JP6671216B2 - Ophthalmic examination device - Google Patents

Description

  The present invention relates to an ophthalmic examination apparatus.

  An ophthalmic examination apparatus is an apparatus capable of optically performing an examination or measurement on an eye to be examined. The tests and measurements that can be performed by the ophthalmic examination device include subjective tests and objective measurements. The subjective test obtains a result based on a response from a subject. Objective measurement is to acquire information about the eye to be examined mainly by using a physical method without referring to a response from the subject.

  In particular, the subjective test is a test in which the subject himself needs to respond, and the test time is longer than that of the objective measurement. As a result, the subject often becomes tired during the examination or hesitates in response. In this case, in order to prevent a decrease in the reliability of the test, it is desired that the tester proceed with the test while checking the fatigue condition and response status of the subject. At this time, it is effective for the examiner to observe the facial expression and the like of the subject during the examination to grasp the degree of fatigue and the degree of confusion of the subject. However, since the measurement head containing the optical system for examining the eye to be examined is located very close to the eye to be examined during the examination, the examiner cannot observe the facial expression of the examinee during the examination. Have difficulty.

  On the other hand, there is known an ophthalmic examination apparatus provided with a camera capable of photographing a wider area than an eye to be examined. For example, Patent Literature 1 and Patent Literature 2 disclose an ophthalmologic examination apparatus provided with an anterior segment camera for photographing an anterior segment of an eye to be inspected and a camera for photographing a wide area including the periphery of the anterior segment. Have been. Patent Literature 3 discloses an ophthalmologic examination apparatus provided with an anterior segment camera for photographing an anterior segment of an eye to be examined and a camera capable of simultaneously photographing a left examinee's eye and a right examinee's eye when switching examinations. I have.

JP 2006-280612 A JP 2008-136617 A JP 2015-139526 A

  However, the cameras provided in the ophthalmologic examination apparatuses disclosed in Patent Literatures 1 to 3 photograph the eye to be examined in order to perform rough alignment before the examination. That is, only the periphery of the subject's eye is photographed in order to perform alignment, and the examiner cannot observe the state of the subject such as the facial expression of the subject from the acquired image.

  On the other hand, it is conceivable to simply arrange the camera at a position where the entire face of the subject can be photographed. However, the eye is blocked by the measuring head that houses the optical system for inspecting the eye to be inspected, and the examiner cannot observe the expression of the examinee from the acquired image.

  The present invention has been made in view of such circumstances, and an object of the present invention is to provide an ophthalmic examination apparatus capable of observing a state of a subject such as a facial expression of the subject during the examination. With the goal.

  The ophthalmologic examination apparatus according to the embodiment examines an eye to be examined. The ophthalmic examination apparatus includes a specifying unit and an image combining unit. The identifying unit includes a first imaging device that captures, from the front, a first range that is at least a part of the face of the subject including the subject's eye, and a second range that is part of the first range and includes the subject's eye. The positional relationship between the second photographing device that photographs from the front and the subject's eye is specified. The image synthesizing unit, when the inspection is being performed, compares the first image acquired by the first imaging device with the second image acquired by the second imaging device based on the positional relationship specified by the specifying unit. Form a composite image.

  ADVANTAGE OF THE INVENTION According to the ophthalmologic examination apparatus which concerns on this invention, it becomes possible to observe the state of a test subject, such as a facial expression of a test subject, during a test.

FIG. 1 is a schematic diagram illustrating an external configuration of an ophthalmologic examination apparatus according to an embodiment. The schematic diagram showing the example of composition of the ophthalmic examination device concerning an embodiment. FIG. 1 is a schematic diagram illustrating a configuration example of an optical system of an ophthalmologic examination apparatus according to an embodiment. FIG. 1 is a schematic diagram illustrating a configuration example of an optical system of an ophthalmologic examination apparatus according to an embodiment. The schematic diagram showing the example of composition of the control system of the ophthalmic examination device concerning an embodiment. The schematic diagram showing the example of composition of the control system of the ophthalmic examination device concerning an embodiment. FIG. 5 is a flowchart of an operation example of the ophthalmologic examination apparatus according to the embodiment. Operation | movement explanatory drawing of the ophthalmic examination apparatus which concerns on embodiment. FIG. 10 is an explanatory diagram of the operation of the ophthalmologic examination apparatus according to the first modification of the embodiment. The schematic diagram showing the example of composition of the control system of the ophthalmologic examination device concerning the 2nd modification of an embodiment.

  An example of an embodiment of an ophthalmologic examination apparatus according to the present invention will be described in detail with reference to the drawings. In addition, the description content of the literature and any known technology cited in this specification can be used in the following embodiments.

  Hereinafter, a description will be given of a case where the ophthalmic examination apparatus according to the embodiment is capable of performing the subjective test and the objective measurement on both the left eye and the right eye and is capable of photographing both the left eye and the right eye. . However, the ophthalmologic examination apparatus according to the embodiment can perform the subjective test and the objective measurement on only one of the left eye and the right eye, and photograph only one of the left eye and the right eye. It may be possible. In addition, the “examination” described below does not only mean an examination on the subject's eye such as a subjective test, but may also include a measurement on the subject's eye such as an objective measurement.

[Constitution]
FIG. 1 schematically illustrates an outline of an external configuration of an ophthalmologic examination apparatus according to an embodiment. The ophthalmologic examination apparatus 1 according to the embodiment is an ophthalmologic apparatus that can perform a subjective test and an objective measurement. The subjective test is a test for presenting a target to the subject's eye (the subject's eye) and acquiring information about the subject's eye based on a response from the subject regarding the appearance. The objective measurement is a measurement for acquiring information about the eye to be examined mainly using a physical method without referring to a response from the subject.

  The ophthalmologic examination apparatus 1 converts the eye to be examined acquired by a narrow-area camera for alignment into an image acquired by a wide-area camera capable of photographing at least a part of the face of the subject during a subjective examination or objective measurement. It is possible to form a composite image obtained by compositing the above images. The wide area camera is an example of a camera with a low magnification. The narrow-area camera is an example of a camera with a high magnification. The composite image is displayed on the display unit during the subjective test or the objective measurement. A moving image can be displayed by forming a new composite image at a predetermined time interval and displaying the composite image on the display unit. This makes it easier for the examiner to observe the expression or the like of the subject during the subjective test or the objective measurement, and to more easily grasp the degree of fatigue or confusion of the subject. Note that the narrow area camera need not be an alignment camera, and may be an anterior ocular segment observation camera.

  The ophthalmic examination apparatus 1 can be communicatively connected to an examiner controller (for example, a tablet terminal) or a subject controller (for example, a control lever unit) (not shown) via a wired or wireless communication path. The ophthalmic examination apparatus 1 is controlled based on an operation performed on a controller for an examiner or a controller for a subject. In the description below, the horizontal direction may be referred to as the X direction as viewed from the subject, the vertical direction as the Y direction, and the depth direction of the measuring head 100 as viewed from the subject as the Z direction.

  The ophthalmic examination apparatus 1 includes a measurement head 100 and a control device 200. The measuring head 100 is provided with an optical system and a moving mechanism system for performing the above-described subjective test and objective measurement. An optical system for performing a subjective test, objective measurement, and the like is provided with an imaging unit (described later) for alignment as a narrow-area camera. Further, inside or outside the measuring head 100, an imaging unit 140 as a wide area camera is provided at a position where the entire face (or a part of the face) of the subject under examination can be imaged. The control device 200 controls the measurement head 100 and the imaging unit 140 and controls the controller for the examiner and the controller for the subject.

  The ophthalmologic examination apparatus 1 includes an optometry table 3. The optometry table 3 is a desk for supporting the measurement head 100 and mounting the controller for the examiner or the controller for the subject. The optometry table 3 is installed in a state where it is supported on the floor by the support unit 4. The height of the optometry table 3 can be adjusted up and down.

  A column 5 is erected on the optometry table 3. The proximal end of the horizontal arm 6 is held at the distal end of the column 5. A measuring head 100 is suspended from the distal end of the horizontal arm 6. For example, the column 5 can be rotated by the arm moving mechanism 7 in the direction around the axis (the arrow direction j and the arrow direction k). Thereby, the horizontal arm 6 is rotated around the axis. That is, the measurement head 100 is rotated around the axis. Thus, the measurement head 100 can be retracted from the examination space above the optometry table 3, and the examination can be efficiently performed using the empty space on the optometry table 3.

