JP2022177043A - Ophthalmologic examination system and ophthalmologic examination apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To suitably transmit the intent of an examiner to an examined person in a remote examination.

SOLUTION: An examination instruction device of an ophthalmologic system according to an embodiment comprises: an input unit for inputting instruction information; and a first communication unit which transmits the instruction information. An examination optical system of an ophthalmologic examination apparatus projects an examination light flux to a subject eye via an optical element. An information presentation optical system guides a display light flux output from a display unit to the subject eye via the optical element. A second communication unit receives the instruction information transmitted from the examination instruction device. A control unit causes the display unit to display a prescribed character image to control the motion of the character image based on the instruction information. The control unit of the ophthalmologic examination apparatus executes the second control of displaying examination information for examining the subject eye instead of the character image after executing the first control of changing the character image.

SELECTED DRAWING: Figure 2

COPYRIGHT: (C)2023,JPO&INPIT

Description

The present invention relates to an ophthalmic examination system and an ophthalmic examination apparatus.

An ophthalmologic examination apparatus is used for eye examination (measurement of characteristics, photographing, etc.) at medical institutions, opticians, venues for physical examinations and examinations, and at patients' homes. Typical examples of ophthalmic examination devices include:
・Visual acuity test equipment that measures visual acuity based on responses to presented visual targets ・Eye refraction test equipment (refractometer, keratometer) that measures the refractive properties of the eyeball
・Tonometer to measure intraocular pressure ・Specular microscope to obtain corneal characteristics (corneal thickness, cell distribution, etc.) ・Wavefront analyzer to obtain ocular aberration information using Hartmann-Shack sensor ・Visual field disorder Perimeter and microperimeter for detection Optical coherence tomography (OCT) for obtaining cross-sectional images, three-dimensional data, and analysis data of the fundus and anterior segment of the eye using optical interference
Fundus camera for taking pictures of the fundus Scanning Laser Ophthalmoscope (SLO) for obtaining images of the fundus by laser scanning using a confocal optical system
・MFPs that combine two or more functions

In many ophthalmologic examinations, examiners give instructions to subjects and operate ophthalmologic examination apparatuses. 2. Description of the Related Art In recent years, remote examination has become popular, in which an examiner at a location different from the installation location of an ophthalmologic examination apparatus conducts an examination while giving instructions to a subject or an ophthalmologic examination apparatus (see Patent Documents 1 to 6, for example). In remote examination, an examiner gives visual or auditory instructions to a subject.

Japanese Patent Application Laid-Open No. 2001-286442 JP-A-2002-10978 JP-A-2002-78679 JP-A-2002-78681 Japanese Patent Application Laid-Open No. 2005-342042 WO2003/041572

In the remote examination, it may be difficult to convey the intention of the examiner to the examinee, or the examinee may feel uneasy. In particular, such a problem is conspicuous when there is no examiner who accompanies the examinee to support the examination. In addition, although subjects vary in sex, age, language, etc., it has been difficult with conventional techniques to convey the examiner's intentions in accordance with such attributes of the subject.

An object of the present invention is to suitably convey the examiner's intention to the subject in remote examination.

An embodiment ophthalmic examination system includes an ophthalmic examination device and an examination instruction device used by an examiner to send instructions to the ophthalmic examination device. The examination instruction device includes an input unit for inputting instruction information regarding examination, and a first communication unit for transmitting instruction information input by the input unit to the ophthalmologic examination apparatus. An ophthalmologic examination apparatus includes an examination optical system including an optical element applied to an eye to be examined, a projection system for projecting an examination light beam for examining the eye to be examined through the optical element, a display unit, and the display unit. an information presentation optical system including a light guide system that guides the display light beam output from the optical element to the eye to be inspected; a second communication unit that receives instruction information transmitted from the inspection instruction device; and a predetermined character image is displayed on the display unit, and the operation of the character image is controlled based on the instruction information received by the second communication unit. After executing the first control of changing the character image, the control unit of the ophthalmologic examination apparatus further executes the second control of displaying examination information for examining the subject's eye instead of the character image.

According to the embodiment, it is possible to suitably convey the intent of the examiner to the subject in the remote examination.

Schematic diagram showing an example of the configuration of an ophthalmologic examination system according to an embodiment. Schematic diagram showing an example of the configuration of an ophthalmologic examination system according to an embodiment. Schematic diagram showing an example of the configuration of an ophthalmologic examination system according to an embodiment. Schematic diagram showing an example of the configuration of an ophthalmologic examination system according to an embodiment. Schematic diagram showing an example of the configuration of an ophthalmologic examination system according to an embodiment. Schematic diagram showing an example of the configuration of an ophthalmologic examination system according to an embodiment. FIG. 2 is a sequence diagram showing an example of a usage pattern of the ophthalmologic examination system according to the embodiment; FIG. 1 is a schematic diagram for explaining a usage pattern of an ophthalmologic examination system according to an embodiment; FIG. 2 is a sequence diagram showing an example of a usage pattern of the ophthalmologic examination system according to the embodiment; FIG. 2 is a sequence diagram showing an example of a usage pattern of the ophthalmologic examination system according to the embodiment; FIG. 2 is a sequence diagram showing an example of a usage pattern of the ophthalmologic examination system according to the embodiment; Schematic diagram showing an example of the configuration of an ophthalmologic examination system according to an embodiment. Schematic diagram showing an example of the configuration of an ophthalmologic examination system according to an embodiment. Schematic showing the modification of the ophthalmologic examination system which concerns on embodiment. Schematic diagram showing an example of a display screen of an ophthalmologic examination system according to an embodiment.

Several examples of exemplary embodiments of the present invention are described. Note that the contents of the documents cited in this specification and known techniques can be incorporated into the embodiments.

The ophthalmologic examination system of the embodiment is used for remote examination using ophthalmologic examination apparatuses installed in various facilities and portable ophthalmologic examination apparatuses. Remote examination in the embodiment involves an examiner (internal examiner) who assists the examination at the facility where the ophthalmologic examination apparatus is installed, and an examiner (external examiner) who assists the examination from outside the facility. . Typically, an internal examiner uses a tablet terminal or wearable device (e.g., wireless earphones) to grasp the status of all or some of the examinees undergoing examinations in the facility and give instructions. send. The external examiner uses an information processing device installed in a facility (administration center) for managing examinations using ophthalmologic examination equipment to check the status of all or some of the examinees currently undergoing examinations. understand and give instructions. The subject can proceed with the examination based on instructions from the internal examiner and/or the external examiner.

Examples of facilities where ophthalmologic examination apparatuses are installed include medical institutions, opticians, health checkup venues, examination venues, patient's homes, welfare facilities, public facilities, and examination vehicles. In other words, the facility where the ophthalmologic examination apparatus is installed may include at least one of a fixed facility such as a medical institution and a mobile facility such as an examination vehicle. Instructions sent from the examiner to the subject may include support regarding how to proceed with the examination, operation of the ophthalmologic examination apparatus, advice to the subject, and the like.

Also, the mode of remote inspection is not limited to the above. For example, an examination instruction device (examiner terminal) installed outside the management center (for example, the examiner's home) can be configured to transmit an instruction to the ophthalmologic examination apparatus via the management center.

The ophthalmologic examination apparatus may be any apparatus used for examination of an eye to be examined, and may have at least one of a function as an ophthalmologic measurement apparatus and a function as an ophthalmologic imaging apparatus. An ophthalmologic measuring device is a device for measuring the characteristics of an eye to be examined. , specular microscope, wavefront analyzer, perimeter, and microperimeter. An ophthalmologic imaging apparatus is an apparatus for imaging an eye to be examined, and examples thereof include OCT, a fundus camera, and an SLO. Furthermore, the ophthalmologic examination device may comprise an application for analyzing measurement data and captured images.

<Configuration of ophthalmic examination system>
An example of the configuration of an ophthalmologic examination system according to an embodiment will be described. The ophthalmologic examination system 1 illustrated in FIG. 1A is constructed using a network (communication line N) connecting each of N facilities (first facility to Nth facility) where examinations are performed and a management center. there is

Each facility (n-th facility: n = 1 to N, N is an integer of 1 or more) is provided with an ophthalmic examination apparatus 2- _in (i _n = 1 to K _n , K _n is an integer of 1 or more). ing. That is, each facility (n-th facility) is equipped with one or more ophthalmic examination apparatuses 2- _in . The ophthalmologic examination apparatus 2- _in constitutes a part of the ophthalmologic examination system 1. FIG. Note that the ophthalmic examination system 1 may include an examination apparatus capable of performing examinations other than ophthalmic examinations.

The ophthalmologic examination apparatus 2- _in of this example has a function as an "examination apparatus" that performs an examination of a subject (eye to be examined) and a function as a "computer" that performs various data processing and communication with external devices. It has both. In other examples, the inspection device and computer can be separate. In this case, the inspection device and the computer may be configured to communicate with each other. Furthermore, the number of inspection devices and the number of computers are arbitrary, and for example, a single computer and a plurality of inspection devices can be provided.

Further, each facility (n-th facility) is provided with an information processing device (internal examiner terminal 3-n) used by the internal examiner. The internal examiner terminal 3-n is a computer used in the facility, and may be, for example, a tablet terminal, a mobile terminal such as a smart phone, or a server installed in the facility (in-facility server, etc.). Furthermore, the internal examiner terminal 3-n may include a wearable device such as wireless earphones. It should be noted that the internal examiner terminal 3-n is sufficient if it is a computer whose function can be used in the facility, and for example, it may be a computer (cloud server, etc.) installed outside the facility. In the embodiment, the internal examiner terminal 3-n can be used as an examination instruction device.

The ophthalmologic examination apparatus 2- _in and the internal examiner terminal 3-n are connected via a network built in the n-th facility (in-facility LAN, etc.), a wide area network (Internet, etc.), or short-distance communication technology. It may be configured to communicate.

The ophthalmologic examination apparatus 2- _in may have a function as a server. When this configuration is applied, the ophthalmologic examination apparatus 2- _in and the internal examiner terminal 3-n can be configured to communicate directly. In this case, it is not necessary to provide a function for communication between the internal examiner terminal 3-n and the management server 4. FIG. That is, it is possible to configure so that communication between the management server 4 and the internal examiner terminal 3-n is performed via the ophthalmologic examination apparatus 2- _in .

A management server 4 is installed in the management center. The management server 4 can communicate with an external examiner terminal 5m (m=1 to M, where M is an integer equal to or greater than 1) used by an external examiner via a network (LAN, wide area network, etc.). Furthermore, the management server 4 can communicate with at least some of the ophthalmologic examination apparatuses 2- _in installed in the first to Nth facilities via a wide area network.

The management server 4 has, for example, a function of relaying communication between the ophthalmologic examination apparatus 2- _in and the external examiner terminal 5m, and a function of recording the content of this communication. The management server 4 also has a function of associating the ophthalmologic examination apparatus 2- _in with the external examiner terminal 5m, that is, a function of assigning an examiner to each ophthalmologic examination apparatus 2- _in . The correspondence between the ophthalmologic examination apparatus 2- _in and the external examiner terminal 5m may be one-to-one correspondence, many-to-one correspondence, or one-to-many correspondence. In addition, the management server 4 detects that a predetermined error has occurred in the content of communication between the ophthalmologic examination apparatus 2- _in and the external examiner terminal 5m, and records this. It may be configured to notify a warning to, etc.

The management server 4 includes one or more computers. An example in which the management server 4 includes multiple computers is shown in FIG. 1B. The management server 4 shown in FIG. 1B includes a master server 6 and R local servers 7-r (R is an integer equal to or greater than 2). The master server 6 and each local server 7-r can communicate via a communication line N. FIG. The master server 6 includes devices installed in each of the first to Nth facilities (including the ophthalmologic examination device 2- _in , and may further include the internal examiner terminal 3-n) and the communication line N Communication is possible via The master server 6 may be installed at a location other than the management center. Also, the master server 6 may include two or more information processing devices.

