JP6895278B2 - Ophthalmic observation device and its operation method - Google Patents

Description

The present invention relates to an ophthalmic observation device used for observing an eye to be inspected and a method of operating the same.

There is known a laser surgical apparatus (ophthalmic observation apparatus) that irradiates a treatment site of an eye to be inspected with a laser beam to treat the eye to be inspected (see Patent Document 1). This laser surgical apparatus includes an illumination optical system for illuminating the eye to be inspected and an observation optical system for observing the eye to be inspected. As a result, the operator identifies the treatment site in the eye to be inspected by confirming the observation image of the eye to be inspected through the observation optical system, and emits a laser beam for treatment from the laser surgical apparatus to the specified treatment site. It can be irradiated.

When irradiating a treatment site in an eye to be inspected with a laser beam in such a laser surgical apparatus, it is necessary to irradiate the laser beam while avoiding blood vessels in the eye to be inspected. Therefore, the operator needs to determine the irradiation position of the laser beam while checking, for example, a fluorescent fundus image of the eye to be inspected (an image obtained by a known fluorescein fluorescent fundus angiography) or the like.

Therefore, Patent Document 2 discloses an ophthalmic lighting system including the above-mentioned illumination optical system, a microdisplay that emits an image including information related to the eye to be inspected, and an observation optical system. The observation optical system of Patent Document 2 observes the emitted light (observation image) emitted from the eye to be inspected by being illuminated by the illumination optical system and the image emitted from the microdisplay with the observation eye of the operator. to enable. As a result, the operator can simultaneously confirm the observation image of the eye to be inspected and the image emitted from the micro display.

Japanese Unexamined Patent Publication No. 2001-108906 International Publication No. 2015/088849

When the ophthalmic lighting system described in Patent Document 2 is applied to a laser surgical apparatus, the operator can simultaneously confirm the observation image of the eye to be inspected and the fluorescent fundus image. In this case, the operator performs operations related to microdisplay control such as switching, scaling, and position adjustment of the fundus fluorescence image as necessary.

However, since the operator of the laser surgical apparatus holds the contact lens in contact with the eye to be inspected with one hand and the operating lever for adjusting the position of the laser surgical apparatus with the other hand, the operator can control the microdisplay. Such an operation cannot be performed manually. In addition, the operator confirms the observation image of the eye to be inspected with both eyes through the eyepiece of the laser surgical apparatus. Therefore, even if one of both hands is free, the operator needs to take both eyes away from the eyepiece or perform an operation related to the control of the micro display by groping. The sex is significantly reduced.

The present invention has been made in view of such circumstances, and an object of the present invention is to provide an ophthalmic observation device having significantly improved operability and a method of operating the same.

An ophthalmic observation device for achieving the object of the present invention includes an illumination optical system that injects light into the eye to be inspected, an image emitting optical system that emits an image, and an eye to be inspected according to the incident of light from the illumination optical system. An observation optical system that guides the emitted light emitted from the image and the image emitted by the image emitting optical system to the optometry lens, a line-of-sight input detection unit that detects the operator's line-of-sight input, and a line-of-sight detected by the line-of-sight input detection unit. An operation instruction detection unit that detects an operation instruction for an operation target including at least an image emission optical system in the illumination optical system, the image emission optical system, and the observation optical system, which is an operation instruction input by input, and an operation instruction. It includes a control unit that controls an operation target based on an operation instruction detected by the detection unit.

According to this ophthalmic observation device, it is possible to perform hands-free control of the operation target based on the operation instruction input by the operator's line of sight.

In the ophthalmic observation device according to another aspect of the present invention, the image emitting optical system emits an image of an operation screen including a plurality of types of objects corresponding to a plurality of types of operation instructions as an image, and the observation optical system is used. , The image of the operation screen emitted from the image emission optical system is guided to the eyepiece, the line-of-sight input detection unit detects the line-of-sight input for multiple types of objects in the operation screen, and the operation instruction detection unit detects multiple types of objects. The operation instruction is detected based on the result of the line-of-sight input detection unit detecting the line-of-sight input for any of the above. Thereby, a desired operation instruction can be determined by line-of-sight input from a plurality of types of operation instructions.

In the ophthalmic observation device according to another aspect of the present invention, the operation instruction detection unit detects an on / off instruction for displaying an image by the image emitting optical system as an operation instruction, and the operation instruction detection unit gives an on / off instruction for the control unit. When is detected, on / off control is performed to turn on / off the image emission by the image emission optical system. As a result, on / off control can be performed hands-free.

In the ophthalmic observation device according to another aspect of the present invention, the operation target includes an illumination optical system and an image emission optical system, and the operation instruction detection unit receives light incident from the illumination optical system as an operation instruction. When the operation instruction detection unit detects the switching instruction, the control unit controls the illumination optical system and the image emission optical system to detect the switching instruction for switching between the image emission optical system and the image emission optical system. Controls switching between incident and image emission. As a result, switching control can be performed hands-free.

In the ophthalmic observation apparatus according to another aspect of the present invention, the image emitting optical system emits a reduced image of a plurality of images, and the operation instruction detection unit enlarges the reduced image in the plurality of reduced images as an operation instruction. The selection instruction for selecting the reduced image and the decision instruction for determining the enlargement of the reduced image selected by the selection instruction are detected, and the control unit outputs an image when the operation instruction detection unit detects the selection instruction and the determination instruction. The optical system is controlled to magnify the reduced image selected by the selection instruction. As a result, it is possible to select the reduced image to be enlarged and to enlarge the selected reduced image hands-free.

The ophthalmic observation device according to another aspect of the present invention includes an observation image acquisition unit that acquires an observation image of the eye to be inspected formed by emitted light, and the operation instruction detection unit can be used as an operation instruction to obtain the position and size of the image. The control unit detects the superimposition instruction to match the posture with the observation image, and the control unit analyzes the image and the observation image acquired by the observation image acquisition unit when the operation instruction detection unit detects the superposition instruction. The image emitting optical system is controlled to perform superimposition control to match the position, size, and orientation of the image with the observed image. As a result, the superimposition control can be performed hands-free.

In the ophthalmic observation device according to another aspect of the present invention, the operation instruction detection unit detects the first adjustment instruction for adjusting at least one of the position, size, and posture of the image as the operation instruction, and the control unit. When the operation instruction detection unit detects the first adjustment instruction, controls the image emitting optical system to adjust the image emitted from the image emitting optical system according to the first adjustment instruction. As a result, at least one of the position, size, and orientation of the image emitted from the image emitting optical system can be adjusted hands-free.

In the ophthalmic observation device according to another aspect of the present invention, the operation instruction detection unit detects the second adjustment instruction for adjusting the image quality of the image as the operation instruction, and the operation instruction detection unit makes the second adjustment in the control unit. When the instruction is detected, the image emitting optical system is controlled to adjust the image quality of the image according to the second adjustment instruction. As a result, the image quality of the image emitted from the image emitting optical system can be adjusted hands-free.

In the ophthalmic observation device according to another aspect of the present invention, the image is an image including information about the feature portion of the eye to be inspected, and the operation instruction detection unit detects an emphasis instruction for emphasizing the feature portion as an operation instruction. When the operation instruction detection unit detects an emphasis instruction, the control unit controls the image emitting optical system to emit an image in which the feature portion is emphasized. As a result, the feature portion of the image emitted from the image emitting optical system can be emphasized hands-free.

The method of operating the ophthalmic observation device for achieving the object of the present invention depends on the illumination optical system that injects light into the eye to be inspected, the image emitting optical system that emits an image, and the incident of light from the illumination optical system. In the method of operating an ophthalmic observation device including an observation optical system that guides the emitted light emitted from the eye to be inspected and the image emitted from the image emitting optical system to the eyepiece, the line-of-sight input detection unit is operated by the operator. The line-of-sight input detection step for detecting the line-of-sight input and the operation instruction detection unit are the operation instructions input by the line-of-sight input detected by the line-of-sight input detection unit, and the illumination optical system, the image emission optical system, and the observation optics. An operation instruction detection step for detecting an operation instruction for an operation target including at least an image emitting optical system in the system, and a control step for the control unit to control the operation target based on the operation instruction detected by the operation instruction detection unit. And have.

The ophthalmic observation device of the present invention and its operating method can significantly improve operability.

It is external perspective view of the laser surgical apparatus to which the ophthalmic observation apparatus of this invention was applied. It is a schematic diagram of the structure of the surgical apparatus main body of a laser surgical apparatus, particularly various optical systems provided in the surgical apparatus main body. It is explanatory drawing for demonstrating an example of an operation screen. It is a functional block diagram of a computer. It is explanatory drawing for demonstrating the line-of-sight input detection method of the line-of-sight input detection part using a Purkinje image. It is explanatory drawing for demonstrating the method of detecting the line-of-sight direction of an observation eye based on the captured image data of an observation eye. It is explanatory drawing for demonstrating an example of an operation instruction database. It is explanatory drawing which showed an example of the composite image of the observation image of the eye to be examined and the thumbnail image displayed in the observation field of view area. It is explanatory drawing for demonstrating the change of the display mode of the icon in the operation screen. It is explanatory drawing for demonstrating "enlargement control" by a micro display control unit. It is explanatory drawing for demonstrating "superimposition control" by a micro display control unit in a state which a magnified image is displayed in an observation field view area. "Enlargement control", "Reduction control", "Up and down movement control", "Left and right movement control", "Left rotation control", and "Left rotation control" by the micro display control unit while the enlarged image is displayed in the observation field of view. It is explanatory drawing for demonstrating "right rotation control". It is explanatory drawing for demonstrating "emphasis control" by the micro display control unit in the state which the enlarged image is displayed in the observation field of view area. It is a flowchart which shows an example of the flow of the laser operation of the eye to be examined by the laser operation apparatus.

[Construction of laser surgery equipment]
FIG. 1 is an external perspective view of a laser surgical apparatus 10 to which the ophthalmic observation apparatus of the present invention is applied. The laser surgical apparatus 10 is an intraocular surgery in which a therapeutic laser beam L2 (see FIG. 2) is irradiated to a treatment site in the eye E1 (see FIG. 2) of the subject H1 (see FIG. 2) for treatment. Used for.

As shown in FIG. 1, the laser surgical apparatus 10 is provided on the table 11. In addition to the laser surgical apparatus 10, a face support portion 12 and a monitor 13 are provided on the table 11. A foot switch 14 is provided below the table 11.

The face support portion 12 is provided on the table 11 between the subject H1 (see FIG. 2) and the laser surgery device 10. The face support portion 12 has a forehead pad 12a and a chin rest 12b whose positions can be adjusted in the vertical direction in the drawing, and supports the face of the subject H1 during intraocular surgery by the laser surgery device 10.

The monitor 13 is arranged on the table 11, for example, on the side of the laser surgical apparatus 10, and is connected to the laser surgical apparatus 10. As the monitor 13, for example, a touch panel type liquid crystal display device is used. The monitor 13 displays information on the subject H1 (see FIG. 2) and various setting screens of the laser surgical apparatus 10 [for example, an irradiation pattern of the laser beam L2 (see FIG. 2)]. Then, the operator H2 (see FIG. 2) can perform various settings of the laser surgery apparatus 10 by performing a touch operation on the setting screen on the monitor 13.

