S as an enlargement control target described later.

  In the present embodiment, the image selection icon 76 displayed in the observation visual field region R makes it possible to identify a thumbnail image 51S that is an object of enlargement control described later. However, the display mode of the image selection icon 76 is illustrated in FIG. It is not limited to the display mode shown in FIG. Further, in the observation visual field region R, the thumbnail image 51S is emitted from the micro display 46 so that the display mode of either the thumbnail image 51S to be enlarged or the other thumbnail image 51S is changed. May be controlled.

  FIG. 10 is an explanatory diagram for explaining “enlargement control” by the microdisplay control unit 73. As shown in FIG. 10, the micro display control unit 73 receives an input of the determination result of “enlargement control” from the operation instruction detection unit 65B described above, and uses it as an object of enlargement control in the “selection control” described above. An enlarged image 51E of the selected thumbnail image 51S is generated, and the enlarged image 51E is emitted from the micro display 46. The enlarged image 51E may be the fluorescent fundus image 51 before reduction, that is, the original image. Thereby, an enlarged image 51E of the thumbnail image 51S indicated by the image selection icon 76 is displayed in the observation visual field region R. As a result, the operator H2 can confirm more detailed information [the position of the treatment site, the position of the blood vessel 58 (see FIG. 13), etc.] than the thumbnail image 51S.

  The micro display control unit 73 receives the input of the “selection control” determination result from the operation instruction detection unit 65B described above while the enlarged image 51E is being emitted, that is, the operator H2 observes the observation eye. When the line-of-sight input of “selection instruction” is performed in E2, the enlarged image 51E emitted from the micro display 46 is switched to another enlarged image 51E. Thereby, the enlarged image 51E displayed in the observation visual field region R is switched.

  FIG. 11 is an explanatory diagram for explaining “superimposition control” by the microdisplay control unit 73 in a state where the enlarged image 51E is displayed in the observation visual field region R. As shown in FIG. 11, when receiving the determination result of “superimposition control” from the operation instruction detection unit 65B, the micro display control unit 73 displays the enlarged image 51E superimposed on the observation image 50 in the observation visual field region R. Let

  For example, the micro display control unit 73 analyzes the enlarged image 51E and the captured image data of the observation image 50 acquired from the observation image acquisition unit 63. Then, based on the analysis result, the micro display control unit 73 controls the emission position, the size, and the posture of the enlarged image 51E emitted from the micro display 46, and each part of the eye E1 to be examined included in the enlarged image 51E [ Superposition control is performed to match the position, size, and posture of the macular and blood vessel 58 (see FIG. 13) with each part of the eye E1 included in the observation image 50 in the observation visual field region R. As a specific method of this superposition control, known methods such as a phase only correlation method, a pattern matching method, and a template matching method are used. Thereby, the observation image 50 and the enlarged image 51E are superimposed and displayed in the observation visual field region R.

  In addition, although FIG. 11 demonstrated the case where the enlarged image 51E was superimposed on the observation image 50 in the observation visual field area | region R, you may superimpose images other than the enlarged image 51E. For example, when a plurality of thumbnail images 51S are displayed in the observation visual field region R as shown in FIG. 8 described above, the micro display control unit 73 displays the thumbnail image 51S (or the image selection icon 76). Superimposition control for superimposing the original fluorescent fundus image 51) on the observation image 50 in the observation visual field region R is performed. Further, when a later-described blood vessel emphasized image 51a (see FIG. 13) is displayed in the observation visual field region R, the micro display control unit 73 uses the blood vessel emphasized image 51a as the observation image 50 in the observation visual field region R. Superimposing control to superimpose on is performed.

  FIG. 12 shows “enlargement control”, “reduction control”, “up / down movement control”, “left / right movement control”, “right / left movement control”, “by left / right movement control” by the micro display control unit 73 in a state where the enlarged image 51E is displayed in the observation visual field region R. It is explanatory drawing for demonstrating "left rotation control" and "right rotation control."

