JP7199895B2 - ophthalmic equipment - Google Patents

Description

The present disclosure relates to ophthalmic devices.

An ophthalmologic apparatus is an eye refractive power measuring apparatus that objectively measures the refractive power of an eye to be examined, and measures the eye refractive power while changing the presentation position of a fixation target fixed by the eye to be examined from a far point to a near point. It is known to obtain the accommodative power of an eye to be inspected by measuring it (see Patent Document 1).

This ophthalmologic apparatus changes the presentation position of the fixation target by moving the light source and the fixation target plate in the optical axis direction, and measures the refractive power of the eye when changing from the far point to the near point. The accommodation power of the eye to be examined is sought as possible.

JP 2014-147570 A

Here, in order to appropriately obtain the accommodative power, it is desirable to measure the refractive power of each eye while actually looking at a visual target that moves from far to near. On the other hand, the above-described ophthalmologic apparatus simply moves the light source and the fixation target plate in the optical axis direction, and there is room for improvement from the viewpoint of appropriately obtaining accommodation power.

The present disclosure has been made in view of the above circumstances, and an object thereof is to provide an ophthalmologic apparatus capable of appropriately determining the accommodative power of an eye to be examined.

In order to solve the above-described problems, an ophthalmologic apparatus according to the present disclosure is provided in pairs corresponding to both eyes to be examined of a subject, and presents a fixation image to the eyes to be examined. an eye information acquisition unit that acquires information of; a driving mechanism that adjusts the positions of the two eye information acquisition units and rotates them about the corresponding eyeball rotation point of the eye to be examined; the eye information acquisition unit; a control unit that performs an accommodative force measurement step of acquiring information about the subject's eye while changing the presentation position of the fixation image between far and near in a state of binocular vision by controlling the drive mechanism; wherein, in the accommodative force measuring step, the control unit adjusts the focus distance of the fixation image in the eye information acquisition unit and the fixation image presented by the eye information acquisition unit in accordance with a change in the presentation position. It is characterized in that the size of the visual image and the angle of rotation of the eye information acquisition unit are changed integrally.

According to the ophthalmologic apparatus of the present disclosure, it is possible to appropriately obtain the accommodative power of the subject's eye.

1 is an explanatory diagram showing the overall configuration of an ophthalmologic apparatus according to a first embodiment as an example of an ophthalmologic apparatus according to the present disclosure; FIG. FIG. 4 is an explanatory view schematically showing a configuration in which a pair of measuring heads are movable via a drive mechanism in an ophthalmologic apparatus; FIG. 3 is an explanatory diagram showing a schematic configuration of an eye information acquisition unit of an ophthalmologic apparatus; 3 is a block diagram showing the configuration of the control system of the ophthalmologic apparatus; FIG. FIG. 4 is an explanatory diagram showing the configuration of an optical system of an eye information acquisition unit; FIG. 10 is an explanatory diagram showing the relationship between the focal distance, the rotation angle, and the size of the fixation image on the display with respect to changes in the presentation position; FIG. 10 is an explanatory diagram showing the relationship between the presentation position, the focusing distance, and the rotation angle; It is a figure which shows an example of the accommodative force measurement screen displayed on the display part of an ophthalmologic apparatus. 4 is a flowchart showing accommodation measurement processing (accommodation measurement method) executed by the control unit of the ophthalmologic apparatus.

Example 1 of an ophthalmic device 10 as one embodiment of the ophthalmic device according to the present disclosure will be described below with reference to FIGS. 1 to 9 . 5, 6, and 7 omit the deflecting member 26 in order to facilitate understanding of the configuration and contents shown therein.

As shown in FIG. 1, the ophthalmologic apparatus 10 includes a base 11 installed on the floor, an optometry table 12, a column 13, an arm 14 as a support, a drive mechanism 15, and a pair of measurement heads. 16 and. The ophthalmologic apparatus 10 is configured such that the subject facing the eye examination table 12 presses the forehead against the forehead support 17 provided between the measuring heads 16, and the subject's eye to be examined E (see FIG. 3). etc.). Hereinafter, when viewed from the subject, the left-right direction is the X direction, the up-down direction (vertical direction) is the Y direction, and the direction orthogonal to the X and Y directions (the depth direction of the measurement head 16 (the subject side is The front side)) is the Z direction.

The optometry table 12 is a desk on which an examiner controller 31 and a subject controller 32 (see FIG. 4), which will be described later, are placed, and objects used for optometry are placed, and is supported by the base 11 . . The optometric table 12 may be supported by the base 11 so that its position in the Y direction (height position) can be adjusted.

The post 13 is erected in the Y direction from the rear end of the optometry table 12, and an arm 14 is provided on the top. The arm 14 suspends a pair of measuring heads 16 on the optometry table 12 via a drive mechanism 15, and extends in the Z direction from the column 13 toward the near side. The arm 14 is movable in the Y direction with respect to the column 13, and its position (height position) in the Y direction is adjusted by an arm drive mechanism 34 (see FIG. 4), which will be described later. In addition, the arm 14 may be movable in the X direction and the Z direction with respect to the column 13 . Both measuring heads 16 are suspended from the tip of the arm 14 by a drive mechanism 15 and supported.

The measuring heads 16 are provided in pairs so as to individually correspond to the left and right eyes E of the subject to be examined. do. The left eye measurement head 16L acquires information on the left eye E of the subject, and the right eye measurement head 16R acquires information on the right eye E of the subject. The left-eye measurement head 16L and the right-eye measurement head 16R are configured to be symmetrical with respect to a vertical plane positioned between them in the X direction.

Each measuring head 16 includes an eye information acquisition unit 21 (referred to as a right eye information acquisition unit 21R and a left eye information acquisition unit 21L (see FIG. 2) when describing separately) for acquiring eye information of the eye E to be examined. Contained. The eye information always includes the refractive power of the eye E to be examined, and also includes an image of the eye E to be examined, an image of the fundus Ef of the eye E to be examined (see FIG. 4), and a retina of the eye E to be examined. , the corneal endothelium image of the eye to be examined E, the corneal shape of the eye to be examined E, the intraocular pressure of the eye to be examined E, and the like are appropriately combined. Each eye information acquiring unit 21 necessarily includes a refractive power measuring mechanism (a refractometer in the first embodiment) for measuring refractive power, and a target presenting mechanism for presenting a target on the same optical axis. Each eye information acquiring unit 21 also includes a visual acuity testing device that performs a visual acuity test while switching the target to be presented, a phoropter that switches and arranges corrective lenses to acquire an appropriate corrective refractive power of the eye to be inspected E, A wavefront sensor that measures refractive power, a fundus camera that takes images of the fundus, a tomography device that takes tomographic images of the retina (OCT (Optical Coherence Tomography)), a specular microscope that takes images of the corneal endothelium, and a corneal shape measurement A keratometer for measuring intraocular pressure, a tonometer for measuring intraocular pressure, etc. are appropriately combined. Note that the refractive power measuring mechanism is not limited to the configuration of the first embodiment as long as it can measure eye refractive power on the same optical axis as the optotype presenting mechanism.

Both measuring heads 16 are movably suspended by a drive mechanism 15 via a mounting base portion 18 provided at the tip of the arm 14, as shown in FIG. In the first embodiment, the drive mechanism 15 includes a left vertical drive section 22L, a left horizontal drive section 23L, a left Y-axis rotation drive section 24L, a left X-axis rotation drive section 25L, and a right eye measurement head 16L. It has a right vertical drive section 22R, a right horizontal drive section 23R, a right Y-axis rotation drive section 24R, and a right X-axis rotation drive section 25R corresponding to the measurement head 16R. The configuration of each drive unit corresponding to the left eye measurement head 16L and the configuration of each drive unit corresponding to the right eye measurement head 16R are plane symmetrical with respect to a vertical plane positioned between them in the X direction. They are simply referred to as a vertical drive section 22, a horizontal drive section 23, a Y-axis rotation drive section 24, and an X-axis rotation drive section 25, unless otherwise specified. The drive mechanism 15 is provided with a vertical drive section 22, a horizontal drive section 23, a Y-axis rotation drive section 24, and an X-axis rotation drive section 25 in this order from the arm 14 side.

