JP2020036741A - Ophthalmologic device and operation method thereof - Google Patents

Abstract

To provide an ophthalmologic device and an operation method thereof capable of easily identifying a fixation state of a subject's eyes.SOLUTION: An ophthalmologic device includes: a fixation light emission unit for emitting fixation light; a visual line position detection unit 215 for detecting a visual line position of a subject's eye relative to the fixation light emission unit; and an information generation unit 216 for generating relative position information showing a relative position in a vertical position of the visual line position to an emission position on the basis of a detection result of the visual line position detection unit 215 and the emission position of the fixation light emitted from the fixation light emission unit where a direction perpendicular to the emission direction of the fixation light emitted from the fixation light emission unit is the vertical direction.SELECTED DRAWING: Figure 5

Description

  The present invention relates to an ophthalmologic apparatus that performs fixation of an eye to be examined and a method of operating the apparatus.

  In an ophthalmologic examination (including various actions for acquiring data of an eye to be examined, such as examination, measurement, and imaging, etc.), fixation is performed to inspect a desired part of the eye to be examined (see Patent Document 1). ). The fixation is realized by emitting fixation light toward the subject's eye and causing the subject's eye to gaze at the fixation light. As such fixation, internal fixation and peripheral fixation are well known (see Patent Document 2).

  In internal fixation, fixation light of a fixation target (bright point image) displayed by a target display unit such as a dot matrix liquid crystal display and a matrix light emitting diode is projected (projected) to an eye to be examined through an objective lens by an optical system. This is a fixation method. In this internal fixation, the emission position of fixation light to the eye to be examined can be set freely.

  For example, when acquiring data on the macula of the fundus, fixation light emitted from a display position corresponding to the macula in the optotype display unit is projected on the subject's eye through the lens center of the objective lens by the optical system. . The macula is guided to the examination (imaging) position by the eye to be examined fixating (fixing) on the fixation light. Further, when acquiring data of the peripheral portion of the fundus of the fundus, fixation light emitted from a display position corresponding to the peripheral portion of the fundus in the optotype display section passes through the lens peripheral portion of the objective lens by the optical system, and the eye to be inspected. Is projected to When the eye to be examined fixates on the fixation light, the eye to be examined is largely rotated, so that the periphery of the fundus is guided to the examination position.

  Peripheral fixation is performed using a plurality of fixation lamps arranged around the objective lens. By selectively turning on these fixation lamps, the subject's eye can be largely rotated in a desired direction. Thereby, the periphery of the fundus is guided to the examination position.

JP 2018-038687 A JP 2017-143919 A

  By the way, the eye to be inspected fixes the fixation light emitted from the peripheral portion of the lens of the objective lens as in the inspection of the peripheral portion of the fundus, or the fixation light emitted from the fixation lamp arranged around the objective lens. When the subject's eye fixates on the visual light, the subject's eye may lose sight of the fixation light because the fixation light does not exist in the central region of the visual field range of the subject. In this case, the examiner determines the fixation state of the subject's eye (whether or not the subject's eye is capturing fixation light, and in which direction the subject's eye gazes with respect to the fixation light). It is difficult to determine. For this reason, it is difficult for the examiner to give the examinee appropriate attention. As a result, data acquisition of the fundus oculi may be performed in a state where the eye to be inspected does not fixate the fixation light, and data of a desired examination target site may not be obtained.

  The present invention has been made in view of such circumstances, and an object of the present invention is to provide an ophthalmologic apparatus that can easily determine the fixation state of an eye to be inspected, and an operation method thereof.

  An ophthalmologic apparatus for achieving the object of the present invention includes: a fixation light emitting unit that emits fixation light; a gaze position detection unit that detects a gaze position of the subject's eye with respect to the fixation light emission unit; In the case where the direction perpendicular to the emission direction of the fixation light emitted from the unit is the vertical direction, the detection result of the gaze position detection unit, and the emission position of the fixation light emitted from the fixation light emission unit , An information generation unit that generates relative position information indicating a vertical relative position of the line-of-sight position with respect to the emission position.

  According to this ophthalmologic apparatus, the fixation state of the subject's eye can be easily determined based on the relative position information.

  An ophthalmologic apparatus according to another aspect of the present invention includes an output unit that displays or outputs audio information of the relative position information generated by the information generation unit. This makes it possible to easily determine the fixation state of the subject's eye.

  In the ophthalmologic apparatus according to another aspect of the present invention, the output unit, based on the relative position information generated by the information generation unit, when the shift amount in the vertical direction of the line of sight with respect to the emission position is larger than a predetermined threshold value , Display of relative position information or audio output is performed, and display or audio output of relative position information is omitted when the deviation amount is equal to or less than the threshold value. Accordingly, the display of the relative position information or the voice output is executed only when the attention of the examiner or the like is required.

  In the ophthalmologic apparatus according to another aspect of the present invention, the information generation unit generates a first image indicating relative position information and a first image centered on the emission position, and the output unit generates the first image. indicate. This makes it possible to easily determine the fixation state of the subject's eye.

  In an ophthalmologic apparatus according to another aspect of the present invention, an optical system that irradiates an eye to be inspected with illumination light through an objective lens having an optical axis parallel to an emission direction and receives reflected light of the illumination light reflected by the eye to be inspected The information generating unit generates, as relative position information, a second image centered on the optical axis and a second image indicating a vertical relative position of each of the emission position and the line-of-sight position with respect to the optical axis. , The output unit displays the second image. This makes it possible to easily determine the fixation state of the subject's eye and the emission position and the line-of-sight position based on the optical axis.

  In the ophthalmologic apparatus according to another aspect of the present invention, the fixation light emission unit includes an operation unit that selectively emits fixation light from a plurality of emission positions and receives a designation operation of the emission position, and the information generation unit includes: , Relative position information corresponding to the emission position selected by the designation operation on the operation unit. Thereby, even when fixation light is selectively emitted from a plurality of emission positions, it is possible to easily determine the fixation state of the subject's eye for each emission position.

  In the ophthalmologic apparatus according to another aspect of the present invention, the fixation light emitting unit is displayed on the optotype display unit through an optotype display unit that displays a fixation target and an objective lens having an optical axis parallel to the emission direction. And a projection optical system that projects fixation light corresponding to the fixed fixation target to the eye to be inspected.

  In an ophthalmologic apparatus according to another aspect of the present invention, an optical system that irradiates an eye to be inspected with illumination light through an objective lens having an optical axis parallel to an emission direction and receives reflected light of the illumination light reflected by the eye to be inspected And the fixation light emitting unit includes a plurality of fixation lights surrounding the objective lens.

  An operation method of an ophthalmologic apparatus for achieving the object of the present invention is a method of operating an ophthalmologic apparatus including a fixation light emission unit that emits fixation light, wherein the gaze position detection unit includes an eye to be inspected with respect to the fixation light emission unit. The gaze position is detected, and the information generation unit, when the direction perpendicular to the emission direction of the fixation light emitted from the fixation light emission unit is the vertical direction, the detection result of the gaze position detection unit, Based on the emission position of the fixation light emitted from the fixation light emission unit, relative position information indicating a vertical relative position of the line of sight to the emission position is generated.

  According to the present invention, the fixation state of the subject's eye can be easily determined.

