JP2020138002A - Ophthalmologic apparatus and operation method therefor - Google Patents

Abstract

To provide an ophthalmologic apparatus and an operation method therefor, capable of easily discriminating a vision fixation state of a subject's eye in the case of performing external vision fixation.SOLUTION: An ophthalmologic apparatus comprises: an ophthalmologic apparatus body including an optical system for acquiring an image of a subject's eye via an objective lens; an external vision fixation lamp including a light source supported so that its position is capable of being changed with respect to the ophthalmologic apparatus body; a light source position information acquisition unit for acquiring light source position information showing a relative position of the light source with respect to the ophthalmologic apparatus body; a visual line position detection unit for detecting a visual line position of the subject's eye; and an information generation unit that on the basis of the light source position information acquired by the light source position information acquisition unit and the visual line position detected by the visual line position detection unit, generates relative position information showing a relative position of the visual line position with respect to the light source in a perpendicular direction, where a direction perpendicular to the objective lens's optical axis is taken as the perpendicular direction.SELECTED DRAWING: Figure 14

Description

The present invention relates to an ophthalmic device including an external fixation lamp and a method of operating the same.

In an ophthalmic examination using an ophthalmic apparatus (including various actions for acquiring data of the eye to be inspected, such as examination, measurement, and imaging), fixation is performed to inspect a desired part of the eye to be inspected. The fixation is realized by emitting the fixation light toward the eye to be inspected and allowing the fixation light to be gazed at the eye to be inspected. As such fixation, in addition to internal fixation that projects the fixation light onto the eye to be inspected through the objective lens of the main body of the ophthalmic apparatus, external fixation using an external fixation lamp is well known (Patent Document 1). And 2). External fixation occurs when the eye to be inspected is rotated in an arbitrary direction by adjusting the position of the light source of the external fixation lamp, or when the internal fixation cannot be performed. This is a fixation method in which the direction of the eye to be inspected is adjusted by guiding the line of sight of the eye to be inspected or a companion eye.

Japanese Unexamined Patent Publication No. 2015-181494 Japanese Unexamined Patent Publication No. 2009-172157

By the way, in external fixation, the fixation light often does not exist in the central region of the visual field range of the subject, and there is a high possibility that the subject's eye loses sight of the fixation light (light source). Therefore, the examiner can determine the state of fixation of the eye to be inspected (whether or not the eye to be inspected captures the fixation light, and in which direction the line of sight of the inspected eye is directed with respect to the fixation light, etc.). Is difficult. Therefore, it is difficult for the examiner to give appropriate attention to the subject at the time of external fixation. As a result, data acquisition of the fundus is executed in a state where the fixation of the eye to be inspected is insufficient, and there is a possibility that data of a desired site to be inspected cannot be obtained.

The present invention has been made in view of such circumstances, and an object of the present invention is to provide an ophthalmic apparatus capable of easily determining the fixation state of the eye to be inspected when performing external fixation and an operation method thereof. To do.

An ophthalmic apparatus for achieving the object of the present invention includes an ophthalmic apparatus main body having an optical system for acquiring an image of an eye to be inspected through an objective lens, and an external having a light source supported so as to be repositionable with respect to the ophthalmic apparatus main body. With respect to the fixed-eye lamp, the light source position information acquisition unit that acquires the light source position information indicating the relative position of the light source with respect to the main body of the ophthalmic apparatus, the line-of-sight position detection unit that detects the line-of-sight position of the eye to be inspected, and the optical axis of the objective lens. When the vertical direction is the vertical direction, the relative position of the line-of-sight position with respect to the light source in the vertical direction is determined based on the light source position information acquired by the light source position information acquisition unit and the line-of-sight position detected by the line-of-sight position detection unit. It includes an information generation unit that generates the relative position information shown.

According to this ophthalmic apparatus, the fixation state of the eye to be inspected can be easily determined based on the relative position information.

In an ophthalmic apparatus according to another aspect of the present invention, the external fixation lamp guides the line of sight of the eye under test or the companion eye of the eye under test.

The ophthalmic apparatus according to another aspect of the present invention includes an output unit that displays or outputs relative position information generated by the information generation unit. This makes it possible to easily determine the fixation state of the eye to be inspected.

In the ophthalmic apparatus according to another aspect of the present invention, when the amount of deviation of the line-of-sight position with respect to the light source in the vertical direction becomes larger than a predetermined threshold value, the output unit is based on the relative position information generated by the information generation unit. The display or audio output of the relative position information is executed, and the display or audio output of the relative position information is omitted when the deviation amount is equal to or less than the threshold value. As a result, the relative position information is displayed or the voice output is executed only when it is necessary to call attention to the examiner or the like.

In the ophthalmic apparatus according to another aspect of the present invention, a face support member that supports the face of the subject at a position facing the ophthalmic apparatus main body and a light source provided on the surface side of the face support member facing the ophthalmic apparatus main body. And a camera that continuously captures the main body of the ophthalmic apparatus, and the light source position information acquisition unit acquires the light source position information based on the light source captured by the camera and the captured image of the main body of the ophthalmic apparatus. As a result, the light source position information can be acquired.

In the ophthalmic apparatus according to another aspect of the present invention, the external fixation lamp is a movable arm having a tip and a proximal end, a light source is provided on the distal end side, and the proximal end side supports the subject's face. A movable arm attached to the face support member or the main body of the ophthalmic device and a rotation angle detection sensor for detecting the rotation angles of all the rotation axes of the movable arm are provided, and the light source position information acquisition unit detects the rotation angle detection sensor. Based on the result, the light source position information is acquired. As a result, the light source position information can be acquired.

In the ophthalmologic apparatus according to another aspect of the present invention, the optical system acquires a fundus image of the fundus of the eye to be inspected through an objective lens, the fundus image acquired by the optical system, and the relative position information generated by the information generator. Based on the monitor that displays and the light source position information acquired by the light source position information acquisition unit, the assumed position of a specific part of the fundus that is assumed in the fundus image when it is assumed that the eye to be inspected is staring at the light source. It is provided with an assumed position determining unit for determining, and a display control unit for superimposing and displaying an index indicating an assumed position determined by the assumed position determining unit on the fundus image displayed on the monitor. As a result, the examiner determines whether or not the eye to be inspected sufficiently fixes the light source based on the actual position and the assumed position of the special part of the fundus, and the position of the special part is at the final target position. It can be determined whether or not.

The method of operating the ophthalmic apparatus for achieving the object of the present invention includes an ophthalmic apparatus main body having an optical system for acquiring an image of the eye to be inspected through an objective lens, and a light source supported so as to be repositionable with respect to the ophthalmic apparatus main body. In the method of operating the ophthalmic apparatus including the external fixation lamp having the light source position information, the light source position information acquisition step for acquiring the light source position information indicating the relative position of the light source with respect to the main body of the ophthalmologic apparatus, and the line-of-sight position for detecting the line-of-sight position of the eye to be inspected. Based on the light source position information acquired in the light source position information acquisition step and the line-of-sight position detected in the line-of-sight position detection step when the direction perpendicular to the optical axis of the objective lens is set to the vertical direction in the detection step. It has an information generation step of generating relative position information indicating a relative position of the line-of-sight position in the direction perpendicular to the light source.

According to the present invention, the state of fixation of the eye to be inspected can be easily determined when external fixation is performed.