The mounting base portion 18 is fixed to the tip of the arm 14 and extends in the X direction. A right vertical drive section 22R, a right horizontal drive section 23R, a right Y-axis rotation drive section 24R, and a right X-axis rotation drive section 25R are suspended from the other end. A forehead support portion 17 is provided in the central portion of the mounting base portion 18 .

The vertical driving portion 22 is provided between the mounting base portion 18 and the horizontal driving portion 23 and moves the horizontal driving portion 23 in the Y direction (vertical direction) with respect to the mounting base portion 18 . The horizontal drive unit 23 is provided between the vertical drive unit 22 and the Y-axis rotation drive unit 24, and moves the Y-axis rotation drive unit 24 in the X direction and the Z direction (horizontal direction) with respect to the vertical drive unit 22. . The vertical drive unit 22 and the horizontal drive unit 23 include an actuator such as a pulse motor that generates a driving force, and a transmission mechanism that transmits the driving force such as a combination of gears or a rack and pinion. set up and configured. The horizontal drive unit 23 can be easily configured and easily controlled for movement in the horizontal direction by providing separate combinations of actuators and transmission mechanisms for the X and Z directions, for example.

The Y-axis rotation drive unit 24 is provided between the horizontal drive unit 23 and the X-axis rotation drive unit 25, and the X-axis rotation drive unit 25 is connected to the horizontal drive unit 23 at the corresponding eyeball rotation point of the eye E to be examined. Rotate around the Y-axis eyeball rotation axis extending in the Y direction through . The X-axis rotation drive section 25 is provided between the Y-axis rotation drive section 24 and the corresponding measurement head 16, and rotates the corresponding measurement head 16 with respect to the Y-axis rotation drive section 24 to the eyeball of the eye E to be examined. Rotation is performed around the X-axis eyeball rotation axis extending in the X direction through the rotation point. The Y-axis rotation driving section 24 and the X-axis rotation driving section 25, for example, have an actuator and a transmission mechanism like the vertical driving section 22 and the horizontal driving section 23, and the transmission mechanism receives the driving force from the actuator. moves along an arcuate guide groove. The Y-axis rotation drive unit 24 can rotate the measurement head 16 around the Y-axis eyeball rotation axis of the eye E to be examined by aligning the center position of the guide groove with the Y-axis eyeball rotation axis. Further, the X-axis rotation drive unit 25 can rotate the measuring head 16 about the X-axis eyeball rotation axis of the eye E to be examined by aligning the center position of the guide groove with the X-axis eyeball rotation axis. That is, the measurement head 16 is arranged such that the central positions of the guide grooves of the Y-axis rotation drive unit 24 and the X-axis rotation drive unit 25 are aligned with the eyeball rotation point of the eye E to be examined. , in the left-right direction (rotating direction about the Y direction) and the vertical direction (rotating direction about the X direction).

The Y-axis rotation driving section 24 supports the measuring head 16 so as to be rotatable around its own Y-axis rotation axis, and cooperates with the horizontal driving section 23 to rotate the measuring head through the X-axis rotation driving section 25 . The measurement head 16 may be rotated around the Y-axis eyeball rotation axis of the eye E to be inspected by rotating while changing the supporting position of the measurement head 16 . In addition, the X-axis rotation driving section 25 supports the measuring head 16 so as to be rotatable around the X-axis rotation axis provided therein, and cooperates with the vertical driving section 22 to change the position at which the measuring head 16 is supported. By rotating, the measurement head 16 may be rotated around the X-axis ocular rotation axis of the eye E to be examined.

As a result, the driving mechanism 15 can move the measuring heads 16 individually or in conjunction with each other in the X, Y, and Z directions, and move the respective measuring heads 16 around the eyeball rotation point of the corresponding subject's eye E. It can be rotated vertically and horizontally, and each measuring head 16 can be moved to a position (orientation) corresponding to the rotation of the corresponding eye E to be examined. By adjusting the position of each measuring head 16, the driving mechanism 15 can cause the corresponding subject's eye E to diverge (divergence movement) or converge (convergence movement). As a result, the ophthalmologic apparatus 10 can perform a divergence motion test and a convergence motion test, perform a distance test and a near test in a state of binocular vision, and measure various characteristics of both eyes E to be examined.

Each measuring head 16 is provided with a deflecting member 26 , and information on the corresponding subject's eye E is acquired by the eye information acquisition unit 21 through the deflecting member 26 . As shown in FIG. 3, the ophthalmologic apparatus 10 adjusts the positions of the measurement heads 16 so that the deflecting members 26 are positioned corresponding to the left and right eyes E of the subject. With both eyes open (binocular vision state), information on the subject's eye E can be obtained simultaneously with both eyes. In addition, the ophthalmologic apparatus 10 changes the rotation posture of each measuring head 16 about the X-axis eyeball rotation axis by the X-axis rotation drive unit 25, so that the corresponding subject's eye E is viewed downward or upward. Information on the eye E to be examined can be acquired. Then, the ophthalmologic apparatus 10 changes the rotational posture of each measuring head 16 about the Y-axis eyeball rotation axis by the Y-axis rotation drive unit 24, thereby moving the corresponding eye E to be examined left and right. information can be obtained.

In addition, each measuring head 16 simultaneously changes its rotational posture symmetrically about the Y-axis eyeball rotation axis of the corresponding eye E to be examined, so that divergence or convergence is detected when the corresponding eye E is in binocular vision. The direction of the optical axis L of the optical system of the eye information acquisition unit 21 can be changed in accordance with the visual axis (line of sight direction) that changes depending on the angle. The upper side of FIG. 3 shows a state in which the rotational posture of the binocular information acquisition unit 21 is adjusted so that the optical axes L from both eyes E to each deflection member 26 are parallel. In the upper state of FIG. 3, when each eye information acquiring unit 21 presents a fixation image Sf or the like to the corresponding eye E to be examined as will be described later, the subject looks at infinity in a state of binocular vision. The visual axis can be the same as in the state where the In addition, the lower side of FIG. 3 shows the rotational posture of the binocular information acquisition unit 21 so that the extended ends of the optical axes L from both eyes E to each deflection member 26 are directed toward the predetermined position P. is regulated. In the state shown in the lower part of FIG. 3, when each eye information acquiring unit 21 presents a fixation image Sf or the like to the corresponding eye E to be examined, the subject sees the predetermined position P with binocular vision. can be the same visual axis as In this way, the ophthalmologic apparatus 10 changes the rotational postures of the measurement heads 16 symmetrically at the same time, so that the visual axes of both eyes to be examined E are changed so as to converge or diverge. can be presented.

The base 11 is provided with a control unit 27 that is housed in a control box and that controls each part of the ophthalmologic apparatus 10 (see FIG. 1). As shown in FIG. 4, the control unit 27 includes the above-described eye information acquisition unit 21, each vertical driving unit 22 as the driving mechanism 15, each horizontal driving unit 23, each Y-axis rotating driving unit 24, and each X-axis driving unit 24. In addition to the rotation drive unit 25, the examiner controller 31, the subject controller 32, the storage unit 33, and the arm drive mechanism 34 are connected. In the ophthalmologic apparatus 10, power is supplied from a commercial power supply to a control unit 27 via a cable 28 (see FIGS. 1 and 2), and the control unit 27 controls the drive mechanism 15 and both measurement heads 16 (both eye information acquisition unit 21). to power the The control unit 27 can exchange information with the drive mechanism 15 and both measurement heads 16 (binocular information acquisition unit 21), controls their operations, and acquires information from them as appropriate.

The examiner controller 31 is used by the examiner to operate the ophthalmologic apparatus 10 . The examiner controller 31 is communicably connected to the controller 27 via short-range wireless communication. Note that the examiner controller 31 is not limited to the configuration of the first embodiment as long as it is connected to the control unit 27 via a wired or wireless communication path. A portable terminal (information processing device) such as a tablet terminal or a smartphone is used as the examiner controller 31 of the first embodiment. Therefore, the examiner's controller 31 can be operated by being held by the examiner's hand or placed on the optometry table 12 and operated. It can be operated from anywhere, increasing the degree of freedom of the examiner during measurement. Note that the controller for examiner 31 is not limited to a mobile terminal, and may be a notebook personal computer, a desktop personal computer, or the like, and may be configured by being fixed to the ophthalmologic apparatus 10. Not limited to configuration.

