JP3108261B2 - Ophthalmic instruments - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ophthalmic instrument for measuring eye data, such as a non-contact tonometer.

[0002]

2. Description of the Related Art Conventionally, an image of an anterior segment of an eye to be inspected guided by an observation optical system is observed by an observation means such as a monitor or an eyepiece, and the amount of measurement light guided by the measurement optical system is detected by a detector. Non-contact tonometers are examples of ophthalmic instruments that are designed to obtain eye data through measurement.

This non-contact ophthalmic instrument aligns the visual axis of the eye to be examined with the optical axis of the anterior ocular segment observation optical system, and then jets an air pulse toward the cornea of the eye to be examined. The intraocular pressure is determined by measuring the increase in the amount of corneal reflected light received by the light receiving element at the same time that the corneal deformation due to the ejection of the cornea starts.

[0004] At this time, when the amount of light received by the light receiving element is significantly different from the reference value, the different intraocular pressure values are distinguished from other intraocular pressure values so as to be displayed. In some cases, a value is mechanically indicated to be low-reliability eye data.

[0005]

By the way, at the moment when eye data is measured, the measurement light may be interrupted by eyelids or eyelashes and the amount of light may decrease. Since the reliability of the eye data to be examined is mechanically determined, whether the low-reliability eye data is due to the corneal reflectance of the eye to be examined or is measured on the eyelids or eyelashes It is difficult to distinguish whether the data is caused by a decrease in the amount of light due to the interruption of the light, and there is a risk that the data may be erroneously recognized as having low reliability despite being correctly measured.

SUMMARY OF THE INVENTION The present invention has been made in view of the above circumstances, and it is an object of the present invention to confirm an anterior eye image of a subject's eye during corneal applanation.
And to provide an ophthalmic apparatus capable of the reliability of the intraocular pressure data examiner objectively determine.

[0007]

According to the present invention, there is provided a photographing means capable of photographing an anterior eye image of an eye to be examined guided by an anterior eye observation optical system, and Direction
And injects an air pulse based on the injection of the air pulse.
Measurement means for measuring intraocular pressure by deforming the cornea, and tonometry
An index image for regular alignment is projected and the cornea is compressed.
The gist of the present invention is to include a measurement status confirmation unit for photographing the anterior segment image in the flattened state by the photographing unit and displaying the photographed result on the display unit. It is preferable that an image of an allowable range mark for determining whether or not the target image exists within the allowable alignment range is taken together with the target image .

[0008]

In such a configuration, the structure is suitable for the cornea of the eye to be examined.
When the air pulse is injected, the angle is
The membrane is deformed. This deformation of the cornea measures the intraocular pressure
You. Anterior segment during corneal applanation based on injection of its air pulse
An image is taken with the alignment index projected on the cornea.
The photographing result is displayed on the display means.

[0009]

Next, an embodiment of the ophthalmic instrument according to the present invention will be described with reference to FIGS.

(First Embodiment) FIGS. 1 to 5 show a first embodiment of an ophthalmic instrument according to the present invention.

In FIGS. 1 and 2, reference numeral 10 denotes an anterior eye observation optical system for observing an anterior eye image including an eye E to be examined;
Reference numeral 0 denotes an alignment optical system that moves a device main body (not shown) in the up, down, left, and right directions with respect to the eye E to align the visual axis O ′ of the eye E with the optical axis O of the anterior eye observation optical system 10.
Reference numerals A and 30B denote alignment optical systems that are symmetrically arranged with respect to the optical axis O of the objective lens 11 and set the working distance of the apparatus main body with respect to the eye E to be inspected.

The anterior ocular segment observation optical system 10 includes an objective lens 1
1. An injection nozzle 12, which is provided on the optical axis O of the objective lens 11 and injects an air pulse toward the eye E, an oblique half mirror 13, an imaging lens 14, a half mirror 15, C
It has a CD16.

The luminous flux forming the anterior segment image is supplied to the objective lens 1
1. An image is formed on the CCD camera 16 via the oblique half mirror 13, the imaging lens 14, and the half mirror 15.