More than one management center may be provided in this example. The local server 7-r is installed, for example, in one of the management centers, and manages the external examiner terminals 5m in the management center. The master server 6 manages two or more local servers 7-r.

The configuration of the management server 4 will be described later. When the management server 4 includes a plurality of computers, components of the management server 4, which will be described later, are distributed over the plurality of computers. Also, any component can be redundantly provided in two or more computers. As a result, for example, distributed processing and redundancy are realized.

The external examiner terminal 5m includes a computer used by an examiner who guides and manages examinations performed using the ophthalmologic examination apparatus 2- _in . In the embodiment, the external examiner terminal 5m can be used as an examination instruction device. In the following embodiments, an example in which both the external examiner terminal 5 and the internal examiner terminal 3-n can be used as an examination instruction device will be described. It is also possible to apply an example in which at least one of these and another computer can be used as an inspection instructing device, or an example in which only another computer can be used as an inspection instructing device.

<Configuration of Ophthalmic Examination Apparatus>
The configuration of the ophthalmologic examination apparatus 2- _in will be described. The ophthalmic examination apparatus 2 illustrated in FIG. 2 corresponds to _each of the plurality of ophthalmic examination apparatuses 2-in shown in FIG. 1A. Similarly, each of the internal examiner terminals 3-n may be described as an internal examiner terminal 3, and each of the external examiner terminals 5m may be described as an external examiner terminal 5. FIG.

The ophthalmologic examination apparatus 2 includes a control section 20 , an examination section 21 , an examination situation information generation section 22 a , a communication request generation section 22 b , a user interface (UI) section 23 and a communication section 24 . These components may be provided integrally (that is, within a single housing), or may be distributed within two or more housings. Examples of the former include refractometers, keratometers, tonometers, specular microscopes, wavefront analyzers, perimeters, microperimeters, OCT, fundus cameras, and SLOs. An example of the latter is a vision testing device that includes a target presenting device and a phoropter. Also, part or all of the control unit 20 can be provided in a personal computer or a mobile terminal. Moreover, part or all of the user interface unit 23 can be provided in a personal computer, a mobile terminal, a television receiver, a smart television, or the like.

<Control unit 20>
The control unit 20 executes various controls and calculations. Control unit 20 includes a processor. In this specification, "processor" includes, for example, CPU (Central Processing Unit), GPU (Graphics Processing Unit), ASIC (Application Specific Integrated Circuit), programmable logic device (e.g., SPLD (Simple Programmable Logic Device), CPLD Device (Complex Programmable Logic Device), FPGA (Field Programmable Gate Array)) or the like. The control unit 20 implements the functions according to the embodiment by, for example, reading and executing a computer program stored in a storage circuit or storage device. Controller 20 may further include RAM, ROM, hard disk drives, solid state drives, and the like.

<Output control unit 201>
The control unit 20 has an output control unit 201 . The output control unit 201 performs control for outputting information transmitted from the internal examiner terminal 3 or the external examiner terminal 5 to the ophthalmologic examination apparatus 2 . Examples of output information include visual information and audio information. Visual information is information recognized by the visual system, and includes character string information (text information) and image information. The character string information includes, for example, character messages representing instructions from the examiner. The image information includes, for example, moving images of the examiner's face and hands, and marks representing the examiner's instructions. The output control unit 201 outputs visual information by controlling an LCD 214 and a display device 231, which will be described later. Audio information is information that is perceived by the auditory system and includes warning sounds and voice messages. The output control unit 201 outputs auditory information by controlling an audio output device 233, which will be described later. A specific example of the processing executed by the output control unit 201 will be described later.

<Character control unit 202>
A character control unit 202 is provided in the output control unit 201 . The character control unit 202 controls the output of the visual information described above, and particularly performs control for expressing instructions directed to the subject using characters (character images). Instructions directed to the subject are instructions from any one of the external examiner, the internal examiner, and the ophthalmologic examination apparatus 2 . A character is an image of a person, an animal, a virtual creature, a robot, or the like, and may include a so-called avatar. An avatar is a character that acts as an alter ego of a source of instructions (external examiner, internal examiner, ophthalmologic examination apparatus 2, etc.).

Techniques for controlling characters are described in, for example, Japanese Patent Publication No. 2006-520053, Japanese Patent Publication No. 2016-1885, Japanese Patent Publication No. 2014-149836, Japanese Patent Publication No. 2015-210547, and the like. The character control unit 202 executes control using known techniques represented by these. Character control unit 202 includes a processor and a computer program therefor. An example of processing executed by the character control unit 202 will be described later.

<Inspection unit 21>
The inspection unit 21 performs an inspection of the subject's eye under the control of the control unit 20 . The examination unit 21 has a configuration corresponding to the type of the ophthalmologic examination apparatus 2 . The configuration of the inspection unit 21 may be at least part of a known configuration, or may include a known configuration. The inspection unit 21 includes an optical system as described below and a mechanism (actuator, power transmission mechanism, etc.) not shown.

When the inspection unit 21 has a function of measuring the characteristics of the eye E to be inspected, the inspection unit 21 has, for example, at least an optical system for projecting light onto the eye to be inspected, and detects return light of the light projected onto the eye to be inspected. It further comprises an optical system for detecting. Furthermore, the inspection unit 21 may include optical systems with various functions, such as an optical system for projecting a fixation target onto the subject's eye, an optical system for alignment, and an optical system for focusing. . Moreover, the inspection unit 21 may include a processor for processing the detection result of the return light (image signal, video signal, etc.).

When the inspection unit 21 has a function of photographing the eye E to be inspected, the inspection unit 21 includes, for example, an optical system for projecting light onto the eye to be inspected and a system for detecting return light of the light projected onto the eye to be inspected. and an optical system. Furthermore, the inspection section 21 may include various optical systems, as in the case of the measurement function. Moreover, the inspection unit 21 may include a processor for processing the detection result of the return light (image signal, video signal, etc.).

The optical system as described above corresponds to the inspection optical system 211 . The inspection optical system 211 includes an optical element 212 and a projection system 213 . The optical element 212 is applied to the eye E to be inspected in order to guide the light beam output from the projection system 213 to the eye E to be inspected. The optical element 212 may include, for example, any one of various optical elements such as a lens (objective lens, etc.), a prism (objective prism, etc.), a concave mirror (parabolic mirror, etc.), and a glass plate.

The projection system 213 projects a luminous flux (inspection luminous flux) for inspecting the subject's eye E onto the subject's eye E via an optical element 212 . An LCD 214 is provided in the projection system 213 . LCD 214 operates under the control of control unit 20 . The LCD 214 has a function of displaying information used for examination (examination information: optotype, fixation target, etc.) and a function of displaying information transmitted from the internal examiner terminal 3 or the external examiner terminal 5 . The latter is a function of the information presentation optical system, and the LCD 214 corresponds to the display section of the information presentation optical system. Furthermore, the projection system 213 is a light guide system that guides a light flux (display light flux) from the LCD 214 corresponding to information transmitted from the internal examiner terminal 3 or the external examiner terminal 5 to the eye to be examined E via the optical element 212. function. That is, in the inspection unit 21 of this embodiment, the inspection optical system and the information presentation optical system have a common configuration. On the other hand, it is also possible to configure the inspection optical system and the information presentation optical system separately, an example of which will be described later.

<Examination status information generator 22a>
The examination status information generation unit 22a generates examination status information representing the examination status of the eye E to be examined. The examination status information includes examination progress (examination phase), interim results of examination (for example, optotype presentation history in visual acuity examination), examination time (for example, examination start time, elapsed time), and the like. If the ophthalmologic examination apparatus 2 has a function of photographing the subject's eye E and the subject, the examination status information may include captured images (still images and moving images) of the subject's eye E and the like. Also, the examination status information may include the subject's voice information input via the voice input device 234 . The generated examination status information is transmitted to, for example, the internal examiner terminal 3 and/or the external examiner terminal 5 and referred to by the examiner. Further, in this embodiment, the generated inspection status information is sent to the communication request generator 22b. The examination status information generator 22a includes, for example, a processor and a computer program for conducting examination or a computer program for monitoring it.

It should be noted that not all of the information transmitted from the ophthalmologic examination apparatus 2 to the internal examiner terminal 3 and/or the external examiner terminal 5 need to be processed by the examination status information generator 22a. For example, the moving image of the subject's eye E and the voice information of the subject can be transmitted to the internal examiner terminal 3 and/or the external examiner terminal 5 as they are. Thereby, the state of the eye E to be examined, the state of the subject, and the request of the subject can be provided to the examiner substantially without time lag.

<Communication request generator 22b>
The communication request generator 22b generates a request (communication request) for reading out the internal examiner and/or the external examiner. The communication request generator 22b performs at least a process of generating a communication request in response to an instruction from the subject and a process of generating a communication request based on the examination status information generated by the examination status information generator 22a. configured to be able to run one or the other.

Instructions from the subject are input using the user interface unit 23 . Instructions are input via, for example, an operation device 232 and/or a voice input device 234, which will be described later. As a specific example, the subject uses the operation device 232 to perform a predetermined operation (pressing a button, tilting a lever, etc.) for calling the internal examiner and/or the external examiner. In addition, the subject operates a software key displayed on a display device 231, which will be described later, using the operation device 242, or operates a software key displayed on the touch panel display with a finger. A call request can be entered. In addition, when the subject utters a message to the effect that he/she does not understand the contents of the examination, or a message to the effect that he/she needs instructions from the internal examiner and/or the external examiner, the voice information is detected by the voice input device 234. can do. According to this example, it is possible to provide assistance according to the subject's request.

An example of generating a communication request based on examination status information will be described. The examination status information generating unit 22a sequentially generates examination status information while monitoring the examination status. The communication request generator 22b determines whether or not the generated inspection status information satisfies a predetermined condition. Predetermined conditions include, for example, that the test is not progressing, that the interim result of the test (for example, the history of optotype presentation in a visual acuity test) is inappropriate, that the elapsed time from the start of the test is long, and that the eyelids is closed for a long time, fixation of the eye to be examined E is not applicable, and the like. The fact that the examination is not progressing is recognized, for example, by detecting that the examination phase has not shifted for a predetermined time or longer (for example, the same target is presented). Inappropriate interim test results are recognized by, for example, detecting an inappropriate presentation order of the visual targets (for example, failure to converge response content). The closing of the eyelids and the fixation state of the eye E to be examined are recognized by analyzing the photographed image of the eye E to be examined. This image analysis includes, for example, pupil detection. According to this example, it is possible to automatically detect a situation in which assistance is required.

The communication request generated by the communication request generation unit 22b is transmitted to the management server 4 and/or the internal examiner terminal 3 by the communication unit 24. FIG.

<User Interface Unit 23>
The user interface unit 23 has a function of outputting information to the subject (and the internal examiner), and a function of inputting information and giving operation instructions. The user interface unit 23 includes a display device 231 and an audio output device 233 for the former function, and an operation device 232 and an audio input device 234 for the latter function.

The display device 231 includes a display device such as a flat panel display. The operation device 232 includes operation devices such as buttons, keys, joysticks, knobs, and an operation panel provided on the housing or outside of the ophthalmologic examination apparatus 2 . The operation device 232 may also include an operation device (mouse, keyboard, trackpad, button, touch panel, etc.) such as a personal computer connected to the ophthalmologic examination apparatus 2 . The user interface unit 23 may include a device such as a touch panel in which the display device 231 and the operation device 232 are integrated, or a graphical user interface (GUI). The user interface unit 23 may also include a processor and a computer program for performing operations and inputs based on the subject's voice input from the voice input device 234 .

The audio output device 233 includes, for example, a circuit for processing output audio information (audio signal) and a speaker for outputting the processed audio information. Audio input device 234 also includes a microphone that converts audio information into an electrical signal, and circuitry that processes the electrical signal.

