JP2018143587A - 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 first operation reception unit for receiving a first input operation made by a foot; an operation direction detection unit 65A for detecting an operation direction input by the first input operation received by the first operation reception 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 for controlling an 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 An 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 first operation reception unit that receives a first input operation by an operator's foot, and a first operation reception An operation instruction input by the first input operation received by the unit and detecting 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 An instruction detection unit; and a control unit that controls an operation target based on the operation instruction detected by the operation instruction 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 a first input operation by an operator's foot.

  In the ophthalmic observation apparatus according to another aspect of the present invention, a laser beam irradiation optical system that emits a therapeutic laser beam toward the eye to be examined, and a second input operation by an operator's foot and laser beam irradiation A control unit comprising: a second operation receiving unit that receives a second input operation for starting emission of laser light from the optical system; and a foot detection unit that is provided in the second operation receiving unit and detects an operator's foot. When the operator's foot is detected by the foot detection unit, a warning image indicating that the operator's foot has been detected is output from the image output optical system. Thereby, the operator can recognize that his / her foot is in the second operation receiving unit, and as a result, it is possible to prevent the therapeutic laser beam from being accidentally emitted from the laser beam irradiation optical system.

  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, the first operation receiving unit 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 receiving step of receiving a first input operation by a person's foot, and the operation instruction detecting unit is an operation instruction input by the first input operation received by the first operation receiving unit, and an illumination optical system and an image output optical system , And a detection step of detecting an operation instruction for an operation target including at least the image emission optical system in the observation optical system, and control for controlling the operation target by the control unit based on the operation instruction detected by the operation instruction detection unit Process 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 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 explanatory drawing for demonstrating the emission control of the warning image from a micro display. 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 first foot switch 14 and a second foot switch 15 are 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 first foot switch 14 corresponds to the first operation accepting unit of the present invention, and the second foot switch 15 corresponds to the second operation accepting unit of the present invention. Each operator H2 (see FIG. 2). ) Input operation (hereinafter referred to as foot operation). The first foot switch 14 and the second foot switch 15 are each connected to the laser surgical apparatus 10. In FIG. 1, the first foot switch 14 and the second foot switch 15 are integrally formed, but both may be provided separately.

  The first foot switch 14 includes a foot operation lever 14a that is operated by the operator H2 (see FIG. 2), a determination button 14b that is operated by the foot, and a cancel button 14c. The first foot switch 14 is used for inputting operation instructions to the illumination optical system 21 (illumination light source 28) and the image emission optical system 25 (micro display 46) shown in FIG. The foot operation on the first foot switch 14, that is, the foot operation lever 14a, the foot operation determination button 14b, and the foot operation on the cancel button 14c correspond to the first input operation of the present invention.

  The second foot switch 15 includes an operation pedal 15a that is operated (pressed) by the operator H2 (see FIG. 2), and a foot detection sensor 15b that detects the foot of the operator H2. The operation pedal 15a is an operation switch for starting the irradiation (exit) of the treatment laser beam L2 (see FIG. 2) by the laser surgical apparatus 10. A foot operation on the second foot switch 15, that is, a foot operation (pressing operation) on the operation pedal 15a corresponds to the second input operation of the present invention.

  The foot detection sensor 15b corresponds to the foot detection unit of the present invention, and detects the foot of the operator H2 placed on the operation pedal 15a. As the foot detection sensor 15b, a known non-contact type sensor or a contact type sensor can be used.

  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, and an image emission optical system 25.

  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) is guided to the eyepieces 39 and 40. The observation optical system 23 shares the objective lens 36 described above with the laser light irradiation optical system 22 and includes a mirror 37, a protective filter 37P, and a mirror 38.

  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. This 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 it toward the eyepiece lenses 39 and 40, and also enters a fluorescent fundus image 51 incident from an image output optical system 25 described later. At least a part of the image of the operation screen 79 (see FIGS. 2 and 3) 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, and the reflected light L3 incident from the mirror 38, 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. Are observed (see FIGS. 2 and 3). 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 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 is used by the operator H2 to input operation instructions for the illumination optical system 21 (illumination light source 28) and the image output optical system 25 (micro display 46) through the first foot switch 14. An image of the operation screen 79 is emitted.

  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.