It is a front perspective view of the ophthalmic apparatus seen from the subject side. It is a rear perspective view of the ophthalmic apparatus seen from the examiner side. It is a front view of the lens accommodating part. It is a front view of the face support member seen from the measurement head side. It is the schematic which shows an example of the structure of an ophthalmic apparatus. It is a functional block diagram of an arithmetic control unit. It is explanatory drawing for demonstrating the line-of-sight direction detection method (cornea detection method) of the line-of-sight position detection part using a Purkinje image. It is explanatory drawing for demonstrating the method (sclera reflection method, dark pupil method) of detecting the line-of-sight direction of an eye to be examined based on the image data of the eye to be examined. It is explanatory drawing for demonstrating the generation of relative position information by an information generation part. It is explanatory drawing which showed an example of the relative position information generated by an information generation part. It is explanatory drawing for demonstrating the determination of the assumed position of the macula of the fundus by the assumed position determination part. It is explanatory drawing for demonstrating the relationship between the assumed position of the macula and the actual position of the macula when the external fixation of the eye to be examined is performed. It is explanatory drawing which showed an example of the imaging screen and relative position information superposed on the monitor at the time of alignment of a fundus camera unit. It is explanatory drawing which showed an example of the imaging screen and relative position information superposed on the monitor at the time of the focus adjustment of a fundus camera unit. It is explanatory drawing which showed an example of the imaging screen and relative position information superposed on the monitor at the time of auto-optimization of an ophthalmic apparatus. It is a flowchart which shows the flow of the inspection process of the eye under test by an ophthalmic apparatus, particularly the display process of the relative position information and the optotype on the monitor 3 at the time of performing external fixation of the eye under test. It is a flowchart which shows the flow of the examination process of the eye to be examined by the ophthalmic apparatus of another Embodiment 1, in particular, the display process of the relative position information on a monitor. It is the schematic of the ophthalmic apparatus of another Embodiment 2. It is explanatory drawing for demonstrating the relative position information generated from the information generation part of another Embodiment 2.

[Overall configuration of ophthalmic equipment]
FIG. 1 is a front perspective view of the ophthalmic apparatus 1 as seen from the subject side. FIG. 2 is a rear perspective view of the ophthalmic apparatus 1 as seen from the examiner's side. The X direction in the figure is the left-right direction with respect to the subject (the eye width direction of the subject E shown in FIG. 4), the Y direction is the vertical direction, and the Z direction is before approaching the subject. It is a front-back direction (also called a working distance direction) parallel to the direction and the rear direction away from the subject.

As shown in FIGS. 1 and 2, the ophthalmic apparatus 1 is a composite machine that combines a fundus camera and an optical coherence tomography that obtains a tomographic image using optical coherence tomography (OCT). .. The ophthalmic apparatus 1 includes a base 400, a face support member 401, a gantry 402, and a measurement head 403. A calculation control unit 200 (see FIG. 5) and the like, which will be described later, are stored in the base 400.

The face support member 401 is provided integrally with the base 400 at a position on the front side of the measurement head 403 in the Z direction. The face support member 401 has a chin rest 401a and a forehead pad 401b whose position can be adjusted in the Y direction, and faces the face of the subject toward the main body of the ophthalmic apparatus such as the measurement head 403 (objective lens 22 described later). Support in the position to be.

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

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

The operation lever 210a is an operation member for moving the measurement head 403 in each direction of XYZ. For example, when the operating lever 210a is tilted in the Z direction (front-back direction) or the X direction (horizontal direction), the measurement head 403 is moved in the Z direction or the X direction by an electric drive mechanism (not shown). Further, when the operation lever 210a is rotationally operated around its longitudinal axis, the measurement head 403 is moved in the Y direction (vertical direction) by the above-mentioned electric drive mechanism according to the rotational operation direction. A measurement button is provided on the top of the operating lever 210a to start the measurement of the eye to be inspected E (see FIG. 5) by the ophthalmic apparatus 1.

The measurement head 403 constitutes the main body of the ophthalmic apparatus of the present invention together with the base 400 and the gantry 402 described above. The fundus camera unit 2 and the OCT unit 100 shown in FIG. 5 to be described later are built in the measurement head 403. Further, a monitor 3 is provided on the back surface of the measurement head 403 on the rear side (examiner side) in the Z direction, and a lens accommodating portion 403a is provided on the front surface on the front direction side (examinee side) in the Z direction. Is provided.

As the monitor 3, for example, a touch panel type liquid crystal display device is used. The monitor 3 has various imaging screens 230 (see FIG. 13 and the like) displayed at the time of inspection of the eye E to be inspected, various imaging data of the eye E to be inspected (see FIG. 5), and input screens for various setting operations. Etc. are displayed.

FIG. 3 is a front view of the lens accommodating portion 403a. As shown in FIG. 3, the lens accommodating portion 403a accommodates an objective lens 22 that constitutes a part of the fundus camera unit 2 (see FIG. 5) and has an optical axis OA parallel to the Z direction. Further, the lens accommodating portion 403a is provided with eight fixation holes 95 (also referred to as fixation lamps) arranged at equal intervals along the circumferential direction of the objective lens 22 so as to surround the objective lens 22. There is. Each fixation hole 95 selectively emits fixation light in the Z direction according to the operation by the operation unit 210. The arrangement position and the number of arrangements of each fixation hole 95 may be appropriately changed.

Each fixation hole 95 is used for peripheral fixation and imaging of the corner angle (edge of the iris) of the eye E (see FIG. 5). Peripheral fixation is a fixation method in which each of the fixation holes 95 is selectively turned on to rotate the eye E to be examined in a desired direction.

Further, two anterior segment cameras 300 of the fundus camera unit 2 (see FIG. 5) are provided in front of the measurement head 403 and in the vicinity of the lens accommodating portion 403a.

As shown in FIGS. 1 to 3, the face support member 401 is provided with an external fixation lamp 96. The external fixation lamp 96 has a light source 99 that emits fixation light, and the position of the light source 99 can be arbitrarily adjusted. The external fixation lamp 96 is used for external fixation. In external fixation, the eye to be inspected is rotated in an arbitrary direction by adjusting the position of the light source 99, or is rotated more than in the case of internal fixation, or when internal fixation cannot be performed. This is a fixation method in which the direction of the eye to be inspected is adjusted by guiding the line of sight of the eye.

In external fixation, the fixation target eye that irradiates the fixation light from the external fixation lamp 96 is selected. For example, it is determined whether the eye to be fixed-eye irradiating the fixed-eye light from the external fixed-eye lamp 96 is the eye to be inspected E for observation or the companion eye (opposite eye) of the eye to be inspected E. For example, when the positions of the external fixation lamp 96 and the measurement head 403 interfere with each other, the external fixation lamp 96 cannot irradiate the eye to be inspected E with the fixation light. The optometry light from the lamp 96 is irradiated. In addition, when the eye to be inspected E is dazzling after a plurality of shots, the eye to be inspected E may not be irradiated with the fixation light from the external fixation lamp 96, but the companion eye may be irradiated with the fixation light. .. The examiner selects the fixation target eye, and the operation unit 210 performs the fixation target eye selection operation. The arithmetic control unit 200 (see FIG. 6), which will be described later, may recognize the situation and automatically select the eye to be fixed. Hereinafter, the "external fixation of the eye to be inspected E" includes the case where the companion eye is fixed at the external fixation lamp 96 (light source 99).

The external fixation lamp 96 includes a mounting shaft 97, an articulated movable arm 98, and a light source 99 (also referred to as an fixation lamp). The mounting shaft 97 is fixed to the face support member 401 and rotatably holds the movable arm 98 around a rotation shaft parallel to the Y direction.

The movable arm 98 has a tip end and a base end. The base end side of the movable arm 98 is attached to the face support member 401 via a mounting shaft 97, and a light source 99 is provided on the tip end side of the movable arm 98. Further, the movable arm 98 has a structure that can be flexed by a plurality of joints 98a having a rotation axis perpendicular to the Y direction. The movable arm 98 can arbitrarily change the position of the light source 99 by rotating the movable arm 98 around the mounting shaft 97 and adjusting the bending angle for each joint 98a.

The light source 99 is supported by the movable arm 98 and the mounting shaft 97 so as to be repositionable with respect to the main body of the ophthalmic apparatus such as the measurement head 403. As the light source 99, for example, an LED (light emitting diode) is used to emit (emit) fixed-vision light.

In the present embodiment, the external fixation lamp 96 is provided on the face support member 401, but the external fixation lamp 96 may be provided on the main body of the ophthalmic apparatus such as the base 400 and the measurement head 403.

FIG. 4 is a front view of the face support member 401 as seen from the measurement head 403 (objective lens 22) side. As shown in FIG. 4, an external fixation lamp camera 500 is provided on the surface side of the face support member 401 facing the measurement head 403 (objective lens 22).