The examiner controller 31 includes a display section 35 consisting of a liquid crystal monitor. The display unit 35 has a display surface 35a (see FIG. 1, etc.) on which an image or the like is displayed, and a touch panel type input unit 35b superimposed thereon. Under the control of the controller 27, the examiner controller 31 generates an anterior segment image I (see FIG. 5) based on an image signal from an imaging device 41g provided in the observation system 41 described later, a measurement ring image described later, and A fundus image or the like is appropriately displayed on the display surface 35a. Further, the examiner controller 31 outputs to the control unit 27 operation information such as an alignment instruction and a measurement instruction which are displayed on the input unit 35 b under the control of the control unit 27 and input there.

The examinee controller 32 is used by the examinee to respond when obtaining various types of eye information about the eye E to be examined. The subject controller 32 is, for example, an input device such as a keyboard, mouse, or joystick. The subject controller 32 is connected to the controller 27 via a wired or wireless communication path.

The control unit 27 appropriately controls the controller 31 for the examinee and the controller 32 for the examinee by expanding the program stored in the connected storage unit 33 or the built-in internal memory 27a on, for example, a RAM (random access memory). The operation of the ophthalmologic apparatus 10 is centrally controlled according to the operation. In the first embodiment, the internal memory 27a is composed of a RAM or the like, and the storage unit 33 is composed of a ROM (Read Only Memory), an EEPROM (Electrically Erasable Programmable ROM), or the like. In addition to the configuration described above, the ophthalmologic apparatus 10 is appropriately provided with a printer that prints the measurement results in response to a measurement completion signal or an instruction from the measurer, and an output unit that outputs the measurement results to an external memory or server.

Next, an optical configuration as an example of the eye information acquisition section 21 will be described with reference to FIG. As described above, the configurations of the right eye information acquisition section 21R and the left eye information acquisition section 21L are basically the same, and therefore the eye information acquisition section 21 will be simply described.

As shown in FIG. 5, the optical system of the eye information acquisition unit 21 includes an observation system 41, a target projection system 42, an eye refractive power measurement system 43, a subjective inspection system 44, a Z alignment optical system 45, and an XY alignment optical system. 46 and a kerat system 47 . An observation system 41 observes the anterior segment of the eye E to be examined, a target projection system 42 presents a target to the eye E to be examined, and an eye refractive power measurement system 43 measures eye refractive power (refractive characteristics). I do. The subjective examination system 44 has a function of presenting an optotype to the eye E to be examined, and shares an optical element constituting an optical system with the optotype projection system 42 . The Z alignment optical system 45 and the XY alignment optical system 46 align the optical system with the eye E to be inspected. The Z alignment optical system 45 generates alignment information in the front-rear direction (Z direction) along the optical axis L of the observation system 41, and the XY alignment optical system 46 generates alignment information in the vertical and horizontal directions (Y direction, X direction) orthogonal to the optical axis L. orientation).

The observation system 41 has an objective lens 41a, a dichroic filter 41b, a half mirror 41c, a relay lens 41d, a dichroic filter 41e, an imaging lens 41f, and an imaging device 41g. The observation system 41 forms an image of the luminous flux reflected by the subject's eye E (anterior segment) via the objective lens 41a and the imaging lens 41f on the imaging element 41g (its light receiving surface). Therefore, an anterior ocular segment image I is formed on the imaging element 41g by projecting a keratling light flux, a light flux from the alignment light source 45a, and a light flux (bright spot image) from the alignment light source 46a, which will be described later. The control unit 27 causes the display surface 35a of the display unit 35 to display the anterior segment image I based on the image signal output from the imaging device 41g. A kerato system 47 is provided in front of the objective lens 41a.

The kerato system 47 has a kerato plate 47a and a kerato ring light source 47b. The kerato plate 47a has a plate shape provided with a slit concentric with respect to the optical axis L of the observation system 41, and is provided near the objective lens 41a. The keratizing light source 47b is provided in alignment with the slit of the keratoplate 47a. In the keratometry system 47, a keratometry beam (for corneal curvature measurement) for measuring the shape of the cornea is directed to the subject's eye E (its cornea Ec) by passing a luminous flux from a lighted keratometry light source 47b through a slit in a keratoplate 47a. A ring-shaped optotype) is emitted (projected). This keratling luminous flux is reflected by the cornea Ec of the eye E to be examined, and is imaged on the imaging device 41g by the observation system 41, and the imaging device 41g detects an image (image) of the ring-shaped keratling luminous flux ( receive). Based on the image signal from the imaging device 41g, the control unit 27 displays the image of the measurement pattern on the display surface 35a, and measures the corneal shape (curvature radius) by a well-known method. Therefore, the keratometric system 47 projects a light beam onto the anterior segment (cornea Ec) of the eye E to be inspected, and measures the corneal shape of the eye E to be inspected from reflected light from the anterior segment (cornea Ec). It functions as a shape measurement system. In addition, in Example 1, an example (kerato system 47) using a keratoplate 47a for measuring the curvature of the vicinity of the center of the cornea with one to three ring slits is shown as the corneal topography measurement system. As long as the shape is measured, a placide plate having multiple rings and capable of measuring the shape of the entire cornea may be used, or other configurations may be used. A Z alignment optical system 45 is provided behind the kerato system 47 (kerato plate 47a).

The Z alignment optical system 45 has a pair of alignment light sources 45a and a projection lens 45b. The light beams from each alignment light source 45a are collimated by each projection lens 45b, and projected through an alignment hole provided in a kerat plate 47a. The parallel light flux is projected (projected) onto the cornea Ec of E. Thereby, a target for alignment is projected onto the cornea of the eye E to be examined. This visual target is detected as a virtual image (Purkinje image) due to corneal surface reflection. Alignment using a target is alignment in the direction of the optical axis L of the optical system of the eye information acquisition unit 21, that is, in the Z direction. Alignment using this target may include alignment in the X direction and the Y direction.

The control unit 27 drives the horizontal driving unit 23 to move the measuring head 16 in the front-rear direction (Z direction) based on the alignment information of the target for alignment, thereby adjusting the optical system of the eye information acquiring unit 21. Alignment in the front-rear direction (Z direction) along the optical axis L can be performed. This longitudinal alignment is performed by adjusting the position of the measuring head 16 so that the ratio of the distance between the two bright spot images by the alignment light source 45a on the imaging device 41g and the diameter of the keratling image is within a predetermined range. Here, the control unit 27 may obtain the amount of misalignment from the ratio and display the amount of misalignment on the display surface 35a. Note that the alignment in the front-rear direction may be performed by adjusting the position of the right-eye measurement head 16R so that the luminescent spot image by the alignment light source 46a, which will be described later, is in focus.

Also, the observation system 41 is provided with an XY alignment optical system 46 . The XY alignment optical system 46 has an alignment light source 46a and a projection lens 46b, and shares the half mirror 41c, the dichroic filter 41b and the objective lens 41a with the observation system 41. The XY alignment optical system 46 projects the light flux from the alignment light source 46a onto the cornea Ec as a parallel light flux through the objective lens 41a. The control unit 27 acquires alignment information (for example, movement amounts in the Y and X directions) based on the bright spots projected onto the cornea Ec on the anterior segment image I (the bright spot image). Based on this alignment information, the control unit 27 drives the vertical driving unit 22 and the horizontal driving unit 23 to move the measuring head 16 in the horizontal direction (X direction) and the vertical direction (Y direction). Alignment is performed in the direction (the direction perpendicular to the optical axis L). At this time, the control unit 27 causes the display surface 35a to display an alignment mark AL, which serves as a guide for the alignment mark, in addition to the anterior segment image I in which the bright spot image is formed. Further, the control unit 27 may be configured to perform control so as to start measurement when alignment is completed.

The visual target projection system 42 (subjective inspection system 44) includes a display 42a, a half mirror 42b, a relay lens 42c, a reflecting mirror 42d, a focusing lens 42e, a relay lens 42f, a field lens 42g, and a variable cross cylinder lens (VCC) 42h. , a reflecting mirror 42i and a dichroic filter 42j, and shares the dichroic filter 41b and the objective lens 41a with the observation system 41. FIG. In addition, the subjective examination system 44 has at least two glare light sources 42k that irradiate the subject's eye E with glare light at positions surrounding the optical axis on optical paths other than the optical path leading to the display 42a and the like. The display 42a presents a fixation target or a point-like target as a target for fixing the line of sight of the eye E to be examined, or displays characteristics of the eye E to be examined (visual acuity value, correction power (distance power, near power), etc.). ) is presented, and a fixation image Sf (see FIG. 6, etc.) is presented for an accommodation measuring step, which will be described later. The display 42 a can use EL (electroluminescence) or a liquid crystal display (LCD), and displays any image under the control of the control section 27 . The display 42a is movably provided along the optical axis at a position conjugate with the fundus Ef of the subject's eye E on the optical path of the optotype projection system 42 (subjective examination system 44).

