JP2020044199A - Ophthalmologic apparatus - Google Patents

Abstract

To provide an ophthalmologic apparatus capable of improving reliability of information acquisition of an eye to be inspected.SOLUTION: An ophthalmologic apparatus 10 for acquiring information of an eye to be inspected E comprises: an imaging element 31g for acquiring an anterior segment image E' of the eye to be inspected E; and a control unit 26 as an open eyelid state detecting unit which detects the open eyelid state of the eye to be inspected E on the basis of the anterior segment image E' photographed by the imaging element 31g and, when the detected open eyelid state of the eye to be examined E is improper, reports the fact.SELECTED DRAWING: Figure 3

Description

  The present invention relates to an ophthalmic device.

  The lowering of the eyelid of the subject's eye due to aging or the like is called eyelid ptosis. If the eye to be inspected is not sufficiently opened (opened eyelids) due to eyelid droop or the like, information on the eye to be inspected may not be able to be appropriately acquired. 1, 2).

  Patent Document 1 discloses that even if there is a lack of pupil diameter due to eyelid droop or the like, a comparison is made between a pre-detection eyeball image captured in an open eyelid state and a detection eyeball image for detecting pupil diameter. A pupil diameter detection device that attempts to detect a proper pupil diameter is disclosed. Patent Literature 2 discloses an intraocular pressure measurement apparatus that determines the credibility of measured intraocular pressure according to an eyelid opening state by specifying the outer edge of an eyelid from an image of a subject's eye.

  However, in the above-described conventional technique, even when the eyelid opening state is insufficient, information on the eye to be inspected such as the pupil and intraocular pressure is acquired or information on the eye to be inspected is estimated, so that the reliability of the measurement result is high. There was a problem in that.

JP 2012-196364 A JP 2013-106821 A

  The present invention has been made in view of the above problems, and has as its object to provide an ophthalmologic apparatus that can improve the reliability of acquiring information on an eye to be examined.

  In order to achieve the above object, the ophthalmologic apparatus of the present invention is an ophthalmologic apparatus that acquires information on an eye to be inspected, an image acquiring unit that acquires an anterior segment image of the eye to be inspected, and the image acquired by the image acquiring unit. An eyelid opening state detecting unit that detects an eyelid opening state of the eye to be inspected based on the anterior eye image and, when the detected eyelid opening state of the eye to be inspected is not appropriate, notifies that fact. It is characterized by.

  In the ophthalmologic apparatus configured as described above, the anterior segment image is analyzed to detect the eyelid opening state of the subject's eye, and when the eyelid opening state is not appropriate, the examiner is notified of that fact. Therefore, the examiner can recognize that the eye-opening state of the subject's eye is not sufficient, and the examiner can quickly take measures to achieve an appropriate eye-opening state. Therefore, it is possible to provide an ophthalmologic apparatus that can improve the reliability of information acquisition of the eye to be examined.

It is a perspective view showing the appearance of the ophthalmologic apparatus concerning a 1st embodiment. It is a figure showing the schematic structure of the measurement unit of the ophthalmologic apparatus concerning a 1st embodiment. FIG. 2 is a diagram illustrating a schematic configuration of a measurement optical system of the ophthalmologic apparatus according to the first embodiment. FIG. 3 is a diagram illustrating a block configuration of a control system of the ophthalmologic apparatus according to the first embodiment. It is a figure for demonstrating an eyelid opening state, (a) shows a normal eyelid opening state and (b) shows an eyelid drooping eyelid opening state. 5 is a flowchart illustrating an example of an operation of the ophthalmologic apparatus according to the first embodiment. It is a figure showing an example of the screen at the time of the objective examination displayed on the display of the ophthalmologic apparatus concerning a 1st embodiment. It is a figure showing other examples of a screen at the time of an objective examination displayed on a display part of the ophthalmologic apparatus concerning a 1st embodiment. It is a figure showing other examples of a screen at the time of a subjective test displayed on a display part of an ophthalmologic apparatus concerning a 1st embodiment. FIG. 9 is a diagram schematically illustrating a positional relationship between two cameras and an eye to be inspected in an ophthalmologic apparatus according to another different embodiment.

(1st Embodiment)
Hereinafter, a first embodiment of the ophthalmologic apparatus of the present invention will be described. First, the overall configuration of the ophthalmologic apparatus 10 according to the first embodiment will be described with reference to FIGS. The ophthalmologic apparatus 10 according to the first embodiment is a binocular open-type ophthalmologic apparatus capable of simultaneously measuring the characteristics of the subject's eye with the subject's left and right eyes open. The present invention is not limited to the binocular open type, and the present invention can be applied to an ophthalmologic apparatus for measuring characteristics of each eye.

[Overall configuration of ophthalmic device]
As shown in FIG. 1, the ophthalmologic apparatus 10 according to the present embodiment includes a base 11 installed on the floor, an optometry table 12, a support 13, an arm 14 as a support, a measurement unit 20, It has. In the ophthalmologic apparatus 10, the subject facing the optometry table 12 measures the characteristics of the subject's eye with the forehead applied to the forehead contact portion 15 provided in the measurement unit 20. As shown in FIG. 1 throughout this specification, the X axis, the Y axis, and the Z axis are taken, and when viewed from the subject, the left-right direction is the X direction, the up-down direction (vertical direction) is the Y direction, and the X direction is the X direction. A direction orthogonal to the Y direction (the depth direction of the measurement unit 20) is defined as a Z direction.

  The optometry table 12 is a desk on which an examiner controller 27 and an examinee controller 28 to be described later are placed and a table used for optometry is placed, and is supported by the base 11. The optometry table 12 may be supported by the base 11 so that the position (height position) in the Y direction can be adjusted.

  The support 13 stands upright in the Y direction from the rear end of the optometry table 12, and has an arm 14 provided at an upper portion thereof. The arm 14 is attached to the column 13 and suspends and supports a pair of measurement heads 23 above the optometry table 12 via a pair of drive mechanisms 22. The arm 14 is movable with respect to the support 13 in the Y direction. Note that the arm 14 may be movable in the X direction and the Z direction with respect to the support 13. A measuring unit 20 having a pair of measuring heads 23 is provided at a tip of the arm 14 via a driving mechanism 22.

  The base 11 is provided with a control unit 26 that controls each part of the ophthalmologic apparatus 10 in a control box 26b. The controller 26 is supplied with power from a commercial power supply via a power cable 17a.

