JP2021087874A - Ophthalmologic examination apparatus - Google Patents

Abstract

To provide a new technique for evaluating the change in the eye position with a simple structure.SOLUTION: An ophthalmologic examination apparatus comprises: first and second target presentation units which present targets to left subject eye and right subject eye respectively; an imaging unit which images an anterior eye part of each of the left subject eye and right subject eye; a control unit which controls at least one of the first and second target presentation units so as to switch the target presented on at least one of the left subject eye and right subject eye; and an image analyzing unit which analyzes the images of the anterior eye part acquired by the imaging unit before and after the switching of the target by the control unit to obtain the change in the eye position of at least one of the left subject eye and right subject eye. The control unit switches to the second target that has the small visual angle and the weak fusion stimulus after presenting the first target that has the large visual angle and the strong fusion stimulus.SELECTED DRAWING: Figure 4

Description

The present invention relates to an ophthalmic examination device.

Misalignment of the eye position causes poor visual function and eyestrain, and may be corrected by a prism lens or the like. It is possible to evaluate the presence or absence of such misalignment by a cover test, a cover uncover test, or the like. The cover test is a test for evaluating the change in the eye position of the other eye when the subject is binocularly viewed and one eye is shielded. The cover uncover test is a test for evaluating the change in the eye position of the shielded eye when the shield is removed from the state in which one eye is shielded.

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

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

Japanese Patent No. 501144

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

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

The ophthalmologic examination apparatus according to the embodiment includes a first visual target presenting unit, a second visual target presenting unit, an imaging unit, a control unit, and an image analysis unit. The first optotype presenting unit presents an optotype to the left eye to be inspected. The second optotype presenting unit presents an optotype to the right eye to be inspected. The imaging unit photographs the anterior segment of each of the left eye and the right eye. The control unit controls at least one of the first optotype presenting unit and the second optotype presenting unit so as to switch the optotype presented to at least one of the left eye and the right eye. The control unit presents the first target with a large viewing angle and strong fusion stimulus, and then switches to the second target with a small viewing angle and weak fusion stimulus.

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

The schematic diagram which shows the appearance structure of the ophthalmologic examination apparatus which concerns on embodiment. The schematic diagram which shows the structural example of the ophthalmic examination apparatus which concerns on embodiment. The schematic diagram which shows the structural example of the optical system of the ophthalmologic examination apparatus which concerns on embodiment. The schematic diagram which shows the structural example of the control system of the ophthalmic examination apparatus which concerns on embodiment. The operation explanatory drawing of the ophthalmologic examination apparatus which concerns on embodiment. The operation explanatory drawing of the ophthalmologic examination apparatus which concerns on embodiment. The flow chart of the operation example of the ophthalmologic examination apparatus which concerns on embodiment. The flow chart of the operation example of the ophthalmologic examination apparatus which concerns on embodiment. The operation explanatory drawing of the ophthalmologic examination apparatus which concerns on the 1st modification of embodiment. The operation explanatory drawing of the ophthalmologic examination apparatus which concerns on the 1st modification of embodiment. The operation explanatory drawing of the ophthalmologic examination apparatus which concerns on the 1st modification of embodiment. The operation explanatory drawing of the ophthalmologic examination apparatus which concerns on the 1st modification of embodiment. The operation explanatory drawing of the ophthalmologic examination apparatus which concerns on the 1st modification of embodiment. The operation explanatory drawing of the ophthalmologic examination apparatus which concerns on the 1st modification of embodiment. The operation explanatory drawing of the ophthalmologic examination apparatus which concerns on the 1st modification of embodiment. The operation explanatory drawing of the ophthalmologic examination apparatus which concerns on the 2nd modification of embodiment.

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

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

The ophthalmologic examination apparatus 1 can perform eye position examinations such as a cover test and a cover uncover test by using an optical system that presents an optotype to the eye to be inspected in a subjective examination. The cover test is a test for evaluating the change in the eye position of the other eye when the subject is binocularly viewed and one eye is shielded. The cover uncover test is a test for evaluating the change in the eye position of the shielded eye when the shield is removed from the state in which one eye is shielded.

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

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

The ophthalmologic examination device 1 includes an optometry table 3. The optometry table 3 is a desk for supporting the measurement head 100 and placing the controller for the examiner or the controller for the subject. The optometry table 3 is installed while being supported on the floor by the support portion 4. The height of the optometry table 3 can be adjusted up and down.