  In 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”, are performed by the foot operation of the operator H2 on the first foot switch 14. An “instruction”, “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 eyepiece 40 (FIG. 9). reference). 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 used to input an operation instruction on the operation screen 79 by the operator H2, specifically, to select and determine an icon on the operation screen 79. 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 is a direction corresponding to the tilting direction of the foot operation lever 14a when the operator H2 tilts the foot operation lever 14a of the first foot switch 14 by foot operation (hereinafter referred to as foot tilt operation). Move in (X-axis direction and Y-axis direction). Thereby, the operator H2 can set the cursor 80 to a desired icon by the foot tilting operation of the foot operation lever 14a. In this state, when the operator H2 presses the enter button 14b by foot operation, an operation instruction corresponding to the icon is input. When the operator H2 presses the cancel button 14c by foot operation, the input of the operation instruction is canceled.

  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 drive unit 17, illumination light source 28, laser light source 34, image sensor 43, and micro display 46 are controlled (driven) by a computer 55 (arithmetic processing unit) provided inside (or even outside) the laser surgical apparatus 10. Done. 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 first foot switch 14, the second foot switch 15, the drive unit 17, the illumination light source 28, In addition to the laser light source 34, the image sensor 43, and the micro display 46, 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, an operation detection unit 64A, an operation instruction detection unit 65A, 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. The overall control unit 61 includes a monitor 13, a first foot switch 14, a second foot switch 15, an operation lever 18, an image acquisition unit 62, an observation image acquisition unit 63, an operation detection unit 64A, an operation instruction detection unit 65A, The operation instruction database 66A is connected. 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 operation detection unit 64A includes a foot operation lever 14a of the first foot switch 14 (a direct-acting potentiometer that detects a foot tilting operation (tilting direction and tilting angle) of the foot operating lever 14a), a determination button 14b, Each is connected to a cancel button 14c. The operation detection unit 64A determines the movement direction and movement amount of the cursor 80 within the operation screen 79 based on the detection result of the potentiometer of the foot operation lever 14a, and further, the cursor 80 corresponding to the determined movement direction and movement amount. The position coordinates in the operation screen 79 are determined. Then, the operation detection unit 64A outputs the determined position coordinates of the cursor 80 to the operation instruction detection unit 65A and the overall control unit 61 (a microdisplay control unit 73 described later). Then, the operation detection unit 64A always performs determination of the movement direction and movement amount of the cursor 80, and determination and output of the position coordinates of the cursor 80.

  Further, the operation detection unit 64A outputs a determination signal indicating that to the operation instruction detection unit 65A when detecting the pressing operation of the determination button 14b, and when detecting the pressing operation of the cancel button 14c. Is output to the operation instruction detector 65A.

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

  FIG. 5 is an explanatory diagram for explaining an example of the operation instruction database 66A. As shown in FIG. 5, in the operation instruction database 66A, 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 are stored. 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. 6) 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. 8).

  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. 9).

  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. 6).

  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. 6).

  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. . “Left rotation control” is 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. 6).

  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. . The “right rotation control” is a control for rotating the posture of the fluorescent fundus image 51 emitted from the micro display 46 to the right within the observation visual field region R (see FIG. 6).

  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. 11).

  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. 6).

  Returning to FIG. 4, the operation instruction detection unit 65A refers to the operation instruction database 66A based on the determination signal input from the operation detection unit 64A and the position coordinates of the cursor 80, and when the determination signal is input. When the position coordinate of the cursor 80 matches any position coordinate (range) of each icon, it is determined that an operation instruction corresponding to the position coordinate (icon) has been input. Accordingly, the operation instruction detection unit 65A can detect the type of operation instruction input by the operator H2 by operating the first foot switch 14 with a foot operation (such as a foot tilting operation and a pressing operation). Then, the operation instruction detection unit 65A 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 65A 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 65A described above, 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 controller 72 emits therapeutic laser light L2 from the laser light source 34 in response to a pressing operation of the operation pedal 15a of the second foot switch 15. Regarding the emission of the aiming laser light L2 from the laser light source 34, the laser light source 34 was switched from the standby mode to the operation mode for emitting the therapeutic laser light L2 in response to the pressing operation of the second foot switch 15. If 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. 6 is an explanatory diagram 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. 6, the micro display control unit 73 reduces thumbnail images 51 </ b> S 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 E <b> 1 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. 6, 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 cursor 80 sequentially input from the above-described operation detection unit 64A. As a result, the cursor 80 is displayed on the operation screen 79 in the observation visual field region R in conjunction with the foot tilting operation (tilting direction and tilting angle) of the foot operating lever 14a of the first foot switch 14 by the operator H2. The position moves. Accordingly, the operator H2 can adjust the cursor 80 to a desired icon in the operation screen 79 by performing the foot tilting operation of the foot operation lever 14a while confirming the operation screen 79. Then, the operator H2 can input an operation instruction by pressing the enter button 14b with the cursor 80 positioned on a desired icon in the operation screen 79.

