JP2021146184A - Ophthalmologic apparatus and measurement method - Google Patents

Abstract

To provide an ophthalmologic apparatus capable of changing the examination distance and the presentation condition of an optotype as desired, quickly and easily performing measurement of the eye characteristics of an eye to be examined under various examination distances and presentation conditions to improve the measurement efficiency.SOLUTION: An ophthalmologic apparatus 10 comprises a measurement optical system 21 including an optotype projection system 32, an eye refractive power measurement system 33, a kerato system 37, and the like, and a control unit 26. The optotype projection system 32 presents an optotype at a presentation position separated from an eye E to be examined by a predetermined examination distance under a predetermined presentation condition. The control unit 26 controls the optotype projection system 32 so as to present the optotype at each examination distance under a plurality of different presentation conditions while changing the examination distance from a far point distance to a near point distance, and measures the eye characteristics of the eye E to be examined at each examination distance for each of the different presentation conditions.SELECTED DRAWING: Figure 5

Description

The present invention relates to an ophthalmic apparatus and a measuring method.

For the treatment of cataracts and correction of refractive power, a technique of surgically inserting an artificial lens called an intraocular lens (IOL) into the eye is known (see, for example, Patent Document 1). For the treatment of cataracts, the lens is removed from the capsular bag and an intraocular lens is inserted into the capsular bag. In addition to the type that is inserted into the crystalline lens sac, the intraocular lens is a crystalline intraocular lens (fake) that is inserted and fixed between the lens and the iris and between the iris and the crystalline lens without removing the crystalline lens. Various things such as IOL, Phakic IOL) have been developed.

The intraocular lens can focus on a plurality of distances such as apogee, near point, and even midpoint so that the wearer of such an intraocular lens can carry out daily life without any trouble. .. There are also intraocular lenses that can correct astigmatism. Therefore, in order to grasp whether the intraocular lens is functioning properly, the eye characteristics of the eye to be inspected are measured at a plurality of inspection distances (distance from the eye to be inspected to the optotype) from the far point distance to the near point distance. Is desirable. In addition, in order to grasp the eye characteristics of the eye to be inspected in more detail, such as how it looks at night, a contrast test that measures the contrast sensitivity of the eye to be inspected by changing the contrast of the optotype, or irradiating the eye to be inspected with light. Various inspections such as a glare inspection for inspecting in a dazzling state (glare) are performed (see, for example, Patent Document 2).
It is desirable that these tests also measure the appearance at various test distances.

In addition, as a method for correcting the refractive force of the eye to be inspected, a treatment method called orthokeratology, in which a special contact lens is worn in the eye before going to bed and the shape of the cornea is changed during sleep to correct myopia, and the cornea There is also a LASIK treatment that corrects the cornea by irradiating it with laser light. Further, some commonly used soft contact lenses, hard contact lenses, and the like have functions such as bifocals and astigmatism correction. Regarding the ocular characteristics of the eye to be inspected corrected by these, it is desirable to be able to perform a plurality of examinations at various distances and using various optotypes.

However, when measuring eye identification by changing the examination distance, the subject needs to measure by approaching the visual acuity chart on which the optotype is displayed, or conversely, by measuring at a distance, which takes time. At the same time, the subject may become tired and affect the measurement efficiency and measurement accuracy. In addition, the focal length is set variously depending on the type of intraocular lens or the like, and the contrast sensitivity or the like may also differ. Therefore, it is desired to develop a technique capable of efficiently performing various examinations by changing the examination distance and the display condition of the optotype according to the characteristics of the intraocular lens and the correction state of the eye to be inspected.

Japanese Unexamined Patent Publication No. 2020-22762 Japanese Unexamined Patent Publication No. 2019-136569

The present invention has been made in view of the above circumstances, and the examination distance and the presentation conditions of the optotype can be changed as desired, and the eye characteristics of the eye to be inspected under various examination distances and presentation conditions can be quickly changed. It is an object of the present invention to provide an ophthalmic apparatus capable of easily performing and improving measurement efficiency.

In order to achieve the above object, the ophthalmic apparatus of the present invention comprises an objective measurement optical system for measuring eye characteristics of an eye to be inspected, and a visual acuity that presents an optotype to the eye to be inspected at a predetermined presentation position under predetermined presentation conditions. It includes a target projection system, the objective measurement optical system, and a control unit that controls the target projection system, and the presentation conditions are a visual acuity value, an inspection distance from the eye to be inspected to the presentation position, and a type of inspection. The control unit changes the inspection distance from a far point distance to a near point distance, including at least one of the type of the optotype, the magnification of the optotype, and the display mode of the optotype. , The optotype projection system is controlled so as to present the optotype under a plurality of different presentation conditions at each inspection distance, and the eye characteristics of the eye to be inspected for each different presentation condition at each inspection distance. It is characterized by measuring.

With the ophthalmic apparatus configured in this way, the examination distance and the presentation conditions of the optotype can be changed as desired, and the eye characteristics of the eye to be examined under various examination distances and presentation conditions can be quickly and easily performed. It is possible to improve the measurement efficiency.

It is a perspective view which shows the whole structure of the ophthalmic apparatus which concerns on this embodiment. It is a block diagram which shows the whole structure of the ophthalmic apparatus which concerns on this embodiment. It is a figure for demonstrating the relationship between the posture of the measuring head of the ophthalmic apparatus which concerns on this embodiment, and the visual axis, and (a) shows the posture of the measuring head when visually recognizing infinity with binocular vision. , (B) show the posture of the measuring head when the predetermined distance is visually recognized by binocular vision. It is a block diagram which shows the structure of the control system of the ophthalmic apparatus which concerns on this embodiment. It is a figure which shows the detailed structure of the measurement optical system for the right eye of the ophthalmic apparatus which concerns on this embodiment. It is a figure which shows an example of the optotype (multi-ratio contrast optotype) displayed on the display at an inspection distance of a far point distance, a midpoint distance, and a near point distance. It is a figure which shows the other example of the optotype shown on the display, (a) shows the single ratio contrast optotype, (b) shows the ETDR optotype, (c) shows the single ratio contrast optotype for night inspection. .. It is a figure which shows an example of the graph of the measurement result displayed on the display surface. It is a flowchart for demonstrating an example of the operation of the ophthalmic apparatus which concerns on this embodiment. It is a figure for demonstrating the display state of the optotype on the display of the ophthalmic apparatus which concerns on a modification, and (a) is the state which the mark corresponding to the tap operation of a subject is superposed on the optotype. And the state in which the measurement result is displayed, and (b) shows the state in which the mark corresponding to the drag operation of the subject is superimposed on the optotype and the state in which the measurement result is displayed. It is a figure which shows the example of the optotype for stereoscopic inspection, (a) shows the ETDR optotype for stereoscopic inspection, and (b) shows the optotype for precision stereoscopic inspection. It is a figure which shows the display example of the optotype for precision stereoscopic inspection on the display, (a) shows the display example on the display for the left eye, (b) shows the display example on the display for the right eye. .. It is a figure for demonstrating an example of the inspection using the multi-ratio contrast optotype and the optotype for precision stereoscopic inspection. It is a figure for demonstrating another different modification in which a control part determines the correctness of the input input from a subject input part, and the state in which a subject is responding by a tap operation, and the correctness of a response. Indicates the state in which the measurement result based on is displayed.

Hereinafter, the ophthalmic apparatus according to the present embodiment will be described. First, the overall configuration of the ophthalmic apparatus 10 according to the present embodiment will be described with reference to FIGS. 1 to 5. The ophthalmic apparatus 10 of the present embodiment is a binocular open type ophthalmic apparatus capable of simultaneously measuring the characteristics of the eye to be inspected while the subject has both left and right eyes open. In the ophthalmic apparatus of the present embodiment, it is possible to inspect one eye at a time by shielding one eye or turning off the fixation target. Further, the ophthalmic apparatus is not limited to the binocular open type, and the present invention can be applied to an ophthalmic apparatus that measures the characteristics of each eye.

In addition, the ophthalmic apparatus 10 of the present embodiment presents the eye characteristics of the eye to be inspected in a corrected state, such as an eye to be inspected into which an intraocular lens (IOL) is inserted, at various examination distances (presentation of an optotype from the eye to be inspected). It is a device that measures under various measurement conditions (inspection type, procedure, target presentation conditions, etc.) with (distance to position). Examples of intraocular lenses include single-focus intraocular lenses, multifocal intraocular lenses, progressive intraocular lenses and other bifocal intraocular lenses (multifocal IOL), and intraocular lenses with dyskinesia correction function (premium IOL). Examples thereof include, but are not limited to, a crystalline intraocular lens (fake IOL). In addition, using this ophthalmic apparatus 10, the eye to be inspected after orthokeratology treatment with a special contact lens, the eye to be inspected after laser treatment, the eye to be inspected with soft contact lenses and hard contact lenses, and the subject with eyeglasses. It is also possible to measure the ocular characteristics of optometry.

The ophthalmic apparatus 10 of the present embodiment performs an arbitrary subjective test, and can also perform an objective test. In the subjective test, a target is presented to the subject at a predetermined presentation position, and the test result is acquired based on the response of the subject to the target. This subjective test includes a subjective refraction measurement such as a distance test, a medium-sized test, a near-field test, a contrast test, and a glare test, and a visual field test. In the objective test, the eye to be inspected is irradiated with light, and information (eye characteristics) regarding the eye to be inspected is measured based on the detection result of the return light. This objective test includes measurement for acquiring the characteristics of the eye to be inspected and photographing for acquiring an image of the eye to be inspected. Furthermore, for objective examination, objective refraction measurement (ref measurement), corneal shape measurement (kerato measurement), tonometry, fundus photography, optical coherence tomography (hereinafter referred to as "OCT") are used. There are tomography (OCT photography), measurement using OCT, etc.