The foot switch 14 is an operation pedal that is operated by the operator H2 (see FIG. 2) by foot operation (pressing operation by foot), and is connected to the laser surgery device 10. The foot switch 14 is an operation switch for starting irradiation of the laser beam L2 (see FIG. 2) for treatment by the laser surgical apparatus 10.

The laser surgical apparatus 10 includes a base 16 (also referred to as a base) provided on the table 11, a drive unit 17 and an operation lever 18 provided on the base 16, and a surgical apparatus main body provided on the drive unit 17. 19 and.

The drive unit 17 movably holds the surgical device main body 19 on the base 16 in each direction of up and down, front and back, and left and right (each axial direction of the XYZ axes). The drive unit 17 moves the surgical apparatus main body 19 with respect to the base 16 in each of the above-described directions under the control of the computer 55 (see FIG. 2) described later in response to the operation of the operation lever 18 described later. This makes it possible to adjust the position of the surgical device main body 19 with respect to the eye to be inspected E1 (see FIG. 2).

The operating lever 18 is provided at the end of the base 16 on the operator H2 (see FIG. 2) side. The operation lever 18 is an operation unit for manually moving the surgical apparatus main body 19 in each direction of up / down, front / back, and left / right. For example, by rotating the operating lever 18 around its longitudinal axis (rotating clockwise or counterclockwise), the driving unit 17 moves the surgical apparatus main body 19 in the vertical direction. By tilting the operating lever 18 in the front-rear direction or the left-right direction, the drive unit 17 moves the surgical device main body 19 in the front-rear direction or the left-right direction.

The surgical apparatus main body 19, which will be described in detail later with reference to FIG. 2, is for illuminating the eye to be inspected E1, acquiring an observation image 50 of the eye to be inspected E1 by the operator H2, and treating the treatment site in the eye to be inspected E1. Irradiation of the laser beam L2 of the above. An eyepiece 20 is provided on the surgical apparatus main body 19. The operator H2 binocularly views the observation image 50 and the like of the eye E1 to be inspected through the eyepiece 20.

[Structure of surgical device body]
FIG. 2 is a schematic view of the configuration of the surgical apparatus main body 19 of the laser surgical apparatus 10, particularly various optical systems provided in the surgical apparatus main body 19. As shown in FIG. 2, the surgical apparatus main body 19 includes an illumination optical system 21, a laser beam irradiation optical system 22, an observation optical system 23, an imaging optical system 24, an image emission optical system 25, and a line-of-sight input detection. It includes an optical system 26.

The illumination optical system 21 causes the illumination light L1 (corresponding to the light of the present invention) to be incident on the eye E1 of the subject H1. The illumination optical system 21 includes an illumination light source 28, a lens 29, and a mirror 30.

As the illumination light source 28, for example, a halogen lamp or the like is used, and the illumination light L1 is emitted toward the lens 29. The lens 29 collects the illumination light L1 incident from the illumination light source 28 and causes the illumination light L1 to enter the mirror 30. The mirror 30 reflects the illumination light L1 incident from the illumination light source 28 toward the contact lens 31. The contact lens 31 is used for laser surgery of the eye E1 to be inspected, and is in contact with the eye E1 to be inspected while being held by one hand of the operator H2. The contact lens 31 causes the illumination light L1 incident from the mirror 30 and the laser light L2 incident from the laser light irradiation optical system 22 described later to be incident on the eye E1 to be inspected.

The laser light irradiation optical system 22 includes a laser light source 34, a mirror 35, and an objective lens 36. The laser light source 34 indicates the irradiation position of the laser light L2 for treatment that photocoagulates the treatment site of the eye E1 to be inspected and the laser light L2 for treatment, and aligns the laser light L2 for treatment with the treatment site. The aiming laser beam L2 and the laser beam L2 are emitted toward the mirror 35.

The mirror 35 reflects each laser beam L2 incident from the laser light source 34 toward the objective lens 36, and transmits the aiming laser beam L2 incident from the objective lens 36 and the reflected light L3 described later to the mirror 37. Make it incident. The objective lens 36 emits each laser beam L2 incident from the mirror 35 toward the contact lens 31. As a result, each laser beam L2 enters the eye E1 to be inspected via the contact lens 31.

The observation optical system 23 includes reflected light L3 (corresponding to the emitted light of the present invention) emitted from the eye to be inspected E1 due to the incident of the illumination light L1 from the illumination optical system 21, and the fluorescent fundus incident from the image emitting optical system 25 described later. The image 51 (image light) and the near-infrared light IR incident from the line-of-sight input detection optical system 26 described later are guided to the eyepieces 39 and 40. The observation optical system 23 shares the mirror 35 and the objective lens 36 described above with the laser beam irradiation optical system 22, and includes a mirror 37, a mirror 38, and a mirror 38IR.

The objective lens 36 emits reflected light L3 or the like incident from the eye E1 to be inspected through the contact lens 31 toward the mirror 35. As a result, the reflected light L3 and the like are incident on the mirror 37 through the mirror 35. For the mirror 37, for example, a beam splitter is used. The mirror 37 divides the reflected light L3 and the like incident from the objective lens 36, transmits a part of the reflected light L3 and the like as it is toward the protection filter 37P, and transmits the rest of the reflected light L3 and the like to the photographing optical system 24. It emits toward. The protection filter 37P cuts the light corresponding to the wavelength range of the therapeutic laser beam L2. The protection filter 37P emits the reflected light L3 or the like incident from the mirror 37 toward the mirror 38.

As the mirror 38, for example, a dichroic mirror or a half mirror is used. The mirror 38 transmits at least a part of the reflected light L3 and the like incident from the protection filter 37P as it is and emits the mirror 38 toward the mirror 38IR, and also emits the fluorescent fundus image 51 and the operation screen incident from the image emitting optical system 25 described later. At least a portion of 79 images (see FIGS. 2 and 3) is reflected towards the mirror 38IR.

As the mirror 38IR, for example, a dichroic mirror is used. The mirror 38IR transmits the reflected light L3 and the like incident from the mirror 38 and the images of the fluorescent fundus image 51 and the operation screen 79 as they are and emits them toward the eyepieces 39 and 40, and also emits the line-of-sight input detection optical system described later. The near-infrared light IR incident from 26 is reflected toward the eyepieces 39 and 40.

The eyepiece lenses 39 and 40 are provided on the eyepiece portion 20 described above. The observation eye E2 of the operator H2 is an observation image 50 of the eye to be inspected E1 formed based on the reflected light L3 incident from the mirror 38IR through the eyepieces 39 and 40, that is, the reflected light L3, a fluorescent fundus image 51, and an operation screen. While observing 79 images (see FIGS. 2 and 3), the near-infrared light IR incident through the eyepieces 39 and 40 is reflected. In the present embodiment, the optical axis of the reflected light L3 is shifted in the left-right direction (vertical direction on the paper surface in FIG. 2) with respect to the lens centers of the eyepieces 39 and 40. Therefore, in the observation field area R (see FIG. 6) of the operator H2, the center position of the observation image 50 is shifted in the left-right direction with respect to the center of the observation field area R.

Further, the eyepieces 39 and 40 emit the reflected light IR1 of the near-infrared light IR reflected by the observation eye E2 toward the mirror 38IR. The mirror 38IR reflects the reflected light IR1 incident from the eyepieces 39 and 40 toward the line-of-sight input detection optical system 26 described later.

The photographing optical system 24 constitutes the observation image acquisition unit of the present invention, and includes a lens 42 and an image pickup element 43. The lens 42 forms an image of the reflected light L3 reflected by the mirror 37 on the image pickup surface of the image pickup element 43. As the image sensor 43, for example, a CMOS (complementary metal oxide semiconductor) type or CCD (Charge Coupled Device) type image sensor is used. The image sensor 43 captures the reflected light L3 imaged on the image pickup surface, that is, the observation image 50 of the eye E1 to be inspected, and outputs the captured image data of the observation image 50.

The image emitting optical system 25 includes a micro display 46 (also referred to as a micro display projector) and a lens 47.

The micro display 46 is an image emitting unit that emits various images (image light of an image), for example, a reflective liquid crystal panel (Liquid crystal on silicon), DMD (Digital Micro mirror Device), MEMS (Micro Electro Mechanical Systems), and the like. An EL display (electroluminescence display), a transmissive liquid crystal display, a microscanner for image generation, and the like are used. The microdisplay 46 may include a relay optical system for emitting various images, and a collimation lens or a projection lens.

Further, the microdisplay 46 may have at least one or a plurality of an illumination source that emits visible light and an illumination source that emits invisible light, for example, in order to emit an infrared image or a color image. The illumination source may be a halogen lamp, a white light emitting diode (LED), one or more coaxial LEDs (eg, red, green, blue, amber, or near infrared LED), or one or more. Coaxial lasers (eg, red-green-blue (RGB) or near-infrared LEDs) and the like can be used.

The microdisplay 46 emits a fluorescent fundus image 51 (also referred to as a microdisplay image) of the eye to be inspected E1 obtained in advance by the fluorescein fluorescent fundus angiography as an image of the present invention toward the lens 47. The fluorescent fundus image 51 referred to here includes a thumbnail image 51S of the fluorescent fundus image 51 described later, an enlarged image 51E (including the original image of the fluorescent fundus image 51) obtained by enlarging the thumbnail image 51S, and a fluorescent fundus image. A blood vessel-enhanced image 51a and the like created based on the 51 are included.

The fluorescent fundus image 51 is an image showing the position of the blood vessel 58 in the eye to be inspected E1 as information related to the eye to be inspected E1. In the laser surgical apparatus 10, it is necessary to avoid irradiation of the blood vessel 58 (see FIG. 11) in the eye E1 to be treated with the laser beam L2 for treatment. Therefore, the operator H2 needs to confirm the fluorescent fundus image 51 of the eye E1 to be inspected before irradiating the eye E1 to be treated with the laser beam L2 for treatment.

Further, the micro display 46 outputs an image of the operation screen 79 in addition to the fluorescent fundus image 51. The operation screen 79 is an input screen for inputting operation instructions to the illumination optical system 21 (illumination light source 28) and the image emission optical system 25 (micro display 46) with the observation eye E2 of the operator H2. The operation screen 79 includes icons (see FIG. 3, corresponding to the object of the present invention) corresponding to each of a plurality of types of operation instructions.

FIG. 3 is an explanatory diagram for explaining an example of the operation screen 79. The X-axis and Y-axis in the figure indicate the coordinate axes of the operation screen 79. As shown in FIG. 3, the operation screen 79 is provided with a “Micro” column, a “brightness” column, and an “Overlay” column. In the "Micro" field, operation instructions related to the operation of the illumination light source 28 and the micro display 46 are input. In the "brightness" column, an operation instruction for adjusting the image quality (brightness) of the fluorescent fundus image 51 emitted from the microdisplay 46 is input. In the "Overlay" field, an operation instruction relating to the position adjustment of the fluorescent fundus image 51 emitted from the microdisplay 46 is input.

