JPH05146410A - Apparatus for observing and photographing endothelial cell of cornea - Google Patents

Abstract

PURPOSE:To provide the apparatus for observing and photographing the endothelial cell of the cornea which can decrease the burdens of an inspector and a patient as far as possible. CONSTITUTION:An illuminating optical system 28 which irradiates the cornea C of the eye E to be examined diagonally with the respective illuminating light rays from an illuminating light source 30 for observation and an illuminating light source 32 for photographing and an observing and photographing optical system 29 for observing and photographing the cornea C including the endothelial cell of the cornea by receiving the image of the scattered light reflected from the cornea are provided. The observing and photographing optical system 29 is provided with a sensor 47 for detecting a focus state which detects the focus state of the endothelial cell of the cornea.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a device for observing corneal endothelial cells, and more particularly, a device for observing and photographing corneal endothelial cells of an eye to be examined by illuminating the cornea of the subject's eye with illumination light. It relates to the device.

[0002]

2. Description of the Related Art Conventionally, as a corneal endothelial cell observation and photographing device for observing and photographing an image of corneal endothelial cells of an eye to be inspected, a cone is placed on the corneal surface of the eye to be inspected after anesthetizing the eye of the subject (patient). A contact type in which a lens is contacted to observe and photograph a corneal endothelium image is known. In this contact type,
There is a problem of damaging the corneal surface. In addition, it takes time and effort to disinfect the cone lens. Therefore, a non-contact type in which an optical attachment for observing corneal endothelium is attached to a slit lamp to observe and photograph a corneal endothelium image has been developed.

In this non-contact type corneal endothelial cell observing / photographing device, the relative positional relationship between the eye to be inspected and the optical system of the device is roughly adjusted by visual observation, and then the illumination light from the illumination light source for observation is directed to the cornea. It is known to irradiate obliquely and focus corneal endothelium cells through an eyepiece lens based on the reflected light flux from the cornea. It is also known to focus on the corneal endothelial cells displayed on the monitor.

[0004]

By the way, since the cornea is thin, it must be observed at a high magnification in order to observe corneal endothelial cells. Further, although the subject's eye constantly undergoes involuntary eye movement, since the magnification is high, the image of corneal endothelial cells is greatly shaken by the involuntary eye movement. Therefore, the non-contact type requires considerable skill to observe and photograph the corneal endothelial cells.

When photographing a corneal endothelial cell image, the photographing switch must be operated at the same time as focusing.
A considerable skill is required to operate the photographing switch at the same time when the corneal endothelial cells are focused.

Further, in the alignment operation of the main body of the apparatus with respect to the cornea, the proper absolute positional relationship between the eye to be inspected and the optical system of the apparatus has not been determined, and the corneal endothelium image itself or the reflection from the corneal surface appearing beside it. Since you will be observing a completely dark state where you cannot see anything until you search for the luminous flux, it depends greatly on the intuition and experience of the examiner.

Moreover, since alignment often takes a long time, the subject is forced to keep his eyes open for a long time until the subject is focused and the photographing is completed, which causes great pain to the subject. ..

The present invention has been made in view of the above circumstances, and it is an object of the present invention to provide a corneal endothelial cell observation and imaging device which can reduce the burden on the examiner and the subject as much as possible.

[0009]

In order to solve the above-mentioned problems, a corneal endothelial cell observation and photographing device according to a first aspect of the present invention is provided with an illumination light source for observation and an illumination light source for photographing. An illumination optical system that obliquely irradiates the cornea of the eye to be inspected, and an observation and photographing optical system that receives and scatters reflected and scattered light from the cornea including corneal endothelial cells are provided, and the observation and photographing are performed. The optical system is provided with a focus state detection sensor for detecting the focus state of the corneal endothelial cells.

Preferably, the illumination light source for photographing is connected to a light emission amount control circuit, the light emission amount control circuit is controlled based on a detection output of the focusing state detection sensor, and the illumination light source for photographing is combined with the light emission amount control circuit. Light is emitted automatically based on the output of the focus state detection sensor.

