JP2023158776A - Ophthalmologic apparatus, control method of ophthalmologic apparatus, and program - Google Patents

Abstract

To reduce too much or too little amount of announcements for urging examination to a subject, in an ophthalmologic apparatus.SOLUTION: An ophthalmologic apparatus includes selection means for selecting announcement according to an examination content of a subject eye from multiple announcements for urging a subject upon examination, determination means whether the announcement is proper or not, which is selected on the basis of operation of a survey instrument executed in the state where the subject is urged by the selected announcement, and changing means for changing the selected announcement, when determined to be improper by the determination means.SELECTED DRAWING: Figure 4

Description

The present disclosure relates to an ophthalmologic apparatus, a method for controlling an ophthalmologic apparatus, and a program.

As an ophthalmological apparatus, a device for acquiring a two-dimensional image of the fundus of an eye to be examined (hereinafter referred to as a fundus camera device) is used. Additionally, a device (hereinafter referred to as an OCT device) for acquiring a tomographic image of an eye to be examined using optical coherence tomography (OCT) using low-coherence light has been put into practical use. .

For example, in the examination of a subject's eye using these apparatuses, there are ophthalmological apparatuses that perform guidance work for the examiner or subject to assist in measurement during the examination. Since the device itself guides the examinee, the examiner no longer needs to be closely attached to the device or the examinee during the examination, allowing remote examiners to perform examinations and reducing the burden on the examiner. can. Some of these ophthalmological apparatuses aim to reduce the intervention of the examiner and improve the efficiency of the examination by guiding the examinee through, for example, voice announcements.

Patent Document 1 discloses an example of such an ophthalmologic apparatus. Specifically, in the ophthalmological apparatus disclosed in Patent Document 1, a series of announcement patterns from the start of the examination to the end of the examination is switched depending on the environment in which the apparatus is used, the examination items, and the like. This switching prevents unnecessary announcements from prolonging the examination time.

JP2020-199226A

When performing an examination using conventional ophthalmological equipment, for example, it is conceivable that a subject who has undergone the same examination many times and a subject who is undergoing the examination for the first time undergo the examination together at the same medical examination, etc. . In such a case, if the same announcement pattern is used, depending on the subject, the announcement may be redundant, or the explanation may not be sufficient or the frequency of explanation may be insufficient. If the announcements are redundant, there is a possibility that the inspection efficiency will decrease, and if there are insufficient announcements, this may become a factor that lowers the success rate of the inspection.

In view of the above-mentioned situation, an embodiment of the present disclosure provides an ophthalmological apparatus, a method for controlling an ophthalmological apparatus, and a program that can reduce excessive or insufficient announcements for prompting examinations for subjects. One of its purposes is to do so.

In order to solve the above problems, an ophthalmological apparatus according to an embodiment of the present disclosure selects an announcement according to the content of the examination of the subject's eye from among a plurality of announcements for prompting the subject during the examination. a selection means, a determination means for determining whether or not the selected announcement is appropriate based on an operation of the ophthalmological apparatus performed while the subject is prompted by the selected announcement; and a determination means for determining whether the selected announcement is appropriate. and a changing means for changing the selected announcement when it is determined that the selected announcement is not.

According to an embodiment of the present disclosure, it is possible to reduce excessive or insufficient announcements for prompting a test subject to take a test.

1 shows an external view of an example of a schematic configuration of an ophthalmologic apparatus according to an embodiment of the present disclosure. 1 shows an example of a schematic configuration of an ophthalmologic apparatus according to an embodiment of the present disclosure. 1 shows an example of a configuration of a control unit of an ophthalmologic apparatus according to an embodiment of the present disclosure. 5 shows a flowchart regarding a series of processing for one test illustrated in the present disclosure. A flowchart regarding an example of chin rest adjustment processing is shown. The flowchart regarding an example of the process of changing an announcement is shown. A flowchart regarding an example of automatic alignment processing is shown. A flowchart regarding an example of OCT imaging processing is shown. A flowchart relating to an example of automatic coherence gate adjustment processing in OCT imaging processing is shown. A flowchart relating to an example of a process for changing an announcement performed before OCT imaging is shown. FIG. 7 shows a flowchart regarding a series of processes for continuous binocular testing exemplified in the present disclosure. FIG.

Hereinafter, exemplary embodiments for carrying out the present invention will be described in detail with reference to the drawings. However, the dimensions, materials, shapes, relative positions of components, etc. described in the following embodiments are arbitrary and can be changed depending on the configuration of the device to which the present invention is applied or various conditions. Additionally, in the drawings, the same reference numerals are used between the drawings to indicate elements that are identical or functionally similar.

The ophthalmologic apparatus exemplified as the ophthalmologic apparatus according to the present embodiment is an ophthalmologic apparatus that photographs the fundus of an eye to be examined, and is particularly used to obtain a frontal fundus image and a tomographic image, which are two-dimensional images of the fundus of the eye to be examined. Regarding what is used. In the examination of the subject's eye, the ophthalmological apparatus makes, for example, a voice announcement in place of the examiner, thereby guiding the subject. When issuing a voice announcement, the control state of the ophthalmological apparatus and the operating state of the subject are referred to, and the selected announcement scheduled for use is changed to a more appropriate announcement according to the reference results.

In the following embodiments, an announcement with insufficient explanation means that the subject cannot correctly understand the content of the announcement and that the desired result is not obtained from the operation performed by the ophthalmological apparatus for the subject when prompted. Refers to announcements that can only provide information that is not available. Furthermore, in contrast to such announcements, an announcement that is made to explain the guidance of the examinee in more detail so that the examinee can understand the content correctly is referred to as an announcement that explains in detail. Announcements that provide too much explanation refer to announcements that repeatedly provide unnecessary information in order to encourage the examinee, even though the examinee has already fully understood the content of the announcement. Further, in contrast to such announcements, an announcement that provides a simple explanation necessary and sufficient for the subject to understand the guidance content is referred to as an announcement that is simply explained.

(Schematic configuration of the device)
The configuration of an example of an ophthalmologic apparatus used in this embodiment will be described with reference to FIGS. 1(a) to 1(c). FIG. 1(a) is a side view showing the appearance of the ophthalmological device 1, FIG. 1(b) is a schematic configuration diagram mainly showing the optical system of the ophthalmological device 1, and FIG. 1(c) is a side view showing the appearance of the ophthalmological device 1. FIG. 1 is a block diagram showing the configuration of a control section of FIG. Note that in the embodiment described below, an ophthalmologic apparatus including an OCT apparatus and a fundus camera apparatus is illustrated. However, the application target of the present disclosure is not limited to the ophthalmological apparatuses illustrated, and at least requires the subject to maintain a certain posture for a certain period of time and fixation of the subject's eye for a certain period of time, and The invention is applicable to any ophthalmological device that makes announcements that prompt these. Specifically, the present disclosure is applicable to known ophthalmological devices used for examining the eye to be examined, such as a fundus camera device, a scanning laser ophthalmoscope, an OCT device, and a tonometer, as well as a combination device thereof. can do.

As shown in the external side view of FIG. 1(a), the ophthalmological apparatus 1 according to the present embodiment includes a stage section 180 and an optical head section 100 movably supported with respect to the stage section 180. I can do it. The stage section 180 is provided with a face receiving section 181 for receiving the subject's face. The face receiver 181 may further include a forehead rest 182 for resting the forehead of the subject and a chin rest 183 for receiving the chin of the subject. The chin rest 183 is supported by a drive section (not shown) connected to the control section 300 shown in FIG. As a result, the height of the eye E to be examined is roughly adjusted with respect to the optical head unit 100 by moving the chin rest 183 up and down (moved in the Y-axis direction, which will be described later) according to the size of the face of the examinee. becomes possible. The subject maintains a state in which the forehead and chin are fixed relative to the face holder 181, and, for example, the optical head section 100 moves relative to the stage section 180, so that the OCT optical system etc. for the subject's eye E is adjusted. Alignment can be performed.

Next, the internal configuration of the ophthalmologic apparatus 1 will be described with reference to FIG. 1(b). The ophthalmological apparatus according to the present embodiment includes a fundus image capturing unit (fundus camera unit) that captures a two-dimensional fundus image, and a tomographic image capturing unit that captures a three-dimensional tomographic image of the fundus of the subject's eye using information based on optical interference. An image capturing unit (OCT capturing unit). The ophthalmological apparatus 1 including both of these photographing sections includes an optical head section 100, a spectrometer 200, and a control section 300.

Hereinafter, the configurations of the optical head section 100, spectrometer 200, and control section 300 will be explained in this order. For convenience of explanation, regarding the ophthalmological apparatus 1 according to the present embodiment, X, Y, and Z are expressed as follows: when viewed from the subject side, the left-right direction is the X-axis direction, the up-down direction is the Y-axis direction, and the front-back direction is the Z-axis direction. In the axial direction. Regarding the vertical direction, the upward direction is defined as the +Y-axis direction, and the downward direction is defined as the -Y-axis direction.

<Configuration of optical head unit 100 and spectrometer 200>
The optical head section 100, which is an examination unit, is configured with an optical system for photographing a two-dimensional image and a tomographic image of the anterior segment Ea of the eye E to be examined and the fundus Ef of the eye E to be examined. Various optical systems arranged within the optical head section 100 will be described below. In the optical head section 100, an objective lens 101 is arranged facing the eye E to be examined. That is, the optical head unit 100 includes, for example, an optical system for capturing an image of the eye E of the subject. Note that the optical system included in the optical head section 100 may include, for example, a measurement optical system that configures an OCT measurement optical path including an objective optical system. At this time, the optical system included in the optical head section 100 may or may not include various optical systems described below. Various optical systems described below may be configured to be included inside the stage section 180, for example, and in this case, the optical system inside the optical head section 100 and the optical system inside the stage section 180 are connected by an optical fiber. It may be configured to be connected by, etc.

On the optical axis L1 of the objective lens 101, a first dichroic mirror 102 and a second dichroic mirror 103 functioning as an optical path separation section are arranged. These dichroic mirrors branch the optical path of the anterior segment observation system (optical axis L2), the optical path of the fundus imaging system (optical axis L3), and the optical path of the OCT interference system (optical axis L5) for each wavelength band. However, the optical paths provided in the transmission direction and reflection direction of each dichroic mirror may be opposite to each other.

<Anterior segment observation optical system>
On the optical axis L2 of the second dichroic mirror 103 in the reflection direction, a lens 120, an aperture 121, a prism 122, a lens 123, and an image sensor 124 are arranged in order from the second dichroic mirror. The image sensor 124 is a monochrome sensor made of, for example, CMOS and has sensitivity in the infrared region. These optical members arranged on the optical axis L2 constitute an anterior segment observation optical system for observing the anterior segment Ea of the eye E to be examined. The image sensor 124 is connected to an acquisition unit 301 in the control unit 300, which will be described later. Each pixel value acquired by the image sensor 124 is configured as an anterior segment image by the control unit 300 (image generation unit 302) and output to the display unit 401. Further, the anterior eye segment observation light source 125 disposed near the objective lens 101 illuminates the anterior eye segment Ea of the eye E to be examined during anterior eye segment observation.