The alignment optical system 20 includes an LED 21 for emitting infrared light, an aperture stop 22, and a collimator lens 2.
3. The oblique half mirror 13 is provided.

As shown in FIG. 3, the LED 21 is driven by a light source driving circuit 52 controlled by an arithmetic control circuit 51.

The infrared light emitted from the LED 21 passes through the aperture stop 22 and is converted into a parallel light beam by the collimator lens 23, is reflected by the oblique half mirror 13, passes through the inside of the ejection nozzle 12, and passes through the cornea of the eye E to be examined. C is reflected on the cornea C.

The light beam reflected from the cornea C is transmitted to the objective lens 11
After being condensed, the image is guided to the CCD camera 16 via the imaging lens 14 and the half mirror 15 to form an index image i3 for visual axis alignment alignment. Further, a part of the light beam reflected from the cornea C is reflected by the half mirror 15 and condensed on the light receiving sensor 17 having a conjugate relationship with the CCD camera 16.

A reticle image (not shown) for forming a visual axis allowable range mark is projected on the CCD camera 16.
Further, the anterior eye image and the index image i3 formed on the CCD camera 16 are input to the video signal processing circuit 53 to be imaged, and then displayed on the monitor 54 on the screen.

The alignment optical systems 30A and 30B set the working distance W from the vertex P of the cornea C to the tip Q of the injection nozzle 12.

One alignment optical system 30A includes, for example, an LED 31A as an alignment light source that emits infrared light having a wavelength of 760 nm, a condenser lens 32A,
Aperture stop 33A, dichroic mirror 34A, objective lenses 35A and 35B, dichroic mirror 34B, total reflection mirror 36A, imaging lens 37A, total reflection mirror 3
8A, a half mirror 39A, a light receiving element 40, and a half mirror 41.

The other alignment optical system 30B includes, for example, an LED 31B as an alignment light source for emitting infrared light having a wavelength of 860 nm, a condenser lens 32B,
Aperture stop 33B, dichroic mirror 34B, objective lenses 35B and 35A, dichroic mirror 34A, total reflection mirror 36B, imaging lens 37B, total reflection mirror 3
8B, a half mirror 39B, and a light receiving element 40.

The LEDs 31A and 31B are connected to the arithmetic and control circuit 5
The light source is driven by light source drive circuits 55 and 56 controlled to 1. The LEDs 31A and 31B are alternately turned on and off as shown in FIG.

The dichroic mirror 34A has a wavelength of 760
It has a characteristic of reflecting infrared light having a wavelength of 860 nm and transmitting infrared light having a wavelength of 860 nm. Also, dichroic mirror 34B
Has a characteristic of reflecting infrared light having a wavelength of 860 nm and transmitting infrared light having a wavelength of 760 nm. The wavelength characteristics of the dichroic mirrors 34A and 34b are the same as those of the LEDs 31A and 3D.
The light corresponding to the wavelength of the infrared light emitted from 1B is appropriately used.

The wavelength 760n emitted from the LED 31A
The m infrared light is condensed by the condenser lens 32A, is focused at the center of the aperture stop 33A, is reflected by the dichroic mirror 34A, and is guided to the objective lens 35A. The focus position of the objective lens 35A is the aperture stop 33
At the center of A, the infrared light guided to the objective lens 35A is converted into a parallel light beam by the objective lens 35A and projected onto the cornea C, thereby forming an index image i1 for working distance alignment based on corneal specular reflection.

The reflected light beam forming the index image i1 is guided to the objective lens 35B, and becomes a parallel light beam when the focal position of the objective lens 35B is at the position where the index image i1 is formed.
And this parallel light beam is a dichroic mirror 34A,
Half mirror 41, total reflection mirror 36A, imaging lens 3
The image is formed on the light receiving element 40 via the 7A, the total reflection mirror 38A, and the half mirror 39A.