[Overall configuration of ophthalmic equipment]
As shown in FIG. 1, the ophthalmic apparatus 10 of the present embodiment includes a base 11, an optometry table 12, a support column 13, an arm 14, a drive mechanism (drive unit) 15, and a pair of measurement heads 16. In the ophthalmic apparatus 10, the subject facing the optometry table 12 acquires information on the subject's eye to be inspected while the subject is in contact with the forehead portion 17 provided between the measurement heads 16. In addition, as shown in FIG. 1 throughout the present specification, the X-axis, the Y-axis and the Z-axis are taken, and when viewed from the subject, the left-right direction is the X direction, the vertical direction (vertical direction) is the Y direction, and the X direction. And the direction orthogonal to the Y direction (the depth direction of the measuring head 16) is the Z direction.

The optometry table 12 is a desk on which a display unit / examiner controller (hereinafter, simply referred to as “inspector controller”) 27 and a subject controller 28, which will be described later, are placed, or an object used for optometry is placed. Yes, it is supported by the base 11. The optometry table 12 may be supported by the base 11 so that the position (height position) in the Y direction can be adjusted.

The support column 13 is supported by a base 11 so as to extend in the Y direction at the rear end of the optometry table 12, and an arm 14 is provided at the tip. The arm 14 suspends both measurement heads 16 on the optometry table 12 via a drive mechanism 15, and extends in the Z direction from the support column 13 toward the front side. The arm 14 is movable in the Y direction with respect to the support column 13. The arm 14 may be movable in the X direction and the Z direction with respect to the support column 13. A pair of measuring heads 16 are supported at the tip of the arm 14 by being suspended by a drive mechanism 15.

The measurement heads 16 are provided in pairs so as to individually correspond to the left and right eyes of the subject, and will be referred to as the left eye measurement head 16L and the right eye measurement head 16R when described individually below. .. The left eye measurement head 16L acquires information on the eye to be inspected on the left side of the subject, and the measurement head 16R for the right eye acquires information on the eye to be inspected on the right side of the subject. The measurement head 16L for the left eye and the measurement head 16R for the right eye have a plane-symmetrical configuration with respect to the vertical plane located between the two in the X direction.

Each measurement head 16 is provided with a mirror 18 which is a deflection member, and information on the corresponding eye to be inspected is acquired by the measurement optical system 21 described later through the mirror 18.

Each measurement head 16 is provided with a measurement optical system 21 for acquiring eye information of the eye to be inspected (referred to as a measurement optical system 21R for the right eye and a measurement optical system 21L for the left eye when described individually). The detailed configuration of the measurement optical system 21 will be described later.

Both measurement heads 16 are movably suspended by a drive mechanism 15 provided on a base portion 19 suspended from the tip of the arm 14. In the present embodiment, the drive mechanism 15 includes a left eye drive mechanism 15L corresponding to the left eye measurement head 16L and a right eye drive mechanism 15R corresponding to the right eye measurement head 16R, as shown in FIG. And have. The left eye drive mechanism 15L includes a left eye vertical drive unit 22L, a left eye horizontal drive unit 23L, a left eye X-direction rotation drive unit (left eye horizontal rotation drive unit) 24L, and a left eye Y-direction rotation. It has a drive unit (vertical rotation drive unit for the left eye) 25L. The drive mechanism 15R for the right eye includes a vertical drive unit 22R for the right eye, a horizontal drive unit 23R for the right eye, an X-direction rotation drive unit (horizontal rotation drive unit for the right eye) 24R for the right eye, and a Y-direction rotation drive unit for the right eye. It has a drive unit (vertical rotation drive unit for the right eye) 25R.

The configuration of each drive unit corresponding to the left eye measurement head 16L and the configuration of each drive unit corresponding to the right eye measurement head 16R are plane-symmetrical with respect to the vertical plane located between the two in the X direction. Has been done. In the following, except when described individually, the vertical drive unit 22, the horizontal drive unit 23, the X-direction rotation drive unit 24, and the Y-direction rotation drive unit 25 may be simply referred to. The same applies to other components provided symmetrically to the left and right.

In the drive mechanism 15, as shown in FIG. 2, the vertical drive unit 22, the horizontal drive unit 23, the X-direction rotation drive unit 24, and the Y-direction rotation drive unit 25 are arranged in this order from the upper side.

The vertical drive unit 22 is fixed to the base unit 19 at the tip of the arm 14, and is driven by the horizontal drive unit 23, the X-direction rotation drive unit 24, and the Y-direction rotation drive with respect to the arm 14 based on the control signal from the control unit 26. The portion 25 is moved in the Y direction (vertical direction). The horizontal drive unit 23 is fixed to the vertical drive unit 22, and based on the control signal from the control unit 26, the X-direction rotation drive unit 24 and the Y-direction rotation drive unit 25 are set to the X-direction and the Y-direction rotation drive unit 25 with respect to the vertical drive unit 22. Move in the Z direction (horizontal direction).

The vertical drive unit 22 and the horizontal drive unit 23 are provided with an actuator that generates a driving force such as a pulse motor and a transmission mechanism that transmits a driving force such as a combination of gears or a rack and pinion. It is composed of. The horizontal drive unit 23 can be easily configured and can be easily controlled to move in the horizontal direction by, for example, providing a combination of an actuator and a transmission mechanism individually in the X direction and the Z direction.

The X-direction rotation drive unit 24 is connected to the horizontal drive unit 23. Based on the control signal from the control unit 26, the X-direction rotation drive unit 24 makes the measurement head 16 and the Y-direction rotation drive unit 25 corresponding to the horizontal drive unit 23 the eyeball rotation point O of the corresponding eye E to be inspected. The eyeball rotation axis v extending in the vertical direction (Y direction) through (left eyeball rotation point OL and right eyeball rotation point OR shown in FIG. 2) (vL shown by a single point chain line on the left eye test EL and right eye test ER in FIG. 4). , VR) as the center (rotation axis) and rotate in the X direction (horizontal direction).

The Y-direction rotation drive unit 25 is connected to the X-direction rotation drive unit 24. The measurement head 16 is suspended from the Y-direction rotation drive unit 25. Based on the control signal from the control unit 26, the Y-direction rotation drive unit 25 sets the measurement head 16 corresponding to the X-direction rotation drive unit 24 to the eyeball rotation point O (left eyeball rotation point O) of the corresponding eye E to be inspected. The eye rotation axis h (left eye EL in FIG. 4, hL, hR indicated by a chain double-dashed line in the right eye ER) extending in the horizontal direction (X direction) through the OL and the right eye rotation point OR (see FIG. 2). As the center (rotation axis), it is rotated in the Y direction (vertical direction, vertical direction).

The X-direction rotation drive unit 24 and the Y-direction rotation drive unit 25 can be configured such that, for example, a transmission mechanism that receives a driving force from an actuator moves along an arc-shaped guide groove. By matching the center position of each guide groove with the eyeball rotation axes h (hL, hV) and v (vL, vR), the eyeball rotation of the eye E to be inspected by the X-direction rotation drive unit 24 and the Y-direction rotation drive unit 25 The measuring head 16 can be rotated around the axes v (vL, vR) and h (hL, hV).

The X-direction rotation drive unit 24 supports the Y-direction rotation drive unit 25 and the measurement head 16 so as to be able to rotate around the rotation axis provided by the X-direction rotation drive unit 24, and supports the measurement head 16 in cooperation with the horizontal drive unit 23. It can also be configured to rotate while changing the position to be used. Further, the Y-direction rotation drive unit 25 supports the measurement head 16 so as to be rotatable around the rotation axis provided by itself, and in cooperation with the vertical drive unit 22, rotates while changing the position of supporting the measurement head 16. It can also be configured to be used.

With the above configuration, the drive mechanism 15 can move each measurement head 16 individually or in conjunction with each other in the X direction, the Y direction, and the Z direction, and is centered on the eyeball rotation axes v and h of the eye to be inspected. It can be rotated in the X and Y directions. In the ophthalmic apparatus 10 of the present embodiment, each drive unit 22 to 25 of the drive mechanism 15 is driven to move and rotate each measurement head 16 in response to a control signal from the control unit 26. Further, an examiner or the like can manually drive each of the drive units 22 to 25 to move and rotate each measurement head 16.

Further, the left eye X-direction rotation drive unit 24L and the right eye X-direction rotation drive unit 24R rotate the left eye measurement head 16L and the right eye measurement head 16R in the X direction (left-right direction). The eye E to be inspected can be dissipated (dissociation movement) or converging (convergence movement). Further, the left eye measurement head 16L and the right eye measurement head 16R are rotated in the Y direction (vertical direction) by the left eye Y direction rotation drive unit 25L and the right eye Y direction rotation drive unit 25R. The line of sight of the eye E to be inspected can be directed downward or returned to the original position. As a result, the ophthalmic apparatus 10 can test divergence motion and convergence motion, and can perform various examination distances from apogee distance examination to apogee distance examination in a binocular vision state. It is possible to measure various characteristics of both eyes by performing the above-mentioned examination.