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

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

A stand or the like for storing the measuring head 100 may be separately provided, and the measuring head 100 may be arranged at a stable position by the above-mentioned rotation or vertical movement. In this case, it is possible to continuously reduce the load on the lateral arm 6 due to the weight of the measuring head 100.

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

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

[Measurement head]
The measuring head 100 includes a left eye inspection unit 120L and a right eye inspection unit 120R. The left eye examination unit 120L and the right eye examination unit 120R are formed with optometry windows 130L and 130R, respectively. The left eye of the subject (the left eye to be examined) is examined through the optometry window 130L. The subject's right eye (right eye) is examined through the optometry window 130R.

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

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

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

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

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

By rotating the left eye inspection unit 120L and the right eye inspection unit 120R by the rotating mechanisms 112L and 112R, the orientations of the left eye inspection unit 120L and the right eye inspection unit 120R are relatively changed. Is possible. For example, the left eye examination unit 120L and the right eye examination unit 120R are rotated in opposite directions around the eye rotation points of the left and right eyes of the subject. As a result, the eye to be inspected can be dissected and congested.

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

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

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

The left eye examination unit 120L includes a first visual target display unit 122L, a first objective measurement unit 123L, and a first imaging unit 124L. The first optotype presenting unit 122L selectively presents a plurality of optotypes to the left eye to be inspected. The first objective measurement unit 123L is used to measure the objective refraction of the left eye to be inspected. The first imaging unit 124L photographs the anterior segment of the left eye to be inspected. The left eye examination unit 120L may be provided with an optical element application unit that selectively applies a plurality of optical elements that can be arranged between the left eye to be inspected and the deflection member P described later to the left eye to be inspected. ..

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

The left eye inspection unit 120L and the right eye inspection unit 120R include an optical system as shown in FIG. By operating the optical system of the left eye inspection unit 120L and the right eye inspection unit 120R, the left eye examination EL and the right eye examination unit ER can be subjected to subjective examination using the optotype presenting unit and others. It is configured to perform objective refraction measurement using the optometry unit and the imaging unit. The examiner and the examinee perform the inspection by appropriately operating the controller and the like. In addition, each of the left eye inspection unit 120L and the right eye inspection unit 120R has an eye position based on the analysis results of the image of the eye to be inspected obtained by the cover test and the uncover test using the optotype presenting section and the imaging section. It is configured to perform the calculation of changes in.

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

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

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

The optotype presenting optical system 10L is an optical system for projecting an optotype onto the fundus Ef of the left eye subject EL. The optotype presenting optical system 10L includes an LCD (Liquid Crystal Display) 11, a moving lens 70, and a reflection mirror M. The LCD 11 displays various optotypes (charts) for optometry and eye position examination. The LCD 11 includes a fixation target composed of a landscape chart, a visual acuity chart such as a Randold ring for visual acuity test, a cross cylinder test chart, a radiation chart for astigmatism test, a cross chart for oblique position test, a red-green test chart, which will be described later. Objectives such as charts for eye position examination are selectively displayed. By turning off the LCD 11 on which the optotype was presented (turning off the display), a state equivalent to a state in which a shielding member is arranged in front of the left optometry EL in which the examination is performed through the optometry window 130L is reproduced. It is possible. In the optotype display optical system 10L, instead of the LCD 11, any one of an electronic display device using EL (electroluminescence) or a plurality of optotypes drawn on a rotating glass plate or the like is appropriately mounted on the optical axis. An arrangement (turret type) may be provided.

The moving lens 70 is movable in the optical axis direction of the optotype display optical system 10L. The moving lens 70 is moved by the drive mechanism 70L. The drive mechanism 70L moves the moving lens 70 in response to a control signal from the control device 200. Thereby, it is possible to change the sphericality added to the left eye subject EL. For example, by moving the moving lens 70 in the optical axis direction by an amount of movement corresponding to the refractive power of the left eye EL to be inspected at the time of reflex measurement, it is possible to perform fixation cloud fog on the left eye to be inspected EL. In addition, at the time of subjective examination, the optotype can be presented at a position corresponding to the far point of the eye to be inspected, a position corresponding to the near point, or an arbitrary position in between, and the examination can be performed at an arbitrary examination distance. it can.