  Furthermore, the micro display control unit 73 indicates that the cursor 80 has been set to one of the icons in the operation screen 79 and that the determination button 14b has been pressed in this state (that is, an operation instruction is input). The display mode of the icon in the operation screen 79 is changed in accordance with each of these steps so that the operator H2 can recognize that the operation H2 has been performed.

  FIG. 7 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. 7, the micro display control unit 73 positions the coordinates of the cursor 80 sequentially input from the operation detection unit 64A and the position coordinates of each icon acquired by accessing the operation instruction database 66A (FIG. 5). Compare with).

  If the micro display control unit 73 determines that the cursor 80 is positioned on one of the icons (here, the icon “Auto”) based on the above comparison result, as shown in the middle part of FIG. The display 46 is controlled to change the display mode of the corresponding icon by one step. Next, as shown in the lower part of FIG. 7, the micro display control unit 73 receives an input of control contents (here, duplicate control) from the operation instruction detection unit 65 </ b> A with the cursor 80 positioned on the icon. The micro display 46 is controlled to change the display mode of the corresponding icon one more time. As a result, the operator H2 has moved the cursor 80 to one of the icons in the operation screen 79, and has pressed the enter button 14b in this state (that is, an operation instruction has been input). Can be recognized.

  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 6, the microdisplay control unit 73 performs various controls of the microdisplay 46 based on the determination result of the control content input from the operation instruction detection unit 65 </ b> A 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 65A, and turns on the power when the power of the micro display 46 is off, and conversely 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 “switch control” determination result from the operation instruction detection unit 65A, 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. Thereby, every time the determination result of “switching control” from the operation instruction detection unit 65A 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 65A, 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. 8 is an explanatory diagram for explaining “enlargement control” by the microdisplay control unit 73. As shown in FIG. 8, the micro display control unit 73 receives an input of the “enlargement control” determination result from the operation instruction detection unit 65A described above, and uses the above described “selection control” as an object of enlargement control. 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. 11), etc.] than the thumbnail image 51S.

  Note that the micro display control unit 73 receives the input of the “selection control” determination result from the operation instruction detection unit 65A described above while the enlarged image 51E is being emitted, that is, the operator H2 performs the first operation. When the foot switch 14 is operated to input a “selection instruction”, 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. 9 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. 9, when receiving the determination result of “superimposition control” from the operation instruction detection unit 65 </ b> A, the micro display control unit 73 displays an enlarged image 51 </ b> E 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. 11) 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. 9 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 the plurality of thumbnail images 51S are displayed in the observation visual field region R as shown in FIG. 6 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. 11) 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

  FIG. 10 shows “enlargement control”, “reduction control”, “up / down movement control”, “left / right movement control”, “right / left movement control”, “ It is explanatory drawing for demonstrating "left rotation control" and "right rotation control."

  As shown in the upper part of FIG. 10, the micro display control unit 73 controls the micro display 46 when the input of the determination result of “enlargement control” or “reduction control” is received from the operation instruction detection unit 65A. 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. 10, when the micro display control unit 73 receives the input of the “up / down movement control” determination result from the operation instruction detection unit 65A, 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 65A, 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 an input of the determination result of “left rotation control” or “right rotation control” from the operation instruction detection unit 65A, 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.

  Note that FIG. 10 illustrates the case where the position, size, and orientation of the enlarged image 51E are adjusted, but 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. 11) and the like can be similarly adjusted.

  Returning to FIG. 8, the micro display control unit 73 receives an input of the determination result of “brightness increase control” from the operation instruction detection unit 65A 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 an input of the determination result of “brightness reduction control” from the operation instruction detection unit 65A, 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. 5 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.

  In addition, the brightness of images other than the enlarged image 51E, for example, the thumbnail images 51S shown in FIG. 6 described above and the blood vessel emphasized image 51a (see FIG. 11) 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. 11 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 receiving the determination result of “enhancement control” from the operation instruction detection unit 65A, the microdisplay control unit 73 obtains the blood vessel enhancement image 51a corresponding to the enlarged image 51E emitted from the microdisplay 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. 11, 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. 9 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.

  Note that although FIG. 11 illustrates the case where the enlarged image 51E displayed in the observation visual field region R is switched to the blood vessel emphasized image 51a, 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. 6, the micro display control unit 73 determines the “thumbnail image emission control” from the operation instruction detection unit 65A 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.