The wavelength 860n emitted from the LED 31B
The m infrared light is condensed by the condenser lens 32B, is focused at the center of the aperture stop 33B, is reflected by the dichroic mirror 34B, and is guided to the objective lens 35B. The focus position of the objective lens 35B is the aperture stop 33
The infrared light at the center of B and guided to the objective lens 35B is converted into a parallel light beam by the objective lens 35B and projected onto the cornea C, and forms an index image i2 for working distance alignment based on corneal specular reflection.

The reflected light beam forming the index image i2 is guided to the objective lens 35A, and becomes a parallel light beam when the focal position of the objective lens 35A is at the position where the index image i2 is formed.
And this parallel light beam is a dichroic mirror 34A,
An image is formed on the light receiving element 40 via the total reflection mirror 36B, the imaging lens 37B, the total reflection mirror 38B, and the half mirror 39B.

The reflected light flux formed on the light receiving element 40 is input to the signal processing circuit 57 as an output value,
The reflected light flux formed on the signal processing circuit 58 is output as an output value.
Is input to

The signal processing circuit 57 includes a pair of index images i1, i
2 is detected. The signal processing circuit 58 outputs the index image i
3 is detected. The detection result is stored in the storage circuit 59. The detection data stored in the storage circuit 59 is input to the arithmetic and control circuit 51. The arithmetic control circuit 51 calculates the distance between the centers of gravity of the pair of index images i1 and i2.

The arithmetic control circuit 51 includes a video signal processing circuit 5
3 and a function of controlling the ejection driving circuit 60 for ejecting air pulses from the ejection nozzle 12. The output of the CCD camera 16 is input to the video signal processing circuit 53. The output of the video signal processing circuit 53 is input to a monitor 54.
As shown in FIG. 5A, the monitor 54 displays the anterior segment image 1, the working distance allowable range mark 2, and the visual axis allowable range mark 3
Is displayed.

The examiner determines that the index image i3 is the visual axis allowable range mark 3
The optical axis O of the optical system is adjusted with respect to the visual axis O ′ so as to fall within the range. On the other hand, the video signal processing circuit 53 is
1, the working distance W is calculated using a bar graph 56 '.
Display by The working distance W is adjusted so that the target i4 of the bar graph 56 'falls within the working distance range mark 2.

The arithmetic and control circuit 51 determines whether or not the working distance is within the allowable range, and also determines whether or not the visual axis O 'is within the visual axis allowable range mark 3, and determines the working distance W and the visual axis. When both O ′ are set within the allowable range, a fluid discharge drive start signal is output to the ejection drive circuit 60. The ejection driving circuit 60 automatically outputs the cornea C from the ejection nozzle 12.
Start emitting air pulses toward The air pulse can be emitted by a manual switch.

LED 31A, condenser lens 32
A, the aperture stop 33A, the dichroic mirror 34A, and the objective lens 35A detect the projection of the corneal deformation detection light toward the cornea C in order to optically detect the deformation of the cornea C due to the ejection of the air pulse from the ejection nozzle 12. Functions as a light projection optical system. The cornea C is applanated by the injection of air pulses.

On the other hand, an objective lens 35B, a dichroic mirror 34B, a half mirror 41, a relay lens 42,
The light receiving element 43 constitutes a detection light receiving optical system that receives reflection of the corneal deformation detection light by the cornea C. The reflected light flux from the cornea C, which is applanated by the ejection of the air pulse, is guided to the half mirror 41 via the objective lens 35B and the dichroic mirror 34B, is reflected by the half mirror 41, and passes through the relay lens 42, and then the light receiving element. 43.

The reflected light flux formed on the light receiving element 43 is input to the signal processing circuit 61 as an output value. Light receiving element 43
The amount of received light increases as the deformation of the cornea C starts, and the arithmetic control circuit 51 measures the increase in the amount of received light due to the deformation of the cornea C via the signal processing circuit 61 and measures the intraocular pressure according to a known procedure.

On the other hand, as shown in FIGS. 5B to 5D, the anterior eye images 1A, 1B, and 1C at the time of measuring the data of the subject's eye to which the air pulse is jetted are displayed on the monitor 54. , Make sure that the eyelids are closed when measuring
It is possible to objectively recognize the reliability of the measurement result by confirming whether or not it is applied, and to measure the diameter of the deformed portion of the cornea C.

