JP4464144B2 - Balance function diagnosis system - Google Patents

Balance function diagnosis system Download PDF

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JP4464144B2
JP4464144B2 JP2004004486A JP2004004486A JP4464144B2 JP 4464144 B2 JP4464144 B2 JP 4464144B2 JP 2004004486 A JP2004004486 A JP 2004004486A JP 2004004486 A JP2004004486 A JP 2004004486A JP 4464144 B2 JP4464144 B2 JP 4464144B2
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head
patient
display
recording
diagnosis
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JP2005192925A (en
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俊彦 大場
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有限会社桜葉
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  The present invention relates to a balanced function diagnosis system and a vertigo treatment method using the same.

In diagnosing dizziness, it is essential to observe the patient's eye movements (nystagmus). Characteristic nystagmus appears in each disease.
Benign paroxysmal positional change vertigo accounts for the majority of dizziness patients currently visiting the hospital. This benign paroxysmal positional vertigo is a disease in which a piece of otolith peeled from the vestibule of the inner ear gets into the semicircular canal, resulting in impaired balance function and dizziness. For this disease, it is treatment that a doctor performs "vertigo exercise" that changes the head position with the patient's head for the purpose of returning the otolith piece floating in the semicircular canal to the original place. (Expley method for example).

  In this case, the patient's eye movement (nystagmus) is an important indicator for diagnosing dizziness, so doctors should make a diagnosis by moving the patient's head and body while watching the patient's eye movement. Yes. In this diagnosis, Frenzel glasses are used as an instrument for viewing the movement of the patient's eyes.

FIG. 7 shows widely used lens-type Frenzel glasses.
In order to accurately observe nystagmus, it is necessary to block external scenes. In other words, the Frenzel glasses 1 are mounted on the head of the patient A by the headband 2, and a lens 4 is provided on the front surface of the light-shielding goggles 3 that covers the eyes of the patient. Is.

  Since this lens 4 has a considerably high frequency, the outside is very difficult to see from the patient, but the nystagmus of the patient can be clearly seen from the doctor. The Frenzel glasses 1 have a headband 2, but the shading goggles 3 themselves are quite heavy and cannot be supported by the headband 2 alone, so the doctor holds the patient's head while holding the Frenzel glasses with both hands. I'm trying to look forward.

However, since this lens-type Frenzel eyeglasses makes it difficult to see the movement of the patient's eyes through the lens, camera-type Frenzel eyeglasses are used for accurate diagnosis and treatment of nystagmus.
FIG. 8 shows a state of diagnosis using camera-type Frenzel glasses.
The camera-type Frenzel glasses 1 have a CCD camera built in a light-shielding goggles that covers the patient's eyes. The CCD camera shoots the movement of the patient's eyes, and the image is displayed on the screen of the external television monitor 5. It is what is projected. Then, as shown in the figure, the doctor B moves the patient's head and body while supporting the Frenzel glasses 1 mounted on the patient A's head with both hands, and also moves the patient's head according to the tilt of the head and body reflected on the screen of the television monitor 5. Diagnosis and treatment of the above-mentioned benign paroxysmal positional change dizziness are performed by looking at images of eye movements.

  However, in this case, the doctor has to look back at the screen of the television monitor while moving the patient's head and body with his / her waist, which is a very difficult operation for the doctor, Since doctors often hurt their backs, they are inefficient, and when they look back, they turn their eyes away from the patient, which is dangerous for diagnosis and treatment.

  Therefore, in order to solve this problem, conventionally, Frenzel glasses with a liquid crystal screen as shown in FIG. 9 have been put into practical use. That is, the Frenzel glasses 1 have a liquid crystal screen 6 on the front surface of the light-shielding goggles 3 that covers the eyes of the patient, and an image of the movement of the patient's eyes taken by a CCD camera built in the light-shielding goggles 3 is displayed on the liquid crystal screen 6. Is projected on the screen.

However, even when the Frenzel glasses with a liquid crystal screen are used, there are the following problems.
That is, when moving the patient's head, if the head is turned backward, the liquid crystal screen will face the patient's upper side, so that the image of the patient's eye movement will be invisible to the doctor and can be seen. In some cases, the doctor must take an unnatural posture such as stretching his back, and if the patient is considerably taller than the doctor, diagnosis may be impossible.

  Diagnosis and treatment of dizziness with Frenzel glasses is such that the doctor holds the patient's head and Frenzel glasses together with both hands and shakes the patient's head fairly or moves the patient's upper body violently. Frenzel glasses with an LCD screen are heavy and bulky, so the LCD system may be accidentally dropped when the patient's head is moved violently, and the LCD system may be damaged when the patient's head is moved violently. The centrifugal force due to the weight of the screen may damage the patient's head and neck, etc., and it is difficult to use because it requires sufficient care.