The external fixed-view camera 500 corresponds to the camera of the present invention, and for example, an electronic camera having a wide-angle lens is used. The external fixation lamp camera 500 simultaneously uses the light source 99 of the external fixation lamp 96 and the main body of the ophthalmic apparatus such as the measurement head 403 when the external fixation of the eye E (see FIG. 5) is performed. Further, continuous imaging (moving image imaging) is performed, and the light source captured image data D1 (see FIG. 10), which is captured image data of the light source 99 and the measurement head 403, is sequentially output. The imaging interval of the external fixed-view camera 500 is not particularly limited.

In the present embodiment, the external fixation lamp camera 500 is provided on the surface side of the face support member 401 facing the measurement head 403, but the light source 99 and the measurement are performed when the eye E (see FIG. 5) is externally fixed. If the head 403 and the like can be simultaneously imaged (at least the light source 99 is imaged), the external fixation lamp camera 500 may be provided at an arbitrary position of the face support member 401. Further, the external fixed vision camera 500 may be fixed to the main body of the ophthalmic apparatus such as the measurement head 403.

FIG. 5 is a schematic view showing an example of the configuration of the ophthalmic apparatus 1. As shown in FIG. 5, the ophthalmic apparatus 1 includes a fundus camera unit 2, an OCT unit 100, an arithmetic control unit 200, and the like. The fundus camera unit 2 is housed in the measurement head 403 and has an optical system substantially similar to that of a conventional fundus camera. The OCT unit 100 is housed in the measurement head 403 and has an optical system for acquiring an OCT image of the fundus Ef. The arithmetic control unit 200 is housed in the base 400 (may be in the measurement head 403), and is an arithmetic processing device such as a personal computer that executes various arithmetic processes and control processes.

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

The illumination optical system 10 irradiates the fundus Ef with illumination light. The image pickup optical system 30 guides the fundus reflection light of the illumination light reflected by the fundus Ef to, for example, CMOS (Complementary Metal Oxide Semiconductor) type or CCD (Charge Coupled Device) type image pickup elements 35 and 38. Further, the imaging optical system 30 guides the signal light output from the OCT unit 100 to the fundus Ef and guides the signal light passing through the fundus Ef to the OCT unit 100.

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

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

As the observation light source 11, for example, a halogen lamp or an LED is used, and the observation illumination light is emitted. The observation illumination light emitted from the observation light source 11 is reflected by the reflection mirror 12, passes through the condensing lens 13, passes through the visible cut filter 14, and becomes near-infrared light. Further, the observation illumination light is once focused in the vicinity of the photographing light source 15, reflected by the mirror 16, and passes through the relay lenses 17, 18, the diaphragm 19, and the relay lens 20. Then, the observation illumination light is reflected at the peripheral portion of the perforated mirror 21 (the region around the perforated portion), passes through the dichroic mirror 46, is refracted by the objective lens 22, and illuminates the fundus Ef.

The fundus reflected light of the observation illumination light is refracted by the objective lens 22, passes through the dichroic mirror 46, passes through the hole formed in the central region of the perforated mirror 21, passes through the dichroic mirror 55, and is a focusing lens. It is reflected by the mirror 32 via 31. Further, the fundus reflected light passes through the half mirror 39A, is reflected by the dichroic mirror 33, and is imaged on the light receiving surface of the image sensor 35 by the condensing lens 34. The image sensor 35 captures (receives) the fundus reflected light and outputs an image pickup signal. An observation image based on the image pickup signal output from the image pickup device 35 is displayed on the monitor 3. When the focus of the imaging optical system 30 is adjusted to the anterior segment Ea of the eye to be inspected E, the observation image of the anterior segment Ea is displayed on the monitor 3, and the focus of the imaging optical system 30 is adjusted to the fundus Ef. If so, the observed image of the fundus Ef is displayed on the monitor 3.

As the photographing light source 15, for example, a xenon lamp or an LED light source is used, and the photographing illumination light is emitted. The photographing illumination light emitted from the photographing light source 15 irradiates the fundus Ef through the same path as the observation illumination light described above. The fundus reflected light of the photographing illumination light is guided to the dichroic mirror 33 through the same path as the fundus reflected light of the observation illumination light, passes through the dichroic mirror 33, is reflected by the mirror 36, and is reflected by the condensing lens 37. An image is formed on the light receiving surface of 38.

The image sensor 38 captures (receives) the fundus reflected light and outputs an image pickup signal. An image captured image based on the image pickup signal output from the image sensor 38 is displayed on the monitor 3. The monitor 3 for displaying the observed image and the monitor 3 for displaying the captured image may be the same or different from each other.

The optotype display unit 39 is used for internal fixation that projects the fixation light of the fixation target (bright spot image) onto the eye E to be examined through the objective lens 22, for example, a dot matrix liquid crystal display (LCD: Liquid Crystal). Display) and matrix light emitting diode (LED) and the like are used. The target display unit 39 displays a fixed target. In addition, the optotype display unit 39 can arbitrarily set the display mode (shape, etc.) and display position of the fixed optotype. The visual acuity display unit 39 can display not only a fixed visual acuity but also a visual acuity test target.

After a part of the fixation light of the fixation target displayed on the optotype display unit 39 is reflected by the half mirror 39A, the holes of the mirror 32, the focusing lens 31, the dichroic mirror 55, and the perforated mirror 21 It is projected onto the eye E to be inspected through the unit, the dichroic mirror 46, and the objective lens 22. As a result, the fixation target, the visual acuity test target, and the like are presented to the eye E to be inspected through the objective lens 22.

The fundus camera unit 2 includes an alignment optical system 50 and a focus optical system 60, as in the conventional fundus camera. The alignment optical system 50 generates an alignment index for aligning the fundus camera unit 2 with respect to the eye E to be inspected. The focus optical system 60 generates a split index for focusing on the fundus Ef.

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

The alignment light emitted from the LED 51 of the alignment optical system 50 is reflected by the dichroic mirror 55 via the diaphragms 52 and 53 and the relay lens 54, passes through the hole of the perforated mirror 21, and passes through the dichroic mirror 46. , The objective lens 22 projects the image onto the corneum of the anterior segment Ea of the eye E to be examined.

The corneal reflected light of the alignment light passes through the holes of the objective lens 22, the dichroic mirror 46, and the perforated mirror 21, and after a part of the light passes through the dichroic mirror 55, the focusing lens 31, the mirror 32, and the half mirror It is incident on the light receiving surface of the image pickup element 35 via the 39A, the dichroic mirror 33, and the condensing lens 34.

The image sensor 35 captures (receives) the corneal reflected light of the alignment light and outputs an image pickup signal. As a result, the alignment index is displayed on the monitor 3 together with the observation image of the anterior segment Ea described above. Then, the user performs the alignment by performing the same operation as that of the conventional fundus camera. Further, the arithmetic control unit 200 may analyze the position of the alignment index and move the optical system to perform alignment (auto alignment).

The reflective surface of the reflective rod 67 is set on the optical path of the illumination optical system 10 when the focus is adjusted by the focus optical system 60. The focus light emitted from the LED 61 passes through the relay lens 62, is separated into two light beams by the split index plate 63, and then is reflected by the reflecting rod 67 through the two-hole diaphragm 64, the mirror 65, and the condensing lens 66. Once imaged on the surface, it is reflected toward the relay lens 20 on this reflecting surface. Further, the focus light is projected onto the fundus Ef via the relay lens 20, the perforated mirror 21, the dichroic mirror 46, and the objective lens 22.

The fundus reflected light of the focus light is imaged by the image sensor 35 through the same path as the corneal reflected light of the alignment light. The image sensor 35 captures the fundus reflected light of the focus light and outputs an image pickup signal. As a result, the split index is displayed on the monitor 3 together with the observed image. The arithmetic control unit 200, which will be described later, analyzes the position of the split index and moves the focusing lens 31 or the like to automatically perform focusing, as in the conventional case. Further, the user may manually focus while visually recognizing the split index.