FIG. 3A shows the rotational postures of the left and right measuring heads 16L and 16R so that the optical axes LL and LR from the left and right eye ELs and ERs to the left and right mirrors 18L and 18R are parallel to each other. Indicates that is being adjusted. In the state of FIG. 3A, when the target (fixed image) or the like is presented to the left and right eye ELs and ERs by the target projection system 32 of the left and right measurement heads 16L and 16R, the subject's vision The axis can be the same as when looking at infinity in the state of binocular vision. Further, FIG. 3B shows the left and right so that the extended ends of the respective optical axes LL and LR from the left and right eye-tested ELs and ERs to the left and right mirrors 18L and 18R point toward the predetermined position P. Indicates a state in which the rotational postures of the measuring heads 16L and 16R are adjusted. In the state of FIG. 3B, when the optotypes (fixed vision images) or the like are presented to the left and right eye ELs and ERs to be inspected by the optotype projection systems 32 of the left and right measurement heads 16L and 16R, the visual axis of the subject is presented. Can be set to the same visual axis as the state of looking at the predetermined position P in the state of binocular vision. In this way, the ophthalmic apparatus 10 changes the rotational postures of the left and right measuring heads 16L and 16R symmetrically at the same time to change the visual axes of the left and right eye ELs and ERs to be converging or diverging. The visual axis can be directed to the presentation position of the optotype (apparent presentation position, for example, position P, which is separated from the eye E to be inspected by a predetermined examination distance).

By changing the rotation angle α shown in FIG. 3B, the position P for presenting the optotype can be changed. As shown in FIG. 3A, the rotation angle α is an angle based on the visual axis (parallel to each other) of each eye E in the state of looking at infinity. At infinity, the rotation angle α is 0 °. In addition, parallax can be given to the optotypes presented to the left and right eyes E to be inspected in response to the change in the rotation angle α. That is, the rotation angle α is changed to change the position P for presenting the optotype, and the parallax given to the optotype is changed in response to this change. As a result, the target can be presented three-dimensionally to the subject in a state corresponding to the position P.

As shown in FIG. 1 or 2, the base 11 is provided with a control unit 26 that collectively controls each unit of the ophthalmic apparatus 10. Further, the ophthalmic apparatus 10 is used for the examiner's controller 27 used for the examiner to operate the ophthalmic apparatus 10 and for the examinee to respond when acquiring various ophthalmic information of the eye to be inspected. It is provided with a controller 28 for a subject.

The examiner controller 27 is an information processing device capable of short-range communication with the control unit 26, such as a tablet terminal or a smartphone. The controller 27 for an examiner is not limited to a tablet terminal or the like, and may be a notebook personal computer, a desktop personal computer, or the like, or may be a controller dedicated to the ophthalmic apparatus 10.

In the ophthalmic apparatus 10 of the present embodiment, the examiner controller 27 is configured to be portable and may be operated while being arranged on the eye examination table 12, or may be held by the examiner in his / her hand. It may be manipulated.

The subject controller 28 includes, for example, a subject input unit 28a such as a keyboard, a mouse, a joystick, a touch pad, and a touch panel. The subject controller 28 is connected to the control unit 26 via a wired or wireless communication path, and sends an input signal corresponding to the operation accepted by the subject input unit 28a to the control unit 26. It can be said that the subject controller 28 itself is also a subject input unit.

[Measurement optical system]
The measurement optical system 21L for the left eye and the measurement optical system 21R for the right eye are an intraocular pressure test device that performs an intraocular pressure test while switching the target to be presented, and an appropriate corrective refractive power of the eye to be inspected while switching and arranging a correction lens. Foropter to be acquired, reflex meter and wave surface sensor to measure refractive power, fundus camera to take image of the fundus, tomography device to take tomographic image of retina, specular microscope to take image of corneal endothelial image, measure corneal shape A keratometer, a tonometer for measuring intraocular pressure, and the like are configured alone or in combination.

FIG. 5 is a diagram showing a detailed configuration of the measurement optical system 21R for the right eye in the ophthalmic apparatus according to the present embodiment. In FIG. 5, the mirror 18R is omitted. Since the configuration of the measurement optical system 21L for the left eye is the same as that of the measurement optical system 21R for the right eye, the description thereof will be omitted, and only the measurement optical system 21R for the right eye will be described below.

As shown in FIG. 5, the measurement optical system 21R for the right eye is an example of an observation system 31, an optotype projection system 32, a subjective inspection system 34, an alignment system 35, an alignment system 36, and an objective measurement optical system. It has an optical power measuring system 33 and a kerato system 37.

The observation system 31 observes the anterior segment of the eye E to be inspected, the optotype projection system 32 presents the optotype to the eye E to be inspected, and the refractive power measurement system 33 measures the refractive power of the eye. The subjective examination system 34 presents an optotype to the eye E to be inspected, and shares the optical elements constituting the optical system with the optotype projection system 32. In the present embodiment, the optical power measuring system 33 has a function of projecting a predetermined measurement pattern on the fundus Ef of the eye E to be inspected and a function of detecting an image of the measurement pattern projected on the fundus Ef.

The alignment system 35 and the alignment system 36 perform alignment of the optical system with respect to the eye E to be inspected. The alignment system 35 aligns the observation system 31 in the direction along the optical axis (front-back direction, Z direction) in the direction in which the alignment system 36 is orthogonal to the optical axis (vertical direction and horizontal direction; Y direction and X direction). Align each one.

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

In the observation system 31, the luminous flux reflected by the eye E (anterior eye portion) to be inspected is imaged on the image sensor 31g by the imaging lens 31f via the objective lens 31a. As a result, an anterior segment image E'in which the keratling light flux, the light flux of the alignment light source 35a, and the light flux (bright spot image Br) of the alignment light source 36a, which will be described later, are projected (projected) is formed on the image pickup element 31g. NS. The image sensor 31g of the observation system 31 captures this anterior eye portion image E'. The control unit 26 causes the front eye portion image E'and the like based on the image signal output from the image pickup element 31g to be displayed on the display surface 30a of the display unit 30 of the examiner controller 27.

A kerato system 37 is provided in front of the objective lens 31a. The kerato system 37 has a kerato plate 37a and a kerat ring light source 37b. The kerato plate 37a has a plate shape in which concentric slits are provided with respect to the optical axis of the observation system 31, and is provided in the vicinity of the objective lens 31a. The kerat ring light source 37b is provided so as to match the slit of the kerato plate 37a.

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

In the present embodiment, as the corneal shape measurement system, an example (kerato system 37) in which a kerato plate 37a for measuring the curvature near the center of the cornea with one to three ring slits is used is shown. As long as the corneal shape is measured, a purachido plate having multiple rings and capable of measuring the shape of the entire cornea may be used, or other configurations may be used, and the configuration is not limited to the configuration of the present embodiment.

An alignment system 35 is provided behind the kerato system 37 (kerato plate 37a). The alignment system 35 has a pair of alignment light sources 35a and a projection lens 35b, and the luminous flux from each alignment light source 35a is made into a parallel luminous flux by each projection lens 35b, and the cornea of the eye E to be inspected is passed through an alignment hole provided in the kerato plate 37a. The parallel light flux is projected onto Ec.

The control unit 26 or the examiner moves the measurement head 16 in the front-rear direction based on the bright spot (bright spot image Br) projected (projected) on the cornea Ec, so that the direction along the optical axis of the observation system 31 Align (front-back direction). This alignment in the front-rear direction is performed by adjusting the position of the measuring head 16 so that the ratio between the distance between the two point images by the alignment light source 35a on the image sensor 31g and the diameter of the keratling image is within a predetermined range.

In the present embodiment, the optical axis of the measuring optical system 21 is bent by the mirror 18, and the optical axis of the measuring optical system 21 is abbreviated as the Z axis at the position of the mirror image of the measuring optical system 21 with respect to the mirror 18. It is configured to match. Therefore, the alignment of the measurement optical system 21 in the optical axis direction corresponds to the alignment in the Z direction.

Here, the control unit 26 may obtain the amount of misalignment from the ratio and display the amount of misalignment on the display surface 30a. The alignment in the front-rear direction may be performed by adjusting the position of the measurement head 16R so that the bright spot image Br by the alignment light source 36a described later is in focus.

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

The alignment system 36 projects (projects) the luminous flux from the alignment light source (point light source) 36a onto the corneal Ec of the eye E to be inspected as a parallel luminous flux through the objective lens 31a. The parallel light flux projected from the alignment system 36 onto the cornea Ec of the eye E to be inspected forms a bright spot of the alignment light at a position substantially intermediate between the apex of the cornea and the center of curvature of the cornea. The control unit 26 or the examiner moves the measurement head 16 in the front-rear direction based on the image of the bright spot (bright spot image Br) projected (projected) on the cornea Ec, thereby moving the measurement head 16 to the optical axis of the observation system 31. Align in orthogonal directions (vertical direction, horizontal direction).

At this time, the control unit 26 displays the alignment mark AL, which is a guideline for the alignment mark, on the display surface 30a in addition to the anterior eye portion image E'in which the bright spot image Br is formed. The control unit 26 may be configured to control so that the measurement is started when the alignment is completed.

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

The optotype projection system 32 (subjective examination system 34) is an optical system that projects an optotype and presents it to the fundus Ef in order to fix the eye E to be inspected and fog it. The optotype projection system 32 includes a display 32a, a half mirror 32b, a relay lens 32c, a reflection mirror 32d, a focusing lens 32e, a relay lens 32f, a field lens 32g, a variable cross cylinder lens (VCC) 32h, a reflection mirror 32i, and a dichroic filter. It has 32j and shares the dichroic filter 31b and the objective lens 31a with the observation system 31. Further, the subjective inspection system 34 has at least two glare light sources 32k that irradiate the eye E to be inspected with glare light at a position surrounding the optical axis in an optical path different from the optical path leading to the display 32a or the like.

