JP2020103936A - Ophthalmologic examination apparatus - Google Patents

Abstract

To provide a new technology to evaluate a change in an eye position with a simple configuration.SOLUTION: An ophthalmologic examination apparatus includes: first and second visual target presentation units for presenting visual targets through movable lenses that are movable in an optical axis direction to right and left eyes to be examined respectively; an imaging unit for imaging the respective anterior eye parts of the right and left eyes to be examined; a control unit for controlling at least one of the first and second visual target presentation units so as to switch the visual target presented in at least one of the right and left eyes to be examined after the movable lens in at least one of the first and second visual target presentation units is moved to any one of two or more positions on the optical axis; and an image analysis unit for obtaining a change in an eye position of at least one of the right and left eyes to be examined by analyzing images of the anterior eye part obtained by the imaging unit before and after the switching of the visual targets by the control unit respectively.SELECTED DRAWING: Figure 4

Description

The present invention relates to an ophthalmic examination apparatus.

Misalignment of the eye position causes poor visual function and asthenopia, and correction may be performed using a prism lens or the like. The presence or absence of such a shift in the eye position can be evaluated by a cover test or a cover uncover test. The cover test is a test for evaluating a change in the eye position of the other eye when one eye is blocked while the subject is viewing the optotype with both eyes. The cover uncover test is a test for evaluating a change in the eye position of the blocked eye when the shield is removed from the state in which one eye is shielded.

These tests are performed by directly observing the eye movements of the subject while the examiner is positioned in front of the subject and the examiner moves a shielding member for shielding the subject's eyes. Therefore, it was difficult to accurately evaluate the eye position abnormality. Various ophthalmologic examination apparatuses for accurately evaluating such abnormalities of the eye position have been proposed.

For example, in Patent Document 1, by providing a shielding portion that has a wavelength selection characteristic that shields visible light and transmits invisible light for measurement, and that can be arranged in front of the eye of the subject, An ophthalmic examination apparatus is disclosed that measures the accommodation of a subject's eyes before and after blocking light or transmitting visible light.

Japanese Patent No. 5011144

However, in the conventional ophthalmologic examination apparatus, it is necessary to separately provide a shielding part for the cover test and the cover uncover test. Further, in the conventional ophthalmologic examination apparatus, since it is performed by the visual inspection of the examiner, it is difficult to perform the degree of displacement of the eye position and the quantitative evaluation.

The present invention has been made to solve the above problems, and an object thereof is to provide a new technique for evaluating a change in eye position with a simple configuration.

The ophthalmologic examination apparatus according to the embodiment includes a first optotype presenting unit, a second optotype presenting unit, a photographing unit, a control unit, and an image analysis unit. The first optotype presenting section presents the optotype to the left eye to be inspected through a movable lens that is movable in the optical axis direction. The second optotype presenting section presents the optotype to the right eye to be inspected through a movable lens that is movable in the optical axis direction. The imaging unit images the anterior ocular segment of each of the left eye and the right eye. The control unit moves at least one of the first optotype presenting unit and the second optotype presenting unit to any one of two or more positions on the optical axis, and then at least the left eye and the right eye to be examined. At least one of the first optotype presenting unit and the second optotype presenting unit is controlled so as to switch the optotype presented to one side. The image analysis unit, by analyzing the image of the anterior segment acquired by the imaging unit before and after the switching of the optotype by the control unit, at least one eye position of the left and right eye to be examined. Seeking change.

According to the ophthalmologic examination apparatus of the present invention, it is possible to provide a new technique for evaluating a change in eye position with a simple configuration.

The schematic diagram showing the appearance composition of the ophthalmic examination device concerning an embodiment. The schematic diagram showing the example of composition of the ophthalmic examination device concerning an embodiment. The schematic diagram showing the example of composition of the optical system of the ophthalmic examination apparatus concerning an embodiment. The schematic diagram showing the example of composition of the control system of the ophthalmic examination device concerning an embodiment. Operation|movement explanatory drawing of the ophthalmic examination apparatus which concerns on embodiment. Operation|movement explanatory drawing of the ophthalmic examination apparatus which concerns on embodiment. FIG. 6 is a flowchart of an operation example of the ophthalmic examination apparatus according to the embodiment. FIG. 6 is a flowchart of an operation example of the ophthalmic examination apparatus according to the embodiment. Operation|movement explanatory drawing of the ophthalmic examination apparatus which concerns on the 1st modification of embodiment. Operation|movement explanatory drawing of the ophthalmic examination apparatus which concerns on the 1st modification of embodiment. Operation|movement explanatory drawing of the ophthalmic examination apparatus which concerns on the 1st modification of embodiment. Operation|movement explanatory drawing of the ophthalmic examination apparatus which concerns on the 1st modification of embodiment. Operation|movement explanatory drawing of the ophthalmic examination apparatus which concerns on the 1st modification of embodiment. Operation|movement explanatory drawing of the ophthalmic examination apparatus which concerns on the 1st modification of embodiment. Operation|movement explanatory drawing of the ophthalmic examination apparatus which concerns on the 1st modification of embodiment. Operation|movement explanatory drawing of the ophthalmologic examination apparatus which concerns on the 2nd modification of embodiment.

The ophthalmic examination apparatus according to the embodiment will be described in detail with reference to the drawings.

[Constitution]
FIG. 1 schematically shows the outline of the external configuration of the ophthalmic examination apparatus according to the embodiment. The ophthalmologic examination apparatus 1 according to the embodiment is an ophthalmologic apparatus capable of subjective examination and objective measurement. The subjective test is a test for presenting an optotype to the eye of the subject (eye to be examined) and acquiring information about the subject's eye based on a response from the subject regarding the appearance. The objective measurement is a measurement for obtaining information about the eye to be inspected mainly by a physical method without referring to the response from the subject.

The ophthalmologic examination apparatus 1 can perform eye position examinations such as a cover test and a cover uncover test by using an optical system that presents a target on the eye to be examined in the subjective examination. The cover test is a test for evaluating a change in the eye position of the other eye when one eye is blocked while the subject is viewing the optotype with both eyes. The cover uncover test is a test for evaluating a change in the eye position of the blocked eye when the shield is removed from the state in which one eye is shielded.

The ophthalmologic examination apparatus 1 can be communicatively connected to an examiner controller (for example, a tablet terminal) or an examinee controller (for example, a control lever unit) (not shown) via a wired or wireless communication path. The ophthalmologic examination apparatus 1 is controlled based on the operation on the controller for examiner or the controller for subject. In the following description, the left-right direction when viewed from the subject is the X direction, the up-down direction is the Y direction, and the depth direction of the measurement head 100 when viewed from the subject is the Z direction.

The ophthalmologic examination apparatus 1 includes a measurement head 100 and a control device 200. The measuring head 100 is provided with an optical system and a moving mechanism system for moving an optical element for performing the above-mentioned subjective test and objective measurement. The control device 200 controls the measuring head 100 and controls the inspector controller and the inspector controller.

The ophthalmologic examination apparatus 1 includes an optometry table 3. The optometry table 3 is a desk for supporting the measuring head 100 and mounting a controller for an examiner or a controller for a subject. The optometry table 3 is installed in a state of being supported on the floor by the support unit 4. The height of the optometry table 3 can be adjusted up and down.

A column 5 is erected on the optometry table 3. The base end of the lateral arm 6 is held at the tip of the column 5. The measuring head 100 is suspended at the tip of the lateral arm 6. For example, the column 5 can be rotated in the axial direction (arrow direction j, arrow direction k) by the arm moving mechanism 7. As a result, the lateral arm 6 is rotated around the axis. That is, the measuring head 100 is rotated around the axis. As a result, the measuring head 100 can be retracted from the examination space above the optometry table 3, and the examination can be efficiently advanced by utilizing the empty space on the optometry table 3.