  As shown in the upper part of FIG. 12, when receiving the determination result of “enlargement control” or “reduction control” from the operation instruction detection unit 65B, the microdisplay control unit 73 controls the microdisplay 46 to perform enlargement. The image 51E is enlarged (see arrow T1) or reduced (see arrow T2) by a predetermined magnification. Thereby, the enlarged image 51E is further enlarged or reduced in the observation visual field region R.

  As shown in the lower part of FIG. 12, when the micro display control unit 73 receives an input of the determination result of “vertical movement control” from the operation instruction detection unit 65B, the micro display control unit 73 controls the micro display 46 to display the enlarged image 51E. It is moved by a predetermined distance in the direction (see arrow T3) or in the downward direction (see arrow T4). When the micro display control unit 73 receives an input of the determination result of “left / right movement control” from the operation instruction detection unit 65B, the micro display control unit 73 controls the micro display 46 to display the enlarged image 51E in the left direction (see arrow T5) or Move it a predetermined distance in the right direction (see arrow T6). Thereby, the display position of the enlarged image 51E can be moved in the observation visual field region R in any direction, up, down, left, and right.

  Further, when the micro display control unit 73 receives the input of the determination result of “left rotation control” or “right rotation control” from the operation instruction detection unit 65B, the micro display control unit 73 controls the micro display 46 to change the posture of the enlarged image 51E. Rotate left by a predetermined angle (see arrow T7) or rotate right by a predetermined angle (see arrow T8). Thereby, the posture of the enlarged image 51E can be arbitrarily adjusted in the observation visual field region R.

  Although the case where the position, size, and orientation of the enlarged image 51E are adjusted has been described with reference to FIG. 12, images other than the enlarged image 51E, for example, the thumbnail images 51S shown in FIG. The position, size, and posture of the blood vessel emphasized image 51a (see FIG. 13) can be similarly adjusted.

  Returning to FIG. 10, the micro display control unit 73 receives an input of the determination result of “brightness increase control” from the operation instruction detection unit 65B in a state where the enlarged image 51E is displayed in the observation visual field region R. In this case, the brightness of the enlarged image 51E emitted from the micro display 46 is increased by a predetermined amount. Conversely, when the micro display control unit 73 receives the input of the “brightness reduction control” determination result from the operation instruction detection unit 65B, the micro display control unit 73 decreases the brightness of the enlarged image 51E emitted from the micro display 46 by a predetermined amount. Let Thereby, the brightness of the enlarged image 51E displayed in the observation visual field region R can be arbitrarily adjusted.

  At this time, the illumination light source control unit 71 performs the brightness of the illumination light L1 emitted from the illumination light source 28 in conjunction with the increase in the brightness of the enlarged image 51E emitted from the micro display 46 by the micro display control unit 73. That is, the brightness of the observation image 50 displayed in the observation visual field region R is decreased by a predetermined amount. Conversely, the illumination light source control unit 71 is linked to the brightness of the illumination light L1 emitted from the illumination light source 28 in conjunction with a decrease in the brightness of the enlarged image 51E emitted from the micro display 46 by the micro display control unit 73. That is, the brightness of the observation image 50 displayed in the observation visual field region R is increased by a predetermined amount. Thereby, the contrast difference between the observation image 50 and the enlarged image 51E can be enlarged.

  Instead of linking the brightness of the enlarged image 51E and the brightness of the observation image 50 (illumination light L1), the icon “Micro” in the “Brightness” column in the operation screen 79 shown in FIG. The operation of selecting and determining the icon “View” may be executed to increase or decrease the brightness of the enlarged image 51E and the brightness of the observation image 50 (illumination light L1) separately. In this case, in the operation instruction database 66A shown in FIG. 7 described above, the coordinates of the icon “View” corresponding to the illumination light source 28, operation instructions, and control contents, and the icon “Micro” corresponding to the micro display 46 are stored. Coordinates, operation instructions, and control details are stored.

  Further, the brightness of images other than the enlarged image 51E, for example, the thumbnail images 51S shown in FIG. 8 described above, and a blood vessel emphasized image 51a (see FIG. 13) described later can be adjusted in the same manner. Further, various image quality adjustments (gamma adjustment and sharpness adjustment) other than the brightness of the enlarged image 51E and the like may be performed.