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

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

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

Further, the fundus camera unit 2 includes a line-of-sight position detection optical system 70. The line-of-sight position detection optical system 70 includes a mirror 71, an infrared LED 72, a pinhole 73, a condensing lens 74, a mirror 75, an imaging lens 76, a mirror 77, an image sensor 78, and a semiconductor position detection. It includes a PSD79, which is an element (Position Sensitive Detector).

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

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

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

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

The image pickup device 78 is a CMOS type or a CCD type, and the reflected light reflected by the mirror 77 is imaged as an image of the eye E to be inspected on the image pickup surface thereof. The image sensor 78 captures an image of the eye E to be inspected formed on the image pickup surface, and outputs the captured image data D2 (see FIG. 7 and the like) to the arithmetic control unit 200.

The reflected light incident from the mirror 77 is incident on the light receiving surface of the PSD 79. The PSD 79 is a sensor capable of detecting the light receiving position of the reflected light on the light receiving surface, and outputs a light receiving signal indicating the light receiving position to the arithmetic control unit 200. A line sensor may be used instead of PSD79.

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

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

[Calculation control unit]
FIG. 6 is a functional block diagram of the arithmetic control unit 200. As shown in FIG. 6, the arithmetic control unit 200 includes a general control unit 202, a storage unit 204, an image forming unit 206, a data processing unit 208, and the like. Further, each part of the fundus camera unit 2, the monitor 3, the fixation hole 95, the external fixation lamp 96, the OCT unit 100, the operation unit 210, and the like are connected to the arithmetic control unit 200.

The integrated control unit 202 controls the operations of each unit of the ophthalmologic device 1 such as the fundus camera unit 2, the monitor 3, and the OCT unit 100 in response to an input operation to the operation unit 210 by the examiner. Note that FIG. 6 illustrates only the functions related to the generation and display of the relative position information 219 (see FIG. 10), which will be described later, among the various functions of the overall control unit 202, and the other functions are known techniques. Illustration is omitted.

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

The storage unit 204 stores image data of the OCT image, image data of the fundus image, eye information to be inspected (including subject information), and the like, in addition to the control program executed by the processor of the general control unit 202. Further, the storage unit 204 stores the positional relationship information 226 described later.

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

[Generation and display of relative location information]
The integrated control unit 202 executes the control program read from the storage unit 204 when executing the fixation (particularly external fixation) of the eye E to be inspected at the time of inspection (imaging) of the eye E to be inspected. It functions as a control unit 214, a light source position information acquisition unit 216, a line-of-sight position detection unit 218, an information generation unit 220, an assumed position determination unit 222, and a display control unit 224.

The fixation control unit 214 receives internal fixation using the optotype display unit 39, the objective lens 22 and the like, peripheral fixation using each fixation hole 95, and peripheral fixation using each fixation hole 95 in response to an input operation to the operation unit 210 by the examiner. External fixation using the external fixation lamp 96 is controlled.

The fixation control unit 214 controls the display position of the fixation target on the target display unit 39 in response to an input operation to the operation unit 210 when the internal fixation of the eye E to be inspected is executed. As a result, the fixation control unit 214 controls the fixation position, which is the position where the fixation light of the fixation target passes through the objective lens 22, in the direction perpendicular to the optical axis OA of the objective lens 22 (XY direction). can do.

Further, when the fixation control unit 214 executes peripheral fixation of the eye E to be inspected, the fixation control unit 214 lights (lights) the fixation hole 95 designated by the input operation in response to an input operation to the operation unit 210. Further, the fixation control unit 214 turns on (lights) the light source 99 of the external fixation lamp 96 in response to an input operation to the operation unit 210 when the external fixation of the eye E to be inspected is executed.

The light source position information acquisition unit 216 acquires the light source image capture image data D1 from the external fixation lamp camera 500 when the external fixation of the eye E to be examined is started, and based on the light source imaging image data D1, the measurement head 403 and the like The light source position information indicating the relative position of the light source 99 with respect to an arbitrary reference point (for example, the position coordinates of the optical axis OA on the lens surface of the objective lens 22) of the main body of the ophthalmic apparatus is calculated. Since both the above-mentioned reference point (optical axis OA) and the light source 99 are included in the light source image based on the light source captured image data D1, the light source captured image data D1 itself is also the light source position information of the present invention. Corresponds to.

Since the position of the external fixed-view camera 500 is fixed and the imaging magnification of the external fixed-view camera 500 is also fixed, the reference point (of the lens surface) in the light source captured image based on the light source captured image data D1. The position coordinates of the optical axis OA) are obtained in advance. Further, the light source position information acquisition unit 216 can detect the light source 99 from the image captured by the light source by using a known image analysis method such as a pattern matching method. Then, the light source position information acquisition unit 216 determines the position coordinates (XYZ) of the light source 99 with respect to the above-mentioned reference point based on the detection result of the light source 99 in the light source captured image and the imaging magnification of the known external fixed-view camera 500. Coordinates (see FIG. 9) are calculated as light source position information.

The light source position information acquisition unit 216 detects the light source position information based on the light source captured image data D1 continuously input from the external fixation light camera 500 while the external fixation of the eye E to be inspected is being executed. It is sequentially output to the unit 218, the information generation unit 220, and the assumed position determination unit 222. Further, the light source position information acquisition unit 216 sequentially outputs the light source image capture image data D1 together with the light source position information to the information generation unit 220.

The line-of-sight position detection unit 218 constitutes the line-of-sight position detection unit of the present invention together with the line-of-sight position detection optical system 70 described above. The line-of-sight position detection unit 218 turns on the infrared LED 72 when the external fixation of the eye E to be inspected is started. At the same time, the line-of-sight position detection unit 218 detects the line-of-sight direction of the eye E to be inspected based on the captured image data D2 (see FIG. 7) of the eye E to be inspected input from the image sensor 78 and the received light signal input from the PSD 79. To do.

FIG. 7 is an explanatory diagram for explaining a line-of-sight direction detection method (cornea detection method) of the line-of-sight position detection unit 218 using the Purkinje image 151. As shown by reference numeral VIA in FIG. 7, a Pulkinje image 151, which is a reflected image of near-infrared light, is generated on the surface of the cornea of the eye E to be inspected by the incident of near-infrared light from a point light source. The position of the Purkinje image 151 changes according to the change in the line-of-sight direction of the eye E to be inspected.

Therefore, as shown by reference numeral VIIB in FIG. 7, the line-of-sight position detection unit 218 is based on the image data D2 of the eye to be inspected E input from the image sensor 78 and the received signal received from the PSD 79. The position coordinate C1 of the Pulkinje image 151 in the above is detected. Then, the line-of-sight position detection unit 218 detects the line-of-sight direction of the eye E to be inspected based on the relative position between the position of the Pulkinje image 151 indicated by the position coordinates C1 and the center of the pupil. The method of detecting the line-of-sight direction using the Purkinje image 151 is a known technique, and detailed description thereof will be omitted. Further, although PSD79 is used in this embodiment, PSD79 may be omitted and the position coordinates C1 of the Pulkinje image 151 may be detected based only on the captured image data D2 input from the image sensor 78.

FIG. 8 is an explanatory diagram for explaining a method (sclera reflection method, dark pupil method) of detecting the line-of-sight direction of the eye E to be inspected based on the captured image data D2 of the eye E to be inspected. In this method, the incident of near-infrared light of a point light source on the eye E to be inspected can be omitted. The line-of-sight position detection unit 218 acquires the captured image data D2 of the eye to be inspected E from the image sensor 78 as shown by the reference numeral VIIIA in FIG. 8, and then the captured image data of the eye to be inspected E as shown in the reference numeral VIIIB in FIG. D2 is binarized at a predetermined brightness threshold. Since the pupil of the eye E to be inspected has a lower brightness than the surrounding region, when the captured image data D2 is binarized, the region corresponding to the pupil of the eye E to be inspected becomes a black pixel region, and the region around the pupil becomes. Is the white pixel area. Thereby, the pupil region of the eye E to be inspected can be specified from the captured image data D2 of the eye E to be inspected.