On the operation screen 79 of the present embodiment, a plurality of types of operation instructions (see FIG. 5), specifically, "on / off instruction", "switching instruction", and "selection instruction" are input by the line-of-sight input by the observation eye E2 of the operator H2. , "Decision instruction", "superimposition instruction", "first adjustment instruction", "second adjustment instruction", "emphasis instruction", "thumbnail image confirmation instruction" and the like can be input.

The “on / off instruction” is an operation instruction for turning on / off the power of the micro display 46. In the "Micro" field of the operation screen 79, an icon "ON" for inputting "on instruction" among "on / off instructions" and an icon "OFF" for inputting "off instruction" are provided. ing.

The "switching instruction" is an operation instruction for switching between the incident of the illumination light L1 from the illumination light source 28 to the eye E1 to be inspected and the emission of the fluorescent fundus image 51 from the microdisplay 46. In the "Micro" field of the operation screen 79, an icon "Change" for inputting a "switching instruction" is provided.

The "selection instruction" is an operation instruction for selecting one thumbnail image 51S to be enlarged from a plurality of thumbnail images 51S (see FIG. 6) to be described later, which are emitted from the microdisplay 46. In the "Micro" field of the operation screen 79, an icon "Up" and an icon "Down" for inputting a "selection instruction" are provided.

The "decision instruction" is an operation instruction for determining the enlargement execution of the thumbnail image 51S selected in the above-mentioned "selection instruction". In the "Micro" field of the operation screen 79, an icon "decision" for inputting a "decision instruction" is provided.

The "superimposition instruction" is an operation instruction for superimposing (overlaying) the fluorescence fundus image 51 on the observation image 50 of the eye to be inspected E1 observed by the observation eye E2 of the operator H2 through the eyepieces 39 and 40 (overlay). (See FIG. 9). In the "Overlay" field of the operation screen 79, an icon "Auto" for inputting an "overlay instruction" is provided.

The "first adjustment instruction" is an operation instruction for adjusting at least one of the position, size, and posture of the fluorescent fundus image 51 emitted from the microdisplay 46. This "first adjustment instruction" includes "enlargement instruction", "reduction instruction", "up / down movement instruction", "left / right movement instruction", "left rotation instruction", and "right rotation instruction".

The “enlargement instruction” is an operation instruction for enlarging the fluorescent fundus image 51 emitted from the microdisplay 46. Further, the "reduction instruction" is an operation instruction for reducing the fluorescent fundus image 51 emitted from the microdisplay 46. In the "Overlay" field of the operation screen 79, an icon "enlargement" for inputting an "enlargement instruction" and an icon "reduction" for inputting an "reduction instruction" are provided.

The "vertical movement instruction" is an operation instruction for moving the position of the fluorescent fundus image 51 emitted from the microdisplay 46 in the vertical direction within the observation field area R (see FIG. 6). The "left-right movement instruction" is an operation instruction for moving the position of the fluorescent fundus image 51 emitted from the microdisplay 46 in the left-right direction within the observation field area R. In the "Overlay" field of the operation screen 79, the icon "left" and the icon "right" for inputting the "left / right movement instruction", and the icon "up" and the icon "bottom" for inputting the "up / down movement instruction". "Is provided.

The “left rotation instruction” is an operation instruction for rotating the position of the fluorescent fundus image 51 emitted from the microdisplay 46 counterclockwise within the observation field area R (see FIG. 6). Further, the "right rotation instruction" is an operation instruction for rotating the position of the fluorescent fundus image 51 emitted from the microdisplay 46 to the right within the observation visual field region R. In the "Overlay" field of the operation screen 79, an icon "left turn" for inputting "left rotation instruction" and an icon "right turn" for inputting "right rotation instruction" are provided.

The "second adjustment instruction" is an operation instruction for adjusting the image quality, here, the brightness of the fluorescent fundus image 51 emitted from the microdisplay 46. The second adjustment instruction includes a "brightness increase instruction" and a "brightness decrease instruction". The "brightness increase instruction" is an operation instruction for increasing the brightness of the fluorescent fundus image 51 emitted from the microdisplay 46. Further, the "brightness reduction instruction" is an operation instruction for reducing the brightness of the fluorescent fundus image 51 emitted from the microdisplay 46. In the "brightness" field of the operation screen 79, an icon "Up" for inputting the "brightness increase instruction" and an icon "Down" for inputting the "brightness decrease instruction" are provided.

In this embodiment, which will be described in detail later, the brightness of the illumination light L1 emitted from the illumination light source 28 (observation image 50) according to the increase or decrease in the brightness of the fluorescent fundus image 51 emitted from the microdisplay 46. Brightness) is reduced. Therefore, the icon "Micro" and the icon "View" are provided in the "brightness" column. The icon "Micro" is an icon for inputting an operation instruction for increasing or decreasing the brightness of only the fluorescent fundus image 51. Further, the icon "View" is an icon for inputting an operation instruction for increasing or decreasing the brightness of only the illumination light L1 (observation image 50).

The "emphasis instruction" is an "operation instruction" for the operator H2 to confirm the position of the blood vessel-enhanced image 51a (see FIG. 11), that is, the blood vessel 58 (see FIG. 11) in the eye E1 to be inspected. In the "Micro" field of the operation screen 79, an icon "emphasis" for inputting an "emphasis instruction" is provided.

The "thumbnail image confirmation instruction" is an operation instruction for the operator H2 to confirm a plurality of thumbnail images 51S (see FIG. 6) described later. In the "Micro" field of the operation screen 79, an icon "thumbnail" for inputting a "thumbnail image confirmation instruction" is provided.

In addition to each icon, the cursor 80 is displayed (superposed) on the operation screen 79. The cursor 80 is an index indicating the line-of-sight position of the observation eye E2 of the operator H2 on the operation screen 79, and the input of the operation instruction on the operation screen 79, specifically, the selection of the icon on the operation screen 79. And used for determination. The cursor 80 is displayed at an initial position (for example, a position in the drawing) on the operation screen 79 in the initial state (when the power of the laser surgical apparatus 10 is turned on).

Then, the cursor 80 moves in the operation screen 79 according to the change in the line-of-sight position (line-of-sight direction) of the observation eye E2 of the operator H2 on the operation screen 79. As a result, the cursor 80 can be aligned with the desired icon simply by gazing at the desired icon in the operation screen 79 with the observation eye E2 of the operator H2. Then, for example, if this state is continued for a predetermined time (several seconds),
The operation instruction corresponding to the icon is input. Further, if the line-of-sight position of the observation eye E2 of the operator H2 deviates from the desired icon within the above-mentioned predetermined time, the input of the operation instruction is cancelled. An icon for inputting input execution and input cancellation of the operation instruction may be provided on the operation screen 79.

The display position and display mode of each icon are not limited to the display position and display mode shown in FIG. 3, and may be changed as appropriate.

Returning to FIG. 2, the lens 47 collects the fluorescent fundus image 51 and the image of the operation screen 79 incident from the microdisplay 46 and emits them toward the mirror 38 of the observation optical system 23. As a result, the fluorescent fundus image 51 and the image of the operation screen 79 merge with the observation optical system 23. As a result, the operator H2 can confirm the composite image (parallel image or superimposed image) of the observation image 50 of the eye E1 to be inspected, the fluorescence fundus image 51, and the operation screen 79 through the eyepieces 39 and 40.

The line-of-sight input detection optical system 26 includes an infrared LED 101, a pinhole 102, a condenser lens 103, a mirror 104, an imaging lens 105, a mirror 106, an image sensor 107, and a semiconductor position detection element (Position Sensitive). It includes a PSD 108, which is a Detector). The line-of-sight input detection optical system 26 may be provided in two corresponding to both the left and right eyes of the observation eye E2, or may be provided in only one corresponding to one of the left and right eyes.

The infrared LED 101 emits near-infrared light IR toward the pinhole 102. The pinhole 102 uses the near-infrared light IR incident from the infrared LED 101 as a point light source, and then emits the near-infrared light IR of the point light source toward the condenser lens 103. The condenser lens 103 emits the near-infrared light IR of the point light source incident from the pinhole 102 toward the mirror 104.

As the mirror 104, for example, a half mirror is used. The mirror 104 transmits a part of the near-infrared light IR of the point light source incident from the condenser lens 103 as it is toward the mirror 38IR of the observation optical system 23 described above. As a result, the near-infrared light IR of the point light source transmitted through the mirror 104 is reflected by the mirror 38IR toward the eyepieces 39 and 40, and is incident on the observation eye E2 through the eyepieces 39 and 40. Then, the reflected light IR1 of the near-infrared light IR of the point light source reflected by the observation eye E2 is incident on the mirror 38IR through the eyepieces 39 and 40, and is reflected toward the mirror 104 by the mirror 38IR. The mirror 104 reflects a part of the reflected light IR1 incident from the mirror 38IR toward the imaging lens 105.

The imaging lens 105 emits the reflected light IR1 incident from the mirror 104 toward the mirror 106. The mirror 106 reflects a part of the reflected light IR1 incident from the imaging lens 105 toward the image sensor 107, and transmits the rest of the reflected light IR1 incident from the imaging lens 105 as it is and emits it toward the PSD 108. To do.

The image sensor 107 is a CMOS type or CCD type image sensor, and the reflected light IR1 reflected by the mirror 106 is imaged as an image of the observation eye E2 on the image pickup surface. The image sensor 107 takes an image of the observation eye E2 imaged on the image pickup surface, and outputs the captured image data 110 (see FIG. 5) of the observation eye E2.

The reflected light IR1 incident from the mirror 106 is incident on the light receiving surface of the PSD 108. The PSD 108 is a sensor capable of detecting the light receiving position of the reflected light IR1 on the light receiving surface, and outputs a light receiving signal indicating the light receiving position. A line sensor may be used instead of the PSD 108.

The control (drive) of the drive unit 17, the illumination light source 28, the laser light source 34, the image pickup element 43, the microdisplay 46, the infrared LED 101, the image pickup element 107, and the PSD 108 is provided inside (or outside) the laser surgical apparatus 10. It is performed by the computer 55 (arithmetic processing device). The computer 55 controls the operation of each part of the laser surgical apparatus 10 in an integrated manner.

The computer 55 includes the monitor 13, the operation lever 18 (potentiometer for detecting the rotation operation and tilt operation of the operation lever 18), the foot switch 14, the drive unit 17, the illumination light source 28, the laser light source 34, and the image sensor 43. In addition to the microdisplay 46, the infrared LED 101, the image sensor 107, and the PSD 108, the image database 57 is connected.