The arm moving mechanism 7 may be an arm up-and-down moving mechanism that moves the tip end of the column 5 in the up-down direction (arrow direction h). As a result, the lateral arm 6 is moved in the vertical direction. That is, the measuring head 100 is moved in the vertical direction. The arm moving mechanism 7 may move the lateral arm 6 in the vertical direction by expanding and contracting the support column 5 protruding upward from the optometry table 3 as an arm extending/contracting mechanism. Even in this case, it is possible to move the measuring unit 100 up and down according to the sitting height of the subject, and to retract the measuring head 100 from the examination space above the optometry table 3.

It is also possible to separately provide a stand for storing the measurement head 100 and to arrange the measurement head 100 at a stable position by the above-described rotation and vertical movement. In this case, it is possible to continuously reduce the load on the lateral arm 6 due to the weight of the measuring head 100.

The arm moving mechanism 7 is capable of manually moving the lateral arm 6 in the axial direction and the vertical direction in response to an operation by the operator. The arm moving mechanism 7 may move the lateral arm 6 by an electric mechanism. In this case, an actuator that generates a driving force for moving the arm moving mechanism 7 and a transmission mechanism that transmits the driving force are provided. The actuator is composed of, for example, a pulse motor. The transmission mechanism is composed of, for example, a combination of gears and a rack and pinion.

A storage unit 9 is provided on the side surface of the support unit 4 to store the control device 200 and the like. The configuration of the optometry table 3 is not limited to the configuration shown in FIG.

[Measuring head]
The measurement head 100 includes a left-eye inspection unit 120L and a right-eye inspection unit 120R. The left eye inspection unit 120L and the right eye inspection unit 120R are provided with optometry windows 130L and 130R, respectively. The left eye (left eye to be inspected) of the subject is inspected through the eye examination window 130L. The right eye (right eye to be inspected) of the subject is inspected through the eye examination window 130R.

FIG. 2 shows a block diagram of a configuration example of the measuring head 100 according to the embodiment. The measuring head 100 includes a moving mechanism system 110, a left-eye inspection unit 120L, and a right-eye inspection unit 120R. The moving mechanism system 110 is suspended by the horizontal arm 6. The left-eye inspection unit 120L and the right-eye inspection unit 120R are three-dimensionally moved by the moving mechanism system 110 independently or in conjunction with each other. The left eye inspection unit 120L houses an optical system for inspection of the left eye to be inspected. The right-eye inspection unit 120R accommodates an optical system for inspecting the right eye to be inspected.

(Movement system)
The moving mechanism system 110 includes a horizontal moving mechanism 111, rotating mechanisms 112L and 112R, and vertical moving mechanisms 113L and 113R. The moving mechanism system 110 may further include the arm moving mechanism 7.

The horizontal movement mechanism 111 includes the rotation mechanisms 112L and 112R, the vertical movement mechanisms 113L and 113R, the left-eye inspection unit 120L, and the right-eye inspection unit 120R in the horizontal direction (lateral direction (X direction), front-back direction (Z direction)). ) To. Thereby, the positions of the optometry windows 130L and 130R in the horizontal direction can be adjusted according to the arrangement position of the eye to be inspected. The horizontal movement mechanism 111 has, for example, a known configuration using a pulse motor, a feed screw, or the like, and receives the control signal from the control device 200 to move the rotation mechanisms 112L, 112R and the like in the horizontal direction. The horizontal movement mechanism 111 can also be manually moved in the horizontal direction by the operation of the operator, such as the rotation mechanisms 112L and 112R.

The rotation mechanism 112L rotates the vertical movement mechanism 113L and the left-eye inspection unit 120L about a predetermined first shaft connected to the horizontal movement mechanism 111. The first axis is an axis extending in a substantially vertical direction, and may be tiltable at an arbitrary angle with respect to the horizontal plane. The rotation mechanism 112L has, for example, a known configuration using a pulse motor, a rotation shaft, or the like, and receives a control signal from the control device 200 to rotate the left-eye inspection unit 120L or the like around the first axis. Let The rotating mechanism 112L can also be manually rotated by the operator's operation, such as the left-eye inspection unit 120L around the first axis.

The rotation mechanism 112R rotates the vertical movement mechanism 113R and the right-eye inspection unit 120R about a predetermined second shaft connected to the horizontal movement mechanism 111. The second axis is an axis that extends in a substantially vertical direction like the first axis, and may be tiltable at an arbitrary angle with respect to the horizontal plane. The second axis is an axis arranged at a position separated from the first axis by a predetermined distance. The distance between the first axis and the second axis is adjustable. The rotating mechanism 112R may rotate the right-eye inspection unit 120R or the like in conjunction with the rotation of the rotating mechanism 112L, or the right-eye inspection unit 120R independently of the rotation of the rotating mechanism 112L. Etc. may be rotated. The rotating mechanism 112R has a known configuration similar to that of the rotating mechanism 112L, and receives a control signal from the control device 200 to rotate the right-eye inspection unit 120R and the like around the second axis. The rotation mechanism 112R can also be manually rotated by the operator's operation, such as the right-eye inspection unit 120R about the second axis.

Rotating the left eye inspection unit 120L and the right eye inspection unit 120R by the rotating mechanisms 112L and 112R to relatively change the orientations of the left eye inspection unit 120L and the right eye inspection unit 120R. Is possible. For example, the left-eye inspection unit 120L and the right-eye inspection unit 120R are rotated in opposite directions about the eyeball rotation points of the right and left eyes of the subject. Thereby, the eye to be inspected can be diverged and convergent.

The vertical movement mechanism 113L moves the left-eye inspection unit 120L in the vertical direction (Y direction). Thereby, the position of the eye examination window 130L in the height direction can be adjusted according to the arrangement position of the eye to be inspected. The vertical movement mechanism 113L has a known configuration using, for example, a pulse motor or a feed screw, and receives the control signal from the control device 200 to move the left eye inspection unit 120L in the vertical direction. The vertical movement mechanism 113L can also manually move the left-eye inspection unit 120L in the vertical direction in response to an operation by the operator.

The vertical movement mechanism 113R moves the right-eye inspection unit 120R in the vertical direction. Thereby, the position of the eye examination window 130L in the height direction can be adjusted according to the arrangement position of the eye to be inspected. The vertical movement mechanism 113R may move the right-eye inspection unit 120R in conjunction with movement by the vertical movement mechanism 113L, or may move the right-eye inspection unit 120R independently of movement by the vertical movement mechanism 113L. Good. The vertical movement mechanism 113R has a known configuration similar to that of the vertical movement mechanism 113L, and receives the control signal from the control device 200 to move the right-eye inspection unit 120R in the vertical direction. The vertical movement mechanism 113R can also be manually moved in the vertical direction by the operator's operation to move the right-eye inspection unit 120R in the vertical direction.

(Structure of each inspection unit)
The left-eye inspection unit 120L and the right-eye inspection unit 120R can operate individually.

The left eye inspection unit 120L includes a first optotype presenting unit 122L, a first objective measuring unit 123L, and a first imaging unit 124L. The first optotype presenting unit 122L selectively presents a plurality of optotypes to the left eye to be inspected. The first objective measurement unit 123L is used to perform objective refraction measurement of the left eye to be inspected. The first imaging unit 124L images the anterior segment of the left eye to be examined. The left-eye inspection unit 120L may be provided with an optical element application section that selectively applies a plurality of optical elements that can be arranged between the left eye to be inspected and a deflection member P described below to the left eye to be inspected. ..