  The arm moving mechanism 7 may move the distal end of the column 5 in the vertical direction (the direction of the arrow h) as an arm vertical moving mechanism. Thereby, the horizontal arm 6 is moved in the vertical direction. That is, the measuring head 100 is moved in the vertical direction. The arm moving mechanism 7 may move the horizontal arm 6 in the vertical direction by expanding and contracting the column 5 protruding upward from the optometry table 3 as an arm expanding and contracting mechanism. Also in this case, the measurement head 100 can be moved up and down in accordance with the sitting height of the subject, and the measurement head 100 can be retracted from the examination space above the optometry table 3.

  A stand or the like for storing the measuring head 100 may be separately provided, and the measuring head 100 may be arranged at a stable position by the above-described rotation or vertical movement. In this case, it is possible to continuously reduce the load on the lateral arm 6 due to the weight of the measuring head 100.

  The arm moving mechanism 7 is capable of manually moving the horizontal arm 6 in the direction around the axis or in the vertical direction in response to an operation by the operator. The arm moving mechanism 7 may move the horizontal arm 6 by an electric mechanism. In this case, an actuator for generating a driving force for moving the arm moving mechanism 7 and a transmission mechanism for transmitting the driving force are provided. The actuator is constituted by, for example, a pulse motor. The transmission mechanism is composed of, for example, a combination of gears and a rack and pinion.

  A storage unit 9 is provided on a side surface of the support unit 4 and stores the control device 200 and the like. The configuration of the optometry table 3 is not limited to the configuration shown in FIG.

[Measurement head]
The measurement head 100 includes a left eye inspection unit 120L and a right eye inspection unit 120R. Optometry windows 130L and 130R are formed in the left-eye inspection unit 120L and the right-eye inspection unit 120R, respectively. The left eye (left eye to be examined) of the subject is examined through the optometry window 130L. The right eye (right eye) of the subject is examined through the optometry window 130R.

  FIG. 2 shows a block diagram of a configuration example of the measuring head 100 according to the embodiment. The measurement head 100 includes a moving mechanism system 110, a left-eye inspection unit 120L, a right-eye inspection unit 120R, and an imaging unit 140. The moving mechanism system 110 is suspended from the horizontal arm 6. The left eye inspection unit 120L and the right eye inspection unit 120R are three-dimensionally moved independently or in conjunction with each other by the moving mechanism system 110. The left eye inspection unit 120L houses an optical system for inspection of the left eye. The right eye inspection unit 120R houses an optical system for inspection of the right eye.

(Moving mechanism)
The moving mechanism system 110 includes a horizontal moving mechanism 111, rotating mechanisms 112L and 112R, and vertical moving mechanisms 113L and 113R. The moving mechanism system 110 may further include the arm moving mechanism 7.

  The horizontal movement mechanism 111 moves the rotation mechanisms 112L and 112R, the vertical movement mechanisms 113L and 113R, the left eye inspection unit 120L and the right eye inspection unit 120R in the horizontal direction (lateral direction (X direction), front-rear direction (Z direction)). ). Thereby, the horizontal position of the optometry windows 130L and 130R can be adjusted according to the arrangement position of the subject's eye. The horizontal movement mechanism 111 has a known configuration using, for example, a pulse motor or a feed screw, and receives control signals from the control device 200 to move the rotation mechanisms 112L and 112R in the horizontal direction. The horizontal movement mechanism 111 can also manually move the above-described rotation mechanisms 112L, 112R and the like in the horizontal direction in response to an operation by an operator.

  The rotation mechanism 112L rotates the vertical movement mechanism 113L and the left eye inspection unit 120L about a predetermined first axis connected to the horizontal movement mechanism 111. The first axis is an axis extending in a substantially vertical direction, and may be tiltable at an arbitrary angle with respect to a horizontal plane. The rotation mechanism 112L has a known configuration using, for example, a pulse motor or a rotation axis, and receives a control signal from the control device 200 to rotate the left eye inspection unit 120L or the like about the first axis. Let it. The rotation mechanism 112L can also manually rotate the left eye inspection unit 120L and the like about the first axis in response to an operation by the operator.

  The rotation mechanism 112R rotates the vertical movement mechanism 113R and the right eye inspection unit 120R about a predetermined second axis connected to the horizontal movement mechanism 111. The second axis is an axis extending in a substantially vertical direction similarly to the first axis, and may be tiltable at an arbitrary angle with respect to a horizontal plane. The second axis is an axis arranged at a position separated from the first axis by a predetermined distance. The distance between the first axis and the second axis is adjustable. The rotation mechanism 112R may rotate the right-eye inspection unit 120R or the like in conjunction with the rotation of the rotation mechanism 112L, or may rotate the right-eye inspection unit 120R independently of the rotation of the rotation mechanism 112L. May be rotated. The rotation mechanism 112R has a known configuration similar to the rotation mechanism 112L, and receives a control signal from the control device 200 to rotate the right eye inspection unit 120R and the like about the second axis. The rotation mechanism 112R can also manually rotate the right eye inspection unit 120R and the like about the second axis in response to an operation by the operator.

  By rotating the left-eye inspection unit 120L and the right-eye inspection unit 120R by the rotation mechanisms 112L and 112R, the orientation of the left-eye inspection unit 120L and the right-eye inspection unit 120R is relatively changed. Is possible. For example, the left eye inspection unit 120L and the right eye inspection unit 120R are respectively rotated in opposite directions about the eyeball rotation points of the left and right eyes of the subject. Thereby, the eye to be examined can be diverged and converged.

  The vertical movement mechanism 113L moves the left eye inspection unit 120L in the vertical direction (Y direction). Thereby, the position in the height direction of the optometry window 130L can be adjusted according to the arrangement position of the subject's eye. The vertical movement mechanism 113L has a known configuration using, for example, a pulse motor or a feed screw, and receives a control signal from the control device 200 to move the left eye inspection unit 120L in the vertical direction. The vertical movement mechanism 113L can also manually move the left eye inspection unit 120L in the vertical direction in response to an operation by the operator.

  The vertical movement mechanism 113R moves the right eye inspection unit 120R in the vertical direction. Thereby, the position in the height direction of the optometry window 130L can be adjusted according to the arrangement position of the subject's eye. The vertical movement mechanism 113R may move the right eye inspection unit 120R in conjunction with the movement by the vertical movement mechanism 113L, or may move the right eye inspection unit 120R independently of the movement by the vertical movement mechanism 113L. Is also good. The up-down movement mechanism 113R has a known configuration similar to the up-down movement mechanism 113L, and receives a control signal from the control device 200 to move the right-eye inspection unit 120R in the up-down direction. The vertical movement mechanism 113R can also manually move the right eye inspection unit 120R in the vertical direction in response to an operation by the operator.

(Configuration of each inspection unit)
The left eye inspection unit 120L and the right eye inspection unit 120R are individually operable.

  The left eye inspection unit 120L includes a first optotype presenting unit 122L, a first objective measurement unit 123L, and a first imaging unit 124L. The first target presenting unit 122L selectively presents a plurality of targets to the left subject's eye. The first objective measurement unit 123L is used to perform objective refraction measurement of the left subject's eye. The first imaging unit 124L images the anterior segment of the left subject's eye. The left eye inspection unit 120L may be provided with an optical element application unit that selectively applies a plurality of optical elements that can be arranged between the left eye to be inspected and the deflecting member P described later to the left eye. .

  The right eye inspection unit 120R includes a second optotype presenting unit 122R, a second objective measurement unit 123R, and a second imaging unit 124R. The second target presenting unit 122R selectively presents a plurality of targets to the right subject's eye. The second objective measurement unit 123R is used to perform objective refraction measurement of the right subject's eye. The second imaging unit 124R images the anterior segment of the right subject's eye. The right eye inspection unit 120R may be provided with an optical element application unit that selectively applies a plurality of optical elements that can be arranged between the right eye to be inspected and a deflection member P described later to the right eye. .

  The left eye inspection unit 120L and the right eye inspection unit 120R accommodate optical systems as shown in FIG. The left eye inspection unit 120L and the right eye inspection unit 120R operate their optical systems to perform a subjective test using the optotype presenting unit for the left eye EL and the right eye ER, respectively. It is configured to perform an objective refraction measurement using the sensation measurement unit and the imaging unit. The examiner and the subject perform the examination by appropriately operating the controller and the like.