In order to solve the above-mentioned problems, the corneal endothelial cell observing and photographing apparatus according to claim 3 of the present invention applies each illuminating light from the illuminating light source for observation and the illuminating light source for photographing to the cornea of the eye to be examined. An irradiation optical system that obliquely irradiates, an observation and photographing optical system that receives and scatters reflected and scattered light from the cornea including corneal endothelial cells, and an alignment index for aligning the apparatus main body with respect to the cornea. Alignment index light projection means for projecting light, light receiving means for receiving the alignment index light reflected by the cornea, and the device optical system for aligning the device optical system with respect to the cornea based on the light reception output of the light receiving means. And drive means for driving the main body.

[0012]

According to the corneal endothelial cell observation and photographing device of the first aspect of the present invention, the focused state detection sensor detects the focused state of the corneal endothelial cell image. As a result, when the illumination light source for photographing emits light, the corneal endothelial cell image is automatically photographed.

According to the corneal endothelial cell observation and photographing device of the third aspect of the present invention, the alignment index light is projected by the alignment index light projection means toward the cornea of the eye to be examined. The alignment index light is reflected on the surface of the cornea and received by the light receiving means.The driving means positions the device main body so that the optical axis of the device optical system is aligned with the eye to be inspected based on the light reception output of the light receiving means. To drive.

[0014]

EXAMPLE An example of the corneal endothelial cell observation and photographing device of the present invention will be described below with reference to FIGS. 1 to 16.

FIG. 1 is a plan view showing an apparatus optical system of the corneal endothelial cell observation and photographing apparatus. In FIG. 1, reference numeral 1 is an anterior segment observation optical system for observing an anterior segment of an eye E to be examined. The anterior segment observation optical system 1 is roughly composed of a half mirror 2, an objective lens 3, a half mirror 4, an optical path switching mirror 5 and a CCD 6, and O1 is its optical axis. The anterior segment of the subject's eye E is illuminated by the anterior segment illumination light source 7. The half mirror 2 constitutes a part of the alignment optical system 8 as an alignment index light projection means. As shown in FIG. 2, the alignment optical system 8 has an alignment light source 9, a pinhole plate 10, a projection lens 11, a diaphragm 12, and a half mirror 13. The pinhole plate 10 is a projection lens 11
The alignment index light, which is arranged at the focal point of and passes through the pinhole plate 10, is converted into a parallel light flux by the projection lens 11,
It is guided to the half mirror 2 via the half mirror 13.
The parallel light flux is reflected by the half mirror 2 to form the cornea C.
Is led to. The half mirror 13 constitutes a part of the fixation target projection optical system 14.

The fixation target projection optical system 14 comprises a left eye projection system 15 and a right eye projection system 16 as shown in FIG. In the right eye, as shown in FIG. 3B, the eyeball optical axis O2 of the eye E and the visual axis S1 are tilted to the right by 5 °, while in the left eye, as shown in FIG. This is because the eyeball optical axis O2 and the visual axis S1 are tilted to the left by 5 ° as shown. The left-eye projection system 15 and the right-eye projection system 16 include a fixation target light source 17, a pinhole plate 18, an optical member 19 for presenting a plurality of fixation target light sources 17, and a projection lens 20. The fixation target light source 17 is linked to the movement of the device body H described later,
When performing a right-eye examination, the one for the right eye is automatically turned on,
During the left-eye examination, the one for the left eye is automatically turned on. The fixation target light from the fixation target projection optical system 14 is guided to the eye E through the half mirror 13 and the half mirror 2.
At that time, the fixation target light is reflected by the reflecting surfaces 19a and 19b of the optical member 19.
The plurality of fixation target light source images are presented to the eye E by being reflected multiple times at. The subject fixes the fixation target light source image according to the diopter, and the alignment is performed while fixing the fixation target light source image.

The alignment light beam K is reflected by the surface T of the cornea C as shown in FIG. The alignment light flux K is reflected by the surface T so as to form a bright spot image R at an intermediate position between the corneal vertex P and the corneal curvature center O3. The reflected light flux is guided to the objective lens 3 via the half mirror 2. A part of the reflected light flux guided to the objective lens 3 is reflected by the half mirror 4, and the remaining reflected light flux passes through the half mirror 4. The light flux reflected by the half mirror 4 is guided to an alignment detection sensor 4'as a light receiving means. For example, a sensor or the like capable of detecting a position is used as the alignment detection sensor 4 ', and the details of its function will be described later.