  FIG. 13 is an explanatory diagram for explaining “enhancement control” by the microdisplay control unit 73 in a state where the enlarged image 51E is displayed in the observation visual field region R. When the micro display control unit 73 receives the input of the determination result of “enhancement control” from the operation instruction detection unit 65B, the micro display control unit 73 obtains the blood vessel enhancement image 51a corresponding to the enlarged image 51E emitted from the micro display 46, as the image acquisition unit 62. Get from. Next, the micro display control unit 73 causes the micro display 46 to emit the blood vessel emphasized image 51 a adjusted according to the position, size, and posture of the enlarged image 51E. Thereby, as shown in FIG. 13, the enlarged image 51E displayed in the observation visual field region R is switched to the blood vessel emphasized image 51a. As a result, the operator H2 can grasp the position of the blood vessel 58 in the eye E1.

  Further, when the blood vessel emphasized image 51a is superimposed on the observation image 50 in the observation visual field region R as described with reference to FIG. 11 described above, that is, when “superposition control” and “enhancement control” are combined, The person H2 can irradiate the treatment laser beam L2 while reliably avoiding the blood vessel 58 in the eye E1.

  In FIG. 13, the case where the enlarged image 51E displayed in the observation visual field region R is switched to the blood vessel emphasized image 51a has been described. However, images other than the enlarged image 51E, for example, the thumbnails shown in FIG. The image 51S may be switched to the blood vessel emphasized image 51a. Further, instead of generating the blood vessel emphasized image 51a from the fluorescent fundus image 51 in advance, the micro display control unit 73 analyzes the fluorescent fundus image 51 (including the enlarged image 51E and the thumbnail image 51S) and the features in the image. A portion (blood vessel 58) may be detected, and the blood vessel emphasized image 51a may be generated based on the detection result.

  Returning to FIG. 8, the micro display control unit 73 determines the “thumbnail image emission control” from the operation instruction detection unit 65B in a state where the enlarged image 51E or the blood vessel emphasized image 51a is displayed in the observation visual field region R. Are received, a plurality (m) of thumbnail images 51S are emitted from the micro display 46. Thereby, the display in the observation visual field area | region R can be returned to the display of the observation image 50 and each thumbnail image 51S, ie, an initial state.

  As described above, when the operator H2 inputs the line of sight of the operation instruction with the observation eye E2, the illumination light source control unit 71 and the micro display control unit 73 control the illumination light source 28 and the micro display 46 corresponding to the operation instruction. It can be performed.

[Operation of laser surgery device]
FIG. 14 is a flowchart showing an example of a flow of laser surgery of the eye E1 to be examined by the laser surgical apparatus 10 having the above-described configuration (an operation method of the ophthalmic observation apparatus of the present invention). When the operator H2 turns on the power source of the laser surgical apparatus 10, the illumination light source control unit 71 of the overall control unit 61 turns on the illumination light source 28. Thereby, the illumination light L1 is emitted from the illumination light source 28. Further, the overall control unit 61 starts emission of near infrared light IR from the infrared LED 101.

  Then, the operator H2 inputs the name and patient number of the subject H1 via the touch panel monitor 13 in advance. Thereby, the image acquisition unit 62 acquires a plurality of fluorescent fundus images 51 and blood vessel emphasized images 51a corresponding to the name and patient number of the subject H1 from the image database 57, and controls the overall control unit 61 (micro display control unit 73). ).

  Next, the operator H2 adjusts the position of the forehead pad 12a and the chin rest 12b of the face support portion 12 and adjusts the position of the surgical device main body 19 by tilting and rotating the operation lever 18 to adjust the eye E1 to be examined. The positional relationship with the surgical apparatus main body 19 is adjusted (step S21). When this adjustment is completed, the illumination light L1 from the illumination light source 28 enters the eye E1 via the illumination optical system 21 and the contact lens 31, and the reflected light emitted from the eye E1 according to the incidence of the illumination light L1. L3 is guided to the eyepieces 39 and 40 through the contact lens 31 and the observation optical system 23. Thereby, the observation image 50 can be confirmed with the observation eye E2 of the operator H2 through the eyepieces 39 and 40 (step S22).