In the target projection system 42 (subjective examination system 44), a pinhole plate 42p is placed at a position (between the field lens 42g and the VCC 42h in the first embodiment) that is substantially conjugate with the pupil of the eye to be examined E on the optical path. set up. The pinhole plate 42p is formed by providing a through hole in a plate member, and is capable of being inserted into and removed from the optical path of the optotype projection system 42 (subjective examination system 44) under the control of the control unit 27. so that the through hole is positioned on the optical axis when inserted into the optical path. By inserting the pinhole plate 42p into the optical path in the subjective inspection mode, it is possible to perform a pinhole test for determining whether or not the subject's eye E can be corrected with spectacles. The pinhole plate 42p may be provided at a position substantially conjugate with the pupil of the subject's eye E on the optical path, and is not limited to the configuration of the first embodiment.

The eye refractive power measurement system 43 projects a measurement light beam onto the fundus oculi Ef of the eye E to be examined, and acquires the measurement light beam reflected by the fundus oculi Ef (its reflected light beam) as a measurement ring image described later. Allows measurement of eye refractive power. The eye refractive power measurement system 43 of Example 1 includes a ring-shaped light flux projection system 43A that projects a ring-shaped measurement pattern onto the fundus Ef of the eye to be examined E, and detects the reflected light of the ring-shaped measurement pattern from the fundus Ef ( and a ring-shaped light receiving system 43B for receiving an image. Note that the eye refractive power measurement system 43 has the above-described configuration. Other configurations may be used, and the configuration is not limited to that of the first embodiment. As an example of another configuration, a point-like spot light is projected onto the fundus oculi Ef as a measurement light beam, and the measurement light beam reflected by the fundus oculi Ef (the reflected light beam) passes through a ring-shaped slit or a lens to form a ring-shaped light beam. A light beam for acquiring a measurement ring image can be cited as the light flux.

The ring-shaped beam projection system 43A has a reflector light source unit 43a, a relay lens 43b, a pupil ring diaphragm 43c, a field lens 43d, a perforated prism 43e, and a rotary prism 43f. The dichroic filter 41 b and the objective lens 41 a are shared with the observation system 41 . The reflector light source unit 43a has, for example, a reflector measurement light source 43g for reflector measurement using an LED, a collimator lens 43h, a conical prism 43i, and a ring pattern forming plate 43j. It is integrally movable along the optical axis of the force measuring system 43 .

The ring-shaped light receiving system 43B has a hole portion 43p of a holed prism 43e, a field lens 43q, a reflecting mirror 43r, a relay lens 43s, a focusing lens 43t, and a reflecting mirror 43u. A dichroic filter 41e, an imaging lens 41f, and an imaging device 41g are shared with the observation system 41, a dichroic filter 42j is shared with a target projection system 42 (subjective examination system 44), and a rotary prism 43f and a perforated prism 43e are used as a ring. It is shared with the shaped beam projection system 43A.

The eye refractive power measurement system 43 measures the eye refractive power of the subject's eye E under the control of the control unit 27 in the eye refractive power measurement mode as follows. First, the reflector measurement light source 43g of the ring-shaped beam projection system 43A is turned on, and the reflector light source unit 43a of the ring-shaped beam projection system 43A and the focusing lens 43t of the ring-shaped beam receiving system 43B are moved in the optical axis direction. be. In the ring-shaped luminous flux projection system 43A, the reflector light source unit 43a emits a ring-shaped measurement pattern. It is reflected by the reflecting surface 43v and led to the dichroic filter 42j through the rotary prism 43f. The ring-shaped beam projection system 43A projects the ring-shaped measurement pattern onto the fundus Ef of the subject's eye E by guiding the measurement pattern to the objective lens 41a through the dichroic filters 42j and 41b.

In the ring-shaped light receiving system 43B, the ring-shaped measurement pattern formed on the fundus oculi Ef is collected by the objective lens 41a, passed through the dichroic filter 41b, the dichroic filter 42j, and the rotary prism 43f to the hole 43p of the perforated prism 43e. proceed. In the ring-shaped light receiving system 43B, the measurement pattern passes through a field lens 43q, a reflecting mirror 43r, a relay lens 43s, a focusing lens 43t, a reflecting mirror 43u, a dichroic filter 41e, and an imaging lens 41f, and is transferred to an imaging device 41g. form an image. As a result, the imaging element 41g detects an image of the ring-shaped measurement pattern (hereinafter also referred to as a measurement ring image), and the measurement ring image is displayed on the display surface 35a of the display unit 35 as appropriate. Based on the measurement ring image (image signal from the imaging device 41g), the control unit 27 determines the spherical power S, the cylindrical power C (cylinder power), and the axis angle Ax (cylinder axis angle) as eye refractive power. method. The control unit 27 appropriately displays the calculated eye refractive power on the display surface 35a.

In the eye refractive power measurement mode, the control unit 27 causes the display 42a of the target projection system 42 to display a fixed fixation target. A light beam from the display 42a passes through a half mirror 42b, a relay lens 42c, a reflecting mirror 42d, a focusing lens 42e, a relay lens 42f, a field lens 42g, a VCC 42h, a reflecting mirror 42i, a dichroic filter 42j, a dichroic filter 41b, and an objective lens 41a. Then, light is emitted (projected) onto the fundus Ef of the eye E to be examined. The examiner or the control unit 27 performs alignment with the examinee fixating the presented fixed fixation target, and aligns the subject with the far point of the subject's eye E based on the results of the provisional measurement of the eye refractive power (ref). After moving the focusing lens 42e, the focusing lens 42e is moved to a position out of focus to create a cloudy state. As a result, the subject's eye E enters an accommodation resting state (a state in which the crystalline lens is adjusted and removed), and the eye refractive power is measured in the accommodation resting state.

Other measurements (subjective tests, etc.) using the eye information acquisition unit 21 (its optical system) as described above are performed in the same manner as described in, for example, Japanese Unexamined Patent Application Publication No. 2017-63978. be able to.

Under the control of the control unit 27, the ophthalmologic apparatus 10 acquires the eye information of the subject's eye E using the eye information acquisition unit 21 while performing auto-alignment (automatic alignment). Specifically, the control unit 27 aligns the optical axis L of the eye information acquiring unit 21 (its optical system) with the axis of the subject's eye E based on the alignment information from the Z alignment optical system 45 and the XY alignment optical system 46. Then, the movement amount (alignment information) is calculated so that the distance of the eye information acquisition unit 21 with respect to the subject's eye E becomes a predetermined working distance. Here, the working distance is a default value also called a working distance, and is the distance between the eye information acquisition unit 21 and the subject's eye E for appropriately measuring characteristics using the eye information acquisition unit 21 . The control unit 27 drives the driving mechanism 15 according to the movement amount to move the eye information acquiring unit 21 with respect to the eye E to be inspected, thereby moving the eye information acquiring unit 21 (measuring head 16) for the corresponding eye E to be inspected. are aligned in the XYZ directions. After that, the control unit 27 drives the eye information acquisition unit 21 appropriately to acquire various types of eye information of the eye E to be examined. In the ophthalmologic apparatus 10, the eye information acquiring unit 21 is aligned with the eye to be examined E, the eye refractive power measuring system 43 is driven, and the eye to be examined E is measured by operating the controller for the examiner 31 manually, that is, by the examiner. Various types of eye information can also be acquired. In the ophthalmologic apparatus 10, when acquiring various types of eye information about the eye E to be examined, the subject can respond by operating the controller 32 for subject. assist.

The ophthalmologic apparatus 10 is capable of performing an accommodation measuring process (accommodation measuring mode). In this step of measuring the accommodation power, the accommodation power (accommodation range) is basically calculated by subtracting the eye power (FPA) at the far point from the eye power (NPA) at the near point. The far point may be any set distance, or may be infinite. The near point is the closest distance at which the subject (eye to be examined E) can see properly. In the accommodative force measurement step, a fixation image Sf is presented in a state of binocular vision, and a presentation position Pp for presenting the fixation image Sf is moved from a predetermined far position to a predetermined near position (see FIG. 6). ), the eye refractive power of each subject eye E is measured by the eye refractive power measurement system 43 at all times or at a predetermined timing during the movement.