The right-eye inspection unit 120R includes a second optotype presenting section 122R, a second objective measuring section 123R, and a second imaging section 124R. The second optotype presenting unit 122R selectively presents a plurality of optotypes to the right eye to be examined. The second objective measurement unit 123R is used to perform objective refraction measurement of the right eye to be examined. The second imaging unit 124R images the anterior segment of the right eye to be inspected. The inspection unit 120R for the right eye may be provided with an optical element application section that selectively applies a plurality of optical elements that can be arranged between the right eye to be inspected and a deflection member P described later to the right eye to be inspected. ..

The left-eye inspection unit 120L and the right-eye inspection unit 120R house optical systems as shown in FIG. The left-eye inspection unit 120L and the right-eye inspection unit 120R operate their optical systems to perform a subjective test using the optotype presenting unit for each of the left eye EL and the right eye ER. It is configured to perform objective refraction measurement using the subjective measurement unit and the imaging unit. The inspector or the subject performs the inspection by appropriately operating the controller or the like. In addition, each of the left-eye inspection unit 120L and the right-eye inspection unit 120R includes a cover test using an optotype presenting unit, an uncover test, and an eye position based on an analysis result of an image of the eye to be inspected acquired by the imaging unit. Is configured to perform the change calculation and

When the above-mentioned optical element application section is provided in each inspection unit, the optical element application section includes a plurality of optical elements and a drive mechanism. The plurality of optical elements are a set of various lenses for inspecting the visual function of the subject's eye, and include, for example, at least one of a spherical lens, a cylindrical lens, and a prism lens. The plurality of optical elements are grouped for each type of optometry parameter. For example, the type of optometry parameter includes at least one of spherical power, astigmatic power, astigmatic axis angle, addition power, interpupillary distance, prism power, and prism base direction. As a grouping for each type of optometry parameter, the set of spherical powers includes a plurality of spherical lenses, and the spherical powers each have a different spherical power. The set of astigmatism diopters includes a plurality of cylindrical lenses, each of which is composed of cylindrical lenses of different astigmatism diopters. The set of astigmatic powers may be rotatable according to the astigmatic axis angle. The set of addition powers is composed of a spherical lens of plus power and a spherical lens of minus power that can be inserted and removed. The set of prism diopters includes a plurality of prism lenses, and the prism lenses each have different prism diopters. The set of prism powers may be further rotatable according to the prism base direction. The interpupillary distance is an inspection condition set according to the interpupillary distance of the eye to be inspected. The interpupillary distance is set by one or both of the left-eye inspection unit 120L and the right-eye inspection unit 120R sliding in the horizontal direction (arrow direction m in FIG. 1).

The drive mechanism included in each inspection unit is configured such that each of the plurality of optical elements can be arranged in the optometry window and can be retracted from the optometry window. The drive mechanism included in each inspection unit receives the control signal from the control device 200 and switches the optical element. Thereby, at least one of the spherical power, the astigmatic power, the astigmatic axis angle, the addition power, the interpupillary distance, the prism power, and the prism base direction can be switched and applied to the eye to be inspected.

[Structure of optical system]
FIG. 3 shows a block diagram of a configuration example of an optical system housed in the left-eye inspection unit 120L and the right-eye inspection unit 120R. The left-eye inspection unit 120L includes a deflecting member P, an optotype presenting optical system 10L, a photographing optical system 20L, alignment optical systems 30L and 31L, a ref measuring optical system 40L, and a kerato measuring optical system 50L. .. The left eye inspection unit 120L is provided with an objective lens 60, a moving lens 70, a reflection mirror M, and beam splitters BS1 to BS3. The right-eye inspection unit 120R includes a deflecting member P, an optotype presenting optical system 10R, a photographing optical system 20R, an alignment optical system 30R, a reflex measuring optical system 40R, and a kerato measuring optical system 50R. The right eye inspection unit 120R is provided with an objective lens 60, a moving lens 70, and beam splitters BS1 to BS3. The optical system of the inspection unit 120L for the left eye and the optical system of the inspection unit 120R for the right eye are configured symmetrically. Hereinafter, unless otherwise specified, the optical system of the left-eye inspection unit 120L will be described.

The optotype presenting optical system 10L is an optical system for projecting an optotype on the fundus Ef of the left eye to be examined EL. The optotype presenting optical system 10L includes an LCD (Liquid Crystal Display) 11, a moving lens 70, and a reflecting mirror M. The LCD 11 displays various optotypes (charts) for eye examination and eye position examination. The LCD 11 has a fixation target composed of a landscape chart, a visual acuity chart such as Landolt's ring for a visual acuity test, a cross cylinder test chart, a radiation chart for an astigmatic test, a cross chart for an oblique test, a red-green test chart, which will be described later. A target such as a chart for eye position examination is selectively displayed. By turning off the LCD 11 on which the optotype is presented (turning off the display), a state similar to the state in which the shielding member is arranged on the front surface of the left eye EL to be inspected through the eye examination window 130L is reproduced. It is possible. In the optotype presenting optical system 10L, in place of the LCD 11, an electronic display device using EL (electroluminescence) or any of a plurality of optotypes drawn on a rotating glass plate is appropriately placed on the optical axis. What is arranged (turret type) may be provided.

The moving lens 70 is movable in the optical axis direction of the optotype presenting optical system 10L. The moving lens 70 is moved by the drive mechanism 70L. The drive mechanism 70L receives the control signal from the control device 200 and moves the moving lens 70. Thereby, it is possible to change the spherical degree added to the left eye EL to be inspected. For example, by moving the moving lens 70 in the optical axis direction by a movement amount according to the refractive power of the left eye E to be inspected during reflex measurement, it is possible to perform a fixation fog on the left eye EL to be inspected. In addition, at the time of the subjective test, the target can be presented at a position corresponding to the far point of the eye to be examined, a position corresponding to the near point, or any position in the middle, and the test can be performed at any test distance. it can.

The light from the LCD 11 passes through the moving lens 70 and is reflected by the reflection mirror M. The light reflected by the reflection mirror M passes through the beam splitter BS2 and is reflected by the beam splitter BS1. The light reflected by the beam splitter BS1 passes through the objective lens 60 and is deflected by the deflecting member P toward the fundus Ef of the left eye to be examined EL.

The optotype presenting optical system 10L may be provided with a VCC lens for adjusting the astigmatic power and the astigmatic axis angle of the left eye EL to be inspected.

The imaging optical system 20L is an optical system for imaging the anterior segment of the left eye EL to be inspected. The photographic optical system 20L includes a CCD (Charged-Coupled Device) 21. For example, when the anterior ocular segment of the left eye EL to be examined is illuminated by the anterior ocular segment illumination system (not shown), reflected light from the anterior ocular segment of the left subject eye EL enters the deflection member P. The deflecting member P deflects the reflected light toward the objective lens 60. The reflected light deflected by the deflecting member P passes through the objective lens 60, the beam splitters BS1 and BS3, and is imaged on the light receiving surface of the CCD 21 by a CCD lens (not shown) or the like. Further, the imaging optical system 20L functions as a light receiving system that receives the reflected light of the measurement light beam projected on the left eye EL in the reflex measurement and the kerato measurement.

The alignment optical system 30L is an optical system for performing alignment in the XY directions of the optical system of the left-eye inspection unit 120L with respect to the left eye EL. The alignment optical system 30L projects a light beam (spot light) for alignment onto the left eye EL to be inspected. The light beam for alignment is reflected by the beam splitter BS3, passes through the beam splitter BS1, passes through the objective lens 60, becomes a substantially parallel light beam, and is deflected by the deflecting member P toward the cornea of the left eye to be examined EL. The light reflected by the cornea of the light flux for alignment projected on the left eye E to be examined returns along the same path as the incident path, passes through the beam splitter BS3, and is received by the CCD 21 of the imaging optical system 20L.