<Funus photography system/fixation lamp>
On the optical axis L3 in the transmission direction of the second dichroic mirror 103, an optical member and the like for obtaining a front image of the fundus Ef of the eye E to be examined are arranged. Specifically, a perforated mirror 131, a photographic aperture 132, a focus lens 133, an imaging lens 134, a third dichroic mirror 135, and an image sensor 136 are arranged in order from the second dichroic mirror 103. These optical members and the like constitute an optical system for observing and photographing the fundus Ef.

The perforated mirror 131 has an opening in the center. The focus lens 133 performs focus adjustment by moving its position on the optical axis L3 in the direction of the arrow in the figure by a drive system (not shown) connected to a control unit 300, which will be described later. The optical path on the optical axis L3 is branched by the third dichroic mirror 135 into an optical path leading to the image sensor 136 and an optical path leading to the fixation lamp 137 for each wavelength band. The image sensor 136 is a sensor that is sensitive to visible light and infrared light and is used for both video observation and still image photography. The fixation lamp 137 generates visible light to encourage the subject to fixate. In this embodiment, these configurations constitute a fundus image capturing section that captures a two-dimensional fundus image.

<Fundus illumination system>
The fundus image capturing unit according to this embodiment further includes a fundus illumination system that illuminates the fundus during fundus imaging. Each optical member included in the fundus illumination system is arranged on the optical axis L4 in the reflection direction of the perforated mirror 131. In the fundus illumination system, a corneal baffle 140, a relay lens 141, a focus index unit 142, a lens 143, and a ring slit 144 are arranged in order from the perforated mirror 131. The corneal baffle 140 has a light-blocking point at the center. The ring slit 144 has a ring-shaped slit opening. Further, on the optical axis L4, a crystalline lens baffle 145 as a light shielding member having a light shielding point and a dichroic mirror 146 having a characteristic of transmitting infrared light and reflecting visible light are arranged. The focus index unit 142 is movable along the optical axis L4 and can be inserted and removed from the optical axis L4 by a drive system (not shown) connected to the control section 300 described later.

A condenser lens 147 and a white LED light source 148 are arranged in the reflection direction of the dichroic mirror 146. The white LED light source 148 is a photographing light source in which a plurality of white LEDs that emit visible pulsed light are arranged. A condenser lens 149 and an infrared LED light source 150 are arranged in the transmission direction of the dichroic mirror 146. The infrared LED light source 150 is an observation light source in which a plurality of infrared LEDs that emit constant infrared light are arranged. The objective lens 101, the dichroic mirror 146, the optical members therebetween, the condenser lens 147, and the condenser lens 149 constitute an illumination optical system that illuminates the fundus. The light from the white LED light source 148 or the infrared LED light source 150 illuminates the fundus Ef of the eye E through this illumination optical system.

<OCT optical system>
On the optical axis L5 in the reflection direction of the first dichroic mirror 102, a lens 151, a mirror 152, an OCTX scanner 153-1, an OCTY scanner 153-2, a focus lens 154, and a lens 155 are arranged in this order. The OCTX scanner 153-1 and the OCTY scanner 153-2 are composed of, for example, a galvanometer mirror, and function as a scanning unit that scans the fundus Ef of the eye to be examined with measurement light. Note that any deflection means can be used for these scanners, and the scanners may also be configured with a deflection means that can deflect light in two-dimensional directions using a single mirror such as a MEMS mirror.

Further, the OCTX scanner 153-1 and the OCTY scanner 153-2 are arranged so that the focal position of the lens 151 is near the center thereof. Further, the vicinity of this center position has an optically conjugate relationship with the position of the pupil of the eye E to be examined. With this configuration, the optical path with the scanning unit 153 as the object point becomes approximately parallel between the objective lens 101 and the lens 151. As a result, even when the OCTX scanner 153-1 and OCTY scanner 153-2 scan the fundus Ef with measurement light, the angle of incidence of the measurement light entering the dichroic mirror placed between them can be made the same. becomes. Note that although the OCTX scanner 153-1 and the OCTY scanner 153-2 each scan measurement light in a main scanning direction and a sub-scanning direction perpendicular to the main scanning direction, the scanning directions are not limited thereto.

The measurement light source 157 serves as a light source that emits light for obtaining measurement light incident on the measurement optical path. In the case of this embodiment, the measurement light in the OCT optical system is emitted from the fiber end as a light source, and the fiber end has an optical conjugate relationship with the fundus Ef of the eye E to be examined. The focus lens 154 is a lens for adjusting focus, and is driven in the optical axis direction indicated by an arrow in the figure by a drive system such as a motor (not shown). Focus adjustment of the measurement light is performed so that the measurement light emitted from the fiber end serving as a light source is imaged on the fundus Ef.

A focus lens 154 functioning as a focus adjustment section is arranged between a fiber end serving as a measurement light source and the scanning section 153. By the focusing adjustment described above, the image of the measurement light emitted from the fiber end can be formed on the fundus Ef of the eye E to be examined, and the return light from the fundus Ef can be efficiently returned to the optical fiber 156-2. I can do it. Note that in FIG. 1B, the optical path between the OCTX scanner 153-1 and the OCTY scanner 153-2 is configured within the plane of the paper, but in reality it is configured in a direction substantially perpendicular to the plane of the paper.

Next, the configuration of the optical path from the measurement light source 157, the reference optical system, and the spectrometer 200 will be described. In the OCT imaging unit used in this embodiment, a Michelson interference system is configured by a measurement light source 157, an optical coupler 156, optical fibers 156-1 to 4, a lens 158, a dispersion compensation glass 159, a reference mirror 160, and a spectrometer 200. ing. Optical fibers 156-1 to 156-4 are single-mode optical fibers connected to and integrated with optical coupler 156.

Light emitted from measurement light source 157 is guided to optical coupler 156 via optical fiber 156-1. The light guided to the optical coupler 156 is split by the optical coupler 156 into measurement light guided to the optical fiber 156-2 side and reference light guided to the optical fiber 156-3 side. The measurement light is irradiated onto the fundus Ef of the eye E to be observed through the measurement optical path of the OCT optical system described above, and reaches the optical coupler 156 as return light through the same optical path due to reflection and scattering by the retina.

On the other hand, the reference light reaches the reference mirror 160 via the optical fiber 156-3, the lens 158, and the dispersion compensating glass 159 inserted to match the dispersion of the measurement light and the reference light, and is reflected. The reference light reflected by the reference mirror 160 returns along the same optical path and reaches the optical coupler 156 again. The reference light and measurement light (return light) that have reached the optical coupler 156 again are combined by the optical coupler 156. Here, when the optical path length of the measurement light and the optical path length of the reference light become almost the same, interference between the respective lights occurs due to this combination.

The reference mirror 160 is held so that its position in the optical axis direction indicated by an arrow in the figure can be adjusted by a motor and a drive mechanism (not shown). The drive mechanism is an example of a drive means for driving an optical member for changing the optical path length difference between the measurement light and the reference light, and is composed of a stepping motor (not shown), a feed screw, and a linear guide. By using this motor or the like, the optical path length of the reference light can be adjusted to the optical path length of the measurement light, which varies depending on the eye E to be examined. The obtained interference light is guided to the spectrometer 200 via the optical fiber 156-4.

Spectrometer 200 includes a lens 201, a diffraction grating 202, a lens 203, and a line sensor 204. The interference light emitted from the optical fiber 156-4 becomes substantially parallel light through the lens 201, is separated by the diffraction grating 202, and is imaged onto the line sensor 204 by the lens 203. Each element in the line sensor 204 outputs a signal according to the received light. The control unit 300 samples this signal (hereinafter referred to as an interference signal) at a predetermined timing using an acquisition unit 301, which will be described later, and performs predetermined signal processing to generate a tomographic image.

Next, the surroundings of the measurement light source 157 will be described. In this embodiment, the measurement light source 157 uses an SLD (Super Luminescent Diode), which is a typical low coherent light source. In this embodiment, the center wavelength of the light emitted from the measurement light source 157 is 855 nm, and the wavelength bandwidth is approximately 100 nm. Further, as for the type of light source, although an SLD is selected in this embodiment, it is sufficient as long as it can emit low coherence light, and ASE (Amplified Spontaneous Emission) or the like may also be used.

Considering that the eye is to be measured, near-infrared light is appropriate as the center wavelength of the measurement light. Furthermore, since the center wavelength affects the lateral resolution of the obtained tomographic image, it is desirable that the center wavelength be as short as possible. For both reasons, this embodiment uses light having a center wavelength of 855 nm.

Note that although a Michelson interferometer is used as the interferometer in this embodiment, a Mach-Zehnder interferometer may also be used. Depending on the difference in light intensity between the measurement light and the reference light, it is desirable to use a Mach-Zehnder interferometer when the difference in light intensity is large, and to use a Michelson interferometer when the difference in light intensity is relatively small.

<Head drive section>
The optical head section 100 further includes a head drive section 170. The head drive unit 170 is an example of a drive unit that drives the optical head unit 100, and is composed of a linear motion mechanism that allows the optical head unit 100 to move in the three-dimensional (X, Y, Z) directions. . The linear motion mechanism in each direction is composed of a stepping motor, a feed screw, and a linear motion guide (not shown), and is capable of moving the optical head section 100 in three-dimensional (X, Y, Z) directions relative to the eye E. It is configured so that This allows alignment of the optical head section 100 with respect to the eye E to be examined. Note that the configuration of the head drive section is not limited to this. Here, the optical head section 100 may be configured to be movable relative to the stage section 180, for example.

<Configuration of control unit 300>
Next, the control unit 300 will be explained with reference to the block diagram of FIG. 1(c). The control unit 300 in the ophthalmologic apparatus according to this embodiment includes, for example, an acquisition unit 301, an image generation unit 302, a storage unit 303, a selection unit 304, a determination unit 305, and a change unit 306. The control section 300 is connected to a display section 401, an input section 402, and an announcement output section 310, and can control these. For example, the control unit 300, as a display control unit, can cause the display unit 401 to display an anterior segment observation image, a fundus observation image, and a tomographic image of the subject's eye E generated by an image generation unit 302, which will be described later. . The announcement output unit 310 can output an announcement selected by the selection unit 304 (described later) or an announcement changed by the change unit 306 as a voice announcement.

The display unit 401 can be configured with any monitor, and displays various information such as patient information, various images, a mouse cursor, etc. according to the operation of the input unit 402 under the control of the control unit 300. The input unit 402 is an input device that gives instructions to the control unit 300, and specifically includes a keyboard and a mouse. Note that the display section 401 may be a touch panel display, and in this case, the display section 401 is also used as the input section 402. Further, the control section 300 is connected to an announcement output section 310, and can also execute a voice announcement or the like selected by a selection section 304, which will be described later.