  A part of the reflected light L <b> 3 is imaged on the imaging surface of the imaging device 43 from the middle of the observation optical system 23 via the imaging optical system 24 and is imaged by the imaging device 43. Thereby, the captured image data of the observation image 50 is input from the image sensor 43 to the overall control unit 61 (micro display control unit 73) via the observation image acquisition unit 63.

  On the other hand, the micro display control unit 73 generates thumbnail images 51S of a plurality (n) of fluorescent fundus images 51 acquired from the image acquisition unit 62, and m thumbnail images among the generated n thumbnail images 51S. 51S is emitted from the micro display 46 (step S23). Further, the micro display control unit 73 causes the image of the operation screen 79 stored in advance to be emitted from the micro display 46 (step S23).

  The m thumbnail images 51 </ b> S emitted from the micro display 46 and the image on the operation screen 79 are guided to the eyepieces 39 and 40 through the image emission optical system 25 and a part of the observation optical system 23. As a result, as shown in FIG. 8 described above, the observation image 50, the thumbnail images 51S, and the operation screen 79 are combined and displayed (parallel display) in the observation visual field region R, and are displayed on the observation eye E2 of the operator H2. Thus, the observation image 50, each thumbnail image 51S, and the operation screen 79 can be simultaneously confirmed.

  Further, near-infrared light IR emitted from the infrared LED 101 enters the observation eye E2 through the line-of-sight input detection optical system 26, a part of the observation optical system 23, and the eyepieces 39 and 40. Thereby, the reflected light IR1 reflected by the observation eye E2 enters the image sensor 107 and the PSD 108 via the eyepieces 39 and 40, a part of the observation optical system 23, and the line-of-sight input detection optical system 26. As a result, the picked-up image data 110 of the observation eye E2 is output from the image pickup device 107 and the received light signal is output from the PSD 108 to the line-of-sight input detection unit 64B.

  The line-of-sight input detection unit 64B that has received the input of the captured image data 110 of the observation eye E2 from the image sensor 107 and the input of the light reception signal from the PSD 108, the line of sight of the observation eye E2 based on the captured image data 110 and the light reception signal. Detect direction. Then, the line-of-sight input detection unit 64B, based on the detected line-of-sight direction of the observation eye E2 and the observation magnification of the known observation optical system 23, position coordinates of the point of interest on the operation screen 79 that the observation eye E2 is gazing at. And the detection result of the position coordinates of the gazing point are output to the operation instruction detection unit 65B and the micro display control unit 73, respectively. Thereby, the line-of-sight input by the observation eye E2 of the operator H2 is started (step S24, corresponding to the line-of-sight input detection step of the present invention).

  When the operator H2 executes any of the control contents of the illumination light source 28 and the micro display 46 shown in FIG. 7 described above, the operator H2 starts to input the line of sight of the operation instruction, that is, the operation screen 79 in the observation visual field region R. The corresponding icon is watched (YES in step S25). Thereby, the position coordinates of the gazing point respectively output from the line-of-sight input detection unit 64B to the operation instruction detection unit 65B and the micro display control unit 73 change as the line-of-sight direction of the observation eye E2 changes.

  Then, the micro display control unit 73 that has received the gaze point position coordinate input from the line-of-sight input detection unit 64B changes the emission position of the image of the cursor 80 emitted from the micro display 46 based on the gaze point position coordinate. Let As a result, the display position of the cursor 80 on the operation screen 79 in the observation visual field region R moves to the icon being watched by the observation eye E2.

  On the other hand, the operation instruction detection unit 65B that has received an input of the position coordinate of the gazing point from the line-of-sight input detection unit 64B refers to the operation instruction database 66A, and the position coordinate of the gazing point is any position coordinate (range) of each icon. ), And a matching state continues for a predetermined time or more, it is determined that an operation instruction corresponding to this position coordinate (icon) has been input. Thereby, the operation instruction detection unit 65B detects the type of the operation instruction input by the line-of-sight input with the observation eye E2 of the operator H2, and refers to the operation instruction database 66A and corresponds to the detected operation instruction. The control contents of the illumination light source 28 and the micro display 46 are determined (step S26, corresponding to the operation instruction detection step of the present invention). The determination result of the control content by the operation instruction detection unit 65B is output to at least one of the illumination light source control unit 71 and the micro display control unit 73 according to the control content.