[Measurement unit]
The measurement unit 20 performs at least one of an arbitrary subjective test and an arbitrary objective test. In the subjective test, a test target or the like is presented to the subject, and the test result is obtained based on the test subject's response to the test target or the like. The subjective test includes a subjective refraction measurement such as a distance test, a near test, a contrast test, and a glare test, and a visual field test. In the objective test, light is applied to the eye to be inspected, and information (characteristics) on the eye to be inspected is measured based on the detection result of the return light. The objective inspection includes measurement for acquiring characteristics of the eye to be inspected and photographing for acquiring an image of the eye to be inspected. In addition, objective refraction measurement (refraction measurement), corneal shape measurement (keratometry), intraocular pressure measurement, fundus photography, optical coherence tomography (hereinafter referred to as "OCT") are used for objective tests. Tomographic imaging (OCT imaging), measurement using OCT, and the like.

  Further, as shown in FIG. 2, the measurement unit 20 is connected to a control unit 26 via a control / power cable 17b, and power is supplied via the control unit 26. Further, transmission and reception of information between the measurement unit 20 and the control unit 26 are also performed via the control / power cable 17b.

  As shown in FIG. 2, the measuring unit 20 is supported by a mounting base 21, a left-eye driving mechanism 22L and a right-eye driving mechanism 22R provided on the mounting base 21, and a left-eye driving mechanism 22L. And a right-eye measuring head 23R supported by the right-eye driving mechanism 22R.

  The left-eye measurement head 23L and the right-eye measurement head 23R are configured to be plane-symmetric with respect to a vertical plane located between them in the X direction. The configuration of each drive unit of the left-eye drive mechanism 22L corresponding to the left-eye measurement head 23L and the configuration of each drive unit of the right-eye drive mechanism 22R corresponding to the right-eye measurement head 23R are in the X direction. The configuration is plane-symmetric with respect to the vertical plane located between the two. Hereinafter, the measuring head 23 and the driving mechanism 22 may be simply referred to except when individually described. The same applies to other components provided symmetrically to the left and right.

  The mounting base 21 is fixed to the tip of the arm 14, extends in the X direction, has a left-eye driving mechanism 22L suspended at one end, and a right-eye driving mechanism 22R at the other end. Is suspended. A forehead contact 15 is suspended from the center of the mounting base 21.

  The left-eye driving mechanism 22L is configured to control the position of the left-eye measuring head 23L in the X, Y, and Z directions and the eyeball rotation axis OL of the left eye EL based on a control command from the control unit 26 (see FIG. 2). Change the orientation around. As shown in FIG. 2, the left-eye driving mechanism 22L includes a left vertical driving unit 22a, a left horizontal driving unit 22b, and a left rotation driving unit 22c. These drive units 22a to 22c are arranged between the mounting base unit 21 and the left eye measurement head 23L in the order of the left vertical drive unit 22a, the left horizontal drive unit 22b, and the left rotation drive unit 22c from above. I have.

  The left vertical drive unit 22a moves the left horizontal drive unit 22b relative to the mounting base 21 in the Y direction. The left horizontal drive unit 22b moves the left rotation drive unit 22c in the X direction and the Z direction with respect to the left vertical drive unit 22a. The left rotation drive unit 22c rotates the left eye measurement head 23L about the eyeball rotation axis OL of the left eye EL with respect to the left horizontal drive unit 22b.

  The right eye drive mechanism 22R is configured to control the position of the right eye measurement head 23R in the X, Y, and Z directions and the eyeball rotation axis OR of the right eye ER (see FIG. 2) based on a control command from the control unit 26. Change the orientation around. As shown in FIG. 2, the right eye drive mechanism 22R includes a right vertical drive unit 22d, a right horizontal drive unit 22e, and a right rotation drive unit 22f. These drive units 22d to 22f are disposed between the mounting base unit 21 and the right eye measurement head 23R in the order of a right vertical drive unit 22d, a right horizontal drive unit 22e, and a right rotation drive unit 22f from above. I have.

  The right vertical driving unit 22d moves the right horizontal driving unit 22e in the Y direction with respect to the mounting base 21. The right horizontal drive unit 22e moves the right rotation drive unit 22f in the X direction and the Z direction with respect to the right vertical drive unit 22d. The right rotation drive unit 22f rotates the right eye measurement head 23R about the eyeball rotation axis OR of the right eye ER with respect to the right horizontal drive unit 22e.

  Here, each of the left vertical drive unit 22a, the left horizontal drive unit 22b, the right vertical drive unit 22d, and the right horizontal drive unit 22e includes an actuator that generates a driving force such as a pulse motor, a plurality of gear sets, a rack and A transmission mechanism for transmitting a driving force such as a pinion; The left horizontal drive unit 22b and the right horizontal drive unit 22e may be provided with a combination of an actuator and a transmission mechanism separately in the X direction and the Z direction, so that the configuration can be simplified and the control of the horizontal movement can be easily performed. It can be.

  Further, the left rotation drive unit 22c and the right rotation drive unit 22f also include an actuator that generates a driving force such as a pulse motor and a transmission mechanism that transmits a driving force such as a plurality of gear sets and a rack and pinion. doing. Here, the left rotation drive unit 22c and the right rotation drive unit 22f move the transmission mechanism receiving the driving force from the actuator along the arc-shaped guide groove centered on the eyeball rotation axes OL and OR. Thus, the left eye measurement head 23L and the right eye measurement head 23R can be rotated around the eye rotation axis OL of the left eye EL and the eye rotation axis OR of the right eye ER, respectively.

  In addition, the left rotation drive unit 22c and the right rotation drive unit 22f may be configured to rotatably mount the left eye measurement head 23L and the right eye measurement head 23R around their own rotation axis.

  By rotating the left eye measurement head 23L and the right eye measurement head 23R in desired directions by the left rotation drive unit 22c and the right rotation drive unit 22f, the eye to be examined can be diverged (divergent movement) or convergence (convergence). Exercise). Accordingly, the ophthalmologic apparatus 10 can perform the tests of the divergence movement and the convergence movement, and can perform the distance test or the near test in the state of the binocular vision to measure various characteristics of the eyes to be examined.

  As shown in FIG. 2, the left-eye measuring head 23L includes a left-eye measuring optical system 24L built in a left housing 23a fixed to the left rotation driving unit 22c, and a left-eye measuring optical system 24L provided on an outer surface of the left housing 23a. And an eye deflecting member 25L.

  As shown in FIG. 2, the right-eye measuring head 23R is provided on a right-eye measuring optical system 24R incorporated in a right housing 23b fixed to the right rotation driving unit 22f, and on an outer surface of the right housing 23b. A right eye deflection member 25R.

  The measurement optical system 24L for the left eye and the measurement optical system 24R for the right eye perform a visual acuity inspection apparatus that performs a visual acuity test while switching the target to be presented, and switch the corrective lens to an appropriate corrective refractive power of the subject's eye while switching and arranging the corrective lens. Acquired phoropter, refractometer and wavefront sensor for measuring refractive power, fundus camera for capturing fundus images, tomographic device for capturing tomographic images of the retina, specular microscope for capturing corneal endothelial images, measuring corneal shape Keratometer, tonometer for measuring intraocular pressure, and the like, alone or in combination.