Note that in this embodiment, the optical head section 100, the control section 300, the display section 401, and the input section 402 are each configured separately, but a part or all of these may be configured as an integrated unit. Further, other imaging devices, storage devices, etc. (not shown) may be connected to the control unit 300. Further, in this embodiment, the subject is encouraged to fixate the subject's gaze through a voice announcement, but the announcement is not limited to voice. For example, a fixation light may be used to display an announcement on a monitor that the subject views during the examination.

Further, the control section 300 is also connected to the chin rest section 183 and the head drive section 170. Thereby, fixation of the subject's face and the subject's eye E can be encouraged, and alignment of the optical head section 100 with respect to the subject's eye E can be performed in a three-dimensional direction. Although these operations can be performed by the examiner, they can also be performed by conveying instructions to the examinee through voice announcements, which will be described later.

Further, as described above, the control section 300 is connected to each drive system, sensor, etc. and light source in the optical head section 100, as well as the line sensor 204 of the spectrometer 200, and can control these. Specifically, the control unit 300 can further control the driving of the focus lenses 133 and 154, the focus index unit 142, the scanning unit 153, the reference mirror 160, and the like. The control unit 300 can also control turning on and off of the anterior segment observation light source 125, the white LED light source 148, the infrared LED light source 150, the fixation lamp 137, and the measurement light source 157. Further, the control unit 300 is connected to the image sensor 124 and the image sensor 136.

The acquisition unit 301 acquires signals output from these sensors. Furthermore, the acquisition unit 301 can acquire instructions from the examiner via the input unit 402. Furthermore, the acquisition unit 301 acquires various information such as patient information stored in the storage unit 303 (described later), various images such as tomographic images, and various images generated by the image generation unit 302 (described later). be able to.

The image generation unit 302 generates an observation image of the anterior segment Ea based on the signal obtained from the image sensor 124 acquired by the acquisition unit 301, and generates an observation image of the fundus Ef based on the signal obtained from the image sensor 136. can do. The image generation unit 302 is also connected to the line sensor 204, and can generate a tomographic image of the eye E based on the sampled interference signal. Note that any known method can be used to generate images for ophthalmologists such as tomographic images and frontal images of the fundus from the interference signal or ophthalmological information such as data related to the tomography of the eye E to be examined based on the interference signal and data related to the fundus. You may do so.

The storage unit 303 can store various information acquired by the acquisition unit 301 and various images generated by the image generation unit 302, for example. Furthermore, the storage unit 303 can store identification information of the subject and the like. Furthermore, the storage unit 303 can store programs for photographing, etc., and various audio announcements to be described later. Note that the storage unit 303 that stores announcements is not limited to being provided in the control unit 300. For example, a configuration may be adopted in which the announcements are stored on the server and the control unit 300 selects the announcements via the network.

As described above, the control unit 300 is also connected to the announcement output unit 310, which is a means for outputting audio announcements, and can make announcements to assist the test subject with respect to the test subject. The announcement output unit 310 is capable of making announcements not only to the subject but also to the examiner.

The selection unit 304 selects a predetermined series of messages output from the announcement output unit 310 from the start of the examination to the end of the examination, which is stored in advance in the storage unit 303, in accordance with the examination content, information regarding the subject, information regarding the eye to be examined, and the like. Select the announcement. The examination contents can include, for example, the examination site and whether information regarding simple tomography in OCT or information regarding blood vessels is to be acquired. In addition to general information such as age and gender, information about the test subject includes, for example, how many tests have been taken, and how many days have passed since the same test. This may include: Even if the same examination or imaging is to be performed, for example, if the examination is repeated multiple times or if only a few days have passed since the previous examination, it may be difficult to carry out the examination even if the announcement is simple. It is assumed that there will be enough to proceed. In such a case, the selection unit 304 can select an announcement with simpler content even if the announcement is about the same test. Further, the information on the eye to be examined may include the left and right side, disease history, past test results, and the like.

When the same announcement is repeated a predetermined number of times or more during an examination, it is assumed that, for example, the subject is not accustomed to the examination or that the instructions provided by the announcement are insufficient. Specifically, when performing alignment by driving the optical head unit 100, for example, it may be necessary to repeat the same announcement so that the subject maintains the same posture every time the optical head unit 100 is moved. . The determination unit 305 can determine whether the currently repeated announcement is suitable for the subject, based on the number of repetitions, for example. Note that the number of repetitions described here corresponds to the number of announcements. The number of times this announcement is made can also correspond to the number of times that one posture is determined for the subject during the examination and the ophthalmological apparatus repeats an operation such as alignment that corresponds to that posture. In addition, the number of repetitions may correspond to the number of times the ophthalmological apparatus repeats the announcements made up to that point and the actions performed by the ophthalmological apparatus in response to the announcements, for example, when prompting the subject to fixate during OCT imaging. can.

Depending on the result of the determination made by the determining unit 305, the changing unit 306 changes the content of the announcement that was repeated during the examination to, for example, an announcement that presents more detailed instructions. Furthermore, for example, there may be a case where the number of repetitions during alignment is less than a predetermined number and the determination unit 305 determines that an announcement consisting of simpler instructions is sufficient for this subject. In such a case, the changing unit 306 may change the announcement used in the subsequent testing procedure from the announcement selected by the selecting unit 304 to a simpler announcement.

Note that each component of the control unit 300 other than the storage unit 303 may be configured by a software module executed by a processor such as a CPU (Central Processing Unit) or an MPU (Micro Processing Unit). Further, the processor may be, for example, a GPU (Graphical Processing Unit) or an FPGA (Field-Programmable Gate Array). Further, each component may be configured by a circuit that performs a specific function, such as an ASIC. The storage unit 303 may be configured by, for example, any storage medium such as an optical disk such as a hard disk or a memory.

(Voice announcement during inspection and inspection)
Next, the processing performed during the actual inspection will be explained with reference to FIG. 2. FIG. 2 is a flowchart illustrating an example of processing performed during an examination in the ophthalmologic apparatus according to the present embodiment. In the examination of the subject's eye E using the ophthalmologic apparatus according to the present embodiment, various instructions are given to the subject by voice announcements corresponding to the operations of the ophthalmologic apparatus at each step. Here, as an example of the test, a case will be described in which a tomographic image of the fundus Ef of the eye E to be examined is taken, that is, OCT imaging is performed.

Prior to imaging, the examiner first seats the subject in front of the device. Furthermore, the examiner uses the input unit 402 to input examination details and patient information. At this time, it is input that a fundus tomographic image is to be photographed, and the selection unit 304 selects a default announcement to be used in this photographing based on various inputted information. After selecting the default announcement, the control unit 300 moves the flow to step S201. Note that in this embodiment, the default announcement is an announcement made to a subject undergoing the test for the first time.

<Announcement at start>
In step S201, when the control unit 300 detects that the subject is seated in front of the apparatus based on the signal acquired by the acquisition unit 301 from the image sensor 136, for example, the control unit 300 makes an announcement at the start of the examination according to a selected series of announcements. I do. At that time, the announcement output unit 310 outputs, for example, ``Please rest your face on it and place your forehead on it.'' ``If your posture is uncomfortable, please adjust the height of the chair.If there is no problem, press the button at hand.''"Please keep your forehead firmly attached," and "We're about to start making adjustments. Please look ahead."

In this embodiment, a case has been described in which the image sensor 136 is used to detect a characteristic part of the subject, such as the face, and to detect whether the subject is sitting. However, the method of detecting seating is not limited to this. For example, this may be done by detecting a characteristic part of the subject such as the face using the image sensor 124, or by providing a proximity sensor on the subject's side of the face receiving section 181 to detect when the subject is seated. You can also do that. When the above-mentioned announcement is made in step S201 and a predetermined period of time, such as several seconds, has elapsed, the control unit 300 assumes that the subject has been seated and the face of the subject has been fixed on the face receiver 181. The flow moves to step S202.

<Chin rest adjustment>
In step S202, the control unit 300 executes chin rest adjustment processing. FIG. 3 is a flowchart showing details of the process executed when adjusting the chin rest in step S202. When the chin rest adjustment process is started, the control unit 300 moves the flow to step S301.

In step S301, the image generation unit 302 generates an anterior segment image using the signal acquired by the acquisition unit 301 from the image sensor 124. Generation of this anterior segment image is performed periodically, and its analysis is repeated. At the time of analysis, specifically, the control unit 300 detects the pupil region of the eye E to be examined within the input anterior segment image. A known detection method can be used to detect the pupil area. Note that when the optical head section 100 is away from the eye E to be examined in the Z direction, similar processing can be performed by acquiring an anterior segment image from the image sensor 136. When the anterior segment image is acquired, the control unit 300 moves the flow to step S302.

In step S302, the control unit 300 determines whether a pupil has been detected in the anterior segment image obtained in step S301. If it is determined that the pupil is not detected, that is, if the pupil is located outside the angle of view of the anterior segment image, the control unit 300 moves the flow to step S303. On the other hand, if the pupil is detected, the control unit 300 determines that the eye to be examined is in a position where automatic alignment etc. for the examination can be performed, and the control unit 300 ends the chin rest adjustment process and moves the flow to step S203. .

In step S303, the control unit 300 executes an operation to move the chin rest 183 by a predetermined amount in the +Y direction. Thereby, the positional relationship between the eye E to be examined and the optical head section 100 can be changed. The control unit 300 also records the number of trials in adjusting the chin rest (i=i+1). After the number of trials is stored in the storage unit 303, the control unit 300 moves the flow to step S304.

In step S304, the determining unit 305 determines whether the number of attempts to drive the motor is less than a first predetermined number n1. If it is determined that the number of trials has exceeded the first predetermined number n1, the control unit 300 moves the flow to step S305. If the determination unit 305 determines that the number of trials is less than the first predetermined number n1, the control unit 300 returns the flow to step S301, and these processes are repeated until the pupil of the eye E to be examined is detected in step S302. .

In step S305, the determining unit 305 further determines whether the number of trials is greater than a second predetermined number n2. If it is determined that the number of trials is equal to or less than the second predetermined number n2, the control unit 300 moves the flow to step S306. On the other hand, if it is determined that the number of trials is greater than the second predetermined number n2, the control unit 300 shifts the flow to step S307.

If the number of trials is greater than or equal to the first predetermined number n1 and less than or equal to the second predetermined number n2, it is assumed that the subject has not yet taken an appropriate posture with respect to the face receiving portion 181. Therefore, in step S306, the announcement output unit 310 again makes the announcement at the start of the examination made in step S201, and urges the subject to take an appropriate posture. After making the announcement again, the control unit 300 moves the flow to step S301.