The image database 57 is a database (server) for medical support that stores medical information and the like of the subject H1 who is a patient, and "IMAGEnetR4" of Topcon Medical Japan Co., Ltd. can be mentioned as an example. In this image database 57, a plurality of fluorescent fundus images 51 obtained by fluorescein fluorescent fundus angiography of the eye E1 of the subject H1 are obtained with the unique identification information of the subject H1 (name and patient of the subject H1). It is stored in association with the number, etc.).

Further, based on the fluorescent fundus image 51 (original image), a blood vessel-enhanced image 51a in which the blood vessel 58 (see FIG. 11), which is a characteristic portion of the eye E1 to be inspected, is emphasized is created in advance and associated with the original fluorescent fundus image 51. Is stored in the image database 57. Since the method for generating the blood vessel-enhanced image 51a (the method for enhancing the blood vessel 58) is a known technique, a specific description thereof will be omitted here.

[Computer configuration]
FIG. 4 is a functional block diagram of the computer 55. As shown in FIG. 4, the computer 55 includes a general control unit 61 corresponding to the control unit of the present invention, an image acquisition unit 62, an observation image acquisition unit 63, a line-of-sight input detection unit 64B, and an operation instruction detection unit 65B. , And an operation instruction database 66A.

The central control unit 61 is an arithmetic circuit composed of various arithmetic units including a CPU (Central Processing Unit) or an FPGA (field-programmable gate array), a memory, and the like. A monitor 13, a foot switch 14, an operation lever 18, an image acquisition unit 62, an observation image acquisition unit 63, a line-of-sight input detection unit 64B, an operation instruction detection unit 65B, and an operation instruction database 66A are connected to the integrated control unit 61. Has been done. Then, based on the instructions and information (images) from each of these units, the integrated control unit 61 controls (drives) the drive unit 17, the illumination light source 28, the laser light source 34, the microdisplay 46, and the like described above.

The image acquisition unit 62 has various interfaces connected to the image database 57. Under the control of the integrated control unit 61 (microdisplay control unit 73 described later), the image acquisition unit 62 acquires the fluorescent fundus image 51 and the blood vessel-enhanced image 51a corresponding to the eye to be inspected E1 to be operated from the image database 57. Is output to the integrated control unit 61. For example, when the operator H2 performs a touch operation for inputting the name and patient number of the subject H1 on the touch panel type monitor 13, the image acquisition unit 62 receives the subject H1 under the control of the general control unit 61. The fluorescent fundus image 51 and the blood vessel-enhanced image 51a corresponding to the name and the patient number are acquired from the image database 57 and output to the integrated control unit 61.

The observation image acquisition unit 63 constitutes the observation image acquisition unit of the present invention together with the photographing optical system 24 described above, and has various interfaces connected to the image sensor 43. Under the control of the integrated control unit 61 (microdisplay control unit 73 described later), the observation image acquisition unit 63 acquires the captured image data of the observation image 50 from the image sensor 43 and outputs the captured image data to the integrated control unit 61. Based on the captured image data of the observation image 50, the position, size, and posture of the eye E1 to be inspected in the observation image 50 observed by the operator H2 through the eyepieces 39 and 40 can be determined.

The line-of-sight input detection unit 64B constitutes the line-of-sight input detection unit of the present invention together with the line-of-sight input detection optical system 26 described above, and is connected to the image sensor 107 and the PSD 108, respectively. The line-of-sight input detection unit 64B detects the line-of-sight input of the observation eye E2 based on the captured image data 110 (see FIG. 5) of the observation eye E2 input from the image pickup element 107 and the received light signal input from the PSD 108. Specifically, the position coordinates of the gazing point on the operation screen 79 that the observing eye E2 is gazing at are detected.

FIG. 5 is an explanatory diagram for explaining a line-of-sight input detection method (cornea detection method) of the line-of-sight input detection unit 64B using the Purkinje image 110p. As shown in the upper part of FIG. 5, on the corneal surface of the observation eye E2, the Pulkinje image 110p, which is a reflected image of the near-infrared light IR, is generated by the incident of the near-infrared light IR of the point light source. The position of the Purkinje image 110p changes according to the change in the line-of-sight direction of the observation eye E2.

Therefore, as shown in the lower part of FIG. 5, the line-of-sight input detection unit 64B in the observation eye E2 is based on the captured image data 110 of the observation eye E2 input from the image sensor 107 and the light receiving signal input from the PSD 108. The position coordinate C1 of the Pulkinje image 110p is detected. Then, the line-of-sight input detection unit 64B detects the line-of-sight direction of the observation eye E2 based on the relative position between the position of the Purkinje image 110p indicated by the position coordinates C1 and the center of the pupil. The method of detecting the line-of-sight direction using the Purkinje image 110p is a known technique, and detailed description thereof will be omitted. Further, although the PSD 108 is used in the present embodiment, the PSD 108 may be omitted and the position coordinates C1 of the Purkinje image 110p may be detected based only on the captured image data 110 input from the image sensor 107.

FIG. 6 is an explanatory diagram for explaining a method of detecting the line-of-sight direction of the observation eye E2 based on the captured image data 110 of the observation eye E2 (sclera reflection method, dark pupil method). In this method, the incident of the near-infrared light IR of the point light source on the observation eye E2 can be omitted. The line-of-sight input detection unit 64B acquires the captured image data 110 of the observation eye E2 from the image pickup element 107 as shown in the upper part of FIG. 6, and then obtains the captured image data 110 of the observation eye E2 as shown in the middle part of FIG. It is binarized at a predetermined brightness threshold. Since the pupil of the observation eye E2 has a lower brightness than the surrounding region, when the captured image data 110 is binarized, the region corresponding to the pupil of the observation eye E2 becomes a black pixel region, and the region around the pupil becomes a black pixel region. Is the white pixel area. Thereby, the pupil region of the observation eye E2 can be specified from the captured image data 110 of the observation eye E2.

Then, as shown in the lower part of FIG. 6, the line-of-sight input detection unit 64B obtains the center coordinates C2 of the pupil region (black pixel region) of the observation eye E2 from the binarized image data 110 of the observation eye E2. , The line-of-sight direction of the observation eye E2 is detected based on the obtained center coordinates C2 and the known geometric structure of the eyeball. Since the detection of the line-of-sight direction by the scleral reflection method (dark pupil method) is a known technique, detailed description thereof will be omitted.

Returning to FIG. 4, the line-of-sight input detection unit 64B notes on the operation screen 79 that the observation eye E2 is gazing at based on the detected eye-gaze direction of the observation eye E2 and the observation magnification of the known observation optical system 23. The position coordinates of the viewpoint are detected, and the detection result of the position coordinates of the gazing point is output to the operation instruction detection unit 65B and the general control unit 61 (microdisplay control unit 73 described later), respectively.

The operation instruction detection unit 65B constitutes the operation instruction detection unit of the present invention together with the operation instruction database 66A. In addition to the integrated control unit 61 and the line-of-sight input detection unit 64B, the operation instruction database 66A is connected to the operation instruction detection unit 65B.

FIG. 7 is an explanatory diagram for explaining an example of the operation instruction database 66A. As shown in FIG. 7, the operation instruction database 66A contains the position coordinates of each icon in the operation screen 79 shown in FIG. 3, the type of operation instruction corresponding to each icon, and each operation instruction. The corresponding control contents of the illumination light source 28 and the micro display 46 are stored in association with each other. That is, in the present embodiment, the illumination light source 28 and the microdisplay 46 correspond to the operation target of the present invention.

The position coordinates (X1, Y1) to (X19, Y19) of each icon do not indicate the position coordinates of one point, and each icon occupies in the operation screen 79 shown in FIG. 3 described above. It is a position coordinate range indicating a range.

The position coordinates (X1, Y1) are the position coordinates (range) of the icon "ON", and the position coordinates (X2, Y2) are the position coordinates (range) of the icon "OFF". In the operation instruction database 66A, "on / off instruction" which is an operation instruction corresponding to the icon "ON" and the icon "OFF" and "on / off control" which is a control content corresponding to the "on / off instruction" are set. ing. The “on / off control” is a control for turning on / off the power of the micro display 46.

The position coordinates (X3, Y3) are the position coordinates (range) of the icon "Change". In the operation instruction database 66A, an operation instruction "switching instruction" corresponding to the icon "Change" and a control content "switching control" corresponding to the "switching instruction" are set. The "switching control" is a control for switching between the incident of the illumination light L1 from the illumination light source 28 to the eye E1 to be inspected and the emission of the fluorescent fundus image 51 from the microdisplay 46.

The position coordinates (X4, Y4) are the position coordinates (range) of the icon "Up" in the "Micro" column, and the position coordinates (X5, Y5) are the position coordinates (range) of the icon "Down" in the "Micro" column. is there. In the operation instruction database 66A, "selection instruction" which is an operation instruction corresponding to the icon "Up" and the icon "Down" and "selection control" which is a control content corresponding to the "selection instruction" are set. ing. The "selection control" is a control for selecting one thumbnail image 51S from a plurality of thumbnail images 51S (see FIG. 8) emitted from the microdisplay 46.

The position coordinates (X6, Y6) are the position coordinates (range) of the icon "decision". In the operation instruction database 66A, an operation instruction "decision instruction" corresponding to the icon "decision" and a control content "decision control" corresponding to the "decision instruction" are set. The "determination control" is a control for enlarging the thumbnail image 51S selected by the "selection instruction" (see FIG. 10).

The position coordinates (X7, Y7) are the position coordinates (range) of the icon "Auto". In the operation instruction database 66A, an operation instruction "superimposition instruction" corresponding to the icon "Auto" and a control content "superimposition control" corresponding to the "superimposition instruction" are set. The “superimposition control” is a control for superimposing the fluorescent fundus image 51 emitted from the microdisplay 46 on the observation image 50 (see FIG. 11).

The position coordinates (X8, Y8) are the position coordinates (range) of the icon "enlargement". In the operation instruction database 66A, an operation instruction "expansion instruction" corresponding to the icon "expansion" and a control content "expansion control" corresponding to the "expansion instruction" are set. The “enlargement control” is a control for enlarging the fluorescent fundus image 51 emitted from the microdisplay 46.

The position coordinates (X9, Y9) are the position coordinates (range) of the icon "reduction". In the operation instruction database 66A, an operation instruction "reduction instruction" corresponding to the icon "reduction" and a control content "reduction control" corresponding to the "enlargement instruction" are set. The "reduction control" is a control for reducing the fluorescent fundus image 51 emitted from the microdisplay 46.

The position coordinates (X10, Y10) are the position coordinates (range) of the icon "top", and the position coordinates (X11, Y11) are the position coordinates (range) of the icon "bottom". In the operation instruction database 66A, there are "up / down movement instruction" which is an operation instruction corresponding to the icon "up" and "down", and "up / down movement control" which is a control content corresponding to this "up / down movement instruction". Is set. The "vertical movement control" is a control for moving the position of the fluorescent fundus image 51 emitted from the microdisplay 46 in the vertical direction within the observation field area R (see FIG. 8).