<Communication unit 24>
The communication unit 24 performs data communication with the management server 4 . Furthermore, the communication unit 24 may be able to perform data communication with the internal examiner terminal 3 . Any data communication method may be used. For example, the communication unit 24 includes an Internet-compliant communication interface, a LAN-compliant communication interface, a short-range communication-compliant communication interface, and the like. Data communication may be wired communication or wireless communication. The communication unit 24 may be capable of data communication with an external device other than the management server 4 and the internal examiner terminal 3 . Data transmitted and received by the communication unit 24 may be encrypted. In that case, for example, the control unit 20 includes an encryption processing unit that encrypts transmission data and a decryption processing unit that decrypts reception data.

<Configuration of internal examiner terminal>
The configuration of the internal examiner terminal 3 will be described. The internal examiner terminal 3 illustrated in FIG. 3 includes a control section 30 , a user interface (UI) section 31 and a communication section 32 .

<Control unit 30>
The control unit 30 controls each unit of the internal examiner terminal 3 and executes various arithmetic processing. Control unit 30 includes a processor. Controller 30 may further include RAM, ROM, hard disk drives, solid state drives, and the like.

<User Interface Unit 31>
The user interface unit 31 has a function of outputting information to the user and a function of allowing the user to input information and give operational instructions. The user interface unit 31 includes a display device 311 , an operation device 312 , an audio output device 313 and an audio input device 314 , similar to the user interface 23 of the ophthalmologic examination apparatus 2 .

<Communication unit 32>
The communication unit 32 performs data communication between the management server 4 and the ophthalmologic examination apparatus 2 . The data communication method and encryption may be the same as those of the communication unit 24 of the ophthalmologic examination apparatus 2 .

<Configuration of External Examiner Terminal>
The configuration of the external examiner terminal 5 will be described. The external examiner terminal 5 illustrated in FIG. 4 includes a control unit 50 , an imaging unit 51 , a user interface (UI) unit 52 , a transmission information generation unit 53 and a communication unit 54 .

<Control unit 50>
The control unit 50 controls each unit of the external examiner terminal 5 and executes various kinds of arithmetic processing. Control unit 50 includes a processor. The controller 50 may further include RAM, ROM, hard disk drives, solid state drives, and the like.

<Photographing unit 51>
The photographing unit 51 is used to photograph a moving image of the examiner, and includes, for example, a video camera. The imaging target includes body parts (eg, face, upper body, hands, etc.) used to express instructions to the subject.

<User Interface Unit 52>
The user interface unit 52 has a function of outputting information to the examiner and a function of allowing the examiner to input information and give operation instructions. The user interface unit 52 includes a display device 521, an operation device 522, an audio output device 523, and an audio input device 524, like the user interface 23 of the ophthalmologic examination apparatus 2.

For example, the control unit 50 causes the display device 521 to display a screen (GUI or the like) for displaying examination status information sequentially transmitted from the ophthalmologic examination apparatus 2 and for inputting instructions to the subject. In addition, the control unit 50 causes the voice output device 523 to output voice information of the subject. The examiner refers to the display information and voice information to determine the content of the instruction, and inputs it using the operation device 522 . A voice instruction is input via the voice input device 524 .

<Transmission information generator 53>
The transmission information generation unit 53 generates information (transmission information) directed to the subject using the ophthalmologic examination apparatus 2 based on the contents (instructions) input by the examiner using the user interface 52 . The transmission information generator 53 includes, for example, a processor and a transmission information generation program executed in conjunction with the screen (GUI).

Note that it is not necessary for the transmission information generation unit 53 to process all the information transmitted from the external examiner terminal 5 to the ophthalmologic examination apparatus 2 . For example, moving images and voice information of the examiner can be transmitted to the ophthalmologic examination apparatus 2 as they are. As a result, the examiner's instructions can be provided to the examinee with substantially no time lag.

<Communication unit 54>
The communication unit 54 performs data communication with the management server 4 . The data communication method and encryption may be the same as those of the communication unit 24 of the ophthalmologic examination apparatus 2 .

<Management server configuration>
A configuration of the management server 4 will be described. The management server 4 illustrated in FIG. 5 includes a control section 40 , a communication establishment section 41 , a control management section 42 and a communication section 43 . At least one of these components is realized, for example, by cooperation of hardware and software distributed in master server 6 and local servers 7-r shown in FIG. 1B.

<Control unit 40>
The control unit 40 controls each unit of the management server 4 . For example, part of the control unit 40 (master control unit) is provided in the master server 6, and this master control unit controls each local server 7-r. The control unit 40 may be capable of executing other arithmetic processing. Control unit 40 includes a processor. Controller 40 may further include RAM, ROM, hard disk drives, solid state drives, and the like.

The controller 40 includes a communication controller 401 and a transfer controller 402 .

The communication control unit 401 controls establishment of communication among the ophthalmologic examination apparatus 2 , the internal examiner terminal 3 and the external examiner terminal 5 . For example, the communication control unit 401 performs control for establishing communication with each of the devices selected by the selection unit 412, which will be described later, from among the ophthalmologic examination device 2, the internal examiner terminal 3, and the external examiner terminal 5. send a signal.

The transfer control unit 402 controls exchange of information between devices with which communication has been established by the communication establishment unit 41 (and the communication control unit 401). For example, the transfer control unit 402 transfers information transmitted from one of at least two devices with which communication has been established by the communication establishment unit 41 (and the communication control unit 401) to another device. As a specific example, when communication is established between the ophthalmologic examination apparatus 2 and the external examiner terminal 5, the transfer control unit 402 sends information transmitted from the ophthalmologic examination apparatus 2 (or the external examiner terminal 5) to the external device. Transfer to the examiner terminal 5 (or the ophthalmologic examination apparatus 2). At this time, the transfer control unit 402 may transmit information obtained by processing the information transmitted from the ophthalmologic examination apparatus 2 or the like to the external examiner terminal 5 or the like. For example, the transfer control unit 402 can extract part of the information transmitted from the ophthalmic examination apparatus 2 or the like and transmit it to the external examiner terminal 5 or the like. In addition, information transmitted from the ophthalmologic examination apparatus 2 or the like (for example, image data of the eye to be examined E) is analyzed by the management server 4 or another device, and the analysis results (and original information) are sent to the external examiner terminal 5 or the like. You may make it transmit. Processing of information is not limited to such extraction and analysis, and may include arbitrary data processing.

<Communication establishment unit 41>
The communication establishment unit 41 executes processing for establishing communication between at least two devices selected from the ophthalmologic examination device 2 , the internal examiner terminal 3 and the external examiner terminal 5 . "Establishment of communication" in the present embodiment means, for example, (1) establishing one-way communication after communication is disconnected, (2) establishing two-way communication after communication is disconnected, This concept includes at least one of (3) switching from a state in which only reception is possible to a state in which transmission is also possible, and (4) switching from a state in which only transmission is possible to a state in which reception is also possible. As a specific example, the "establishment of communication" changes from a state in which the external examiner is monitoring the examination using the external examiner terminal 5 (a state in which only reception is possible) to a state in which instructions can be sent to the subject. may include switching to

Furthermore, the communication establishment unit 41 can execute processing for disconnecting established communication. In the present embodiment, "communication disconnection" means, for example, (1) disconnecting communication from a state in which one-way communication has been established, (2) disconnecting communication from a state in which two-way communication has been established, (3) switching from a state in which two-way communication is established to one-way communication, (4) switching from a state in which transmission and reception are possible to a state in which only reception is possible, (5) a state in which transmission and reception are possible to a state in which only transmission is possible. As a specific example, "disconnection of communication" means that only the monitoring of the examination is performed from a state in which the external examiner can transmit instructions to the subject using the external examiner terminal 5 (a state in which transmission and reception are possible). Switching to an enabled state (a state where only reception is possible) may be included.

Each of the ophthalmologic examination apparatus 2, the internal examiner terminal 3, and the external examiner terminal 5 sends a communication request (call request) for calling another apparatus (its user) and communication between the other two apparatuses. At least one of a communication request for interrupting (interrupt request) can be transmitted to the management server 4 . Call and interrupt requests can be initiated manually or automatically. The management server 4 (communication unit 43 ) receives communication requests transmitted from the ophthalmologic examination apparatus 2 , the internal examiner terminal 3 , or the external examiner terminal 5 .

In an embodiment, the communication establishment section 41 may include a selection section 412 . Based on the received communication request, the selection unit 412 selects one or more devices from among the ophthalmologic examination device 2, the internal examiner terminal 3, and the external examiner terminal 5 other than the device that transmitted the communication request. For example, when receiving a communication request from the ophthalmologic examination apparatus 2, the selection unit 412, for example, selects the internal examiner terminal 3 of the facility where this ophthalmologic examination apparatus 2 is installed and any management center (any One or both of the external examiner terminal 5 installed in the local server 7-r) is selected. The communication establishment unit 41 establishes communication between the selected internal examiner terminal 3 and/or external examiner terminal 5 and the ophthalmologic examination apparatus 2 that has transmitted the communication request. This makes it possible to automatically select an examiner and provide examination support according to the request of the examinee of the ophthalmologic examination apparatus 2 .

Selection of the device according to the communication request is performed based on preset attributes, for example. Examples of this attribute include the type of examination, the degree of specialization/proficiency required to assist in the examination, and the type of language. In order to implement this example, the communication establishment unit 41 may include a storage unit 411 in which attribute information created in advance is stored. The attribute information represents attributes of the internal examiner terminal 3 and/or its user (internal examiner) and attributes of the external examiner terminal 5 and/or its user (external examiner). Here, the internal examiner and the external examiner are identified, for example, by pre-assigned examiner IDs. Further, the internal examiner terminal 3 and the external examiner terminal 5 are identified by, for example, device IDs and network addresses assigned in advance. In a typical example, the attribute information includes, as attributes of each examiner (internal examiner and external examiner, respectively), the type of examination that the examiner can support, and the examiner's specialization/skill level. , and the type of language that the examiner can use.

When the selection unit 412 refers to the attribute information, the communication request transmitted from the ophthalmologic examination apparatus 2, the internal examiner terminal 3, or the external examiner terminal 5 may include information regarding attributes. For example, a communication request (for example, a call request) transmitted from the ophthalmologic examination apparatus 2 may include any of the following: (1) information indicating the type of examination being performed by the ophthalmologic examination apparatus 2; ) Information indicating the difficulty level of examination support (information indicating that the subject is difficult to test, information indicating the subject's progress, information indicating the progress of the examination, etc.); (3) Subject's disease name, age, etc. (4) Information indicating the language used by the subject. The selection unit 412 selects at least one of the internal examiner terminal 3 and the external examiner terminal 5 based on the received communication request and attribute information. At this time, the selection unit 412 collates the attribute information included in the communication request with the information included in the attribute information. Accordingly, the selection unit 412 selects, for example, the internal examiner terminal 3 and/or the external examiner terminal 5 corresponding to one of the following examiners: (1) an examiner capable of supporting the examination type; (2) an examiner who can support the examination of the difficulty level; (3) an examiner who can support the subject with the disease and age; and (4) an examiner who can use the language. Here, the correspondence between the internal examiner and the internal examiner terminal 3 and the correspondence between the external examiner and the external examiner terminal 5 are determined, for example, by the examiner terminal (to which the device ID is assigned) when logging into the system. ) by the examiner ID entered in ).

<Control Management Unit 42>
The control management unit 42 executes processing for managing information output control by the ophthalmologic examination apparatus 2 . In particular, the control management unit 42 of this example learns the control executed by the ophthalmologic examination apparatus 2 according to instructions from the examiner, and executes processing for reflecting it in subsequent control. In order to execute such processing, the control management section 42 includes a storage section 421 and a search section 422 .

The control manager 42 collects the examination situation information generated by the examination situation information generator 22 a of the ophthalmologic examination apparatus 2 . Specifically, at least part of the examination status information generated by the examination status information generating section 22 a is transmitted to the management server 4 and stored in the control management section 42 .