The display 32a presents a fixed optotype or a punctate optotype as an optotype that fixes the line of sight of the eye E to be inspected when performing an objective examination, and the characteristics of the eye E to be inspected (visual acuity value and correction power (far)). It presents a subjective optometry target for subjectively inspecting the dioptric power, near dioptric power), etc. As the display 32a, an EL (electroluminescence) or a liquid crystal display (Liquid Crystal Display (LCD)) can be used, and an arbitrary image is displayed under the control of the control unit 26. The display 32a is provided at a position conjugate with the fundus Ef of the eye E to be inspected on the optical path of the optotype projection system 32 (subjective examination system 34).

The focusing lens 32e is driven forward and backward along the optical axis by a drive motor (not shown). By moving the focusing lens 32e to the E side of the eye to be inspected, the refractive power can be displaced to the minus side. By moving the focusing lens 32e in a direction away from the eye E to be inspected, the refractive power can be displaced to the positive side. Therefore, by driving the in-focus lens 32e forward and backward, it is possible to change the inspection distance from the presentation position of the optotype displayed on the display 32a to the eye E to be inspected. That is, the presentation position of the optotype image can be changed, and the eye E to be inspected can be fixed and fogged.

Further, in the optotype projection system 32 (subjective inspection system 34), a pinhole plate is located on the optical path at a position substantially conjugated with the pupil of the eye E to be inspected (in the present embodiment, between the field lens 32g and the VCS 32h). It has 32p. The pinhole plate 32p is formed by providing a through hole in the plate member, and under the control of the control unit 26, the target projection system 32 (awareness inspection system 34) is inserted into the optical path and separated from the optical path. Allows the through hole to be positioned on the optical axis when inserted into the optical path. By inserting the pinhole plate 32p into the optical path during the subjective examination, it is possible to perform a pinhole test for determining whether or not the eye E to be inspected can be corrected by the spectacles. The pinhole plate 32p may be provided at a position substantially conjugated with the pupil of the eye E to be inspected on the optical path, and is not limited to the configuration of the present embodiment.

The optotype displayed on the display 32a in the subjective examination or the like is not particularly limited as long as it is used for optometry, and examples thereof include a Randolt ring, a Snellen optotype, and an E chart. In addition, the optotypes are characters such as hiragana and katakana, optotypes consisting of pictures of animals and fingers, and binocular vision functions such as cross optotypes, landscape paintings, and landscape photographs. Various optotypes such as markers can be used. Further, the optotype may be a still image or a moving image. In the present embodiment, since the display 32a made of an LCD or the like is provided, an optotype of a desired shape, form and contrast can be displayed at a predetermined inspection distance, and a multifaceted and detailed eye examination is possible. Become. Further, since the two displays 32a are provided corresponding to the left and right eyes E to be inspected, the optotype giving parallax can be displayed corresponding to a predetermined inspection distance (presentation position), and stereoscopic inspection can also be performed. It is possible to perform easily and precisely with the natural orientation of the visual axis.

The optical power measurement system 33 is a ring-shaped luminous flux projection system 33A that projects a ring-shaped measurement pattern onto the fundus Ef of the eye E to be inspected, and a ring that detects (receives) the reflected light of the ring-shaped measurement pattern from the fundus Ef. It has a luminous flux light receiving system 33B.

The ring-shaped luminous flux projection system 33A includes a reflex light source unit 33a, a relay lens 33b, a pupil ring diaphragm 33c, a field lens 33d, a perforated prism 33e, and a rotary prism 33f, and shares the dichroic filter 32j with the optotype projection system 32. Then, the dichroic filter 31b and the objective lens 31a are shared with the observation system 31. The reflex light source unit unit 33a includes, for example, a reflex measurement light source 33g for reflex measurement using an LED, a collimator lens 33h, a conical prism 33i, and a ring pattern forming plate 33j, which have an optical refractive power under the control of the control unit 26. It is made movable integrally on the optical axis of the measurement system 33.

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

Next, the operation at the time of measuring the refractive power of the eye will be described. The control unit 26 lights the reflex light source 33g and moves the reflex light source unit 33a of the ring-shaped luminous flux projection system 33A and the focusing lens 33t of the ring-shaped luminous flux light receiving system 33B in the optical axis direction. In the ring-shaped luminous flux projection system 33A, the reflex light source unit 33a emits a ring-shaped measurement pattern, and the measurement pattern is advanced to the perforated prism 33e via the relay lens 33b, the pupil ring aperture 33c, and the field lens 33d. It is reflected by the reflecting surface 33v and guided to the dichroic filter 32j via the rotary prism 33f. In the ring-shaped luminous flux projection system 33A, the ring-shaped measurement pattern is projected onto the fundus Ef of the eye E to be inspected by guiding the measurement pattern to the objective lens 31a via the dichroic filter 32j and the dichroic filter 31b.

In the ring-shaped luminous flux light receiving system 33B, the ring-shaped measurement pattern formed on the fundus Ef is focused by the objective lens 31a, passed through the dichroic filter 31b, the dichroic filter 32j, and the rotary prism 33f, and becomes the hole 33p of the perforated prism 33e. To proceed. In the ring-shaped luminous flux light receiving system 33B, the measurement pattern is passed through a field lens 33q, a reflection mirror 33r, a relay lens 33s, a focusing lens 33t, a reflection mirror 33u, a dichroic filter 31e, and an imaging lens 31f to form an image pickup element 31g. Make an image. As a result, the image sensor 31g detects an image of the ring-shaped measurement pattern, and the control unit 26 displays the image of the measurement pattern on the display surface 30a, and based on the image signal from the image (image sensor 31g), the control unit 26 displays the image of the measurement pattern on the display surface 30a. The spherical power, the cylindrical power, and the axial angle as the optical power are measured by a well-known method.

Further, at the time of measuring the refractive power of the eye, the control unit 26 causes the display 32a of the optotype projection system 32 to display the fixed optotype. The light beam from the display 32a includes a half mirror 32b, a relay lens 32c, a reflection mirror 32d, a focusing lens 32e, a relay lens 32f, a field lens 32g, a VCS 32h, a reflection mirror 32i, a dichroic filter 32j, a dichroic filter 31b, and an objective lens 31a. Then, light is projected (projected) onto the fundus Ef of the eye E to be inspected. The examiner or the control unit 26 performs alignment with the presented fixed fixation target fixed by the subject, and determines the distance point of the eye E to be inspected based on the result of the provisional measurement of the optical refractive power (ref). After moving the focusing lens 32e, the focusing lens 32e is moved to a position where it is out of focus to bring it into a cloud fog state. As a result, the eye E to be inspected is in the accommodative dormant state (the state in which the crystalline lens is adjusted and removed), and the optical refractive power is measured in the accommodative dormant state.

Since the configurations of the eye refractive power measurement system 33, the alignment system 35, the alignment system 36, the kerato system 37, etc., and the measurement principles of the eye refractive power (ref), subjective examination, and corneal shape (kerato) are known. , Detailed description will be omitted.

[Control system for ophthalmic equipment]
With reference to FIG. 4, the functional configuration of the control unit 26 of the ophthalmic apparatus 10 of the present embodiment will be described. As shown in FIG. 4, the control unit 26 includes the above-mentioned measurement optical system for the left eye (in FIG. 4, “for the left eye” and “for the right eye” are referred to as “left eye”, “right eye” or “left”. 21L, the measurement optical system 21R for the right eye, the vertical drive unit 22L for the left eye, the horizontal drive unit 23L for the left eye, and the left eye drive mechanism 15L for the left eye. X-direction rotation drive unit 24L, left-eye Y-direction rotation drive unit 25L, right-eye drive mechanism 15R right-eye vertical drive unit 22R, right-eye horizontal drive unit 23R, right-eye X-direction rotation drive unit 24R In addition to the Y-direction rotation drive unit 25R for the right eye, the examiner controller 27, the examinee controller 28, and the storage unit 29 are connected.

The examiner controller 27 includes a display unit 30 including a touch panel display. The display unit 30 includes a display surface 30a on which an image or the like is displayed, and a touch panel type input unit (inspector input unit) 30b arranged so as to be superimposed on the display surface 30a. It can be said that the examiner controller 27 itself is also an examiner input unit. The examiner controller 27 causes the display surface 30a to display a predetermined screen such as the anterior eye portion image E'acquired by the image pickup device 31g based on the display control signal transmitted from the control unit 26. Further, the examiner controller 27 is capable of short-range communication with the control unit 26 by communication means such as short-range radio, and sends an input signal corresponding to the operation accepted by the input unit 30b to the control unit 26.

The control unit 26 includes an internal memory 26a, and is capable of short-range wireless communication with the examiner controller 27 and the examinee controller 28 via communication means. Further, the control unit 26 appropriately responds to operations on the examiner controller 27 and the examinee controller 28 by expanding the program stored in the connected storage unit 29 or the built-in internal memory 26a on, for example, a RAM. Therefore, the operation of the ophthalmic apparatus 10 is comprehensively controlled. In the present embodiment, the internal memory 26a is composed of RAM or the like, and the storage unit 29 is composed of ROM, EEPROM or the like.

The control unit 26 functions as a measurement condition setting unit, and controls the measurement optical system 21 according to the type of examination to measure the eye characteristics. Examples of the measurement conditions include the types of tests in the above-mentioned objective test and subjective test, and the conditions for presenting the optotype used at the time of the test. Further, the control unit 26 functions as an optotype control unit, sets a predetermined presentation condition of the optotype to be presented to the subject, and controls the optotype projection system 32 based on the presentation condition to control the optotype. It is displayed on the display 32a. At this time, the control unit 26 causes the display surface 30a of the display unit 30 to display the same optotype as the display 32a so that the examiner can recognize the optotype displayed on the display 32a. The presentation conditions include visual acuity value, inspection distance, inspection type, optotype type, optotype magnification rate, optotype display mode, and the like. These presentation conditions can be input by the examiner at the time of examination from the input unit 30b of the examiner controller 27, but in the present embodiment, the examination mode is set according to the type of the intraocular lens and the like. An inspection mode list in which appropriate presentation conditions are set in advance for each inspection mode is stored in the storage unit 29 so that it can be updated. Then, when the examiner selects the inspection mode from the input unit 30b, the control unit 26 that receives the instruction signal by this selection acquires the presentation condition corresponding to the selected inspection mode from the storage unit 29.