[Measurement optical system]
Hereinafter, an example of the configuration of the measurement optical system 24R for the right eye will be described with reference to FIG. FIG. 3 is a diagram showing a schematic configuration of the measurement optical system 24R for the right eye of the ophthalmologic apparatus 10 according to the present embodiment. Note that the configuration of the left-eye measurement optical system 24L is the same as that of the right-eye measurement optical system 24R, and a description thereof will be omitted, and only the right-eye measurement optical system 24R will be described below. In addition, since the measurement principle and the like by the measurement optical system are known, detailed description is omitted.

  As shown in FIG. 3, the right-eye measurement optical system 24R includes an observation system 31, a target projection system 32, an eye refractive power measurement system 33, an alignment system 35, an alignment system 36, and a kerato system 37.

  The observation system 31 observes the anterior segment of the eye E, the target projection system 32 presents a target to the eye E, and the eye refractive power measurement system 33 measures the eye refractive power. In the present embodiment, the eye refractive power measurement system 33 has a function of projecting a predetermined measurement pattern on the fundus oculi Ef of the eye E and a function of detecting an image of the measurement pattern projected on the fundus oculi Ef.

  The alignment system 35 and the alignment system 36 perform alignment (alignment) of the optical system with respect to the eye E to be inspected. The alignment system 35 performs alignment in a direction (front-back direction, Z direction) along the optical axis of the observation system 31 in a direction (up-down direction, left-right direction, Y direction, and X direction) perpendicular to the optical axis. Perform each alignment.

  The observation system 31 includes an objective lens 31a, a dichroic filter 31b, a half mirror 31c, a relay lens 31d, a dichroic filter 31e, an imaging lens 31f, and an image pickup device (CCD) 31g as an image acquisition unit.

  In the observation system 31, the light beam reflected by the eye E (anterior eye) is imaged on the image sensor 31g by the imaging lens 31f via the objective lens 31a. As a result, an anterior segment image E ′ is formed on the image sensor 31g, on which a keratling light beam, a light beam of the alignment light source 35a, and a light beam (bright spot image Br) of the alignment light source 36a are projected (projected). You. The image sensor 31g of the observation system 31 captures the anterior segment image E '. The control unit 26 displays an anterior ocular segment image E ′ or the like based on the image signal output from the imaging element 31g on the display surface 30a of the display unit 30 of the examiner controller 27.

  A kerato system 37 is provided in front of the objective lens 31a. The kerato system 37 includes a kerato plate 37a and a kerato ring light source 37b. The kerato plate 37a has a plate shape provided with a slit concentric with the optical axis of the observation system 31, and is provided near the objective lens 31a. The kerato ring light source 37b is provided in accordance with the slit of the kerato plate 37a.

  In the kerato-system 37, the luminous flux from the lit kerato-ring light source 37b passes through a slit of the kerato-plate 37a, so that the kerato-ring luminous flux (ring for measuring the corneal curvature) is measured on the eye E (cornea Ec). The target is projected (projected). The kerattling light beam is reflected by the cornea Ec of the eye E to be examined, and is imaged on the image sensor 31g by the observation system 31. As a result, the image sensor 31g detects (receives) an image (image) of the ring-shaped kerat ring light beam, and the control unit 26 displays the image of the measurement pattern on the display surface 30a of the display unit 30, and displays the image. The corneal shape (radius of curvature) is measured by a well-known method based on the image signal from the (imaging element 31g).

  In the present embodiment, an example (keratous system 37) is shown as a corneal shape measuring system in which a ring slit is about 1 to 3 times and a keratoplate 37a that measures curvature near the center of the cornea is used. As long as the corneal shape is measured, a platid plate having multiple rings and capable of measuring the shape of the entire cornea may be used, other configurations may be used, and the configuration is not limited to the configuration of the present embodiment.

  An alignment system 35 is provided behind the kerato system 37 (kerato plate 37a). The alignment system 35 has a pair of alignment light sources 35a and a projection lens 35b, converts the light flux from each alignment light source 35a into a parallel light flux with each projection lens 35b, and passes the cornea of the eye E through an alignment hole provided in the kerato plate 37a. The parallel light beam is projected (projected) on Ec.

  The control unit 26 or the examiner moves the measuring head 23R in the front-back direction based on the bright spot (bright spot image) projected (projected) on the cornea Ec, so that the direction along the optical axis of the observation system 31 ( Alignment in the front-back direction). The alignment in the front-rear direction is performed by adjusting the position of the measuring head 23R so that the ratio between the distance between two point images by the alignment light source 35a on the image sensor 31g and the diameter of the kerattling image is within a predetermined range.

  In the present embodiment, the optical axis of the measurement optical system 24R is bent by the right-eye deflecting member 25R, and the position of the mirror image of the measurement optical system 24R with respect to the right-eye deflecting member 25R is different from that of the measurement optical system 24R. The optical axis is configured to substantially coincide with the Z axis. For this reason, alignment in the optical axis direction of the measurement optical system 24R corresponds to alignment in the Z direction.

  Here, the control unit 26 may calculate the amount of misalignment from the ratio and display the amount of misalignment on the display surface 30a. Note that the alignment in the front-rear direction may be performed by adjusting the position of the measuring head 23R so that the bright spot image Br is focused by the alignment light source 36a described later.

  The observation system 31 is provided with an alignment system (parallel optical system) 36. The alignment system 36 has an alignment light source 36a and a projection lens 36b, and shares the half mirror 31c, the dichroic filter 31b, and the objective lens 31a with the observation system 31.

  The alignment system 36 projects (projects) a light beam from an alignment light source (point light source) 36a to the cornea Ec of the eye E as a parallel light beam via the objective lens 31a. The parallel light beam projected from the alignment system 36 onto the cornea Ec of the subject's eye E forms a bright spot R of the alignment light at a substantially intermediate position between the corneal vertex and the corneal curvature center. The control unit 26 or the examiner moves the measuring head 23 in the front-rear direction based on the virtual image (bright spot image) Br of the bright spot R projected (projected) on the cornea Ec, so that the optical axis of the observation system 31 is adjusted. Alignment is performed in the direction (vertical direction, horizontal direction) orthogonal to.

  At this time, the control unit 26 causes the display surface 30a to display an alignment mark AL as a guide of the alignment mark, in addition to the anterior eye image E 'on which the bright spot image Br is formed. The control unit 26 may be configured to control to start the measurement when the alignment is completed.