At this time, the anterior eye images 1A, 1B, 1
C outputs a signal fetched from the CCD camera 16 to the video signal storage circuit 62 and stored in the video signal processing circuit 53 by operating the call switch 63 and displayed on the monitor 54.

The anterior ocular segment image 1A shown in FIG. 5B is just before the air pulse is jetted, and is displayed together with the measurement result, the visual axis allowable range mark 3 and the index image i3. The examiner can confirm the reliability of the measured value by confirming whether or not the index image i3 is located within the visual axis allowable range mark 3.

The anterior ocular segment image 1B shown in FIG. 5 (C) is an image in which the cornea C is deformed by jetting an air pulse, and the anterior ocular segment image 1B and the measurement result are displayed in a combined manner. The examiner can measure the diameter D of the applanation portion from the anterior segment image 1B. At this time, a scale for visually measuring the diameter D may be displayed on the monitor 54 in combination.

The anterior ocular segment image 1C shown in FIG. 5 (D) is the one immediately after the end of the air pulse ejection, and the anterior ocular segment image 1B and the measurement result are combined and displayed. The examiner can ensure the reliability of the measured value by confirming the series of time-lapsed images. Note that the storage of the anterior segment image need not be performed at all of these three timings.

The timing for storing the anterior segment image in the video signal storage circuit 62 is determined by the applanation peak detection circuit 64 detecting the applanation peak of the cornea C from the reflected light beam received by the light receiving element 43. When the anterior ocular segment image is stored by the video storage timing signal output from the timing generation circuit 65 based on the detection result, the image storage timing signal output by the manual setting by the timing setting unit 66 installed in the apparatus main body is used. When storing the eye part image, the anterior eye part image may be stored based on a video storage timing signal output based on the ejection signal output to the ejection drive circuit 60.

The applanation peak detection circuit 64 is used to set the timing when storing the anterior segment image during applanation. May be used for setting the timing when storing. Further, the anterior segment image over time is displayed on the monitor 54 alone or divided at a time by operating the call switch 63. The measurement result and the index image i3
Need not be combined and displayed.

(Second Embodiment) FIG. 6 is a side view of an optical system showing a second embodiment of the present invention. In the above embodiment used as to detect the centroid position on the light receiving sensor 17 has been disclosed what was to detect Alignment by the position of the imaged alignment reflection light beam to the light receiving sensor 17, in front of the light receiving sensor 17 Aperture 1
7 'is provided so that the light receiving sensor 17 detects the light amount of the alignment reflected light beam to determine the alignment.

At this time, since the detection is affected by the reflectance of the cornea C, a mode changeover switch corresponding to each of the case where the reflectance is normal, the case where the reflectance is high, and the case where the reflectance is low is provided outside. By changing the light amount level determined by the light receiving sensor 17, in the case of a normal eye, it is possible to accurately measure by this switching.
In FIG. 6, the same components as those of the above-described embodiment are denoted by the same reference numerals, and description thereof will be omitted.

(Third Embodiment) FIGS. 7 to 9 show a third embodiment of the ophthalmic instrument according to the present invention.

7 and 8, reference numeral 70 denotes a fixation target projection optical system for projecting a fixation target to the eye E, and reference numeral 80 denotes an anterior eye part for observing an anterior eye image including the eye E. Observation optics,
Reference numeral 90 denotes an alignment light projecting optical system that projects an alignment light beam onto the eye E to be inspected, and 100 denotes an alignment observation optical system that observes a matching state between the visual axis O ′ of the eye E and the optical axis O of the anterior eye observation optical system 80. , 110 is an alignment detection optical system for detecting the alignment between the visual axis O ′ and the optical axis O including the working distance of the apparatus body with respect to the eye E, and 120 is a detection light receiving optical system for receiving reflection of corneal deformation detection light It is. Since each detection system in the third embodiment conforms to the above-described embodiment, detailed description will be omitted.