The presentation position Pp indicates the position at which the fixation image Sf is presented for measurement of the accommodative force, and as shown in FIG. allows measurement of eye refraction at far and near points. The presentation position Pp of Example 1 can be set as appropriate, and as an example, can be moved from infinity to 0.3 m. It should be noted that the predetermined far position and the predetermined near position (movable range) may be appropriately set as long as the adjustment force can be measured, and are not limited to the configuration of the first embodiment.

By displaying the fixation image Sf on the display 42a under the control of the control unit 27, the fixation image Sf is displayed on each eye E in the same manner as displaying a fixed fixation target using the target projection system 42. presented to. As shown on the right side of FIG. 6, the size of the fixation image Sf is changed according to the change of the presentation position Pp. is intended to be recognized. The fixation image Sf is the smallest at infinity, gradually increases as it approaches, and is the largest at 0.3 m. This change is performed by changing the size of the fixation image Sf displayed on the display 42a. This change is due to the fact that, in a state in which the image displayed as the fixation image Sf exists in the real world, the enlargement ratio (rate of change) is adjusted according to the sense of perspective when the change in the presentation position Pp is viewed with the naked eye. set. Therefore, the fixation image Sf basically has a substantially constant magnification with respect to the change in the presentation position Pp.

However, the fixation image Sf of Example 1 does not have a fixed magnification ratio with respect to the change in the presentation position Pp, and the magnification ratio of the fixation image Sf with respect to the change in the presentation position Pp increases as the object becomes closer. As shown on the right side of FIG. 6, the one-dotted chain line showing the mode of change curves outward when approaching (downward). This is due to the following. The fixation image Sf of Example 1 is presented to each subject's eye E using the target projection system 42. In this target projection system 42, the focal distance Df is also changed as described later. The image magnification changes with . In this eye target projection system 42, the smaller the focal distance Df, the smaller the image presented through the eye target projection system 42 than the image displayed on the display 42a. Therefore, by increasing the magnification of the fixation image Sf, the influence of the change in the image magnification of the target projection system 42 can be canceled. In other words, the fixation image Sf is increased in magnification as it becomes closer on the display 42a. It is assumed to be the expansion rate. The enlargement ratio of the fixation image Sf displayed on the display 42a with respect to the change in the presentation position Pp is adjusted to the perspective when viewed with the naked eye when presented to each eye E by the target projection system 42. The magnification is not limited to the configuration of the first embodiment, and may be appropriately set according to the characteristics of the target projection system 42 so as to obtain the same magnification.

Further, the fixation image Sf of Example 1 is a moving image, and the change in size as described above is continuous. This allows the subject to feel more naturally that the object shown in the fixation image Sf is approaching (or moving away). In addition, the fixation image Sf of Example 1 is an image that has been observed to approach and move away from the real world in order to make it more natural to recognize that the presentation position Pp has changed. An automobile is used as an example. Here, the fixation image Sf in the example shown in FIG. 6 simply displays only the automobile, but also displays a simple background (for example, a straight road, etc.) in order to facilitate grasping of perspective. It's okay. Note that the fixation image Sf may be a plurality of still images that are frame-advanced, as long as the size of the fixation image Sf changes so as to make it possible to recognize that the presentation position Pp has changed. and contents to be drawn may be appropriately set, and are not limited to the configuration of the first embodiment.

In the accommodation measuring step, the control unit 27 causes the display 42a to display the fixation image Sf, and changes the size of the fixation image Sf on the display 42a according to the change in the presentation position Pp. This allows the subject to recognize that the fixation image Sf approaches or recedes just by looking at the fixation image Sf with both eyes E to be examined.

In addition, the fixation image Sf can be provided with binocular parallax in accordance with changes in the presentation position Pp. In this case, it is assumed that there is no binocular parallax when the fixation image Sf is minimized in accordance with the presentation position Pp at infinity. In addition, when the presentation position Pp is closer than infinity, the fixation image Sf is displayed on the right eye measurement head 16R (right eye information acquisition unit 21R) as if viewed obliquely from the front on the right side and The object displayed on the measurement head 16L (left eye information acquisition unit 21L) provides binocular parallax as if viewed obliquely from the front left side. Specifically, parallax is given to the left and right fixation images Sf in accordance with the state of viewing the fixation images Sf from an angle corresponding to the rotation angle α, which will be described later. Then, the fixation image Sf changes the parallax given to the fixation image Sf according to the change in the presentation position Pp, that is, the change in the rotation angle α. In this way, by showing the fixation image Sf at the same presentation position Pp to each subject eye E, the fixation image Sf can be stereoscopically viewed in a manner corresponding to the presentation position Pp. The subject can be made to clearly recognize that the At this time, in both fixation images Sf presented to each eye to be examined E, the positions displayed on the left and right can be changed according to the changes in the parallax and the rotation angle α. By changing the display position in this way, stereoscopic viewing can be performed more easily and appropriately.

This parallax need not be provided when the presentation position Pp is at infinity, and is not very effective when the presentation position Pp is relatively large, but becomes more effective as the presentation position Pp becomes smaller. Therefore, the range in which the parallax is provided can be set as appropriate. As a result, even within the variable range of the presentation position Pp, the fixation image Sf is switched between an image with no parallax and an image with parallax. If the examiner can comprehend this, usability can be improved. Such a display can be easily recognized without a sense of incompatibility by, for example, showing a portion (range) where parallax is provided beside a scale 52g of the operation display portion 52, which will be described later.

In the accommodative force measurement step, the control unit 27 changes the size of the fixation image Sf in accordance with the change in the presentation position Pp as described above. The rotation angle α of (both measuring heads 16) and the focusing distance Df of the fixation image Sf in the target projection system 42 are changed integrally. The rotation angle α is the direction of the optical axis L of the eye target projection system 42 (the eye information acquisition unit 21) (the direction of the optical axis L from the eye E to each deflection member 26), and the fixed image at infinity. It is an angle based on the state of displaying Sf (parallel to each other). The direction of the optical axis L can be adjusted by rotating both measuring heads 16 around the eyeball rotation point of the corresponding eye E, as described above. Therefore, when the rotation angle α is 0 (zero) degrees, the directions of both optical axes L are parallel, and the visual axis of the subject's eye E is set at infinity. As shown in FIG. 7, the rotation angle α can be obtained from the interpupillary distance PD, which is the distance between both eyes E, and the presentation distance Dp, which is the distance from both eyes E to the presentation position Pp. That is, the rotation angle α can be obtained by tan ⁻¹ (PD/2Dp). The interpupillary distance PD may be obtained from the anterior segment image I or the alignment position, or may be a general value.

In the accommodative force measurement process, the control unit 27 displays the fixation image Sf on the display 42a, and controls the eye target projection system 42 (eye information acquisition unit 21 (both measurement heads 16)) that presents the fixation image Sf to the eye E to be examined. The turning angle α is changed according to the change of the presentation position Pp. As a result, when the fixation images Sf are viewed with both eyes E to be examined, the visual axes of the eyes to be examined E are converged or diverged according to the presentation position Pp, and the fixation images Sf approach or recede. The subject can be made to recognize that the

The focus distance Df is a state in which the displayed fixation image Sf is focused on the presentation position Pp, and can be indicated by the distance from each subject eye E to the presentation position Pp. The focusing distance Df can be obtained from the presentation distance Dp, which is the distance from the center position of both eyes E to the presentation position Pp, and the rotation angle α described above. That is, the focusing distance Df can be obtained by Dp/cosα.