When the inspection mode is set for each intraocular lens, for example, "single focus IOL inspection mode", "multifocal IOL inspection mode", "multifocal IOL inspection mode", "fake kick IOL inspection mode" and the like can be mentioned. .. It is desirable that these set values can be arbitrarily set or changed at, for example, an ophthalmology clinic, an optician store, a contact lens store, a health examination center, or other facility. As a result, for example, information can be set according to the products handled at each facility, the correction method, the type of inspection performed at each facility, and the like, and more appropriate inspection becomes possible.

The visual acuity value is a visual acuity value used for the examination, and when presenting one visual acuity value, a predetermined visual acuity value (for example, "1.0") is set, and a plurality of visual acuity values having different visual acuity values are presented. In this case, a plurality of predetermined visual acuity values or ranges (for example, “0.4 to 1.0”, “0.4, 0.5, 0.6, ...”) are set. Further, the control unit 26 can select and set an appropriate visual acuity value based on the optical power of refraction measured by the objective test. In this way, by performing objective measurement in advance, it is possible to efficiently and appropriately perform an subjective test such as an optical power, and to improve the reliability of the subjective test. In addition, since the required (normal value) visual acuity value differs between when looking at a distance and when looking at a close distance, the visual acuity value is not always the same for the distance examination, the intermediate examination, and the near examination. It is not necessary to set to, but different visual acuity values can be set. Further, since the required visual acuity values are different between monocular vision and binocular vision, different visual acuity values can be set between the monocular examination and the binocular examination.

The inspection distance is the distance at which the optotype is presented, and is the distance at the far point for measurement at the far point (for example, 5 m), the distance at the midpoint for measurement at the midpoint (for example, 2 m), and the distance at the near point. The near point distance (for example, 50 cm, 40 cm, 33 cm, 20 cm, 10 cm, etc.) for the measurement of is set. The inspection distance is not the actual distance between the subject and the target, but the apparent distance created by the target projection system 32 as if the target is presented at this distance.

Examples of the type of subjective examination include a visual acuity examination (eye refractive power examination), a contrast examination, a nighttime examination, a glare examination, a pinhole examination, a stereoscopic examination, and the like. Examples of the optotype for performing these inspections include a contrast inspection optotype, a glare inspection optotype, a nighttime inspection optotype, and a stereoscopic inspection optotype. Examples of the type of the optotype include the Randold ring, the Snellen optotype, the E chart, characters, pictures, figures, and photographs as described above. The magnification of the optotype is increased as the examination distance becomes closer to the near point distance so that the subject feels perspective when he / she visually recognizes the optotype with the naked eye. As a display mode of the optotype, for example, a contrast (for example, 100%, 50%, 25%, etc.) is set at the time of a contrast inspection. On the other hand, when performing a normal low vision test, the contrast is set to 100%. Further, when presenting a plurality of optotypes in a contrast test, a multi-ratio contrast optotype (see FIG. 6) that presents a plurality of optotypes with different contrasts, and a single optotype that presents a plurality of optotypes with a single contrast. A ratio contrast optotype (see FIG. 7A), an ETDR optotype whose visual acuity value changes in order from the upper row to the lower row (see FIG. 7C), and the like are set as display modes.

In addition, the nighttime inspection is an inspection performed assuming the appearance at night, and an optotype (see FIG. 7B) in which the color of the optotype is reversed to white and the background color is reversed to black is used. .. In addition, when performing a glare test, the contrast of the optotype can be set to 100%, and the glare test can be performed in combination with the normal visual acuity test. In this state, the contrast can be set appropriately to combine the contrast inspection and the glare inspection. In addition, in the stereoscopic examination for examining the appearance with binocular vision, when parallax is given to the eye E to be inspected, for example, the visual angle is changed to 30 seconds, 1 minute, 2 minutes, 3 minutes, 4 minutes, etc. Present the mark.

Here, the contrast test is a test for obtaining the spatial frequency characteristics (contrast sensitivity) of the visual system including the eye to be inspected. The contrast is the difference in brightness (brightness) between the area where the optotype is displayed and the background on the display 32a. The contrast can be obtained by the following formula (1).

C (%) = 100 × (Max-Min) / (Max + Min)… (1)
In the above equation (1), C is the contrast, Max is the maximum brightness (brightness) of the optotype region or the background, and Min is the minimum brightness (brightness) of the optotype region or the background.

Due to the different contrast, the appearance of the presented optotype is different. That is, in the case of a high level of contrast (for example, C = 100%), the boundary between the optotype and the background becomes clear, and the optotype looks relatively clear. With medium-level contrast (eg C = 50%) and low-level contrast (eg C = 25%), the lower the contrast, the more blurry the boundary between the optotype and the background becomes and the more blurry the optotype becomes. You will be able to see it.

In the eye to be inspected with the intraocular lens inserted, the contrast was changed in the normal low vision test, that is, in the target with 100% contrast, even if there was no difference in the appearance from the case of the inspected eye before insertion. The optotype may look different. In addition, the insertion of an intraocular lens may change the appearance at night, the reflection and bleeding of car lights during night driving, and the appearance with binocular vision. Such a change in appearance also differs depending on the type of intraocular lens and the like. For this reason, it is possible for the subject to lead a comfortable life (visual life) without any discomfort in the appearance by performing contrast inspection, glare inspection, and stereoscopic inspection of various contrasts at various inspection distances. It is very important and meaningful to do so.

The control unit 26 also functions as a pupil detection unit and a visual axis calculation unit, detects the positions of the pupil center and the bright spot image Br of the left eye test EL and the right eye test ER, and based on these, the left cover The angle formed by the visual axis of the eye examination EL and the right eye examination ER and the optical axis L of the left eye measurement head 16L and the right eye measurement head 16R is calculated. The center of the pupil is detected from each anterior segment image E'of the left eye test EL and the right eye test ER acquired by the image sensor 31 g of the observation system 31. The position of the bright spot image Br is based on the bright spots obtained by forming a parallel light flux from the alignment light source 36a of the alignment system 36 in the left eye test EL and the right eye test ER, and these left eye test EL and right. It is detected as a corneal reflex of the eye ER to be inspected, that is, an image of a bright spot. The bright spot image Br is formed in a spot shape at a predetermined position inside the cornea Ec (half of the radius of curvature r of the cornea, r / 2) due to the incident of the parallel light beam.

Based on the calculated visual axis (angle formed by the visual axis and the optical axis), the control unit 26 determines whether the eye E to be inspected has an oblique position or a squint, and whether the subject is properly staring at the optotype. Can also be determined. The control unit 26 displays the determination result on the display unit 30, displays a schematic diagram of the eye E to be inspected displaying the numerical value of the angle and the visual axis, and the like on the display unit 30, and displays the determination result on the display unit 30 to the examiner and the examinee. You can also notify. As a result, the examiner and the like can recognize the presence / absence of oblique position and strabismus, and the appropriateness of fixation. Further, the control unit 26 can rotate the measurement head 16 in the X direction based on the calculated visual axis and arrange the measurement head 16 at a position aligned with the visual axis of the eye E to be inspected.

The control unit 26 also functions as a measurement result output unit, and associates the presentation condition of the optotype presented to the subject with the measurement result of the eye characteristics when the optotype is presented under this presentation condition. Output to the display unit 30, printer, etc. Specifically, for example, in the case of a contrast inspection, as shown in FIG. 8, the relationship between the inspection distance, the visual acuity value (measurement result), and the contrast is graphed, and the display unit 30 is controlled on the display surface 30a. Display. Further, when a print instruction is input from the input unit 30b or the like, or the graph is automatically printed out from the printer. The graph is not limited to the two-dimensional graph as shown in FIG. 8, and a three-dimensional graph or the like is also suitable, so that the examiner or the subject can grasp the correlation of a plurality of items more clearly. Become.

Further, the control unit 26 controls the display unit 30 to display the anterior eye portion images E'of the left and right eye E to be inspected on the display surface 30a. By visually recognizing the anterior segment image E', it is possible to recognize whether the examination is properly performed. For example, if the alignment or inspection is not successful, the cause can be grasped. Causes of poor alignment and examination include, for example, poor fixation, binocular vision, strabismus and oblique position, ptosis, suppression, pupillary miosis, and head. The part is tilted, and so on. Therefore, by visually recognizing the anterior eye portion image E'of the display unit 30, the examiner can clearly grasp the cause of the inability to align or the like. Then, the position of the head can be corrected, the subject can be alerted, and countermeasures can be taken promptly, and the success rate of realignment and examination can be improved.

(Example of operation of ophthalmic device)
An example of the operation of the ophthalmic apparatus 10 of the present embodiment having the above-described configuration will be described with reference to the flowchart of FIG. In the flowchart of FIG. 9, after performing an objective test with binocular vision, a case where a visual acuity test, a contrast test, a nighttime test, and a glare test are performed while changing the test distance will be described as a subjective test. The operation of the ophthalmic apparatus 10 is not limited to the following steps. It is also possible to change the order of examinations and the type of examinations, and it is also possible to inspect one eye at a time by changing the examination distance and contrast.

First, in step S1, the control unit 26 drives the left and right X-direction rotation drive units 24 to rotate the left and right measurement heads 16 in the X direction in order to set the presentation position of the fixation target to a predetermined position. Next, in step S2, the optotype projection system 32 displays a fixation target (for example, a point light source optotype) at the center position of the display 32a. In this state, the examiner instructs the subject to fix the fixation target.