Note that since the number of trials exceeds the first predetermined number n1, it is possible that the default announcement is not able to sufficiently guide the subject. Therefore, the changing unit 306 can also change the default announcement according to the determination made by the determining unit 305 in step S304. In this case, for example, ``Please rest your face on the chair and rest your forehead on it'', ``If your posture is uncomfortable, adjust the height of the chair'', ``Keep your forehead firmly on the chair'', ``Put your forehead in front of you''. It is possible to change the announcement to something like "Please keep an eye on it." Note that the first predetermined number of times n1 is set smaller than the second predetermined number of times n2.

In step S305, if the pupil cannot be detected even after the number of trials exceeds the second predetermined number n2, it is possible that the subject cannot be appropriately guided only by the voice announcement. Therefore, in step S307, the control unit 300 abandons the guidance using only the audio announcement by the announcement output unit 310, and notifies the examiner of the need for assistance. Then, the control unit 300 interrupts the test and uses the announcement output unit 310 to inform the subject to wait. In this case, for example, it is preferable to make a voice announcement such as "Please remove your face and get into a comfortable position" or "I am calling someone. Please wait in a comfortable position."

As described above, if it is repeatedly determined that the pupil is not detected even after moving the chin rest part 183 in step S303, even if the default announcement at the start of the examination is made, the state in which the chin rest adjustment can be made is not possible. There is a possibility that the patient may not be able to take the test. This situation may occur, for example, when the subject lacks announcement information and is unable to guide the subject well. Therefore, in this embodiment, the default announcement is repeated or changed to the above-mentioned announcement to guide more detailed operations.

On the other hand, if the pupil can be detected with a small number of trials, in addition to the fact that the positional relationship between the optical head unit 100 and the subject's eye E is good to begin with, the announcement at the start of the test may indicate that the subject is ready to adjust the chin rest. It is possible that the guidance was successful. Furthermore, it is possible that the subject was accustomed to the examination and was able to adjust the chin rest independently. In other words, the number of trials in step S303 is based on the judgment criteria, such as how well the subject understands the default announcement at the start of the test, follows the guidance, and is able to adjust the chin rest. can do.

That is, the determination unit 305 stores this number of trials and compares it with a predetermined number of trials as a threshold for determining whether or not the person is accustomed to the test, for example, so that the announcement in subsequent processing does not change. You can decide whether it is necessary or not. If it is determined that the number of trials is large, the changing unit 306 can increase the amount of information in announcements performed in subsequent processing, or increase the number of times the announcement is repeated. By changing the content of the announcement in this manner, the patient can be guided more carefully, thereby improving the success rate of each process in the examination. On the other hand, if it is determined that the number of trials is small, the amount of information in subsequent announcements may be reduced or the number of announcements made may be reduced, thereby improving test throughput by omitting unnecessary announcements for some patients. and efficiency. Furthermore, by changing the content of the announcement in this way, it is possible to reduce the psychological burden on the subject by eliminating the need to keep listening to redundant announcements.

Note that, at the start of the test, the chin rest 183 is moved to the initial position (the lowest end of the drive range) according to instructions from the control unit 300. Then, in step S303, while gradually moving the chin rest part 183 in the +Y direction, the chin rest height is adjusted so that the pupil area of the eye E to be examined is detected. Note that at the start of the test, the chin rest may be controlled to move to the top end of the drive range, and then move in the -Y direction in step S303. When the chin rest adjustment process is completed based on the determination in step S302, the control unit 300 shifts the flow to step S203.

<Decision and execution of announcement before alignment>
As described above, it can be determined from the number of attempts to adjust the chin rest 183 whether the currently made default announcement is insufficient or overly informative for the subject. In step S203, before executing the alignment between the eye E and the optical head unit 100, the control unit 300 determines an announcement to be made at the time of alignment based on the determination result obtained by the determination unit 305 in step S202. Execute. Specifically, based on the number of trials in the chin rest adjustment process before step S203 (the number of operations performed by the ophthalmological apparatus 1), the determination unit 305 determines the amount of information and repetition amount of the announcement to the subject. judge. Then, the changing unit 306 changes, for example, the default announcement that has been set, according to the determination result of the determining unit 305. Then, the announcement output unit 310 executes the changed announcement.

FIG. 4 is a flowchart showing details of the process when determining and executing an announcement before alignment processing in step S203. When the process of determining and executing an announcement is started, the control unit 300 moves the flow to step S401.

In step S401, the determining unit 305 determines whether the number of trials in step S202 is equal to or greater than a third predetermined number nmax. If the number of trials is not equal to or greater than the third predetermined number nmax, the control unit 300 shifts the flow to step S402. On the other hand, if the number of trials is equal to or greater than the third predetermined number nmax, the control unit 300 determines that the amount of information in the default announcement to the subject is insufficient, and the control unit 300 shifts the flow to step S405.

In step S402, the determining unit 305 further determines whether the number of trials in step S202 is equal to or greater than a fourth predetermined number nmin. If the number of trials is equal to or greater than the fourth predetermined number nmin, it can be determined that the default announcement provides just the right amount of information to the subject. In this case, the control unit 300 moves the flow to step S404. on the other hand. If the number of trials is less than the fourth predetermined number nmin, the control unit 300 moves the flow to step S403.

If the number of trials is less than the fourth predetermined number nmin in step S402, there is a high possibility that the default announcement to the subject is redundant. Therefore, in step S403, the changing unit 306 changes the announcement setting to a simpler one. After the change, the control unit 300 moves the flow to step S404, and in step S404, uses the announcement output unit 310 to make a simple announcement after the change. For example, in step S402, the default announcement that is set to be just the right amount of announcements may say, ``When you see the orange cross, please look at the center of it,'' and ``Don't blink.'' It's okay if you do.'' On the other hand, the announcement after the change in step S403 may be, for example, "When you see the cross mark, please look at the center."

In step S401, if the number of trials is equal to or greater than the third predetermined number nmax, it can be determined that the amount of information in the default announcement to the subject is insufficient. In this case, in step S405, the control unit 300 changes the announcement setting to a more detailed announcement with an increased amount of information. For example, if the default announcement is as described above, the revised announcement may include things like ``Please look ahead'' or ``When you see the orange cross, please look in the middle.'' I can think of things. Additionally, it is possible to add statements such as ``It's okay to blink'' or ``Please keep an eye on the orange cross.''

When the above announcement is made by the announcement output unit 310, the process in step S203 ends, and the control unit 300 moves the flow to step S204. According to the announcement, the subject fixes his or her face on the face receiving part 181, and the pupil of the subject's eye is detected, and the subject's eye is gazing at the fixation lamp. In this state, automatic alignment processing in step S204 is executed.

<Automatic alignment>
In step S204, the control unit 300 executes automatic alignment processing. FIG. 5 is a flowchart showing details of the process executed when performing automatic alignment in step S204. When the automatic alignment process is started, the control unit 300 moves the flow to step S501.

In step S501, the image generation unit 302 generates an anterior segment image based on the signal that the acquisition unit 301 periodically acquires from the image sensor 124. The control unit 300 analyzes the generated anterior segment image. Specifically, the control unit 300 detects the pupil area in the generated anterior segment image, and calculates the center position of the detected pupil area. The control unit 300 calculates the amount of displacement (positional deviation amount) between the detected center position of the pupil area and the center position of the anterior segment image. The ophthalmological apparatus of this embodiment is configured such that the center of the anterior segment image and the optical axis of the objective lens 101 coincide, and the amount of displacement calculated in step S501 is the difference between the eye E and the measurement optical axis. It represents the amount of positional deviation. After calculating the amount of deviation, the control unit 300 moves the flow to step S502.

In step S502, the control unit 300 determines whether the positional deviation amount calculated in step S501 is less than a predetermined value. If it is determined that the positional deviation amount is equal to or greater than the predetermined value, the control unit 300 moves the flow to step S503. On the other hand, if it is determined that the positional deviation amount is less than the predetermined value, the control unit 300 shifts the flow and ends the automatic alignment process.

In step S503, the control unit 300 instructs the head driving unit 170 to move the optical head unit 100 according to the positional deviation amount calculated in step S501 in order to reduce the positional deviation amount. The head driving section 170 drives three motors (not shown) to move the position of the optical head section 100 in three-dimensional (X, Y, Z) directions with respect to the eye E to be examined. More specifically, the control unit 300 instructs the rotation speed of each of three motors (not shown). As a result, the position of the optical axis of the objective lens 101 mounted on the optical head section 100 is corrected so as to approach the pupil center position of the anterior segment Ea of the eye E to be examined. Furthermore, the storage unit 303 stores the number of trials i=i+1 in automatic alignment. After storing the number of trials, the control unit 300 moves the flow to step S501.

After that, the control unit 300 returns to step S501, and repeats the same operation in step S502 until the amount of positional deviation becomes less than a predetermined value. Through this series of automatic alignment operations, the optical axis position of the objective lens 101 approximately matches the pupil center position of the anterior segment Ea of the eye E to be examined, making it possible to take a tomographic image of the eye to be examined in a proper alignment state. Become. The positional relationship between the eye E and the optical head section 100 in this alignment state is an example of a predetermined positional relationship.

Note that if this number of attempts is large, it is not because the subject was effectively guided by the announcement during the chin rest adjustment, but because the subject's posture happened to be appropriate, and the chin rest adjustment was not performed properly. This may be due to the fact that the number of trials stored at the time was small. In such a case, it is assumed that the subject is not able to fully understand the content of the announcement. Therefore, depending on the number of trials obtained in step S503, a re-announcement similar to steps S304 to S307 in the chin rest adjustment process may be performed or the test may be interrupted.

When making a re-announcement during automatic alignment, the control unit 300 may use the announcement output unit 310 to guide the subject to a situation where alignment is easy to perform. Specifically, more detailed instructions may be announced after being changed in step S405. Possible announcements made here include, for example, ``When you see an orange cross, please look at the center of it'' or ``It's okay to blink.'' When the alignment is completed through the above processing, the control unit 300 ends the processing in step S204 and moves the flow to step S205.

<OCT photography>
In step S205, the control unit 300 executes a process of photographing a tomographic image of the fundus Ef. FIG. 6 is a flowchart showing details of the process executed when tomographic image imaging (OCT imaging) is performed in step S206. When the tomographic image capturing process is started, the control unit 300 moves the flow to step S601.

<Fundus observation image focus adjustment>
In step S601, the control unit 300 performs focus adjustment when acquiring a fundus observation image. Specifically, the control unit 300 uses the index image of the focus index unit 142 projected onto the fundus Ef to drive the focus lens 133 with a motor (not shown) to obtain an observation image of the fundus Ef. Obtain a focused state. The focus lens 154 in the OCT optical system is moved on the optical axis in conjunction with the focus lens 133, and by obtaining a focused state using the fundus observation image, the focused state can be similarly obtained in the OCT optical system. That will happen. After the focus adjustment of the OCT optical system using the fundus observation image is completed, the control unit 300 moves the flow to step S602.