  The alignment light source 36a is a light emitting diode that emits infrared light (for example, 940 nm) in order to prevent the subject from visually recognizing the alignment light source 36a during the alignment operation by the alignment system 36.

  The optotype projection system 32 is an optical system that projects an optotype to fixate and cloud the eye to be inspected E and presents it to the fundus oculi Ef. The optotype projection system 32 has a display 32a, rotary prisms 32A and 32B, an imaging lens 32b, a moving lens 32c, a relay lens 32d, a field lens 32f, a mirror 32h, and a dichroic filter 32i, a dichroic filter 31b and an objective lens 31a. Is shared with the observation system 31.

  The display 32a displays a landscape chart that performs fixation and fogging, a Landolt ring, an E-character optotype, an optometry optotype, and the like when performing an objective test and a subjective test.

  An electronic display device such as an EL (electroluminescence) or a liquid crystal display (LCD) can be used as the display 32a, and an arbitrary image is displayed under the control of the control unit 26. The display 32a is provided movably along the optical axis at a position conjugate with the fundus oculi Ef of the eye E on the optical path of the optotype projection system 32.

  The rotary prisms 32A and 32B are used for adjusting the prism power and the prism base direction in the oblique inspection. The rotary prisms 32A and 32B are independently rotated by driving a pulse motor or the like. When the rotary prisms 32A and 32B are rotated in opposite directions, the prism power is continuously changed, and when they are integrally rotated in the same direction, the prism base direction is continuously changed.

  The moving lens 32c is driven forward and backward along the optical axis by a drive motor. By moving the moving lens 32c to the eye E, the refractive power can be displaced to the minus side, and by moving the moving lens 32c in a direction away from the eye E, the refractive power can be moved to the positive side. Can be displaced. Therefore, the moving distance of the optotype displayed on the display 32a can be changed by moving the moving lens 32c forward and backward, that is, the presenting position of the optotype image can be changed, and the eye E can be fixed and fogged. it can.

  The eye-refractive-power measuring system 33 projects a ring-shaped luminous flux projection system 33A that projects a ring-shaped measurement pattern onto the fundus oculi Ef of the eye E, and a ring that detects (receives) reflected light of the ring-shaped measurement pattern from the fundus oculi Ef. It has a linear light beam receiving system 33B.

  The ring-shaped light beam projection system 33A has a reflex light source unit 33a, a relay lens 33b, a pupil ring stop 33c, a field lens 33d, a perforated prism 33e, and a rotary prism 33f, and shares a dichroic filter 32i with the target projection system 32. Then, the dichroic filter 31b and the objective lens 31a are shared with the observation system 31. The reflex light source unit 33a includes, for example, a reflex measurement light source 33g for reflex measurement using an LED, a collimator lens 33h, a conical prism 33i, and a ring pattern forming plate 33j. It can move integrally on the optical axis of the measurement system 33.

  The ring-shaped light beam receiving system 33B includes a hole 33p of a perforated prism 33e, a field lens 33q, a reflection mirror 33r, a relay lens 33s, a focusing lens 33t, and a reflection mirror 33u, and an objective lens 31a, a dichroic filter 31b, and a dichroic. The filter 31e, the imaging lens 31f, and the image sensor 31g are shared with the observation system 31, the dichroic filter 32i is shared with the target projection system 32, and the rotary prism 33f and the perforated prism 33e are shared with the ring light beam projection system 33A. .

[Control unit]
The control unit 26 controls each unit of the ophthalmologic apparatus 10 as a whole. As shown in FIG. 4, the control unit 26 includes the above-described measurement optical system 24L for the left eye, the measurement optical system 24R for the right eye, the left vertical drive unit 22a of the drive mechanism 22L for the left eye, and the left horizontal drive unit. In addition to the 22b and the left rotation drive unit 22c, the right vertical drive unit 22d, the right horizontal drive unit 22e and the right rotation drive unit 22f of the right eye drive mechanism 22R, and the arm drive mechanism 16, the controller 27 for the examiner. , The subject controller 28 and the storage unit 29 are connected.

  The examiner controller 27 is used by the examiner to operate the ophthalmologic apparatus 10. The examiner controller 27 and the control unit 26 are communicably connected to each other by short-range wireless communication, but may be connected by wire.

  In the present embodiment, a portable terminal (information processing device) such as a tablet terminal or a smartphone is used as the examiner controller 27. This allows the examiner to hold the device in his / her hand and operate the subject or the ophthalmologic apparatus 10 from any position, thereby increasing the degree of freedom of the examiner during measurement. Can be. The examiner's controller 27 can also be operated by placing it on the optometry table 12. Further, the examiner controller 27 is not limited to a portable terminal, but may be a notebook personal computer, a desktop personal computer, or the like. Further, a controller dedicated to the ophthalmologic apparatus 10 may be used.

  The examiner's controller 27 includes a display unit 30 including a touch panel display. The display unit 30 includes a display surface 30a on which an image and the like are displayed, and a touch panel type input unit 30b disposed on the display surface 30a so as to overlap. The examiner inputs an alignment instruction and a measurement instruction from the input unit 30b when measuring the characteristics of the eye to be inspected. On the display surface 30a, an anterior ocular segment image E '(EL', ER ') based on an image signal received by the image sensor 31g, an operation screen as the input unit 30b, and the like are displayed.

  Further, the examiner controller 27 includes a notifying unit 30c for notifying the examiner of information. The notification unit 30c includes, for example, a speaker, a buzzer, a light, and the like, and outputs a voice message or a sound effect, and turns on or blinks light under the control of the control unit 26, in accordance with the information to be notified. In the present embodiment, a notification message or an image is displayed on the display unit 30 for notification, and the display unit 30 also functions as a notification unit.

  The subject controller 28 is used by the subject to respond when acquiring various pieces of eye information of the subject's eye E. The subject controller 28 includes an input device such as a keyboard, a mouse, and a joystick. The subject controller 28 is connected to the control unit 26 via short-range wireless communication or wired communication.

  The control unit 26 expands the program stored in the connected storage unit 29 or the built-in internal memory 26a on, for example, a RAM, and appropriately operates the controller 27 for the examiner or the controller 28 for the subject according to the operation. A drive control unit that controls the overall operation of the ophthalmologic apparatus 10 and controls various drive mechanisms, a display control unit that controls display on the display unit 30, and an eyelid state detection that detects an eyelid state of the eye E to be inspected. Functions as a unit. In the present embodiment, the internal memory 26a is configured by a RAM or the like, and the storage unit 29 is configured by a ROM, an EEPROM, or the like.