The alignment optical system 31L includes two or more cameras for photographing the anterior segment of the left eye EL to be examined from two or more different directions. Alignment in the Z direction (working distance direction) is performed based on the parallax obtained based on the captured images of the anterior segment from two or more different directions acquired using these cameras.

The ref measurement optical system 40L is an optical system for performing reflex measurement (objective refraction measurement) of the left eye EL. The light beam for reflex measurement emitted from the reflex measurement optical system 40L is reflected by the beam splitter BS2, reflected by the beam splitter BS1, passes through the objective lens 60, and is directed by the deflecting member P to the fundus Ef of the left eye to be examined EL. Be biased. The reflected light from the fundus of the light flux for reflex measurement projected on the left eye EL to be examined returns along the same path as the incident path, passes through the beam splitters BS1 and BS3, and is received by the CCD 21 of the imaging optical system 20L.

The kerato measurement optical system 50L is an optical system for performing kerato measurement of the left eye EL to be inspected. The ring-shaped light flux from the kerato ring light source emitted by the kerato measurement optical system 50L is deflected by the deflection member P and illuminates the cornea of the left eye EL to be inspected. The reflected light from the cornea of the left eye EL is deflected by the deflecting member P, passes through the objective lens 60, passes through the beam splitters BS1 and BS3, and is formed as a ring-shaped image on the light receiving surface of the CCD 21 by a CCD lens (not shown) or the like. It is imaged.

The measurement head 100 automatically executes alignment of the optical systems of the left-eye inspection unit 120L and the right-eye inspection unit 120R, objective optometry, and subjective optometry under the control of a control system described later. It is supposed to do. The measuring head 100 may further automatically execute a binocular balance test. In the subjective test, the value obtained by the objective measurement (objective value) is used. Particularly, in the cross cylinder test of the subjective test, the astigmatic power and the astigmatic axis angle obtained in the objective test are used.

[Control system]
Next, the control system of the ophthalmic examination apparatus 1 of the embodiment will be described with reference to FIG. The block diagram shown in FIG. 4 shows a schematic configuration of a main part of a control system of the ophthalmologic examination apparatus 1. 4, the same parts as those in FIGS. 1 to 3 are denoted by the same reference numerals, and the description thereof will be omitted as appropriate.

As shown in FIG. 4, the control system of the ophthalmologic examination apparatus 1 mainly includes a control device 200 that controls each part of the apparatus. The control device 200 is stored in, for example, the storage unit 9. The control device 200 includes a control unit 201 and a storage unit 202.

The storage unit 202 stores a computer program for an ophthalmic examination including a control program for executing a process described below, image data of the optotype pattern displayed on the LCD 11, and the like. Further, the storage unit 202 stores an image of the anterior segment of the left eye to be examined EL acquired by using the imaging optical systems 20L and 20R, an image of the anterior segment of the right eye to be examined ER, a reflex measurement result, and a kerato measurement result. Is saved. The control unit 201 reads out the computer program stored in the storage unit 202 and sequentially executes the computer programs while referring to the image data stored in the storage unit 202. Such a control unit 201 includes a processor for arithmetic control such as a CPU (Central Processing Unit).

A computer device (not shown) may be connected to the ophthalmic examination apparatus 1. In this case, the computer device is used as a console of the ophthalmic examination apparatus 1 and is also used for accumulating and managing examination results by the ophthalmic examination apparatus 1. It should be noted that the CPU and the storage device of this computer device can be configured as the control device 200.

The control device 200 (control unit 201) controls the operation of the left-eye inspection unit 120L and the right-eye inspection unit 120R. Specifically, the control device 200 controls the horizontal movement mechanism 111 that horizontally moves the left-eye inspection unit 120L and the right-eye inspection unit 120R. The control device 200 controls a rotating mechanism 112L that rotates the left-eye inspection unit 120L and a vertical movement mechanism 113L that vertically moves the left-eye inspection unit 120L. Similarly, the control device 200 controls a rotating mechanism 112R that rotates the right-eye inspection unit 120R and a vertical movement mechanism 113R that vertically moves the right-eye inspection unit 120R. The control device 200 may control the arm moving mechanism 7 that vertically moves or rotates the lateral arm 6.

The control device 200 (control unit 201) controls the operations of the optical systems stored in the left-eye inspection unit 120L and the right-eye inspection unit 120R. The control device 200 executes, for example, display control of the LCD 11, operation control of the drive mechanisms 70L and 70R that move the moving lens 70 in the optical axis direction, and the like. The display control of the LCD 11 includes optotype switching control, optotype lighting control, optotype extinction control, and the like.

The control device 200 can switch the optotypes so as to weaken the fusion stimulus by controlling the optotype presenting optical systems 10L and 10R. For example, as shown in FIG. 5, the control device 200 causes the LCD 11 to display the crosshair charts FL and FR which are the same cross chart on both the left eye EL and the right eye ER, and then only the eyepiece FR is displayed. Erase from the screen of LCD 11. That is, after turning on the visual targets FL and FR presented to both the left eye EL and the right eye ER, only the visual target FR is turned off. More specifically, the control device 200 presents an optotype in which a cross pattern (predetermined pattern) is drawn on a predetermined background (for example, a white background), and then displays a background optotype including the predetermined background. Switch. As a result, after the subject has both eyes viewed, a state equivalent to the state in which the shielding member is arranged on the front surface of the right eye ER can be reproduced. The control device 200 can also turn off only the optotypes FL or turn off the optotypes FL and FR at the same time.

The control device 200 executes light receiving control by the CCD 21, operation control of the alignment optical systems 30L, 31L, 30R, 31R, the ref measuring optical systems 40L, 40R, the kerato measuring optical systems 50L, 50R, and the like. The inspection unit 120L for the left eye to the left eye to be inspected EL so that the deviation between the position of the image of the spot light projected on the left eye to be inspected EL by the alignment optical system 30L and the position of the center of the pupil of the left eye to be inspected EL is canceled. It is possible to perform alignment in the XY directions of the optical system. Similarly, the alignment optical system 30R can perform alignment in the XY directions of the optical system of the right-eye inspection unit 120R with respect to the right eye ER. It is possible to perform the alignment in the Z direction from the parallax obtained based on the captured images of the anterior segment of the left eye to be inspected EL from two or more different directions acquired using the alignment optical system 31L. Similarly, the alignment optical system 31R can perform alignment in the Z direction based on parallax obtained based on captured images of the anterior segment of the right eye ER from two or more different directions. The operation control of the reflex measurement optical systems 40L and 40R includes control of a measurement light source that emits a light beam for reflex measurement. The operation control of the kerato measurement optical systems 50L and 50R includes control of a kerato ring light source.

When the optical element application unit is provided in each inspection unit, the control device 200 (control unit 201) is a drive mechanism for selectively applying the plurality of optical elements to at least one of the left eye EL and the right eye ER. The control of is executed.