  When the above-described optical element application unit is provided in each inspection unit, the optical element application unit includes a plurality of optical elements and a driving mechanism. The plurality of optical elements are a set of various lenses for inspecting the visual function of the eye to be inspected, and include, for example, at least one of a spherical lens, a cylindrical lens, and a prism lens. The plurality of optical elements are grouped for each type of the optometry parameter. For example, the types of the optometry parameters include at least one of a spherical power, an astigmatic power, an astigmatic axis angle, an addition power, a pupil distance, a prism power, and a prism base direction. As a grouping for each type of the optometry parameter, a set of spherical powers includes a plurality of spherical lenses, and is configured by spherical lenses having different spherical powers. The set of astigmatic powers includes a plurality of cylindrical lenses, and is constituted by cylindrical lenses having different astigmatic powers. The set of astigmatic powers may be rotatable in accordance with the astigmatic axis angle. The set of addition power is constituted by a spherical lens having a positive power and a spherical lens having a negative power which can be inserted and removed. The set of prism powers includes a plurality of prism lenses, and is configured by prism lenses having different prism powers. The set of prism powers may be rotatable in accordance with the prism base direction. The interpupillary distance is an examination condition set in accordance with the interpupillary distance of the subject's eye. The interpupillary distance is set by one or both of the left-eye inspection unit 120L and the right-eye inspection unit 120R sliding in the horizontal direction (the arrow direction m in FIG. 1).

  The drive mechanism included in each inspection unit is configured so that each of the plurality of optical elements can be arranged in the optometry window and retracted from the optometry window. A drive mechanism included in each inspection unit switches an optical element in response to a control signal from the control device 200. Thus, at least one of the spherical power, the astigmatic power, the astigmatic axis angle, the addition power, the interpupillary distance, the prism power, and the prism base direction can be switched and applied to the eye to be examined.

(Shooting department)
The imaging unit 140 is held by, for example, a holding unit (not shown). The base end of the holding means is fixed to the measuring head 100. In other words, the imaging unit 140 is arranged such that the relative positional relationship between the face of the subject under examination (examined eye) and the imaging unit 140 is substantially a predetermined positional relationship. The imaging unit 140 images the entire face of the subject in which the left eye and the right eye are arranged near the optometry windows 130L and 130R in FIG. The imaging unit 140 may image a part of the face of the subject.

[Configuration of optical system]
3 and 4 show configuration examples of the optical system housed in the measurement head 100. FIG. FIG. 3 is a block diagram illustrating a configuration example of an optical system housed in the left eye inspection unit 120L and the right eye inspection unit 120R. FIG. 4 schematically shows an arrangement of a photographing unit for photographing the face of the subject and a photographing unit for photographing the eye to be examined. 3 and 4, a camera 80 is provided as the photographing unit 140.

  The left eye inspection unit 120L includes a deflecting member P, a target presenting optical system 10L, an imaging optical system 20L, alignment optical systems 30L and 31L, a reflex measurement optical system 40L, and a kerato measurement optical system 50L. . The inspection unit 120L for the left eye is provided with the objective lens 60 and the beam splitters BS1 to BS3. The right eye inspection unit 120R includes a deflecting member P, a target presenting optical system 10R, an imaging optical system 20R, alignment optical systems 30R and 31R, a reflex measurement optical system 40R, and a kerato measurement optical system 50R. . The right eye inspection unit 120R is provided with an objective lens 60 and beam splitters BS1 to BS3. The optical system of the left-eye inspection unit 120L and the optical system of the right-eye inspection unit 120R are configured symmetrically. Hereinafter, the optical system of the left eye inspection unit 120L will be described unless otherwise specified.

  The optotype presenting optical system 10L is an optical system for projecting an optotype on the fundus oculi Ef of the left subject's eye EL. The optotype presenting optical system 10L includes an LCD (Liquid Crystal Display) 11, a moving lens 70, and a reflection mirror M. The LCD 11 displays various optotypes (charts) for optometry. The LCD 11 includes a visual fixation target such as a landscape chart, a visual acuity chart such as a Landolt ring for visual acuity test, a cross cylinder test chart, a radiation chart for an astigmatism test, a cross chart for an oblique test, and a red-green test chart. Marks are selectively displayed. In the optotype presenting optical system 10L, instead of the LCD 11, an electronic display device using EL (electroluminescence) or the like, or one of a plurality of optotypes drawn on a rotating glass plate or the like is appropriately placed on the optical axis. An arrangement (turret type) may be provided.

  The moving lens 70 is movable in the optical axis direction of the optotype presenting optical system 10L. The moving lens 70 is moved by a driving mechanism 70L (described later). The drive mechanism 70L moves the movable lens 70 in response to a control signal from the control device 200. Thereby, it is possible to change the sphericity added to the left subject's eye EL. For example, by moving the moving lens 70 in the optical axis direction by an amount corresponding to the refractive power of the left subject's eye EL during the reflex measurement, fixation cloud fogging on the left subject's eye EL can be performed. Also, at the time of the subjective test, the optotype can be presented at a position corresponding to the far point of the eye to be examined, a position corresponding to the near point, or any position in between, so that the test can be performed at any test distance. it can.

  Light from the LCD 11 passes through the moving lens 70 and is reflected by the reflection mirror M. The light reflected by the reflection mirror M passes through the beam splitter BS2 and is reflected by the beam splitter BS1. The light reflected by the beam splitter BS1 passes through the objective lens 60 and is deflected by the deflection member P toward the fundus oculi Ef of the left eye EL.

  The target presenting optical system 10L may be provided with a VCC lens for correcting the astigmatic power and the astigmatic axis angle of the left subject's eye EL.

  The imaging optical system 20L is an optical system for imaging the anterior segment of the left subject's eye EL. The photographing optical system 20 </ b> L includes a CCD (Charged-Coupled Device) 21. For example, when the anterior segment of the left eye EL is illuminated by an anterior segment illumination system (not shown), the reflected light from the anterior segment of the left eye EL enters the deflection member P. The deflecting member P deflects the reflected light toward the objective lens 60. The reflected light deflected by the deflecting member P passes through the objective lens 60, passes through the beam splitters BS1 and BS3, and is imaged on the light receiving surface of the CCD 21 by a CCD lens or the like (not shown). Further, the imaging optical system 20L functions as a light receiving system that receives reflected light of the measurement light beam projected on the left eye E in the reflex measurement and the kerato measurement.

  The alignment optical system 30L is an optical system for performing alignment in the XY directions of the optical system of the left eye inspection unit 120L with the left subject's eye EL. The alignment optical system 30L projects an alignment light beam (parallel light) to the left subject's eye EL. The light beam for alignment is reflected by the beam splitter BS3, passes through the beam splitter BS1, passes through the objective lens 60, becomes a substantially parallel light beam, and is deflected by the deflection member P toward the cornea of the left eye EL. The reflected light of the alignment light beam projected onto the left subject's eye EL by the cornea returns along the same path as the incident path, passes through the beam splitter BS3, and is received by the CCD 21 of the imaging optical system 20L.

  The alignment optical system 31L is an optical system for performing alignment in the Z direction of the optical system of the left eye inspection unit 120L with respect to the left subject's eye EL. The alignment optical system 31L includes two or more photographing optical systems that photograph the anterior segment of the left eye E substantially simultaneously from two or more different directions. Hereinafter, as shown in FIG. 4, the alignment optical system 31L captures the left subject's eye EL from two different directions using two capturing optical systems. Each imaging optical system includes an infrared camera including a CCD having high sensitivity in the near infrared region as a narrow-area camera, and an imaging lens that forms light from the left eye EL on the light receiving surface of the CCD. . Each imaging optical system is capable of imaging not only the anterior eye part (pupil and iris) of the eye to be inspected, but also at least part of the upper eyelid and at least part of the lower eyelid of the eye to be inspected. Alignment in the Z direction (working distance direction) is performed based on parallax obtained based on images of the anterior ocular segment from two or more different directions acquired using these imaging optical systems.

  As illustrated in FIG. 4, a cover member 90 that covers both the left eye EL and the right eye ER may be provided in front of both the left eye EL and the right eye ER. Thus, the subject can concentrate on the examination without being distracted by the appearance in front of the subject's eye. In this case, the camera 80 is capable of color photographing (or monochrome photographing) the entire face of the subject under examination covered by the cover member 90 (at least the region including the periphery of the subject's eye, the cheeks, and the mouth). .