<How to take tomographic images>
In step S602, the control unit 300 first acquires a reference tomographic image for observation of the fundus Ef when adjusting the coherence gate. Here, first, a method of photographing a tomographic image for observation using the ophthalmologic apparatus according to the present embodiment will be described. At this time, the control unit 300 generates a tomographic image for recording based on the interference signal periodically output from the line sensor 204. Note that "for recording" may also be expressed as "for photographing."

Here, the interference signal output from the line sensor 204 is a signal for each frequency separated by the diffraction grating 202. The control unit 300 performs FFT (Fast Fourier Transform) processing on the signal from the line sensor 204 to generate information in the depth direction at a certain point on the fundus Ef. This generation of information in the depth direction at a certain point on the fundus Ef is called an A scan. Moreover, the image obtained from this A-scan is called an A-scan image.

The measurement light irradiated onto the fundus Ef can be arbitrarily scanned over the fundus Ef by driving and controlling at least one of the OCTX scanner 153-1 and the OCTY scanner 153-2. The control unit 300 collects a tomographic image at an arbitrary trajectory on the fundus Ef by bundling a series of A-scan images acquired during one scan using this arbitrary trajectory into one two-dimensional image. can be generated.

The control unit 300 can repeat the above-described scanning based on the arbitrary locus a plurality of times by driving and controlling at least one of the OCTX scanner 153-1 and the OCTY scanner 153-2. When the same locus operation is performed multiple times, the image generation unit 302 can generate multiple tomographic images at an arbitrary locus on the fundus Ef. For example, the control unit 300 can drive only the OCTX scanner 153-1 to repeatedly perform scanning in the X direction, and cause the image generation unit 302 to generate a plurality of tomographic images on the same scanning line of the fundus Ef. Further, the control unit 300 can also drive the OCTX scanner 153-1 and the OCTY scanner 153-2 at the same time to repeatedly perform circular scanning to generate a plurality of tomographic images on the same circle of the fundus Ef. In the ophthalmological apparatus according to the present embodiment, the image generation unit 302 generates one high-quality tomographic image by performing averaging processing on the plurality of tomographic images, and causes the display unit 401 to display the generated single high-quality tomographic image.

On the other hand, the control unit 300 drives and controls at least one of the OCTX scanner 153-1 and the OCTY scanner 153-2 to perform multiple scans while shifting the above-described arbitrary trajectory scan in the XY direction. You can also do that. For example, by performing scanning in the X direction multiple times while shifting in the Y direction at regular intervals, the image generation unit 302 can generate a plurality of tomographic images that cover the entire rectangular area on the fundus Ef. The image generation unit 302 can also generate three-dimensional information of the fundus Ef by combining the plurality of tomographic images, and display this on the display unit 401. The scanning patterns of these OCTX scanner 153-1 and OCTY scanner 153-2 can be arbitrarily switched by pressing a scan pattern selection button (not shown). When a tomographic image for observation is obtained by the method described above, the automatic coherence gate adjustment described below is started using this tomographic image.

<Automatic coherence gate adjustment>
FIG. 7 is a flowchart showing details of the coherence gate automatic adjustment process executed in step S602 after obtaining a fundus tomographic image for observation. Automatic adjustment of the coherence gate is performed by adjusting the position of the reference mirror 160 on the optical axis so that the retina is placed at an appropriate position in the tomographic image displayed on the display unit 401. When a tomographic image is acquired and coherence gate adjustment processing is started, the control unit 300 moves the flow to step S701.

In step S701, the image generation unit 302 generates an “adjustment” tomographic image based on the interference signal that the acquisition unit 301 periodically acquires from the line sensor 204. The control unit 300 analyzes the generated tomographic image. Specifically, the control unit 300 detects the position of the retina within the generated tomographic image. The position of the retina is calculated using a known method, such as by referring to the peak position of brightness in the depth direction of the tomographic image. The control unit 300, as a deviation amount calculation means, calculates the amount of displacement (Z deviation amount) between the calculated retinal position (Z direction) and a predetermined position (Z direction) where the retina should be placed in the tomographic image. Once the Z shift amount is calculated, the control unit 300 moves the flow to step S702.

In step S702, the control unit 300 determines whether the Z shift amount calculated in step S701 is less than a predetermined value. If it is determined that the Z shift amount is equal to or greater than the predetermined value, the control unit 300 moves the flow to step S703. On the other hand, if it is determined that the Z shift amount is less than the predetermined value, the control unit 300 determines that the retina is displayed in a suitable position in the tomographic image and that a tomographic image suitable for the examination has been obtained. to complete the automatic coherence gate adjustment process.

In step S703, the control unit 300 instructs the drive mechanism (not shown) to move the reference mirror 160 according to the Z shift amount calculated in step S701 in order to reduce the Z shift amount. The drive mechanism drives a motor (not shown) to move the position of the reference mirror 160 by a predetermined amount in the optical axis direction. More specifically, the control unit 300 instructs a motor (not shown) to rotate at a predetermined number of rotations. As a result, by moving the reference mirror 160, the optical path length of the reference system is corrected to approximately match the optical path length of the measurement light of the OCT optical system, and the display position of the retina of the subject's eye in the tomographic image is moved. . After moving the reference mirror 160 by a predetermined amount, the control unit 300 stores the number of trials i=i+1 in automatic coherence gate adjustment in the storage unit 303, and moves the flow to step S704.

In step S704, the determination unit 305 compares the stored number of trials with the third predetermined number nmax described above. If it is determined that the number of trials is less than the third predetermined number nmax, the control unit 300 returns the flow to step S701 and repeats the processing from step S701. If it is determined that the number of trials is equal to or greater than the third predetermined number nmax, the control unit 300 moves the flow to step S705. Note that in this embodiment, the number of times the reference mirror 160 is driven is compared with the third predetermined number of times nmax. However, the number of times to be referred to during comparison is not limited to this, and for example, a new number of times to be compared may be provided. Furthermore, the cumulative value of the number of trials of each adjustment up to step S704, such as the number of times the motor is driven during chin rest adjustment, the number of times the head drive section 170 is driven during automatic adjustment alignment, etc., may be referred to. The appropriateness of the announcement may be determined from these cumulative numbers and a fifth predetermined number of times provided for comparison with the cumulative number of times.

Here, if it is determined that the Z deviation amount is equal to or greater than the predetermined value even after repeating the process of step S703, the amount of movement of the eye E to be examined is greater than the predetermined value for reference in S702, and the moving speed is set to the reference mirror 160. It is thought that it continues to move faster than the moving speed of . In such a state, it is assumed that, for example, the subject's posture is such that the head is away from the forehead rest, and the movement of the subject's eyes is unstable. Alternatively, it is also assumed that the subject is not looking firmly at the fixation light, resulting in unstable visual acuity and, as a result, the fundus of the eye moves over time. This may be due to the fact that the announcement in step S203 fails to guide the subject into a state where OCT imaging is performed.

Therefore, the number of trials recorded in step S703 can be used as a criterion for determining how well the subject understood and was guided by the announcements made up to step S704. Specifically, if the number of trials is equal to or greater than the third predetermined number nmax, it is possible that the subject's understanding of the announcement is insufficient. Therefore, in step S705, the same announcement is repeated again. Alternatively, the changing unit 306 changes the content of the announcement so that the announcement is made more carefully. If the announcement before the change was, for example, ``Please look at the orange cross mark,'' then after the change, for example, the announcement would be ``When you see the orange cross mark, please look at the center of it.'' It's okay to blink,'' or something like that. Furthermore, if the user's posture is unstable, an announcement such as ``Please keep your forehead firmly on your head'' may be added to address the possibility that your head is away from the forehead rest.

That is, the success rate of each process in the test can be improved by increasing the amount of information in the announcement after the change in step S705, increasing the number of times the announcement is repeated, and guiding the examinee more carefully. . Although the case where the number of trials is small is not particularly considered here, the announcement may be changed when the number of trials is small. In this case, by reducing the amount of information in subsequent announcements or reducing the number of announcements, unnecessary announcements can be omitted depending on the patient, thereby increasing the throughput and efficiency of the examination. Furthermore, by eliminating the need to keep listening to redundant announcements, the psychological burden on the subject can be reduced.

Note that if the coherence gate movement process is still required after the announcement is changed in step S705, the second predetermined number of times n2 used as a determination criterion may be compared with the number of trials in step S305, for example. In this case, the test interruption process may be performed in the same way as steps S305 to S307 in the chin rest adjustment. When the coherence gate adjustment processing is completed and conditions are obtained for displaying the retina at a predetermined position in the adjustment tomographic image, the control unit 300 shifts the flow to step S603.

Note that after the automatic coherence gate adjustment is completed, the control unit 300 can further perform focus adjustment of the tomographic image. In this case, for example, with reference to the brightness profile of the tomographic image, the focus lens 154 is driven by a motor (not shown) so that the contrast and the like of the displayed tomographic image are in a suitable state.

<Decision and execution of announcement before OCT imaging>
In step S603, the determination unit 305 determines whether the amount of information and repetition amount of the announcement to the subject is excessive or insufficient based on the number of trials in the adjustment process before step S603. Further, the changing unit 306 can change the announcement setting according to the determination result. Note that the process of determining and executing the announcement is performed by repeating the processes from step S401 to step S405 performed in step S203. However, in step S603, the number of times the reference mirror 160 is driven during coherence gate adjustment is compared with the third predetermined number of times nmax and the fourth predetermined number of times nmin. However, the number of times to be referred to during comparison is not limited to this, and for example, a new number of times to be compared may be provided. Further, for example, the cumulative value of the number of trials of each adjustment up to step S704, such as the number of times the motor is driven during chin rest adjustment, the number of times the head drive unit 170 is driven during automatic adjustment alignment, etc., may be referred to. You may refer to the cumulative number of times which are these cumulative values, and the sixth predetermined number of times and the seventh predetermined number of times newly provided for the cumulative value number of times. In the following, a case will be described in which the cumulative value is referred to.

FIG. 8 is a flowchart showing the details of the process when determining and executing an announcement before tomographic imaging processing in step S603. When the process of determining and executing an announcement is started, the control unit 300 moves the flow to step S801.

In step S801, the determination unit 305 determines whether the cumulative value j of the number of trials during adjustment performed up to step S702 is equal to or greater than the sixth predetermined number mmax. If the cumulative value j is less than the sixth predetermined number of times mmax, the control unit 300 moves the flow to step S802. On the other hand, if the cumulative value j is equal to or greater than the sixth predetermined number of times mmax, the control unit 300 determines that the amount of information in the announcements made so far to the subject is insufficient, and the control unit 300 shifts the flow to step S805. let

In step S802, the determining unit 305 further determines whether the cumulative value j is equal to or greater than a seventh predetermined number of times mmin. If the cumulative value j is equal to or greater than the seventh predetermined number of times mmin, it can be determined that the announcements made so far are sufficient in terms of the amount of information given to the subject. In this case, the control unit 300 moves the flow to step S804. on the other hand. If the cumulative value j is less than the seventh predetermined number of times mmin, the control unit 300 moves the flow to step S803.