In the accommodative force measurement step, the control unit 27 causes the display 42a to display the fixation image Sf, and presents the focusing distance Df in the eye target projection system 42 (eye information acquisition unit 21) that presents it to the eye E to be examined. It is changed according to the change of the position Pp. This focusing distance Df can be adjusted by moving the focusing lens 42 e in the target projection system 42 . As a result, when both eyes E are focused and the fixation image Sf is viewed, the presentation position Pp is in focus. The examiner can feel

When starting the accommodative force measurement process, the control unit 27 displays the smallest fixation image Sf0 on the display 42a, sets the target projection system 42 to an infinity focus distance Df0, and sets the eye information The fixation image Sf0 is displayed at the presentation position Pp0 at infinity (presentation distance Dp0) with the acquisition unit 21 having a rotation angle α0 of 0 (zero) degrees. After that, the control unit 27 causes the display 42a to display a fixation image Sf1 larger than the fixation image Sf0, sets the target projection system 42 to the focus distance Df1, sets the eye information acquisition unit 21 to the rotation angle α1, and sets the presentation distance The fixation image Sf is displayed at the presentation position Pp1, which is Dp1. Then, the control unit 27 causes the display 42a to display a fixation image Sf2 that is larger than the fixation image Sf1. The fixation image Sf is displayed at the presentation position Pp2, which is Dp2. After that, the control unit 27 causes the display 42a to display a fixation image Sf3 larger than the fixation image Sf2, sets the target projection system 42 to the focus distance Df3, sets the eye information acquisition unit 21 to the rotation angle α3, and sets the presentation distance The fixation image Sf is displayed at the presentation position Pp3, which is Dp3.

In this way, the control unit 27 controls the size of the fixation image Sf to be displayed on the display 42a, the focal distance Df of the target projection system 42, and the rotation of the eye information acquiring unit 21 in accordance with changes in the presentation position Pp. and are changed integrally (all at once). Therefore, the subject can feel that the object shown by the fixation image Sf is approaching from a distance to a near area according to the change of the presentation position Pp, and both eyes E to be examined can be naturally moved to the extreme. The fixation image Sf can be shown by converging in a close state, and both eyes E to be examined can be appropriately adjusted. Similarly, by changing the presentation position Pp from near to far, the subject can be made to feel that the object shown in the fixation image Sf moves away from near to far, and both eyes to be examined E It is possible to show the fixation image Sf in a state that is extremely close to natural divergence, and to appropriately adjust both eyes E to be examined. In addition, if a binocular parallax is given to the fixation image Sf in accordance with the change in the presentation position Pp, the fixation image Sf can be displayed with a stereoscopic effect, and the both eyes E to be examined can be converged more appropriately. Or it can be diversified and adjusted.

Here, the presentation position Pp may be changed automatically by the control unit 27 or by an instruction from the examiner. Then, in the accommodation measuring step, as shown in FIG. 8, an accommodation measurement screen Sa for performing operations thereon can be displayed on the display surface 35a of the display unit 35. FIG. The accommodative force measurement screen Sa of the first embodiment includes two fixation image display areas 51, an operation display area 52 provided therebetween, two limit operation buttons 53 provided below them, and and two measured value display locations 54 provided in the .

A both fixation image display area 51 is an area where both fixation images Sf currently being displayed are displayed. , the fixation image Sf displayed to the right eye is displayed on the left side. Both fixation image display locations 51 may display the anterior segment image I (see FIG. 5) obtained by the observation system 41 together with the corresponding fixation image Sf. Also, the anterior segment image I may be displayed at a position different from each fixation image display location 51 .

The operation display portion 52 is provided for an operation to change the presentation position Pp in the accommodation measurement process, and a finger or a touch pen is provided using the touch panel type input section 35b arranged superimposed on the display surface 35a. It is possible to operate by touching with . The operation display portion 52 has a far-moving symbol 52a for a far-moving operation on the upper left, and a near-moving symbol 52b below it for a near-moving operation. The far movement symbol 52a and the near movement symbol 52b are used by the examiner to manually change the presentation position Pp. In addition, the operation display portion 52 includes an automatic selection symbol 52c for automatically changing the presentation position Pp below the near movement symbol 52b, and a temporary mode for temporarily stopping the automatic change of the presentation position Pp at the lower left of the symbol 52c. It has a stop symbol 52d and an execution symbol 52e for automatically changing the presentation position Pp to the right of the stop symbol 52d. Further, the operation display portion 52 has a presentation position indicator symbol 52f indicating the current presentation position Pp on the right side of each symbol described above. The presentation position indicator symbol 52f has a scale 52g that indicates the presentation distance Dp from the subject's eye E, and a mark 52h that indicates the presentation position Pp on the scale 52g.

The limit operation button 53 is operated when the subject sees a blurred fixation image Sf moving closer to the subject or is aware of diplopia (sees two). This is an operation point for detecting the presenting position Pp, which is the limit of the near distance, by awareness. The limit operation button 53 may be operated by the subject, or may be operated by the examiner based on the reaction of the subject.

The measurement value display area 54 is an area for displaying various numerical values measured in the accommodative force measurement process, and when viewing FIG. display. The measured value display portion 54 of Example 1 is, from the top, the spherical power S, the cylindrical power C, the axial angle Ax, the eye refractive power NPA at the near point, the eye refractive power FPA at the far point, and the accommodation power as the eye refractive power. (NPA-FPA) shall be displayed. Note that the measured value display portion 54 may display other measured values together, and the display order and arrangement may be appropriately set, and is not limited to the configuration of the first embodiment.

Note that the accommodation measurement screen Sa may have other configurations (including functions and designs) as long as the operation for performing the accommodation measurement process and the display of the measurement results can be performed, and it is displayed at another location. It is not limited to the configuration of the first embodiment. Further, each operation described above may use a display different from that of the accommodation measurement screen Sa, may be provided with an operation unit separate from the display unit 35, or may have another configuration. is not limited to

Next, accommodation measurement processing (accommodation measuring method) as an example of measuring the accommodation of the subject's eye E by the accommodation measuring process using the ophthalmologic apparatus 10 will be described with reference to FIG. 9 . This measurement process is executed by the control unit 27 based on a program stored in the storage unit 33 or the internal memory 27a. Each step (each process) of the flow chart of FIG. 9 will be described below. The flowchart of FIG. 9 starts when the ophthalmologic apparatus 10 is activated, the browser or application of the examiner's controller 31 is activated, the display surface 35a is displayed, and the accommodation measurement process is started in the input section 35b. be done. At this time, the subject is sitting on a chair or the like, and the forehead is applied to the forehead support portion 17 . In the flowchart of FIG. 9 of the first embodiment, each step (each process) is performed simultaneously by a pair of measurement heads 16 (binocular information acquisition unit 21), and measurements are performed simultaneously in the state of binocular vision. I am assuming.

In step S1, display of the anterior segment image I of the subject's eye E on the display surface 35a of the display unit 35 is started, and the process proceeds to step S2. In step S1, the moving image of the anterior segment image I acquired by the observation system 41 is displayed on the display surface 35a.

In step S2, auto-alignment is executed, and the process proceeds to step S3. In step S2, as described above, the Z alignment optical system 45 and the XY alignment optical system 46 are used to perform auto-alignment of the eye information acquisition unit 21, and the optical axis L of the optical system of the eye information acquisition unit 21 is aligned with the eye to be examined. Match the visual axis (line of sight) of E.

In step S3, it is determined whether or not the measurement is to be performed with a view other than the front view. If YES, the process proceeds to step S4, and if NO, the process proceeds to step S5. In step S3, it is determined whether or not the accommodative power of the subject's eye E is to be measured with the optical axis L of the optical system of the eye information acquiring section 21 provided in each measuring head 16 being horizontal. In step S3, it is determined whether or not the examiner's controller 31 or other operation unit has been operated to perform measurement while looking downward, upward, or left and right.

In step S4, the direction of the optical axis L is adjusted, and the process proceeds to step S5. In step S4, the Y-axis rotation drive unit 24 and the X-axis rotation drive unit 25 are appropriately driven to rotate the optical information of the eye information acquiring unit 21 according to the direction (downward viewing, upward viewing, lateral viewing) set in step S3. Adjust the orientation of the optical axis L of the system.

In step S5, the fixation image Sf is presented at infinity, and the process proceeds to step S6. In step S5, the smallest fixation image Sf0 is displayed on the display 42a, the target projection system 42 is set to an infinity focus distance Df0, the eye information acquisition unit 21 is set to 0 (zero) degree rotation angle α0, and an infinite The fixation image Sf is displayed at the far presentation position Pp0 (presentation distance Dp0) (see FIG. 6).

In step S6, clouding is performed to measure the refractive power of the eye, and the process proceeds to step S7. In step S6, the target projection system 42 is used to move the focusing lens 43t from the state set in step S5 to a cloudy state, and the subject's eye E is placed in an accommodation pause state. Then, in step S6, the eye refractive power measurement system 43 is used to detect the measurement ring image of the subject eye E, which is in the accommodation resting state due to fog. The power, cylinder power, and axis angle are calculated by well-known methods.