Further, the control management unit 42 can collect instruction contents (instruction information) from the examiner. Specifically, instruction information transmitted from the external examiner terminal 5 (or the internal examiner terminal 3) to the ophthalmologic examination apparatus 2 is stored in the control management unit 42. FIG. Examples of instruction information include transmission information generated by the transmission information generation unit 53 of the external examiner terminal 5 and information similarly generated by the internal examiner terminal 3 .

Furthermore, the control management unit 42 can collect control information representing control executed by the ophthalmologic examination apparatus 2 in accordance with instruction information from the examiner. Specifically, control information representing control executed by the control unit 20 (in particular, the output control unit 201) is sent to the management server 4 and stored in the control management unit 42. FIG. Note that the control management unit 42 may be configured to generate control information based on instruction information from the external examiner terminal 5 (or the internal examiner terminal 3). Alternatively, the control management unit 42 may be configured to regard instruction information from the external examiner terminal 5 (or the internal examiner terminal 3) as control information.

<Storage unit 421>
The control management unit 42 is executed by the ophthalmologic examination apparatus 2 based on (at least part of) examination status information from the ophthalmologic examination apparatus 2 and instruction information from the external examiner terminal 5 (and/or the internal examiner terminal 3). (at least part of) the control information representing the executed control is stored in the storage unit 421 . An example of this process is described below.

When the ophthalmologic examination apparatus 2 generates examination status information, this examination status information is sent to the external examiner terminal 5 via the management server 4 . The external examiner inputs an instruction to the external examiner terminal 5 according to the examination status information. The external examiner terminal 5 generates instruction information according to the input instruction. This instruction information is sent to the ophthalmologic examination apparatus 2 via the management server 4 . The output control unit 201 of the ophthalmologic examination apparatus 2 causes the user interface unit 23 to output information (visual information, auditory information, etc.) corresponding to the instruction information. Control information representing at least part of this output control is sent to the management server 4 . The control management unit 42 associates the examination status information and control information (or instruction information) in this series of flows and stores them in the storage unit 421 . According to this example, the content of the control instructed by the examiner is stored according to the examination situation. As a result, the relationship between the examination status and the examiner's instruction content is accumulated in the storage unit 421 .

The control manager 42 can classify the accumulated examination status information and/or control information. Examples of classification of examination status information include classification according to subject attributes (age, sex, disease, etc.), classification according to examination type, and classification according to examination progress (examination phase). There are also classifications according to interim test results (for example, the history of optotype presentation in a visual acuity test), and classifications according to test time (for example, length of elapsed time). Examples of the classification of control information include, in addition to the above-described classification examples of examination status information, classification according to the degree of specialization and skill of the examiner, classification according to the language used, and the like.

<Search unit 422>
When new examination situation information is generated by the examination situation information generation section 22 a of the ophthalmologic examination apparatus 2 , the search section 422 searches the storage section 241 for control information corresponding to the new examination situation information. An example of this search processing will be described below.

When new examination situation information is generated by the examination situation information generator 22 a of the ophthalmologic examination apparatus 2 , this new examination situation information is sent to the management server 4 . The control management unit 42 identifies past examination status information (for example, any class in the above classification) corresponding to this new examination status information, and stores control information associated with the identified past examination status information. Acquired from unit 421 . The "control information corresponding to the new examination status information" includes not only the control information associated with the same past examination status information as the new examination status information, but also the control information that is the same as or similar to the new examination status information. Control information associated with deemed past examination status information (eg, the class in which new examination status information is included) is also included.

<Communication unit 43>
The communication unit 43 performs data communication with the ophthalmologic examination apparatus 2, the internal examiner terminal 3, and the external examiner terminal 5, respectively. The data communication method and encryption may be the same as those of the communication unit 24 of the ophthalmologic examination apparatus 2 .

<Usage form>
A typical example of usage of the ophthalmologic examination system 1 of the present embodiment will be described.

<First example of usage pattern>
As a first example of the usage pattern of the ophthalmologic examination system 1, a usage pattern for providing assistance using a character in response to a call from the subject will be described with reference to FIG.

(S1: Start inspection)
An examination of the subject's eye E using the ophthalmologic examination apparatus 2 is started. Communication (two-way communication) between the ophthalmologic examination apparatus 2 and the internal examiner terminal 3 and/or the external examiner terminal 5 may be started from this stage. Further, upon receiving the start of the examination, the control section 20 causes the examination status information generating section 22a to start generating examination status information.

(S2: Request to call examiner)
The subject calls the examiner using the user interface unit 23 when the examiner's assistance is required. Examples of cases in which the examiner's assistance is required include when the examiner does not know how to perform the examination, when the examiner is tired, and when the examiner wants to go back through the examination steps. Further, examples of how to use the user interface unit 23 for inputting a call request include execution of a predetermined operation by the operation device 232 and input of voice by the voice input device 234 .

(S3: Send request/information)
The control unit 20 controls the communication unit 24 to transmit the examiner call request (communication request) input in step S2 to the management server 4 together with predetermined information. Examples of information transmitted together with the examiner call request include identification information pre-assigned to the ophthalmologic examination apparatus 2 (apparatus ID), identification information pre-assigned to the subject (subject ID), ophthalmic examination apparatus 2 identification information (facility ID) assigned in advance to the facility where the is installed, at least a part of the examination status information generated up to the present time, the content of the examiner call request, and the like.

(S4: Selection of examiner terminal)
The management server 4 receives the examiner call request and information transmitted from the ophthalmologic examination apparatus 2 in step S3 by the communication unit 43 . The selection unit 412 selects an examiner who assists the subject. That is, the selection unit 412 selects one of the internal examiner terminals 3 and/or the external examiner terminal 5 existing in the facility where the subject is being examined.

For this purpose, the selection unit 412 has, for example, a function of monitoring the operating state (communication establishment information) of each external examiner terminal 5, and the currently inactive external examiner terminal 5 You can choose one of the examiners who did not go). External examiners who are not currently assisting other subjects can thereby be assigned to assist the subject who sent the call request. Such a selection process can be realized, for example, by managing the operating state of each external examiner terminal 5 by the presence or absence of a flag.

As another example, the selection unit 412 determines whether communication is currently established with one of the internal examiner terminal 3 and the external examiner terminal 5 corresponding to the communication request, and if not established, can establish communication between the one device and the ophthalmic examination device 2 and, if established, between the other device and the ophthalmic examination device 2 . As a specific example, when all internal examiner terminals 3 in the facility are in operation (that is, when communication with other ophthalmologic examination apparatuses 2 or external examiner terminals 5 is established), the selection unit 412 can select any of the external examiner terminals 5 that are not in operation. Also, when any internal examiner terminal 3 in the facility is not in operation, the selection unit 412 can select this internal examiner terminal 3 . According to such a configuration, by comprehensively considering the operation states of the internal examiner terminal 3 and the external examiner terminal 5, it is possible to quickly provide assistance to the examinee. This example can also be realized by managing the operation state of each internal examiner terminal 3 and the operation state of each external examiner terminal 5 by the presence or absence of flags.

(S5: Transmission of control signal for establishing communication)
The communication control unit 401 instructs the examiner terminal (the internal examiner terminal 3 and/or the external examiner terminal 5) selected in step S4 to establish communication between the examiner terminal and the ophthalmologic examination apparatus 2. control signal. The example of FIG. 6 represents a case where a control signal is transmitted to the external examiner terminal 5 .

(S6: Start bidirectional communication)
Two-way communication between the external examiner terminal 5 and the ophthalmologic examination apparatus 2 is established by the control signal transmitted in step S5. At this time, at least one of establishing communication between the internal examiner terminal 3 and the external examiner terminal 5 and establishing communication between the internal examiner terminal 3 and the ophthalmologic examination apparatus 2 is further performed. can also Incidentally, as described above, it is also possible to configure so that communication is established at an earlier stage.

(S7: start shooting)
The transfer control unit 402 of the management server 4 sends the information transmitted from the ophthalmologic examination apparatus 2 in step S3 to the external examiner terminal 5 . The control unit 50 of the external examiner terminal 5 controls the photographing unit 51 to start photographing a moving image of the examiner. At this time, the input of the voice uttered by the examiner is also started. Frames sequentially captured by the imaging unit 51 are transferred to the ophthalmologic examination apparatus 2 via the management server 4 in real time. This processing is executed by the transfer control unit 402 .

(S8: Start of character display/voice output)
The ophthalmologic examination apparatus 2 receives frames and audio information sequentially transmitted from the external examiner terminal 5 . The output control unit 201 controls any one of the LCD 214, the display device 231, and the audio output device 233 based on the information that is sequentially received.

In this example, the character control unit 202 causes the LCD 214 to display a character (avatar) that acts as an alter ego of the examiner. When a plurality of characters are prepared, the character control unit 202 can select a character according to, for example, the attribute of the subject, the attribute of the examiner, the type of examination, and the like. Furthermore, the output control unit 201 causes the voice output device 233 to output the voice uttered by the examiner, the synthesized voice, and the like. The output control unit 201 can synchronize the action of the character and the output of the voice (that is, they can be linked). In addition, the output control unit 201 can display moving images of the examiner in real time. Such processing enables the examiner's instructions to be transmitted to the examinee by a character or the like.

The examiner can grasp the subject's voice and operations in real time. Such two-way information exchange is mainly realized by the transfer control unit 402 of the management server 4 .

(S9: Start displaying information)
In order to facilitate assisting work by the examiner, the control unit 50 of the external examiner terminal 5 causes the display device 521 to display the aforementioned screen (GUI, etc.) and transfers it from the ophthalmologic examination apparatus 2 via the management server 4 . The received information (in particular, examination status information) can be displayed on this screen. Upon receiving new examination status information, the control unit 50 updates the display content. As a result, the status of the examination being performed using the ophthalmologic examination apparatus 2 can be grasped substantially in real time, and appropriate assistance can be provided at an appropriate timing using visual information and audio information. can.

(S10: Start inputting instructions)
The examiner inputs instructions using the operation device 522 (GUI). Examples of the contents of the instruction include examination change, presentation of character string information, presentation of image information, and the like. Instructions using means other than the GUI include instructions by gestures, instructions by voice, and the like.

(S11: Start generating information)
The transmission information generator 53 generates transmission information directed to the subject based on the content (instruction) input in step S10. The transmission information is generated, for example, each time the examiner inputs an instruction.

(S12: Start sending information)
The external examiner terminal 5 transmits the transmission information generated in step S<b>11 to the ophthalmologic examination apparatus 2 via the management server 4 . This processing is implemented by the transfer control unit 402 .

(S13: Character control start)
The ophthalmologic examination apparatus 2 receives the transmission information transmitted from the external examiner terminal 5 in step S12. The output control unit 201 controls the action of the character displayed on the LCD 214 and controls the voice output device 233 based on the transmission information. At this time, the output control unit 201 can synchronize the action of the character and the output of the voice. Furthermore, the output control unit 201 can cause the LCD 214 and the display device 231 to display character string information and image information based on the transmission information.

An example of character control will be described. As described in step S10, the instructions input by the examiner include instructions using the operation device 522, instructions by gestures, instructions by voice, and the like. Note that the instruction input method is not limited to these.

Instructions using the operation device 522 are operations using various keys (hardware keys, software keys). Control content of the character is associated in advance with each key and each operation content. This correspondence information is stored in advance in at least one of the ophthalmologic examination apparatus 2 , external examiner terminal 5 (internal examiner terminal 3 ), and management server 4 . If stored in the external examiner terminal 5, for example, the control unit 50 identifies the control content corresponding to the operated key (and/or its operation content) and outputs it as transmission information. If the correspondence information is stored in the ophthalmologic examination apparatus 2 or the management server 4 , the control unit 20 or 40 specifies control details based on transmission information (instruction information) transmitted from the external examiner terminal 5 . The character control unit 202 moves the character displayed on the LCD 214 based on this control content. For example, the character control unit 202 controls the character to point to an object (for example, target) displayed with the character. When synchronous control with voice output is performed, the character control unit 202 can move the mouth part of the character or move other parts or the whole body in accordance with the voice output.