The position coordinates (X12, Y12) are the position coordinates (range) of the icon "left", and the position coordinates (X13, Y13) are the position coordinates (range) of the icon "right". In the operation instruction database 66A, there are "left / right movement instruction" which is an operation instruction corresponding to the icon "left" and "right", and "left / right movement control" which is a control content corresponding to this "left / right movement instruction". Is set. The "left-right movement control" is a control for moving the position of the fluorescent fundus image 51 emitted from the microdisplay 46 in the left-right direction within the observation field area R (see FIG. 8).

The position coordinates (X14, Y14) are the position coordinates (range) of the icon "left turn". In the operation instruction database 66A, "left rotation instruction" which is an operation instruction corresponding to the icon "left rotation" and "left rotation control" which is a control content corresponding to this "left rotation instruction" are set. .. The “left rotation control” is a control for rotating the posture of the fluorescent fundus image 51 emitted from the microdisplay 46 counterclockwise within the observation field area R (see FIG. 8).

The position coordinates (X15, Y15) are the position coordinates (range) of the icon "right turn". In the operation instruction database 66A, "right rotation instruction" which is an operation instruction corresponding to the icon "right rotation" and "right rotation control" which is a control content corresponding to this "right rotation instruction" are set. .. The “right rotation control” is a control for rotating the posture of the fluorescent fundus image 51 emitted from the microdisplay 46 clockwise within the observation field area R (see FIG. 8).

The position coordinates (X16, Y16) are the position coordinates (range) of the icon "Up" in the "brightness" column. In the operation instruction database 66A, "brightness increase instruction" which is an operation instruction corresponding to the icon "Up" and "brightness increase control" which is a control content corresponding to this "brightness increase instruction" are set. ing. The “brightness increase control” is a control for increasing the brightness of the fluorescent fundus image 51 emitted from the microdisplay 46.

The position coordinates (X17, Y17) are the position coordinates (range) of the icon "Down" in the "brightness" column. In the operation instruction database 66A, "brightness reduction instruction" which is an operation instruction corresponding to the icon "Down" and "brightness reduction control" which is a control content corresponding to this "brightness reduction instruction" are set. ing. The “brightness reduction control” is a control for reducing the brightness of the fluorescent fundus image 51 emitted from the microdisplay 46.

The position coordinates (X18, Y18) are the position coordinates (range) of the icon "emphasis". In the operation instruction database 66A, an operation instruction "emphasis instruction" corresponding to the icon "emphasis" and a control content "emphasis control" corresponding to the "emphasis instruction" are set. The "enhancement control" is a control for emitting a blood vessel-enhanced image 51a corresponding to the fluorescent fundus image 51 instead of the fluorescent fundus image 51 from the microdisplay 46 (see FIG. 13).

The position coordinates (X19, Y19) are the position coordinates (range) of the icon "thumbnail". In the operation instruction database 66A, "thumbnail image confirmation instruction" which is an operation instruction corresponding to the icon "thumbnail" and "thumbnail image emission control" which is a control content corresponding to this "thumbnail image confirmation instruction" are set. ing. The “thumbnail image emission control” is a control for emitting a plurality of thumbnail images 51S from the micro display 46 (see FIG. 8).

Returning to FIG. 4, the operation instruction detection unit 65B refers to the operation instruction database 66A based on the position coordinates of the gazing point on the operation screen 79 input from the line-of-sight input detection unit 64B, and the position coordinates of the gazing point are each. When the position coordinates (range) of any of the icons are matched and this state continues for a predetermined time or longer, it is determined that the operation instruction corresponding to the position coordinates (icon) has been input. As a result, the operation instruction detection unit 65B can detect the type of operation instruction input by the line-of-sight input of the observation eye E2 of the operator H2. Then, the operation instruction detection unit 65B refers to the operation instruction database 66A and determines the control contents of the illumination light source 28 and the micro display 46 corresponding to the detected operation instruction. Next, the operation instruction detection unit 65B outputs the determined control content to the overall control unit 61 (illumination light source control unit 71 and micro display control unit 73, which will be described later).

[Functions of the integrated control unit]
The integrated control unit 61 functions as a drive control unit 70, an illumination light source control unit 71, a laser light source control unit 72, and a micro display control unit 73 by executing a control program read from a memory (not shown) or the like.

The drive control unit 70 controls the drive of the drive unit 17 to move the surgical device main body 19 relative to the base 16. For example, the drive control unit 70 controls the drive of the drive unit 17 with respect to the base 16 based on the result of detecting the tilting operation of the operation lever 18 in the front-rear direction and the left-right direction with a linear motion potentiometer (not shown). The surgical device main body 19 is relatively moved in the front-back direction and the left-right direction. Further, the drive control unit 70 controls the drive of the drive unit 17 based on the result of detecting the rotation operation of the operation lever 18 with a rotary potentiometer (not shown), and causes the surgical apparatus main body 19 to move up and down with respect to the base 16. Move relative to each other.

The illumination light source control unit 71 controls the on / off of the power supply of the illumination light source 28. Specifically, the illumination light source control unit 71 turns on / off the power of the illumination light source 28 according to the on / off of the power of the laser surgical apparatus 10. Further, when the illumination light source control unit 71 receives the input of the determination result of the "switching control" from the operation instruction detection unit 65B described above, the illumination light source control unit 71 responds to the on / off of the power of the micro display 46 by the micro display control unit 73 described later. The power of the illumination light source 28 is turned off and on.

The laser light source control unit 72 controls the emission of the laser beam L2 for treatment and aiming from the laser light source 34. The laser light source controller 72, in response to the pressing operation of the foot switch 14 causes emits laser light L2 for the treatment from the laser light source 34. Regarding the emission of the laser beam L2 for aiming from the laser light source 34, when the laser light source 34 is switched from the standby mode to the operation mode for emitting the laser beam L2 for treatment in response to the pressing operation of the foot switch 14. It is always done.

The micro display control unit 73 controls the micro display 46. In the initial state, the microdisplay control unit 73 of the present embodiment emits a thumbnail image 51S (corresponding to the reduced image of the present invention) obtained by reducing each of the plurality of fluorescent fundus images 51 of the eye E1 to be inspected, as described above. The microdisplay 46 is made to output the image of the operation screen 79. In the initial state, the image emitted from the microdisplay 46 is not limited to the thumbnail image 51S, and may be another image such as the enlarged image 51E described later. Further, in the initial state, the power of the micro display 46 may be turned off.

FIG. 8 is an explanatory diagram showing an example of a composite image of the observation image 50 of the eye to be inspected E1 displayed in the observation visual field region R, the thumbnail image 51S, and the operation screen 79. The display referred to here means that the eyepieces 39, 40 and the like can be observed by the observation eye E2 of the operator H2.

As shown in FIG. 8, the microdisplay control unit 73 reduces the thumbnail images 51S of a plurality of fluorescent fundus images 51 of the eye E1 to be inspected (for example, n: n is a natural number of 3 or more) acquired by the image acquisition unit 62. To generate. Then, the micro-display control unit 73 emits a plurality of (for example, m: m is a natural number of 2 or more and less than n) thumbnail images 51S out of the generated n thumbnail images 51S from the micro-display 46. As a result, m thumbnail images 51S are displayed in the observation field area R of the operator H2.

In the present embodiment, the center position of the observation image 50 in the observation field area R is shifted in the left-right direction with respect to the center of the observation field area R as described above. Then, the microdisplay control unit 73 controls the emission position of each thumbnail image 51S emitted from the microdisplay 46 to display each thumbnail image 51S at a position adjacent to the observation image 50 in the observation field area R. .. As a result, the observation image 50 and each thumbnail image 51S can be simultaneously confirmed by the observation eye E2 of the operator H2. The number of thumbnail images 51S emitted from the microdisplay 46, that is, the number of thumbnail images 51S displayed in the observation field area R may be one.

Further, when another thumbnail image 51S that is not displayed in the observation field area R exists, the micro display control unit 73 emits the switching icon 75 of the thumbnail image 51S from the micro display 46. For example, the micro display control unit 73 controls the emission position of the switching icon 75 (image light) from the micro display 46, and displays the switching icon 75 at a position adjacent to each thumbnail image 51S. As a result, the operator H2 can recognize the existence of another thumbnail image 51S.

Further, when the micro display control unit 73 displays two or more thumbnail images 51S in the observation field area R, the micro display 46 displays an image selection icon 76 indicating the thumbnail image 51S to be enlarged and controlled, which will be described later. Emit from. For example, the microdisplay control unit 73 controls the emission position of the image of the image selection icon 76 from the microdisplay 46 so that the image selection icon 76 is adjacent to any of the thumbnail images 51S in the observation field area R. Display at the position. As a result, the operator H2 can determine the thumbnail image 51S that is the target of the enlargement control.

On the other hand, the micro-display control unit 73 outputs an image of the operation screen 79 (see FIG. 3) stored in advance from the micro-display 46. Then, the micro display control unit 73 controls the output position of the image of the operation screen 79 from the micro display 46, so that the operation screen is located at a position in the observation field area R where the observation image 50 and each thumbnail image 51S are not displayed. 79 is displayed.

At this time, the micro display control unit 73 currently selects the icon "ON" and the icon "OFF", the icon "decision", the icon "emphasis", and the icon "thumbnail" in the operation screen 79. The one corresponding to the controlled content is displayed in a display mode different from the others. For example, in FIG. 8, since the power of the micro display 46 is turned on and each thumbnail image 51S is emitted from the micro display 46, the display mode of the icon “ON” and the icon “thumbnail” is changed.

Further, the microdisplay control unit 73 emits an image of the cursor 80 from the microdisplay 46, and in the initial state, the cursor 80 is superimposed and displayed on the above-mentioned initial position (see FIG. 3) on the operation screen 79. In addition, the position where the image of the cursor 80 is emitted from the microdisplay 46 is controlled.

Further, the microdisplay control unit 73 changes the emission position of the image of the cursor 80 from the microdisplay 46 based on the position coordinates of the gazing point sequentially input from the line-of-sight input detection unit 64B described above. As a result, the display position of the cursor 80 on the operation screen 79 in the observation visual field area R moves in conjunction with the change in the line-of-sight direction of the observation eye E2 of the operator H2. As a result, the cursor 80 can be aligned with the desired icon in the operation screen 79 by simply gazing at the desired icon in the operation screen 79 with the observation eye E2 of the operator H2. Then, the operator H2 can input the operation instruction by the line of sight by continuing the state of gazing at the desired icon in the operation screen 79 with the observation eye E2 for a predetermined time. If the position of the gazing point deviates from the icon within a predetermined time, the line-of-sight input of the operation instruction is canceled.

Furthermore, the microdisplay control unit 73 has set the gazing point (cursor 80) to any of the icons in the operation screen 79 (the observation eye E2 is gazing at any of the icons). And, so that the operator H2 can recognize that this state has continued for a predetermined time or more (that is, the line-of-sight input of the operation instruction has been executed), the display mode of the icon in the operation screen 79 is changed according to each of these stages. Change.