  In addition, even though this has a liquid crystal screen on the front of the Frenzel glasses, the doctor can not see the nystagmus of the patient unless the eyes are aligned with the patient as when using conventional lens-type Frenzel glasses, For this reason, doctors cannot see the screen unless they are in the middle, which is painful and hurts the back.

  The present invention has been made in view of the above problems, and aims to improve the above problems in vertigo diagnosis and treatment, and to realize a system capable of performing an efficient, reliable and safe diagnosis. Yes.

  In order to achieve the above object, the invention according to claim 1 of the present invention provides Frenzel glasses equipped with a camera for photographing the movement of the eyes of a patient, and a transmissive display on which an image photographed by the Frenzel glasses is displayed. The head-mounted display device has a head-mounted display device, and at the time of diagnosis, the doctor wears the head-mounted display device and also wears Frenzel glasses on the patient. The system is characterized in that a diagnosis is performed while viewing the patient's figure that is transmitted through the transmissive display simultaneously with the displayed image of the patient's eye movement.

  According to a second aspect of the present invention, in the above system, the Frenzel glasses are provided with a recording device for recording images taken with the Frenzel glasses, and a switch for switching on / off of recording to the recording device is provided in the Frenzel glasses. It is characterized by having a configuration.

  Furthermore, the invention according to claim 3 of the present invention is characterized in that, in the above system, the head mounted display device is provided with a camera for photographing the patient, and an image photographed by the camera is recorded in the recording device. And

  Furthermore, the invention according to claim 4 of the present invention is characterized in that, in the above system, a microphone is provided in the head-mounted display device, and sound collected by the microphone is recorded in a recording device.

  Furthermore, the invention according to claim 5 of the present invention is characterized in that, in the above system, data recorded in a recording device is stored in an electronic medical chart system.

  Furthermore, the invention according to claim 6 of the present invention is characterized in that, in the above-described system, the Frenzel glasses and the head-mounted display device, and the head-mounted display device and the recording device are electrically connected wirelessly. And

  According to the first aspect of the present invention, by using a head-mounted display device having a transmissive display, a doctor can observe the overall condition of a patient without taking an unnatural posture such as a middle waist. At the same time, since the movement of the patient's eyes is known, efficient, reliable and safe diagnosis and treatment can be performed in the treatment of dizziness.

  Further, according to the invention according to claim 2 of the present invention, since the doctor can operate the switch while supporting the Frenzel glasses with both hands at the time of diagnosis, the recording can be turned on / off. Therefore, more efficient diagnosis and treatment can be performed.

  Further, according to the invention of claim 3 of the present invention, the appearance of the patient photographed by the camera attached to the head mounted display device is recorded on the recording device together with the movement of the eye of the patient, so that the state at the time of the examination can be further increased. Record in detail and make more effective diagnosis and treatment.

  Furthermore, according to the fourth aspect of the present invention, the voice collected by the microphone is recorded at the same time, so that the state at the time of the examination can be recorded in more detail and can be used as a reference for treatment.

  Furthermore, according to the invention which concerns on Claim 5 of this invention, the data recorded on the recording device can be systematically used for the future treatment of a patient by taking in the electronic medical chart system.

  Further, according to the invention of claim 6 of the present invention, the electrical connection between the Frenzel glasses and the head mounted display device and between the head mounted display device and the recording device is made wireless, so that the cords are entangled. Since it can be eliminated, both doctors and patients can move easily, and more efficient diagnosis and treatment can be performed.

Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.
FIG. 1 is a block diagram showing an outline of the configuration of a balanced function diagnosis system according to the present invention.
This system mainly includes a Frenzel glasses 1 having a CCD camera 7 for photographing a movement of a patient's eyes, and a head-mounted display device 10 having a transmissive display 12 on which an image photographed by the Frenzel glasses 1 is displayed. As a constituent element, the recording apparatus 20 further includes a recording device 20 that records an image captured by the Frenzel glasses 1 and a television monitor 22 that displays the image. In this system, the recording apparatus 20 is connected to an electronic medical chart system 23.