The optical path switching mirror 5 is normally retracted from the optical path of the anterior segment observation optical system 1. The optical path switching mirror 5 has a light shielding surface 5a on one surface and a total reflection surface 5b on the other surface. The light flux that has passed through the half mirror 4 is guided to the CCD 6 to form an image, and a bright spot image is formed on the CCD 6. The half mirror 4 reflects the light flux from the alignment pattern projection optical system 21. The alignment pattern projection optical system 21 is roughly composed of an alignment pattern light source 22, an alignment pattern plate 23, and a projection lens 24. An annular pattern is formed on the alignment pattern plate 23. The pattern forming light flux forming the annular pattern is reflected by the half mirror 4 and the CCD 6
The image of the circular pattern is formed on the CCD 6.

The CCD 6 is connected to a monitor device (not shown), and an anterior ocular segment image 26 of the eye E is displayed on the screen 25 of the monitor device as shown in FIG. Further, the annular pattern image 27 is displayed. Alignment is performed by swinging the device body H described later up and down (Y direction) and left and right (X direction) so that the light flux that is reflected by the cornea C and forms the bright spot image R ′ is located at the center of the annular pattern image 27. Adjustment is performed so that the eyeball optical axis O2 of the eye E and the apparatus optical axis O1 are aligned with each other. Further, the device body H is moved forward and backward with respect to the eye E (in the Z direction).
Shift to set the working distance.

An illumination optical system 28 and an observation / photographing optical system 29 are provided on both sides of the anterior segment observation optical system 1. The illumination optical system 28 irradiates the cornea C of the eye E with an illumination light beam from an oblique direction. The illumination optical system 28 includes an illumination light source 30 for observation, a condenser lens 31, an infrared filter 31 ′, an illumination light source 32 for photographing, a condenser lens 33, and a slit plate 3.
4, a light projecting lens 35, and an optical member for correcting optical path length 35 '. The illumination light source 30 and the illumination light source 32 include a condenser lens 31.
Is conjugate with respect to. FIG. 1 shows a state in which an optical path length correcting optical member 35 'is inserted in the optical path when observing endothelial cells. Since the optical path length is corrected by retracting it when photographing with visible light, in this embodiment, the optical path length correcting optical member 35 'is a convex lens, but conversely, the optical path length correcting member is used during observation. When inserting the optical path length correcting optical member at the time of photographing without inserting it, a plane parallel plate or a concave lens is inserted.

A halogen lamp is used as the illumination light source 30, and a xenon lamp is used as the illumination light source 32. The light flux emitted from the illumination light source 30 is an infrared filter 31.
Since ′ is inserted, the infrared light flux is emitted from the infrared filter 31 ′. The infrared light flux is once converged at the position where the illumination light source 32 is arranged. This infrared luminous flux is the illumination light source 3
The light is guided to the condenser lens 33 as if it was emitted from 2. The infrared light flux condensed by the condenser lens 33 is guided to the slit plate 34. An elongated rectangular slit 36 is formed in the slit plate 34. The infrared light flux passes through the slit 36 and is guided to the light projecting lens 35. When the alignment is completed, the slit plate 34
And the cornea C are almost conjugate with respect to the projection lens 35,
The cornea C is irradiated with the slit light flux. This slit light flux traverses the cornea C from its surface T toward the inside.

The light source unit including the illumination light source 30, the condenser lens 31, the infrared filter 31 ', the illumination light source 32, and the condenser lens 33 may be arranged as shown in FIG.
In FIG. 6, 37 is a dichroic mirror, 3
Reference numerals 8 and 39 are concave reflecting mirrors. Dichroic mirror 3
7 is disposed between the condenser lens 31 and the slit plate 34, transmits infrared light, and reflects visible light.