The control device 200 (control unit 201) controls the calculation unit 210. The calculation unit 210 obtains an objective value based on the measurement result of the objective refraction measurement using the left-eye inspection unit 120L or the right-eye inspection unit 120R. The calculation unit 210 analyzes the shape of the ring visual target image obtained by receiving the ring-shaped measurement light beam projected on the fundus oculi Ef by the reflex measurement optical systems 40L and 40R by the CCD 21, for example, by a known method. To obtain the objective value. The calculation unit 210 performs a predetermined calculation process on the image obtained by receiving, by the CCD 21, the reflected light beam of the cornea of the ring-shaped light beam projected on the cornea of the eye to be inspected by the kerato measurement optical systems 50L and 50R, for example. Give. Thereby, it is possible to calculate the parameter representing the shape of the cornea as the objective value. The control device 200 may include a calculation unit 210.

The calculation unit 210 includes an image analysis unit 210A. The image analysis unit 210A analyzes the images of the anterior ocular segment acquired by the imaging optical systems 20L and 20R before and after the switching of the optotypes by the control device 200 (control unit 201) to thereby analyze the left eye to be examined. A change in the eye position of at least one of the EL and the right eye ER is obtained. The image analysis unit 210A obtains, for example, the rotation angle θ of the visual axis about the eyeball rotation point O as a change in the eye position.

The image analysis unit 210A can obtain the rotation angle θ based on the amount of movement of the position of the bright spot image formed by the spot light incident on the eyeball in the images of the anterior segment before and after the switching of the target. Is. As shown in FIG. 6, when a parallel light beam is incident on the eyeball, a spot-shaped virtual image (Purkinje image) is formed at a position Q (half of corneal curvature, R/2) inside the cornea. Since the center R of curvature of the cornea and the eye rotation point O are different, when the eye rotates about the eye rotation point O at the rotation angle θ, the position Q of the bright spot image in the image of the anterior segment is shown in FIG. To move. For example, as shown in FIG. 6, it is assumed that the eye position of the eye to be examined changes when the eye target is turned off with respect to the eye to be examined whose eye position is normal in the state where the eye target is presented. In this case, the image analysis unit 210A specifies the movement amount d of the position Q of the bright spot image from the images of the anterior segment before and after the switching of the visual target. For example, the image analysis unit 210A identifies the position of the position Q of the bright spot image based on the characteristic part in the image of the anterior segment before and after the switching of the optotypes, and determines the displacement of these positions by the movement amount d. Specify as.

Assuming that the distance from the apex of the cornea to the eyeball rotation point O is L and the curvature of the cornea is r, the movement amount d of the position Q of the bright spot image is expressed by Expression (1).

The image analysis unit 210A can obtain the turning angle θ from the expression (1). The distance L from the corneal apex to the eyeball turning point O may be a predetermined value (for example, an average value of 13 mm). Alternatively, this value may be inputtable when the actual distance is known in the measurement by another device. As the curvature r of the cornea, it is possible to use the value acquired by the kerato measurement.

The image analysis unit 210A can also generate evaluation information indicating whether or not the eye position has changed, based on the obtained rotation angle θ. For example, it is determined whether or not the turning angle θ is equal to or larger than a predetermined threshold value, and when it is determined to be equal to or larger than the threshold value, the image analysis unit 210A generates evaluation information indicating that there is a change in eye position. The image analysis unit 210A may generate the evaluation information indicating the degree of change in the eye position based on the obtained rotation angle θ.

The control device 200 executes all kinds of operation control and data processing of the ophthalmic examination apparatus 1 in addition to the above control.

The control device 200 can be connected to the examiner controller 300 and the examinee controller 310 via wired or wireless communication paths, respectively. The control device 200 receives the operation signal corresponding to the operation content of the examiner controller 300 or the examinee controller 310, and controls each unit of the ophthalmic examination apparatus 1. The control device 200 can display an operation screen, various kinds of information for performing measurement, and the like on the display unit of the examiner controller 300 or the examinee controller 310.

Since the operation principle of alignment using the above-described optical system, the measurement principle of subjective examination, the measurement principle of objective measurement, the measurement principle of cornea shape, etc. are already known, detailed description thereof will be omitted.

The function of the first optotype presenting unit 122L is realized by the optotype presenting optical system 10L included in the left-eye inspection unit 120L. The function of the second optotype presenting unit 122R is realized by the optotype presenting optical system 10R included in the right-eye inspection unit 120R.

The function of the first objective measuring unit 123L is realized by the ref measuring optical system 40L and the kerato measuring optical system 50L included in the left eye inspection unit 120L. The function of the second objective measurement unit 123R is realized by the ref measurement optical system 40R and the kerato measurement optical system 50R included in the right eye inspection unit 120R.

The optotype presenting optical systems 10L and 10R are examples of the “optotype presenting unit” according to the embodiment. The imaging optical systems 20L and 20R are examples of the “imaging unit” according to the embodiment.

[Operation example]
Next, the operation of the ophthalmic examination apparatus 1 according to the embodiment will be described.

FIG. 7 shows an overall flow chart of an operation example of the ophthalmic examination apparatus 1.

(S1)
Upon receiving a predetermined operation on the examiner controller 300 or the examinee controller 310, the control device 200 starts operation. First, the control device 200 causes the left eye to be examined EL and the right eye to be examined ER to both present the same landscape chart by the optotype presenting optical systems 10L and 10R. The subject fixes his/her face on a not-shown forehead so that the presented landscape chart can be visually recognized with both eyes. The position of the forehead rest itself may be adjusted automatically or manually.

(S2)
The control device 200 waits until an inspection start is instructed by an operation on the examiner controller 300 or the examinee controller 310 (S2:N). When the start of the examination is instructed (S2:Y), the operation of the ophthalmic examination apparatus 1 proceeds to S3.

(S3)
When the start of the examination is instructed (S2:Y), the control device 200 executes the alignment for the left and right eyes. That is, the control device 200 executes the alignment of the optical system of the left eye inspection unit 120L with respect to the left eye E by the alignment optical system 30L, and the optical of the right eye inspection unit 120R with respect to the right eye ER by the alignment optical system 30R. Perform system alignment.

(S4)
The control device 200 executes the kerato measurement as described above for each of the left eye EL and the right eye ER by the kerato measurement optical systems 50L and 50R. The result of the kerato measurement for each of the left eye EL and the right eye ER is stored in the storage unit 202.

(S5)
The control device 200 performs the ref measurement as described above on each of the left eye EL and the right eye ER by the ref measurement optical systems 40L and 40R. The result of the reflex measurement for each of the left eye EL and the right eye ER is stored in the storage unit 202.

(S6)
The control device 200 controls the optotype presenting optical systems 10L and 10R to display the optotype selected by the examiner or the control device 200 on the LCD 11. Thereby, the optotype is presented to the subject. The subject responds to the optotype. In response to the input of the response content, the control device 200 performs further control and calculation of the subjective test value. For example, the control device 200 selects and presents the next target based on the response to the Landolt ring or the like, and determines the correction value by repeating this.

(S7)
The control device 200 determines whether or not to perform the distance eye position examination. In the far-sighted eye position test, a cover test or a cover uncover test is performed with an optotype present at a position corresponding to the far point of the eye to be inspected. The examiner or the examinee designates whether or not to perform the far-sighted eye position examination by using the examiner controller 300 or the examinee controller 310, and stores the examination information in the storage unit 202 in advance. It is possible. In this case, the control device 200 can determine whether to perform the far-sighted eye position examination based on the examination information stored in the storage unit 202. When it is determined to perform the distance eye position test (S7:Y), the operation of the ophthalmologic examination apparatus 1 proceeds to S8. When it is determined that the distance eye position examination is not performed (S7:N), the operation of the ophthalmologic examination apparatus 1 proceeds to S9.

(S8)
When it is determined that the distance vision position test is to be performed (S7:Y), the control device 200 executes the distance vision position test. Details of S8 will be described later.