The fixation target projection optical system 70 includes an LED 71 that emits visible light, an aperture stop 72, a wavelength division filter 73 that transmits visible light and reflects near-infrared light, a collimator lens 74, a stop 75, and an oblique arrangement. It has a half mirror 76, a chamber window 77, and a jet nozzle 12.

As shown in FIG. 7, the visible light emitted from the LED 71 and passing through the aperture stop 72 and the wavelength division filter 73 is converted into a parallel light beam by the collimator lens 74. After being reflected by the oblique half mirror 76 in this state, the transmitted light passes through the chamber window 77, further passes through the inside of the ejection nozzle 12, and a diaphragm image is presented on the cornea C of the eye E to be examined. The visible light reflected by the cornea C is set so that it is reflected by the objective lens 11 and is not guided to an optical member thereafter.

The anterior eye observation optical system 80 includes an LED 8 for emitting infrared light for directly illuminating the eye E from above and below.
1, a cover glass 82 fixed to the tip of the injection nozzle 12,
An objective lens 11 for reflecting visible light, a chamber window 77,
Oblique half mirror 76, half mirror 83, total reflection mirror 84, first imaging lens 85, second imaging lens 86, total reflection mirror 87, half mirror 88, CCD camera 16
Having.

The infrared light from the LED 81 reflected by the subject's eye E passes through the cover glass 82 and is converted into a parallel light beam by the objective lens 11, passes through the chamber window 77 and the oblique half mirror 76, and passes through the half mirror 83. Is reflected by the total reflection mirror 84, and further reflected by the first and second
The light is condensed by the imaging lenses 85 and 86, and forms an image on the CCD camera 16 via the total reflection mirror 87 and the half mirror 88.

The alignment light projection optical system 90 includes an LED 91 for emitting near-infrared light, an aperture stop 92, a wavelength division filter 73, a collimator lens 74, a stop 75, an oblique half mirror 76, a chamber window 77, and an injection nozzle 12. Have.

The near-infrared light emitted from the LED 91 passes through the aperture stop 92, is reflected by the wavelength division filter 73, is converted into a parallel light beam by the collimator lens 74, and is obliquely arranged as a stop image by the stop 75. Half mirror 76
After being reflected through the chamber window 77,
The light is projected onto the cornea C of the eye E through the inside of the ejection nozzle 12 and is reflected by the cornea C.

The alignment observation optical system 100 includes a cover glass 82, an objective lens 11, a chamber window 77, an oblique half mirror 76, a half mirror 83, and a half mirror 8.
Half mirror 10 tilted in the direction crossing 3
1, an imaging lens 102, a half mirror 88, and a CCD camera 16.

The alignment reflected light beam reflected by the cornea C passes through the cover glass 82 and is converted into a parallel light beam by the objective lens 11, and then passes through the chamber window 77, the oblique half mirror 76, the half mirror 83, and the half mirror 101. This imaging lens 10 is transmitted and guided to the imaging lens 102.
2 and further passes through the half mirror 88 and C
An image is formed on the CD camera 16.

In the alignment detection optical system 110, a part of the alignment reflected light beam guided by the alignment observation optical system 100 is reflected by the half mirror 101 and guided to the optical path, and the central mirror 111 and the imaging lens 1
12, total reflection mirror 113, aperture 114, light receiving sensor 1
Seven.

A part of the alignment reflected light beam reflected by the half mirror 101 passes through the periphery of the central mirror 111 and is condensed on the image forming lens 112, and is reflected by the total reflection mirror 1.
The light is reflected by 13 and passes through the stop 114,
Is imaged.

The light receiving sensor 17 detects the alignment between the visual axis O ′ and the optical axis O, including the working distance of the apparatus main body with respect to the eye E, based on the amount of received light and the light receiving position.