FIG. 9 is an explanatory diagram for explaining a change in the display mode of the icon in the operation screen 79. As shown in the upper part of FIG. 9, the microdisplay control unit 73 has the position coordinates of the gazing point sequentially input from the line-of-sight input detection unit 64B and the position coordinates of each icon acquired by accessing the operation instruction database 66A (FIG. 9). 7) and compare.

Then, based on the above comparison result, the microdisplay control unit 73 determines that the gazing point (cursor 80) is aligned with any of the icons (here, the icon “Auto”) as shown in the middle of FIG. If so, the microdisplay 46 is controlled to change the display mode of the corresponding icon by one step. Next, as shown in the lower part of FIG. 9, the microdisplay control unit 73 controls the microdisplay 46 when the state in which the gazing point is aligned with the icon continues for a predetermined time or longer, and displays the corresponding icon. Is changed one more time. As a result, the operator H2 can recognize that the gazing point (cursor 80) is aligned with any of the icons in the operation screen 79 and that the operation instruction is input.

In the micro display control unit 73, the icons whose display mode is changed are the icons "Up", "Down", "Change", "emphasis" in the "Micro" column, and the icons in the "brightness" column. , If it is any of the icons in the "Overlay" column, the display mode of the icon is restored after the corresponding control content (enlargement control) is executed.

Returning to FIGS. 4 and 8, the microdisplay control unit 73 performs various controls on the microdisplay 46 based on the determination result of the control content input from the operation instruction detection unit 65B described above.

Specifically, the micro display control unit 73 receives the input of the determination result of "on / off control" from the operation instruction detection unit 65B, and turns on the power when the power of the micro display 46 is off, and conversely, the micro display 46. When the power of the display 46 is on, the power is turned off. As a result, the display of each thumbnail image 51S is turned on and off in the observation field area R.

The microdisplay control unit 73 receives the input of the determination result of "switching control" from the operation instruction detection unit 65B, and turns off and on the power of the microdisplay 46 according to the on / off of the power of the illumination light source 28 by the illumination light source control unit 71. To do. As a result, each time the determination result of "switching control" from the operation instruction detection unit 65B is input to both the illumination light source control unit 71 and the microdisplay control unit 73, the illumination light L1 to the eye E1 to be inspected by the illumination light source 28 Is switched between the incident and the emission of the fluorescent fundus image 51 from the microdisplay 46. That is, the display of the observation image 50 and the display of each thumbnail image 51S are alternately executed in the observation field area R.

The microdisplay control unit 73 controls the microdisplay 46 each time the input of the determination result of the “selection control” is received from the operation instruction detection unit 65B described above, and the image selection icon 76 is displayed in the observation field area R. The indicated thumbnail image 51S is switched to another thumbnail image 51S (including those not displayed in the observation field area R). As a result, the operator H2 can select the desired thumbnail image 51S as the target of the enlargement control described later.

In the present embodiment, the thumbnail image 51S, which is the target of the enlargement control described later, can be identified by the image selection icon 76 displayed in the observation field area R, but the display mode of the image selection icon 76 is shown in FIG. The display mode is not limited to that shown in 8, and may be changed as appropriate. Further, in the observation field area R, the thumbnail image 51S is emitted from the microdisplay 46 so that the display mode of either the thumbnail image 51S to be enlarged or controlled and the other thumbnail image 51S is changed. May be controlled.

FIG. 10 is an explanatory diagram for explaining “enlargement control” by the microdisplay control unit 73. As shown in FIG. 10, the microdisplay control unit 73 receives the input of the determination result of the “enlargement control” from the operation instruction detection unit 65B described above, and targets the enlargement control in the above-mentioned “selection control”. An enlarged image 51E of the selected thumbnail image 51S is generated, and the enlarged image 51E is emitted from the microdisplay 46. The enlarged image 51E may be a fluorescent fundus image 51 before reduction, that is, an original image. As a result, the enlarged image 51E of the thumbnail image 51S indicated by the image selection icon 76 is displayed in the observation field area R. As a result, the operator H2 can confirm more detailed information [position of treatment site, position of blood vessel 58 (see FIG. 13), etc.] than the thumbnail image 51S.

In addition, when the micro display control unit 73 receives the input of the determination result of "selection control" from the operation instruction detection unit 65B described above while the enlarged image 51E is being emitted, that is, the operator H2 observes the eyes. When the line-of-sight input of the "selection instruction" is performed in E2, the enlarged image 51E emitted from the microdisplay 46 is switched to another enlarged image 51E. As a result, the enlarged image 51E displayed in the observation field area R is switched.

FIG. 11 is an explanatory diagram for explaining "superimposition control" by the microdisplay control unit 73 in a state where the enlarged image 51E is displayed in the observation field of view region R. As shown in FIG. 11, when the microdisplay control unit 73 receives the input of the determination result of the “superimposition control” from the operation instruction detection unit 65B, the microdisplay control unit 73 superimposes and displays the enlarged image 51E on the observation image 50 in the observation field area R. Let me.

For example, the microdisplay control unit 73 analyzes the enlarged image 51E and the captured image data of the observation image 50 acquired from the observation image acquisition unit 63. Then, based on this analysis result, the microdisplay control unit 73 controls the emission position, size, and posture of the enlarged image 51E emitted by the microdisplay 46, and each part of the eye E1 to be inspected included in the enlarged image 51E [ The position, size, and posture of the macula, blood vessel 58 (see FIG. 13)] are superposed to match each part of the eye E1 to be inspected included in the observation image 50 in the observation visual field region R. As a specific method of this superimposition control, known methods such as a phase-limited correlation method, a pattern matching method, and a template matching method are used. As a result, the observation image 50 and the enlarged image 51E are superimposed and displayed in the observation field area R.

Although the case where the enlarged image 51E is superimposed on the observation image 50 in the observation field area R has been described in FIG. 11, an image other than the enlarged image 51E may be superimposed. For example, when the microdisplay control unit 73 displays a plurality of thumbnail images 51S in the observation field area R as shown in FIG. 8, the microdisplay control unit 73 indicates the thumbnail image 51S (or the thumbnail image 51S) indicated by the image selection icon 76. Superimposition control is performed so that the original fluorescent fundus image 51) is superimposed on the observation image 50 in the observation field area R. Further, when the blood vessel-enhanced image 51a (see FIG. 13) described later is displayed in the observation visual field region R, the microdisplay control unit 73 displays the blood vessel-enhanced image 51a as the observation image 50 in the observation visual field region R. Superimposition control is performed.

FIG. 12 shows “enlargement control”, “reduction control”, “vertical movement control”, “left-right movement control”, and “left / right movement control” by the microdisplay control unit 73 in a state where the enlarged image 51E is displayed in the observation field area R. It is explanatory drawing for demonstrating "left rotation control" and "right rotation control".

As shown in the upper part of FIG. 12, when the operation instruction detection unit 65B receives the input of the determination result of "expansion control" or "reduction control", the microdisplay control unit 73 controls the microdisplay 46 to enlarge the image. The image 51E is enlarged (see arrow T1) or reduced (see arrow T2) by a predetermined magnification. As a result, the enlarged image 51E is further enlarged or reduced in the observation field area R.

As shown in the lower part of FIG. 12, when the operation instruction detection unit 65B receives the input of the determination result of "vertical movement control", the microdisplay control unit 73 controls the microdisplay 46 to raise the enlarged image 51E. It is moved in the direction (see arrow T3) or downward (see arrow T4) by a predetermined distance. Further, when the micro display control unit 73 receives the input of the determination result of "left / right movement control" from the operation instruction detection unit 65B, the micro display control unit 73 controls the micro display 46 to move the enlarged image 51E to the left (see arrow T5) or. Move it to the right (see arrow T6) by a predetermined distance. As a result, the display position of the enlarged image 51E can be moved in any direction up, down, left, and right within the observation field area R.

Further, when the micro display control unit 73 receives the input of the determination result of "left rotation control" or "right rotation control" from the operation instruction detection unit 65B, the micro display control unit 73 controls the micro display 46 to change the posture of the enlarged image 51E. Rotate counterclockwise by a predetermined angle (see arrow T7) or clockwise by a predetermined angle (see arrow T8). As a result, the posture of the magnified image 51E can be arbitrarily adjusted within the observation field of view R.

Although the case of adjusting the position, size, and posture of the enlarged image 51E has been described in FIG. 12, images other than the enlarged image 51E, for example, each thumbnail image 51S shown in FIG. 8 described above, and the thumbnail image 51S described later will be described later. The position, size, and posture of the blood vessel-enhanced image 51a (see FIG. 13) and the like can be adjusted in the same manner.

Returning to FIG. 10, the microdisplay control unit 73 received the input of the determination result of “brightness increase control” from the operation instruction detection unit 65B while the enlarged image 51E was displayed in the observation field area R. In this case, the brightness of the enlarged image 51E emitted from the microdisplay 46 is increased by a predetermined amount. On the contrary, when the micro display control unit 73 receives the input of the determination result of "brightness reduction control" from the operation instruction detection unit 65B, the micro display control unit 73 reduces the brightness of the enlarged image 51E emitted from the micro display 46 by a predetermined amount. Let me. Thereby, the brightness of the enlarged image 51E displayed in the observation field of view R can be arbitrarily adjusted.

At this time, the illumination light source control unit 71 increases the brightness of the illumination light L1 emitted by the illumination light source 28 in conjunction with the increase in the brightness of the enlarged image 51E emitted from the microdisplay 46 by the microdisplay control unit 73. That is, the brightness of the observation image 50 displayed in the observation field area R is reduced by a predetermined amount. On the contrary, the illumination light source control unit 71 increases the brightness of the illumination light L1 emitted by the illumination light source 28 in conjunction with the decrease in the brightness of the enlarged image 51E emitted from the microdisplay 46 by the microdisplay control unit 73. That is, the brightness of the observation image 50 displayed in the observation field area R is increased by a predetermined amount. As a result, the contrast difference between the observation image 50 and the enlarged image 51E can be enlarged.

Instead of linking the brightness of the enlarged image 51E with the brightness of the observation image 50 (illumination light L1), the icon "Micro" in the "brightness" column in the operation screen 79 shown in FIG. 3 described above or The brightness of the enlarged image 51E and the brightness of the observation image 50 (illumination light L1) may be increased or decreased separately by executing the selection operation and the determination operation of the icon “View”. In this case, in the operation instruction database 66A shown in FIG. 7 described above, the coordinates of the icon “View” corresponding to the illumination light source 28, the operation instruction, and the control contents, and the icon “Micro” corresponding to the micro display 46 are displayed. The coordinates, operation instructions, and control contents are stored.

Further, the brightness of images other than the enlarged image 51E, for example, each thumbnail image 51S shown in FIG. 8 described above, and the blood vessel emphasized image 51a (see FIG. 13) described later can be adjusted in the same manner. Further, various image quality adjustments (gamma adjustment and sharpness adjustment) other than the brightness of the enlarged image 51E and the like may be performed.