The observation / photographing optical system 29 is roughly composed of an objective lens 40, a half mirror 41, a mask 42, a relay lens 43, a mirror 44, a variable magnification lens 45, a focusing lens 46, and an optical path switching mirror 5. The optical path switching mirror 5 is automatically inserted into the optical path of the anterior segment observation optical system 1 based on the detection output of the alignment detection sensor 4 '.
When the alignment is completed, the mask 42 and the cornea C
Are almost conjugate with respect to the objective lens 40.

The slit light beam is scattered and reflected by the cornea C. The state of the scattered reflection is shown in FIG. Part of the slit light flux is first reflected on the corneal surface T which is the boundary surface between the air and the cornea C. The light quantity of the scattered reflected light flux L from the corneal surface T is the largest. The light quantity of the scattered reflected light flux M from the corneal endothelial cell N is relatively small. The light quantity of the reflected light flux L ′ from the corneal substance M ′ is the smallest. The scattered reflected light flux M is condensed by the objective lens 40 and guided to the half mirror 41. A part of the scattered and reflected light flux is reflected by the half mirror 41 and guided to the line sensor 47 as a focus state detection sensor. Further, the scattered reflected light flux passing through the half mirror 41 is guided to the mask 42, and the corneal endothelial cell N
A corneal endothelial cell image including the above is formed at the position where the mask 42 is arranged. Note that the mask 42 plays a role of blocking an extra reflected light beam other than forming the corneal endothelial cell image. The scattered reflected light flux that forms the image of corneal endothelial cells is relay lens 43,
The optical path switching mirror 5 is guided to the optical path switching mirror 5 via the mirror 44, the variable power lens 45, and the focusing lens 46.
Is reflected by and is imaged on the CCD 6. A corneal endothelial cell image 48 is displayed on the screen 25 as shown in FIG. In FIG. 8, reference numeral 49 indicated by a broken line is an optical image formed by a reflected light beam from the corneal surface T if it is not shielded by the mask 42, and 50 is an optical image by a scattered reflected light beam from the corneal substance M ′. ..

The line sensor 4 with respect to the cross-sectional direction of the cornea C
7 are arranged as shown in FIG. 9B, and the intensity distribution of the scattered reflected light flux is as shown in FIG. 9A. In FIG. 9A, the symbol U is a peak portion due to the scattered reflected light beam scattered and reflected on the surface T of the cornea C. Reference numeral V is a peak portion due to the scattered reflected light flux scattered and reflected in the endothelial cell portion of the cornea C. The peak portion U corresponds to the optical image 49, and the peak portion V corresponds to the optical image 48. Known means are used to detect the peak.

The output of the element at each address of the line sensor 47 is input to the focus determination circuit 47 'as shown in FIG. The focus determination circuit 47 'has a peak U as shown in FIG.
And all signals of peak V are stored and arithmetic processing is performed to determine the address of peak V. Then, the focus determination circuit 47 'determines whether or not the address L of the peak portion V coincides with the central address Q of the line sensor 47.

When the apparatus main body H is moved away from the eye E toward the anterior segment of the eye E (the optical system of the apparatus is moved in the Z direction), the address L of the peak portion V is moved. The device body H is designed so that the corneal endothelial cells are focused when the address L of the peak portion V coincides with the central address Q. Focus determination circuit 47
When the address L of the peak portion V coincides with the central address Q, the signal ′ outputs a photographing signal to the photographing light source light emission control circuit 32 ′, whereby the illumination light source 32 emits light and the eye E to be examined is illuminated. , Shooting is done automatically.

As shown in FIG. 10, the line sensor 47 is arranged in the direction orthogonal to the thickness of the cornea C, and the detection output W by the contrast of the corneal endothelial cell image 48 is a predetermined level V1 as shown in FIG. In the above case, the illumination light source 32 may be automatically caused to emit light and the corneal endothelial cell image 48 may be photographed.