Incidentally, the alignment light projection optical system 90
Each optical member from the LED 91 to the injection nozzle 12 is
As shown in FIG. 8, it functions as a detection light projection optical system that projects corneal deformation detection light toward the cornea C in order to optically detect the deformation of the cornea C due to the ejection of the air pulse from the ejection nozzle 12. Each optical system for guiding the alignment reflected light reflected from the eye E to the half mirror 101 constitutes a part of the detection light receiving optical system 120.

A part of the detected reflected light guided to the half mirror 101 is reflected toward the central mirror 111,
The light is reflected by the mirror portion 111 a of the central mirror 111, condensed on the image forming lens 121, and forms an image on the light receiving element 43 through the stop 122.

On the other hand, the other part of the detected reflected light guided to the half mirror 101 is transmitted through the half mirror 101 and guided to the image forming lens 102, and passes through the image forming lens 102 and the half mirror 88, and the CCD camera 16. Is imaged.

As shown in FIGS. 9A and 9B, the corneal deformation detection light imaged on the CCD camera 16 is transmitted to the monitor 54.
Is displayed on the screen as an index image i4. The monitor 54
, An anterior ocular segment image 1 and a visual axis allowable range mark 3 are combined and displayed.

The index image i4 is, as shown in FIG.
When the cornea C is correctly applanated, it is located at the center of the visual axis allowable range mark 3 and, as shown in FIG.
When the applanation is not performed correctly, such as when the cornea C is shifted, the eye is positioned off the center of the visual axis allowable range mark 3. The examiner can confirm the state of the eye E during corneal applanation based on the shift of the index image i4.

[0063]

[0064]

As described above, in the ophthalmic instrument according to the present invention, the image of the anterior segment during corneal applanation is projected onto the cornea.
Photographed with the alignment index, which can be confirmed
Therefore, the examiner should objectively judge the reliability of the tonometry.
Can be.

[Brief description of the drawings]

FIG. 1 is a plan view of an optical system showing an ophthalmic instrument of the present invention.

FIG. 2 is a side view of the optical system.

FIG. 3 is a block diagram showing a control system.

FIG. 4 is a timing chart of on / off control of an LED.

5A and 5B show the display states of the monitor, wherein FIG. 5A shows an anterior segment display state during an alignment operation, FIG. 5B shows an anterior segment display state immediately before air pulse ejection, and FIG. 5C shows a state during corneal applanation. (D) is an anterior segment display state immediately after air pulse ejection.

FIG. 6 is a side view of an optical system showing a second embodiment of the present invention.

FIG. 7 is a side view of an optical system during alignment showing a third embodiment of the present invention.

FIG. 8 is a side view of the optical system during corneal applanation.

9A and 9B show display states of the monitor, wherein FIG. 9A shows a display state of an anterior eye part when applanation of a cornea is performed correctly, and FIG.
Is an anterior segment display state when applanation of the cornea was not performed correctly.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Anterior eye image 1A ... Anterior eye image 1B ... Anterior eye image 1C ... Anterior eye image 10 ... Anterior eye observation optical system 16 ... CCD camera (photographing means) 51 ... Calculation control circuit (measuring means) 54 ... Monitor (display means) 62 ... Video signal storage circuit (measurement status confirmation means)

Continuation of the front page (56) References JP-A-4-224731 (JP, A) JP-A-1-265938 (JP, A) JP-A-3-118030 (JP, A) JP-A-5-293084 (JP , A) JP-A-63-97142 (JP, A) (58) Fields investigated (Int. Cl. ⁷ , DB name) A61B 3/10-3/16

Claims (2)

(57) [Claims] A photographing means for photographing an anterior eye image of an eye to be examined guided by an anterior eye observation optical system; and a cornea of the eye to be examined
To the air pulse and to the injection of the air pulse
Measuring means for measuring the intraocular pressure by deformation of the cornea based, eye
The target image for alignment during pressure measurement is projected and the cornea
An ophthalmologic instrument comprising: a measurement state confirming means for photographing an anterior ocular segment image in a state of applanation by the photographing means and displaying a photographing result on a display means. 2. The ophthalmologic apparatus according to claim 1, wherein an image of an allowable range mark for judging whether or not the target image exists within an allowable alignment range is taken together with the target image.