  Hereinafter, the function of the control unit 26 as the eyelid opening state detection unit will be described. The control unit 26 detects the eyelid opening state of the eye E based on the anterior eye image E ′ captured by the image sensor 31g. The detection of the eyelid opening state may be performed only once at the timing when the anterior ocular segment image E ′ is photographed by the imaging element 31g in a series of inspection steps. However, in the present embodiment, alignment and objective inspection are performed. In each process such as a subjective test, an anterior segment image E 'is taken to detect the eyelid opening state.

  The eyelid opening state means the degree of opening of the eyelid of the eye E to be examined. If the eyelid opening state is insufficient, the projection of various light beams to the eye E and the detection of a bright spot image, a ring image, a pattern image, and the like reflected by the eye E during alignment and inspection of the eye E are excellent. Cannot be performed, which may affect alignment and inspection reliability.

  A skilled examiner constantly checks the state of the eye to be examined and performs an examination or the like while coping with the eyelid opening state to be appropriate, but an unskilled examiner concentrates on the operation of the ophthalmologic apparatus 10 and the like. In some cases, it may not be possible to consider the eyelid opening state. Further, when the ophthalmologic apparatus 10 is remotely controlled through a communication system or the like, it is difficult to constantly check the state of the eye E. Therefore, in order to enhance the reliability of the alignment and the inspection, it is important to make the examiner recognize the eyelid opening state of the eye E to be inspected.

  FIG. 5 shows an example of the eyelid opening state. FIG. 5A shows the eye E to be examined in a normal eyelid state, in which the upper eyelid is sufficiently pulled up, and the entire pupil can be clearly confirmed. FIG. 5B shows the eyelid open state of the eye E to be examined with the eyelid droop, in which the upper eyelid is insufficiently opened and the iris and pupil are hidden by the upper eyelid.

  The detection of the eyelid opening state can be performed using a known image processing technique. For example, images of the eye to be inspected in various eyelid states are prepared in advance, such as an image of the eye to be inspected in a normal eyelid state, an image of the eye to be examined in eyelid droop, and the eyelid state is detected by using a pattern matching technique or the like. May be. At this time, it is more desirable to prepare images of the eye to be examined for various types of eyelid droop according to the degree (severity) of eyelid droop, age, race, and the like. Further, since the shape and eyelid opening state of the eye E vary from person to person, it is desirable to prepare more images for the eye to be examined in the normal eyelid opening state. Thereby, the eyelid opening state of the eye E can be detected with higher accuracy.

  Further, as another detection of the eyelid opening state, the outer edge (outline) of the eyelid of the eye E to be examined may be analyzed by analyzing the anterior eye image E ′ as in the method described in Patent Document 2. In this case, since the eyelid has higher luminance than the pupil and the iris, the outer edge of the eyelid can be specified based on this luminance difference. For example, for the pupil, an image area (pupil area) corresponding to the pupil is searched for by searching for a substantially circular and low-luminance image area based on the distribution of the luminance value and the like of the captured image while considering the shape of the pupil. And the pupil can be easily detected.

  More specifically, the control unit 26 scans the pixels of the anterior ocular segment image E ′ in the up-down direction (Y direction) and detects a change in luminance, thereby detecting a boundary point between the eyelid and the iris or pupil. Can be identified. That is, when the luminance is switched from a high value to a low value, it is known that the scanning target has switched from the eyelid to the iris and the like. When the luminance is switched from the low value to the high value, the scanning target is from the iris and the like. It turns out that it has switched to. The boundary of this switching can be the outer edge of the eyelid.

  The specification of the outer edge of the eyelid may be, for example, one point of the upper eyelid and one point of the lower eyelid at a predetermined position (for example, the center) of the eye E, or may specify two or more points. Alternatively, a plurality of points may be acquired, and these points may be connected by a Pezier curve or the like to specify the entire outer edge of the eyelid.

  The control unit 26 determines whether or not the detected eyelid opening state is appropriate. For example, the ratio of the width of the eye E to the length of the eye E is calculated. If the ratio is equal to or larger than the threshold, the eyelid opening state is determined to be appropriate. As another example, the distance between the outer edge of the upper eyelid and the outer edge of the lower eyelid of the subject's eye E is calculated, and the distance is compared with a threshold to determine whether or not the eyelid is appropriate.

  As still another example, suitability can be determined according to the positional relationship of the eyelids with respect to the pupil. Specifically, the eyelid (upper eyelid) and the pupil are detected from the anterior eye image E ′, and if the outer edge of the upper eyelid is located above the pupil and the pupil is not hidden by the upper eyelid, the eyelid is opened. It is determined that the eyelid state is appropriate. On the other hand, when the outer edge of the upper eyelid overlaps the pupil, or when the pupil is hidden by the upper eyelid and the pupil cannot be detected, etc., it is determined that the eyelid opening state is not appropriate, specifically, eyelid droop. Alternatively, if the detected pupil is circular or elliptical, the eyelid opening state is determined to be appropriate, and if the pupil circle or ellipse is missing, the pupil is hidden by the upper eyelid, so the eyelid opening state Is not appropriate.

  When the control unit 26 determines that the eyelid opening state is not appropriate, for example, by detecting eyelid droop, the control unit 26 notifies the examiner to that effect by the notification unit 30c. In the present embodiment, a notification message is displayed on the display unit 30 for notification. It is more desirable that this notification message be notified with contents corresponding to the cause of the determination that the eyelid opening state is inappropriate. For example, when eyelid droop is detected during alignment, a notification message indicating that eyelid droop is detected is displayed on the display surface 30a of the display unit 30 as an image. By this notification, the examiner can recognize that the alignment is not properly performed by the eye drop. In addition, every time a ptosis is detected during the execution of the subjective test or the objective test, a notification according to the test being performed is performed each time.

  The notification to the examiner is not limited to the display of the notification message or the like on the display unit 30. It may be a notification sound such as a voice message or a buzzer, may be notified by lighting or blinking light, or may be a combination of the above.

(Operation example of ophthalmologic apparatus)
An example of the operation of the ophthalmologic apparatus 10 according to the present embodiment having the above-described configuration will be described with reference to the flowchart in FIG.

  First, when the power switch of the ophthalmologic apparatus 10 is turned on and the browser or the application of the controller 27 for the examiner is started, the control unit 26 selects the objective examination mode or the subjective examination mode on the display surface 30 a of the display unit 30. A selection screen (input unit 30b) to be displayed is displayed.

  Next, the subject is seated on a chair or the like, opposed to the ophthalmologic apparatus 10, and the forehead is applied to the forehead section 15 of the measurement unit 20. In this state, the examiner selects, for example, the objective examination mode on the selection screen.

  When the objective inspection mode is selected, the optotype projection system 32 displays a fixation target at the center position of the display 32a under the control of the control unit 26 (step S1). In this state, the examiner instructs the subject to fixate the fixation target.