If the cumulative value j is less than the seventh predetermined number of times mmin in step S802, there is a high possibility that the announcements made to the subject so far are redundant. Therefore, in step S803, the changing unit 306 changes the announcement setting to a simpler one. After the change, the control unit 300 moves the flow to step S804, and in step S804, uses the announcement output unit 310 to make a simple announcement after the change. For example, in step S802, the announcements that have been made so far are just the right amount, such as, ``When you see the orange cross mark, please look at the center of it'' in order to get people to look at the fixation light. It's okay to blink.'' In this case, the announcement after the change in step S803 may be, for example, "When you see the cross mark, please look at the center."

In step S801, if the cumulative value j is equal to or greater than the sixth predetermined number of times mmax, it can be determined that the amount of information in the announcements made to the subject so far is insufficient. In this case, in step S805, the control unit 300 changes the announcement setting to a more detailed announcement with an increased amount of information. For example, if the previous announcement was as described above, the new announcement may include things like ``Please look ahead'' and ``When you see the orange cross mark, please look in the middle.'' ”, etc. can be considered. It is also possible to add statements such as ``It's okay to blink'' and ``Please keep an eye on the orange cross.''

When the above announcement is made by the announcement output unit 310, the process in step S603 ends, and the control unit 300 moves the flow to step S604. According to the announcement, the subject fixes his or her face on the face receiving part 181, and the pupil of the subject's eye is detected, and the subject's eye is gazing at the fixation lamp. In this state, the OCT imaging process in step S604 is executed.

<Execution of OCT imaging>
In step S604, the control unit 300 photographs a tomographic image for storage and a fundus observation image. In addition, specifically, the tomographic image for storage can be acquired by the same acquisition procedure as the tomographic image for observation mentioned above. However, for example, the number of A-scan images acquired from one scanning line in the Various known methods for obtaining this may be applied. After acquiring the tomographic image for storage, the control unit 300 ends the OCT imaging process and moves the flow to step S206.

<Confirm OCT imaging results>
In step S206, the control unit 300 checks the OCT imaging results. Specifically, the control unit 300 checks whether there is any problem with the sensitivity, the part to be photographed, etc. of the tomographic image for storage taken in step S604, and if there is no problem, ends the imaging. When the imaging ends, the control unit 300 uses the announcement output unit 310 to notify the subject of the end of imaging. The content to be announced may be, for example, "The shooting has ended" or "Please remove your face. Thank you for your hard work." On the other hand, if it is determined that re-imaging is necessary, the control unit 300 shifts the flow to step S207.

<Change of announcement settings (when reshooting OCT)>
When performing re-imaging, the control unit 300 returns the flow to step S204 so as to repeat the processes from step S204 to step S206 described above. The announcement made in the processing from step S204 to step S206 is the one made immediately before for the subject. Therefore, in step S207, the changing unit 306 changes the audio announcement to be output when repeating the same test to a more simplified one. These repetitive processes are already experienced by test subjects, so by simplifying the announcements, it is possible to omit unnecessary announcements for some patients, improving test throughput and efficiency. . Furthermore, by eliminating the need to keep listening to redundant announcements, the psychological burden on the subject can be reduced.

(Modified example)
Here, for example, in a medical examination or the like, OCT imaging of the left and right eyes to be examined may be performed successively. In the following, as a modification of the above-described embodiment, reference will be made to FIG. 9, which is a flowchart showing the processing performed at the time of examination in the ophthalmological apparatus according to this modification, in the case where OCT imaging of both the left and right eyes to be examined is performed continuously. and explain. It should be noted that the steps for performing the same processing as the processing illustrated in FIG. 2 as the processing at the time of inspection in the above-described embodiment are given the same step numbers, and the description here will be omitted. Below, processing different from the processing shown in FIG. 2 will be described in detail.

<Change announcement settings (during continuous shooting with both eyes)>
FIG. 9 is a flowchart showing the processing performed when both eyes are successively examined by the ophthalmological apparatus according to the present embodiment. The processing performed from step S201 to step S207 is similar to the processing performed during the single eye examination shown in FIG. 2. In the flowchart of FIG. 9, if it is determined in step S206 that a suitable tomographic image of one eye has been taken and the examination has ended, the control unit 300 shifts the flow to step S908.

In step S908, the control unit 300 determines whether the examination of both eyes has been completed. Here, if it is determined that only one eye has been tested, the control unit 300 shifts the flow to step S909. When determining that the examination of both the left and right eyes has been completed, the control unit 300 advances the flow and ends the flow.

In step S909, the announcement output unit 310 makes an announcement that is set to be output before the left and right eye switching selected by default by the selection unit 304 in step S201. The set announcement may be, for example, "The next eye will be photographed, so please keep looking ahead." After the announcement ends, the control unit 300 moves the flow to step S910.

In step S910, the control unit 300 performs processing for switching between the left and right eyes. The control unit 300 instructs the head drive unit 170 to move the optical head unit 100 from one eye (for example, the left eye) to in front of the other eye (for example, the right eye). After moving the optical head unit 100, the control unit 300 moves the flow to step S203. In step S203, since the same test is repeated, the changing unit 306 changes the audio announcement to be output to a simpler one. In the examination of the other eye, the control unit 300 will perform the processes performed from step S204 to step S207 again. These processes are processes that the examinee has already experienced, so it is possible to further simplify the announcements. By simplifying the process, unnecessary announcements can be omitted depending on the examinee, and the throughput of the examination can be increased. Improvements and efficiencies can be made. Furthermore, by eliminating the need to keep listening to redundant announcements, the psychological burden on the subject can be reduced. After the announcement ends, the control unit 300 returns the flow to step S204 and re-executes the process up to OCT imaging for this eye.

When the test for both eyes is completed in step S908, the control unit 300 advances the flow and ends the test, as described above. Note that, at the end of the test, the announcement output section 310 makes an announcement at the end of the test in the announcement selected by the selection section 304. Examples of announcements to notify the subject of the completion of the imaging may be, "The imaging has been completed," or "Please remove your face. Thank you for your hard work."

Note that in the embodiment described above, the default announcement selected by the selection unit 304 in step S201 is initially used as is in each subsequent process. However, this default announcement is likely to be redundant for the subject, for example, if the subject has performed the same test several days ago or many times in the past. For example, if a predetermined period of time has not elapsed since the last announcement in the examination or the last operation of the ophthalmological apparatus, the determination unit 305 may determine that the default announcement is not appropriate for this subject. Alternatively, if these announcements and actions have been performed a predetermined number of times in the past, the determination unit 305 may determine that the default announcement is not appropriate for this subject.

Furthermore, in the embodiment described above, the announcement selected by default is stored as a series of announcement patterns, and individual announcements are sequentially performed in response to processing or operation in the target ophthalmological apparatus. There is. Then, based on the number of repetitions of an operation such as alignment of the ophthalmological apparatus performed when the subject is prompted by each announcement, the announcement corresponding to the operation is changed. However, for example, if it can be determined that the subject fully understands the content of the announcement at the alignment stage, it may be preferable to change all subsequent announcements to simpler ones. Therefore, all the announcements in the announcement pattern provided according to the operation of the ophthalmological apparatus after the operation in which the change in announcement is determined may be changed. Further, after the change, for example, when adjusting the coherence gate, it may be found that the subject did not fully understand the content of the announcement because the fixation of the subject's eye is not stable. In this case, the changing unit 306 may further change the changed announcement and make an announcement that provides a detailed explanation again.

As described above, the ophthalmologic apparatus according to one embodiment of the present disclosure includes a selection means (selection unit 304), a determination unit (determination unit 305), and a change unit (change unit 306). Further, a method for controlling an ophthalmologic apparatus according to an embodiment of the present disclosure includes executing each process executed by these means. When performing a test, the selection unit 304 selects an announcement pattern or an announcement according to the content of the test scheduled to be performed, from among a plurality of announcement patterns for prompting the subject. Although OCT imaging was exemplified in the above-described embodiment as the examination content, it may include various eye examinations performed in other medical examinations and the like. The determining unit 305 determines the selection by the selecting unit 304 based on, for example, the operation of the head drive unit 170, which is an operation of the ophthalmological apparatus performed when the subject is prompted by an announcement in the selected announcement pattern. It is determined whether the announcement made is appropriate. Furthermore, when the determining unit 305 determines that the selected announcement is inappropriate, the changing unit 306 changes the selected announcement to be suitable for the subject.

The above-mentioned determination unit 305 determines that, for example, for an operation such as one drive of the motor in step S303 when adjusting the chin rest, the number of times the same operation is repeated (the number of trials i) is equal to or greater than a predetermined number of times (the third predetermined number of times nmax). In this case, it can be determined that the selected announcement is inappropriate. In this case, the changing unit 306 can change the announcement that has been selected to prompt the subject when performing the same action of driving the motor. Alternatively, the changing unit 306 changes the subject when performing the same operation after motor driving, such as motor driving, operation of the head driving unit 170 during alignment, and operation of the reference mirror 160 during OCT imaging. The announcement selected for prompting can be changed.

Furthermore, the determination unit 305 can use as a criterion the cumulative number of repetitions of operations performed before a predetermined operation in each operation of the ophthalmological apparatus performed during OCT imaging. Examples of the predetermined operation include one drive of the head drive unit 170 in step S503 in automatic alignment in each operation of the ophthalmological apparatus performed during OCT imaging. In this case, the determination unit 305 can determine that the selected announcement is inappropriate when the cumulative number of times (cumulative value j) is equal to or greater than the predetermined number of times (sixth predetermined number of times mmax). At this time, the changing unit 306 can change the announcement selected to prompt the subject to perform the predetermined movement and subsequent movements.

As described above, for example, when the number of repetitions or the cumulative number of repetitions of an operation of the ophthalmological apparatus performed during OCT imaging is a predetermined number or more, the determination unit 305 determines that the announcement selected to prompt the corresponding operation is appropriate. It is determined that it is not. In such a case, the changing unit 306 changes the selected announcement so that the operation performed by the ophthalmological apparatus while prompting the subject with the selected announcement is explained in more detail than the selected announcement. change. As a result, if, for example, chin rest adjustment or alignment is not performed properly due to lack of repeated announcements, a more thorough and detailed explanation can be presented to the examinee to facilitate smooth chin rest adjustment or alignment. It is possible to do this.

Further, the determination unit 305 determines that, for example, regarding an operation such as one drive of the motor in step S303 when adjusting the chin rest, the number of times the same operation is repeated (the number of trials i) is less than a predetermined number of times (fourth predetermined number of times nmin). In this case, it can be determined that the selected announcement is inappropriate. In this case, the changing unit 306 can change the announcement that has been selected to prompt the subject when performing the same action of driving the motor. Alternatively, the changing unit 306 may change the subject when performing operations subsequent to motor driving, which are the same operations, such as motor driving, operation of the head driving unit 170 during alignment, and operation of the reference mirror 160 during OCT imaging. You can change the selected announcement to prompt you.