  The camera 80 is an example of a photographing apparatus that photographs a first range, which is at least a part of the face of the subject including the subject's eye, from the front (front or oblique). The CCD included in the alignment optical system 31L is an example of a photographing device that photographs a second range including the subject's eye from the front, which is a part of the first range of the subject's face. Hereinafter, the image of the subject acquired by the camera 80 is referred to as a “face image”, and the images of the subject's eye acquired by the CCDs included in the alignment optical systems 31L and 31R are referred to as “examined eye images” and “anterior eyes”. Part image ".

  The reflex measurement optical system 40L is an optical system for performing reflex measurement (objective refraction measurement) of the left subject's eye EL. The light beam for reflex measurement emitted by the reflex measurement optical system 40L is reflected by the beam splitter BS2, reflected by the beam splitter BS1, passes through the objective lens 60, and is directed to the fundus oculi Ef of the left eye EL by the deflecting member P. Is deflected. The reflected light from the fundus of the reflex measurement light beam projected on the left subject's eye EL returns along the same path as the incident path, passes through the beam splitters BS1 and BS3, and is received by the CCD 21 of the imaging optical system 20L.

  The kerato measurement optical system 50L is an optical system for performing kerato measurement of the left subject's eye EL. The ring light emitted from the kerat ring light source emitted by the kerat measuring optical system 50L is deflected by the deflecting member P to illuminate the cornea of the left eye EL. The reflected light from the cornea of the left subject's eye EL is deflected by the deflecting member P, passes through the objective lens 60, passes through the beam splitters BS1 and BS3, and is formed as a ring image on the light receiving surface of the CCD 21 by a CCD lens or the like (not shown). It is imaged.

  The measurement head 100 automatically executes alignment, objective measurement, subjective inspection, and the like of the optical systems of the left-eye inspection unit 120L and the right-eye inspection unit 120R under the control of a control system described below. ing. The measuring head 100 may further automatically execute a binocular balance test. In the subjective test, a value (objective value) obtained by the objective measurement is used. In particular, in the cross cylinder test of the subjective test, the astigmatic power and the astigmatic axis angle obtained by the objective test are used.

(Control system)
Next, a control system of the ophthalmologic examination apparatus 1 of the embodiment will be described with reference to FIGS. The block diagram shown in FIG. 5 shows a schematic configuration of a main part of a control system of the ophthalmologic examination apparatus 1. The block diagram shown in FIG. 6 shows a schematic configuration of a main part of the arithmetic unit 210 in FIG. 5 and 6, the same parts as those in FIGS. 1 to 4 are denoted by the same reference numerals, and the description will be appropriately omitted.

  As shown in FIG. 5, the control system of the ophthalmologic examination apparatus 1 mainly includes a control device 200 that controls each unit of the apparatus. The control device 200 is stored in, for example, the storage unit 9. The control device 200 includes a control unit 201 and a storage unit 202.

  The storage unit 202 stores a computer program for an ophthalmic examination including a control program for executing a process to be described later, image data of an optotype pattern displayed on the LCD 11, and the like. In addition, in the storage unit 202, an image of the anterior segment of the left subject's eye EL acquired using the imaging optical systems 20L and 20R, an image of the anterior segment of the right subject's eye ER, and acquired using the alignment optical system 31L. The image of the left eye E, the image of the anterior segment of the right eye ER obtained using the alignment optical system 31R, the reflex measurement result, the kerato measurement result, and the like are stored. The control unit 201 reads out the computer programs stored in the storage unit 202, and sequentially executes the computer programs while referring to the image data and the like stored in the storage unit 202. Such a control unit 201 includes an arithmetic control processor such as a CPU (Central Processing Unit).

  A computer device (not shown) may be connected to the ophthalmic examination apparatus 1. In this case, the computer device is used as a console of the ophthalmologic examination apparatus 1 and is used to accumulate and manage examination results by the ophthalmologic examination apparatus 1. Note that the CPU and the storage device of the computer device can be configured as the control device 200.

  The control device 200 (the control unit 201) controls the operation of the left eye inspection unit 120L and the right eye inspection unit 120R. Specifically, the control device 200 controls the horizontal movement mechanism 111 that horizontally moves the left-eye inspection unit 120L and the right-eye inspection unit 120R. The control device 200 controls a rotation mechanism 112L that rotates the left-eye inspection unit 120L and a vertical movement mechanism 113L that vertically moves the left-eye inspection unit 120L. Similarly, the control device 200 controls a rotation mechanism 112R for rotating the right eye inspection unit 120R and a vertical movement mechanism 113R for vertically moving the right eye inspection unit 120R. The control device 200 may control the arm moving mechanism 7 that moves the horizontal arm 6 up and down or rotates.

  The control device 200 (control unit 201) controls the operation of the optical system housed in the left-eye inspection unit 120L and the right-eye inspection unit 120R. The control device 200 executes, for example, display control of the LCD 11, operation control of the drive mechanisms 70L and 70R for moving the movable lens 70 in the optical axis direction, and the like. The display control of the LCD 11 includes control of switching of the target, control of turning on the target, control of turning off the target, and the like.

  The control device 200 executes light reception control by the CCD 21, operation control of the alignment optical systems 30L, 31L, 30R, 31R, reflex measurement optical systems 40L, 40R, kerato measurement optical systems 50L, 50R, camera 80, and the like. The left eye examination unit 120L for the left subject eye EL such that the deviation between the position of the image of the spot light projected on the left subject eye EL by the alignment optical system 30L and the position of the pupil center of the left subject eye EL is canceled. Can be aligned in the X and Y directions. Similarly, the alignment optical system 30R can perform alignment in the XY directions of the optical system of the right eye inspection unit 120R with respect to the right eye ER. It is possible to perform Z-direction alignment from parallax obtained based on images of the anterior segment of the left subject's eye EL from two or more different directions acquired using the alignment optical system 31L. Similarly, the alignment optical system 31R can also perform Z-direction alignment from parallax obtained based on images of the anterior segment of the right eye ER from two or more different directions. The operation control of the reflex measurement optical systems 40L and 40R includes control of a measurement light source that emits a light beam for reflex measurement. The operation control of the kerato measuring optical systems 50L and 50R includes control of a kerat ring light source. The operation control of the camera 80 includes focus control, zoom control, control for changing shooting conditions, control for starting shooting, and control for ending shooting.

  When an optical element application unit is provided in each inspection unit, the control device 200 (control unit 201) drives the plurality of optical elements selectively to at least one of the left eye E and the right eye ER. And the like.

  The control device 200 (control unit 201) controls the arithmetic unit 210. The calculation unit 210 obtains an objective value based on a measurement result by objective refraction measurement using the left eye inspection unit 120L or the right eye inspection unit 120R. The arithmetic unit 210 analyzes the shape of the ring target image acquired by receiving the ring-shaped measurement light beam projected on the fundus oculi Ef by the reflex measurement optical systems 40L and 40R by the CCD 21, for example, by a known method. To determine the objective value. The calculation unit 210 performs a predetermined calculation process on an image obtained by receiving, by the CCD 21, a light beam reflected by the cornea of the ring-shaped light beam projected on the cornea of the subject's eye by the kerato-measuring optical systems 50L and 50R, for example. Apply. Thereby, it is possible to calculate a parameter representing the shape of the cornea as an objective value. The control device 200 may include a calculation unit 210.

  The calculation unit 210 includes a positional relationship specifying unit 220, an image forming unit 230, and an image processing unit 240, as shown in FIG. The image processing unit 240 includes a size changing unit 241, a luminance changing unit 242, a color setting unit 243, and an image combining unit 244.

  The arithmetic unit 210 reads out a computer program stored in the storage unit 202 or a storage unit (not shown), and sequentially executes the computer program while referring to data or the like stored in the storage unit to realize the following functions. Such an operation unit 210 includes an operation control processor such as a CPU.