Then, as shown by reference numeral VIIIC in FIG. 8, the line-of-sight position detection unit 218 obtains the center coordinates C2 of the pupil region (black pixel region) of the eye to be inspected E from the binarized image data D2 of the eye to be inspected E. The line-of-sight direction of the eye E to be inspected is detected based on the obtained center coordinates C2 and the known geometric structure of the eyeball. Since the detection of the line-of-sight direction by the scleral reflection method (dark pupil method) is a known technique, detailed description thereof will be omitted.

Returning to FIG. 6, the line-of-sight position detection unit 218 receives an eye to be inspected with respect to the fundus camera unit 2 [for example, the above-mentioned reference point (optical axis OA)] based on the captured image data D2 and the imaging magnification of the known imaging optical system 30. Detects the relative position of E. The method of detecting the relative position of the eye E to be inspected is not particularly limited. In this case, the line-of-sight position detection unit 218 functions as an eye-tested position detection unit that detects the relative position of the eye-tested eye E with respect to the fundus camera unit 2 (the main body of the ophthalmic apparatus).

Next, the line-of-sight position detection unit 218 is as shown in FIG. 9 described later, based on the detected relative position and line-of-sight direction of the eye E to be inspected and the light source position information input from the light source position information acquisition unit 216 described above. The line-of-sight position (XY coordinates) of the eye E to be inspected in the XY plane including the light source 99 is calculated. Then, the line-of-sight position detection unit 218 outputs the calculation result of the line-of-sight position of the eye E to be inspected to the information generation unit 220. The line-of-sight position detection unit 218 repeatedly detects the line-of-sight position of the eye E to be inspected at regular intervals, and sequentially outputs the detection result of the new line-of-sight position to the information generation unit 220.

FIG. 9 is an explanatory diagram for explaining the generation of relative position information 219 (see FIG. 10) by the information generation unit 220. In FIG. 9, reference numeral LP indicates the position of the light source 99, reference numeral SD indicates the line-of-sight direction of the eye E to be inspected, reference numeral F indicates an XY plane including the light source 99, and reference numeral SP is an eye to be inspected on the XY plane. Indicates the line-of-sight position of E.

As shown in FIG. 9, the information generation unit 220 generates relative position information 219 (see FIG. 10) when the external fixation of the eye E to be inspected is started. The relative position information 219 is relative to the light source 99 in the direction perpendicular to the optical axis of the line-of-sight position of the eye E to be inspected when the vertical direction (XY direction) perpendicular to the optical axis OA (Z direction) is set to the "optical axis vertical direction". This is information indicating the position, that is, the deviation direction and the deviation amount Δd in the direction perpendicular to the optical axis of the line-of-sight position with respect to the light source 99. In FIG. 9, the line-of-sight position is shifted in the X direction with respect to the light source 99, but it may be shifted in the Y direction, and may be further shifted in both the X direction and the Y direction.

FIG. 10 is an explanatory diagram showing an example of relative position information 219 generated by the information generation unit 220. As shown in FIG. 10, the information generation unit 220 input the light source image capture image data D1 and the light source position information (see LP in FIG. 9) input from the light source position information acquisition unit 216 and the line-of-sight position detection unit 218. Based on the line-of-sight position of the eye E to be inspected (see SP in FIG. 9), relative position information 219 with the light source captured image data D1 as the background image is generated. The relative position information 219 includes an index ML indicating the relative position of the light source 99 with respect to the above-mentioned reference point (optical axis OA), an index ME indicating the line-of-sight position of the eye E to be inspected with respect to the reference point (optical axis OA), and the index ME. Is included. The indicators ML and ME referred to here include marks, numbers, symbols and the like.

In the relative position information 219, the index ME corresponding to the line-of-sight position is separated from the index ML corresponding to the position of the light source 99 by a distance corresponding to the deviation amount Δd (see FIG. 9) in the deviation direction described above. It is provided at the position. As a result, from the relative position information 219, the fixation state of the eye E to be inspected (whether or not the eye to be inspected captures the light source 99 (fixation light), and where the line of sight of the eye E to be inspected faces the light source 99. Whether it is present, etc.) can be determined.

When the light source captured image data D1 is not used as the background image of the relative position information 219, the information generation unit 220 inputs the light source position information input from the light source position information acquisition unit 216 and the line-of-sight position detection unit 218. Based on the line-of-sight position of the eye E to be inspected, relative position information 219 including the indexes ML and ME and the reference point (optical axis OA) is generated. Further, the information generation unit 220 may generate relative position information 219 indicating only the relative position of the other with respect to one of the indexes ML and ME.

Returning to FIG. 6, the information generation unit 220 receives each time new light source image capture image data D1 and light source position information are input from the light source position information acquisition unit 216, and the line-of-sight position of the eye E to be inspected from the line-of-sight position detection unit 218. Each time a new detection result is input, the relative position information 219 is sequentially updated. As a result, for example, when the line-of-sight position of the eye E to be inspected moves toward the light source 99, the position of the index ME in the relative position information 219 is updated accordingly, and the index ME moves toward the index ML. Then, the information generation unit 220 sequentially outputs new relative position information 219 to the display control unit 224 each time the relative position information 219 is updated.

FIG. 11 is an explanatory diagram for explaining the determination of the assumed position AP of the macula Em (corresponding to the specific site of the present invention) of the fundus Ef by the assumed position determination unit 222. As shown in FIG. 11, the assumed position AP of the macula Em is the fundus Ef when it is assumed that the eye E to be inspected is staring at the light source 99 (including the case where the companion eye is staring at the light source 99). This is the position of the macula Em assumed in the fundus image, that is, the position of the image of the macula Em assumed on the imaging surface of the image pickup device 35 that images the fundus image.

Assuming that the eye E to be inspected is staring at the light source 99, the line-of-sight direction of the eye E to be inspected coincides (substantially coincides with) the direction of the light source 99. Therefore, for example, when the line-of-sight direction of the eye E to be inspected coincides with (substantially coincides with) the optical axis OA, the position of the macula Em in the fundus Ef is also located on the optical axis OA, that is, the imaging of the imaging element 35. An image of the macula Em is formed on the center point on the surface (intersection with the optical axis OA: reference point). Then, when the line-of-sight direction of the eye E to be inspected changes, the position of the image of the macula Em on the image pickup surface of the image pickup device 35 changes accordingly. Therefore, if the relative position of the light source 99 with respect to the main body of the ophthalmic apparatus such as the measurement head 240 [center point (reference point) of the image sensor 35] is determined, the image of the macula Em assumed on the image pickup surface of the image sensor 35 can be obtained. The position is also fixed.

Therefore, in the present embodiment, an experiment or a simulation is performed in advance to show the correspondence between the relative position of the light source 99 and the position of the image of the macula Em on the imaging surface (in the fundus image) of the imaging element 35. A formula, a data table, or a positional relationship information 226 (see FIG. 6) which is a table is created in advance and stored in the storage unit 204. As a result, the assumed position determination unit 222 sequentially determines (updates) the assumed position AP of the macula Em by referring to the positional relationship information 226 based on the light source position information sequentially input from the light source position information acquisition unit 216. be able to. Then, the assumed position determination unit 222 sequentially outputs information on the new assumed position AP of the macula Em to the display control unit 224 every time the assumed position AP of the macula Em is updated.

The method for determining the assumed position AP of the macula Em is not limited to the above method. For example, the size (diameter) of an adult eyeball is about the same size with an average of 23 mm to 25 mm, and the position of the macula Em in the fundus Ef is also almost constant. Therefore, the eye E to be inspected is based on the relative position of the light source 99 with respect to the main body of the ophthalmic apparatus such as the measurement head 240 [center point (reference point) of the image sensor 35] and the relative position of the eye E to be inspected with respect to the main body of the ophthalmic apparatus. The position of the macula Em in the fundus Ef when it is assumed that the light source 99 is fixed is determined, and as a result, the position of the image of the macula expected on the imaging surface of the image sensor 35 is also determined.