In step S7, the refractive power of the eye in the case of distant vision under correction is measured, and the process proceeds to step S8. In step S7, the focusing lens 42e, the reflex light source unit 43a, and the focusing lens 43t are arranged at the D (diopter) position suitable for the eye refractive power obtained in the measurement in step S6. A fixation image Sf at infinity is fixed. In other words, in step S7, the state of looking at a distant place (infinite fixation image Sf) is reproduced while being corrected with glasses or the like. Then, in step S7, the eye refractive power (spherical power, cylindrical power, axis angle) is calculated using the eye refractive power measurement system 43 in this state. In this accommodative power measuring step, the value calculated in step S7 is set as the eye refractive power FPA at the far point. Note that the eye refractive power FPA is not calculated by forcibly obtaining the eye refractive power by performing clouding (S6→S7), but is measured in the state of presenting the fixation image Sf at infinity (state of S5). It may be force and is not limited to this example of the accommodation force measurement process.

In step S8, measurement of adjustment force is started, and the process proceeds to step S9. In step S8, the change of the presentation position Pp of the fixation image Sf to be presented to the near side is started, and the eye refractive power of each eye to be examined E is measured by the eye refractive power measurement system 43 at all times or at a predetermined timing during the change. Measured by At that time, in step S8, the presentation position Pp is changed from infinity to near, and the size of the fixation image Sf displayed on the display 42a is reduced in accordance with the change. The focusing distance Df is shortened, and the rotation angle α of the eye information acquisition unit 21 is increased in unison. In step S8, when returning from step S11, which will be described later, the operation described above is continued from the presentation position Pp at the time of returning. Note that the speed at which the presentation position Pp is changed can be set arbitrarily. Moreover, the mode of change of the presentation position Pp may be changed at a constant speed, or may be changed non-linearly, and can be arbitrarily set.

In step S9, it is determined whether or not the subjective response is also used. If YES, the process proceeds to step S10, and if NO, the process proceeds to step S11. In step S9, it is determined whether or not detection of the presentation position Pp, which is the limit of near distance, is also used, based on subject's awareness. In step S9, it is determined whether or not the examiner's controller 31 or other operation unit has been operated to the effect that the subjective response is also used.

In step S10, it is determined whether or not the limit operation button 53 has been operated. If YES, the process proceeds to step S12, and if NO, the process proceeds to step S11. In step S10, it is determined whether or not the limit operation button 53 has been operated, that is, whether or not the subject has seen the fixation image Sf blurred or has been aware of diplopia.

In step S11, it is determined whether or not the presentation position Pp has reached a predetermined near position. If YES, the process proceeds to step S12, and if NO, the process returns to step S8. In step S11, it is determined whether or not the presentation position Pp has changed to a set predetermined near position, ie, the closest position (0.3 m in the first embodiment) in the set movement range.

In step S12, the change of the presentation position Pp is stopped, and the process proceeds to step S13. In step S12, the change in the presentation position Pp is stopped. also stop changing the rotation angle α. For this reason, the measurement of the eye refractive power associated with the change in the presentation position Pp started in step S8 is performed at the predetermined near position where the presentation position Pp is set (S11), or the subjective response is used in combination. This is continued until the examiner becomes aware of the near limit (S12).

In step S13, it is determined whether or not reciprocating measurement has been set. If YES, the process proceeds to step S14, and if NO, the process proceeds to step S17. In step S13, it is determined whether reciprocating measurement has been set, that is, whether or not the presentation position Pp, which has been changed to the closest distance, is to be turned back to infinity to measure the eye refractive power.

In step S14, measurement of adjustment force is started, and the process proceeds to step S15. In step S14, the presenting position Pp of the fixation image Sf to be presented starts to change to the far side. Measure. This step S14 is the same as step S8 except that the direction in which the presentation position Pp is changed is changed from near to infinity opposite to step S8. In step S14, when returning from step S15, which will be described later, the above operation is continued from the presentation position Pp at the time of returning.

In step S15, it is determined whether or not the presentation position Pp has reached a predetermined distant position. If YES, the process proceeds to step S16, and if NO, the process returns to step S14. In step S15, it is determined whether or not the presentation position Pp has been changed to the set predetermined far position, that is, the farthest position (infinity in the first embodiment).

In step S16, the change of the presentation position Pp is stopped, and the process proceeds to step S17. In step S16, the change in the presentation position Pp is stopped. also stop changing the rotation angle α. As a result, the measurement of the eye refractive power associated with the change in the presentation position Pp started in step S14 is continued until the presentation position Pp changes to the set predetermined far position (infinity).

In step S17, the measured value is displayed, and this accommodation measuring process ends. In this step S17, the eye refractive power measured while changing the presentation position Pp from far to near (steps S7 to S12) or the eye refractive power measured while changing the presentation position Pp from near to far (step S14 to The eye refractive power NPA at the near point, the eye refractive power FPA at the far point, and the accommodative power (NPA-FPA) acquired in S15) are displayed at the measured value display locations 54 of the accommodative power measurement screen Sa on the display surface 35a (FIG. 8 ) are displayed as appropriate. The eye refractive power NPA at the near point is obtained from transition of the eye refractive power measured while changing the presentation position Pp. Note that the eye refractive power NPA at the near point may be the eye refractive power immediately before the presentation position Pp that the subject perceives as the near limit, and is not limited to the configuration of the first embodiment. In addition, in Example 1, the eye refractive powers (spherical power, cylindrical power, axial angle) of both eyes to be examined E measured in each step described above are appropriately displayed in each measurement value display area 54 .

This accommodative force measurement step is performed in a state of binocular vision, but the subject may have difficulty in binocular vision due to disease or the like. In such a case, the control unit 27 drives only the measuring head 16 and the eye information acquisition unit 21 corresponding to the subject's eye E to be measured, and performs each step in the same manner as described above in the state of monocular vision. and The settings for this monocular measurement can be performed by the controller for examiner 31 or other operating units.

Next, technical problems of the ophthalmologic apparatus will be described. In the above-described conventional ophthalmologic apparatus, the presentation position of the fixation target is changed by moving the light source and the fixation target plate in the optical system in the optical axis direction. Therefore, the subject only feels that the fixation target is blurring, and it is unlikely that the subject will feel that the fixation target is moving. In addition, since the conventional ophthalmologic apparatus described above performs measurement for each eye, the fixation target is viewed in an unnatural state. For these reasons, it is difficult for the conventional ophthalmologic apparatus described above to converge or diverge the subject's eye in a state that is very close to the natural state to show the fixation target, and it is difficult to appropriately adjust the subject's eye.

Here, the ophthalmologic apparatus is provided with a moving mechanism that actually moves the fixation target so that the moving fixation target can be viewed through a transparent polarizing plate, and the refractive power of the eye is measured after being reflected by the polarizing plate. A method of providing an optical system (so-called external target method) is being considered. This ophthalmologic apparatus can measure accommodative power in a state of being appropriately adjusted while converging or diverging in a state very close to nature. However, since this ophthalmologic apparatus requires a size that allows the movement mechanism to sufficiently move the fixation target, the entire configuration becomes quite large, and lacks practicality.

On the other hand, the ophthalmologic apparatus 10 of the present disclosure can measure the accommodation power of the subject's eye E by the accommodation power measurement process described above. At this time, the ophthalmologic apparatus 10 changes the presentation position Pp at which the fixation image Sf is presented. , and the rotation angle α of the eye information acquisition unit 21 are changed integrally. Therefore, the subject can feel that the object displayed in the fixation image Sf is moving in accordance with the change in the presentation position Pp in the same way as the object that actually exists. By seeing the , both eyes E to be examined are converged or diverged in a natural state and adjusted appropriately. Since the ophthalmologic apparatus 10 measures the accommodative power based on the eye refractive powers obtained by measuring both eyes E in that state, the accommodative power can be measured accurately. In addition, the ophthalmologic apparatus 10 converges or diverges in a natural state by the above-described three integral operations (so-called internal eye target method) in both the measuring heads 16 and the eye information acquisition unit 21, and is appropriately adjusted. , the configuration can be made extremely small, and practicality can be enhanced.