  The positional relationship specifying unit 220 is configured to control the positional relationship between the two CCDs (either one of the two CCDs or their representative positions) included in the alignment optical system 31L, the camera 80, and the left subject's eye EL. To identify. The relative position between the camera 80 and the predetermined reference position of the ophthalmic examination apparatus 1 (for example, the forehead provided on the measuring head 100) is uniquely determined based on the structure and optical design of the apparatus (known). The relative position between the reference position and the camera 80 may be determined by calibration or the like. The relative position between the CCD and the camera 80 and the relative position between the CCD and the left eye to be inspected EL are obtained from the alignment result before or during the inspection. For example, the relative position between the CCD and the camera 80 and the relative position between the CCD and the left subject's eye EL are determined based on the amount of movement of the left-eye inspection unit 120L moved by the alignment. The movement amount of the left-eye inspection unit 120L can be specified based on the control content of a moving mechanism that moves the left-eye inspection unit 120L and a detection signal obtained by a sensor that detects the position of the left-eye inspection unit 120L. It is. Therefore, the positional relationship specifying unit 220 obtains the relative position between the CCD and the camera 80 and the relative position between the CCD and the left subject's eye EL from the above alignment result, and determines the known reference position of the ophthalmic examination apparatus 1 and the camera 80 It is possible to specify the positional relationship between the CCD, the camera 80, and the left subject's eye EL by using the relative positions of That is, the positional relationship specifying unit 220 can specify the positional relationship between the CCD, the camera 80, and the left subject's eye EL based on the two subject's eye images of the left subject's eye EL used for alignment. It is.

  The face image of the subject is acquired by the camera 80, and the subject's eye image of the left subject's eye EL is acquired by the CCD included in the alignment optical system 31L. The positional relationship specifying unit 220 can obtain the position of the subject eye image of the left subject eye EL in the face image from the movement amount of the left eye inspection unit 120L (measurement head 100) moved by the alignment. Accordingly, even when the position of the subject's face is not constant with respect to the measurement head 100, the combined image in which the subject's eye image is combined (placed) in a region corresponding to the left subject's eye in the face image is displayed. It can be observed without discomfort.

  Similarly, an eye image of the right eye ER is acquired by the CCD included in the alignment optical system 31R. Similarly to the left-eye inspection unit 120L, the positional-relation identifying unit 220 of the right-eye inspection unit 120R determines the positional relationship between the CCD included in the alignment optical system 31R, the camera 80, and the right eye ER. To identify. The positional relationship specifying unit 220 can obtain the position of the eye image of the right eye ER in the face image from the movement amount of the right eye inspection unit 120R (measurement head 100) moved by the alignment.

  The image forming unit 230 forms a subject eye image of one left subject eye EL based on two or more subject eye images of the left subject eye EL acquired by the alignment optical system 31L. Since the acquired two or more eye images are not images acquired by photographing from the front, distortion occurs in each image. The image forming unit 230 selects one of the obtained two or more eye images to be inspected, performs distortion correction on the selected eye image to be inspected by a predetermined correction amount, and obtains the left eye EL viewed from the front. An eye image to be inspected is formed. Further, the image forming unit 230 specifies a characteristic portion common to the two or more eye images of the acquired left eye to be inspected EL, obtains a correction amount based on the specified characteristic portion, and obtains the two or more eye image to be inspected. May be corrected by the obtained correction amount to form a subject eye image of the left subject eye EL viewed from the front. Similarly, the image forming unit 230 forms an eye image of one right eye ER based on two or more eye images of the right eye ER acquired by the alignment optical system 31R. In addition, the image forming unit 230 determines the subject acquired by the camera 80 in accordance with the relative position between the camera 80 and a predetermined reference position (the subject's face (examined eye)) of the ophthalmologic examination apparatus 1. Of the subject can be corrected by a predetermined amount to form a face image of the subject viewed from the front.

  The image processing unit 240 combines the subject's eye image acquired by the alignment optical systems 31L and 31R with the subject's face image acquired by the camera 80 to form a combined image. The image processing unit 240 can perform predetermined image processing on at least one of the subject's eye image and the face image as needed. Examples of image processing include size change processing, luminance change processing, and color setting processing as described below. This makes it possible to form a composite image that does not give the examiner an uncomfortable feeling.

  The size changing unit 241 changes the size of at least one of the face image of the subject and the subject's eye image (the image of the left subject's eye EL and the right subject's eye ER). In this embodiment, the size changing unit 241 changes the size of the eye image of the left eye EL and the size of the eye image of the right eye ER. The size changing unit 241 adjusts the photographing magnification of the camera 80 and the alignment optical system 31L so that the size of the area corresponding to the left eye to be examined in the face image of the subject matches the size of the eye to be examined of the left eye to be examined EL. The size of the subject's eye image of the left subject's eye EL is changed based on the photographing magnification of. Similarly, the size changing unit 241 adjusts the photographing magnification of the camera 80 and the alignment so that the size of the area corresponding to the right eye to be examined in the face image of the subject matches the size of the eye image of the right eye ER. The size of the eye image of the right eye ER is changed based on the imaging magnification of the optical system 31R.

  The brightness changing unit 242 controls at least the face image and the subject's eye image of the subject so that the brightness of the face image matches the brightness of the subject's eye image (the image of the left subject's eye EL and the right subject's eye ER). Change the brightness of one. In this embodiment, the brightness changing unit 242 can change the brightness of the subject's eye image based on the brightness distribution of the face image. For example, the luminance changing unit 242 obtains the luminance distribution of the face image, and changes the luminance of the subject's eye image so as to match the difference between the maximum luminance and the minimum luminance in the face image.

  The color setting unit 243 sets the color of at least one of the face image and the eye image. In this embodiment, the face image is a color image, and the subject's eye image is a grayscale image acquired by a CCD having sensitivity in the near infrared region. The color setting unit 243 sets the color of the area corresponding to the skin in the subject's eye image so as to be the same color as the color of the area corresponding to the skin in the face image. That is, the color setting unit 243 colors the area corresponding to the skin in the eye image to be examined so as to have the same color as the color of the area corresponding to the skin in the face image. Similarly, the color setting unit 243 sets a color of a region corresponding to an iris or a pupil in the eye image to be examined to a predetermined color.

  The image combining unit 244 forms a combined image by combining the face image and the subject's eye image based on the positional relationship identified by the positional relationship identifying unit 220. Specifically, the image synthesizing unit 244 specifies an area corresponding to the left eye and an area corresponding to the right eye in the face image based on the positional relationship identified by the positional relationship identifying unit 220. The image synthesizing unit 244 arranges the subject eye image of the left subject eye EL in an area corresponding to the left subject eye, and arranges the subject eye image of the right subject eye ER in a region corresponding to the right subject eye to form a composite image. Form.

  Each of the camera 80 and the CCDs included in the alignment optical systems 31L and 31R is controlled by the control device 200 and repeats photographing at predetermined time intervals. The image combining unit 244 can form a new combined image based on a new image obtained by at least one of the CCDs included in the camera 80 and the alignment optical systems 31L and 31R.

  The image synthesizing unit 244 can perform a known smoothing process or an interpolation process on at least one of the face image and the subject's eye image so that the boundary between the face image and the subject's eye image is not noticeable. is there.

  The control device 200 executes all operation control and data processing of the ophthalmologic examination apparatus 1 in addition to the above control.

  The control device 200 can be connected to the examiner controller 300 and the examinee controller 310 via a wired or wireless communication path. The control device 200 controls each unit of the ophthalmologic examination apparatus 1 in response to an operation signal corresponding to an operation performed on the controller 300 for the examiner or the controller 310 for the examinee. The control device 200 can display an operation screen, various information for performing measurement, and the like on the display unit of the controller 300 for the examiner or the controller 310 for the examinee.

  The control device 200 and the arithmetic unit 210 may include, for example, a microprocessor, a RAM, a ROM, a hard disk drive, a communication interface, and the like. Arithmetic unit 210 may be included in control device 200.

  The operation principle of the alignment using the above-described optical system, the measurement principle of the subjective test, the measurement principle of the objective measurement, the measurement principle of the corneal shape, and the like are already known, and thus detailed description is omitted.

  The function of the first optotype presenting unit 122L is realized by the optotype presenting optical system 10L included in the left eye inspection unit 120L. The function of the second optotype presenting unit 122R is realized by the optotype presenting optical system 10R included in the right eye inspection unit 120R. The function of the first objective measurement unit 123L is realized by the reflex measurement optical system 40L and the kerato measurement optical system 50L included in the left eye inspection unit 120L. The function of the second objective measurement unit 123R is realized by the reflex measurement optical system 40R and the kerato measurement optical system 50R included in the right eye inspection unit 120R. The function of the imaging unit 140 is realized by the camera 80.