Further, in this case, the positional relationship information indicating the correspondence between the relative position of the light source 99, the relative position of the eye E to be inspected, and the position of the macula Em in the image pickup surface (in the fundus image) of the image sensor 35. Create 226. As a result, the assumed position determination unit 222 provides the positional relationship information based on the light source position information sequentially acquired by the light source position information acquisition unit 216 and the relative position information of the eye E to be inspected sequentially detected by the line-of-sight position detection unit 218. By referring to 226, the assumed position AP of the macula Em can be sequentially determined. The relative position information of the eye E to be inspected may be obtained from the alignment information of the fundus camera unit 2.

FIG. 12 is an explanatory diagram for explaining the relationship between the assumed position of the macula Em and the actual position of the macula Em when external fixation of the eye E to be inspected is performed. Here, the reference numeral PI in the drawing is a panoramic image obtained by panoramic synthesis of a plurality of fundus images in the central portion and the peripheral portion of the fundus Ef. Further, in FIG. 12, the assumed position AP of the macula Em is indicated by the index MA.

As shown in FIG. 12, when the external fixation of the eye E to be inspected is executed, when the eye E (companion eye) to be inspected sufficiently fixes the light source 99, the inside of the fundus image imaged by the image sensor 35 ( The actual position of the macula Em on the imaging surface) and the index MA (assumed position AP) match (including substantially matching). On the other hand, when the eye E (companion eye) loses sight of the light source 99 or the fixation of the light source 99 is insufficient, the actual position of the macula Em in the fundus image (in the imaging plane) is used. It deviates from the index MA (assumed position AP). Therefore, the examiner determines whether or not the eye E to be inspected sufficiently fixes the light source 99 based on the actual position of the macula Em and the index MA (assumed position AP), and the position of the macula Em is final. It is possible to determine whether or not it is in the target position.

Returning to FIG. 6, the display control unit 224 controls the display of the monitor 3. When the external fixation is started, the display control unit 224 causes the monitor 3 to display the relative position information 219 sequentially input from the information generation unit 220 described above. Therefore, the display control unit 224 functions as the output unit of the present invention together with the monitor 3.

Further, the display control unit 224 is a photographing screen 230 (FIG. 13 and the like) corresponding to various operations executed by the ophthalmologic apparatus 1 at the same time as the fixation (internal fixation, peripheral fixation, and external fixation) of the eye E to be inspected. (See) is generated, and this shooting screen 230 is displayed on the monitor 3. In this case, the display control unit 224 superimposes and displays the shooting screen 230 and the relative position information 219 on the monitor 3. Further, when the display control unit 224 displays the fundus image of the fundus Ef as in the photographing screen 230 shown in FIGS. 14 and 15 described later, the macula Em is sequentially input from the assumed position determination unit 222 described above. Based on the determination result of the assumed position AP of, the index MA is superimposed and displayed on this fundus image.

The types of operations of the ophthalmologic apparatus 1 executed at the same time as the fixation of the eye E to be inspected (external fixation, etc.) include, for example, the alignment of the fundus camera unit 2 with respect to the anterior segment Ea and the focus of the fundus camera unit 2 with respect to the fundus Ef. Examples include adjustment and auto-optimization (auto-optimization) of the ophthalmologic apparatus 1. The alignment referred to here is auto alignment, but manual alignment may be performed. The auto-optimize finely adjusts the position of the fundus camera unit 2 in the Z direction, adjusts the sensitivity of the OCT image, and the like.

FIG. 13 is an explanatory diagram showing an example of a photographing screen 230 and relative position information 219 superimposed and displayed on the monitor 3 when the fundus camera unit 2 is aligned. FIG. 14 is an explanatory diagram showing an example of a photographing screen 230 and relative position information 219 superimposed and displayed on the monitor 3 when the focus of the fundus camera unit 2 is adjusted. FIG. 15 is an explanatory diagram showing an example of an imaging screen 230 and relative position information 219 superimposed and displayed on the monitor 3 at the time of auto-optimization of the ophthalmic apparatus 1.

As shown in FIG. 13, the display control unit 224 acquires an anterior segment image (observation image) of the anterior segment Ea from the fundus camera unit 2 at the time of alignment of the fundus camera unit 2. Then, the display control unit 224 generates a shooting screen 230 including the front eye image observation screen 230a, which is an observation screen of the front eye image, and the relative position information sequentially input from the shooting screen 230 and the information generation unit 220. 219 and 219 are superimposed and displayed on the monitor 3.

As shown in FIGS. 14 and 15, when the display control unit 224 adjusts the focus of the fundus camera unit 2 or auto-optimizes the ophthalmologic device 1, the fundus camera unit 2 sets the fundus in addition to the above-mentioned anterior ocular image. The fundus image (observation image) of Ef is acquired, and the OCT image (observation image) is acquired from the image forming unit 206. Then, the display control unit 224 generates a photographing screen 230 including an anterior segment image observation screen 230a, a fundus image observation screen 230b which is an observation screen of the fundus image, and an OCT image observation screen 230c which is an observation screen of the OCT image. , The photographing screen 230 and the relative position information 219 are superimposed and displayed on the monitor 3.

Further, when the display control unit 224 displays the fundus image observation screen 230b on the monitor 3, the fundus image observation screen is based on the determination result of the assumed position AP of the macula Em, which is sequentially input from the assumed position determination unit 222. The index MA indicating the assumed position of the macula Em is superimposed and displayed on 230b.

The display position, display range, and the like of the relative position information 219 in the shooting screen 230 are not particularly limited. Further, when the ophthalmic apparatus 1 is provided with a plurality of monitors 3, the display control unit 224 may display the relative position information 219 on a monitor 3 different from the monitor 3 that displays the photographing screen 230. Further, in the present embodiment, the shooting screen 230 displayed on the monitor 3 at the time of alignment, focus adjustment, and auto-optimization has been described as an example, but other operations (for example, each illumination of the illumination optical system 10 and the imaging optical system 30) have been described. The superimposed display of the various shooting screens 230 and the relative position information 219 may be executed even at the time of setting the amount of light, etc.).

[Action of ophthalmic device]
FIG. 16 shows a flow chart of the inspection process of the eye E to be inspected by the ophthalmology apparatus 1 having the above configuration, particularly the display process of the relative position information 219 and the index MA on the monitor 3 when the external fixation of the eye E to be inspected is executed (ophthalmology of the present invention). It is a flowchart which shows (corresponding to the operation method of the apparatus).

As shown in FIG. 16, after the predetermined examination preparation process in the ophthalmic apparatus 1 is completed, the examiner performs a predetermined adjustment / setting operation on the operation unit 210. In response to this operation, the general control unit 202 controls each part of the ophthalmologic apparatus 1 to set the amount of illumination light of the illumination optical system 10 and the imaging optical system 30 by a known method (step S1). , Alignment of the fundus camera unit 2 (step S2), focus adjustment of the fundus camera unit 2 (step S3), and auto-optimization of the ophthalmologic apparatus 1 (step S4) are executed in order.

On the other hand, when the examiner performs external fixation of the eye E to be inspected, the examiner performs a lighting operation of the light source 99 on the operation unit 210. In response to this operation, the fixation control unit 214 turns on (lights up) the light source 99. Next, the examiner selects the eye to be fixed-eye (eye to be inspected E or companion eye), and then manually adjusts the position of the light source 99 (step S5). As a result, external fixation of the eye E to be inspected is started.

In response to the start of external fixation of the eye E to be inspected, continuous imaging of the light source 99 and the measurement head 403 by the external fixation light camera 500, continuous output of the light source imaging image data D1, and the light source position by the light source position information acquisition unit 216. Continuous acquisition (calculation) of information is executed (step S6, corresponding to the light source position information acquisition step of the present invention). As a result, the light source position information acquisition unit 216 sequentially outputs the light source position information to the line-of-sight position detection unit 218 and the assumed position determination unit 222. Further, the light source position information acquisition unit 216 sequentially outputs the light source image capture image data D1 and the light source position information to the information generation unit 220.