In step S3, under the control of the control unit 26, the image sensors 31g of the left and right measurement optical systems 21 start photographing the anterior eye portions of the left and right eye E to be inspected. The control unit 26 displays the anterior segment image E'of the left and right eye E to be inspected based on the image signal output from the image sensor 31g on the display surface 30a. Further, the control unit 26 may display the fixation target currently presented by the display 32a on the display surface 30a.

By visually recognizing the anterior segment image E'displayed on the display unit 30, the examiner visually confirms the suitability of fixation, the suitability of binocular vision, strabismus, oblique position, ptosis, suppression, pupillary miosis, and head. You can check the inclination of. As a result, for example, the examiner can open the eyelids by hand for ptosis, and the subject can be alerted for the inclination of the head.

In step S4, under the control of the control unit 26, the alignment system 35 aligns in the Z direction and the alignment system 36 aligns in the X direction by the operation as described above in a state where the subject is made to fix the fixation target. And align in the Y direction.

In step S5, the eye refraction force (refraction force) is measured by the eye refractive power measurement system 33 under the control of the control unit 26 after receiving (or automatically) the instruction input of the objective test from the input unit 30b by the examiner. Objective tests such as corneal shape (kerato) measurement by the kerato system 37 are performed.

Next, in step S6, the control unit 26 sets the inspection mode (for example, multifocal IOL mode) based on (or automatically) the input of the subjective inspection instruction from the input unit 30b by the examiner and the selection instruction of the inspection mode. get. Next, in step S8, the control unit 26 acquires the presentation conditions according to the inspection mode from the storage unit 29. Further, the visual acuity value can be set according to the degree of the refractive power of the eye E to be examined based on the eye refractive power obtained in the objective examination in step S5.

Next, in step S8, the control unit 26 drives the left and right X-direction rotation drive units 24 according to the examination distance in order to orient the visual axis of the eye E to be inspected according to the examination distance, and measures the left and right. The head 16 is rotated in the X direction. For example, in the case of inspection at a long point distance, the measurement head 16 is rotated so as to be in the posture shown in FIG. 3A, and the visual axis is set to the infinity state. In step S9, the control unit 26 moves the focusing lens 32e to a predetermined position in order to present the optotype at the apogee distance, or to the apogee in the case of inspection at the apogee distance.

Next, in step S10, the control unit 26 controls the optotype projection system 32 to display an index on the display 32a at an enlargement ratio according to the type of optotype, the display mode, the visual acuity value, and the apogee distance. , The same optotype (the enlargement ratio does not have to be the same) is displayed on the display surface 30a of the display unit 30. First, a target is presented with a contrast of 100%, and a normal low vision test is performed (step S11).

When a plurality of optotypes having different visual acuity values are displayed in a table format, the examiner asks the subject to answer the appearance of the optotypes in a predetermined row or column. Instruct them to respond verbally (eg, the orientation of the Randolt ring). Or, instruct them to declare how far they can be identified. Depending on the response of the subject, the examiner taps the individual target that the subject can identify, or clicks or drags the row or column on the display surface 30a to perform the examiner's response. Enter the response. The response signal by this operation is transmitted from the input unit 30b to the control unit 26. In step S12, the control unit 26 obtains the position information of the optotype clicked or the like based on the response signal, and acquires the measurement result such as the visual acuity value based on the position information. It should be noted that the response can be input by the subject himself / herself from the subject input unit 28a of the subject controller 28.

When performing another type of inspection, the processes of steps S10 to S12 are repeated according to the type of inspection. When performing a contrast inspection, for example, as shown in FIG. 6, the control unit 26 causes the display 32a and the display surface 30a to display a multi-ratio contrast optotype whose contrast is changed for each row. The paper-based view of FIG. 6 is a visual target displayed on the display 32a at the time of inspection at a long distance. As shown in FIG. 6, by simultaneously presenting a plurality of optotypes having different visual acuity values and contrasts at one inspection distance and performing the inspection, quick and efficient measurement (inspection) becomes possible. At the same time, the measurement accuracy can be improved.

The control unit 26 acquires the measurement result of the contrast test based on the response signal from the input unit 30b (or the subject input unit 28a). Next, when performing a night inspection, the control unit 26 sets the optotype for night inspection, in which the color of the optotype and the color of the background are inverted, according to the apogee distance, as shown in FIG. 7 (c). It is displayed on the display 32a and the display surface 30a at the same magnification. Then, the control unit 26 acquires the measurement result of the nighttime inspection based on the response signal from the input unit 30b. Next, when performing a glare inspection, the control unit 26 blinks the glare light source 32k while displaying the target or the like shown in FIG. 7 (c) for night inspection on the display surface 30a to make the subject respond. .. The control unit 26 acquires the measurement result of the glare inspection based on the response signal from the input unit 30b.

In the next step S13, it is determined whether the measurement at all the inspection distances is completed, and if it is completed (YES), the process proceeds to step S14. If it is not completed (NO), the process returns to step S8 and a subjective test is performed at the next test distance.

For example, when inspecting at the midpoint distance, in step S8, the control unit 26 controls the rotation of the measuring head 16 so that the visual axis faces the midpoint, and in step S9, the optotype is set at the midpoint distance. The focusing lens 32e is moved to the midpoint so that it can be presented to (for example, 2 m), and in step S10, the optotype is displayed on the display 32a or the like at a magnification corresponding to the midpoint distance (for example, in the case of contrast inspection). , The target shown in the figure in the center of the paper in FIG. 6), the visual acuity test of the subject is performed. In step S12, the measurement result is acquired based on the response signal from the input unit 30b. By repeating these processes, a normal visual acuity test, a contrast test, a night test, a glare test, and a stereoscopic visual test are performed at a midpoint distance, and the measurement results of each are obtained.

Further, when performing the inspection at the near point distance, in step S8, the control unit 26 controls the rotation of the measuring head 16 so that the visual axis faces the near point, and in step S9, the optotype is set to the near point distance. The focusing lens 32e is moved to a near point in order to be presented to (for example, 50 cm or the like), and in step S10, the optotype is displayed on the display 32a or the like at a magnification corresponding to the near point distance (for example, in contrast inspection). In this case, the visual acuity test of the subject is performed. In step S12, the measurement result is acquired based on the response signal from the input unit 30b. By repeating these processes, a normal visual acuity test, a contrast test, a night test, a glare test, and a stereoscopic visual test are performed at a near point distance, and the measurement results of each are obtained.

When all kinds of inspections are completed at all inspection distances, the process proceeds to step S14, and the control unit 26 graphs the measurement results and displays them on the display surface 30a, and prints if there is a print instruction. For example, in the case of contrast inspection, a graph as shown in FIG. 8 is displayed. Further, after this, an objective test can be performed to confirm whether the result of the subjective test is appropriate. As a result, the operation of the ophthalmic apparatus 10 is completed.

(Modification example)
Hereinafter, a modified example of the ophthalmic apparatus 10 according to the present embodiment will be described. The modified example ophthalmic apparatus 10 has the same configuration and function as the ophthalmic apparatus 10 of the present embodiment shown in FIG. 1 and the like. In the modified example, the control unit 26 is further configured to control the display 32a so that the mark corresponding to the response operation from the subject input unit 28a is superimposed on the optotype and displayed.

In the modified example ophthalmic apparatus 10, during the subjective examination, the control unit 26 displays the display 32a (furthermore, the controller 27 for the examiner) as shown in the left side of the paper of FIGS. 10A and 10B. A target corresponding to the inspection mode is displayed on the surface 30a). Then, the subject can visually recognize the target displayed on the display 32a, and respond or identify each identifiable target by tapping or clicking from the subject input unit 28a such as a touch panel or a mouse. Respond by dragging or swiping the range. The control unit 26, which receives the response signal based on these response operations from the subject input unit 28a, controls the display 32a to superimpose a mark (image) corresponding to the response operation on the optotype and display it. In the left figure of FIG. 10 (a), a dot (maru) mark indicating a tap operation is displayed, and in the left figure of FIG. 10 (b), a line mark indicating a drag operation is displayed.

The control unit 26 acquires the measurement result based on the response operation by the subject, and as shown in the right view of the paper in FIGS. 10 (a) and 10 (b), the control unit 26 is a target in a range that can be identified by the subject. Is surrounded by a rectangular mark and displayed on the display 32a. From this display, the subject can confirm the measurement result. Further, by displaying the mark by the response operation of the subject and the rectangular mark of the measurement result on the display surface 30a of the controller 27 for the examiner, the examiner can clearly show the response state and the measurement result of the examinee. I can grasp it.

Further, if the control unit 26 displays a cursor, a finger mark, or the like on the display 32a based on the position information of the subject's finger, the position information of the mouse, or the like on the touch panel, the subject can perform a response operation. It will be easier to do. Further, the finger of the subject may be photographed with a camera or the like to acquire the position information of the finger.

As described above, the examination distance and the presentation conditions of the optotype can be changed as desired by the ophthalmic apparatus 10 of the modified example, and the eye characteristics of the eye to be inspected under various examination distances and presentation conditions can be quickly and easily performed. , Measurement efficiency can be improved. Further, the subject input unit 28a enables the subject to perform a response operation, so that the eye characteristics can be acquired more efficiently and quickly.

Further, FIG. 11 shows an example of an optotype for stereoscopic examination that can be used in the ophthalmic apparatus 10 of the present embodiment and the modified example. FIG. 11A shows an example of an ETDR optotype for stereoscopic inspection in which the vertical axis is the visual acuity value and the horizontal axis is the parallax. FIG. 11B shows an example of an optotype for precision stereoscopic examination in which the vertical axis is parallax and the horizontal axis is contrast and visual acuity value (fixed value).