  In this way, the illumination light source control unit 71 and the micro display control unit 73 operate when the operation instruction is input by the foot operation (foot tilting operation and pressing operation) on the first foot switch 14 of the operator H2. It is possible to control the illumination light source 28 and the micro display 46 corresponding to the above. The illumination light source control unit 71 and the micro display control unit 73 receive a cancel signal from the operation detection unit 64A in response to the pressing operation of the cancel button 14c of the first foot switch 14 by the operator H2. The execution of the above control is stopped.

  FIG. 12 is an explanatory diagram for explaining the emission control of the warning image 83 from the micro display 46 by the micro display control unit 73. As shown in FIG. 12, the micro display control unit 73 monitors the detection signal input from the foot detection sensor 15b, and when the foot detection sensor 15b detects the foot of the operator H2 on the operation pedal 15a, The warning image 83 is emitted from 46. The warning image 83 is an image that warns the operator H2 that the foot of the operator H2 has been detected on the operation pedal 15a, that is, that the treatment laser beam L2 is being irradiated.

  For example, the warning image 83 of the present embodiment is a color (for example, yellow) display frame image surrounding each thumbnail image 51S (including the enlarged image 51E and the blood vessel emphasized image 51a) emitted from the micro display 46. Accordingly, when the operator H2 puts his / her foot on the operation pedal 15a, the warning image 83 is displayed in the observation visual field region R, so that the operator H2 recognizes that his / her foot is on the operation pedal 15a. it can. As a result, it is possible to prevent the operator H2 from erroneously operating the second foot switch 15 with the intention of operating the foot of the first foot switch 14, that is, erroneously emitting the therapeutic laser beam L2. Is done.

  The display mode of the warning image 83 in the observation visual field region R is not limited to the display frame as shown in FIG. 12 and can be changed as appropriate. For example, a display frame surrounding the operation screen 79 may be used. . Further, as the warning image 83, a character information image indicating that the operator H2 has placed his / her foot on the operation pedal 15a (that is, the irradiation state of the treatment laser beam L2) may be used.

[Operation of laser surgery device]
FIG. 13 is a flowchart showing an example of the flow of laser surgery of the eye E1 to be examined by the laser surgical apparatus 10 having the above configuration (the method for operating 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 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 S11). 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 S12).

  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 S13). 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 S13).

  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. 6 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.

  When the operator H2 executes any of the control contents of the illumination light source 28 and the micro display 46 shown in FIG. 5 described above, the operator H2 confirms the operation screen 79 in the observation visual field region R and changes the control contents to be executed. The corresponding operation instruction is input by foot operation (foot tilting operation and pressing operation) on the first foot switch 14 (YES in step S14, corresponding to the reception step of the present invention). Specifically, after the operator H2 moves the cursor 80 to a desired icon by the foot tilting operation of the foot operation lever 14a, when the operator H2 presses the enter button 14b by foot operation, the operation is detected from the operation detection unit 64A. The determination signal and the position coordinates of the cursor 80 are output toward the instruction detection unit 65A.

  Receiving the input of the determination signal and the position coordinates of the cursor 80 from the operation detection unit 64A, the operation instruction detection unit 65A refers to the operation instruction database 66A, and the position coordinates of the cursor 80 when the determination signal is input are the icons. If it matches any of the position coordinates (range), it is determined that an operation instruction corresponding to the icon at the position coordinates has been input. As a result, the operation detection unit 64A detects the type of operation instruction input by the operator H2 by operating the foot of the first foot switch 14, and corresponds to the detected operation instruction with reference to the operation instruction database 66A. The control contents of the illumination light source 28 and the micro display 46 are determined (step S15, corresponding to the detection process of the present invention). The determination result of the control content by the operation instruction detection unit 65A 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, based on the position coordinates of the cursor 80 input from the operation detection unit 64A, the micro display control unit 73 changes the display mode of the icon on which the cursor 80 is positioned as shown in FIG. Change one step. Then, the micro display control unit 73 receives the input of the control content determination result from the operation instruction detection unit 65A, and further changes the icon display mode by one step. Thereby, the operator H2 can recognize that the cursor 80 is set to an icon in the operation screen 79 and that an operation instruction is input.

  The illumination light source control unit 71 that has received the input of the control content determination result from the operation instruction detection unit 65A executes control of the illumination light source 28 (such as the switching control described above) according to the control content (step S16). In addition, the micro display control unit 73 that has received the determination result of the control content from the operation instruction detection unit 65A 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 S16). Step S16 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, the “superimposition control” and the “enhancement control” can be executed based on an operation instruction input to the first foot switch 14 by the foot operation of the operator H2. For this reason, the operator H2 performs “superimposition control” without releasing the observation eye E2 from the eyepiece 20 even when the operator H2 holds the contact lens 31 with one hand and holds the operation lever 18 with the other hand. And “emphasis control” can be executed in a hands-free manner.