The anterior ocular segment observation optical system 1, the illumination optical system 28, and the observation and photographing optical system 29 are housed in a case 52 of the apparatus main body H as shown in FIG. In FIG. 12, 5
3 is a base. The base 53 has a built-in power supply. A base 54 is provided above the base 53 so as to be movable back and forth and left and right. Reference numeral 54a is its control lever, and 54b is a photographing switch. This shooting switch 5
4b is used in the manual photographing mode. A motor 55 and a pillar 56 are provided on the top of the gantry 54. The motor 55 and the support column 56 are coupled to each other by a pinion rack (not shown), and the support column 56 is vertically moved by the motor 55. A table 57 is provided at the upper end of the pillar 56. The table 57 is provided with columns 58 and a motor 59.
A table 60 is slidably provided on the upper ends of the columns 58. A rack 61 is provided at the rear end of the table 60 as shown in FIG. A pinion 62 is provided on the output shaft of the motor 59, and the pinion 62 is meshed with the rack 61. A motor 63 is provided above the table 60.
And columns 64 are provided. A pinion 65 is provided on the output shaft of the motor 63. Device body case 52
Is slidably provided on the upper portion of the support column 64. A rack 66 is provided on the side of the apparatus body case 52.
The rack 66 is meshed with the pinion 65. In FIG. 13, 6'denotes a signal processing unit.

The motor 55 is a device body H for the eye E to be examined.
Motor 59 is used to automatically perform alignment in the Y direction of the device, the motor 59 is used to automatically perform alignment of the device body H with respect to the eye E in the X direction, and the motor 63 is used with the motor 63. Are used to automatically perform the alignment in the Z direction, and these can be operated in the automatic photographing mode. That is, the motors 55, 5
Reference numerals 9 and 63 constitute drive means for driving the apparatus main body H based on the light receiving output of the light receiving means.

In this automatic photographing mode, the control lever 54a is operated while observing the anterior segment image 26 displayed on the screen 25 by the anterior segment observation optical system 1 to operate the bright spot image R '.
Can be clearly seen, and the gantry 54 is roughly operated so that the bright spot image R ′ approaches the predetermined annular circle 27. Thereby, the scattered reflected light flux forming the bright spot image R ′ is guided to the alignment detection sensor 4 ′. The X-direction position information and the Y-direction position information of the bright spot image R ′ are detected by the alignment detection sensor 4 ′. The X-direction position information and the Y-direction position information are XY as shown in FIG.
It is input to the alignment detection circuit 67. When the X-direction alignment and the Y-direction alignment are completed, the XY alignment detection circuit 67 outputs an alignment completion signal to the mirror drive circuit 68. The optical path switching mirror 5 is inserted into the optical path of the anterior segment observation optical system 1 by the mirror drive circuit 68.

Further, the X of the alignment detection sensor 4 '
The direction position information and the Y direction position information are input to an alignment determination circuit (not shown). The alignment determination circuit drives the motor 59 so that the optical axis O1 of the device optical system approaches the optical axis O2 of the eye E from the X direction based on the X direction position information, and the device optical system starts from the Y direction based on the Y direction position information. The motor 55 is driven so that the optical axis O1 of (1) approaches the optical axis O2 of the eye E to be examined. The table 60 is slid in the X direction by the motor 59, and the table 57 is moved by the motor 55 in the Y direction.
The optical axis O1 of the apparatus optical system and the optical axis O2 of the eye E are automatically aligned based on the alignment detection sensor 4 '. On the other hand, the motor 63 moves the apparatus main body case 52 in the Z direction so that the address L of the peak portion V detected by the one-dimensional line sensor 47 and the central address Q coincide with each other. As a result, the alignment of the optical system of the apparatus with respect to the eye E is automatically completed, and the corneal endothelial cells N are photographed.

FIG. 15 shows another embodiment of the corneal endothelial cell observing and photographing apparatus according to the present invention, in which a dichroic mirror 69 is used instead of the optical path switching mirror 5 for observing the anterior segment of the eye. An infrared light source is used as the illumination light source 7, and the alignment index light and the pattern forming light flux are infrared light, and the alignment index light flux reflected by the cornea C and the reflected light flux reflected by the anterior segment are transmitted. The slit light flux reflected by the cornea C is reflected. In this case, on the screen 25, the screen is switched from the anterior ocular segment image 26 to the corneal endothelial cell image 48 by turning off the illumination light source 7, the alignment light source 9, and the alignment pattern light source 22. It is also effective to insert a shutter in the other optical path while using one optical path.