  At this time, the micro display control unit 73 matches the gazing point (cursor 80) as shown in FIG. 9, based on the position coordinates of the gazing point input from the line-of-sight input detection unit 64B. The icon display mode is changed by one step. And the micro display control part 73 receives the input of the determination result of the control content from the operation instruction detection part 65B, and changes the icon display mode one step further. Thereby, the operator H2 can recognize that the gazing point is set to the icon in the operation screen 79 and that the line-of-sight input of the operation instruction is executed.

  The illumination light source control unit 71 that has received the control result determination result from the operation instruction detection unit 65B executes control of the illumination light source 28 (such as the switching control described above) in accordance with the control content (step 7). Further, the micro display control unit 73 that has received the determination result of the control content from the operation instruction detection unit 65B controls the micro display 46 according to this control content (on / off control, switching control, enlargement control, superposition control described above). , Enlargement / reduction control, enhancement control, etc.) are executed (step S27). Step S27 corresponds to the control process of the present invention.

  For example, when both the above-described “superimposition control” and “enhancement control” are executed, the blood vessel emphasized image 51a is superimposed and displayed on the observation image 50 in the observation visual field region R, so that the operator H2 The position of the blood vessel 58 in E1 can be reliably grasped. At this time, “superimposition control” and “enhancement control” can be executed based on an operation instruction that the operator H2 inputs a line of sight with the observation eye E2. For this reason, even when the operator H2 holds the contact lens with one hand and holds the operation lever 18 with the other hand, the operator H2 does not separate the observation eye E2 from the eyepiece 20 and The “emphasis control” can be executed hands-free.

  On the other hand, when the laser light source 34 is switched from the standby mode described above to the operation mode after the power source of the laser surgical apparatus 10 is turned on, emission of the aiming laser light L2 from the laser light source 34 is started. As a result, the aiming laser beam L2 enters the eye E1 through the laser beam irradiation optical system 22 and the contact lens 31. The operator H2 adjusts the position of the surgical device body 19 by operating the operation lever 18 and the like while observing the aiming laser beam L2 reflected by the eye E1 through the contact lens 31 and the observation optical system 23. Then, the position adjustment between the aiming laser beam L2 and the treatment site in the eye E1 is completed (YES in step S28).

  Next, when the operator H2 depresses the foot switch 14, the therapeutic laser beam L2 is emitted from the laser light source 34, and the therapeutic laser beam L2 passes through the laser beam irradiation optical system 22 and the contact lens 31. Then, the treatment site in the eye E1 is irradiated (step S29). Thus, the intraocular operation of the eye E1 to be examined by the laser surgical apparatus 10 is completed.

[Effect of this embodiment]
As described above, in the laser surgical apparatus 10 according to this embodiment, even if both hands of the operator H2 are closed, the illumination light source corresponding to the operation instruction is input based on the operation instruction that the operator H2 inputs a line of sight with the observation eye E2. 28 and various control contents of the micro display 46 can be executed. Thereby, the operativity of the laser surgical apparatus 10 can be remarkably improved.

[Others]
In the above-described embodiment, based on the operation instruction that the operator H2 inputs a line of sight with the observation eye E2, the control of the illumination optical system 21 (illumination light source 28) and the image emission optical system 25 (micro display 46) corresponding to the operation instruction is performed. However, the present invention is not limited to this, and only the image output optical system 25 may be controlled. Further, for example, a modulation element (DMD and transmissive liquid crystal panel) that modulates at least one of the reflected light L3 and an image (thumbnail image 51S, enlarged image 51E, blood vessel emphasized image 51a, etc.) emitted from the micro display 46. Etc.) may be provided in the observation optical system 23, and the observation optical system 23 (modulation element) may be controlled together.