FIG. 13 is an explanatory diagram for explaining "emphasis control" by the microdisplay control unit 73 in a state where the enlarged image 51E is displayed in the observation field area R. When the micro-display control unit 73 receives the input of the determination result of "emphasis control" from the operation instruction detection unit 65B, the micro-display control unit 73 obtains the blood vessel-enhanced image 51a corresponding to the enlarged image 51E emitted by the micro-display 46. Get from. Next, the microdisplay control unit 73 emits the blood vessel-enhanced image 51a adjusted according to the position, size, and posture of the enlarged image 51E from the microdisplay 46. As a result, as shown in FIG. 13, the enlarged image 51E displayed in the observation field area R is switched to the blood vessel-enhanced image 51a. As a result, the operator H2 can grasp the position of the blood vessel 58 in the eye E1 to be inspected.

Further, when the blood vessel-enhanced image 51a is superimposed on the observation image 50 in the observation field area R as described with reference to FIG. 11, that is, when "superimposition control" and "emphasis control" are combined, the operation is performed. Person H2 can irradiate the therapeutic laser beam L2 while surely avoiding the blood vessel 58 in the eye E1 to be examined.

Although the case where the enlarged image 51E displayed in the observation field area R is switched to the blood vessel-enhanced image 51a has been described with reference to FIG. 13, images other than the enlarged image 51E, for example, each thumbnail shown in FIG. 8 described above, have been described. The image 51S may be switched to the blood vessel-enhanced image 51a, respectively. Further, instead of generating the blood vessel-enhanced image 51a from the fluorescent fundus image 51 in advance, the microdisplay control unit 73 analyzes the fluorescent fundus image 51 (including the enlarged image 51E and the thumbnail image 51S) and features in the image. A portion (blood vessel 58) may be detected and a blood vessel-enhanced image 51a may be generated based on the detection result.

Returning to FIG. 8, the micro-display control unit 73 determines the “thumbnail image emission control” from the operation instruction detection unit 65B in a state where the enlarged image 51E or the blood vessel-enhanced image 51a is displayed in the observation field area R. When the input of is received, a plurality of (m) thumbnail images 51S are emitted from the micro display 46. As a result, the display in the observation field area R can be returned to the display of the observation image 50 and each thumbnail image 51S, that is, the initial state.

As described above, when the operator H2 inputs the line-of-sight of the operation instruction with the observation eye E2, the illumination light source control unit 71 and the micro display control unit 73 control the illumination light source 28 and the micro display 46 corresponding to the operation instruction. It can be performed.

[Action of laser surgical device]
FIG. 14 is a flowchart showing an example of the flow of laser surgery of the eye to be inspected E1 by the laser surgery device 10 having the above configuration (the operating method of the ophthalmic observation device of the present invention). When the operator H2 turns on the power of the laser surgical apparatus 10, the illumination light source control unit 71 of the integrated control unit 61 turns on the power of the illumination light source 28. As a result, the illumination light L1 is emitted from the illumination light source 28. In addition, the integrated control unit 61 starts emitting near-infrared light IR from the infrared LED 101.

Then, the operator H2 inputs the name and the patient number of the subject H1 in advance via the touch panel type monitor 13. As a result, the image acquisition unit 62 acquires a plurality of fluorescent fundus images 51 and blood vessel-enhanced images 51a corresponding to the name and patient number of the subject H1 from the image database 57, and the integrated control unit 61 (microdisplay control unit 73). ) Is output.

Next, the operator H2 adjusts the positions of the forehead pad 12a and the chin rest 12b of the face support portion 12, and adjusts the position of the surgical apparatus main body 19 by tilting and rotating the operating lever 18, and then sets the eye to be inspected E1. The positional relationship with the surgical device main body 19 is adjusted (step S21). When this adjustment is completed, the illumination light L1 from the illumination light source 28 enters the eye E1 to be inspected via the illumination optical system 21 and the contact lens 31, and the reflected light emitted from the eye E1 in response to the incident of the illumination light L1. L3 is guided to the optometry lenses 39 and 40 via the contact lens 31 and the observation optical system 23. As a result, the observation image 50 can be confirmed by the observation eye E2 of the operator H2 through the eyepieces 39 and 40 (step S22).

A part of the reflected light L3 is imaged on the image pickup surface of the image pickup element 43 from the middle of the observation optical system 23 via the photographing optical system 24, and is imaged by the image pickup element 43. As a result, the captured image data of the observation image 50 is input from the image pickup element 43 to the overall control unit 61 (microdisplay control unit 73) via the observation image acquisition unit 63.

On the other hand, the micro display control unit 73 generates thumbnail images 51S of a plurality of (n) fluorescent fundus images 51 acquired from the image acquisition unit 62, and m thumbnail images out of the generated n thumbnail images 51S. The 51S is emitted from the microdisplay 46 (step S23). Further, the micro-display control unit 73 outputs the image of the operation screen 79 stored in advance from the micro-display 46 (step S23).

The m thumbnail images 51S and the images of the operation screen 79 emitted from the microdisplay 46 are guided to the eyepieces 39 and 40 via the image emitting optical system 25 and a part of the observation optical system 23. As a result, as shown in FIG. 8 described above, the observation image 50, each thumbnail image 51S, and the operation screen 79 are combined and displayed (parallel display) in the observation field area R, and are displayed on the observation eye E2 of the operator H2. The observation image 50, each thumbnail image 51S, and the operation screen 79 can be confirmed at the same time.

Further, the near-infrared light IR emitted from the infrared LED 101 enters the observation eye E2 through the line-of-sight input detection optical system 26, a part of the observation optical system 23, and the eyepieces 39 and 40. As a result, the reflected light IR1 reflected by the observation eye E2 is incident on the image pickup element 107 and the PSD 108 via the eyepieces 39 and 40, a part of the observation optical system 23, and the line-of-sight input detection optical system 26. As a result, the image pickup element 107 outputs the image pickup image data 110 of the observation eye E2 to the line-of-sight input detection unit 64B, and the PSD 108 outputs a light receiving signal.

The line-of-sight input detection unit 64B, which receives the input of the captured image data 110 of the observation eye E2 from the image pickup element 107 and the input of the light-receiving signal from the PSD 108, receives the line-of-sight of the observation eye E2 based on the captured image data 110 and the light-receiving signal. Detect the direction. Then, the line-of-sight input detection unit 64B is based on the detected line-of-sight direction of the observation eye E2 and the observation magnification of the known observation optical system 23, and the position coordinates of the gazing point on the operation screen 79 that the observation eye E2 is gazing at. Is detected, and the detection result of the position coordinates of the gazing point is output to the operation instruction detection unit 65B and the micro display control unit 73, respectively. As a result, the line-of-sight input by the observation eye E2 of the operator H2 is started (step S24, corresponding to the line-of-sight input detection step of the present invention).

When the operator H2 executes any of the control contents of the illumination light source 28 and the microdisplay 46 shown in FIG. 7, the operator H2 starts the line-of-sight input of the operation instruction, that is, the operation screen 79 in the observation field area R. Gaze at the corresponding icon (YES in step S25). As a result, the position coordinates of the gazing point output from the line-of-sight input detection unit 64B to the operation instruction detection unit 65B and the micro-display control unit 73, respectively, change with the change in the line-of-sight direction of the observation eye E2.

Then, the microdisplay control unit 73, which receives the input of the position coordinates of the gazing point from the line-of-sight input detection unit 64B, changes the emitting position of the image of the cursor 80 emitted from the microdisplay 46 based on the position coordinates of the gazing point. Let me. As a result, the display position of the cursor 80 on the operation screen 79 in the observation field area R moves to the icon being watched by the observation eye E2.

On the other hand, the operation instruction detection unit 65B, which receives the input of the position coordinates of the gazing point from the line-of-sight input detection unit 64B, refers to the operation instruction database 66A, and the position coordinates of the gazing point are the position coordinates (range) of any of the icons. ), And if the matched state continues for a predetermined time or longer, it is determined that the operation instruction corresponding to the position coordinates (icon) has been input. As a result, the operation instruction detection unit 65B detects the type of the operation instruction input by the line-of-sight input of the observation eye E2 of the operator H2, and also refers to the operation instruction database 66A to correspond to the detected operation instruction. The control contents of the illumination light source 28 and the microdisplay 46 are determined (step S26, corresponding to the operation instruction detection step of the present invention). The determination result of the control content by the operation instruction detection unit 65B is output to at least one of the illumination light source control unit 71 and the micro display control unit 73 according to the control content.

At this time, the microdisplay control unit 73 is aligned with the gazing point (cursor 80) as shown in FIG. 9 above, based on the position coordinates of the gazing point input from the line-of-sight input detecting unit 64B. The display mode of the icon is changed by one step. Then, the micro display control unit 73 receives the input of the determination result of the control content from the operation instruction detection unit 65B, and changes the display mode of the icon one more step. As a result, the operator H2 can recognize that the gazing point is aligned with the icon in the operation screen 79 and that the line-of-sight input of the operation instruction is executed.

Upon receiving the input of the determination result of the control content from the operation instruction detection unit 65B, the illumination light source control unit 71 executes the control of the illumination light source 28 (switching control and the like described above) according to the control content (step 7). Further, the microdisplay control unit 73, which receives the input of the determination result of the control content from the operation instruction detection unit 65B, controls the microdisplay 46 according to the control content (on / off control, switching control, enlargement control, superimposition control described above). , Enlargement / reduction control, emphasis control, etc.) (step S27). Note that step S27 corresponds to the control step of the present invention.

For example, when both the above-mentioned "superimposition control" and "emphasis control" are executed, the blood vessel-enhanced image 51a is superimposed and displayed on the observation image 50 in the observation visual field region R, so that the operator H2 can see the eye to be examined. The position of the blood vessel 58 in E1 can be surely grasped. At this time, the "superimposition control" and the "emphasis control" can be executed based on the operation instruction input by the operator H2 with the observation eye E2. Therefore, even when the operator H2 holds the contact lens with one hand and holds the operation lever 18 with the other hand, the operator H2 does not separate the observation eye E2 from the eyepiece 20 and performs "superimposition control" and "Emphasis control" can be executed hands-free.

On the other hand, when the laser light source 34 is switched from the above-described standby mode to the operation mode after the power of the laser surgical apparatus 10 is turned on, the laser light L2 for aiming is started to be emitted from the laser light source 34. As a result, the laser beam L2 for aiming is incident on the eye E1 to be inspected via the laser beam irradiation optical system 22 and the contact lens 31. The operator H2 adjusts the position of the surgical apparatus main body 19 by operating the operation lever 18 and the like while observing the laser beam L2 for aiming reflected by the eye to be inspected E1 through the contact lens 31 and the observation optical system 23. Then, the position adjustment between the laser beam L2 for aiming and the treatment site in the eye E1 to be inspected is completed (YES in step S28).

Next, when the operator H2 presses the foot switch 14, the laser light L2 for treatment is emitted from the laser light source 34, and the laser light L2 for treatment is emitted via the laser light irradiation optical system 22 and the contact lens 31. The treatment site in the eye to be inspected E1 is irradiated (step S29). This completes the intraocular surgery of the eye to be inspected E1 by the laser surgery device 10.