In the ophthalmologic apparatus 10, the eye information acquisition unit 21 is configured to measure the eye refractive power while presenting the fixation image Sf on the same optical axis L, and each measuring head 16 provided therewith is attached to the corresponding eyes E to be examined. By making the structure rotatable around the rotation point of the eyeball, the above-described three integrated operations are made possible. Therefore, the ophthalmologic apparatus 10 can accurately measure the accommodative power of both eyes E to be examined with a simple and small configuration and simple control. In addition to the eye refractive power measured while changing the presentation position Pp from near to near (steps S7 to S12), the ophthalmologic apparatus 10 measures the eye refractive power measured while changing the presentation position Pp from near to far. Since the force (steps S14 to S15) can also be used to measure the accommodation force, the accommodation force of both eyes E to be examined can be measured more accurately. Furthermore, since the ophthalmologic apparatus 10 can perform measurement while looking downward, upward, or left and right, it is possible to measure the accommodative power of both eyes E in many ways.

In addition, the ophthalmologic apparatus 10 drives only the measurement head 16 and the eye information acquisition unit 21 corresponding to the subject's eye E to be measured, even in monocular vision, to determine the presentation position Pp for presenting the fixation image Sf. The accommodative power of the subject's eye E can be measured by integrally performing the above three operations while changing. Therefore, even if the subject has monocular vision, the object displayed in the fixation image Sf appears to be moving according to the change in the presentation position Pp in a state that is close to what actually exists. By viewing the fixation image Sf, the subject's eye E can be appropriately adjusted in a state close to nature. Thereby, the ophthalmologic apparatus 10 can accurately measure the accommodative power even in monocular vision.

The ophthalmic device 10 of the first embodiment of the ophthalmic device according to the present disclosure can obtain the following effects.

In the accommodative force measurement step, the ophthalmologic apparatus 10 adjusts the focus distance Df of the fixation image Sf in the eye information acquisition unit 21 and the focus distance Df of the fixation image Sf presented by the eye information acquisition unit 21 in accordance with the change in the presentation position Pp. The size and the rotation angle α of the eye information acquisition unit 21 are changed integrally. Therefore, the ophthalmologic apparatus 10 can make the subject feel as if the object displayed in the fixation image Sf is moving according to the change in the presentation position Pp in a state close to what actually exists. By viewing the fixation image Sf, the subject's eye E can be appropriately adjusted by converging or diverging in a state close to nature. Thereby, the ophthalmologic apparatus 10 can accurately measure the accommodative force.

The ophthalmologic apparatus 10 presents the fixation image Sf displayed on the display 42a by the eye information acquisition unit 21 to the subject's eye E using a visual target projection system. When changing the size of the fixation image Sf to be presented, the magnification of the fixation image Sf displayed on the display 42a with respect to the change in the presentation position Pp is increased as the presentation position Pp is closer. For this reason, the ophthalmologic apparatus 10 cancels out the influence of the change in the image magnification of the target projection system 42, and when the fixation image Sf is presented to each subject eye E by the target projection system 42, it is visually observed with the naked eye. The enlargement ratio can be set according to the perspective of the time. As a result, the ophthalmologic apparatus 10 can make the subject recognize that the fixation image Sf is approaching or receding by showing the fixation image Sf with both eyes E to be examined.

The ophthalmologic apparatus 10 presents the fixation image Sf as a moving image to the eye information acquiring unit 21 in the accommodation measuring step. Therefore, the ophthalmologic apparatus 10 can make the subject more naturally feel that the object shown in the fixation image Sf is approaching (or moving away).

The ophthalmologic apparatus 10 can give binocular parallax to both of the fixation images Sf presented by the two eye information acquisition units 21 in accordance with the change in the presentation position Pp in the accommodative force measurement process. In this way, the ophthalmologic apparatus 10 shows the fixation images Sf with both eyes E to be examined, so that the subject feels that the fixation images Sf are approaching and moving away more naturally. be able to.

In the accommodation measuring step, the ophthalmologic apparatus 10 changes the fixation image Sf presented by the eye information acquisition unit 21 according to the change in the presentation position Pp. Therefore, the ophthalmologic apparatus 10 can make the subject more naturally feel that the object shown in the fixation image Sf is approaching (or moving away).

Even in the state of monocular vision, the ophthalmologic apparatus 10 adjusts the focal distance Df of the fixation image Sf in the eye information acquisition unit 21 and the eye information acquisition unit 21 presents it in accordance with the change in the presentation position Pp in the accommodative force measurement process. The size of the fixation image Sf and the rotation angle α of the eye information acquisition unit 21 are changed integrally. For this reason, the ophthalmologic apparatus 10 makes the subject feel as if the image displayed in the fixation image Sf is moving according to the change in the presentation position Pp, even in the state of monocular vision. By viewing the fixation image Sf, the subject's eye E can be appropriately adjusted in a state close to nature. As a result, the ophthalmologic apparatus 10 can accurately measure the accommodative power even in monocular vision.

Therefore, in the ophthalmologic apparatus 10 as an embodiment of the ophthalmic apparatus according to the present disclosure, the accommodation power of the subject's eye E can be obtained appropriately.

The ophthalmologic apparatus of the present disclosure has been described above based on Example 1, but the specific configuration is not limited to Example 1, and does not depart from the gist of the invention according to each claim. Design changes, additions, etc. are permitted as long as

For example, in Example 1, the eye information acquisition unit 21 having the configuration described above is used. However, the eye information acquisition unit of the present disclosure can measure the eye refractive power of the eye to be inspected E while presenting the fixation image Sf to the eye to be inspected E on the same optical axis L. Any configuration that allows adjustment of the position of the optical axis L so as to match the visual axis of the eye E can be applied, and is not limited to the configuration of the first embodiment.

In addition, in Example 1, the measurement heads 16 (eye information acquisition units 21) are provided in pairs so that the characteristics of the subject's eye E can be measured in a state of binocular vision. . However, the ophthalmologic apparatus of the present disclosure may be configured to measure the ocular refractive power of the subject's eye E in the state of monocular vision, and is not limited to the configuration of the first embodiment.

Furthermore, in Example 1, the presentation position Pp is basically changed from far to near. However, in the ophthalmologic apparatus of the present disclosure, as long as the presentation position Pp is changed between near and far to measure the accommodative power of the subject's eye E, it may be changed from near to far. After the change from near to far, it may be reciprocated by changing from far to near, or may be moved in another manner, and is not limited to the configuration of the first embodiment.

REFERENCE SIGNS LIST 10 ophthalmologic apparatus 15 drive mechanism 21 eye information acquisition unit 27 control unit 42a display E eye to be examined Df focus distance Pp presentation position Sf fixation image α rotation angle

Claims (4)

an eye information acquiring unit provided in a pair corresponding to both eyes to be inspected of a subject and acquiring information of the eye to be inspected while presenting a fixation image to the eye to be inspected;
a drive mechanism that adjusts the positions of the two eye information acquisition units and rotates them around the corresponding eyeball rotation point of the eye to be examined;
Accommodative force measuring step of controlling the eye information acquiring unit and the driving mechanism to acquire information of the eye to be inspected while changing the presentation position of the fixation image between far and near in a state of binocular vision. and a control unit for
In the accommodative force measuring step, the control unit adjusts the focus distance of the fixation image in the eye information acquisition unit and the fixation image presented by the eye information acquisition unit in accordance with the change in the presentation position. integrally changing the size and the angle of rotation of the eye information acquiring unit ,
The ophthalmologic apparatus characterized in that , in the accommodation measuring step, the control unit gives binocular parallax to both of the fixation images presented by the two eye information acquisition units in accordance with a change in the presentation position. . The eye information acquiring unit presents the fixation image displayed on the display to the eye to be inspected using a target projection system,
In the accommodation measuring step, when changing the size of the fixation image presented by the eye information acquiring unit, the control unit controls the above-mentioned 2. The ophthalmologic apparatus according to claim 1, wherein the magnification of the fixation image displayed on the display is increased. 3. The ophthalmologic apparatus according to claim 1, wherein the control unit causes the eye information acquisition unit to present the fixation image as a moving image in the accommodative force measurement step. 4. The apparatus according to any one of claims 1 to 3, wherein in the accommodation measuring step, the control unit changes the fixation image presented by the eye information acquisition unit according to a change in the presentation position. An ophthalmic device according to any one of the preceding claims.

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