FIG. 2 is a front perspective view of the ophthalmologic apparatus viewed from the subject side. FIG. 3 is a rear perspective view of the ophthalmologic apparatus viewed from the examiner. It is a front view of a lens accommodation part. It is the schematic which shows an example of a structure of an ophthalmologic apparatus. FIG. 3 is a functional block diagram of an arithmetic and control unit. FIG. 4 is an explanatory diagram showing an example of a relationship between a test target portion of a fundus and a display position of a fixation target on a display surface of a target display unit. It is a front enlarged view of a lens accommodation part. FIG. 4 is an explanatory diagram for describing a gaze position detection method of a gaze position detection unit using a Purkinje image. FIG. 5 is an explanatory diagram for describing a method of detecting a line-of-sight direction of an eye to be inspected based on a captured image of the eye to be inspected. FIG. 9 is an explanatory diagram for describing generation of relative position information by an information generation unit. FIG. 4 is an explanatory diagram showing a first example of relative position information. FIG. 9 is an explanatory diagram showing a second example of relative position information. FIG. 5 is an explanatory diagram showing an example of a shooting screen and relative position information superimposed and displayed on a display device during alignment of a fundus camera unit. FIG. 5 is an explanatory diagram showing an example of a shooting screen and relative position information superimposed on a display device when adjusting the focus of a fundus camera unit. FIG. 4 is an explanatory diagram showing an example of a shooting screen and relative position information superimposed on a display device during auto-optimization of an ophthalmologic apparatus. 9 is a flowchart showing a flow of inspection processing of an eye to be inspected by an ophthalmologic apparatus, in particular, processing of displaying relative position information on a display device. It is a flowchart which shows the flow of the test | inspection process of the to-be-examined eye by the ophthalmologic apparatus of another embodiment, especially the display process of the relative position information in a display device.

[Overall configuration of ophthalmic device]
FIG. 1 is a front perspective view of the ophthalmologic apparatus 1 viewed from the subject side. FIG. 2 is a rear perspective view of the ophthalmologic apparatus 1 viewed from the examiner. As shown in FIGS. 1 and 2, the ophthalmologic apparatus 1 is a multifunction peripheral in which a fundus camera and an optical coherence tomography that obtains a tomographic image using optical coherence tomography (OCT) are combined. .

  Note that the X direction in the figure is the left-right direction (the interpupillary direction of the eye E shown in FIG. 4) with respect to the subject, the Y direction is the up-down direction, and the Z direction is before approaching the subject. This is a front-back direction (also referred to as a working distance direction) parallel to the direction and a rear direction moving away from the subject.

  The ophthalmologic apparatus 1 includes a base 400, a face receiving unit 401, a gantry 402, and a measuring head 403. The base 400 stores a later-described arithmetic control unit 200 (see FIG. 4) and the like.

  The face receiving portion 401 is provided integrally with the base 400 at a position on the front side of the measuring head 403 in the Z direction. The face receiving unit 401 has a chin rest 401a and a forehead pad 401b that can be adjusted in the Y direction, and supports the face of the subject.

  The gantry 402 is provided on the base 400 and is movable with respect to the base 400 in the X direction and the Z direction (front and rear, left and right directions). An operation unit 210 and a measurement head 403 are provided on the gantry 402.

  The operation unit 210 is provided on the gantry 402 at a position on the rear side (examiner side) of the measurement head 403 in the Z direction. The operation unit 210 is provided with an operation lever 210a in addition to operation buttons for performing various operations of the ophthalmologic apparatus 1.

  The operation lever 210a is an operation member for moving the measuring head 403 in each of the XYZ directions. For example, when the operation lever 210a is tilted in the Z direction (front-back direction) or the X direction (left-right direction), the measuring head 403 is moved in the Z direction or the X direction by an electric drive mechanism (not shown). When the operation lever 210a is rotated around its longitudinal axis, the measuring head 403 is moved in the Y direction (up-down direction) by the above-described electric drive mechanism according to the rotation operation direction. A measurement button for starting the measurement of the eye E (see FIG. 4) by the ophthalmologic apparatus 1 is provided at the top of the operation lever 210a.

  The measurement head 403 incorporates a fundus camera unit 2 and an OCT unit 100 shown in FIG. A display device 3 is provided on the rear side of the measurement head 403 on the rear side (examiner side) in the Z direction, and a lens housing section is provided on the front side of the front side (examinee side) in the Z direction. 403a is provided.

  The display device 3 is, for example, a touch panel type liquid crystal display device. The display device 3 displays various photographing screens 220 (see FIG. 13 and the like) displayed during the examination of the eye E, various photographing data of the eye E, input screens for various setting operations, and the like. .

  FIG. 3 is a front view of the lens housing portion 403a. The lens housing section 403a houses the objective lens 22 which forms a part of the fundus camera unit 2 (see FIG. 4) and has an optical axis OA parallel to the Z direction. In the lens housing 403a, eight fixation lamps 95 (equivalent to a fixation light emitting unit of the present invention) are arranged at equal intervals along the circumferential direction of the objective lens 22 so as to surround the objective lens 22. ) Is provided. Each fixation lamp 95 selectively emits fixation light in the Z direction in accordance with an operation of designating a part to be inspected using the operation unit 210. In addition, the arrangement position and the arrangement number of each fixation lamp 95 may be appropriately changed.

  Further, two anterior eye cameras 300 of the fundus camera unit 2 (see FIG. 4) are provided in front of the measurement head 403 and near the lens housing 403a.

  Referring back to FIGS. 1 and 2, the face receiving unit 401 is provided with an external fixation lamp 96. The external fixation lamp 96 has a light source that emits fixation light, and the position of this light source and the emission direction of fixation light can be arbitrarily adjusted. This external fixation lamp 96 is used for external fixation. The external fixation is a fixation method in which the direction of the eye E is adjusted by guiding the line of sight of the contributing eye when the internal fixation of the eye E cannot be performed.

  FIG. 4 is a schematic diagram illustrating an example of the configuration of the ophthalmologic apparatus 1. As shown in FIG. 4, the ophthalmologic apparatus 1 includes a fundus camera unit 2, an OCT unit 100, an arithmetic control unit 200, and the like. The fundus camera unit 2 is housed in the measurement head 403, and has an optical system substantially similar to that of a conventional fundus camera. The OCT unit 100 is housed in the measurement head 403, and has an optical system for acquiring an OCT image of the fundus oculi Ef. The arithmetic and control unit 200 is housed in the base 400 (may be in the measuring head 403), and is an arithmetic processing device such as a personal computer that executes various arithmetic processes and control processes.

[Fundus camera unit]
The fundus camera unit 2 includes an illumination optical system 10 and a photographing optical system 30 as an optical system for acquiring a two-dimensional image (fundus image) representing the surface morphology of the fundus oculi Ef of the eye E to be inspected. The illumination optical system 10 and the photographing optical system 30 function as the optical system of the present invention.

  The illumination optical system 10 emits illumination light to the fundus oculi Ef. The imaging optical system 30 guides the fundus reflection light of the illumination light reflected by the fundus oculi Ef to image sensors 35 and 38 of a complementary metal oxide semiconductor (CMOS) type or a charge coupled device (CCD) type. Further, the imaging optical system 30 guides the signal light output from the OCT unit 100 to the fundus oculi Ef, and guides the signal light having passed through the fundus oculi Ef to the OCT unit 100.

  The illumination optical system 10 includes an observation light source 11, a reflection mirror 12, a condenser lens 13, a visible cut filter 14, an imaging light source 15, a mirror 16, relay lenses 17, 18, an aperture 19, a relay lens 20, a perforated mirror 21, a dichroic. It includes a mirror 46, the objective lens 22, and the like.