[Effect of this embodiment]
As described above, in the laser surgical apparatus 10 of the present embodiment, even if both hands of the operator H2 are blocked, the illumination light source corresponding to the operation instruction is based on the operation instruction input by the operator H2 with the observation eye E2. Various control contents of the 28 and the microdisplay 46 can be executed. Thereby, the operability of the laser surgical apparatus 10 can be remarkably improved.

[Other]
In the above embodiment, the operator H2 controls the illumination optical system 21 (illumination light source 28) and the image emission optical system 25 (microdisplay 46) corresponding to the operation instruction based on the operation instruction input by the observation eye E2. However, the present invention is not limited to this, and only the image emitting optical system 25 may be controlled. Further, for example, a modulation element (DMD and a transmissive liquid crystal panel) that modulates at least one of the reflected light L3 and the image (throttle image 51S, enlarged image 51E, blood vessel emphasized image 51a, etc.) emitted from the microdisplay 46. Etc.) are provided in the observation optical system 23, the observation optical system 23 (modulation element) may be controlled at the same time.

In the above embodiment, as the line-of-sight input detection method by the line-of-sight input detection unit 64B, the method using the Purkinje image 110p described in FIG. 5 described above and the scleral reflection method (dark pupil method) described in FIG. 6 described above. ) Has been described as an example, but the present invention is not limited thereto. For example, a known line of sight such as a method using the positional relationship between a reference point such as the inner corner of the eye of the operator H2 and a moving point such as the iris of the observation eye E2, and a method of detecting the movement of the observation eye E2 using an electro-oculography sensor. An input detection method can be used.

In the above embodiment, the control contents of the illumination light source 28 and the microdisplay 46 corresponding to various operation instructions input by the operator H2 with the observation eye E2 will be described using the operation instruction database 66A of FIG. 7 described above. However, the types of operation instructions and control contents are not limited to those listed in the operation instruction database 66A, and include other operation instructions and control contents (for example, display of the original image of the fluorescent fundus image 51). You may.

In the above embodiment, the fluorescent fundus image 51 (throat image 51S, enlarged image 51E, and blood vessel emphasized image 51a) is emitted from the microdisplay 46, and the eye to be inspected obtained in advance by, for example, an OCT (Optical Coherene Tomography) examination. An image showing information related to the eye to be inspected E1, such as a tomographic image of the retina of E1, may be emitted. In addition, an image (textual information) showing information related to the laser surgical apparatus 10 (irradiation pattern of the laser beam L2 for treatment, etc.) and information related to the eye E1 to be inspected (patient number, medical history, etc.) of the subject H1. The image is included) may be emitted from the microdisplay 46.

In the above embodiment, the blood vessel-enhanced image 51a has been described as an example of emphasizing the characteristic portion of the eye E1 to be inspected, but an emphasized image emphasizing other characteristic portions (for example, macula) of the eye E1 to be inspected is used instead. You may use it.

In the above embodiment, the laser surgical apparatus 10 has been described as an example of the ophthalmic observation apparatus of the present invention. For example, a surgical microscope, a fundus camera, OCT, an SLO (Scanning Laser Ophthalmoscope), an axial length meter, and a slit lamp have been described. The present invention can also be applied to a refractometer, a keratometer, a tonometer, a specular microscope, and a combination machine thereof. That is, the present invention can be applied to various ophthalmic observation devices capable of observing the observation image 50 of the eye E1 to be inspected through the eyepieces 39 and 40, but in particular, the ophthalmic observation in which both hands of the operator H2 are blocked. It is preferably applied to the device.

10 ... Laser surgical device, 14 ... Foot switch, 19 ... Surgical device body, 20 ... Eyepiece, 21 ... Illumination optical system, 23 ... Observation optical system, 24 ... Imaging optical system, 25 ... Image emission optical system, 26 ... Line-of-sight input detection optical system, 28 ... illumination light source, 39 ... eyepiece lens, 40 ... eyepiece lens, 43 ... image pickup element, 46 ... microdisplay, 50 ... observation image, 51E ... magnified image, 51S ... thumbnail image, 51a ... blood vessel enhancement Image, 51 ... Fluorescent fundus image, 55 ... computer, 57 ... image database, 61 ... general control unit, 62 ... image acquisition unit, 63 ... observation image acquisition unit, 64B ... line-of-sight input detection unit, 65B ... operation instruction detection unit, 66A ... Operation instruction database, 71 ... Illumination light source control unit, 73 ... Micro display control unit, 107 ... Image pickup element, 108 ... PSD

Claims (10)

Illumination optics that inject light into the eye to be inspected,
An image emitting optical system that emits an image and
An observation optical system that guides the emitted light emitted from the eye to be inspected in response to the incident of light from the illumination optical system and the image emitted by the image emitting optical system to the eyepieces, respectively.
A line-of-sight input detection unit that detects the line-of-sight input of the operator,
An operation instruction input by the line-of-sight input detected by the line-of-sight input detection unit, and an operation target including the illumination optical system, the image emission optical system, and at least the image emission optical system among the observation optical systems. Operation instruction detection unit that detects operation instructions for
A control unit that controls the operation target based on the operation instruction detected by the operation instruction detection unit, and a control unit that controls the operation target.
Equipped with a,
The image emitting optical system is based on an image of an operation screen including a plurality of types of objects corresponding to the plurality of types of operation instructions as the image and a detection result of the line-of-sight input detection unit. The image of the gazing point being watched on the operation screen and the image of the gazing point are emitted,
The observation optical system guides the image of the operation screen emitted from the image emitting optical system to the eyepiece.
The operation instruction detecting unit, when the on the operation screen plurality of matching state is a state in which the gaze point by pairs were combined in any object continues for a predetermined time or longer, the gazing point is combined There line detection of the operation instruction corresponding to the obtained selected object,
Based on the detection result of the line-of-sight input detection unit, the image emitting optical system changes the display mode of the selected object by one step when the gazing point is adjusted to the selected object on the operation screen, and further, the above. An ophthalmic observation device that changes the display mode of the selected object by another step when the matching state continues for the predetermined time or longer. The operation instruction detection unit detects an on / off instruction for displaying the image by the image emitting optical system as the operation instruction.
The ophthalmic observation device according to claim 1 , wherein the control unit performs on / off control for turning on / off the emission of the image by the image emission optical system when the operation instruction detection unit detects the on / off instruction. The operation target includes the illumination optical system and the image emission optical system.
As the operation instruction, the operation instruction detection unit detects a switching instruction for switching between the incident of the light by the illumination optical system and the emission of the image by the image emission optical system.
When the operation instruction detecting unit detects the switching instruction, the control unit controls the illumination optical system and the image emitting optical system to perform switching control between the incident of the light and the emission of the image. Item 2. The ophthalmic observation device according to item 1 or 2. The image emitting optical system emits a plurality of reduced images of the image.
As the operation instruction, the operation instruction detection unit includes a selection instruction for selecting the reduced image to be enlarged among the plurality of reduced images, and a decision instruction for determining the enlargement of the reduced image selected by the selection instruction. Detected and
From claim 1, the control unit controls the image emitting optical system to enlarge the reduced image selected by the selection instruction when the operation instruction detecting unit detects the selection instruction and the determination instruction. The ophthalmic observation device according to any one of 3. When the reduced image is enlarged, the operation instruction detection unit detects, as the operation instruction, a brightness adjustment instruction for adjusting the brightness of the enlarged image which is the enlarged reduced image.
When the operation instruction detection unit detects the brightness adjustment instruction, the control unit controls the image emitting optical system to adjust the brightness of the enlarged image, and increases or decreases the brightness of the enlarged image. The ophthalmic observation device according to claim 4, wherein the light incident on the eye to be inspected from the illumination optical system is reduced accordingly. An observation image acquisition unit for acquiring an observation image of the eye to be inspected formed by the emitted light is provided.
As the operation instruction, the operation instruction detection unit detects a superimposition instruction for matching the position, size, and posture of the image with the observation image.
When the operation instruction detection unit detects the superposition instruction, the control unit controls the image emission optical system based on the result of analyzing the image and the observation image acquired by the observation image acquisition unit. The ophthalmic observation device according to any one of claims 1 to 5, wherein superimposition control is performed so that the position, size, and posture of the image are matched with the observation image. The operation instruction detection unit detects, as the operation instruction, a first adjustment instruction for adjusting at least one of the position, size, and posture of the image.
When the operation instruction detecting unit detects the first adjustment instruction, the control unit controls the image emitting optical system and adjusts the image emitted from the image emitting optical system according to the first adjusting instruction. The ophthalmic observation device according to any one of claims 1 to 6. The operation instruction detection unit detects a second adjustment instruction for adjusting the image quality of the image as the operation instruction.
The control unit controls the image emitting optical system when the operation instruction detection unit detects the second adjustment instruction, and adjusts the image quality of the image according to the second adjustment instruction according to claims 1 to 7. The ophthalmic observation device according to any one of the following items. The image is an image containing information about the characteristic portion of the eye to be inspected.
The operation instruction detection unit detects an emphasis instruction for emphasizing the feature portion as the operation instruction.
The control unit controls the image emitting optical system to emit the image in which the characteristic portion is emphasized when the operation instruction detecting unit detects the emphasis instruction. Any one of claims 1 to 8. The ophthalmic observation device described in 1. An illumination optical system that injects light into the eye to be inspected, an image exit optical system that emits an image, an emission light emitted from the eye to be inspected in response to the incident of light from the illumination optical system, and an image exit optical system. In the method of operating an ophthalmic observation device including an observation optical system that guides the emitted image to an optometry lens, respectively.
The line-of-sight input detection process in which the line-of-sight input detection unit detects the line-of-sight input of the operator,
The operation instruction detection unit is an operation instruction input by the line-of-sight input detected by the line-of-sight input detection unit, and at least the image in the illumination optical system, the image emission optical system, and the observation optical system. An operation instruction detection step for detecting an operation instruction for an operation target including an emission optical system,
A control process in which the control unit controls the operation target based on the operation instruction detected by the operation instruction detection unit.
Have a,
The image emitting optical system is based on an image of an operation screen including a plurality of types of objects corresponding to the plurality of types of operation instructions as the image and a detection result of the line-of-sight input detection step. The image of the gazing point being watched on the operation screen and the image of the gazing point are emitted,
The observation optical system guides the image of the operation screen emitted from the image emitting optical system to the eyepiece.
In the operation instruction detection step, when the coincidence state in which the gazing point is aligned with any of the plurality of types of objects continues for a predetermined time or longer on the operation screen, the gazing point is aligned. The operation instruction corresponding to the selected object is detected, and the operation instruction is detected.
Based on the detection result of the line-of-sight input detection step, the image emitting optical system changes the display mode of the selected object by one step when the gazing point is adjusted to the selected object on the operation screen, and further, the above. A method of operating an ophthalmic observation device that changes the display mode of the selected object by another step when the matching state continues for the predetermined time or longer.

Images