Further, in response to the start of external fixation of the eye E to be inspected, the line-of-sight position detection unit 218 lights the infrared LED 72 and sequentially inputs the captured image data D2 and PSD79 of the eye E to be inspected sequentially input from the image sensor 78. Acquires the input received signal.

Next, the line-of-sight position detection unit 218 includes the light source 99 as shown in FIG. 9 based on the captured image data D2, the light receiving signal, the imaging magnification of the known imaging optical system 30, and the light source position information. The line-of-sight position (XY coordinates) of the eye E to be inspected in the plane is sequentially calculated (step S7, corresponding to the line-of-sight position detection step of the present invention). As a result, the line-of-sight position detection unit 218 sequentially outputs the detection result of the line-of-sight position of the eye E to be inspected to the information generation unit 220.

Then, the information generation unit 220 includes the light source image capture image data D1 and the light source position information sequentially input from the light source position information acquisition unit 216, and the detection result of the line-of-sight position of the eye E to be inspected sequentially input from the line-of-sight position detection unit 218. Based on the above, relative position information 219 as shown in FIG. 10 is sequentially generated (step S8, corresponding to the information generation step of the present invention). As a result, the relative position information 219 is sequentially output from the information generation unit 220 to the display control unit 224.

The display control unit 224 is on the monitor 3 as shown in FIGS. 13 to 15 described above based on various images acquired from the fundus camera unit 2 and the like and the relative position information 219 acquired from the information generation unit 220. The shooting screen 230 and the relative position information 219 are superimposed and displayed (step S9). As a result, the examiner can determine the fixation state of the eye E to be inspected based on the relative position information 219 displayed on the monitor 3. Therefore, for example, even if the eye E to be inspected loses sight of the light source 99 (fixed light), the examiner can refer to the relative position information 219 to see where the line of sight of the eye E to be inspected is directed to the light source 99. Can be easily determined. As a result, the examiner can appropriately alert the subject. In addition, the examiner can confirm the position of the light source 99 based on the relative position information 219.

On the other hand, the assumed position determination unit 222 refers to the positional relationship information 226 based on the light source position information sequentially input from the light source position information acquisition unit 216 according to the start of external fixation of the eye E to be inspected, and the macula Em. The assumed position AP of is sequentially determined (step S10). As a result, the information of the assumed position AP is sequentially output from the assumed position determination unit 222 to the display control unit 224.

As shown in FIGS. 14 and 15 described above, the display control unit 224 of the assumed position AP sequentially input from the assumed position determining unit 222 when displaying the fundus image observation screen 230b in the photographing screen 230. Based on the information, the index MA is superimposed and displayed on the fundus image observation screen 230b (step S11). As a result, the examiner determines whether or not the eye E to be inspected sufficiently fixes the light source 99 based on the actual position of the macula Em and the index MA (assumed position AP), and the position of the macula Em is determined. It can be determined whether or not it is in the final target position. In addition, the examiner can indirectly confirm the position of the light source 99 based on the position of the index MA.

Hereinafter, the processes from step S6 to step S12 described above are repeatedly executed until the auto-optimization of step S4 described above is completed, that is, until the preparation for the main imaging of the part to be inspected is completed (NO in step S12). ). As a result, even if the eye E to be inspected loses sight of the light source 99 during alignment, focus adjustment, auto-optimization, etc., the examiner can obtain the relative position information 219 and the actual position of the macula Em and the index MA. It can be easily identified from the positional relationship. Therefore, the examiner can appropriately alert the subject. As a result, data acquisition (main imaging) of the fundus Ef can be performed while the eye E to be inspected is surely staring at the light source 99.

When step S4 is completed (YES in step S12), the fundus image (main photographed image) and the OCT image (main photographed image) of the fundus Ef are photographed by the fundus camera unit 2 and the OCT unit 100 or the like by a known method. (Step S13).

Hereinafter, when the inspection target portion is changed, the above-mentioned processes from step S1 to step S13 are repeatedly executed (step S14).

[Effect of this embodiment]
As described above, in the present embodiment, when performing external fixation, the light source position information of the light source 99 and the line-of-sight position of the eye E to be inspected are detected, and the relative position of the eye E to be inspected with respect to the light source 99 (fixation light). Since the information 219 is generated, the examiner can easily determine the fixation state of the eye E to be inspected based on the relative position information 219.

[Another Embodiment 1 of an ophthalmic apparatus]
In the ophthalmic apparatus 1 of the above embodiment, the relative position information 219 is always displayed on the monitor 3 when performing external fixation, but in the ophthalmology apparatus 1 of another embodiment 1, it depends on the fixation state of the eye E to be inspected. The display / non-display of the relative position information 219 on the monitor 3 is switched. Since the ophthalmic device 1 of the separate embodiment 1 has basically the same configuration as the ophthalmic device 1 of the above embodiment, those having the same function or configuration as the above embodiment are designated by the same reference numerals. Is omitted.

FIG. 17 is a flowchart showing a flow of inspection processing of the eye E to be inspected by the ophthalmic apparatus 1 of another embodiment 1, particularly display processing of relative position information 219 on the monitor 3. Since each process up to step S8 is the same as the above-described embodiment described with reference to FIG. 16 described above, description thereof will be omitted here.

In the display control unit 224 of another embodiment 1, based on the relative position information 219 acquired from the information generation unit 220, the deviation amount Δd (see FIG. 9) of the line-of-sight position of the eye E to be inspected with respect to the light source 99 in the optical axis vertical direction is predetermined. It is determined whether or not the threshold value becomes larger than the predetermined threshold value (step S8A). Then, when the deviation amount Δd becomes larger than the threshold value, the display control unit 224 superimposes and displays the photographing screen 230 and the relative position information 219 on the monitor 3 as in the above embodiment (NO in step S8A, step S9). ). As a result, the same effect as that of the above embodiment can be obtained.

On the other hand, when the deviation amount Δd is equal to or less than the threshold value, the display control unit 224 causes the monitor 3 to display only the shooting screen 230 and omits the display of the relative position information 219 by the monitor 3 (YES in step S8A). As a result, when the fixation state of the eye E to be inspected is good, the display of the relative position information 219 by the monitor 3 is omitted, so that the examiner may feel annoyed or the shooting screen 230 may be difficult to see. Is prevented.

[Another Embodiment 2 of the ophthalmic apparatus]
FIG. 18 is a schematic view of the ophthalmic apparatus 1 of the second embodiment. The light source position information acquisition unit 216 of the ophthalmic apparatus 1 of the above embodiment acquires the light source position information based on the light source image capture image data D1 captured by the external fixed-view camera 500, but is different as shown in FIG. In the ophthalmic apparatus 1 of the second embodiment, the light source position information is acquired by using the rotation angle detection sensor 502 provided in the external fixation lamp 96.

The ophthalmic apparatus 1 of the second embodiment is the same as the ophthalmic apparatus 1 of the above embodiment except that the external fixation lamp 96 is provided with the rotation angle detection sensor 502 instead of the external fixation lamp camera 500. It has basically the same configuration. Therefore, those having the same function or configuration as the above embodiment are designated by the same reference numerals, and the description thereof will be omitted.

As the rotation angle detection sensor 502, for example, a potentiometer is used, and the rotation angle detection sensor 502 is provided on the mounting shaft 97 of the external fixation lamp 96 and each joint 98a, respectively. Each rotation angle detection sensor 502 sequentially detects the rotation angles of all the rotation axes (mounting shaft 97 and each joint 98a) of the external fixation lamp 96 when the external fixation of the eye E to be examined is started, and each rotation. The angle detection result is sequentially output to the light source position information acquisition unit 216.

When the external fixation of the eye E to be inspected is started, the light source position information acquisition unit 216 of the second embodiment is based on the detection result of the rotation angle from each rotation angle detection sensor 502, and the measurement head 403 and the like (ophthalmic apparatus main body). ), The light source position information indicating the relative position of the light source 99 with respect to an arbitrary reference point is calculated. Then, the light source position information acquisition unit 216 gazes at the light source position information based on the detection result of the rotation angle continuously input from each rotation angle detection sensor 502 while the external fixation of the eye E to be inspected is executed. It is sequentially output to the position detection unit 218, the information generation unit 220, and the assumed position determination unit 222.