  Next, in step S2, the control unit 26 controls the driving of the alignment systems 35 and 36 to execute the alignment while the subject is fixed at the fixation target. The alignment systems 35 and 36 turn on the alignment light sources 35a and 36a, and based on the bright spot image Br and the like in the anterior eye image E ′ captured by the image sensor 31g, the vertical direction (Y direction) of the measuring head 23, Alignment in the left-right direction (X direction) and the front-back direction (Z direction) is performed.

  In step S3, the control unit 26 detects the eyelid opening state of the eye E by performing the above-described analysis processing based on the anterior eye image E ′ taken during the alignment. Next, in step S4, the control unit 26 determines whether or not the eyelid opening state is appropriate. If it is determined that the eyelid opening state is appropriate (the determination in step S4 is YES), the process proceeds to step S6.

  On the other hand, if the eyelid droop is detected and it is determined that the eyelid opening state is not appropriate (the determination in step S4 is NO), the process proceeds to step S5, and the control unit 26 has an inappropriate eyelid opening state (the eyelid droop is detected). ) And an anterior segment image E 'is displayed on the display surface 30a of the display unit 30. By this notification message, the examiner can recognize that the eye E has a ptosis. At this time, if an alignment error or the like occurs, the examiner can recognize that an error has occurred due to eyelid droop.

  Further, by visually recognizing the anterior eye image E ′ on the display surface 30a, it is possible to confirm the eyelid opening state in more detail, such as the presence of eyelid droop, and the degree of eyelid droop. Also, by always displaying the anterior eye image E ′ on the display surface 30a as a live video, it is confirmed whether the eye E to be examined actually has eyelid droop or is falsely recognized as eyelid droop by blinking. You can also.

  The examiner can take measures for appropriately executing the alignment based on the notification message or the like. For example, in the case of eyelid droop, the examiner pushes up the eyelid of the eye E to be examined with a finger to open the eyelid. Alternatively, when it is determined that the eyelid is drooping due to blinking, the subject can be instructed not to blink.

  Next, when the examiner performs an instruction operation to continue the process on the inspector controller 27, the control unit 26 receives this instruction operation, returns to step S2, and executes the alignment again.

  When the alignment is properly performed, in the next step S6, objectives such as kerato measurement by the kerato system 37, refractive power measurement (ref measurement) by the eye refractive power measurement system 33, intraocular pressure measurement, fundus photography, OCT photography, etc. Perform inspection. The result of the objective test is displayed on the display surface 30a of the display unit 30 by the control unit 26.

  Also in the case of this objective examination, the process proceeds to step S7, where the anterior eye image E 'is photographed and analyzed, and in step S8, it is determined whether or not the eyelid opening state is appropriate. The photographing of the anterior eye image E 'can be performed immediately before or immediately after photographing the image of the fundus oculi Ef by the image sensor 31g in the objective measurement. When it is determined that the eyelid opening state is appropriate (the determination in step S8 is YES), the process proceeds to step S10.

  FIG. 7A shows an example of a screen displaying the result of the refractive power measurement (reflection measurement) of the objective test on the display unit 30. As shown in FIG. 7A, on the display surface 30a, anterior eye images EL ′ and ER ′ of the left eye EL and the right eye ER and measurement results (spherical power S, cylindrical power C, axis angle A, pupil distance The distance PD, the distance VD between corneal vertices, etc.) are displayed.

  On the other hand, if eyelid droop or the like is detected and it is determined that the eyelid opening state is not appropriate (the determination in step S8 is NO), the process proceeds to step S9 to indicate that the eyelid opening state is not appropriate (eyelid droop was detected). The notification message and the anterior segment image E ′ are displayed on the display surface 30 a of the display unit 30. FIG. 7B illustrates an example of a screen displayed on the display unit 30 when the eyelid opening state is not appropriate. In the example of FIG. 7B, the anterior eye images EL ′ and ER ′ of the left eye EL and the right eye ER with eyelid droop are displayed on the display surface 30a, and the image of the notification message is displayed in a blinking state.

  By this notification, the examiner can recognize that the eye to be inspected E has a ptosis and that the objective test may not be properly performed due to the ptosis. The examiner performs an operation such as opening the eye to be examined E with his / her finger and performs an instruction operation to continue the examination with the examiner controller 27 in order to perform the objective examination again. In response to the instruction operation, the control unit 26 returns to Step S6 and executes the objective test again.

  Next, when the examiner selects the subjective test mode on the selection screen, a subjective test is performed in step S10 in accordance with the selection. The control unit 26 controls the optotype projection system 32 to display a predetermined optotype for optotypes on the display 32a. Further, the control unit 26 drives the drive motor, and arranges the movable lens 32c at a position corresponding to, for example, a reflex measurement result. Further, the control unit 26 drives a pulse motor or the like, and adjusts the prism power by rotating the rotary prisms 32A and 32B so as to correct the astigmatism of the eye E, for example, in accordance with the result of the reflex measurement.

  The subject responds to the presented target. The selection of the target and the response thereto are repeatedly performed by the examiner or the control unit 26. The control unit 26 determines a prescription value based on a response from the subject and displays the prescription value on the display unit 30. FIG. 8 shows an example of a screen on which the result of the subjective test is displayed on the display unit 30. As shown in FIG. 8, anterior eye images EL ′ and ER ′ of the left eye EL and the right eye ER and prescription values are displayed on the display surface 30a.

  Also in this subjective test, in step S11, the anterior segment image E 'is analyzed to detect the eyelid opening state. Next, in step S12, it is determined whether or not the eyelid opening state is appropriate. If it is determined that the eyelid opening state is appropriate (the determination in step S12 is YES), the process ends.

  On the other hand, if the eyelid droop is detected and it is determined that the eyelid opening state is not appropriate (the determination in step S12 is NO), the process proceeds to step S13, and a blinking display of a notification message indicating that the eyelid opening state is not appropriate, The anterior eye image E ′ is displayed on the display surface 30 a of the display unit 30. Thus, the examiner can recognize that the eye E to be examined has eyelid droop, and that the subjective examination may not be performed properly due to eyelid droop. The examiner performs an operation such as opening the eye to be examined E with his / her finger and performs an instruction operation to continue the examination with the examiner controller 27 in order to perform the subjective examination again. In response to the instruction operation, the control unit 26 returns to Step S10 and performs the subjective test again.

  Hereinafter, the operation and effect of the ophthalmologic apparatus 10 of the first embodiment will be described. As described above, the ophthalmologic apparatus 10 according to the first embodiment performs imaging based on the imaging device 31g that acquires the anterior segment image E ′ of the eye E and the anterior segment image E ′ captured by the imaging device 31g. The control unit 26 detects an open eyelid state of the optometry E and, when the detected eyelid open state of the eye E to be inspected is not appropriate, notifies the fact to that effect.