When an instruction is input by gesture, the character can be controlled based on the moving image obtained by the photographing unit 51 . For example, at least one of the ophthalmic examination apparatus 2, the external examiner terminal 5 (internal examiner terminal 3), and the management server 4 has the following elements: a storage device for pre-storing correspondence information; a processor that analyzes moving images from the external examiner terminal 5 to detect the movement of the examiner and specifies control details corresponding to the detected movement based on the correspondence information. The process of analyzing the moving image and detecting the motion of the examiner is realized using a known image analysis technique.

When an instruction is input by voice, the character can be controlled based on the voice information input via the voice input device 524 . For example, at least one of the ophthalmologic examination apparatus 2, the external examiner terminal 5 (internal examiner terminal 3), and the management server 4 has the following elements: A storage device for pre-storing the corresponding information; analyzes voice information from the external examiner terminal 5 to identify the character string uttered by the examiner, and identifies the control content corresponding to the identified character string based on the corresponding information. processor. The process of analyzing the voice information and identifying the character string is implemented using a known voice analysis technique.

An example of a visual acuity test display using Landolt's ring is shown in FIG. In this example, the test information 600 displayed on the LCD 214 includes the Landolt's ring for the visual acuity test, the character string "visual acuity value: 0.5" representing the visual acuity value corresponding to the Landolt's ring, and the cutout portion of the Landolt's ring. Up, down, left, and right directional arrow images arranged around the Landolt's ring for selecting and inputting the direction of.

Furthermore, a character 550 is displayed near the examination information 600 . A character string or the like representing the voice uttered by the character 550 is displayed in the balloon 560 . The character string displayed in balloon 560 and the voice output from voice output device 233 may be the same or different. Character strings (and voices) can be switched according to attributes of subjects, examiners, characters, and the like. For example, it is possible to switch the tone of the character string (and voice) according to the age of the subject and the sex of the examiner.

Some examples of what is output as a character string or voice are shown below. By referring to the image of the anterior segment of the eye to be examined E, the examiner grasps that the eyelid is drooping or that the eye is squinting, and sends a message to point out the fact or a message to encourage the eye to open. Input to external examiner terminal 5 . The output control unit 201 executes control for outputting a character string or voice corresponding to an input message. As a result, it is possible to prevent the improvement of visual acuity due to the pinhole effect and the deterioration of the visual acuity due to the eyelids covering the pupils, thus making it possible to perform the visual acuity test with high accuracy. Note that the ophthalmologic examination apparatus 2, the management server 4, the external examiner terminal 5, and the like can be configured to detect such an event by analyzing the anterior segment image. In this case, it is possible to automatically output a character string or voice, or notify the examiner of the occurrence of a predetermined event.

When the examinee finds out that the subject has not blinked for a predetermined time, the examiner inputs a message to the external examiner terminal 5 to prompt the examinee to blink. The output control unit 201 executes control for outputting a character string and voice corresponding to this message. As a result, it is possible to prevent the cornea from drying out and the visual acuity from deteriorating. Note that the ophthalmologic examination apparatus 2, the management server 4, the external examiner terminal 5, and the like can be configured to detect non-blinking for a predetermined time by analyzing the anterior segment image. In this case, it is possible to automatically output a character string or voice, or notify the examiner that the subject has not blinked for a predetermined time.

During the inspection, the method of inspection can be presented, and instructions for promoting the progress of the inspection can be presented. For example, in a visual acuity test, a message can be output according to the correct/incorrect answer of the subject's response. It is also possible to use the character for the test itself. For example, a character in the form of a snake can be rotated to attract the subject's attention, and the display can be switched from the character to the Landolt's ring at a predetermined timing. Also, in a binocular function test such as an anisotropic vision test, it is possible to present a character in the form of an animal at the presentation position of a fusion target (fixation target) and rotate it to promote fixation. can. A character in the form of an animal is displayed by switching to a normal fusion target (fixation target) at a predetermined timing. Examples of the timing for switching from the character to the visual target include the timing at which a predetermined time has elapsed and the timing at which it is detected from the anterior segment image that the subject's eye E has gazed at the character.

After the examination is completed, the examination results and medical matters may be explained to the examinee. Characters can be used for this purpose. At this time, images and character strings can be displayed to facilitate understanding of the explanation. For example, while an image representing the mechanism by which emmetropia, myopia, and hyperopia occur is displayed together with a character, explanations can be given using audio information.

A character can be used to conduct an interview before the examination. In the medical interview, for example, the presence and frequency of use of vision correction devices (glasses, contact lenses, intraocular lenses, etc.), medical history, etc. can be asked by combining characters, character strings, voices, etc. can.

The voice of the examiner input by the voice input device 524 of the external examiner terminal 5 can be converted into synthesized voice corresponding to the character and output. Voice conversion is performed by the external examiner terminal 5 , the management server 4 , or the ophthalmologic examination apparatus 2 . The output control unit 201 causes the voice output device 233 to output synthetic voice obtained by converting the voice of the examiner.

The voice of the examiner input by the voice input device 524 of the external examiner terminal 5 can be converted according to the attribute of the examinee. For example, the examiner's voice can be translated into the subject's working language. Language conversion (translation) is realized using known speech analysis technology and translation technology. Hardware and software for that purpose are provided in any one of the external examiner terminal 5 , the management server 4 and the ophthalmologic examination apparatus 2 . The output control unit 201 can generate synthesized speech representing the content obtained by translating the examiner's speech, and can cause the speech output device 233 to output this. Further details regarding processing according to the language used by the subject will be described later.

When the information (visual acuity value, refraction power, etc.) regarding the visual acuity of the subject's eye E is acquired in advance, the output control unit 201 can adjust the display size of characters, character strings, and images based on this information. The output control unit 201 stores in advance table information in which visual acuity values and/or refractive powers are associated with display sizes. The output control unit 201 selects a display size associated with the visual acuity value and/or refractive power of the subject's eye E, and causes the LCD 214 to display characters or the like in the selected display size.

<Second example of usage pattern>
As a second example of the usage pattern of the ophthalmologic examination system 1, a usage pattern in which two or more examiners assist a single subject through their respective characters (avatars) will be described with reference to FIG. do.

In this example, one internal examiner and one external examiner assist a single subject, but two or more internal examiners assist a single subject, Two or more external examiners assisting a single subject; one or more internal examiners and two or more external examiners assisting a single subject; It is also possible for the above internal examiners and one or more external examiners to assist a single subject.

In addition, in this example, a case will be described in which an examiner is selected according to the language used by the examinee. may be For example, even when the examination cannot be performed smoothly because the subject is old, etc., it is possible to perform the same processing as described below. It should be noted that the description of steps and processes similar to those of the first example may be omitted.

(S21: Start inspection)
In this example, a subject whose native language is a language other than Japanese (for example, English) and whose understanding of Japanese is insufficient uses an ophthalmologic examination apparatus 2 installed in a facility in Japan. A case where the inspection is performed by An examination of the subject's eye E using the ophthalmologic examination apparatus 2 is started.

It should be noted that the character can be displayed from this stage (or an earlier stage such as an interview). Since the examiner's assistance is not provided at this stage, the output control unit 201 (character control unit 202) autonomously controls the character based on the examination status information. Such autonomous control is executed according to a computer program.

(S22: Unable to understand language)
The ophthalmologic examination apparatus 2 provides examination explanations and instructions (automatic navigation) to the subject in a preset language. In this example, it is set so that explanations and the like are given in Japanese. The subject in this example cannot understand automatic navigation performed in Japanese.

(S23: Call examiner)
When the subject performs a predetermined operation or voice input to request assistance from the examiner, the communication request generation unit 22b generates a communication request (call request) based on this, and the communication unit 24 generates the communication request and Predetermined information is transmitted to the management server 4 . Alternatively, the examination situation information generation unit 22a of the ophthalmologic examination apparatus 2 generates examination situation information, the communication request generation unit 22b generates a communication request (call request) based thereon, and the communication unit 24 transmits the call request and a predetermined Information is sent to the management server 4 .

(S24: Select internal examiner terminal)
The management server 4 receives the examiner call request and information transmitted from the ophthalmologic examination apparatus 2 in step S23 by the communication unit 43 . At this stage, the selection unit 412 selects one of the internal examiner terminals 3 existing in the facility where the subject is being examined as an examiner who assists the subject.

(S25: Control of communication establishment)
The communication control unit 401 transmits a control signal for establishing communication between the internal examiner terminal 3 and the ophthalmologic examination apparatus 2 to the internal examiner terminal 3 selected in step S24.

(S26: Avatar control start)
When communication between the ophthalmologic examination apparatus 2 and the internal examiner terminal 3 is established by the control in step S25, the character control unit 202 controls the character of the internal examiner who uses this internal examiner terminal 3 (internal examiner avatar) is displayed on the LCD 214 . When the internal examiner inputs an instruction using the internal examiner terminal 3, instruction information including the content of the instruction is sent to the ophthalmologic examination apparatus 2 via the management server 4 or directly. The output control unit 201 controls the action of the internal examiner avatar based on this instruction information. Thereby, the internal examiner can confirm the condition of the examinee and send instructions.

(S27: Assist NG)
If the internal examiner can handle the situation, he/she continues assisting the subject (not shown). On the other hand, if it is determined that the situation cannot be dealt with, the internal examiner proceeds to step S28 to request assistance from the external examiner. The latter case will be described below.

(S28: Call external examiner)
The internal examiner performs a predetermined operation using the internal examiner terminal 3 in order to request assistance from the external examiner. This operation may include, for example, selecting the language used by the subject. If the call request or information transmitted from the ophthalmologic examination apparatus 2 to the management server 4 in step S23 includes information indicating the language used by the examinee (English), the internal examiner can use No language selection operation is required. The communication unit 32 transmits a communication request (and predetermined information) for calling an external examiner to the management server 4 .

(S29: Select external examiner terminal)
The management server 4 receives the communication request or the like transmitted from the internal examiner terminal 3 in step S28 by the communication unit 43 . At this stage, the selection unit 412 selects an external examiner (or external examiner terminal 5) who can use English by referring to the attribute information. At this time, one external examiner can be selected according to the operating status of each external examiner who can use English.

(S30: Control of communication establishment)
The communication control unit 401 connects the external examiner terminal 5 selected in step S29 (or the external examiner terminal 5 used by the external examiner selected in step S29) with this external examiner terminal 5. A control signal for establishing communication with the ophthalmologic examination apparatus 2 is transmitted.

(S31: Start bidirectional communication)
Two-way communication between the external examiner terminal 5 and the ophthalmologic examination apparatus 2 is established by the control signal transmitted in step S30. At this time, communication between the internal examiner terminal 3 and the external examiner terminal 5 can be established. It is also possible to continue establishing communication between the internal examiner terminal 3 and the ophthalmologic examination apparatus 2 .

(S32: Start controlling avatar)
When two-way communication between the ophthalmologic examination apparatus 2 and the external examiner terminal 5 is started in step S31, the character control unit 202 controls the character of the external examiner who uses the external examiner terminal 5 (external examiner avatar) is displayed on the LCD 214 . Thereby, both the internal examiner avatar and the external examiner avatar are displayed on the LCD 214 . The motion control of the internal examiner avatar is executed in the manner described in step S26.

On the other hand, when the external examiner inputs an instruction using the external examiner terminal 5 , instruction information including the content of the instruction is transmitted to the ophthalmologic examination apparatus 2 via the management server 4 . The output control unit 201 controls the action of the external examiner avatar based on this instruction information. As a result, the external examiner can check the examinee's situation and send instructions using English. The internal examiner and the external examiner can cooperate with each other to assist the subject.