  The imaging optical system 30 includes a dichroic mirror 55, a focusing lens 31, a mirror 32, a half mirror 39A, an optotype display unit 39, a dichroic mirror, in addition to the objective lens 22, the dichroic mirror 46, and the perforated mirror 21 described above. 33, a condenser lens 34, an image sensor 35, a mirror 36, a condenser lens 37, an image sensor 38, and the like.

  As the observation light source 11, for example, a halogen lamp or an LED (Light Emitting Diode) light source is used, and emits observation illumination light. The observation illumination light emitted from the observation light source 11 is reflected by the reflection mirror 12, passes through the condenser lens 13, passes through the visible cut filter 14, and becomes near-infrared light. Further, the observation illumination light once converges near the imaging light source 15, is reflected by the mirror 16, and passes through the relay lenses 17 and 18, the diaphragm 19, and the relay lens 20. Then, the observation illumination light is reflected at the periphery of the apertured mirror 21 (the area around the aperture), passes through the dichroic mirror 46, is refracted by the objective lens 22, and illuminates the fundus Ef.

  The fundus reflection light of the observation illumination light is refracted by the objective lens 22, passes through the dichroic mirror 46, passes through a hole formed in the central area of the aperture mirror 21, passes through the dichroic mirror 55, and passes through the focusing lens The light is reflected by the mirror 32 via the mirror 31. Further, the fundus reflected light passes through the half mirror 39A, is reflected by the dichroic mirror 33, and is imaged on the light receiving surface of the image sensor 35 by the condenser lens. The image sensor 35 captures (receives) fundus reflected light and outputs a captured signal. The display device 3 displays an observation image based on the imaging signal output from the image sensor 35. When the focus of the photographing optical system 30 is adjusted to the anterior segment Ea of the eye E, the observation image of the anterior segment Ea is displayed on the display device 3, and the focus of the photographing optical system 30 is adjusted to the fundus Ef. If the adjustment has been made, an observation image of the fundus oculi Ef is displayed on the display device 3.

  As the imaging light source 15, for example, a xenon lamp or an LED light source is used, and emits imaging illumination light. The imaging illumination light emitted from the imaging light source 15 is applied to the fundus oculi Ef through the same route as the observation illumination light described above. The fundus reflection light of the photographing illumination light is guided to the dichroic mirror 33 through the same path as the fundus reflection light of the observation illumination light, passes through the dichroic mirror 33, is reflected by the mirror 36, and is condensed by the image sensor 37 by the condenser lens 37. An image is formed on the light receiving surface of the light-receiving element.

  The image sensor 38 captures (receives) fundus reflected light and outputs an imaging signal. The display device 3 displays a captured image based on the imaging signal output from the image sensor 38. Note that the display device 3 that displays the observation image and the display device 3 that displays the captured image may be the same or different.

  As the optotype display unit 39, for example, various display devices (devices) such as a dot matrix liquid crystal display (LCD) and a matrix light emitting diode (LED) are used. The optotype display section 39 displays a fixation optotype. In addition, the optotype display section 39 can arbitrarily set the display mode (shape and the like) and the display position of the fixation optotype. The optotype display unit 39 can display an optotype for visual acuity measurement in addition to the fixation target.

  After a part of the fixation light of the fixation target displayed on the target display unit 39 is reflected by the half mirror 39A, the fixation light of the mirror 32, the focusing lens 31, the dichroic mirror 55, and the hole of the perforated mirror 21 is formed. The light is projected onto the eye E through the unit, the dichroic mirror 46, and the objective lens 22. Thus, the fixation target, the visual acuity measurement target, and the like can be presented to the subject's eye E. The above-described half mirror 39A to the objective lens 22 correspond to the projection optical system of the present invention. Therefore, in the present embodiment, a part of the imaging optical system 30 (from the optotype display unit 39 to the objective lens 22) also functions as the fixation light emitting unit of the present invention.

  The retinal camera unit 2 includes an alignment optical system 50 and a focus optical system 60, similarly to a conventional retinal camera. The alignment optical system 50 generates an alignment index for performing positioning (alignment) of the fundus camera unit 2 with respect to the eye E. The focus optical system 60 generates a split index for focusing on the fundus oculi Ef.

  The alignment optical system 50 includes an LED 51, apertures 52 and 53, and a relay lens 54, in addition to the objective lens 22, the dichroic mirror 46, the aperture mirror 21, and the dichroic mirror 55 described above. In addition to the objective lens 22, the dichroic mirror 46, and the perforated mirror 21, the focus optical system 60 includes an LED 61, a relay lens 62, a split indicator plate 63, a two-hole aperture 64, a mirror 65, and a condenser lens. 66 and a reflection rod 67.

  The alignment light emitted from the LED 51 of the alignment optical system 50 is reflected by the dichroic mirror 55 via the stops 52 and 53 and the relay lens 54, passes through the hole of the perforated mirror 21, and passes through the dichroic mirror 46. Is projected onto the cornea of the anterior segment Ea of the eye E by the objective lens 22.

  The corneal reflection light of the alignment light passes through the objective lens 22, the dichroic mirror 46, and the hole of the perforated mirror 21, and after a part of the light passes through the dichroic mirror 55, the focusing lens 31, the mirror 32, and the half mirror The light enters the light receiving surface of the image sensor 35 via the dichroic mirror 33A and the condenser lens 34.

  The image sensor 35 captures (receives) corneal reflection light of the alignment light and outputs an imaging signal. As a result, the alignment index is displayed on the display device 3 together with the above-described observation image of the anterior segment Ea. Then, the user performs the alignment by performing the same operation as the conventional fundus camera. The arithmetic control unit 200 may perform alignment (auto alignment) by analyzing the position of the alignment index and moving the optical system.

  The reflection surface of the reflection bar 67 is set on the optical path of the illumination optical system 10 when the focus adjustment by the focus optical system 60 is performed. Focus light emitted from the LED 61 passes through a relay lens 62 and is split into two light beams by a split indicator plate 63, and then reflected by a reflecting rod 67 via a two-hole aperture 64, a mirror 65, and a condenser lens 66. The image is once formed on the surface, and is reflected toward the relay lens 20 on this reflecting surface. Further, the focus light is projected on the fundus Ef via the relay lens 20, the aperture mirror 21, the dichroic mirror 46, and the objective lens 22.

  The fundus reflection light of the focus light is imaged by the image sensor 35 through the same path as the corneal reflection light of the alignment light. The image sensor 35 images the fundus reflection light of the focus light and outputs an imaging signal. Thereby, the split index is displayed on the display device 3 together with the observation image. An arithmetic and control unit 200, which will be described later, analyzes the position of the split index, moves the focusing lens 31 and the like, and automatically performs focusing, as in the related art. Alternatively, the user may manually focus while visually checking the split index.

  The dichroic mirror 46 branches an optical path for OCT measurement from an optical path for fundus imaging. The dichroic mirror 46 reflects light in a wavelength band used for OCT measurement and transmits light for fundus imaging. In the optical path for OCT measurement, a collimator lens unit 40, an optical path length changing unit 41, a galvano scanner 42, a focusing lens 43, a mirror 44, and a relay lens 45 are sequentially provided from the OCT unit 100 side. Is provided.

  The optical path length changing unit 41 is movable in the direction of the arrow shown in FIG. 1 and changes the optical path length of the optical path for OCT measurement. The change of the optical path length is used for correcting the optical path length according to the axial length of the eye E, adjusting the interference state, and the like. The optical path length changing unit 41 includes, for example, a corner cube and a mechanism for moving the corner cube.