  The imaging unit 140 and the camera 80 are examples of the “first imaging device” according to the embodiment. The alignment optical systems 31L and 31R are examples of the “second imaging device” according to the embodiment. The positional relationship specifying unit 220 is an example of the “specifying unit” according to the embodiment. The optical system included in the left eye inspection unit 120L and the right eye inspection unit 120R is an example of the “inspection optical system” according to the embodiment. The moving mechanism system 110 is an example of the “moving mechanism” according to the embodiment. The CCD included in each of the alignment optical systems 31L and 31R is an example of “two or more photographing units” according to the embodiment.

[Operation example]
Next, an operation of the ophthalmologic examination apparatus 1 according to the embodiment will be described. Hereinafter, a case will be described in which the ophthalmologic examination apparatus 1 forms a composite image during the subjective examination.

  FIG. 7 is a flowchart illustrating an operation example of the ophthalmologic examination apparatus 1. Here, it is assumed that the face of the subject is arranged at the inspection position of the measuring head 100. FIG. 8 is a diagram illustrating the operation of the ophthalmologic examination apparatus 1. 8, the same parts as those in FIG. 3 are denoted by the same reference numerals, and the description will be appropriately omitted.

(S1)
The control device 200 executes alignment control for the left and right eyes. In other words, the control device 200 performs alignment in the X and Y directions of the optical system of the left eye inspection unit 120L with respect to the left subject's eye EL using the alignment optical system 30L, and performs right alignment with respect to the right subject's eye ER using the alignment optical system 30R. The XY direction alignment of the optical system of the eye inspection unit 120R is performed. Subsequently, the control device 200 performs alignment in the Z direction of the optical system of the left eye inspection unit 120L with respect to the left eye EL based on the two eye images acquired using the alignment optical system 31L, and performs alignment. Based on the two eye images acquired using the optical system 31R, the Z-direction alignment of the optical system of the right eye inspection unit 120R with respect to the right eye ER is performed. When the alignment in the Z direction is completed, as described above, the positional relationship specifying unit 220 determines the relative position between the CCD and the camera 80 included in the alignment optical systems 31L and 31R, and the relative position between the CCD and the left subject's eye EL. And the positional relationship among the CCD, the camera 80, and the left subject's eye EL is determined.

(S2)
The camera 80 captures the entire face of the subject under the control of the control device 200. Thereby, the face image PF of the subject under examination is acquired (see FIG. 8). In the acquired face image PF, the face of the subject blocked by the measurement head 100 (for example, the deflection member P) is depicted, and the left subject's eye and the right subject's eye are not depicted. The image data of the acquired face image PF is stored in the storage unit 202.

(S3)
Under the control of the control device 200, the alignment optical system 31L captures the anterior segment of the left subject's eye EL substantially simultaneously from two different directions. Thereby, two anterior eye images (eye images) of the left eye EL are acquired. Similarly, the alignment optical system 31R captures the anterior segment of the right eye ER substantially simultaneously from two different directions. Thereby, two anterior segment images of the right eye ER are acquired. The acquired image data of the anterior segment image of the left subject eye EL and the acquired image data of the anterior segment image of the right subject eye ER are stored in the storage unit 202. The anterior ocular segment image acquired in S3 may be an image acquired when performing the alignment in S1.

(S4)
The image forming unit 230 receives the control from the control device 200 and converts the anterior eye image viewed from the front from the two anterior eye images of the left eye to be inspected EL acquired in S <b> 3 into the eye to be inspected image PL of the left eye to be inspected EL (See FIG. 8). Similarly, the image forming unit 230 forms an anterior eye image viewed from the front from the two anterior eye images of the right eye ER acquired in S3 as an eye image PR of the right eye ER. The formed image data of the subject's eye image PL and the subject's eye image PR are stored in the storage unit 202.

(S5)
The size changing unit 241 changes the size of the subject's eye image PL formed in S4 under the control of the control device 200. Similarly, the size changing unit 241 changes the size of the subject's eye image PR formed in S4. Thereby, the size of the eye image PL to be inspected substantially matches the size of the region corresponding to the left eye to be inspected in the face image PF acquired in S2, and the size of the eye image PR to be acquired in the face image PF acquired in S2. Substantially coincides with the size of the region corresponding to the right eye to be examined.

(S6)
The calculation unit 210 (the positional relationship specifying unit 220) receives the control from the control device 200, and determines the position of the subject eye image PL and the position of the subject eye image PR in the face image PF acquired in S2. Specifically, the arithmetic unit 210 (the positional relationship specifying unit 220) determines the face image based on the positional relationship between the CCD included in the specified alignment optical system 31L, the camera 80, and the left subject's eye EL. The position of the eye image PL in the PF is determined. Similarly, the arithmetic unit 210 calculates the position of the subject's eye image PR in the face image PF based on the positional relationship between the CCD included in the specified alignment optical system 31R, the camera 80, and the right subject's eye ER. decide.

(S7)
The brightness changing unit 242 receives the control from the control device 200, and controls the brightness of the eye image PL and the brightness of the eye image PL such that the brightness of the face image PF, the brightness of the eye image PL, and the brightness of the eye image PR match. The luminance of the image PR is changed.

(S8)
The color setting unit 243 receives the control from the control device 200 and sets the color of the subject eye image PL and the color of the subject eye image PR. The color setting unit 243 sets the color of the region corresponding to the skin in the eye images PL and PR so as to be the same color as the color of the region corresponding to the skin in the face image PF. Further, the color setting unit 243 sets a color of a region corresponding to an iris or a pupil in the eye images PL and PR to be a predetermined color.

(S9)
The image synthesizing unit 244 receives the control from the control device 200, synthesizes the face image PF acquired in S2, the eye image PL and the eye image PR colored in S8, and forms the synthesized image PM. . The image data of the formed composite image PM is stored in the storage unit 202.

(S10)
The control device 200 causes the display unit of the examiner controller 300 to display the composite image PM formed in S9. Thus, the operation of the ophthalmologic examination apparatus 1 ends (end).

  Note that, in FIG. 7, the case where the anterior eye image (eye image to be inspected) is acquired and the combined image is formed each time the face image is acquired has been described, but the operation of the ophthalmologic examination apparatus 1 according to the embodiment is not limited to this. It is not limited. For example, after acquiring a face image once, only acquisition of an anterior segment image is repeated, and each time a new anterior segment image is acquired, a new composite image is formed using the new anterior segment image. You may do so. Alternatively, for example, after acquiring an anterior segment image once, only acquisition of a face image is repeated, and each time a new face image is acquired, a new composite image is formed using the new face image. You may.

  FIG. 7 illustrates the case where the distortion correction, the size change, the brightness change, and the coloring are performed before the face image PF and the eye images PL and PM are combined, but the operation of the ophthalmologic examination apparatus 1 according to the embodiment is described. Is not limited to this. For example, after S9, at least one of S3, S4, S5, S7, and S8 may be executed.

  As described above, according to the embodiment, during the examination, the face image of the subject and the image of the subject's eye are acquired, and the combined image of the face image and the subject's eye is displayed on the examiner controller 300. The examiner can display the facial expression and the like of the subject during the examination. This allows the examiner to proceed with the examination without impairing the reliability of the examination. In addition, since the images of the subject's eye are acquired by diverting the alignment optical systems 31L and 31R for performing the Z alignment, it is not necessary to greatly add an optical system.

(Modification)
(First Modification)
In the embodiment, the case where the image of the subject's eye is acquired by the CCD included in the alignment optical systems 31L and 31R has been described. However, the configuration of the ophthalmologic examination apparatus 1 according to the embodiment is not limited to this. For example, the image of the eye to be inspected may be acquired by the CCD 21 included in the imaging optical systems 20L and 20R for observing the anterior segment.

  The configuration of the ophthalmologic examination apparatus according to the first modification of the embodiment is the same as the configuration of the ophthalmologic examination apparatus 1 according to the embodiment. The difference between the operation of the ophthalmic examination apparatus according to the first modification and the operation of the ophthalmic examination apparatus 1 according to the embodiment is that, in S1, the positional relationship specifying unit 220 causes the CCD 21, the camera 80, and the eyes to be examined (the left eye EL and the right This is a point in which a positional relationship with the eye to be inspected ER) is obtained, and an image of the eye to be inspected is acquired by the CCD 21 in S3.

  FIG. 9 is an operation explanatory view of the ophthalmologic examination apparatus according to the first modification. In FIG. 9, the same parts as those in FIG. 8 are denoted by the same reference numerals, and the description will be appropriately omitted.