As shown in FIG. 2, the Frenzel glasses 1 are attached to the head of a patient A by a headband 2 and a CCD camera 7 is attached to both eyes inside a light-shielding goggle 3 that covers the eyes of the patient. 7 to capture the eye movements of the patient. In this case, since the movement of the eyes in the dark with the external scene blocked is the most important in clinical practice, the light shielding goggles 3 are closely attached to the periphery of the patient's eyes to block the light entering the inside as much as possible, and in that state the CCD The camera 7 captures the movement of the patient's eyes. For this reason, an infrared camera is mainly used as the CCD camera 7, and an infrared light emitter is provided inside the light shielding goggles 3. Note that the CCD camera is not limited to an infrared camera (since some light enters the light-shielding goggles, shooting is possible with a high-sensitivity CCD camera).
The CCD camera may use two cameras for photographing the eyes on both sides, or may photograph both eyes with one camera. One camera may be used to capture only one eye. Further, a switch for switching the camera may be provided.

  In the Frenzel glasses 1, a switch 21 for switching recording on / off to the recording device 20 is provided on the side of the light shielding goggles 3. That is, recording is performed in the recording device 20 when the switch 21 is turned on, and recording is stopped when the switch 21 is turned off, and the doctor easily operates with the hand holding the Frenzel glasses as will be described later. It is something that can be done. As this switch 21, various types of switches such as a slide type switch and a push type switch can be used.

  As shown in FIG. 3, the head-mounted display device 10 is equipped with a transmissive (see-through) display 12 that is attached to the upper part of the head of the doctor B by the head holder 11 and covers one eye of the doctor. As shown in FIG. 4, the transmissive display 12 has a liquid crystal display screen 14 on a transparent or translucent transmissive plate 13 on which an image of a patient's eye photographed by the CCD camera 7 of the Frenzel glasses 1 is displayed. In addition, the appearance of the patient A in front of the doctor can be seen through the transmission plate 13.

  Further, the head mounted display device 10 is provided with a CCD camera 16 for photographing a patient. The patient's image taken by the CCD camera 16 is displayed on the liquid crystal display screen 15 of the transmissive display 12 as shown in FIG.

  In this head mounted display device 10, both the image of the patient's eye from the Frenzel glasses 1 and the image of the patient from the CCD camera 16 are displayed on the transmissive display 12, or both of them are displayed. It may be possible to switch whether or not to display both, and a switch for switching may be provided.

  Further, the head-mounted display device 10 is provided with a microphone 17, and the sound collected by the microphone 17 is also recorded in the recording device 20. In this case, the voice collected by the microphone 17 is recognized using the voice recognition system, converted into characters, pictures, etc., displayed on the display 12, and further recorded on the recording device 20. Also good.

  The doctor conducts a diagnosis with the head-mounted display device 10 configured as described above attached to the head, but the doctor is accustomed to wearing a medical instrument on the head in daily examinations. Even if the head-mounted display device 10 is worn on the head, it is possible to perform a diagnosis without a sense of resistance.

  In the present embodiment, the head mounted display device in which the transmissive display covers one eye of the doctor is shown, but a head mounted display device in which both eyes are covered can also be adopted. Alternatively, a camera that captures the outside may be used, and a non-transmissive display may be attached in front of the eyes to observe the outside. Further, the head-mounted display device may be a face-mount type or a neck-type display, that is, any display device that is attached to the head and neck.

FIG. 5 shows a state of diagnosis (vertigo treatment) using the system of the present invention.
That is, at the time of this examination, as shown in the figure, the doctor B wears the head-mounted display device 10 and also wears the Frenzel glasses 1 on the patient A. In this state, the doctor B displays the liquid crystal on the transmissive display 12 of the head-mounted display device 10. At the same time as the patient's eye movement image displayed on the display screen, “vertigo exercise” is performed to move the patient A's head and body in various directions while observing the patient A passing through the transmissive display 12. In this case, the patient A sits on the bed, and in a state facing the patient A, the doctor B supports the Frenzel glasses 1 attached to the patient A's head with both hands while holding the patient A on the bed as shown in FIG. The patient's head and body are violently tilted in various directions, and the movement of the patient's eyes at that time is confirmed on the transmissive display 12 of the head-mounted display device 10 for diagnosis.

  At the time of this examination, in the system of the present invention, by using the head-mounted display device 10 having the transmissive display 12, the doctor can observe the entire state of the patient at the same time without taking an unnatural posture such as the middle waist. Since the movement of the patient's eyes can be clearly seen, it is possible to carry out efficient, reliable and safe diagnosis and treatment without hurting the back in the treatment of dizziness. In this system, the Frenzel glasses are light because they do not have a liquid crystal screen as in the prior art, so that both doctors and patients are less burdened, and accidents such as cervical damage at the time of examination are unlikely to occur.