  The galvano scanner 42 changes the traveling direction of the signal light passing through the optical path for OCT measurement. Thereby, the fundus oculi Ef can be scanned with the signal light. The galvano scanner 42 includes, for example, a galvanomirror that scans the signal light in the X direction, a galvanomirror that scans the signal light in the Y direction, and a mechanism that independently drives these. Thus, the signal light can be scanned in any direction on the XY plane.

  Further, the fundus camera unit 2 includes a line-of-sight position detection optical system 70. The line-of-sight position detection optical system 70 includes a mirror 71, an infrared LED 72, a pinhole 73, a condenser lens 74, a mirror 75, an imaging lens 76, a mirror 77, an image sensor 78, and semiconductor position detection. A PSD 79 which is an element (Position Sensitive Detector).

  The mirror 71 is disposed between the dichroic mirror 46 and the objective lens 22 described above, and for example, a dichroic mirror is used. The mirror 71 transmits the above-described illumination light, observation illumination light, signal light, and the like (including the reflected light). The mirror 71 reflects near-infrared light incident from a mirror 75 described later toward the objective lens 22, and reflects reflected light of near-infrared light incident from the objective lens 22 toward the mirror 75.

  The infrared LED 72 emits near-infrared light toward the pinhole 73. The pinhole 73 uses the near-infrared light incident from the infrared LED 72 as a point light source, and emits the near-infrared light of the point light source toward the condenser lens 74. The condenser lens 74 emits near-infrared light incident from the pinhole 73 toward the mirror 75.

  As the mirror 75, for example, a half mirror is used. The mirror 75 transmits part of the near-infrared light incident from the condenser lens 74 toward the mirror 71 as it is. Thus, the near-infrared light transmitted through the mirror 75 is reflected by the mirror 71 toward the objective lens 22 and enters the eye E through the objective lens 22. Then, the reflected light of the near-infrared light reflected by the eye E enters the mirror 71 through the objective lens 22, and is reflected toward the mirror 75 by the mirror 71. The mirror 75 reflects a part of the reflected light incident from the mirror 71 toward the imaging lens 76.

  The imaging lens 76 emits the reflected light from the mirror 75 toward the mirror 77. The mirror 77 reflects a part of the reflected light incident from the imaging lens 76 toward the image sensor 78, and transmits the rest of the reflected light incident from the imaging lens 76 as it is and emits it toward the PSD 79.

  The image sensor 78 is a CMOS type or a CCD type, and the light reflected by the mirror 77 forms an image of the eye E on the imaging surface thereof. The image sensor 78 captures an image of the eye E formed on the imaging surface, and outputs the captured image data 150 (see FIG. 8) to the arithmetic and control unit 200.

  The reflected light from the mirror 77 is incident on the light receiving surface of the PSD 79. The PSD 79 is a sensor capable of detecting the light receiving position of the reflected light on the light receiving surface, and outputs a light receiving signal indicating the light receiving position to the arithmetic and control unit 200. Note that a line sensor may be used instead of the PSD 79.

  The fundus camera unit 2 is provided with two anterior eye cameras 300. Each anterior segment camera 300 photographs the anterior segment Ea substantially simultaneously from different directions. Further, each anterior eye camera 300 is provided at a position deviated from the optical path of the illumination optical system 10 and the optical path of the imaging optical system 30. Then, each anterior eye camera 300 acquires a captured image of the subject's eye E in a state where the subject's eye E is at substantially the same position (direction). Each captured image is used by the arithmetic and control unit 200 for analyzing the three-dimensional position of the characteristic portion of the eye E to be inspected.

[OCT unit]
The OCT unit 100 includes an optical system used for acquiring an OCT image of the fundus oculi Ef. This optical system has the same configuration as a conventional OCT device. That is, the optical system divides the low coherence light into the reference light and the signal light, and causes the signal light passing through the fundus oculi Ef and the reference light passing through the reference optical path to interfere with each other to generate interference light. Detect spectral components. This detection result (detection signal) is output from the OCT unit 100 to the arithmetic and control unit 200. Since the specific configuration of the optical system of the OCT unit 100 is a known technique (for example, see Patent Documents 1 and 2), a specific description will be omitted here.

[Operation control unit]
FIG. 5 is a functional block diagram of the arithmetic and control unit 200. As shown in FIG. 5, the arithmetic and control unit 200 includes an overall control unit 202, a storage unit 204, an image forming unit 206, a data processing unit 208, and the like. In the present embodiment, what is described as “—unit” in the arithmetic and control unit 200 may be “—circuit”, “—device”, or “—device”. That is, what is described as the “unit” may be configured by firmware, software, hardware, or a combination thereof. In addition, the arithmetic control unit 200 is connected to the above-described units of the fundus camera unit 2, the display device 3, the OCT unit 100, the operation unit 210, and the like.

  The general control unit 202 generally controls the operations of the respective units of the fundus camera unit 2, the display device 3, and the OCT unit 100 in accordance with an input operation performed by the examiner on the operation unit 210. Note that FIG. 5 illustrates only functions related to generation and display of relative position information 219 (see FIG. 11), which will be described later, among various functions of the general control unit 202, and other functions are well-known technologies. Illustration is omitted.

  The function of the central control unit 202 can be realized using various processors. Various processors include a CPU (Central Processing Unit), a GPU (Graphics Processing Unit), an ASIC (Application Specific Integrated Circuit), and a programmable logic device [for example, SPLD (Simple Programmable Logic Devices), CPLD (Complex Programmable Logic Device), And FPGA (Field Programmable Gate Arrays)]. The various functions of the general control unit 202 may be realized by one processor, or may be realized by a plurality of same or different processors.

  The storage unit 204 stores image data of an OCT image, image data of a fundus image, eye information (including subject information), and the like, in addition to a control program executed by the processor of the overall control unit 202. Further, the storage unit 204 stores correspondence information 212 described later in detail.

  The image forming unit 206 analyzes the detection signal input from the OCT unit 100 and forms an OCT image of the fundus oculi Ef. The specific method of forming an OCT image is the same as that of a conventional OCT apparatus. The data processing unit 208 performs image processing and the like on the OCT image formed by the image forming unit 206 and the images (fundus image and anterior eye image) acquired by the fundus camera unit 2 described above.

[Generation and display of relative position information]
The overall control unit 202 executes the control program read from the storage unit 204 when performing internal fixation or peripheral fixation in response to the examiner's operation of designating an inspection (imaging) target region on the operation unit 210. , Functions as the fixation target display control unit 214, the gaze position detection unit 215, the information generation unit 216, and the screen display control unit 217.

  The fixation target display control unit 214 performs internal fixation using the target display unit 39 and the objective lens 22 and the surroundings using each fixation lamp 95 based on the inspection target part specified by the specification operation described above. The fixation and the external fixation using the external fixation lamp 96 are respectively controlled. Note that the external fixation is the same as in the related art, and a detailed description thereof will be omitted.