FIG. 19 is an explanatory diagram for explaining the relative position information 219A generated by the information generation unit 220 of the second embodiment. As shown in FIG. 19, the information generation unit 220 of another embodiment 2 sequentially inputs the light source position information from the light source position information acquisition unit 216 and the line-of-sight position of the eye E to be inspected sequentially input from the line-of-sight position detection unit 218. Based on the above, relative position information 219A indicating the relative position of the line-of-sight position of the eye E to be inspected with respect to the light source 99 in the direction perpendicular to the optical axis is sequentially generated.

The relative position information 219A of the second embodiment is different from the display mode of the index ML instead of using the light source captured image data D1 as the background as in the relative position information 219 of the above embodiment shown in FIG. Except for this, it is basically the same as the relative position information 219 of the above embodiment. As a result, the same effect as that of the above embodiment can be obtained.

[Other]
In each of the above embodiments, the relative position information 219 (the same applies to the relative position information 219A) shown in FIG. 10 is superimposed and displayed on the photographing screen 230 when the external fixation of the eye E to be inspected is performed. When performing peripheral fixation of E, the relative position information 219 similar to that at the time of external fixation may be generated, and the relative position information 219 may be superimposed and displayed on the photographing screen 230.

In this case, the light source position information acquisition unit 216 is provided with light source position information indicating the position (known) of the fixation hole 95 that is lit during peripheral fixation, and light source image capture image data D1 (external fixation light camera 500). Case) is output to the information generation unit 220. As a result, the information generation unit 220 can generate relative position information 219 indicating the relative position of the line-of-sight position of the eye E to be inspected with respect to the fixation hole 95 in the direction perpendicular to the optical axis. The relative position information 219 is basically the same as the relative position information 219 shown in FIG. 10, except that the index ML indicates the position of the lit fixation hole 95.

In each of the above embodiments, the relative position information 219 generated by the information generation unit 220 is displayed on the monitor 3, and the relative position information 219 is displayed from an audio output device such as a speaker (corresponding to the output unit of the present invention). Audio may be output.

The method of detecting the line-of-sight direction of the eye E to be inspected by the line-of-sight position detecting unit 218 of each of the above embodiments is not limited to the methods described with reference to FIGS. 7 and 8 described above. For example, known line-of-sight detection such as a method using the positional relationship between a reference point such as the inner corner of the eye of the examiner and a moving point such as the iris of the eye E to be inspected, and a method of detecting the movement of the eye E to be inspected using an electro-oculography sensor. The method can be used.

In each of the above embodiments, an external fixation lamp 96 having an articulated movable arm 98 has been described as an example, but if the position of the light source 99 can be changed with respect to the main body of the ophthalmic apparatus such as the measurement head 403, it is external. The shape and configuration of the fixation lamp 96 are not particularly limited.

The assumed position determination unit 222 of each of the above embodiments determines the assumed position of the macula Em as a specific part of the fundus Ef, and may determine, for example, the assumed position AP of the papilla of the fundus Ef as this specific part. In this case, an experiment or simulation is performed in advance to determine the relative position of the light source 99 (and the relative position of the eye E to be inspected) and the position of the papilla in the image pickup surface (in the fundus image) of the image sensor 35. Positional relationship information 226 indicating the correspondence relationship is created in advance.

In each of the above embodiments, a combined device of an optical interference tomometer and a fundus camera has been described as an example of the ophthalmic apparatus 1, but an external fixation lamp 96 such as an optical interference tomometer, a fundus camera, and a slit lamp 96. The present invention can be applied to various ophthalmologic devices including the above.

1 ... Ophthalmic equipment,
2 ... Fundus camera unit,
3 ... Monitor,
22 ... Objective lens,
95 ... fixation hole,
96 ... External fixation lamp,
98 ... Movable arm,
99 ... Light source,
202 ... Integrated control unit,
214 ... fixation control unit,
216 ... Light source position information acquisition unit,
218 ... Line-of-sight position detection unit,
219, 219A ... Relative position information,
220 ... Information generator,
222 ... Assumed position determination unit,
224 ... Display control unit,
226 ... Positional information,
230 ... Shooting screen,
240 ... Measuring head,
401 ... Face support member,
403 ... Measuring head,
500 ... External fixed-view camera,
502 ... Rotation angle detection sensor

Claims (8)

An ophthalmic apparatus body having an optical system that acquires an image of the eye to be inspected through an objective lens,
An external fixation lamp having a light source supported so as to be repositionable with respect to the main body of the ophthalmic apparatus.
A light source position information acquisition unit that acquires light source position information indicating the relative position of the light source with respect to the main body of the ophthalmic apparatus, and a light source position information acquisition unit.
The line-of-sight position detection unit that detects the line-of-sight position of the eye to be inspected,
When the direction perpendicular to the optical axis of the objective lens is set to the vertical direction, the light source position information acquired by the light source position information acquisition unit and the line-of-sight position detected by the line-of-sight position detection unit are used. Based on this, an information generation unit that generates relative position information indicating the vertical relative position of the line-of-sight position with respect to the light source, and
An ophthalmic device equipped with. The ophthalmic apparatus according to claim 1, wherein the external fixation lamp guides the line of sight of the eye to be inspected or a companion eye of the eye to be inspected. The ophthalmic apparatus according to claim 1 or 2, further comprising an output unit that displays or outputs the relative position information generated by the information generation unit. Based on the relative position information generated by the information generation unit, the output unit displays the relative position information when the amount of deviation of the line-of-sight position with respect to the light source in the vertical direction becomes larger than a predetermined threshold value. Alternatively, the ophthalmologic apparatus according to claim 3, wherein the audio output is executed and the display of the relative position information or the audio output is omitted when the deviation amount is equal to or less than the threshold value. A face support member that supports the subject's face at a position facing the ophthalmic apparatus main body, and
A camera provided on the face side of the face support member facing the ophthalmic apparatus main body and continuously photographing the light source and the ophthalmic apparatus main body.
With
The ophthalmic apparatus according to any one of claims 1 to 4, wherein the light source position information acquisition unit acquires the light source position information based on the captured image of the light source and the main body of the ophthalmic apparatus captured by the camera. The external fixation lamp
A movable arm having a tip and a proximal end, wherein the light source is provided on the distal end side and the proximal end side supports a face of a subject, or a movable arm attached to the ophthalmic apparatus main body.
A rotation angle detection sensor that detects the rotation angles of all the rotation axes of the movable arm, and
With
The ophthalmic apparatus according to any one of claims 1 to 4, wherein the light source position information acquisition unit acquires the light source position information based on the detection result of the rotation angle detection sensor. The optical system acquires a fundus image of the fundus of the eye to be inspected through the objective lens.
A monitor that displays the fundus image acquired by the optical system and the relative position information generated by the information generation unit.
Based on the light source position information acquired by the light source position information acquisition unit, the assumed position of the specific part of the fundus is assumed in the fundus image when it is assumed that the eye to be inspected is staring at the light source. Assumed position determination unit to determine and
A display control unit that superimposes and displays an index indicating the assumed position determined by the assumed position determining unit on the fundus image displayed on the monitor.
The ophthalmic apparatus according to any one of claims 1 to 6. A method of operating an ophthalmic apparatus including an ophthalmic apparatus main body having an optical system for acquiring an image of an eye to be inspected through an objective lens, and an external fixation lamp having a light source supported so as to be repositionable with respect to the ophthalmic apparatus main body. In
A light source position information acquisition step for acquiring light source position information indicating the relative position of the light source with respect to the ophthalmic apparatus main body, and a light source position information acquisition step.
The line-of-sight position detection step for detecting the line-of-sight position of the eye to be inspected,
When the direction perpendicular to the optical axis of the objective lens is set to the vertical direction, the light source position information acquired in the light source position information acquisition step and the line-of-sight position detected in the line-of-sight position detection step Based on the information generation step of generating relative position information indicating the vertical relative position of the line-of-sight position with respect to the light source,
How to operate an ophthalmic device with.