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

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

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

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

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

The reflex measurement optical system 40L is an optical system for performing reflex measurement (objective refraction measurement) of the left eye subject EL. The light beam for reflex measurement emitted by the reflex measurement optical system 40L is reflected by the beam splitter BS2, reflected by the beam splitter BS1, passes through the objective lens 60, and is directed to the fundus Ef of the left eye subject EL by the deflection member P. Is biased. The reflected light from the fundus of the light flux for reflex measurement projected on the left eye EL is returned by the same path as the incident path, passes through the beam splitters BS1 and BS3, and is received by the CCD21 of the photographing optical system 20L.

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

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

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

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

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

A computer device (not shown) may be connected to the ophthalmologic examination device 1. In this case, the computer device is used as a console of the ophthalmic examination device 1 and is used to accumulate and manage the examination results by the ophthalmic examination device 1. It is also possible to configure the CPU and storage device of this computer device as the control device 200.

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

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

By controlling the optotype presenting optical systems 10L and 10R, the control device 200 can switch the optotype so as to weaken the fusion stimulus. For example, as shown in FIG. 5, the control device 200 displays the same cross charts FL and FR on the LCD 11 on both the left eye EL and the right eye ER, and then displays only the optotype FR. Erase from the screen of LCD 11. That is, after turning on the optotypes FL and FR presented to both the left eye test EL and the right eye test ER, only the optotype FR is turned off. More specifically, the control device 200 presents an optotype on which a cross pattern (predetermined pattern) is drawn on a predetermined background (for example, a background on a white background), and then forms a background optotype composed of the predetermined background. Switch. As a result, it is possible to reproduce a state equivalent to a state in which the shielding member is arranged in front of the right eye subject ER after the subject is binocularly viewed. The control device 200 can turn off only the optotype FL or turn off the optotype FL and FR at the same time.

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

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

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

The calculation unit 210 includes an image analysis unit 210A. The image analysis unit 210A analyzes the images of the anterior segment acquired by the photographing optical systems 20L and 20R before and after the switching of the optotype by the control device 200 (control unit 201), respectively, to allow the left eye to be inspected. The change in the eye position of at least one of the EL and the right eye subject ER is determined. The image analysis unit 210A obtains, for example, the rotation angle θ of the visual axis centered on the eyeball rotation point O as a change in the eye position.

The image analysis unit 210A can obtain the rotation angle θ based on the amount of movement of the position of the bright spot image formed by the spot light incident on the eyeball in the image of the anterior eye portion before and after the switching of the optotype. Is. As shown in FIG. 6, when a parallel light flux is incident on the eyeball, a spot-shaped virtual image (Purkinje image) is formed at the position Q (half the curvature of the cornea, R / 2) inside the cornea. Since the center of curvature R of the cornea and the eyeball rotation point O are different, when the eyeball is rotated around the eyeball rotation point O at a rotation angle θ, the position Q of the bright spot image in the image of the anterior segment is shown in FIG. To move. For example, as shown in FIG. 6, it is assumed that the eye position of the eye to be inspected changes when the optotype is turned off with respect to the eye to be inspected whose eye position is normal while the optotype is presented. In this case, the image analysis unit 210A specifies the amount of movement d of the position Q of the bright spot image from the images of the anterior segment of the eye before and after the switching of the optotype. For example, the image analysis unit 210A identifies the position Q of the bright spot image with reference to the featured portion in the image of the anterior segment of the eye before and after the switching of the optotype, and the displacement of these positions is determined by the movement amount d. Identify as.

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

From the equation (1), the image analysis unit 210A can obtain the rotation angle θ. The distance L from the apex of the cornea to the rotation point O of the eyeball may be a predetermined value (for example, 13 mm, which is an average value). Alternatively, this value may be input when the actual distance is known in the measurement by another device. For the curvature r of the cornea, a value obtained by kerato measurement can be used.

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

In addition to the above-mentioned control, the control device 200 executes all operation control and data processing of the ophthalmologic examination device 1.

The control device 200 can be connected to the examiner controller 300 and the examinee controller 310 via a wired or wireless communication path, respectively. The control device 200 controls each part of the ophthalmologic examination device 1 by receiving an operation signal corresponding to the operation content for the examiner controller 300 and the examinee controller 310. The control device 200 can display an operation screen, various information for performing measurement, and the like on the display unit of the examiner controller 300 and the examinee controller 310.