Controls may be provided so that at least some of the interactions between the internal and external examiners are not presented to the subject. At that time, the internal examiner and the external examiner can perform an operation for distinguishing whether the information input by themselves is for the subject or for another examiner. For example, software keys for entering information for other examiners (and/or software keys for entering information for subjects) may be provided in the GUI. When information for other examiners is input, the management server 4 (transfer control unit 402) transfers the information only to other examiner terminals. For example, when such information is input to the external examiner terminal 5 , the transfer control unit 402 transmits this information only to the internal examiner terminal 3 . As another example of processing, when information for another examiner is input, the output control unit 201 of the ophthalmologic examination apparatus 2 switches whether or not to output information based on additional information (flag, etc.) of the information. can be done. For example, when receiving information input from the external examiner terminal 5 or the internal examiner terminal 3, the output control unit 201 adds a predetermined flag (for example, a flag indicating that the information is for other examiners) to this information. is attached, and if not attached, control to output this information is executed, and if attached, the control is not performed.

According to this example, when there is a subject who cannot perform the examination smoothly, it is possible to quickly start direct communication with the subject. Thereby, the subject can be given a sense of security. Even if this direct communication does not resolve the problem, it is possible to automatically select the appropriate external examiner to resolve the issue and provide remote assistance. Therefore, it is possible to deal with various examinees without constantly assigning internal examiners with various attributes to each facility. Furthermore, multiple examiners (eg, an internal examiner and an external examiner) can collaborate to assist the subject. In particular, since instructions can be transmitted to the subject through each examiner's avatar, it is possible to provide appropriate assistance while giving the subject a sense of security.

<Third example of usage pattern> Utilization of learned content In the third example of the usage pattern of the ophthalmologic examination system 1, the process of learning the control executed in accordance with the instruction from the examiner and the control of the learned content are performed. and the processing for reflecting it in. An example of the former process is shown in FIG. 9, and an example of the latter process is shown in FIG.

(S41: Start assist)
First, the learning process will be described with reference to FIG. Assistance by the examiner is started, for example, in the manner described above. In this example, the case where the external examiner assists will be described, but the same processing can be performed when the internal examiner assists.

(S42: Transmission of inspection status information, etc.)
The ophthalmologic examination apparatus 2 transmits examination status information and the like to the management server 4 . As described above, the examination status information includes the examination progress (examination phase), the interim result of the examination (for example, the history of optotype presentation in a visual acuity examination), the examination time (for example, examination start time, elapsed time), and the like. , which is generated and transmitted especially when there is a problem with the inspection.

(S43: Storage of inspection status information)
The management server 4 receives the examination status information transmitted from the ophthalmologic examination apparatus 2 in step S42. The control management unit 42 stores this examination status information in the storage unit 421 together with the device ID of the ophthalmologic examination device 2 .

(S44: Transfer of inspection status information, etc.)
The transfer control unit 402 transfers examination status information and the like from the ophthalmologic examination apparatus 2 to the external examiner terminal 5 . The order in which steps S43 and S44 are executed is arbitrary, and they can be executed in parallel.

(S45: Input of instructions)
The external examiner terminal 5 receives the examination status information and the like transferred in step S44, and outputs the information (information display, voice output, etc.). The external examiner refers to the output information and inputs instructions.

(S46: Transmission of instruction information)
The external examiner terminal 5 generates instruction information according to the contents of the instruction input in step S45, and transmits this to the management server 4. FIG.

(S47: Storage of instruction information)
The management server 4 receives the instruction information transmitted in step S46. The control management unit 42 stores this instruction information in the storage unit 421 . At this time, the control management unit 42 associates this instruction information with the examination status information stored in step S43 by referring to the device ID of the ophthalmologic examination device 2, for example. At this time, as described above, it is possible to classify the inspection status information.

(S48: Transfer of instruction information)
The transfer control unit 402 transfers instruction information from the external examiner terminal 5 to the ophthalmologic examination apparatus 2 . The order in which steps S47 and S48 are executed is arbitrary, and they can be executed in parallel.

(S49: Output of information (character control, etc.))
The ophthalmic examination apparatus 2 receives the instruction information transferred in step S48. The output control unit 201 controls the LCD 214, the display device 231, the audio output device 233, etc. based on this instruction information. For example, the character control unit 202 controls the action of the character based on the instruction information.

(S50: Transmission of control information)
The ophthalmologic examination apparatus 2 generates control information indicating the content of the control executed in step S49, and transmits this to the management server 4. FIG.

(S51: Storage of control information)
The management server 4 receives the control information transmitted from the ophthalmologic examination apparatus 2 in step S50. The control management unit 42 stores this control information in the storage unit 421 . At this time, the control management unit 42 refers to the device ID of the ophthalmic examination device 2, for example, to combine this control information with the examination status information stored in step S43 (and the instruction information stored in step S47). associate with each other. At this time, as described above, it is possible to classify the inspection status information.

Alternatively, only one of the instruction information storage (step S47) and the control information storage (step S51) may be executed. If only the instruction information is stored (step S47), the control information can be generated from the instruction information in the manner described above.

By repeating the above-described processing, the situation (event, etc.) occurring in the examination and the content of the examiner's instruction corresponding thereto (that is, the content of the control executed by the ophthalmologic examination apparatus 2 for that situation) are combined. Correspondence is accumulated. An example of how to use the stored information will be described below with reference to FIG.

(S61: Start assist)
Assistance by the examiner is started, for example, in the manner described above. Since the examiner does not appear in the following processing, description of the external examiner terminal 5 and the like in FIG. 10 is omitted.

(S62: Transmission of inspection status information)
The ophthalmic examination apparatus 2 transmits examination status information to the management server 4 .

(S63: Search for control information)
The management server 4 receives the examination status information transmitted from the ophthalmologic examination apparatus 2 in step S62. The search unit 422 searches the examination situation information (or the like) accumulated in the storage unit 421 for examination situation information corresponding to the examination situation information received this time from the ophthalmologic examination apparatus 2, and searches for the searched examination situation information ( or the like). Thereby, the control information corresponding to the inspection status information transmitted in step S62 is retrieved.

If the control information corresponding to the new examination status information is not retrieved, the external examiner terminal 5 is requested to assist, as in the case of FIG. Then, new examination status information is stored in the storage unit 421 together with instruction information from the external examiner terminal 5 and control information representing the details of control executed by the ophthalmologic examination apparatus 2 according to this instruction information.

(S64: Transmission of control information)
The management server 4 transmits the control information retrieved in step S<b>63 to the ophthalmologic examination apparatus 2 .

(S65: Output of information (character control, etc.))
The ophthalmic examination apparatus 2 receives the control information transmitted in step S64. The output control unit 201 controls the LCD 214, the display device 231, the audio output device 233, etc. based on this control information. For example, the character control unit 202 controls the action of the character based on the control information.

With such processing, when a problem occurs during an examination using the ophthalmologic examination apparatus 2, the assistance actually performed by the examiner when this problem (or a similar problem) occurred in the past is automatically reproduced. becomes possible.

<Switching of control mode according to examination type>
In embodiments, the ophthalmic examination device may be capable of performing multiple examinations. In this case, the control mode of characters (and information display, voice output, etc.) can be switched according to the type of examination. An example of a system capable of such mode switching will be described below.

FIG. 11 shows an example of the configuration of an ophthalmologic examination apparatus included in the ophthalmologic examination system according to the embodiment. In this example, the element for switching the control mode is provided in the ophthalmologic examination apparatus, but it is also possible to provide part or all of the element in another apparatus (for example, a management server).

An ophthalmologic examination apparatus 2A shown in FIG. 11 differs from the ophthalmologic examination apparatus 2 shown in FIG. The rest of the configuration of the ophthalmologic examination apparatus 2, the configuration of the internal examiner terminal 3, the configuration of the management server 4, and the configuration of the external examiner terminal 5 may be the same as in the above embodiment.

The mode switching unit 220 executes various processes related to control modes. Mode switching unit 220 includes a processor, a storage device, and the like. A mode information storage unit 221 is provided in the mode switching unit 220 . First control mode information is stored in advance in the mode information storage unit 221 . In the first control mode information, a control mode is associated with each type of examination that can be performed using the ophthalmologic examination apparatus 2A.

In a typical example, the ophthalmic examination device 2A is configured to function as an eye examination device, a refractometer and a keratometer. A visual acuity test apparatus includes an optical system that projects visual targets for visual acuity testing (Landolt's rings, etc.) onto the fundus of the eye, an input device that receives responses from the subject to the projected visual targets, and a processor that executes various processes. include. The processor executes a process of switching the visual target projected on the fundus according to the subject's response, a process of determining the visual acuity value of the subject's eye based on the history of the subject's response, and the like. A refractometer analyzes an optical system that projects a ring-shaped luminous flux onto the fundus, an optical system that detects the return light of this ring-shaped luminous flux from the fundus with an imaging device, and an output (ring-shaped image) from the imaging device. and a processor for calculating the degree of sphericity, the degree of astigmatism, the axis angle of astigmatism, etc. of the subject's eye. A keratometer consists of an optical system that projects a ring-shaped luminous flux onto the cornea, an optical system that detects the return light of this ring-shaped luminous flux from the cornea with an imaging device, and an image sensor that analyzes the output (ring-shaped image) from the imaging device to determine the corneal a processor for determining the curvature distribution and the like.

The first control mode information includes, for example, the control content in the vision testing mode applied when the vision testing device is used, the control content in the ref mode applied when the refractometer is used, and the keratometer. The control contents in the kerato mode that are applied when.

The type of examination to be performed using the ophthalmologic examination apparatus 2A is input using the user interface 23, for example. A desired examination can be selectively specified, or a plurality of examinations can be specified in a predetermined order. The mode switching unit 220 acquires control mode information corresponding to the designated examination type from the mode information storage unit 221 (first control mode information) and sends it to the output control unit 201 .

The output control unit 201 controls the LCD 214 , the display device 231 , the audio output device 233 and the like based on the information sent from the mode switching unit 220 . For example, the character control unit 202 selects a character to be displayed on the LCD 214 based on the information sent from the mode switching unit 220 and controls the action of the character. According to such an embodiment, it is possible to suitably execute character motion control and the like according to the type of examination.

<Switching of control mode according to subject attribute>
Subjects with various attributes use the ophthalmologic examination apparatus. Typical examples of subject attributes include language used, presence or absence of disease, disease name, sex, age, and the like. An example of a system capable of switching the control mode according to such subject attributes will be described below.

FIG. 12 shows an example configuration of a management server included in the ophthalmologic examination system according to the embodiment. In this example, the management server is provided with the element for switching the control mode, but it is also possible to provide part or all of the element in another apparatus (for example, an ophthalmologic examination apparatus).

A management server 4A shown in FIG. 12 differs from the management server 4 shown in FIG. 5 in that a mode management unit 44 is provided. Otherwise, the configuration of the management server 4, the configuration of the ophthalmologic examination apparatus 2, the configuration of the internal examiner terminal 3, and the configuration of the external examiner terminal 5 may be the same as those of the above embodiments. Note that the management server 4A may or may not include the control management unit 42 shown in FIG.

The mode management unit 44 executes various processes related to control modes of the ophthalmologic examination apparatus 2 . Mode management unit 44 includes a processor, a storage device, and the like. The mode management unit 44 is provided with a mode information storage unit 441 , a mode information search unit 442 and a mode processing unit 443 .

The second control mode information is stored in advance in the mode information storage unit 441 . A control mode is associated with each subject attribute in the second control mode information.

As a typical example, a case where subject attributes include the type of language will be described. Language types include, for example, Japanese, English, Chinese, Korean, German, French, and Spanish. The second control mode information includes control details in operation modes corresponding to each of these languages. For example, the second control mode information may include any of the following: character string information or voice information corresponding to each language; external examiner ID or external examiner terminal ID corresponding to each language; Language-compatible translation processors, translation dictionaries, etc. Although illustration is omitted, a translation processor and a translation dictionary are provided in either the management server 4A or the external examiner terminal 5. FIG.