(S9)
When the far vision examination is completed, or when it is determined that the far vision examination is not performed in S7 (S7:N), the control device 200 determines whether to perform the near vision examination. .. In the near eye position examination, a cover test or a cover uncover test is performed by presenting an optotype at a position corresponding to the near point of the eye to be examined. The examiner or the examinee designates whether or not to perform the near vision examination using the examiner controller 300 or the examinee controller 310, and stores the examination information in the storage unit 202 in advance. It is possible. In this case, the control device 200 can determine whether to perform the near vision examination based on the examination information stored in the storage unit 202. When it is determined to perform the near vision examination (S9:Y), the operation of the ophthalmologic examination apparatus 1 proceeds to S10. When it is determined that the near vision position examination is not performed (S9:N), the operation of the ophthalmic examination apparatus 1 proceeds to S11.

(S10)
When it is determined to perform the near vision examination (S9:Y), the control device 200 executes the near vision examination. Details of S10 will be described later. S10 is almost the same as S8 as described later.

(S11)
When the near vision examination is completed, or when it is determined that the near vision examination is not performed in S9 (S9:N), the control device 200 causes the image analysis unit 210A to determine the eye posture as shown in FIG. Is quantitatively obtained, or evaluation information is generated based on the obtained turning angle θ.

(S12)
The control device 200 causes the display unit of the examiner controller 300 or the subject controller 310 to display the rotation angle obtained in S11 and the evaluation information for the change in the eye position based on the obtained rotation angle. Thus, the operation of the ophthalmic examination apparatus 1 ends (end).

FIG. 8 shows a flow chart of an operation example of S8 and S10 of FIG. Since the operations of S8 and S10 are almost the same, an operation example of S8 will be described below.

(S21)
First, the control device 200 obtains a position (for example, a position of -0.2D) corresponding to the far point of each of the left eye EL and the right eye ER using the result of the subjective test or the reflex measurement. The control device 200 controls the drive mechanisms 70L and 70R to move the moving lens 70 of each inspection unit to the above-mentioned obtained position.

(S22)
Next, the control device 200 controls the optotype presenting optical systems 10L and 10R to present the same optotypes of the left eye EL and the right eye ER.

(S23)
Subsequently, the ophthalmologic examination apparatus 1 rotates at least one of the left-eye inspection unit 120L and the right-eye inspection unit 120R inwardly around the rotation axis. Thereby, the visual target presented in S22 is visually recognized as if the subject were looking at the same visual target 5 m ahead with both eyes.

(S24)
The control device 200 controls the alignment optical systems 30L and 30R to turn on the XY spot light LED, thereby causing the spot light to enter both the left eye EL and the right eye ER. Further, the control device 200 controls the alignment optical systems 31L and 31R to start the acquisition of images of the anterior ocular segment of the left eye to be examined EL and the anterior ocular segment of the right eye to be examined ER.

(S25)
The control device 200 waits until an instruction to start the eye position examination is given by an operation on the examiner controller 300 or the examinee controller 310 (S25:N). When the start of the eye position inspection is instructed (S25:Y), the operation of the ophthalmic examination apparatus 1 proceeds to S26. At this time, if the alignment state with respect to the eye to be inspected is deviated from the allowable amount or more, the alignment operation may be performed again.

(S26)
When the start of the eye position examination is instructed (S25:Y), the control device 200 controls the imaging optical systems 20L and 20R to display moving images of the anterior ocular segment of both the left eye EL and the right eye ER. Start shooting. Data of moving images of the anterior ocular segment of both the left eye EL and the right eye ER captured by the imaging optical systems 20L and 20R are sequentially stored in the storage unit 202.

(S27)
The control device 200 controls the optotype presenting optical system 10R to turn off the optotype (right eye optotype) FR presented to the right eye ER. The lighting state of the optotype FL presented to the left eye to be examined EL is continued. As a result, a state equivalent to the state in which the shielding member is arranged in front of the right eye ER is reproduced. Since imaging is started in S26 and the images of the anterior segment before and after the switching of the optotypes in S27 can be acquired, the left eye to be examined EL using the images before and after the switching of the optotypes. Can evaluate changes in eye position (cover test).

(S28)
Subsequently, the control device 200 controls the optotype presenting optical system 10R to turn on the optotype (right eye optotype) FR on the right eye ER. As a result, the same visual targets FL and FR are presented to both the left eye EL and the right eye ER. Since images of the anterior segment before and after the switching of the optotypes in S28 can be acquired, it is possible to evaluate changes in the eye position of the left eye EL to be examined (cover uncover test). ..

(S29)
Next, the control device 200 controls the optotype presenting optical system 10L to turn off the optotype (left eye optotype) FL presented to the left eye EL. The target FR presented to the right eye ER continues to be lit. As a result, a state equivalent to the state in which the shielding member is arranged on the front surface of the left eye EL to be examined is reproduced. Since images of the anterior segment before and after the switching of the optotypes in S29 can be acquired, it is possible to evaluate changes in the eye position of the right eye ER using these images (cover test).

(S30)
Subsequently, the control device 200 controls the optotype presenting optical system 10L to turn on the optotype (left eye optotype) FL on the left eye EL. As a result, the same visual targets FL and FR are presented to both the left eye EL and the right eye ER. Since it is possible to acquire images of the anterior segment before and after the switching of the optotypes in S30, it is possible to evaluate changes in the eye position of the right eye ER using these images (cover uncover test). ..

(S31)
When the predetermined number of times (for example, 3 or 5 times) determined in advance is completed (S31:Y), the operation of the ophthalmic examination apparatus 1 proceeds to S32. When the predetermined number of times has not been completed (S31: N), the operation of the ophthalmologic examination apparatus 1 proceeds to S27.

(S32)
When the predetermined number of times have been completed (S31: Y), the control device 200 controls the imaging optical systems 20L and 20R to stop capturing moving images of the anterior ocular segment of both the left eye EL and the right eye ER. Let This is the end of the operations of S8 and S10 (END). The alignment state may be checked before each test (before turning off in the cover test and before turning on in the uncover test), and if the alignment is deviated by a predetermined amount or more, the alignment operation may be performed.

S10 operates similarly to S8. In the case of S10, in S21, the control device 200 moves the moving lens 70 of each inspection unit to a position (for example, a position of -3.3D) corresponding to the near point of each of the left eye EL and the right eye ER. .. Further, in the case of S10, in S23, the ophthalmologic examination apparatus 1 induces congestion by rotating at least one of the left-eye inspection unit 120L and the right-eye inspection unit 120R inwardly around the rotation axis. The visual target presented in S22 is visually recognized as if the subject were looking at the same visual target 30 cm away from both eyes.

In S23, even if the congestion state is reproduced by moving the display position of the optotype on the LCD 11 inward without rotating at least one of the left-eye inspection unit 120L and the right-eye inspection unit 120R. Good.

Further, in FIG. 8, the case of recording the moving image of the anterior segment has been described, but still images of the anterior segment before and after the switching of the visual target may be recorded. In addition to the method of measuring the displacement amount of the bright spot image before and after each test, alignment can be performed before the test and again after the test to determine the displacement amount from the amount of movement of the measuring head before and after the test. Good. Further, the same inspection can be performed at any position other than the position corresponding to the far point and the position corresponding to the near point.

As described above, according to the embodiment, the state in which the shielding member is arranged on the front surface of one eye can be reproduced by turning off or turning on the optotype displayed on the LCD 11, so that the shielding member can be reproduced. It is no longer necessary to provide a mechanism for inserting or removing this. Further, it is possible to confirm a change in the eye position of the eye to be inspected on the shielded side, which has been difficult to confirm because of the shielding.