Since the operating principle of alignment using the above-mentioned optical system, the measurement principle of subjective examination, the measurement principle of objective measurement, the measurement principle of corneal shape, and the like are already known, detailed description thereof will be omitted.

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

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

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

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

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

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

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

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

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

(S5)
The control device 200 executes the reflex measurement as described above for each of the left eye test EL and the right eye test ER by the reflex measurement optical systems 40L and 40R. The results of the ref measurement for each of the left eye-tested EL and the right-handed eye-tested ER are stored in the storage unit 202.

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

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

(S8)
When it is determined to perform the distance eye position test (S7: Y), the control device 200 executes the distance eye position test. The details of S8 will be described later.

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

(S10)
When it is determined that the near eye position test is to be performed (S9: Y), the control device 200 executes the near eye position test. Details of S10 will be described later. S10 is substantially the same as S8 as described later.

(S11)
When the near-eye position test is completed, or when it is determined in S9 that the near-eye position test is not performed (S9: N), the control device 200 is set by the image analysis unit 210A as shown in FIG. The change in is quantitatively obtained, and evaluation information is generated based on the obtained rotation angle θ.

(S12)
The control device 200 causes the display unit of the examiner controller 300 or the subject controller 310 to display the evaluation information regarding the rotation angle obtained in S11 and the change in the eye position based on the obtained rotation angle. This completes the operation of the ophthalmologic examination device 1 (end).

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

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

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

(S23)
Subsequently, the ophthalmologic examination device 1 rotates at least one of the left eye examination unit 120L and the right eye examination unit 120R inward around the rotation axis. As a result, the target presented in S22 is visually recognized as if the subject is binocularly looking at the same target 5 m away.

(S24)
The control device 200 controls the alignment optical systems 30L and 30R to turn on the XY spot light LED, so that the spot light is incident on both the left eye test EL and the right eye test ER. Further, the control device 200 controls the alignment optical systems 31L and 31R to start acquiring images of the anterior segment of the left eye subject EL and the anterior segment of the right eye subject ER.

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

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

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

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

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

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

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

(S32)
When the predetermined number of times is completed (S31: Y), the control device 200 stops taking a moving image on the anterior segment of both the left eye test EL and the right eye test ER by controlling the photographing optical systems 20L and 20R. Let me. This completes the operations of S8 and S10 (end). The alignment state may be confirmed before each test (before the lights are turned off in the cover test and before the lights are turned on in the uncover test), and if the alignment is deviated by a predetermined amount or more, the alignment operation may be performed.

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

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

Further, although the case of recording the moving image of the anterior segment of the eye is described in FIG. 8, the still image of the anterior segment of the eye before and after the switching of the optotype may be recorded. In addition to the method of measuring the displacement amount of the bright spot image before and after each test, it is also possible to perform the alignment before the test and perform the alignment again after the test to obtain the displacement amount from the movement amount of the measurement head before and after the test. Good. Further, the same inspection can be performed at any position other than the position corresponding to the far point and the position corresponding to the near point.

As described above, according to the embodiment, the state in which the shielding member is arranged on the front surface of one eye can be reproduced by turning off or turning on the optotype displayed on the LCD 11, and thus the shielding member. And there is no need to provide a mechanism to insert and remove it. In addition, it is possible to confirm the change in the eye position of the eye to be inspected on the shielded side, which has been difficult to confirm because of the shield.

In addition, the moving lens 70 can be moved to clearly present the target to the subject without wearing glasses or a trial frame. As a result, it becomes possible to make the subject work the fusion reliably, and it is possible to evaluate the change in the eye position with high accuracy.

Further, since the examination is performed by the examinee looking into the optometry windows 130L and 130R, the examinee can concentrate on the examination without the examiner being in the field of view. For example, it is possible to avoid a state in which fixation becomes unstable when the examiner enters the field of view of the subject.

Since it is possible to acquire an image of the anterior segment of the subject regardless of whether the optotype is turned off or on, the examiner does not need to observe the change in eye position from the front of the subject and observes the image. be able to. For example, it is possible to observe a change in the eye position of the shielded eye, which is the same as when the shielding member is arranged on the front surface. Further, by analyzing the acquired image, it is possible to quantitatively evaluate not only the presence or absence of the deviation of the eye position but also the change (amount of deviation) of the eye position.