  When the control device 200 executes the alignment for the left and right eyes, the positional relationship specifying unit 220 determines the relative position between the CCD 21 and the camera 80 included in the imaging optical systems 20L and 20R, the CCD 21 and the subject's eye (the left subject's eye EL, the right subject's right subject). A relative position with respect to the optometry ER) is determined, and a positional relationship among the CCD 21, the camera 80, and the subject's eye is determined.

  The control device 200 uses the CCD 21 included in the imaging optical system 20L to photograph the anterior segment of the left eye EL, and obtains an anterior eye image (eye image) of the left eye EL. Similarly, the control device 200 causes the CCD 21 included in the imaging optical system 20R to capture an image of the anterior eye of the right eye ER and acquire an anterior eye image of the right eye ER. The acquired image data of the anterior segment image of the left subject eye EL and the acquired image data of the anterior segment image of the right subject eye ER are stored in the storage unit 202. In the first modification, the anterior eye image acquired using the CCD 21 can be used as it is as the eye image to be inspected.

  The acquired anterior eye image (eye image to be inspected) is subjected to size change, brightness change, and coloring, and then combined with the face image PF, as in the embodiment. Thus, a composite image PM is formed as in the embodiment.

  According to the first modification, the same effect as that of the embodiment can be obtained. Further, an image of the anterior segment viewed from the front can be obtained without performing distortion correction on the acquired anterior segment image. Furthermore, the present invention can be applied to an ophthalmologic examination apparatus that performs Z alignment by another known method without having two or more imaging units for performing Z alignment.

(Second Modification)
In the embodiment or the first modification thereof, the state of the subject is identified by analyzing the formed composite image, and the controller 300 for the examiner and the object for the subject are specified according to the identified state of the subject. It is possible to control at least one of the controllers 310.

  The configuration of the ophthalmologic examination apparatus according to the second modification of the embodiment is different from the configuration of the ophthalmologic examination apparatus 1 according to the embodiment in that an analysis unit 250 is added to the calculation unit 210. Hereinafter, the ophthalmologic examination apparatus according to the second modification will be described focusing on differences from the ophthalmologic examination apparatus 1 according to the embodiment.

  FIG. 10 is a block diagram illustrating a configuration example of a calculation unit in an ophthalmologic examination apparatus according to a second modification. 10, the same parts as those in FIG. 6 are denoted by the same reference numerals, and the description will be appropriately omitted.

  The configuration of the arithmetic unit 210a according to the first modification differs from the arithmetic unit 210 according to the embodiment in that an analysis unit 250 is added. The analysis unit 250 specifies the state of the subject by analyzing the synthesized image formed by the image synthesis unit 244. Specifically, the analysis unit 250 specifies the face part such as the upper eyelid, the lower eyelid, and the mouth by analyzing the composite image, obtains a change in the shape of the specified part, and determines the obtained change in advance. The expression of the subject is specified by determining whether or not the expression matches the determined expression pattern. This makes it possible to specify the degree of fatigue or confusion of the subject. In addition, the analysis unit 250 may specify the facial expression of the subject in consideration of the response state of the subject to the subject controller 310.

  The control device 200 can control the operation of the examiner controller 300 and the examinee controller 310 according to the analysis result by the analysis unit 250.

  When it is determined that the subject is tired based on the analysis result by the analysis unit 250, the control device 200 notifies the examiner that the subject is tired. In order to notify the examiner, a message such as “the subject is tired” is output on the display unit of the controller 300 for the examiner, a sound is output, or an indicator light is displayed. . Further, an avatar (character) may be displayed on the display unit of the examiner's controller 300, and the avatar may notify that the subject is tired.

  When it is determined based on the analysis result by the analysis unit 250 that the subject is puzzled by the response or the like, the control device 200 notifies the examiner that the subject is puzzled. In order to notify the examiner, a message such as “It seems that the subject is confused” is output on the display unit of the controller 300 for the examiner, a sound is output, or an indicator light is displayed. . In addition, an avatar may be displayed on the display unit of the controller 300 for the examiner, and the avatar may notify that the subject is confused. In addition, a message such as “Do you have any trouble?” Is output on the display unit of the controller 310 for the subject, and additional explanation such as a specific response method is displayed on the display unit. May be used to induce a response.

  Further, according to the analysis result by the analysis unit 250, a message is output on the display unit of the examiner controller 300, a sound is output, or a display lamp is turned on without displaying the synthesized image as it is in S10 of FIG. It may be displayed.

[effect]
Effects of the ophthalmic examination apparatus according to the embodiment will be described.

  The ophthalmologic examination apparatus (ophthalmic examination apparatus 1) according to the embodiment performs an examination (a subjective examination and an objective measurement) of an eye to be inspected (a left eye to be inspected EL and a right to-be-examined eye ER). The ophthalmic examination apparatus includes a specifying unit (positional relationship specifying unit 220) and an image combining unit (image combining unit 244). The identification unit is a first imaging device (imaging unit 140, camera 80) that captures, from the front, a first range that is at least a part of the face of the subject including the subject's eye, and a part of the first range. The positional relationship between the second imaging device (the alignment optical systems 31L and 31R or the imaging optical systems 20L and 20R) that images the second range including the eye to be examined from the front and the eye to be inspected is specified. The image synthesizing unit, when the inspection is performed, based on the positional relationship specified by the specifying unit, the first image (face image) obtained by the first imaging device and the second image obtained by the second imaging device. A composite image is formed with two images (anterior eye image and eye image).

  According to such a configuration, the first photographing device capable of photographing the first range of at least a part of the face of the subject and the second photographing device capable of photographing the subject's eye in a part of the first range are provided. A first image capturing device, a second image capturing device, and an eye to be inspected are identified, and a first image and a second image acquired by the first image capturing device based on the identified positional relationship during the examination are specified. Since a composite image with the second image acquired by the imaging device is formed, an image capable of observing the state of the subject such as the facial expression of the subject under examination can be acquired. Thereby, it becomes possible to grasp the degree of fatigue, the degree of confusion, etc. of the subject in which the optical system for performing the inspection is arranged in front of the eyes during the inspection.

  In the ophthalmologic examination apparatus according to the embodiment, the image combining unit may combine the first image and the second image acquired substantially simultaneously by the first imaging device and the second imaging device.

  According to such a configuration, it is possible to acquire an image in which the state of the subject, such as the expression of the subject under examination, can be observed in real time without discomfort.

  Further, in the ophthalmologic examination apparatus according to the embodiment, each of the first imaging apparatus and the second imaging apparatus repeatedly performs imaging at predetermined time intervals, and the image combining unit performs at least one of the first imaging apparatus and the second imaging apparatus. A new composite image may be formed based on the acquired new image.

  According to such a configuration, it is possible to acquire a moving image capable of observing the state of the subject such as the expression of the subject under examination. This makes it easier for the examiner to observe the expression and the like of the subject during the examination, and to more easily understand the degree of fatigue and the degree of confusion of the subject.

  Further, the ophthalmologic examination apparatus according to the embodiment may include a first imaging apparatus arranged at a position where imaging can be performed from the front of the subject.

  According to such a configuration, the predetermined reference position (the face of the subject) of the ophthalmologic examination apparatus or the relative position between the subject's eye and the first imaging apparatus becomes constant, and the first imaging apparatus and the second imaging apparatus It is possible to obtain the positional relationship between the object and the subject's eye with higher accuracy. This facilitates formation of a composite image without a sense of discomfort.

  Further, the ophthalmologic examination apparatus according to the embodiment has a measurement head including an inspection optical system (an optical system included in the left eye inspection unit 120L and the right eye inspection unit 120R) for performing an inspection, and a second imaging device. (Measurement head 100), a moving mechanism (moving mechanism system 110) for moving the measuring head, and measurement to perform alignment of the inspection optical system with respect to the eye to be inspected based on the second image acquired by the second imaging device. A control unit (control device 200, control unit 201) for controlling the head and the moving mechanism.

  According to such a configuration, it is possible to acquire an image capable of observing the state of the subject such as the expression of the subject blocked by the measuring head during the examination.

  Further, in the ophthalmologic examination apparatus according to the embodiment, the specifying unit may obtain the positional relationship using the alignment result of the inspection optical system with respect to the eye to be inspected.