  With this configuration, if the eyelid state of the eye E is appropriate, alignment of the eye E and acquisition of information can be performed quickly and with high accuracy. On the other hand, when the eyelid opening state of the eye E is not appropriate, the examiner is notified to that effect. Therefore, the examiner can recognize that the eyelid opening state of the subject is not sufficient. In particular, even when an unskilled examiner or a remote examination is performed, the eyelid opening state can be reliably grasped. Thus, the examiner can quickly take measures to achieve an appropriate eyelid opening state. Therefore, the reliability of information acquisition of the eye E can be improved.

  In addition, if the control unit 26 is configured to determine that the eyelid opening state is not appropriate when detecting eyelid drooping as the eyelid opening state, the examiner can reliably grasp that the eye E to be examined is eyelid drooping. can do. In this case, it is possible to take measures such that the examiner opens the eyelids of the eye E with his / her finger, so that the eyelids are sufficiently opened, and the reliability of the ophthalmologic apparatus 10 can be improved.

  In addition, the control unit 26 can notify the examiner by displaying a notification message indicating that the eyelid opening state is not appropriate, lighting or blinking the notification message or light, and outputting a sound or a warning sound. Thereby, it is possible to accurately notify the examiner that the eyelid opening state is not appropriate.

  In addition, the control unit 26 can extract the outer edge of the pupil and the eyelid from the anterior eye image E ′, and detect the eyelid opening state based on the positional relationship of the outer edge of the eyelid with respect to the pupil. With this configuration, the eyelid opening state can be more clearly detected. Further, according to the positional relationship between the pupil and the outer edge of the eyelid, a more detailed analysis is performed as to whether the inappropriate state of the eyelid opening is due to eyelid droop, miosis, mydriasis, obliqueness, obliqueness, etc. be able to. Further, the notification message or the like may be changed according to the cause, and more detailed information can be notified to the examiner.

  In the above-described embodiment, the measurement optical system 24 that acquires information on the eye E is provided, and an image pickup device 31g as an image acquisition unit is provided in the measurement optical system 24. This is a configuration for acquiring an anterior ocular segment image E ′ on the axis. With this configuration, the image sensor 31g of the measurement optical system 24 can also be used as an image acquisition unit that acquires the anterior eye image E ′ that detects the eyelid opening state, and the ophthalmologic apparatus 10 can be simplified and downsized. Becomes Further, the present invention can be applied to an existing ophthalmic apparatus.

  Further, in the above embodiment, the control unit 26 may be configured to detect the eyelid opening state at the timing when the image sensor 31g acquires the anterior eye image E ′, and may notify at the timing. Thereby, in the step of acquiring the information of the eye E, the detection of the eyelid opening state is performed once, and the examiner can recognize whether the eyelid opening state is appropriate. In addition, the control unit 26 performs a predetermined timing of a process of acquiring information on the eye E to be inspected, for example, at the time of alignment, at the time of a subjective test such as a distance test, a near test, a contrast test, a glare test, and a visual field test, At the time of subjective examinations such as objective refraction measurement (reflection measurement), corneal shape measurement (keratometry), intraocular pressure measurement, fundus photography, OCT photography, measurement refraction measurement, etc., the anterior ocular segment image E ′ is controlled by controlling the image sensor 31g. It is possible to adopt a configuration in which the eyelid opening state is detected based on the anterior ocular segment image E ′ and the content is notified according to the timing at which the anterior ocular segment image E ′ was acquired. With this configuration, the examiner can know at which timing (step) the malfunction of the eyelid opening state has been detected, and can take appropriate measures according to the step.

  In the above embodiment, a pair of image sensors 31g are provided corresponding to the left and right eyes E, and the control unit 26 controls the left and right eyes E (EL, ER) obtained by the pair of image sensors 31g. The configuration is such that the eyelid opening states of the left and right eyes E (EL, ER) are detected based on the eye images EL ′ and ER ′. With this configuration, it is possible to grasp the eyelid opening state of both eyes, and it is possible to particularly improve the reliability of the inspection in the binocular optometry.

  In the above embodiment, the display unit 30 that displays the anterior ocular segment image E ′ acquired by the imaging element 31g allows the examiner to display the anterior ocular segment image displayed on the display unit 30 together with the notification message. By visually recognizing E ', the eyelid opening state can be grasped in more detail, more appropriate measures can be taken, and the reliability of the ophthalmologic apparatus 10 can be further improved.

  Although the ophthalmologic apparatus of the present invention has been described based on the embodiments, the specific configuration is not limited to these embodiments, and the gist of the invention according to each claim in the claims Unless deviating from the above, design changes and additions are allowed.

  For example, in the above-described embodiment, the image acquisition unit 31g of the observation system 31 is also used as an image acquisition unit that acquires the anterior eye image E ′ of the subject's eye E, but is not limited thereto. As another different embodiment, the image acquisition unit can be configured by two or more imaging units (cameras) that image the anterior segment of the eye E to be examined from different directions.

  Specifically, as shown in FIG. 9, the left and right measurement optical systems 24L in the left and right housings 23a and 23b are located close to the left and right eye deflection members 25L and 25R. , 24R, two cameras (imaging unit, stereo camera) 40L, 41L, 40R, 41R are provided in front and behind (in the Z direction) with the optical axis of each of them. These cameras may be newly provided in the ophthalmologic apparatus 10 or, if the ophthalmologic apparatus 10 includes a stereo camera, the stereo camera may also be used as the image acquisition unit. Note that the stereo camera may be arranged vertically above and below the optical axis. Further, the number of cameras is not limited to two for each eye E, and three or more cameras may be provided, for example, four cameras are provided before and after and vertically.

  Each of the cameras 40L, 41L, 40R, and 41R bends via the left-eye or right-eye deflecting member 25L, 25R, and enters the anterior eye image E ′ of the eye E (the left eye EL and the right eye ER). (EL ', ER') is photographed.

  By analyzing the anterior segment image E ′ taken by the cameras 40L, 41L, 40R, 41R, the eyelid opening state of the eye E is detected. Further, the alignment in the Z direction may be executed based on the analysis of the anterior eye image E ′.

  For example, when performing reflex measurement, fundus photography, or the like of the eye E to be inspected using the measurement optical system 24, the ophthalmologic apparatus 10 uses the ring-shaped light beam projection system 33A to attach a ring-shaped light to the fundus Ef of the eye E to be inspected. Are projected, and an image of the reflected light of the measurement pattern from the fundus oculi Ef is captured by the image sensor 31g. As described above, since the image sensor 31g captures an image of the fundus oculi Ef of the eye E at the time of reflex measurement, it is difficult to simultaneously capture the anterior ocular segment image E 'with the image sensor 31g, and the time is shifted. Need to shoot.