  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. When the operator H2 puts his / her foot on the operation pedal 15a of the second foot switch 15, the foot detection sensor 15b detects this foot and outputs a detection signal indicating that to the micro display control unit 73.

  The micro display control unit 73 that has received the detection signal from the foot detection sensor 15 b causes the warning image 83 to be emitted from the micro display 46. Thus, since the warning image 83 is displayed in the observation visual field region R, the operator H2 can recognize that his / her foot is placed on the operation pedal 15a, and as a result, erroneously treat the laser beam for treatment. Execution of L2 emission is prevented.

  The aiming laser light L2 emitted from the laser light source 34 enters the eye E1 through the laser light 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 S17).

  Next, when the operator H2 depresses the operation pedal 15a, the laser beam L2 for treatment is emitted from the laser light source 34, and the laser beam L2 for treatment 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 S18). 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 the present embodiment, even if both hands of the operator H2 are closed, the operator H2 receives the operation instruction based on the operation instruction input to the first foot switch 14 by foot operation. Various control contents of the corresponding illumination light source 28 and micro display 46 can be executed. Thereby, the operativity of the laser surgical apparatus 10 can be remarkably improved.

[Others]
In the above embodiment, based on the operation instruction input to the first foot switch 14 by the foot operation of the operator H2, the illumination optical system 21 (illumination light source 28) and the image output optical system 25 (micro display 46) corresponding to the operation instruction. 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, the first foot switch 14 including the foot operation lever 14a, the foot operated determination button 14b, and the cancel button 14c is described as an example of the first operation receiving unit of the present invention. If the operation instruction by foot operation can be input, the configuration and structure are not particularly limited. Similarly, the configuration and structure of the second foot switch 15 (second operation receiving unit) are not particularly limited.

  In the embodiment described above, the control contents of the illumination light source 28 and the micro display 46 corresponding to the various operation instructions input to the first foot switch 14 by the foot operation of the operator H2 are stored in the operation instruction database 66A shown in FIG. However, the types of operation instructions and control contents are not limited to those listed in the operation instruction database 66A, and other operation instructions and control contents (for example, display of the original image of the fluorescence fundus image 51). May be included.

  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 ... 1st foot switch, 15 ... 2nd foot switch, 15b ... Foot detection sensor, 19 ... Surgical apparatus main body, 20 ... Eyepiece part, 21 ... Illumination optical system, 23 ... Observation optical system, 24 ... Image-taking optical system, 25 ... Image emission optical system, 28 ... Illumination light source, 39 ... Ocular lens, 40 ... Ocular lens, 43 ... Image sensor, 46 ... Micro display, 50 ... Observed image, 51E ... Enlarged image, 51S ... Thumbnail image, 51a ... vessel enhanced image, 51 ... fluorescent fundus image, 55 ... computer, 57 ... image database, 61 ... general control unit, 62 ... image acquisition unit, 63 ... observation image acquisition unit, 64A ... operation detection unit, 65A ... Operation instruction detection unit, 66A ... Operation instruction database, 71 ... Illumination light source control unit, 73 ... Micro display control unit

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 first operation receiving unit for receiving a first input operation by an operator's foot;
An operation instruction input by the first input operation received by the first operation receiving unit, and at least the image output optical system among the illumination optical system, the image output optical system, and the observation optical system. An operation instruction detection unit for detecting an operation instruction for an operation target including:
A control unit that controls the operation target based on the operation instruction detected by the operation instruction detection unit;
An ophthalmic observation apparatus. A laser beam irradiation optical system for emitting a laser beam for treatment toward the eye to be examined;
A second operation accepting unit that accepts a second input operation by the operator's foot and accepts a second input operation for starting emission of the laser light from the laser light irradiation optical system;
A foot detection unit that is provided in the second operation reception unit and detects the operator's foot;
2. The control unit according to claim 1, wherein, when the foot of the operator is detected by the foot detection unit, a warning image indicating that the foot of the operator is detected is emitted from the image output optical system. Ophthalmic observation device. 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,
A first step of accepting a first input operation by an operator's foot;
The operation instruction detection unit is an operation instruction input by the first input operation received by the first operation reception unit, and at least among the illumination optical system, the image emission optical system, and the observation optical system A detection step of detecting an operation instruction for an operation target including the image output 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