  When performing internal fixation, the fixation target display control unit 214 controls the display position of the fixation target in the target display unit 39 based on the inspection target part specified by the above-described specifying operation. Thereby, the fixation target display control unit 214 sets the target position, at which the fixation light of the fixation target passes through the objective lens 22, to the optical axis OA of the objective lens 22 (the emission direction of the fixation light). On the other hand, control is performed in the vertical direction (XY directions). That is, the fixation target display control unit 214 controls the emission position of the fixation light emitted from the objective lens 22 toward the subject's eye E in the above-described vertical direction. Hereinafter, the vertical direction (XY direction) perpendicular to the optical axis OA (the direction in which fixation light is emitted) of the objective lens 22 is simply referred to as “optical axis vertical direction”.

  FIG. 6 is an explanatory diagram showing an example of the relationship between the inspection target site of the fundus oculi Ef and the display position of the fixation target on the display surface of the target display unit 39.

  As shown in FIG. 6, the symbol “M” is the display position of the fixation target corresponding to the macula of the fundus oculi Ef of both eyes of the subject's eye E. The display position M corresponds to the position of the optical axis OA of the objective lens 22. That is, the fixation light of the fixation target displayed at the display position M passes through the optical axis OA of the objective lens 22.

  The symbol “CR” is a display position of the fixation target corresponding to the center of the fundus Ef of the fundus oculi Ef of the right eye of the eye E, and the symbol “CL” is corresponding to the center of the fundus Ef of the left eye of the eye E to be examined. This is the display position of the fixation target. The symbol “DR” is the display position of the fixation target corresponding to the optic disc of the fundus oculi Ef of the right eye of the eye E, and the symbol “DL” corresponds to the optic disc of the fundus oculi Ef of the left eye of the eye E to be examined. This is the display position of the fixation target. Symbols “P” are display positions of fixation targets corresponding to eight positions around the fundus of the fundus oculi Ef of both eyes of the eye E to be examined.

  The display position of the fixation target displayed on the target display unit 39 is not limited to the position shown in FIG. 6, and may be changed as appropriate. Further, a display position corresponding to another examination target site (for example, an intermediate position between the macula and the optic disc) may be added.

  The fixation light corresponding to the fixation target displayed on the optotype display unit 39 is projected from the half mirror 39A through the dichroic mirror 46 to the eye E through the objective lens 22 as described above. This allows the eye E to fixate the fixation light.

  When performing peripheral fixation, the fixation target display control unit 214 determines the inspection target among the fixation lamps 95 shown in FIG. 3 based on the inspection target part specified by the above-described specification operation. Light the one corresponding to the part.

  FIG. 7 is an enlarged front view of the lens housing portion 403a. As shown in FIG. 7 and FIG. 6 described above, the fixation light corresponding to the fixation target displayed at the display position M of the target display unit 39 is a visual fixation in a later-described lens center portion 22a of the objective lens 22. The light is projected onto the eye E through the target position TM (corresponding to the optical axis OA). As a result, the eye E (right eye and left eye) fixates the fixation light, so that the macula of the fundus oculi Ef is moved to the irradiation position (scan position) of the signal light emitted from the OCT unit 100. .

  Fixation light corresponding to the fixation target displayed at the display position CR of the target display unit 39 is projected to the eye E through the target position TCR in the lens center 22a. The fixation light corresponding to the fixation target displayed at the display position CL of the target display unit 39 is projected to the eye E through the target position TCL in the lens center 22a. As a result, the fixation light passing through the target position TCR is fixed by the right eye of the eye E, or the fixation light passing through the target position TCL is fixed by the left eye of the eye E. Thus, the fundus center of the fundus oculi Ef is moved to the above-described signal light irradiation position.

  Fixation light corresponding to the fixation target displayed at the display position DR of the target display unit 39 is projected to the eye E through a target position TDR in a lens peripheral portion 22b of the objective lens 22 which will be described later. . The fixation light corresponding to the fixation target displayed at the display position DL of the target display unit 39 is projected to the eye E through the target position TDL in the lens peripheral part 22b. Thus, the fixation light passing through the target position TDR is fixed by the right eye of the eye E, or the fixation light passing through the target position TDL is fixed by the left eye of the eye E. As a result, the optic disc of the fundus oculi Ef is moved to the above-described signal light irradiation position.

  Fixation light corresponding to the fixation target displayed at each display position P of the target display unit 39 is projected to the eye E through each of the target positions TP in the lens peripheral portion 22b. As a result, the eye E (the right eye and the left eye) fixates the fixation light that has passed through any of the target positions TP, so that any one of the eight peripheral portions of the fundus oculi Ef has already been fixed. It is moved to the aforementioned signal light irradiation position.

  The lens center portion 22a is a region within a certain range centered on the optical axis OA of the objective lens 22, and includes the target position TM and the target positions TCR and TCL described above in the present embodiment. Here, when the subject's eye E fixes the fixation light passing through the target position TM and the target positions TCR and TCL of the objective lens 22, the fixation light is located in the central region of the visual field range of the subject. Since it is located, it is not necessary to rotate the eye E to a large extent. For this reason, the subject's eye E can easily fixate the fixation light. Therefore, the lens center portion 22a is an area in the objective lens 22 where the eye E can easily fixate on fixation light.

  The lens center portion 22a is not limited to the range shown in FIG. 4 in the objective lens 22, but is a range including only the target position TM or a range including the target positions TDR and TDL. Alternatively, the range may include a target position corresponding to another examination target site (eg, an intermediate position between the macula and the optic disc) of the fundus oculi Ef.

  The lens peripheral portion 22b is a region outside the above-described lens center portion 22a in the objective lens 22, and includes the above-described target positions TDR, TDL and the target position TP in the present embodiment. When the eye E fixes the fixation light passing through the target positions TDR, TDL and the target position TP of the objective lens 22, the fixation light exists in the central region of the visual field range of the subject. Therefore, it is necessary to rotate the eye E to a large extent. For this reason, there is a possibility that the subject's eye E loses the fixation light.

  The fixation lamps 95 for peripheral fixation are arranged so as to surround the objective lens 22 in the lens housing portion 403a, that is, are arranged at positions shifted from the respective target positions TP to the outside in the direction perpendicular to the optical axis. As a result, the eye E (the right eye and the left eye) fixates the fixation light emitted from any of the fixation lamps 95, and the fundus of the eight places corresponding to the internal fixation described above. Any one of the eight peripheral portions of the fundus located further outside than the peripheral portion is moved to the aforementioned signal light irradiation position. In addition, when the eye E is to fixate the fixation light emitted from each fixation lamp 95, it is necessary to rotate the eye E to a greater degree than when performing internal fixation. The fixation light may be lost.

  Returning to FIG. 5, the correspondence information 212 stored in the storage unit 204 includes a plurality of inspection target sites corresponding to internal fixation and peripheral fixation, and a fixation light emission position (XY for each inspection target site). And information indicating the correspondence between the coordinates. Note that the fixation light emission position for each inspection target site includes each target position on the objective lens 22 corresponding to internal fixation and the position of each fixation lamp 95 corresponding to peripheral fixation. (See FIG. 7).

  Returning to FIG. 5, the line-of-sight position detection unit 215 constitutes a line-of-sight position detection unit of the present invention together with the line-of-sight position detection optical system 70 described above. The gaze position detection unit 215 turns on the infrared LED 72 when internal fixation or peripheral fixation is started, that is, when fixation light is emitted from the objective lens 22 or the fixation lamp 95. At the same time, the line-of-sight position detection unit 215 determines the objective lens 22, the fixation lamp 95, and the like based on the captured image data 150 (see FIG. 8) of the eye E input from the image sensor 78 and the light receiving signal input from the PSD 79. The eye gaze position of the subject's eye E with respect to is detected.