In the example of FIG. 11A, for example, the viewing angle is set to 30 seconds, 1 minute, 2 minutes, 3 minutes, and 4 minutes from the left side of the paper, and one of the five targets is given a corresponding parallax in each line. To display. In the example of FIG. 11B, the contrast and the visual acuity value are constant, for example, the viewing angle is set to 30 seconds, 1 minute, 2 minutes, 3 minutes, and 4 minutes from below the paper, and one of the five targets in each line. First, the corresponding parallax is given and displayed. When performing a stereoscopic visual examination using the optotype of FIG. 11, it is more appropriate to measure the optical power and the like by an objective test in advance and set the visual acuity value of the optotype based on the measurement result. Allows for quick subjective examination.

Further, when displaying such an optotype for stereoscopic inspection, the left and right measurement heads 16 are rotated to change the rotation angle α, so that the position P for presenting the optotype, that is, the inspection position is desired. Can be set to distance. The subject responds by operating the subject input unit 28a with the displayed target, which appears to be three-dimensionally raised. The control unit 26 acquires the measurement result by the response signal based on this response operation.

The optotypes in FIGS. 11A and 11B show an image in which the optotypes presented to the left and right eyes E are superimposed, and the actual optotypes are for the left eye and the right eye. And separately are displayed on the display 32a of the measuring head 16. As an example, FIG. 12 shows an example of displaying the optotype for precision stereoscopic examination of FIG. 11B on the display 32a for the left eye and the right eye. FIG. 12A shows an example of displaying the optotype on the display 32a for the left eye, and FIG. 12B shows an example of displaying the optotype on the display 32a for the right eye. Further, in each figure of FIG. 12, in order to facilitate understanding, the other target of the parallax-giving target is shown by a virtual line. Further, in the "2" column of FIG. 12A, the center line representing the center of the optotype is indicated by a virtual line. For example, a target for giving parallax, such as the targets of "A2" and "E2", is displayed at a position deviated from the center line.

Further, the parallax of the superimposed image shown in FIGS. 11A and 11B is displayed on the display unit 30 of the controller 27 for the examiner, for example, so that the parallax is presented to the subject by the examiner. The state of the marker and parallax can be easily recognized.

Next, an example of a subjective test using a plurality of optotypes will be described with reference to FIG. FIG. 13 is a diagram for explaining an example of an inspection using the multi-ratio contrast optotype and the optotype for precision stereoscopic inspection shown in FIGS. 11B and 12. First, the control unit 26 displays the multi-ratio contrast optotype shown on the left side of the paper of FIG. 13 on the display 32a. The subject performs a response operation to an identifiable target by the subject input unit 28a.

Next, the control unit 26 has a predetermined contrast and visual acuity value based on the measurement result of the multi-ratio contrast optotype, and the optotype for precision stereoscopic examination corresponding to the right view of the paper of FIG. 13 (see FIG. 12). Is displayed on the left and right displays 32a. For example, in an inspection using a multi-ratio contrast optotype, if a visual acuity value of 0.32 and a contrast of 50% can be identified, the control unit 26 changes the parallax with the visual acuity value and the contrast to 25 pieces. The target for stereoscopic vision is displayed on the left and right displays 32a. Therefore, it is not necessary for the examiner or the like to manually select and input the visual acuity value and the contrast, and the next stereoscopic examination can be immediately executed.

Then, the subject selects a target that appears to pop out three-dimensionally by the subject input unit 28a, and performs a response operation. The measurement result based on this response operation is displayed by the control unit 26 on the display 32a and the display unit 30 of the examiner controller 27. Then, based on the above measurement result, a stereoscopic optotype with different visual acuity values and contrasts can be displayed, and the inspection can be repeated. The optotype and the measurement procedure described with reference to FIG. 13 are examples, and the present invention is not limited to this. For example, the visual acuity value using the ETDR optotype for stereoscopic examination shown in FIG. 11A. And parallax (stereoscopic vision) is inspected, and based on this measurement result, a more detailed stereoscopic inspection may be performed using the optotype for precision stereoscopic inspection shown in FIG. 11 (b). Further, the control unit 26 graphs the measurement result and displays it on the display surface 30a, and prints or the like if there is a print instruction.

Further, as described with reference to FIG. 10, in the method of responding by self-reporting an optotype that can be identified by the subject, the reliability of the response becomes a problem and may affect the measurement result. In order to avoid this, as another different modification, the control unit 26 is configured to determine the correctness of the response of the subject in the subjective examination. Specifically, as shown on the left side of the paper in FIG. 14, the control unit 26 displays an optotype according to the inspection mode on the display 32a (furthermore, the display surface 30a of the examiner controller 27). In the example of FIG. 14, a multi-ratio contrast optotype consisting of a Randold ring is displayed. In response to this display, the subject taps the vicinity of the opening of each Randold ring on the display 32a to perform a response operation. In the left view of the paper of FIG. 14, the position tapped by the subject is indicated by a check mark, but a marker indicating the tapped position may be superimposed on the optotype. Further, the subject may perform a response operation by indicating the direction of the opening with a joystick or the like. Further, the examiner may perform a response operation from the input unit 30b of the examiner controller 27 based on the oral response of the examinee.

Then, the control unit 26 determines whether the response of the subject is correct or incorrect based on the response signals from the subject input unit 28a and the input unit 30b, and acquires the measurement result based on the determination result. As a result, in the subjective test, the reliability of the response of the subject is improved, and a more objective and more accurate measurement result can be obtained. Further, the control unit 26 may refer to the measurement result in the objective measurement when determining the correctness of the response. Further, as shown in the right view of the paper in FIG. 14, the control unit 26 may be configured to surround only the correct target with a rectangular mark and display it on the display 32a. You can easily check the judgment result and measurement result of.

(Effect of optometry device)
Hereinafter, the effects of the ophthalmic apparatus 10 of the present embodiment will be described. The ophthalmic apparatus 10 of the present embodiment and the modified example includes an objective measurement optical system (for example, an optical power measurement system 33, a kerato system 37, etc.) for measuring the eye characteristics of the eye to be inspected E, and a predetermined ophthalmic apparatus 10 for the eye to be inspected E. It includes an optometric projection system 32 that presents an optotype at a present position under predetermined presentation conditions, and a control unit 26 that controls an objective measurement optical system and an optometric projection system 32. The presentation conditions include at least one of a visual acuity value, an examination distance from the eye E to the presentation position, an examination type, an optotype, an optotype magnification, and an optotype display mode. The control unit 26 controls the optotype projection system 32 so as to present the optotype under a plurality of different presentation conditions at each inspection distance while changing the inspection distance from the far point distance to the near point distance. .. Then, at each examination distance, the eye characteristics of the eye E to be inspected are measured for different presentation conditions.

Further, the measuring method of the present embodiment is executed by the ophthalmic apparatus 10 of the present embodiment and the modified example, and the step of measuring the eye characteristics of the eye E to be inspected by the objective measurement optical system and the objective measurement optical system. Based on the measurement result of In the step of measuring the eye characteristics of the eye to be inspected E, and in the first presentation position, the optotype projection system 32 is made to present the optotype under the second presentation condition different from the first presentation condition, and the eye to be inspected E is presented with the optotype. At the second presentation position, which is separated from the step of measuring the eye characteristics by a second inspection distance (for example, midpoint distance, near point distance) different from the first inspection distance, the optotype is displayed under the first presentation condition. In the step of causing the projection system 32 to present the optotype and measuring the eye characteristics of the eye to be inspected E, and at the second presentation position, the optotype projection system 32 is made to present the optotype under the second presentation condition, and the eye to be inspected E is presented. Includes a step of measuring eye characteristics of the eye.

Therefore, the ophthalmic apparatus 10 can change the examination distance and the presentation condition of the optotype as desired, and can quickly and easily perform the eye characteristics of the eye to be inspected under various examination distances and presentation conditions to improve the measurement efficiency. And measurement methods can be provided. As a result, the burden of measurement of the subject can be reduced. In addition, post-treatment measurement and periodical examination measurement can be performed efficiently and accurately, and follow-up observation and the like can be appropriately performed.

In addition, the ophthalmic apparatus 10 of the above-described embodiment and modified example measures the eye characteristics of the eye E to be inspected corrected by an intraocular lens, a contact lens, spectacles, laser treatment, or other predetermined correction means. That is, the control unit 26 controls each unit in the inspection mode corresponding to each correction means to measure the eye characteristics. Therefore, it is possible to measure the eye characteristics under the inspection distance and the target presentation conditions according to the correction means, and it is possible to obtain more accurate and realistic measurement results.

Further, the optotype includes a subjective visual acuity inspection optotype, and at least one selected from a contrast inspection optotype, a glare inspection optotype, a night inspection optotype, and a stereoscopic inspection optotype. include. In this way, a plurality of types of examinations (visual acuity examination, contrast examination, glare examination, nighttime examination, stereoscopic examination) can be performed using a plurality of types of optotypes, and more appropriate measurement can be performed with the ophthalmologic apparatus 10. It will be possible.

Further, in the above-described embodiment and modification, the input unit 30b for receiving the input of the predetermined inspection mode and the storage unit 29 in which the presentation conditions are stored in advance for each of the plurality of inspection modes are provided. The control unit 26 acquires the presentation conditions from the storage unit 29 based on the inspection mode input from the input unit 30b, and controls the optotype projection system 32 based on the acquired presentation conditions. Therefore, it is not necessary for the examiner to input the presentation conditions for each examination, and the appropriate presentation conditions according to the type of the intraocular lens and the like can be quickly acquired and set, and the measurement with the ophthalmic apparatus 10 is more efficient. Can be done.