  In the above-described embodiment, as a gaze input detection method by the gaze input detection unit 64B, the method using the Purkinje image 110p described with reference to FIG. 5 and the scleral reflection method (dark pupil method) described with reference to FIG. ) Is given as an example, but the present invention is not limited to these. For example, a known line of sight such as a method using a positional relationship between a reference point such as the eye of the operator H2 and a moving point such as an iris of the observation eye E2, and a method of detecting the movement of the observation eye E2 using an electrooculogram sensor. An input detection method can be used.

  In the above embodiment, the control contents of the illumination light source 28 and the micro display 46 corresponding to various operation instructions that the operator H2 inputs a line of sight with the observation eye E2 are described using the operation instruction database 66A of FIG. However, the types of operation instructions and control contents are not limited to those listed in the operation instruction database 66A, and include other operation instructions and control contents (for example, display of the original image of the fluorescence fundus image 51). May be.

  In the above embodiment, the fluorescent fundus image 51 (the thumbnail image 51S, the enlarged image 51E, and the blood vessel enhanced image 51a) is emitted from the micro display 46. For example, the eye to be examined previously obtained by an OCT (Optical Coherene Tomography) examination, for example. An image indicating information related to the eye E1 such as a tomographic image of the retina of E1 may be emitted. Further, an image (character information) indicating information related to the laser surgical apparatus 10 (irradiation pattern of the laser beam L2 for treatment, etc.) and information related to the eye E1 of the subject H1 (patient number, medical history, etc.) (Including an image) may be emitted from the micro display 46.

  In the above-described embodiment, the blood vessel enhancement image 51a is described as an example of an image in which the characteristic part of the eye E1 is emphasized. It may be used.

  In the above embodiment, the laser surgical apparatus 10 has been described as an example of the ophthalmic observation apparatus of the present invention. For example, a surgical microscope, a fundus camera, OCT, an SLO (Scanning Laser Ophthalmoscope), an axial length meter, a slit lamp The present invention can also be applied to a refractometer, a keratometer, a tonometer, a specular microscope, and a complex machine of these. In other words, the present invention can be applied to various ophthalmic observation devices that can observe the observation image 50 of the eye E1 through the eyepieces 39 and 40, and in particular, ophthalmic observation in which both hands of the operator H2 are blocked. It is preferable to apply to an apparatus.

  DESCRIPTION OF SYMBOLS 10 ... Laser surgery apparatus, 14 ... Foot switch, 19 ... Surgical apparatus main body, 20 ... Eyepiece part, 21 ... Illumination optical system, 23 ... Observation optical system, 24 ... Imaging optical system, 25 ... Image emission optical system, 26 ... Gaze input detection optical system, 28 ... illumination light source, 39 ... ocular lens, 40 ... ocular lens, 43 ... imaging device, 46 ... microdisplay, 50 ... observed image, 51E ... enlarged image, 51S ... thumbnail image, 51a ... blood vessel enhancement Image, 51 ... Fluorescent fundus image, 55 ... Computer, 57 ... Image database, 61 ... Overall control unit, 62 ... Image acquisition unit, 63 ... Observation image acquisition unit, 64B ... Gaze input detection unit, 65B ... Operation instruction detection unit, 66A ... Operation instruction database, 71 ... Illumination light source control unit, 73 ... Micro display control unit, 107 ... Imaging device, 108 ... PSD

Claims (10)