  FIG. 8 is an explanatory diagram for describing a gaze position detection method (corneal detection method) of the gaze position detection unit 215 using the Purkinje image 151. As shown by reference numeral VIIIA in FIG. 8, the incidence of near-infrared light from a point light source generates a Purkinje image 151, which is a reflection image of near-infrared light, on the cornea surface of the eye E to be examined. The position of the Purkinje image 151 changes according to a change in the line of sight of the eye E to be inspected.

  Therefore, as indicated by reference numeral VIIIB in FIG. 8, the gaze position detecting unit 215 determines the eye E based on the captured image data 150 of the eye E input from the image sensor 78 and the light receiving signal input from the PSD 79. Of the Purkinje image 151 are detected. Then, the gaze position detection unit 215 detects the gaze direction of the eye E based on the relative position between the position of the Purkinje image 151 indicated by the position coordinates C1 and the center of the pupil. The method of detecting the line of sight direction using the Purkinje image 151 is a known technique, and a detailed description thereof will be omitted. Although the PSD 79 is used in the present embodiment, the PSD 79 may be omitted and the position coordinates C1 of the Purkinje image 151 may be detected based only on the captured image data 150 input from the image sensor 78.

  FIG. 9 is an explanatory diagram for describing a method (scleral reflection method, dark pupil method) for detecting the gaze direction of the eye E based on the captured image data 150 of the eye E. In this method, the incidence of near-infrared light from the point light source on the eye E can be omitted. The gaze position detection unit 215 acquires the captured image data 150 of the eye E from the image sensor 78 as shown by reference numeral IXA in FIG. 9 and then captures the captured image data of the eye E as shown by reference numeral IXB in FIG. 150 is binarized at a predetermined luminance threshold. Since the pupil of the eye E has a lower luminance than the surrounding area, when the captured image data 150 is binarized, the area corresponding to the pupil of the eye E becomes a black pixel area, and the area around the pupil becomes black. Is a white pixel area. Thus, the pupil region of the eye E can be specified from the captured image data 150 of the eye E.

  Then, as indicated by reference numeral IXC in FIG. 9, the gaze position detection unit 215 calculates the center coordinates C2 of the pupil region (black pixel region) of the eye E from the binarized captured image data 150 of the eye E. The gaze direction of the eye E is detected based on the calculated center coordinates C2 and the known geometric structure of the eyeball. Note that detection of the direction of the line of sight by the scleral reflection method (dark pupil method) is a known technique, and a detailed description thereof will be omitted.

  Returning to FIG. 5, the line-of-sight position detection unit 215 detects the relative position of the subject's eye E with respect to the fundus camera unit 2 based on the captured image data 150 and the known imaging magnification of the imaging optical system 30. The method for detecting the relative position of the eye E is not particularly limited. Then, based on the detected relative position and the line-of-sight direction of the eye E, the line-of-sight position detection unit 215 determines the line of sight of the objective lens 22, the fixation lamp 95, and these peripheral parts that the eye E is gazing at. The position coordinates (XY coordinates) of the position (gaze point) are detected, and the detection result of the position coordinates of the line of sight is output to the fixation target display control unit 214. The gaze position detection unit 215 repeatedly performs the detection of the gaze position of the eye E at regular intervals, and sequentially outputs a new gaze position detection result to the information generation unit 216.

  FIG. 10 is an explanatory diagram for explaining the generation of the relative position information 219 (see FIG. 11) by the information generation unit 216. In FIG. 10, reference symbol BL indicates fixation light, reference symbol SD indicates a line-of-sight direction of the eye E, and reference symbol SP indicates a line-of-sight position of the eye E. In FIG. 10, the fixation light is described as being emitted from the target position TDR of the objective lens 22 (any other target position or any of the fixation lights 95 is possible).

  As illustrated in FIG. 10, the information generation unit 216 generates relative position information 219 (see FIG. 11) when internal fixation or peripheral fixation is started. The relative position information 219 is a relative position in the optical axis vertical direction of the line of sight of the eye E to the emission position of the fixation light emitted from the objective lens 22 and the fixation lamp 95, that is, the optical axis vertical of the line of sight to the emission position. This is information indicating the direction of deviation and the amount of deviation Δd.

  The information generating unit 216 first refers to the corresponding information 212 in the storage unit 204 based on the operation of designating the examination target site of the fundus oculi Ef input to the operation unit 210 and corresponds to the examination target site. The emission position of the fixation light (the target position TDR in this case) is determined. Next, the information generation unit 216 generates relative position information 219 (see FIG. 11) based on the line-of-sight position of the subject's eye E detected by the line-of-sight position detection unit 215 and the fixation light emission position. The position information 219 is output to the screen display control unit 217.

  FIG. 11 is an explanatory diagram showing a first example of the relative position information 219. As shown in FIG. 11, the first example of the relative position information 219 is a first image of the present invention centered on the emission position of the fixation light (origin). The relative position information 219 includes a mark ML indicating a fixation light emission position and a mark ME indicating a line-of-sight position of the subject's eye E.

  The information generation unit 216 calculates the direction of displacement of the line of sight line in the direction perpendicular to the optical axis and the amount of deviation Δd with respect to the emission position based on the emission position of the fixation light and the line of sight of the eye E. Then, based on the calculation result, the information generating unit 216 is provided at a position separated from the mark ML provided at the image center position by a distance corresponding to the shift amount Δd in the above-described shift direction from the image center position. The relative position information 219 including the mark ME is generated. Thus, from the relative position information 219, the fixation state of the eye E (whether or not the eye is capturing fixation light, and where the line of sight of the eye E is facing the fixation light, etc.) ) Can be determined.

  FIG. 12 is an explanatory diagram showing a second example of the relative position information 219. As illustrated in FIG. 12, the second example of the relative position information 219 includes the optical axis of the fixation light emission position and the line of sight of the eye E with respect to the optical axis OA, with the optical axis OA as the center (origin). 9 is a second image of the present invention showing a relative position in the vertical direction. That is, the second example of the relative position information 219 is an image indirectly indicating the relative position of the line-of-sight position relative to the emission position in the direction perpendicular to the optical axis. The relative position information 219 includes a mark MO indicating the optical axis OA in addition to the mark ML and the mark ME described above.

  The information generating unit 216 determines the position of the optical axis OA based on the emission position of the fixation light, the line of sight of the eye E, and the position of the optical axis OA corresponding to the target position TM (see FIG. 7). And the first shift direction and the first shift amount of the emission position with respect to the optical axis OA, and the second shift direction and the second shift amount of the line-of-sight position with respect to the position of the optical axis OA. Then, based on each calculation result, the information generating unit 216 is provided at a position separated from the mark MO provided at the image center position by a distance corresponding to the first shift amount in the first shift direction from the image center position. The relative position information 219 including the mark ML and the mark ME provided at a position separated from the image center position by a distance corresponding to the second shift amount in the second shift direction is generated. In this way, from the relative position information 219, in addition to the fixation state of the eye E to be examined, the emission position and the line of sight based on the optical axis OA can be determined.

  Returning to FIG. 5, the information generating unit 216 sequentially updates the relative position information 219 every time a new detection result of the line-of-sight position of the eye E is input from the line-of-sight position detection unit 215. Thus, when the line of sight of the eye E moves toward the fixation light emission position, the position of the mark ME in the relative position information 219 is updated accordingly, and the mark ME moves toward the mark ML. I do. Then, the information generation unit 216 sequentially outputs new relative position information 219 to the screen display control unit 217 every time the relative position information 219 is updated.