Further, it becomes possible to clearly present the target to the subject by moving the moving lens 70 without wearing glasses or a trial frame. As a result, the subject can be made to work the fusion surely, and the change in the eye position can be evaluated with high accuracy.

Further, since the examination is performed by the examinee looking into the eye examination windows 130L and 130R, the examinee can concentrate on the examination without the examiner being in the field of view. For example, it is possible to avoid a state where the fixation is unstable due to the examiner entering the visual field of the subject.

Since it is possible to acquire an image of the anterior segment of the subject regardless of whether the target is turned off or on, the examiner does not need to observe the change in eye position from the front of the subject, and observes the image. be able to. For example, it is possible to observe the change in the eye position of the eye to be inspected, which is the eye to be inspected, which is equivalent to the state in which the shield member is arranged on the front surface. Further, by analyzing the acquired image, it is possible to quantitatively evaluate not only the presence/absence of the eye position shift but also the change in the eye position (shift amount).

Since the photographing optical systems 20L and 20R photograph the anterior segment of the subject's eye from the front, a minute change in the eye position can be confirmed. In addition, since it is possible to obtain a moving image in which changes in eye position before and after the switching of the optotypes can be acquired, there is no oversight by the examiner, and it is not necessary to repeat the examination many times. Further, it is not necessary to observe changes in eye position in real time.

By sending the image acquired by the ophthalmologic examination apparatus 1 to the remote terminal device, it is possible to observe (evaluate) the change in the eye position of the eye to be inspected at the remote location.

[Modification]
(First modification)
It is possible to evaluate changes in the eye position from various viewpoints by changing the pattern presented to the subject's eye.

The control device 200 can switch the target so that a part of the target is erased. For example, as shown in FIGS. 9A to 9E, the control device 200 presents a predetermined optotype (first optotype) and then another optotype (second optotype) that is a part of the optotype. ) Can be switched to.

FIG. 9A illustrates a case where the target in which the cross pattern is drawn before switching is switched to another target including only the vertical pattern (another target in which the horizontal pattern is erased). FIG. 9B illustrates a case where the target in which the cross pattern is drawn before switching is switched to another target including only the horizontal pattern (another target in which the vertical pattern is deleted). FIG. 9C shows another target consisting of only a rectangular pattern (another target in which the vertical and horizontal patterns are erased) from the target in which a cross-shaped pattern including a rectangular pattern is drawn at the intersection before switching. It shows the case of switching to the standard). In FIG. 9D, before switching, a target in which a rectangular frame pattern including a rectangular pattern is drawn in the center thereof is switched to another target including only the rectangular pattern (another target in which the frame pattern is deleted). Represents the case. FIG. 9E shows a case where the optotypes shown in FIG. 9D are simultaneously switched for both eyes. In this case, it is possible to observe changes in eye position at the same time for both eyes.

9A to 9D show the case where the visual target FR is switched, the visual target FL can also be switched similarly. The optotypes shown in FIGS. 9A to 9D may be switched simultaneously for both eyes.

The control device 200 can switch the target so that the size of the target is changed. For example, as shown in FIGS. 10A and 10B, the control device 200 presents a predetermined target (first target), and then displays another target (second target) having a size different from that of the predetermined target. Switch).

FIG. 10A illustrates a case where, for both eyes, the target in which the ring-shaped pattern is drawn before switching is simultaneously switched to another target having a different size (a target having a smaller size). As shown in FIG. 10A, the target after switching may have the same pattern as the target before switching.

FIG. 10B shows a case where, for both eyes, before switching, a target formed of a plurality of rectangular frame patterns having the same center portion and different sizes from each other is simultaneously switched to a target in which the outside is erased. Although FIG. 10B has been described by taking as an example a plurality of rectangular frame patterns having the same central portion and different sizes, a plurality of ring-shaped patterns having the same central portion and different sizes may be used.

The control device 200 can switch the size of the visual target in stages. For example, the control device 200 switches the size of the optotype each time the optotype is switched. In the case shown in FIG. 10A, the control device 200 executes the switching of the optotypes a plurality of times, and presents the optotypes in which a pattern having a smaller size is drawn at each switching. In the case shown in FIG. 10B, the control device 200 executes the switching of the optotypes a plurality of times, and presents the optotypes in which the patterns sequentially erased from the outside are drawn at each switching. In any case, the image analysis unit 210A obtains a change in the eye position each time the visual target is switched by the control device 200.

In any of FIGS. 9A to 9E, FIG. 10A, and FIG. 10B, after presenting a target with a large visual angle and strong fusion stimulus, the target is switched to a target with a small visual angle and weak fusion stimulus. In particular, by switching the targets as shown in FIGS. 10A and 10B, it is possible to evaluate the change in the eye position each time the targets are switched, and thus it is possible to evaluate the degree of the change in the eye position.

9A to 9E, FIG. 10A, and FIG. 10B show an example of switching of optotypes. For example, the target may be switched by reversing the target before switching. It is also possible to present a target with a large viewing angle and then switch to a target with a small viewing angle without erasing a part of the target.

As described above, since the targets can be switched individually for each of the left eye EL and the right eye ER, it is possible to observe various changes in eye position, which have been difficult in the related art.

(Second modified example)
In the above-described embodiment or the first modification, the case where the image analysis unit 210A obtains the rotation angle θ based on the position of the bright spot image formed by the spot light incident on the cornea has been described, but the ophthalmology according to the embodiment The configuration of the inspection device 1 is not limited to this.

FIG. 11 shows an operation explanatory diagram of the image analysis unit 210A according to the second modified example of the embodiment. 11, parts similar to those in FIG. 6 are designated by the same reference numerals, and description thereof will be omitted as appropriate.

The image analysis unit 210A according to the second modification specifies the pupil region in the images of the anterior segment before and after the switching of the visual target, and rotates based on the amount of movement of the position of the pupil center of the specified pupil region. The angle θ1 is calculated. When the eyeball rotates around the eyeball rotation point O, the position Q1 of the center of the pupil in the images of the anterior segment before and after the switching of the target moves, as shown in FIG. For example, as shown in FIG. 11, it is assumed that the eye position of the eye to be inspected changes when the eye target is turned off with respect to the eye to be inspected whose eye position is normal in the state where the eye target is presented. In this case, the image analysis unit 210A according to the second modified example specifies the movement amount d1 of the position Q1 of the pupil center from the images of the anterior segment before and after the switching of the target. For example, the image analysis unit 210A identifies the pupil region in the images of the anterior segment before and after the switching of the visual target, identifies the center position of the identified pupil region as the position Q1 of the pupil center, and The displacement of the position is obtained as the movement amount d1.

When the distance from the apex of the cornea to the eye rotation point O is L and the distance from the apex of the cornea to the position Q1 of the center of the pupil is N, the movement amount d1 of the position Q1 of the center of the pupil is expressed by the equation (2). It

The image analysis unit 210A can obtain the turning angle θ1 from the expression (2). The distance L from the corneal apex to the eyeball turning point O may be a predetermined value (for example, an average value of 13 mm). The distance N from the corneal apex to the position Q1 of the center of the pupil may be a predetermined value (for example, an average value of 3 mm). Alternatively, when the actual distance of L or Q1 is known in the measurement by another device, this value may be inputtable.

[effect]
The effects of the ophthalmic examination apparatus according to the embodiment will be described.