  Therefore, by photographing the anterior ocular segment image E ′ by the cameras 40L, 41L, 40R, and 41R provided separately from the image sensor 31g as in the present embodiment, the objective test using the image sensor 31g is performed substantially simultaneously. The eyelid state of the eye E can be detected by photographing the anterior segment image E ′. Further, the plurality of anterior eye images E ′ taken from different directions by the cameras 40L, 41L, 40R, and 41R can detect the eyelid opening state of the eye E in a more multifaceted manner. Of course, both the detection of the eyelid opening state based on the anterior eye image E ′ captured by the cameras 40L, 41L, 40R, and 41R and the detection of the eyelid opening state based on the anterior eye image E ′ captured by the image sensor 31g. May be executed, or any of the steps may be executed according to the inspection process.

  In another embodiment, the control unit 26 detects information on the pupil of the eye E, specifically, for example, the pupil diameter, the pupil area, the presence or absence of a cataract, and the like, together with the eyelid opening state of the eye E. Alternatively, the anterior eye image E ′ and information on the pupil may be displayed on the display unit 30. Thereby, the state of the eye E can be grasped in more detail, and the alignment and the reliability of the inspection result can be accurately evaluated. Further, when an error occurs in the alignment or examination of the eye E, it is possible to analyze in more detail whether the error is caused by the eyelid opening state, the pupil state, or both, and the reliability is improved. Performance can be improved. Causes of the error, for example, ptosis, miosis or mydriasis, cataract, improper fixation, strabismus, oblique etc., in the case of binocular vision, more inappropriate binocular vision, Suppression, head tilt, and the like. The cause of the error can be analyzed in more detail based on the eyelid opening state and the pupil state.

  Further, even when the alignment and the inspection are performed without error, the examiner visually recognizes the notification message, the anterior ocular segment image E ′, and the information on the pupil displayed on the display unit 30 so that the eyelid drooping and shrinkage can be observed. The presence or absence of the pupil or mydriasis, cataract, strabismus, and other states of the eye E can be recognized. Therefore, the examiner can recognize that the test result may not be appropriate. In this case, it is possible to take measures such as re-examining the examination while assisting the examiner so that the state of the eye E becomes appropriate, or selecting an examination method suitable for the state of the eye E. Accordingly, the reliability of the inspection result can be improved, and an efficient inspection without repetition of an error can be performed.

  The method of detecting the pupil diameter is not particularly limited, and an appropriate method such as a known method can be used. For example, when an anterior segment image E ′ photographed by the image sensor 31g or an anterior segment image E ′ is photographed by a stereo camera, for example, at least one anterior segment of the plurality of anterior segment images E ′ From the partial image E ', the contour of the pupil is detected, and the pupil boundary coordinates are calculated. The outline can be detected, for example, based on the difference in brightness between the pupil and the iris of the anterior eye image E ′. Next, the pupil boundary coordinates are approximated by an ellipse, the center, the major axis, and the minor axis of the pupil approximate ellipse are calculated, and the pupil diameter can be calculated based on the calculation result.

  Further, in the above embodiment, the measurement optical system 24L for the left eye and the measurement optical system 24R for the right eye are provided, and the characteristics of the eye E to be examined are measured with both eyes. However, the present invention is not limited to this. The present invention can also be applied to the case where the characteristics of the eye E to be measured are measured in a monocular state, and the examiner can appropriately grasp the eyelid opening state of the eye E. Thereby, when the eyelid opening state is not appropriate, measures can be taken promptly, and the reliability of the ophthalmologic apparatus 10 can be improved.

10 Ophthalmic apparatus 24 Measurement optical system 26 Control unit (open eyelid state detection unit)
30 display unit 31g image sensor (image acquisition unit)
40L, 40R, 41L, 41R Camera (image acquisition unit)
E eye to be examined E 'anterior segment image

Claims (10)

An ophthalmologic apparatus that acquires information on the subject's eye,
An image acquisition unit that acquires an anterior segment image of the subject's eye,
Based on the anterior segment image captured by the image acquisition unit, detects the eyelid opening state of the eye to be inspected, and when the detected eyelid opening state of the eye to be inspected is not appropriate, the eyelid opening state to notify that fact. An ophthalmologic apparatus comprising: a detection unit.   The ophthalmologic apparatus according to claim 1, wherein the eyelid opening state detection unit determines that the eyelid opening state is not appropriate when detecting eyelid droop as the eyelid opening state.   The eyelid opening state detection unit notifies the examiner by displaying a notification message indicating that the eyelid opening state is not appropriate, lighting or blinking the notification message or light, and outputting a sound or a warning sound. The ophthalmic apparatus according to claim 1, wherein:   The eyelid opening state detection unit extracts the pupil and the outer edge of the eyelid from the anterior segment image and detects the eyelid opening state based on the positional relationship of the outer edge of the eyelid with respect to the pupil. The ophthalmologic apparatus according to any one of Items 1 to 3.   A configuration including a measurement optical system that acquires information on the eye to be examined, wherein the image acquisition unit is provided in the measurement optical system, and acquires the anterior eye image on the optical axis of the measurement optical system of the eye to be examined. The ophthalmologic apparatus according to claim 1, wherein:   The ophthalmologic apparatus according to any one of claims 1 to 4, wherein the image acquiring unit includes two or more photographing units that photograph the subject's eye from different directions.   The eyelid opening state detection unit detects the eyelid opening state at a timing at which the image acquisition unit acquires the anterior eye image, or acquires the image at a predetermined timing in a step of acquiring information on the subject's eye. Controlling the unit to acquire the anterior segment image, detecting the eyelid opening state based on the anterior segment image, and notifying the content according to the timing of acquiring the anterior segment image. The ophthalmologic apparatus according to any one of claims 1 to 6, wherein:   The said eyelid opening state detection part detects the information regarding the pupil of the said eye to be examined, and displays the said anterior eye part image of the said eye to be examined and the information regarding the said pupil on a display part, The Claims 1-7 characterized by the above-mentioned. The ophthalmic apparatus according to any one of the above.   The image acquisition unit is provided in a pair corresponding to the left and right eyes to be examined, and the eyelid opening state detection unit is based on the anterior eye images of the left and right eyes to be examined acquired by the pair of image acquisition units. The ophthalmologic apparatus according to any one of claims 1 to 8, wherein the eyelid opening states of the left and right eyes to be inspected are detected.   The ophthalmologic apparatus according to any one of claims 1 to 3, further comprising a display unit that displays the anterior segment image acquired by the image acquisition unit.