  The screen display control unit 217 controls display of the display device 3. The screen display control unit 217 causes the display device 3 to display the relative position information 219 input from the information generation unit 216 when the internal fixation or the peripheral fixation is started. Therefore, the screen display control unit 217 functions as an output unit of the present invention.

  In addition, the screen display control unit 217 generates a shooting screen 220 (see FIG. 13 and the like) corresponding to various operations performed by the ophthalmologic apparatus 1 simultaneously with the internal fixation or the peripheral fixation, and displays the shooting screen 220. It is displayed on the device 3. In this case, the screen display control unit 217 superimposes the photographing screen 220 and the relative position information 219 on the optotype display unit 39.

  Examples of the type of operation of the ophthalmologic apparatus 1 performed simultaneously with internal fixation or peripheral fixation include alignment of the fundus camera unit 2 with respect to the anterior ocular segment Ea, focus adjustment of the fundus camera unit 2 with respect to the fundus oculi Ef, and ophthalmologic apparatus. One example is auto-optimization (auto-optimization). Although the alignment here is an automatic alignment, a manual alignment may be performed. The auto-optimization performs fine adjustment of the position of the fundus camera unit 2 in the Z direction, sensitivity adjustment of the OCT image, and the like.

  FIG. 13 is an explanatory diagram showing an example of the photographing screen 220 and the relative position information 219 superimposed and displayed on the display device 3 when the fundus camera unit 2 is aligned. FIG. 14 is an explanatory diagram showing an example of the photographing screen 220 and the relative position information 219 superimposed and displayed on the display device 3 when the focus of the fundus camera unit 2 is adjusted. FIG. 15 is an explanatory diagram showing an example of the photographing screen 220 and the relative position information 219 which are superimposed and displayed on the display device 3 at the time of auto-optimization (auto-optimization) of the ophthalmologic apparatus 1.

  As shown in FIG. 13, the screen display control unit 217 acquires an anterior eye image (observation image) of the anterior eye Ea from the fundus camera unit 2 when the fundus camera unit 2 is aligned. Then, the screen display control unit 217 generates the photographing screen 220 including the anterior eye part image observation screen 220a which is the observation screen of the anterior eye part image, and superimposes the photographing screen 220 and the relative position information 219 on the display device 3. Display.

  As shown in FIG. 14 and FIG. 15, the screen display control unit 217 receives the above-described anterior eye image from the fundus camera unit 2 during the focus adjustment of the fundus camera unit 2 or the auto-optimization of the ophthalmologic apparatus 1. A fundus image (observation image) of the fundus oculi Ef is acquired, and an OCT image (observation image) is acquired from the image forming unit 206. Then, the screen display control unit 217 generates the photographing screen 220 including the anterior eye part image observation screen 220a, the fundus image observation screen 220b that is a fundus image observation screen, and the OCT image observation screen 220c that is an OCT image observation screen. Then, the photographing screen 220 and the relative position information 219 are superimposed and displayed on the display device 3.

  The display position, the display range, and the like of the relative position information 219 in the shooting screen 220 are not particularly limited. When a plurality of display devices 3 are provided in the ophthalmologic apparatus 1, the screen display control unit 217 causes the relative position information 219 to be displayed on a display device 3 different from the display device 3 that displays the imaging screen 220. You may. Furthermore, in the present embodiment, the photographing screen 220 displayed on the display device 3 at the time of alignment, focus adjustment, and auto-optimization has been described as an example. However, other operations (for example, each of the illumination optical system 10 and the photographing optical system 30) The superimposed display of the various photographing screens 220 and the relative position information 219 may also be executed at the time of setting the amount of illumination light).

[Operation of ophthalmic device]
FIG. 16 is a flowchart showing a flow of inspection processing of the eye E to be inspected by the ophthalmologic apparatus 1 having the above configuration, in particular, a flow of display processing of the relative position information 219 on the display device 3 (corresponding to an operation method of the ophthalmologic apparatus of the present invention).

  As shown in FIG. 16, after the predetermined examination preparation processing in the ophthalmologic apparatus 1 is completed, the examiner performs an operation of designating an examination target site of the fundus oculi Ef on the operation unit 210 (Step S1). When this designation is performed, the overall control unit 202 controls each unit of the ophthalmologic apparatus 1 and sets the amount of illumination light of each of the illumination optical system 10 and the imaging optical system 30 by a known method (step S2). ), Alignment of the fundus camera unit 2 (step S3), focus adjustment of the fundus camera unit 2 (step S4), and auto-optimization of the ophthalmologic apparatus 1 (step S5).

  On the other hand, the fixation target display control unit 214 of the overall control unit 202 sets the fixation target on the target display unit 39 when the internal fixation is performed based on the inspection target region specified by the specifying operation. When the image is displayed at the corresponding display position (see FIG. 6) and the peripheral fixation is performed, the fixation lamp 95 corresponding to the inspection target part is turned on. Thereby, when internal fixation is performed, fixation light is emitted from the target position (see FIG. 7) corresponding to the inspection target part of the objective lens 22, and when peripheral fixation is performed, it corresponds to the inspection target part. The fixation light 95 emits fixation light (step S6). As a result, internal fixation or peripheral fixation is started.

  In addition, in response to the start of internal fixation or peripheral fixation, the gaze position detection unit 215 turns on the infrared LED 72, and is input from the captured image data 150 of the eye E to be input from the image sensor 78 and the PSD 79. Acquire a light receiving signal.

  Next, based on the captured image data 150, the received light signal, and the photographing magnification of the known photographing optical system 30, the line-of-sight position detecting unit 215 determines the objective lens 22 and the object lens 22 The gaze position of the eye E with respect to the fixation lamp 95 or the like is detected (step S7). Then, the line-of-sight position detection unit 215 outputs the detection result of the line-of-sight position of the subject's eye E to the information generation unit 216.

  Further, in response to the start of the internal fixation or the peripheral fixation, the information generation unit 216 refers to the correspondence information 212 in the storage unit 204 and determines the emission position of the fixation light corresponding to the inspection target site. Then, based on the emission position of the fixation light and the line-of-sight position of the eye E detected by the line-of-sight position detection unit 215, the information generation unit 216 generates the relative position information shown in FIGS. 219, and outputs the relative position information 219 to the screen display control unit 217 (step S8).

  The screen display control unit 217, based on the various images acquired from the retinal camera unit 2 and the like and the relative position information 219 acquired from the information generation unit 216, as shown in FIGS. 3 is superimposed on the photographing screen 220 and the relative position information 219 (step S9). Thus, the examiner can determine the fixation state of the eye E based on the relative position information 219 displayed on the display device 3. For this reason, for example, even if the eye E loses the fixation light, the examiner can easily determine where the line of sight of the eye E is facing the fixation light by referring to the relative position information 219. Can be determined. As a result, the examiner can give an appropriate alert to the subject.

  Hereinafter, the processes from the above-described steps S7 to S9 are repeatedly executed until the above-described auto-optimization in step S5 is completed, that is, until the preparation for the main imaging of the inspection target site is completed (NO in step S10). ). Accordingly, even when the eye E loses the fixation light during the alignment, focus adjustment, auto-optimization, or the like, the examiner can easily determine that from the relative position information 219. For this reason, an appropriate alert can be issued from the examiner to the subject. As a result, data acquisition (final imaging) of the fundus oculi Ef can be performed in a state where the subject's eye E securely fixes the fixation light.