Further, in the above-described embodiment and modification, the optotype projection system 32 has a display 32a made of an electronic display device. Therefore, the magnification of the optotype presented on the display 32a can be freely changed, the contrast of the optotype can be freely changed, and the type of the optotype can be freely changed according to the inspection distance. can. It is possible to measure more appropriate eye characteristics by presenting an appropriate target under appropriate presentation conditions according to the purpose of the examination and the subject.

Further, in the above-described embodiment and modification, the control unit 26 generates and outputs a graph in which the inspection distance, the measurement result, and the display condition of the optotype are associated with each other. As a result, the examiner and the examinee can grasp the examination result more clearly.

Further, in the above-described embodiment and modified example, the control unit 26 can measure the eye characteristics more quickly and with higher accuracy by simultaneously presenting a plurality of optotypes having different presentation conditions to the eye to be inspected. Further, in the above-described embodiment and modification, the control unit 26 includes an input unit (for example, an input unit 30b and a subject input unit 28a) that receives a response operation to the optotype presented by the optotype projection system 32. The measurement result is acquired based on the response operation from the input unit. Therefore, the control unit 26 can acquire the measurement result more appropriately, and can control each unit so as to perform the next inspection immediately after acquiring the measurement result, and can improve the measurement efficiency.

Further, since the input unit includes the subject input unit 28a that accepts the response operation by the subject, the subject can perform the response operation by himself / herself. Therefore, the subjective measurement of eye characteristics can be performed more quickly. Moreover, even when the examiner is absent and unmanned, the eye characteristics can be measured. In addition, based on the response operation of the subject, it is possible to quickly shift to another examination or a more detailed examination. Therefore, it is possible to save the trouble of inputting the refractive power and the like, and to perform the inspection in a plurality of inspection modes more efficiently and quickly. Further, in the above modification, the control unit 26 displays the optotype and displays the mark corresponding to the response operation from the input unit (for example, the subject input unit 28a) superimposed on the optotype. In addition, the display 32a is controlled. With this configuration, the subject can confirm the result of his / her response by the mark on the display 32a without taking his / her eyes off the ophthalmic apparatus 10, and can measure the eye characteristics more accurately. can. Further, as in other different variations, the control unit 26 determines whether the response is correct or incorrect based on the response operation from the input unit (for example, the subject input unit 28a and the input unit 30b), and determines the determination result. Based on this, if the measurement result is acquired, the reliability of the subject's response in the subjective test is increased, and a more objective and more accurate measurement result can be obtained.

Further, in the above-described embodiment and modified example, an image acquisition unit (image sensor 31 g) for acquiring an anterior eye portion image E'of the eye to be inspected E is provided. Then, if the control unit 26 is configured to detect the pupil and the visual axis of the eye E to be inspected based on the anterior eye portion image E', the control unit 26 determines whether the eye E to be inspected is properly opened or not. It is possible to detect whether or not the optometry E is appropriately visually recognizing the target. Further, if the detection result is displayed on the display unit 30 or the like, the examiner can also recognize the state of the pupil and the visual axis, and if it is not appropriate, a countermeasure can be taken promptly.

Further, in the above-described embodiment and modification, a pair of objective measurement optical system and optotype projection system 32 are provided corresponding to the left eye and the right eye. Further, a rotation drive unit (X-direction rotation drive unit 24) that rotates the objective measurement optical system and the optotype projection system 32 around the eyeball rotation axis h extending in the horizontal direction through the eyeball rotation point O of the eye E to be inspected. To be equipped. The control unit 26 drives and controls the rotation drive unit to rotate the objective measurement optical system and the optotype projection system 32 so that the visual axis of the eye E to be inspected faces a position corresponding to the inspection distance. As a result, the ophthalmic apparatus 10 can measure the eye characteristics in binocular vision, and can measure in a natural direction of the visual axis according to the examination distance, so that the measurement accuracy can be improved.

Although the ophthalmic apparatus of the present invention has been described above based on the embodiment, the specific configuration is not limited to this embodiment, and the invention according to each claim in the claims is not limited to this embodiment. Design changes and additions are permitted as long as they do not deviate from the gist.

For example, in the above modification, the mark corresponding to the response operation performed by the subject himself / herself by the subject input unit 28a is superimposed on the optotype and displayed on the display 32a and the display unit 30. There is no limitation. For example, when the examiner performs a response operation from the input unit 30b of the examiner controller 27, the mark corresponding to the response operation of the examiner is superimposed on the optotype and displayed on the display 32a and the display unit 30. May be good. As a result, the examiner and the examinee can confirm whether or not the response operation is performed as the examinee verbally responds.

10 Ophthalmology equipment 21 Measurement optical system 24 X-direction rotation drive unit 26 Control unit 28 Subject input unit 29 Storage unit 30b Input unit 31g Imaging element (image acquisition unit) 32 Target projection system 32a Display 33 Eye refractive power measurement system ( Objective measurement optical system) 37 Kerato system (objective measurement optical system)
E Eye to be inspected E'Anterior eye image O Eye rotation point h Eye rotation axis

Claims (14)

An objective measurement optical system that measures the eye characteristics of the eye to be inspected,
An optotype projection system that presents an optotype to the eye to be inspected at a predetermined presentation position under predetermined presentation conditions.
A control unit for controlling the objective measurement optical system and the optotype projection system is provided.
The presentation condition includes at least one of a visual acuity value, an examination distance from the eye to be inspected to the presentation position, an examination type, an optotype type, an enlargement ratio of the optotype, and a display mode of the optotype. ,
The control unit controls the optotype projection system so as to present the optotype under a plurality of different presentation conditions at each inspection distance while changing the inspection distance from the far point distance to the near point distance. It is a composition,
An ophthalmic apparatus comprising measuring the eye characteristics of the eye to be inspected for each different presentation condition at each examination distance. The ophthalmic apparatus according to claim 1, wherein the ophthalmic apparatus according to claim 1 measures the eye characteristics of the eye to be inspected corrected by an intraocular lens, a contact lens, spectacles, laser treatment, or other predetermined correction means. The optotype includes a subjective visual acuity test optotype, and further includes at least one selected from a contrast test optotype, a glare test optotype, a nighttime inspection optotype, and a stereoscopic inspection optotype. The ophthalmic apparatus according to claim 1 or 2. The control unit includes an input unit that receives an input of a predetermined inspection mode and a storage unit in which the presentation conditions are stored in advance for each of the plurality of inspection modes, and the control unit is based on the inspection mode input from the input unit. The ophthalmic apparatus according to any one of claims 1 to 3, wherein the presentation condition is acquired from the storage unit, and the target projection system is controlled based on the acquired presentation condition. The ophthalmic apparatus according to any one of claims 1 to 4, wherein the optotype projection system includes a display including an electronic display device. The ophthalmic apparatus according to any one of claims 1 to 5, wherein the control unit generates and outputs a graph in which the inspection distance, the measurement result, and the presentation condition of the optotype are associated with each other. .. The ophthalmic apparatus according to any one of claims 1 to 6, wherein the control unit simultaneously presents a plurality of optotypes having different presentation conditions to the eye to be inspected. The claim is characterized in that the control unit includes an input unit that receives a response operation to the target presented by the optotype projection system, and the control unit acquires a measurement result based on the response operation from the input unit. The ophthalmic apparatus according to any one of 1 to 7. The ophthalmic apparatus according to claim 8, wherein the input unit includes a subject input unit that receives a response operation by the subject. The ophthalmology according to claim 8 or 9, wherein the control unit determines the correctness of the response based on the response operation from the input unit, and acquires the measurement result based on the determination result. Device. The target projection system has a display including an electronic display device, and the control unit displays the target and superimposes a mark corresponding to the response operation from the input unit on the target. The ophthalmic apparatus according to any one of claims 8 to 10, wherein the display is controlled so as to display the image. A claim that includes an image acquisition unit that acquires an image of the anterior segment of the eye to be inspected, and the control unit detects the pupil and / or the visual axis of the eye to be inspected based on the image of the anterior segment of the eye. Item 2. The ophthalmic apparatus according to any one of Items 1 to 11. A pair of the objective measurement optical system and the optotype projection system are provided corresponding to the left eye and the right eye, and the objective measurement optical system and the optotype projection system are provided with the eye rotation point of the eye to be inspected. A rotation drive unit that rotates the eyeball rotation axis extending in the horizontal direction as a central axis is provided, and the control unit drives and controls the rotation drive unit so that the visual axis of the eye to be inspected is positioned at a position corresponding to the inspection distance. The ophthalmic apparatus according to any one of claims 1 to 12, wherein the objective measurement optical system and the optotype projection system are rotated so as to face the eye. A method for measuring eye characteristics performed by the ophthalmic apparatus according to any one of claims 1 to 13.
A step of measuring the eye characteristics of the eye to be inspected by the objective measurement optical system, and
Based on the measurement result of the objective measurement optical system, the optotype is presented to the optotype projection system under the first presentation condition at the first presentation position separated from the eye to be inspected by the first examination distance. And the step of measuring the eye characteristics of the eye to be inspected
A step of causing the target projection system to present the target at the first presentation position under a second presentation condition different from the first presentation condition, and measuring the eye characteristics of the eye to be inspected.
At a second presentation position separated by a second inspection distance different from the first inspection distance, the target projection system is made to present the target under the first presentation condition, and the eye characteristics of the eye to be inspected. And the process of measuring
A step of causing the target projection system to present the target at the second presentation position under the second presentation condition and measuring the eye characteristics of the eye to be inspected.
A measurement method comprising.

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