The attributes of the subject using the ophthalmologic examination apparatus 2 (language used in this example) are input using the user interface 23 of the ophthalmologic examination apparatus 2, for example. It is also possible for the examiner who is monitoring the subject's status (examination status) to input the subject's attributes using his/her own terminal. Alternatively, the speech input by the subject may be analyzed to identify the type of language. These are examples of attribute acceptors.

When the language used by the subject is input, the mode information search unit 442 acquires control mode information corresponding to the input language type from the mode information storage unit 441 (second control mode information). The mode processing unit 443 executes, for example, the following processing based on the acquired control mode information.

If the information retrieved by the mode information retrieval unit 442 includes character string information or voice information corresponding to the language, the mode processing unit 443 transmits the retrieved information to the ophthalmologic examination apparatus 2. It controls the communication unit 43 . The output control unit 201 of the ophthalmologic examination apparatus 2 controls the LCD 214, the display device 231, the audio output device 233, etc. based on the information sent from the management server 4A. For example, the character control unit 202 selects a character to be displayed on the LCD 214 and controls actions of the character based on this information. Thereby, the language of the information output by the ophthalmologic examination apparatus 2 can be automatically switched to the language used by the subject.

If the information searched by the mode information search unit 442 includes the ID of the external examiner or the ID of the external examiner terminal corresponding to the language, the mode processing unit 443 directs the information to the external examiner terminal 5. control the communication unit 43 so as to send an assist request. As a result, it is possible to automatically search for an external examiner who can provide assistance in the language used by the examinee.

If the information retrieved by the mode information retrieval unit 442 includes information on a translation processor, a translation dictionary, etc. corresponding to the language, the mode processing unit 443 selects the reference language (for example, A processing start request is sent to a translation processor corresponding to the translation between the standard language of the country or region in which the subject is present and the language used by the subject. As a result, instructions from the examiner can be translated into the language used by the examinee and output from the ophthalmologic examination apparatus 2, and speech uttered by the examinee can be translated into the reference language to be translated into the external examiner terminal 5 or the internal examiner terminal 5. It is possible to output from the user terminal 3.

<Modified Example of Ophthalmic Examination Apparatus>
FIG. 13 shows an example in which the inspection optical system and the information presentation optical system are arranged separately. In the inspection unit 21A of the ophthalmologic inspection apparatus 2B, the inspection optical system used for inspection of the eye E to be inspected includes an optical element 215 applied to the eye E to be inspected, and an inspection light beam for inspecting the eye E to be inspected through the optical element 215. and a projection system 216 for projecting onto the subject's eye E via. The information presentation optical system for presenting information to the subject includes an LCD 217 (display unit) and a light guide system 218 that guides the display light flux output from the LCD 217 to the subject's eye E via an optical element 215. include. Information presented by the information presentation optical system includes information automatically presented by the ophthalmologic examination apparatus 2B, information transmitted from the internal examiner terminal 3 (instructions from the internal examiner, etc.), and external examiner terminal 5 (instructions from external examiners, etc.). Furthermore, characters are displayed on the LCD 217 . Control of the action of the character displayed on the LCD 217 is performed by the character control section 202 in the output control section 201 (not shown). The character display and motion control are the same as in the above embodiment.

The optical path of the inspection optical system and the optical path of the information presentation optical system are combined by the beam splitter 219 . Beam splitter 219 is, for example, a half mirror, a dichroic mirror, or a polarizing beam splitter. Components other than the inspection unit 21 may be the same as those in FIG.

Whether the inspection optical system and the information presentation optical system are configured in common as shown in FIG. 2, or whether they are configured separately as shown in FIG. .

<Information presentation by examiner terminal>
The configuration and processing for presenting information to the examiner will be described. As noted above, the external examiner assists the subject from a remote location. Therefore, it is desirable to be able to present information for appropriately grasping the subject's condition at an appropriate timing and at an appropriate interface. Information can also be presented to the internal examiner in the same manner. In this case, the management server 4 (especially the transfer control unit 402) can perform control so as to synchronize presentation of information on the external examiner terminal 5 and presentation of information on the internal examiner terminal 3. FIG.

The control unit 50 of the external examiner terminal 5 causes the display device 521 to display a screen 1000 shown in FIG. The screen 1000 is provided with presentation information display areas 1010L and 1010R, a communication content display area 1020, a usage status display area 1030, a subject information display area 1040, and a presentation information operation area 1050. FIG.

Information presented to the subject's left eye and right eye is displayed in the presented information display areas 1010L and 1010R, respectively. In this example, the ophthalmologic examination apparatus 2 is configured to be able to simultaneously present information to both the right and left eyes of the subject. In this ophthalmologic examination apparatus 2, for example, an examination optical system and information presentation optical system for the left eye and an examination optical system and information presentation optical system for the right eye are provided independently of each other (for example, left eye an optical head for the right eye and an optical head for the right eye). As another example, the ophthalmologic examination apparatus 2 may be configured to split a light beam from a single examination optical system into two, and direct one to the left eye and the other to the right eye, respectively. As still another example, the ophthalmologic examination apparatus 2 may be configured to divide the light beam from a single information presentation optical system into two, and direct one to the left eye and the other to the right eye, respectively. The configuration capable of simultaneously presenting information to both the left and right eyes is not limited to these, and may be any configuration.

In presentation information display areas 1010L and 1010R shown in FIG. 14, visual targets for a binocular visual function test are displayed. These are the visual targets currently presented to the subject by the ophthalmologic examination apparatus 2 . Information indicating the currently presented optotype is transmitted from the ophthalmologic examination apparatus 2 to the management server 4 and further transmitted to the external examiner terminal 5 by the transmission control unit 402 . Based on the information transferred from the management server 4, the control unit 50 identifies the type of visual target currently presented by the ophthalmologic examination apparatus 2, and displays an image representing the identified visual target in the presentation information display area 1010L and the display area 1010L. Display on 1010R. The images representing the visual targets are pre-stored in a storage device (not shown) in the control unit 50 as thumbnails, for example. When the visual target presented by the ophthalmologic examination apparatus 2 is changed, the transfer process is executed in real time. Thereby, the external examiner can recognize the visual target presented by the ophthalmologic examination apparatus 2 substantially in real time.

A character presented to the subject can be displayed in the presentation information display area 1010 or the like. For example, an avatar of the examiner (external examiner) looking at the screen 1000 can be displayed. Furthermore, it is possible to control the action of the avatar displayed in the presentation information display area 1010 or the like by acquiring the control contents of the character control unit 202 of the ophthalmologic examination apparatus 2 in real time via the management server 4. . Note that the area where the character is displayed is not limited to the presentation information display area 1010 or the like, and may be another display area, or a dedicated display area may be provided.

The communication content display area 1020 displays the communication content between the examiner and the subject, particularly the content of the support provided from the examiner to the subject. The content of the displayed support is at least one of the content of the support provided by the external examiner, the content of the support provided by the internal examiner, and information from the examinee (contents of questions, content of responses, etc.). may contain either Information for each user (external examiner, internal examiner, subject) may be switched and displayed in the communication content display area 1020 . It is also possible to display information from one or more users in chronological order.

In the example shown in FIG. 14, the content of a question posed by an external examiner (the person using the screen 1000) in the management center "A" and the content of the examinee's response to the question are displayed on the communication content display. It is displayed in area 1020 . In addition, it is also possible to convert voice information uttered by the examiner or the subject into text using a known voice recognition technology and display the text. Alternatively, text information pre-associated with a predetermined operation may be displayed.

In the usage display area 1030, the names of a plurality of facilities where the ophthalmologic examination apparatus 2 is installed, such as "Store A" and "Store B" are displayed. Furthermore, identification information such as "apparatus 1" and "apparatus 2" of a plurality of ophthalmologic examination apparatuses 2 installed in a facility (for example, store B) selected by an external examiner or management server 4 from among these facilities is displayed. ing.

In the example shown in FIG. 14, the mark presented to the left of the facility name indicates whether or not it is selected. For example, a white star attached to store A or store C indicates that the facility is not selected, and a black star attached to store B indicates that the facility is selected. Note that such a group of star marks can be configured as radio buttons. In this case, the external examiner can select a desired one from these facilities.

Furthermore, the mark presented on the left side of the identification information of the device installed in the selected store B similarly indicates whether or not there is a selection by the external examiner or the management server 4 or the like. In the example shown in FIG. 14, the white circle mark indicates that it is not selected, and the black circle mark indicates that it is selected. In the example shown in FIG. 14, the ophthalmologic examination apparatus 2 installed in the store B and having the identification information "apparatus 1" is selected as the ophthalmologic examination apparatus 2 (subject) to be assisted by the external examiner. Note that such a circle mark group can be configured as a radio button. In this case, the external examiner can select a desired one from these ophthalmologic examination apparatuses 2 .

On the right side of the identification information of the ophthalmologic examination apparatus 2, time information (for example, the time when the support was started, the elapsed time from the start of the support, etc.) and the communication establishment state (communication mode) regarding the ophthalmologic examination apparatus 2 are presented. there is

Communication modes will now be described. In this embodiment, four communication modes can be selectively applied. Also, it is possible to arbitrarily switch from one communication mode to another communication mode.

Communication mode 1 indicates a state in which the subject is performing an examination by the ophthalmologic examination apparatus 2 alone. In communication mode 1, the subject receives no support from either the internal examiner or the external examiner, and the ophthalmologic examination apparatus 2 communicates with the internal examiner terminal 3 as well as with the external examiner terminal 5. No communication has been established between As described above, even when communication mode 1 is applied, information from the ophthalmologic examination apparatus 2 (examination status information, information displayed on the screen 1000, etc.) It can be transferred to at least one of the examiner terminals 5 . As a result, the examination by the ophthalmologic examination apparatus 2 can be monitored, and the examiner can issue a communication request and start support as necessary. Also, when the subject requests support, the request can be responded to quickly.

Communication mode 2 indicates a state in which an examination is being performed with the assistance of an external examiner. In communication mode 2, communication between the ophthalmologic examination apparatus 2 and the external examiner terminal 5 is established. As described above, information from the ophthalmologic examination apparatus 2 can be transferred to the internal examiner terminal 3 even when the communication mode 2 is applied. This allows the internal examiner, for example, to react quickly when direct assistance is required.

Communication mode 3 indicates a state in which an examination is being performed while receiving support from an internal examiner. In communication mode 3, communication between the ophthalmologic examination apparatus 2 and the internal examiner terminal 3 is established. As described above, information from the ophthalmologic examination apparatus 2 can be transferred to the external examiner terminal 5 even when the communication mode 3 is applied. This allows the external examiner, for example, to react quickly when a situation arises that is out of the hands of the internal examiner.

Communication mode 4 indicates a state in which an examination is being performed with the assistance of both the internal examiner and the external examiner. In communication mode 4, communication among the ophthalmologic examination apparatus 2, the internal examiner terminal 3, and the external examiner terminal 5 is established. Communication mode 4 is applied, for example, when the internal examiner and the external examiner need to talk, or when the external examiner educates the internal examiner. It should be noted that the transfer control unit 402 of the management server 4 can perform control so as not to transfer the contents of communication between the internal examiner and the external examiner to the ophthalmologic examination apparatus 2 . That is, the transfer control unit 402 can perform the following controls: transfer information from the internal examiner to the external examiner only to the external examiner terminal 5; Transfer information only to the internal examiner terminal 3; Transfer information from the internal examiner to the examinee to the external examiner terminal 5 and the ophthalmologic examination apparatus 2; Transfer information from the external examiner to the internal examiner transfer to the internal examiner terminal 3 and the ophthalmologic examination apparatus 2;

Switching of communication modes is performed by the management server 4 that receives a communication request (call request, interrupt request) from a subject, an internal examiner, or an external examiner. For example, when communication mode 1 is used and a call request is generated from the subject, communication mode 2, 3 or 4 is switched to. Which communication mode to switch to is determined according to, for example, designation by the subject, the content of the examination status information, the attributes described above, and the like.