An illumination optical system that makes light incident on the eye to be examined;
An image emitting optical system for emitting an image;
An observation optical system that guides the emitted light emitted from the eye to be examined in response to the incidence of light from the illumination optical system and the image emitted by the image emission optical system, respectively, to an eyepiece;
A line-of-sight input detection unit for detecting an operator's line-of-sight input;
An operation instruction input by the line-of-sight input detected by the line-of-sight input detection unit and including at least the image emission optical system among the illumination optical system, the image emission optical system, and the observation optical system An operation instruction detection unit for detecting an operation instruction for
A control unit that controls the operation target based on the operation instruction detected by the operation instruction detection unit;
An ophthalmic observation apparatus. The image emitting optical system emits an image of an operation screen including a plurality of types of objects corresponding to the plurality of types of operation instructions, as the image,
The observation optical system guides the image of the operation screen emitted from the image emission optical system to the eyepiece,
The line-of-sight input detection unit detects the line-of-sight input for the plurality of types of objects in the operation screen,
The ophthalmic observation apparatus according to claim 1, wherein the operation instruction detection unit detects the operation instruction based on a result of the line-of-sight input detection unit detecting the line-of-sight input for any of the plurality of types of objects. The operation instruction detection unit detects an on / off instruction to display the image by the image emission optical system as the operation instruction,
The ophthalmic observation apparatus according to claim 1, wherein the control unit performs on / off control for turning on / off the emission of the image by the image emission optical system when the operation instruction detection unit detects the on / off instruction. The operation object includes the illumination optical system and the image emission optical system,
The operation instruction detection unit detects, as the operation instruction, a switching instruction for switching between the incidence of the light by the illumination optical system and the emission of the image by the image emission optical system,
When the operation instruction detection unit detects the switching instruction, the control unit controls the illumination optical system and the image emission optical system to perform switching control between the incidence of the light and the emission of the image. Item 4. The ophthalmic observation device according to any one of Items 1 to 3. The image emission optical system emits a reduced image of the plurality of images,
The operation instruction detection unit includes, as the operation instruction, a selection instruction for selecting the reduced image to be enlarged among the plurality of reduced images, and a determination instruction for determining enlargement of the reduced image selected by the selection instruction. Detect
The control unit, when the operation instruction detection unit detects the selection instruction and the determination instruction, controls the image emission optical system to enlarge the reduced image selected by the selection instruction. The ophthalmic observation apparatus according to any one of 4. An observation image acquisition unit that acquires an observation image of the eye to be examined formed by the emitted light;
The operation instruction detection unit detects, as the operation instruction, a superimposition instruction that matches the position, size, and orientation of the image with the observation image,
When the operation instruction detection unit detects the superimposition instruction, the control unit controls the image emission optical system based on a result of analyzing the image and the observation image acquired by the observation image acquisition unit. The ophthalmic observation apparatus according to claim 1, wherein superimposition control is performed to match the position, size, and orientation of the image with the observation image. The operation instruction detection unit detects, as the operation instruction, a first adjustment instruction that adjusts at least one of a position, a size, and a posture of the image,
When the operation instruction detection unit detects the first adjustment instruction, the control unit controls the image emission optical system and adjusts the image emitted from the image emission optical system according to the first adjustment instruction. The ophthalmic observation apparatus according to any one of claims 1 to 6. The operation instruction detection unit detects a second adjustment instruction for adjusting the image quality of the image as the operation instruction,
8. The control unit according to claim 1, wherein when the operation instruction detection unit detects the second adjustment instruction, the control unit controls the image emission optical system to adjust the image quality of the image according to the second adjustment instruction. The ophthalmic observation apparatus according to any one of the above. The image is an image including information on a characteristic part of the eye to be examined,
The operation instruction detection unit detects an emphasis instruction for emphasizing the feature portion as the operation instruction,
9. The control unit according to claim 1, wherein, when the operation instruction detection unit detects the enhancement instruction, the control unit controls the image emission optical system to emit the image with the feature portion emphasized. 9. The ophthalmic observation apparatus described in 1. From the illumination optical system that makes light incident on the eye to be examined, the image emission optical system that emits an image, the emitted light emitted from the eye to be examined in response to the incidence of light from the illumination optical system, and the image emission optical system In an operating method of an ophthalmic observation apparatus comprising: an observation optical system that guides each of the emitted images to an eyepiece lens,
The line-of-sight input detection unit detects the line-of-sight input of the operator,
The operation instruction detection unit is an operation instruction input by the line-of-sight input detected by the line-of-sight input detection unit, and at least the image in the illumination optical system, the image emission optical system, and the observation optical system An operation instruction detection step for detecting an operation instruction for an operation target including the emission optical system;
A control step for controlling the operation target based on the operation instruction detected by the operation instruction detection unit;
Method of operating an ophthalmic observation apparatus having