  In the system of the present invention, an image of the patient's eye movement at the time of the examination is recorded in the recording device 20. At the same time, the image of the patient image taken by the CCD camera 16 of the head mounted display device 10 and the sound collected by the microphone 17 are simultaneously recorded in the recording device 20. As the recording device 20, a video tape recorder, a video disk recorder, or the like is preferably used.

  The image of the patient's eye movement recorded in the recording device 20 is also displayed on the external television monitor 22 and viewed by a third party (for example, another doctor or patient attendant). The state of can be judged. Further, when the image recorded on the recording device 20 is reproduced, the reproduced image can be viewed using the television monitor 22.

  For diagnosis and treatment of dizziness, it is most important to observe and record the nystagmus direction of the patient that appears instantaneously when the head is tilted. In addition, diagnosis is often made by re-examining clinically recorded data. In this case, if all are recorded, it takes approximately the same time as it took to observe the patient's nystagmus, and the doctor must analyze the recorded nystagmus, which is inefficient. In the past, the tape was fast-forwarded, but there were many cases where a slight nystagmus movement was missed. Conventionally, when recording, the Frenzel glasses must be kept away from the patient, which is inefficient in diagnosis and treatment, and it is fatal for diagnosis and treatment to stop observing a series of patient eye movements. there were.

  Therefore, when recording a patient's nystagmus, a switch is necessary for instantaneous recording when the patient's head is tilted rather than simply recording everything. Therefore, in the system of the present invention, as described above, the switch 21 for switching on / off of recording to the recording apparatus 20 is provided on the side of the Frenzel glasses 1. The switch 21 records an image of the patient's eye photographed by the CCD camera 7 of the Frenzel glasses 1, records an image of the patient photographed by the CCD camera 16 of the head mounted display device 10, and the microphone 17. The recording of the collected sound is turned on / off in synchronization. Note that a plurality of switches may be provided in order to independently turn on / off the above recording. Here, the electrical connection between the switch 21 and the recording device 20 may be a connection via the head mounted display device 10 or a configuration in which the switch 21 and the recording device 20 are directly connected.

  In the system of the present invention, the switch 21 is provided on the side of the Frenzel glasses 1 as described above. Therefore, at the time of examination, the doctor holds the Frenzel glasses 1 with both hands as shown in FIG. Since it is possible to switch on / off of recording to the recording device 20 by operating, the operability is very good for the doctor, and more efficient diagnosis and treatment can be performed.

  In this system, an image of the patient's eye movement at the time of medical examination is recorded in the recording device 20, and the image is reproduced later to check the patient's eye movement, and effective diagnosis and treatment are performed. be able to. Further, by recording an image of the patient image taken by the CCD camera 16 provided in the head mounted display device 10 together with an image of the patient's eye movement, the state at the time of the examination is recorded in more detail. it can. That is, in this case, since clinically important information on how the eye moves when the patient's head is facing can be known synchronously, more effective diagnosis and treatment can be performed.

  Conventional external cameras are not attached to doctors, but are installed on external walls, etc., so the location of diagnosis and treatment using the device is limited, and blind spots may exist. It was. On the other hand, in the system of the present invention, the CCD camera 16 is mounted on the head mounted display device 10 mounted on the doctor's head, and photographing is performed based on the scene as seen by the doctor. The scene is linked, and the understanding of the image by the doctor increases, which is effective for diagnosis and treatment.

  Furthermore, in this system, the sound collected by the microphone 17 provided in the head mounted display device 10 is also recorded in the recording device at the same time, so that the state at the time of the examination can be recorded in more detail and used as a reference for treatment. it can. Further, by using a voice recognition system, words such as doctors and patients are converted into letters, pictures, and the like, and recorded in synchronization with the photographed image, which can be used for later medical care. In this case, for example, if the doctor's word “tilt right” is recognized by voice and the word “tilt right” is recorded simultaneously with the image of the patient's nystagmus and displayed on the screen, Easy-to-understand and more efficient diagnosis and treatment. In this case, since the CCD camera 16 for photographing the patient's figure is not required, the weight of the head mounted display device 10 can be reduced.

  Further, in this system, all the images and sounds recorded in the recording device 20 are converted into digital data and stored in the electronic medical chart system 23. This electronic medical record system 23 is a system that stores a medical record of a patient as electronic data using a computer. By taking in image and sound data at the time of this examination, the electronic medical record system 23 can be used for future treatment of the patient. Can be useful. Further, dizziness may be diagnosed and treated by analyzing a recorded image of the patient's eye movement using an eye movement analysis system.