Since the imaging optical systems 20L and 20R photograph the anterior segment of the eye to be inspected from the front, even minute changes in the eye position can be confirmed. Further, since it is possible to acquire a moving image in which the change in the eye position before and after the switching of the optotype is visualized, there is no oversight by the examiner and it is not necessary to repeat the examination many times. Moreover, it is not necessary to observe the change in the eye position in real time.

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

[Modification example]
(First modification)
It is possible to evaluate the change in eye position from various viewpoints depending on the mode of changing the pattern presented to the eye to be inspected.

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

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

9A to 9D show a case where the optotype FR is switched, but the optotype FL can be switched in the same manner. The optotypes shown in FIGS. 9A to 9D may be switched simultaneously for both eyes.

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

FIG. 10A shows a case where both eyes can be simultaneously switched from an optotype having a ring-shaped pattern drawn before switching to another optotype having a different size (an optotype having a smaller size). As shown in FIG. 10A, the optotype after switching may have the same pattern as the optotype before switching.

FIG. 10B shows a case where both eyes are simultaneously switched from an optotype composed of a plurality of rectangular frame patterns having the same central portion and different sizes to each other before switching to an optotype whose outside is erased. Although FIG. 10B has been described as an example of a plurality of rectangular frame patterns having the same central portions and different sizes from each other, a plurality of ring-shaped patterns having the same central portions and different sizes from each other may be used.

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

In any of FIGS. 9A to 9E, 10A, and 10B, after presenting a target having a large viewing angle and a strong fusion stimulus, the target is switched to a target having a small viewing angle and a weak fusion stimulus. In particular, by switching the optotypes as shown in FIGS. 10A and 10B, the change in the eye position can be evaluated each time the optotype is switched, so that the degree of the change in the eye position can be evaluated.

9A-9E, 10A, and 10B show an example of switching the optotype. For example, the optotype may be switched by reversing the optotype before switching. It is also possible to switch to a target having a small viewing angle after presenting a target having a large viewing angle without erasing a part of the target.

As described above, since the optotype can be switched separately for each of the left eye test EL and the right eye test ER, it becomes possible to observe various changes in the eye position, which was difficult in the past.

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

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

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

Assuming that the distance from the corneal apex to the eyeball rotation point O is L and the distance from the corneal apex to the pupil center position Q1 is N, the movement amount d1 of the pupil center position Q1 is expressed by the equation (2). To.

From the equation (2), the image analysis unit 210A can obtain the rotation angle θ1. The distance L from the apex of the cornea to the rotation point O of the eyeball may be a predetermined value (for example, 13 mm, which is an average value). The distance N from the apex of the cornea to the position Q1 at the center of the pupil may be a predetermined value (for example, 3 mm, which is an average value). Alternatively, in the measurement by another device, if the actual distances of L and Q1 are known, this value may be input.

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

The ophthalmologic examination apparatus (ophthalmic examination apparatus 1) according to the embodiment includes an optotype presenting unit (first optotype presenting unit 122L, second optotype presenting unit 122R, optotype presenting optical system 10L, 10R) and an imaging unit (imaging unit (10L, 10R). It includes a first photographing unit 124L, a second photographing unit 124R, an imaging optical system 20L, 20R), a control unit (control device 200 or control unit 201), and an image analysis unit (image analysis unit 210A). The optotype presenting unit presents an optotype to each of the left eye (left eye EL) and the right eye (right eye ER). The imaging unit photographs the anterior segment of each of the left eye and the right eye. The control unit controls the optotype presenting unit so as to switch the optotype presented to at least one of the left eye and the right eye. The image analysis unit analyzes the images of the anterior eye portion acquired by the imaging unit before and after the switching of the optotype by the control unit, so that the image analysis unit has at least one eye position of the left eye and the right eye. Seeking change.

According to such a configuration, the fusion stimulus can be changed by switching the optotype, so that the eye position can be changed with a simple configuration without providing a shielding member or a mechanism for inserting / removing the shielding member. It becomes possible to evaluate. In addition, since the imaging unit can acquire front images of the anterior segment of the eye before and after switching the optotype, the examiner does not need to observe the change in the eye position from the front of the subject, and the eye position. It is also possible to confirm a slight change in. In addition, since the optotype can be switched separately for each of the left eye and the right eye, various changes in eye position are compared with the case where a common optotype is presented to both the left eye and the right eye. Can be observed.