Furthermore, the determination unit 305 can use as a criterion the cumulative number of repetitions of operations performed before a predetermined operation in each operation of the ophthalmological apparatus performed during OCT imaging. Examples of the predetermined operation include, for example, one drive of the head drive unit 170 in step S503 in automatic alignment in each operation of the ophthalmological apparatus. In this case, the determination unit 305 can determine that the selected announcement is inappropriate when the cumulative number of times (cumulative value j) is less than the predetermined number of times (seventh predetermined number of times mmin). In this case, the changing unit 306 can change the announcement selected to prompt the subject when performing the predetermined movement and subsequent movements.

Further, the determination unit 305 determines whether a selected announcement is made when a predetermined period of time has not elapsed since the last operation during the examination in the operation of the ophthalmological apparatus in OCT imaging, or when the last operation has been performed a predetermined number of times or more. It can be determined that this is not appropriate. An example of such a final operation is, for example, an announcement at the end of OCT imaging. In this case, the changing unit 306 can change the announcement selected to prompt the subject when performing the test.

As described above, for example, when the number of repetitions or the cumulative number of repetitions of an operation of the ophthalmological apparatus performed during OCT imaging is less than a predetermined number, the determination unit 305 determines whether the announcement selected to prompt the corresponding operation is appropriate. It is determined that it is not. In addition, by referring to the last announcement during OCT imaging and using the elapsed time and the number of outputs as criteria, the selected announcement is determined if the elapsed time is shorter than the predetermined period or if the number of outputs is less than the predetermined number of times. It has been determined that it is not appropriate. Further, the determining unit 305 determines that the selected announcement is inappropriate based on the preparation operation (announcement for switching between left and right eyes) for completing the examination of one of the left and right eyes and performing the examination of the other eye. Can be judged. In such a case, the changing unit 306 changes the selected announcement so that the operation performed by the ophthalmological apparatus while prompting the examinee with the selected announcement is explained more simply than the selected announcement. change. By doing this, it is possible to avoid the repeated announcements from becoming excessive and, for example, the time required for chin rest adjustment and alignment due to announcements, and to reduce the psychological burden on the examinee and to perform chin rest adjustment and alignment smoothly. is possible.

In the embodiments described above, the ophthalmological apparatus is exemplified as having an OCT imaging unit further equipped with an OCT optical system used to obtain a tomographic image of the eye to be examined. The above-mentioned operations in an ophthalmological apparatus equipped with an OCT imaging unit include vertical adjustment of the chin rest, alignment between the eye to be examined and the OCT optical system, focusing in the OCT optical system, and operation in the OCT optical system. A coherence gate adjustment operation is included. Further, although a voice announcement is illustrated as an example of an announcement, the present invention is not limited to the voice announcement as long as it urges other subjects to take a specific action.

Furthermore, in the embodiment described above, the determining unit 305 determines whether the announcement is appropriate based on the operation of the testing device performed when the subject is prompted by the announcement after being changed by the changing unit 306. It can be determined whether or not. Specifically, subsequent announcements were changed based on, for example, the vertical adjustment of the chin rest. However, if the patient is not appropriately guided by the announcement selected in the alignment operation between the eye to be examined and the OCT optical system, the determination unit 305 can also determine that the announcement is inappropriate. In such a case, the modification unit 306 can further modify the modified announcement.

In the embodiment described above, the determination unit 305 determines a first predetermined number of times (a third predetermined number of times nmax) and a second predetermined number of times (a fourth predetermined number of times nmin) that is smaller than the first predetermined number of times. The appropriateness of the selected announcement can be determined based on the criteria. For example, the determination unit 305 determines that the announcement is insufficiently explained if the same operation is performed a first predetermined number of times (nmax) or more in the operation of the ophthalmological apparatus performed when the subject is prompted by the selected announcement. It can be determined that there is. Further, the determining unit 305 can determine that the announcement is overly descriptive if the same action is performed less than a second predetermined number of times (nmin). If the changing unit 306 determines that the explanation is insufficient, the changing unit 306 can change the selected announcement so that the action that the subject is prompted to perform is explained in more detail than the selected announcement. Further, when it is determined that the selected announcement is too much to explain, the changing unit 306 can change the selected announcement so that the action that the subject is prompted to perform is explained more easily than the selected announcement.

In the embodiment described above, the determination unit 305 determines a first predetermined number of times (sixth predetermined number of times mmax) and a second predetermined number of times (seventh predetermined number of times mmin) that is smaller than the first predetermined number of times. The appropriateness of the selected announcement can be determined based on the criteria. The determining unit 305 determines whether the cumulative number (cumulative value) of the number of repetitions of the operation performed up to a predetermined operation in the operation of the testing device performed when the subject is prompted by the selected announcement is the first one. If the number of times exceeds a predetermined number (mmax), it can be determined that the announcement lacks sufficient explanation. Further, the determining unit 305 can determine that the selected announcement provides too much explanation when the cumulative number of times is less than the second predetermined number (mmin). If the changing unit 306 determines that the explanation is insufficient, the changing unit 306 can change the selected announcement so that the action that the subject is prompted to perform is explained in more detail than the selected announcement. Further, when it is determined that the selected announcement is too much to explain, the changing unit 306 can change the selected announcement so that the action that the subject is prompted to perform is explained more easily than the selected announcement.

According to this embodiment, in the examination of the subject's eye, the apparatus guides the subject by voice announcement instead of the examiner. Then, during the examination, the control state of the device and the operating state of the patient are detected, and an appropriate voice announcement is selected and executed according to the situation of the scene. Thereby, it becomes possible to make an announcement that is easy to understand and has no excess or deficiency depending on the subject.

Note that the disclosure of this embodiment includes the following configuration, method, and program.
(Configuration 1) A selection means for selecting an announcement according to the test content of the eye to be examined from among a plurality of announcements for prompting the examinee during the examination, and a selection means for prompting the examinee to the selected announcement. determining means for determining whether or not the selected announcement is appropriate based on the operation of the ophthalmological apparatus performed in a state where the selected announcement is An ophthalmological apparatus comprising: a changing means for changing the ophthalmological apparatus.
(Configuration 2) The determining means determines that the selected announcement is inappropriate when the number of repetitions of the same motion in the motion is equal to or greater than a predetermined number of times, and the changing means determines that the selected announcement is inappropriate when performing the same motion. The ophthalmological apparatus according to configuration 1, wherein the selected announcement for prompting the subject is changed.
(Configuration 3) The determining means determines that the selected announcement is inappropriate when the number of repetitions of the same action in the action is equal to or greater than a predetermined number of times, and the changing means performs the action subsequent to the same action. The ophthalmologic apparatus according to configuration 1, wherein the selected announcement for prompting the subject is changed when the patient is prompted.
(Configuration 4) The determining means determines that the selected announcement is inappropriate when the cumulative number of repetitions of the motion performed before the predetermined motion in the motion is equal to or greater than a predetermined number, and the changing means The ophthalmologic apparatus according to configuration 1, wherein the selected announcement for prompting the subject when performing an operation subsequent to the predetermined operation is changed.
(Structure 5) The changing means changes the selected announcement so that the action that the subject is prompted to perform is explained in more detail than the selected announcement. The ophthalmological device according to any one of configurations 2 to 4.
(Structure 6) The determining means determines that the selected announcement is inappropriate when the number of repetitions of the same motion in the motion is less than a predetermined number of times, and the changing means determines that the selected announcement is inappropriate when performing the same motion. The ophthalmologic apparatus according to any one of configurations 1 to 5, wherein the selected announcement for prompting the subject is changed.
(Configuration 7) The determining means determines that the selected announcement is inappropriate when the number of repetitions of the same motion in the motion is less than a predetermined number of times, and the changing means performs a motion subsequent to the same motion. 6. The ophthalmological apparatus according to any one of configurations 1 to 5, wherein the selected announcement for prompting the subject is changed at a time.
(Configuration 8) The determining means determines that the selected announcement is inappropriate when the cumulative number of repetitions of the motion performed before the predetermined motion in the motion is less than a predetermined number of times, and the changing means 6. The ophthalmologic apparatus according to any one of configurations 1 to 5, wherein the selected announcement for prompting the subject when performing an operation subsequent to the predetermined operation is changed.
(Structure 9) The determining means determines whether the selected announcement is correct if a predetermined period of time has not elapsed since the last motion during the inspection of the motions, or if the last motion has been performed a predetermined number of times or more. 6. The ophthalmological apparatus according to any one of configurations 1 to 5, wherein the changing means changes the selected announcement for prompting the subject when performing the examination upon determining that it is inappropriate.
(Structure 10) The changing means changes the selected announcement so that the action that the subject is prompted to perform is explained more easily than the selected announcement. The ophthalmological device according to any one of configurations 1 to 9.
(Structure 11) The operation includes a preparatory operation for completing an examination of one eye in both eyes and performing an examination of the other eye, and the determining means determines the selected announcement based on the preparatory operation. is not appropriate, and the changing means changes the selected announcement so that the action that the subject is prompted to perform is explained more easily than the selected announcement. The ophthalmological device according to any one of configurations 1 to 10, which is modified.
(Structure 12) It further includes an OCT optical system used to obtain a tomographic image of the eye to be examined, and the operation includes an alignment operation between the eye to be examined and the OCT optical system, and a focusing operation in the OCT optical system. , and an adjustment operation of a coherence gate in the OCT optical system.
(Configuration 13) The ophthalmologic apparatus according to any one of Configurations 1 to 12, wherein the announcement includes a voice announcement.
(Structure 14) The determining means determines whether the selected announcement is appropriate based on an operation of the testing device performed while the subject is prompted by the changed announcement. ,
14. The ophthalmologic apparatus according to any one of configurations 1 to 13, wherein the changing unit further changes the changed announcement when the determining unit determines that the announcement is inappropriate.
(Structure 15) Selection means for selecting an announcement according to the test content of the eye to be examined from among a plurality of announcements for prompting the examinee during the examination; When the number of repetitions of the same action is equal to or greater than a first predetermined number of times in the operation of the ophthalmological apparatus performed in the state where a determining means that determines that the selected announcement is overexplanatory when the number of times the selected announcement is less than a second predetermined number of times, which is less than the first predetermined number of times; The selected announcement is changed so that the action that the subject is prompted to perform is explained in more detail than the selected announcement, and if it is determined that the selected announcement is an excessive explanation, an ophthalmological apparatus, comprising: a changing means for changing the selected announcement so that the action to be prompted the subject to perform is more easily explained than the selected announcement.
(Structure 16) Selection means for selecting an announcement according to the test content of the eye to be examined from among a plurality of announcements for prompting the examinee during the examination; The selected announcement is determined to be insufficient in explanation when the cumulative number of repetitions of the operation performed up to a predetermined operation in the operation of the ophthalmological apparatus performed in the state of , a determining means for determining that the selected announcement provides too much explanation when the cumulative number of times is less than a second predetermined number of times, which is less than the first predetermined number of times; and the determining means determines that the selected announcement does not provide enough explanation. In this case, the selected announcement is changed so that the action that the subject is prompted to perform is explained in more detail than the selected announcement, and it is determined that the explanation is excessive. changing means for changing the selected announcement so that the action that the subject is prompted to perform by the selected announcement is more easily explained than the selected announcement; Ophthalmology equipment.
(Method 1) Selecting an announcement according to the test content of the eye to be examined from among a plurality of announcements for prompting the examinee during the examination, and determining whether or not the selected announcement is appropriate based on the operation of the ophthalmological apparatus performed in a state in which the announcement is made, and changing the selected announcement when it is determined that the announcement is not appropriate. , a method for controlling an ophthalmological device.
(Method 2) Selecting an announcement according to the examination content of the eye to be examined from among a plurality of announcements for prompting the examinee during the examination, and prompting the examinee by the selected announcement. When the number of repetitions of the same action is equal to or greater than the first predetermined number of times in the operation of the ophthalmological apparatus performed in the state where determining that the selected announcement provides too much explanation when the number of times is less than a second predetermined number of times that is less than a second predetermined number of times; The selected announcement is changed so that the action that the examiner is prompted to perform is explained in more detail than the selected announcement, and if it is determined that the action that the examiner is prompted to perform is explained in more detail than the selected announcement, the selected announcement A method for controlling an ophthalmological apparatus, the method comprising: changing the selected announcement so that an action to be prompted to be performed by a subject is more easily explained than in the selected announcement.
(Method 3) Selecting an announcement according to the test content of the eye to be examined from among a plurality of announcements for prompting the examinee during the examination, and prompting the examinee by the selected announcement. determining that the selected announcement is insufficient in explanation if the cumulative number of repetitions of the operation performed up to a predetermined operation in the operation of the ophthalmological apparatus performed in the state of determining that the selected announcement provides too much explanation when the cumulative number of times is less than a second predetermined number of times that is less than the first predetermined number of times; and determining that the selected announcement provides insufficient explanation; Changing the selected announcement so that the action that the subject is prompted to perform is explained in more detail than the selected announcement, and when it is determined that the explanation is too much, A method for controlling an ophthalmological apparatus, the method comprising: changing the selected announcement so that an action that the subject is prompted to perform is explained more easily than the selected announcement. .
(Program 1) A program that, when executed by a computer, causes the computer to execute each step of the method for controlling an ophthalmic apparatus described in any one of Methods 1 to 3.