When an interrupt request is generated from the internal examiner in communication mode 1, the communication mode is switched to communication mode 3 or 4. Similarly, when an interrupt request from the external examiner occurs in communication mode 1, the communication mode is switched to communication mode 2 or 4. Disconnection of communication (withdrawal from the established state of communication) is performed, for example, according to the selection of the subject, the selection of the subject, or the end of the examination.

Information about the subject is presented in the subject information display area 1040 . In the example shown in FIG. 14, the measured values of each eye of the subject (refractive power, astigmatic degree, astigmatic axis angle, addition, visual acuity value, etc.), the anterior ocular segment image of each eye, and the subject's face Images, etc. are displayed. Furthermore, it is also possible to present arbitrary information about the subject, such as name, age, sex, disease name, language used, and examination difficulty.

The presentation information operation area 1050 is provided with a GUI (software keys, etc.) for operating information presented to the subject. In the example shown in FIG. 14, a GUI for selecting the target to be presented to the subject (selection of target, dial for changing power, etc.) and various operation buttons (print, export, etc.) are provided. ing. The external examiner uses the operation device 522 to operate software keys and the like provided in the presentation information operation area 1050 .

The character presented to the examinee can be displayed on the examiner's terminal that has established communication with the ophthalmologic examination apparatus 2 . For example, avatars for each of one or more examiners assisting the subject can be displayed. Furthermore, it is also possible to control the actions of each avatar by acquiring the control details of the character control unit 202 of the ophthalmologic examination apparatus 2 in real time via the management server 4 .

〈Action and effect〉
Actions and effects of the embodiment will be described.

The ophthalmic examination system of the embodiment includes an ophthalmic examination apparatus (ophthalmic examination apparatus 2, etc.) and an examination instruction apparatus (internal examiner terminal 3, external examiner terminal 5, etc.). The examination order device is used by the examiner to send orders to the ophthalmic examination device.

The inspection instruction device includes a first input unit (operation device 312, voice input device 314, imaging unit 51, operation device 522, voice input device 524, etc.) for inputting instruction information related to inspection, and input by the first input unit. and a first communication unit (communication unit 32, communication unit 54, etc.) that transmits the received instruction information to the ophthalmologic examination apparatus.

The ophthalmic examination apparatus includes an examination optical system (inspection optical system 211, etc.), an information presentation optical system (LCD 214, projection system 213, etc.), a second communication section (communication section 24, etc.), a control section (output control section 220 etc.). The inspection optical system includes an optical element (optical element 212, etc.) applied to the eye to be inspected, and a projection system (projection system 213, etc.) for projecting an inspection light flux for inspecting the eye to be inspected onto the eye to be inspected via the optical element. including. The information presentation optical system includes a display unit (LCD 214, etc.) and a light guide system (projection system 213, etc.) that guides the display light flux output from the display unit to the subject's eye via an optical element. The second communication unit receives instruction information transmitted from the inspection instruction device. The control unit causes the display unit to display a predetermined character image, and controls the action of the character image based on the instruction information received by the second communication unit.

According to such an embodiment, it is possible to convey the examiner's intentions (instructions, advice, etc.) to the examinee using a character such as an avatar. Therefore, in the remote examination, it is possible to convey the intent of the examiner to the subject in an easy-to-understand manner. In addition, by using a friendly character, it is possible to reduce the anxiety felt by the subject.

In an embodiment, the ophthalmologic examination apparatus may include an audio output unit (such as the audio output device 233) that outputs audio information. Furthermore, the control unit can cause the audio output unit to output audio information based on the instruction information received by the second communication unit. According to this configuration, in addition to the visual assistance by the character, instructions and advice can be sent by voice.

In the embodiment, the control section can cause the display section to display at least one of the character string information and the image information based on the instruction information received by the second communication section. As a result, in addition to character assistance, instructions and advice can be sent using character strings and images.

The ophthalmic examination system of the embodiment may include an information generator (examination situation information generator 22a, etc.) that generates examination situation information representing the examination situation using the ophthalmologic examination apparatus. Furthermore, the control section can control the motion of the character image based on the inspection status information generated by the information generation section. According to this configuration, assistance using a character can be provided quickly and autonomously in accordance with the subject and the examination situation.

The ophthalmologic examination system of the embodiment may include an information generation section (examination status information generation section 22a, etc.), a first storage section (storage section 421, etc.), and a search section (search section 422, etc.). The information generator generates examination status information representing the examination status using the ophthalmologic examination apparatus. The first storage unit associates and stores the examination status information generated by the information generation unit and control information representing control executed by the control unit based on the instruction information received by the second communication unit. The search unit searches the first storage unit for control information corresponding to the new examination status information generated by the information generation unit. Further, the control section of the ophthalmologic examination apparatus can control the motion of the character image based on the control information retrieved by the retrieval section. According to this configuration, it is possible to reproduce the contents of the instruction actually given by the examiner according to the examinee and the examination situation. In other words, it is possible to learn the contents of instructions actually given by the examiner and to autonomously control the character.

The ophthalmologic examination system of the embodiment may include a first examination instruction device and a second examination instruction device as examination instruction devices. Examples of the first and second examination instructing devices include one or more internal examiner terminals 3 and one or more external examiner terminals 5 . The control unit of the ophthalmic examination apparatus can display the first character image and the second character image on the display unit. Further, the control unit controls the action of the first character image based on the instruction information from the first inspection instruction device, and controls the action of the second character image based on the instruction information from the second inspection instruction device. can do. According to this configuration, simultaneous assistance by two (or more) examiners can be provided using characters corresponding to each examiner.

The ophthalmologic examination system of the embodiment may include a second storage unit (mode information storage unit 221, etc.) and a designation unit (user interface unit 23, etc.). The second storage stores in advance first control mode information in which control modes are associated with types of examinations that can be performed using the ophthalmologic examination apparatus. The designation unit has a function of designating the type of examination to be performed using the ophthalmologic examination apparatus. Furthermore, the control unit of the ophthalmologic examination apparatus can control the operation of the character image in a control mode corresponding to the examination type designated by the designation unit. According to this configuration, the characters and their actions can be switched according to the examination type, so that instructions and advice can be conveyed to the subject in an easy-to-understand manner.

The ophthalmologic examination system of the embodiment includes a third storage unit (mode information storage unit 441, etc.), an attribute reception unit (user interface 23, etc.), and a control mode processing unit (mode information search unit 442, mode processing unit 443, etc.). and The third storage stores in advance second control mode information in which control modes are associated with subject attributes. The attribute reception unit receives attributes of a subject who uses the ophthalmologic examination apparatus. A control mode processing unit acquires a control mode corresponding to the attribute accepted by the attribute accepting unit from the second control mode information. Furthermore, the control section of the ophthalmologic examination apparatus can control the motion of the character image in the control mode acquired by the control mode processing section. According to this configuration, the character and its action can be switched according to the attributes of the subject (language, disease, sex, age, etc.), so that instructions and advice can be given to the subject in a more comprehensible manner. It becomes possible.

In embodiments, subject attributes may include language type. In this case, the control mode processing section can perform processing for outputting information in a language corresponding to the attribute received by the attribute receiving section. Examples of processing executed by the control mode processing unit include processing related to translation of instructions from the examiner, processing of selecting the examiner according to the language, and processing of outputting character string information and voice information according to the language. . According to this configuration, the language used for assistance can be matched with the language used by the subject.

In an embodiment, the ophthalmologic examination apparatus may include a second input unit (manipulation device 232, voice input device 234, etc.) for the subject to input information. In this case, the second communication unit of the ophthalmologic examination apparatus transmits the information input by the second input unit to the examination instruction apparatus. The first communication unit of the examination instruction device receives information transmitted from the ophthalmologic examination device. Furthermore, the inspection instruction device includes an information output unit (display device 311, audio output device 313, display device 521, audio output device 523, etc.), and output control for outputting the information received by the first communication unit to the information output unit section (control section 30, control section 50, etc.). According to this configuration, two-way communication becomes possible between the ophthalmologic examination apparatus and the examination instruction apparatus, and interactive assistance can be provided.

Moreover, according to the embodiment, it is possible to deal with various situations occurring in remote inspection. For example, the subject can be quickly assisted according to the subject's request or the examiner's judgment. In addition, appropriate instructions can be given at appropriate timing according to the subject's degree of understanding of the examination contents. In addition, even if the examiner is not accompanying the examinee, it is possible to grasp the condition of the examinee, the progress of the examination, etc. substantially in real time and assist the examinee. In addition, it is possible to accurately assign an examiner with the necessary ability to appropriately assist (a highly specialized examiner, a skilled examiner, an examiner who can use a foreign language, etc.) to the examinee. .

<Modification>
The embodiments described above are merely typical examples of the present invention. Therefore, any modification (omission, substitution, addition, etc.) within the scope of the present invention can be applied as appropriate.

For example, it is possible to record instruction contents provided by a skilled person such as an external examiner and to reproduce them. The mode of recording the contents of the instruction includes, for example, video recording, audio recording, text conversion, and the like.

Further, it is possible to arbitrarily combine the embodiments and modifications described above.

1 ophthalmic examination system 2 ophthalmic examination apparatus 20 control unit 201 output control unit 202 character control unit 21 examination unit 214 LCD
24 communication unit 3 internal examiner terminal 4 management server 5 external examiner terminal 51 photographing unit 522 operating device 524 voice input device 54 communication unit

Claims (7)

an ophthalmic examination device;
an examination instruction device used by an examiner to send instructions to the ophthalmic examination device,
The inspection instruction device
an input unit for inputting instruction information about the inspection;
a first communication unit that transmits the instruction information input by the input unit to the ophthalmologic examination apparatus;
The ophthalmologic examination device
an inspection optical system including an optical element applied to an eye to be inspected, and a projection system for projecting an inspection light flux for inspecting the eye to be inspected onto the eye to be inspected via the optical element;
an information presentation optical system including a display unit and a light guide system that guides a display light beam output from the display unit to the eye to be inspected through the optical element;
a second communication unit that receives the instruction information transmitted from the inspection instruction device;
a control unit that displays a predetermined character image on the display unit and controls the action of the character image based on the instruction information received by the second communication unit;
wherein, after executing first control for changing the character image, the control unit executes second control for displaying examination information for examining the eye to be examined instead of the character image. inspection system. 2. The ophthalmologic examination system according to claim 1, wherein the examination information is any one of Landolt's rings, fusion indices, and fixation targets. The ophthalmologic examination system according to claim 1, wherein the control unit executes the second control at a predetermined timing after executing the first control. 4. The ophthalmologic examination system according to claim 3, wherein the control unit executes the second control at a timing when a predetermined time has passed after executing the first control. further comprising a detection unit that detects a predetermined event by analyzing the anterior segment image of the eye to be examined;
4. The ophthalmologic examination system according to claim 3, wherein the control unit executes the second control at a timing when the predetermined event is detected by the detection unit after executing the first control. 6. The ophthalmologic examination system according to claim 5, wherein the detection unit detects, as the predetermined event, that the subject's eye gazes at the character image that is being changed by the first control. An ophthalmic examination apparatus used for remote examination, comprising:
an inspection optical system including an optical element applied to an eye to be inspected, and a projection system for projecting an inspection light flux for inspecting the eye to be inspected onto the eye to be inspected via the optical element;
an information presentation optical system including a display unit and a light guide system that guides a display light beam output from the display unit to the eye to be inspected through the optical element;
a control unit for displaying a predetermined character image on the display unit,
The control unit, after executing first control for changing the character image, executes second control for displaying examination information for examining the eye to be examined instead of the character image.

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