The ophthalmologic examination apparatus (ophthalmologic examination apparatus 1) according to the embodiment includes an optotype presenting section (first optotype presenting section 122L, second optotype presenting section 122R, optotype presenting optical systems 10L and 10R), and an imaging section ( The first photographing unit 124L, the second photographing unit 124R, the photographing optical systems 20L and 20R), the control unit (control device 200 or the control unit 201), and the image analysis unit (image analysis unit 210A) are included. The optotype presenting section presents optotypes to each of the left eye to be examined (left eye to be examined EL) and the right eye to be examined (right eye to be examined ER). The imaging unit images the anterior ocular segment of each of the left eye and the right eye. The control unit controls the optotype presenting unit to switch the optotypes presented to at least one of the left eye and the right eye. The image analysis unit, by analyzing the image of the anterior segment acquired by the imaging unit before and after the switching of the optotype by the control unit, at least one eye position of the left and right eye to be examined. Seeking change.

According to such a configuration, since the fusion stimulus can be changed by switching the optotypes, it is possible to change the eye position with a simple configuration without providing a shielding member or a mechanism for inserting and removing the shielding member. It becomes possible to evaluate. In addition, since it is possible to obtain front images of the anterior segment before and after the switching of the optotype by the imaging unit, the examiner does not need to observe the change in the eye position from the front of the subject, and the eye position It is also possible to confirm a minute change in. Further, since it is possible to switch the optotypes separately for each of the left and right eye, various changes in eye position compared to the case of presenting a common eye target for both the left and right eye. It becomes possible to observe.

Further, in the ophthalmologic examination apparatus according to the embodiment, the control unit may switch to the second optotype, which is a part of the first optotype, after presenting the first optotype.

According to such a configuration, it becomes possible to obtain a change in the eye position when the target is switched so that a part of the pattern is erased, and the change in the eye position is evaluated from a new viewpoint. It becomes possible to do.

Further, in the ophthalmologic examination apparatus according to the embodiment, the control unit may switch to the second optotype having a size different from that of the first optotype after the first optotype is presented.

According to such a configuration, it is possible to obtain a change in eye position when the targets are switched so that the sizes are different, and it is possible to evaluate the change in eye position from a new viewpoint. Become.

In the ophthalmologic examination apparatus according to the embodiment, the second optotype may have the same pattern as the first optotype.

According to such a configuration, in the same pattern as the optotypes between the switching, and it is possible to obtain the change in the eye position when the size is switched to the optotype, and from a new perspective It becomes possible to evaluate changes.

Further, in the ophthalmologic examination apparatus according to the embodiment, the control unit executes the switching of the optotypes a plurality of times, and the image analysis unit obtains the change in the eye position each time the switching of the optotypes is performed by the control unit. Good.

With such a configuration, it is possible to evaluate the degree of change in eye position.

Further, in the ophthalmologic examination apparatus according to the embodiment, the control unit may switch to the background optotype including the predetermined background after presenting the optotype on which the predetermined pattern is drawn on the predetermined background.

With such a configuration, it is possible to reproduce a state equivalent to the state in which the shielding member is arranged on the front surface of the eye to be inspected, and a simple configuration without providing a shielding member or a mechanism for inserting and removing the shielding member. It becomes possible to execute the cover test and the cover uncover test.

Further, in the ophthalmologic examination apparatus according to the embodiment, the control unit may switch the optotype so as to weaken the fusion stimulus.

According to such a configuration, since the optotypes are switched so as to weaken the fusion stimulus, it is possible to evaluate whether or not there is a change in the eye position of the eye to be examined in which the switched optotypes are presented. You can

In the ophthalmologic examination apparatus according to the embodiment, the control unit may cause the optotype to be presented at a position corresponding to the far point of the eye to be inspected, a position corresponding to the near point, or an arbitrary position in between.

According to such a configuration, in addition to the above effects, it is possible to provide an ophthalmologic examination apparatus capable of performing an examination at an arbitrary examination distance.

[Other]
The above-described embodiment or its modification is not limited to the configuration of the optical system described in FIG. 3 and the configuration of the control system described in FIG. 4 and control contents. For example, the objective measurement may include objective measurement for measuring a value related to the subject's eye and imaging for acquiring an image of the subject's eye. Such objective measurement includes, for example, objective refraction measurement, corneal shape measurement, intraocular pressure measurement, fundus imaging, and OCT (Optical Coherence Tomography) measurement using the OCT method. Further, the subjective test includes, for example, subjective refraction measurement such as a distance test, a near test, a contrast test, and a glare test, and a visual field test.

Further, the ophthalmologic examination apparatus according to the embodiment is capable of performing a distance test, a near vision test, a contrast test, a glare test, etc. as a subjective test, and as an objective measurement, an objective refraction measurement, a corneal shape measurement. , OCT measurement and the like may be used. In the OCT measurement, acquisition of eyeball information representing the structure of the eye to be inspected such as the axial length, corneal thickness, anterior chamber depth, and lens thickness may be performed.

The configuration described above is merely an example for preferably implementing the present invention. Therefore, any modification (omission, replacement, addition, etc.) within the scope of the present invention can be appropriately applied.

1 Ophthalmic examination apparatus 100 Measuring head 110 Moving mechanism system 111 Horizontal moving mechanism 112L, 112R Rotating mechanism 113L, 113R Vertical moving mechanism 120L Left eye inspection unit 120R Right eye inspection unit 122L First optotype presenting section 122R Second view Marking unit 123L First objective measuring unit 123R Second objective measuring unit 124L First photographing unit 124R Second photographing unit 200 Control device 210A Image analysis unit

Claims (9)

A first optotype presenting unit that presents an optotype via a moving lens that is movable in the optical axis direction with respect to the left eye to be examined;
A second optotype presenting unit that presents an optotype via a movable lens that is movable in the optical axis direction with respect to the right eye to be examined;
An imaging unit that images the anterior segment of each of the left eye and the right eye,
After moving the moving lens in at least one of the first optotype presenting section and the second optotype presenting section to any one of two or more positions on the optical axis, at least the left eye and the right eye to be inspected A control unit that controls at least one of the first optotype presenting unit and the second optotype presenting unit so as to switch the optotype presented to one side;
By analyzing the image of the anterior segment acquired by the imaging unit before and after switching the optotypes by the control unit, at least one eye position of the left eye and the right eye to be examined An image analysis unit that seeks changes,
Including
An ophthalmologic examination apparatus that obtains a change in the eye position of at least one of the left eye and the right eye at each of the two or more positions. The ophthalmic examination apparatus according to claim 1, wherein the control unit switches to the second optotype, which is a part of the first optotype, after presenting the first optotype. The ophthalmic examination apparatus according to claim 1, wherein the control unit switches to a second optotype having a size different from that of the first optotype after presenting the first optotype. The ophthalmic examination apparatus according to claim 3, wherein the second optotype has the same pattern as the first optotype. The control unit executes the switching of the optotypes a plurality of times,
The ophthalmic examination apparatus according to any one of claims 1 to 4, wherein the image analysis unit obtains a change in the eye position each time the control unit switches the target. The ophthalmic examination apparatus according to claim 1, wherein the control unit presents an optotype on which a predetermined pattern is drawn on a predetermined background and then switches to a background optotype including the predetermined background. The ophthalmic examination apparatus according to any one of claims 1 to 6, wherein the control unit switches the optotype so as to weaken the fusion stimulus. The two or more positions include a position corresponding to a far point of the eye to be inspected, a position corresponding to a near point, or an arbitrary position in the middle thereof. The ophthalmic examination apparatus described in 1. The control unit moves the moving lens in at least one of the first optotype presenting unit and the second optotype presenting unit to any one of two or more positions on the optical axis, and then moves the lens position. 9. The first optotype presenting unit and the second optotype presenting unit are rotated inward so that the optotype is visually recognized at a position corresponding to. The ophthalmic examination apparatus described in 1.

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