(Other embodiments)
The present invention also includes a process in which a program that implements one or more functions of the embodiments and modifications described above is supplied to a system or device via a network or a storage medium, and a computer of the system or device reads and executes the program. It is possible. A computer has one or more processors or circuits and may include separate computers or a network of separate processors or circuits for reading and executing computer-executable instructions.

The processor or circuit may include a central processing unit (CPU), microprocessing unit (MPU), graphics processing unit (GPU), application specific integrated circuit (ASIC), or field programmable gateway (FPGA). The processor or circuit may also include a digital signal processor (DSP), a data flow processor (DFP), or a neural processing unit (NPU).

Although the present invention has been described above with reference to the embodiments and modified examples, the present invention is not limited to the embodiments and modified examples described above. The present invention includes inventions modified within the scope of the spirit of the present invention and inventions equivalent to the present invention. Further, the above-described embodiments and each modification example can be combined as appropriate within the scope of the spirit of the present invention.

100: optical head section, 180: stage section, 182: forehead rest section, 183: chin rest section, 300: control section, 301: acquisition section, 303: storage section, 304: selection section, 305: determination section, 306: Change section, 310: Announcement output section

Claims (20)

a selection means for selecting an announcement according to the content of the examination of the eye to be examined from among a plurality of announcements for prompting the examinee during the examination;
determining means for determining whether the selected announcement is appropriate based on an operation of the ophthalmological apparatus performed while the subject is prompted by the selected announcement;
changing means for changing the selected announcement when the determining means determines that it is inappropriate;
An ophthalmological device comprising: The determining means determines that the selected announcement is inappropriate when the number of repetitions of the same motion in the motion is equal to or greater than a predetermined number of times;
The ophthalmologic apparatus according to claim 1, wherein the changing means changes the selected announcement for prompting the subject when performing the same action. The determining means determines that the selected announcement is inappropriate when the number of repetitions of the same motion in the motion is equal to or greater than a predetermined number of times;
The ophthalmologic apparatus according to claim 1, wherein the changing means changes the selected announcement for prompting the subject when performing the same or subsequent operations. The determining means determines that the selected announcement is inappropriate when the cumulative number of repetitions of the motion performed before the predetermined motion in the motion is equal to or greater than a predetermined number of times;
The ophthalmologic apparatus according to claim 1, wherein the changing means changes the selected announcement for prompting the subject when performing an operation subsequent to the predetermined operation. 5. The changing means changes the selected announcement so that the action that the subject is prompted to perform is explained in more detail than the selected announcement. The ophthalmological device according to any one of the above. The determining means determines that the selected announcement is inappropriate when the number of repetitions of the same motion in the motion is less than a predetermined number of times,
The ophthalmologic apparatus according to claim 1, wherein the changing means changes the selected announcement for prompting the subject when performing the same action. The determining means determines that the selected announcement is inappropriate when the number of repetitions of the same motion in the motion is less than a predetermined number of times,
The ophthalmologic apparatus according to claim 1, wherein the changing means changes the selected announcement for prompting the subject when performing the same or subsequent operations. The determining means determines that the selected announcement is inappropriate when the cumulative number of repetitions of the motion performed before the predetermined motion in the motion is less than a predetermined number of times;
The ophthalmologic apparatus according to claim 1, wherein the changing means changes the selected announcement for prompting the subject when performing an operation subsequent to the predetermined operation. The determining means determines that the selected announcement is inappropriate if a predetermined period of time has not elapsed since the last motion during the inspection of the motions, or if the last motion has been performed more than a predetermined number of times. death,
The ophthalmologic apparatus according to claim 1, wherein the changing means changes the selected announcement for prompting the subject when performing the examination. Claims 6 to 9, wherein the changing means changes the selected announcement so that the movement that the subject is prompted to perform is explained more simply than the selected announcement. The ophthalmological device according to any one of the above. The operation includes a preparatory operation for completing an examination of one eye in both eyes and performing an examination of the other eye,
The determining means determines that the selected announcement is inappropriate based on the preparatory action,
2. The changing means changes the selected announcement so that the action that the subject is prompted to perform is more easily explained by the selected announcement than by the selected announcement. ophthalmological equipment. Further comprising an OCT optical system used to obtain a tomographic image of the eye to be examined,
The ophthalmology clinic according to claim 1, wherein the operation includes an alignment operation between the eye to be examined and the OCT optical system, a focusing operation in the OCT optical system, and an adjustment operation of a coherence gate in the OCT optical system. Device. The ophthalmologic apparatus according to claim 1, wherein the announcement includes an audio announcement. The determining means determines whether the selected announcement is appropriate based on an operation of the testing device performed while the subject is prompted by the changed announcement;
The ophthalmological apparatus according to claim 1, wherein the changing means further changes the changed announcement when the determining means determines that it is inappropriate. a selection means for selecting an announcement according to the content of the examination of the eye to be examined from among a plurality of announcements for prompting the examinee during the examination;
When the number of repetitions of the same action in the operation of the ophthalmological apparatus performed while the subject is prompted by the selected announcement is a first predetermined number of times or more, the selected announcement is determined to be insufficiently explained. determining means for determining that the selected announcement is overly descriptive if the number of times the same action is repeated is less than a second predetermined number, which is less than the first predetermined number;
If the determining means determines that the explanation is insufficient, the selected announcement is configured such that the selected announcement explains the action that the subject is prompted to perform in more detail than the selected announcement. and changing the selected announcement so that, when it is determined that the explanation is too much, the selected announcement explains the action that the subject is prompted to perform more easily than the selected announcement. a modification means for modifying the
An ophthalmological device comprising: a selection means for selecting an announcement according to the content of the examination of the eye to be examined from among a plurality of announcements for prompting the examinee during the examination;
When the cumulative number of repetitions of the operations performed up to a predetermined operation in the operation of the ophthalmological apparatus performed while the subject is prompted by the selected announcement is equal to or greater than the first predetermined number of times; Determining means for determining that the selected announcement does not provide enough explanation, and determining that the selected announcement provides too much explanation when the cumulative number of times is less than a second predetermined number of times, which is less than the first predetermined number of times. and,
If the determining means determines that the explanation is insufficient, the selected announcement is configured such that the selected announcement explains the action that the subject is prompted to perform in more detail than the selected announcement. and changing the selected announcement so that, when it is determined that the explanation is too much, the selected announcement explains the action that the subject is prompted to perform more easily than the selected announcement. a modification means for modifying the
An ophthalmological device comprising: Selecting an announcement according to the content of the eye test from among multiple announcements to prompt the test subject during the test;
determining whether the selected announcement is appropriate based on an operation of the ophthalmological apparatus performed while the subject is prompted by the selected announcement;
changing the selected announcement if it is determined to be inappropriate;
A method of controlling an ophthalmological device including: Selecting an announcement according to the content of the eye test from among multiple announcements to prompt the test subject during the test;
When the number of repetitions of the same action in the operation of the ophthalmological apparatus performed while the subject is prompted by the selected announcement is a first predetermined number of times or more, the selected announcement is determined to be insufficiently explained. and determining that the selected announcement is overly descriptive if the number of times the same action is repeated is less than a second predetermined number, which is less than the first predetermined number;
If it is determined that the explanation is insufficient, the selected announcement is changed so that the action that the subject is prompted to perform is explained in more detail than the selected announcement. , if it is determined that the explanation is too much, the selected announcement is changed so that the movement that the subject is prompted to perform is explained more easily than the selected announcement; to do and
A method of controlling an ophthalmological device including: Selecting an announcement according to the content of the eye test from among multiple announcements to prompt the test subject during the test;
When the cumulative number of repetitions of the operations performed up to a predetermined operation in the operation of the ophthalmological apparatus performed while the subject is prompted by the selected announcement is equal to or greater than the first predetermined number of times; determining that the selected announcement does not provide enough explanation, and determining that the selected announcement provides too much explanation when the cumulative number of times is less than a second predetermined number of times that is less than the first predetermined number of times; ,
If it is determined that the explanation is insufficient, the selected announcement is changed so that the action that the subject is prompted to perform is explained in more detail than the selected announcement. , if it is determined that the explanation is too much, the selected announcement is changed so that the movement that the subject is prompted to perform is explained more easily than the selected announcement; to do and
A method of controlling an ophthalmological device including: A program that, when executed by a computer, causes the computer to execute each step of the method for controlling an ophthalmologic apparatus according to any one of claims 17 to 19.

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