  According to such a configuration, it is possible to obtain the positional relationship by using the result of the alignment of the inspection optical system with respect to the eye to be inspected performed before the inspection. It is possible to acquire an image that allows observation of the state of the subject such as the facial expression of the subject.

  In the ophthalmologic examination apparatus according to the embodiment, the specifying unit obtains the position of the second image in the first image based on the moving amount of the measurement head, and the image combining unit obtains the position of the first image obtained by the specifying unit. The composite image may be formed by arranging the second image at the position.

  According to such a configuration, even when the position of the face of the subject with respect to the measurement head is not constant, the state of the subject such as the expression of the subject during the examination can be observed without discomfort. Images can be obtained.

  In the ophthalmologic examination apparatus according to the embodiment, the second imaging device includes two or more imaging units (CCDs included in each of the alignment optical systems 31L and 31R) that image the second range substantially simultaneously from different directions. May be included.

  According to such a configuration, since the second image is acquired using two or more photographing units that photograph the second range substantially simultaneously from different directions, the acquired second image is acquired in the Z direction. It is possible to acquire an image that can observe the state of the subject, such as the facial expression of the subject being inspected, while being diverted to the alignment.

  Further, the ophthalmologic examination apparatus according to the embodiment may include an image forming unit (image forming unit 230) that forms a second image based on two or more images acquired by two or more imaging units.

  According to such a configuration, it is possible to form a second image viewed from a predetermined direction (for example, the front) from two or more images obtained by photographing the second range from different directions. An image capable of observing the expression and the like of the subject under examination without discomfort can be acquired.

  In the ophthalmologic examination apparatus according to the embodiment, the specifying unit may determine the positional relationship based on two or more images.

  According to such a configuration, the positional relationship is obtained based on the image used for the alignment in the Z direction. Therefore, while the image used for the alignment in the Z direction is diverted, the expression such as the facial expression of the subject being inspected can be inspected. It is possible to acquire an image that allows the observer to observe the situation.

  Further, the ophthalmologic examination apparatus according to the embodiment may include a size changing unit (size changing unit 241) that changes the size of the second image based on the imaging magnification of the first imaging apparatus and the imaging magnification of the second imaging apparatus. Good.

  According to such a configuration, the size of the second image is changed in accordance with the size of the region corresponding to the eye to be inspected in the first image. And the like can be obtained without obstruction.

  Further, the ophthalmologic examination apparatus according to the embodiment may include a luminance changing unit (luminance changing unit 242) that changes the luminance of at least one of the first image and the second image.

  According to such a configuration, since the luminance of at least one of the first image and the second image is changed, an image in which the expression or the like of the subject during the examination depicted in the composite image can be observed without discomfort. Can be obtained.

  In the ophthalmologic examination apparatus according to the embodiment, the second imaging device is an infrared camera, and a color setting unit that sets a color of a second grayscale image acquired by the infrared camera based on the first image. (A color setting unit 243).

  According to such a configuration, the color of the second image is set based on the first image. Therefore, an image in which the expression and the like of the subject being inspected, which is depicted in the composite image and which can be observed without discomfort, can be obtained. Can be obtained.

  In the ophthalmologic examination apparatus according to the embodiment, the second imaging apparatus images both the left eye and the right eye substantially simultaneously, and the image combining unit uses the first image and the second imaging apparatus. A second image including both the left anterior eye image (eye image of the left eye EL to be inspected) and the right anterior eye image (eye image of the right eye ER) acquired in this manner may be combined.

  According to such a configuration, it is possible to acquire an image capable of observing the state of the subject such as the facial expression of the subject during the examination of both eyes. Thereby, it becomes possible to grasp the degree of fatigue, the degree of confusion, etc. of the subject in which the optical system for performing the inspection is arranged in front of the eyes during the inspection.

[Others]
Note that the above-described embodiment or its modified example is not limited to the configuration of the optical system described in FIG. 3 and the configuration and control contents of the control system described in FIGS. 5 and 6. For example, the objective measurement may include objective measurement for measuring a value related to the eye to be inspected, and photographing for acquiring an image of the eye to be inspected. Such objective measurement includes, for example, objective refraction measurement, corneal shape measurement, intraocular pressure measurement, fundus photography, OCT (optical coherence tomography) measurement using an OCT technique, and the like. The subjective test includes, for example, a subjective refraction measurement such as a distance test, a near test, a contrast test, and a glare test, and a visual field test.

  Further, the ophthalmologic examination apparatus according to the embodiment can execute a distance test, a near test, a contrast test, a glare test, and the like as a subjective test, and, as objective measurements, an objective refraction measurement and a corneal shape measurement. , OCT measurement and the like. In OCT measurement, acquisition of eyeball information representing the structure of the eye to be examined, such as the axial length of the eye, corneal thickness, anterior chamber depth, and lens thickness, may be performed.

  The configuration described above is merely an example for suitably implementing the present invention. Therefore, arbitrary modifications (omission, substitution, addition, etc.) within the scope of the present invention can be appropriately made.

1 Ophthalmic examination apparatus 20L, 20R Imaging optical system 21 CCD
31L, 31R Alignment optical system 80 Camera 100 Measuring head 110 Moving mechanism system 120L Left eye inspection unit 120R Right eye inspection unit 140 Imaging unit 200 Control device 210, 210a Operation unit 220 Positional relationship identification unit 230 Image formation unit 240 Image processing Unit 244 image synthesis unit EL left eye ER right eye

Claims (14)

An ophthalmic examination apparatus for examining an examinee's eye,
A first imaging device that captures, from the front, a first range that is at least a part of the face of the subject including the subject's eye, and a second range that is part of the first range and includes the subject's eye; A second photographing apparatus that photographs from, and a specifying unit that specifies a positional relationship between the subject's eye and
When the inspection is performed, the first image acquired by the first imaging device and the second image acquired by the second imaging device are determined based on the positional relationship identified by the identification unit. An image combining unit that forms a combined image;
An ophthalmic examination device including: The ophthalmic examination according to claim 1, wherein the image combining unit combines the first image and the second image acquired substantially simultaneously by the first imaging device and the second imaging device. apparatus. Each of the first imaging device and the second imaging device repeats imaging at predetermined time intervals,
3. The image combining unit according to claim 1, wherein the image combining unit forms a new combined image based on a new image acquired by at least one of the first imaging device and the second imaging device. 4. An ophthalmic examination apparatus as described. The ophthalmologic examination apparatus according to any one of claims 1 to 3, further comprising the first imaging apparatus arranged at a position where imaging is possible from the front of the subject. An inspection optical system for performing the inspection, and a measurement head including the second imaging device;
A moving mechanism for moving the measuring head,
A control unit that controls the measuring head and the moving mechanism to perform alignment of the inspection optical system with respect to the eye to be inspected based on the second image acquired by the second imaging device;
The ophthalmic examination apparatus according to any one of claims 1 to 4, comprising: The ophthalmologic examination apparatus according to claim 5, wherein the identification unit obtains the positional relationship using a result of alignment of the inspection optical system with respect to the eye to be inspected. The specifying unit obtains a position of the second image in the first image based on a moving amount of the measurement head,
The ophthalmologic examination apparatus according to claim 6, wherein the image combining unit forms the combined image by arranging the second image at a position in the first image obtained by the specifying unit. The ophthalmic examination according to any one of claims 1 to 7, wherein the second imaging device includes two or more imaging units that image the second range substantially simultaneously from different directions. apparatus. The ophthalmologic examination apparatus according to claim 8, further comprising: an image forming unit that forms the second image based on two or more images acquired by the two or more imaging units. The ophthalmic examination apparatus according to claim 8, wherein the specifying unit obtains the positional relationship based on the two or more images. The image processing apparatus according to claim 1, further comprising a size changing unit configured to change a size of the second image based on a photographing magnification of the first photographing device and a photographing magnification of the second photographing device. An ophthalmic examination apparatus according to claim 1. The ophthalmologic examination apparatus according to any one of claims 1 to 11, further comprising a luminance changing unit that changes luminance of at least one of the first image and the second image. The second photographing device is an infrared camera,
The color camera according to claim 1, further comprising: a color setting unit configured to set a color of the second image in a gray scale acquired by the infrared camera based on the first image. An ophthalmic examination apparatus as described. The second imaging device images both the left eye and the right eye substantially simultaneously,
The image combining unit combines the first image and a second image including both a left anterior eye image and a right anterior eye image acquired using the second imaging device. An ophthalmic examination apparatus according to any one of claims 1 to 13.

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