  When step S5 is completed (YES in step S10), photographing of the fundus image (final photographed image) and the OCT image (final photographed image) of the fundus oculi Ef by the fundus camera unit 2 and the OCT unit 100 and the like are executed by a known method. Is performed (step S11).

  Hereinafter, when the inspection target part is changed, the above-described processing from step S1 to step S11 is repeatedly executed (step S12).

[Effects of the present embodiment]
As described above, in the present embodiment, when performing internal fixation and peripheral fixation, the gaze position of the eye E is detected, and the gaze position of the eye E with respect to the fixation light emission direction is perpendicular to the optical axis. Is generated, the examiner can easily determine the fixation state of the eye E based on the relative position information 219.

[Another Embodiment of Ophthalmic Device]
In the ophthalmologic apparatus 1 of the above embodiment, the relative position information 219 is always displayed on the display device 3 when performing internal fixation and peripheral fixation. However, in the ophthalmologic apparatus 1 of another embodiment, the fixation of the eye E to be examined is performed. The display of the relative position information 219 on the display device 3 is switched according to the viewing state. The ophthalmologic apparatus 1 according to another embodiment has basically the same configuration as the ophthalmologic apparatus 1 according to the above-described embodiment. Omitted.

  FIG. 17 is a flowchart illustrating a flow of an inspection process of the eye E to be inspected by the ophthalmologic apparatus 1 of another embodiment, particularly, a display process of the relative position information 219 in the display device 3. Note that the processes up to step S8 are the same as those in the above-described embodiment described with reference to FIG. 16, and a description thereof will not be repeated.

  The screen display control unit 217 according to another embodiment, based on the relative position information 219 acquired from the information generation unit 216, shifts the line of sight of the eye E to the line of sight of the eye E in the direction perpendicular to the optical axis (see FIG. Is determined to be larger than a predetermined threshold (step S8A). Then, when the deviation amount Δd is larger than the threshold value, the screen display control unit 217 superimposes and displays the photographing screen 220 and the relative position information 219 on the display device 3 as in the above embodiment (NO in step S8A, Step S9). Thereby, the same effect as in the above embodiment can be obtained.

  On the other hand, when the deviation amount Δd is equal to or smaller than the threshold, the screen display control unit 217 causes the display device 3 to display only the photographing screen 220 and omit the display of the relative position information 219 by the display device 3 (Step S8A). YES). Accordingly, when the fixation state of the eye E is good, the display of the relative position information 219 by the display device 3 is omitted, so that the examiner feels troublesome and the photographing screen 220 becomes difficult to see. Is prevented.

[Others]
In each of the above embodiments, the relative position information 219 generated by the information generating unit 216 is displayed on the display device 3, but the relative position information 219 is output from a sound output device such as a speaker (an output unit of the present invention). It may be output.

  The line-of-sight position detection method by the line-of-sight position detection unit 215 in each of the above embodiments is not limited to the method described with reference to FIGS. For example, known line-of-sight positions such as a method using a positional relationship between a reference point such as the inner corner of the examiner and a moving point such as an iris of the eye E, and a method of detecting the movement of the eye E using an electro-oculogram sensor Detection methods can be used.

  In the above embodiments, the ophthalmologic apparatus 1 capable of performing both internal fixation and peripheral fixation has been described as an example. However, an ophthalmologic apparatus capable of performing only one of internal fixation and peripheral fixation is described. The present invention can be applied to the device 1.

  In each of the above embodiments, the description has been given by taking as an example the multifunction machine of the optical coherence tomography and the fundus camera as the ophthalmologic apparatus 1. However, the optical coherence tomography, the fundus camera, the scanning laser ophthalmoscope, the laser treatment apparatus ( The present invention can be applied to various ophthalmologic devices that fixate the eye E, such as a photocoagulation device), a corneal endothelial cell test device, a non-contact type tonometry device, an auto reflex keratometer, and a perimeter.

1 ... ophthalmic equipment,
2 ... fundus camera unit,
3. Display device,
10 ... Illumination optical system,
22 ... objective lens,
30 ... photographing optical system,
39 ... Target display part,
70 ... gaze position detecting optical system,
95 ... fixation light,
100 ... OCT unit,
200 ... arithmetic and control unit,
202 ... General control unit,
210 ... operation unit,
214 ... fixation target display control unit,
215: gaze position detection unit,
216 ... information generation unit,
217: screen display control unit,
219 ... relative position information,
220 ... shooting screen

Claims (9)

A fixation light emitting unit that emits fixation light,
A line-of-sight position detection unit that detects a line-of-sight position of the subject's eye with respect to the fixation light emitting unit,
When the direction perpendicular to the emission direction of the fixation light emitted from the fixation light emission unit is set to the vertical direction, the detection result of the gaze position detection unit and the light emitted from the fixation light emission unit An emission position of the fixation light, and an information generation unit that generates relative position information indicating the vertical relative position of the line of sight to the emission position,
An ophthalmologic apparatus comprising:   The ophthalmologic apparatus according to claim 1, further comprising an output unit configured to display or output the relative position information generated by the information generation unit.   The output unit, based on the relative position information generated by the information generation unit, when the vertical shift amount of the line-of-sight position with respect to the emission position is greater than a predetermined threshold, the output of the relative position information The ophthalmologic apparatus according to claim 2, wherein display or audio output is performed, and display or audio output of the relative position information is omitted when the displacement amount is equal to or less than the threshold. The information generation unit is a first image indicating the relative position information and generates a first image centered on the emission position,
The ophthalmologic apparatus according to claim 2, wherein the output unit displays the first image. An optical system that irradiates the subject's eye with illumination light through an objective lens having an optical axis parallel to the emission direction and receives reflected light of the illumination light reflected by the subject's eye,
The information generating unit is a second image centered on the optical axis as the relative position information, and indicates a vertical relative position of each of the emission position and the line-of-sight position with respect to the optical axis. Generate an image,
The ophthalmologic apparatus according to claim 2, wherein the output unit displays the second image. The fixation light emitting unit selectively emits the fixation light from a plurality of the emission positions,
An operation unit that receives a designation operation of the emission position,
The ophthalmologic apparatus according to claim 1, wherein the information generation unit generates the relative position information corresponding to the emission position selected by the designation operation on the operation unit.   The fixation light emitting unit, a target display unit that displays a fixation target, and the fixation target corresponding to the fixation target displayed on the target display unit through an objective lens having an optical axis parallel to the emission direction. The ophthalmologic apparatus according to any one of claims 1 to 6, further comprising: a projection optical system that projects fixation light to the eye to be inspected. An optical system that irradiates the subject's eye with illumination light through an objective lens having an optical axis parallel to the emission direction and receives reflected light of the illumination light reflected by the subject's eye,
The ophthalmologic apparatus according to any one of claims 1 to 7, wherein the fixation light emitting unit includes a plurality of fixation lamps surrounding the objective lens. In an operation method of an ophthalmologic apparatus including a fixation light emitting unit that emits fixation light,
A gaze position detection unit detects a gaze position of the subject's eye with respect to the fixation light emitting unit,
When the information generation unit sets a direction perpendicular to an emission direction of the fixation light emitted from the fixation light emission unit to a vertical direction, the detection result of the gaze position detection unit and the fixation light An operation method of an ophthalmologic apparatus that generates relative position information indicating a vertical position of the line-of-sight position with respect to the emission position based on an emission position of the fixation light emitted from an emission unit.

Images