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

With such a configuration, it becomes possible to obtain the change in the eye position when the optotype is switched so that a part of the pattern is erased, and the change in the eye position is evaluated from a new viewpoint. Will be possible.

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

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

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

According to such a configuration, it is possible to obtain a change in the eye position when the target is switched to an optotype having the same pattern as the target between switching and a different size, and the eye position can be obtained from a new viewpoint. It will be possible to evaluate changes.

Further, in the ophthalmologic examination apparatus according to the embodiment, the control unit may switch the optotypes a plurality of times, and the image analysis unit may request a change in the eye position each time the control unit switches the optotypes. Good.

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

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

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

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

According to such a configuration, the optotypes are switched so as to weaken the fusion stimulus. Therefore, it is necessary to evaluate the presence or absence and degree of change in the eye position of the eye to be examined in which the switched optotypes are presented. Can be done.

Further, in the ophthalmologic examination apparatus according to the embodiment, the control unit may present the optotype at a position corresponding to a far point, a position corresponding to a near point, or an arbitrary position in between.

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

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

Further, the ophthalmologic examination apparatus according to the embodiment can perform distance examination, near vision examination, contrast examination, glare examination and the like as subjective examinations, and objective refraction measurement and corneal shape measurement as objective measurements. , The device may be capable of performing OCT measurement and the like. In the OCT measurement, eyeball information representing the structure of the eye to be inspected, such as axial length, corneal thickness, anterior chamber depth, and lens thickness, may be acquired.

The configuration described above is only an example for preferably carrying out the present invention. Therefore, any modification (omission, substitution, addition, etc.) within the scope of the gist of the present invention can be appropriately applied.

1 Ophthalmic examination device 100 Measuring head 110 Moving mechanism system 111 Horizontal movement mechanism 112L, 112R Rotation mechanism 113L, 113R Vertical movement mechanism 120L Left eye inspection unit 120R Right eye inspection unit 122L First visual target display unit 122R Second visual Display unit 123L 1st objective measurement unit 123R 2nd objective measurement unit 124L 1st imaging unit 124R 2nd imaging unit 200 Control device 210A Image analysis unit

Claims (5)

The first optotype presenting part that presents the optotype to the left eye to be inspected,
A second optotype presenting section that presents an optotype to the right eye to be inspected,
An imaging unit that photographs the anterior segment of each of the left eye and the right eye,
A control unit that controls at least one of the first optotype presenting unit and the second optotype presenting unit so as to switch optotypes presented to at least one of the left eye and the right eye.
By analyzing the image of the anterior eye portion acquired by the photographing unit before and after the switching of the optotype by the control unit, at least one eye position of the left eye and the right eye is examined. An image analysis unit that seeks changes,
Including
The control unit is an ophthalmologic examination device that presents a first target having a large viewing angle and a strong fusion stimulus, and then switches to a second target having a small viewing angle and a weak fusion stimulus. The control unit executes switching of the optotype a plurality of times.
The ophthalmologic examination apparatus according to claim 1, wherein the image analysis unit obtains a change in the eye position each time the control unit switches the optotype. The first optotype presenting unit presents an optotype to the left eye to be inspected via a moving lens that can move in the direction of the optical axis.
The second optotype presenting unit presents an optotype to the right eye to be inspected via a moving lens that can move in the direction of the optical axis.
The control unit moves the moving lens in at least one of the first optotype presenting unit and the second optotype presenting unit to any of two or more positions on the optical axis, and then displays the first optotype. The ophthalmologic examination apparatus according to claim 1 or 2, wherein at least one of the unit and the second visual target presenting unit is controlled. The ophthalmologic examination apparatus according to claim 3, wherein the two or more positions include a position corresponding to a far point, a position corresponding to a near point, or an arbitrary position in between. The control unit moves the moving lens in at least one of the first optotype presenting unit and the second optotype presenting unit to any of two or more positions on the optical axis, and then the lens position. The ophthalmologic examination according to claim 3 or 4, wherein the first visual target presenting portion and the second visual target presenting portion are rotated inward so that the optotype can be visually recognized at a position corresponding to the above. apparatus.

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