  In the system configuration described above, the Frenzel glasses 1 and the head mounted display device 10 and the head mounted display device 10 and the recording device 20 are generally electrically connected by a cord. It is convenient to make this a wireless connection. In this case, wireless connection can be easily realized by mounting small transmitters / receivers on the Frenzel glasses 1, the head mounted display device 10 and the recording device 20 and transmitting / receiving signals wirelessly.

  In this way, since the electrical connection between the Frenzel glasses 1 and the head mounted display device 10 and between the head mounted display device 10 and the recording device 20 is made wireless, the entanglement of the codes can be eliminated. This makes it easier for both patients and patients to move more efficiently and safely, such as diagnosis and dizzy exercises.

  As mentioned above, although the Example of this invention was described, this invention is not limited to this Example. For example, a clock may be incorporated in any of the Frenzel glasses 1, the head mounted display device 10, and the recording device 20, and the time may be recorded together with the image. Further, any of the Frenzel glasses 1, the head mounted display device 10, and the recording device 20 may be equipped with a communication function so that the image of the patient's nystagmus can be observed in other places.

  The system of the present invention is the second term of D250 (equilibrium function test) in the Japanese medical treatment reward score table: head position and head position conversion nystagmus test (head position and head position conversion nystagmus test under Frenzel glasses) ) Can be suitably employed for inspections similar to those using conventional Frenzel glasses. In addition, the same item 1: Standard test, and the same item 3: Special test for applying stimulus or load (temperature nystagmus test, optic nystagmus test, rotational nystagmus test, index tracking test, maze follicular symptom test, etc ) Can also be inspected using the system of the present invention.

It is a block diagram which shows the outline | summary of the system configuration | structure of this invention. It is explanatory drawing of the Frenzel glasses used for the system of this invention. It is explanatory drawing of the head mounted display apparatus used for the system of this invention. It is an example of a display of the transmissive display of a head mounted display apparatus. It is a figure which shows the mode of a vertigo treatment using the system of this invention. It is a figure which shows a mode that a patient is laid on a bed and a vertigo treatment is performed. It is explanatory drawing of the lens-type Frenzel glasses in a prior art example. It is a figure which shows the mode of the medical examination using the camera type | mold Frenzel glasses in a prior art example. It is explanatory drawing of the Frenzel glasses with a liquid crystal screen in a prior art example.

Explanation of symbols

A ... Patient B ... Doctor 1 ... Frenzel glasses 7 ... CCD camera 10 ... Head mounted display device 12 ... Transmission type display 16 ... CCD camera 17 ... Microphone 20 ... Recording device 21 ... Switch 22 ... Television monitor 23 ... Electronic medical record system

Claims (6)

  1. And Furentsueru glasses having one of a camera for photographing the eye movement of the patient,
    A head mounted display device comprising: a head holder attached to a doctor's head; and a transmissive display on which an image taken by the one camera attached to the head holder is displayed.
    A balanced function diagnosis system characterized by comprising:
  2. The head-mounted display device has another camera for photographing a patient, and an image photographed by the other camera is displayed on the transmissive display. Equilibrium function diagnostic system.
  3. 2. The balance according to claim 1, further comprising: a recording device that records an image or the like taken by the one camera , wherein the Frenzel glasses are provided with a switch for switching on / off recording to the recording device. Functional diagnostic system.
  4. The balanced function diagnosis system according to claim 1 or 2 , wherein a microphone is provided in the head-mounted display device, and sound collected by the microphone is recorded in the recording device.
  5. The balance function diagnosis system according to claim 3 , wherein data recorded in the recording device is stored in an electronic medical chart system.
  6. During the Furentsueru glasses and the head-mounted display device, and in any one of claims 3 to 5, characterized in that electrically connected wirelessly between the head-mounted display device and the recording device The balanced function diagnostic system described.
JP2004004486A 2004-01-09 2004-01-09 Balance function diagnosis system Active JP4464144B2 (en)

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Families Citing this family (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2007029207A (en) * 2005-07-25 2007-02-08 Univ Of Tokushima Ocular movement imaging apparatus
WO2007128034A1 (en) * 2006-05-01 2007-11-15 Eye Diagnostics Pty Ltd Portable eye monitoring device and methods for using the same
US10426379B2 (en) 2015-03-30 2019-10-01 Natus Medical Incorporated Vestibular testing apparatus
US10251544B2 (en) 2015-05-07 2019-04-09 Kali Care, Inc. Head-mounted display for performing ophthalmic examinations
US9910275B2 (en) * 2015-05-18 2018-03-06 Samsung Electronics Co., Ltd. Image processing for head mounted display devices
WO2019175957A1 (en) * 2018-03-13 2019-09-19 株式会社96da vHIT GOGGLES

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