FIG. 16 shows an embodiment for finely adjusting the focus of the corneal endothelial cell image 48. After the alignment is manually adjusted, the fixation target projection optical system 14 is rotated in the direction of arrow F. The eyeball of the eye E to be inspected with an arrow F around the center of rotation G
The optical axis is rotated in the same direction as that of the objective lens, and the inter-optical axis distance I from the reference position D of the objective lens to the surface T of the cornea C is changed to change the focused state of the corneal endothelial cell image 48. , Δ indicates the change in the distance between the optical axes.

[0035]

Since the apparatus for observing and photographing corneal endothelial cells according to the present invention is configured as described above, the burden on the examiner and the subject can be reduced as much as possible.

[Brief description of drawings]

FIG. 1 is an explanatory diagram of an optical system showing an embodiment of a corneal endothelial cell observation and photographing device according to the present invention.

FIG. 2 is a diagram showing an alignment optical system according to the present invention.

FIG. 3 is a diagram showing a fixation target projection optical system according to the present invention.

FIG. 4 is a diagram showing a reflection state of an alignment index light beam according to the present invention.

FIG. 5 is a diagram showing a display state of an anterior segment image.

FIG. 6 is a diagram showing another example of the light source section of the illumination optical system according to the present invention.

FIG. 7 is a diagram showing a reflection state of a slit light beam on the cornea.

FIG. 8 is a diagram showing a reflection state of a corneal endothelial cell image.

FIG. 9 is a diagram showing a correspondence relationship between a corneal endothelial cell image and the amount of light received by a line sensor.

FIG. 10 is a diagram showing an arrangement state of line sensors for a corneal endothelial cell image.

11 is a diagram showing an output state from the line sensor shown in FIG.

FIG. 12 is a side view showing the overall configuration of a corneal endothelial cell observation and imaging device according to the present invention.

FIG. 13 is a plan view partially showing the corneal endothelial cell observation and photographing device according to the present invention.

FIG. 14 is a diagram showing a drive circuit of an optical path switching mirror according to the present invention.

15 is a diagram showing an example in which a dichroic mirror is used instead of the optical path switching mirror shown in FIG.

FIG. 16 is an explanatory diagram showing an example in which the focused state of corneal endothelial cells is changed by using the fixation target projection optical system according to the present invention.

[Explanation of symbols]

 8 ... Alignment optical system 4 '... Alignment detection sensor 28 ... Illumination optical system 29 ... Observation / photographing optical system 30, 32 ... Illumination light source 47 ... Line sensor (focus state detection sensor) E ... Eye to be examined C ... Corneal N ... Corneal endothelium cell

 ─────────────────────────────────────────────────── ─── Continuation of the front page (72) Koji Nishio Topcon Co., Ltd. 75-1 Hasunuma-cho, Itabashi-ku, Tokyo (72) Inventor Hiroshi Iijima 75-1 Hasunuma-cho, Itabashi-ku, Tokyo Topcon Co., Ltd. Within

Claims (3)

[Claims] 1. An illumination optical system for obliquely irradiating each illumination light from an illumination light source for observation and an illumination light source for photographing toward a cornea of an eye to be examined, and reflection from the cornea including corneal endothelial cells. An observation and photographing optical system for receiving and observing and photographing scattered light, wherein the observation and photographing optical system is provided with a focus state detection sensor for detecting a focus state of the corneal endothelial cells. Corneal endothelial cell observation and imaging device. 2. The illumination light source for photographing is connected to a light emission amount control circuit, the light emission amount control circuit is controlled based on a detection output of the focusing state detection sensor, and the illumination light source for photographing is in focus. The device for observing and photographing corneal endothelial cells according to claim 1, wherein light is emitted and photographed automatically based on the output of the state detection sensor. 3. An illumination optical system for obliquely irradiating each illumination light from an illumination light source for observation and an illumination light source for photographing toward a cornea of an eye to be inspected, and reflection from the cornea including corneal endothelial cells. An observation and photographing optical system that receives scattered light and observes and photographs,
Alignment index light projection means for projecting alignment index light for aligning the device body with respect to the cornea, light receiving means for receiving the alignment index light reflected by the cornea, and the cornea based on the light reception output of the light receiving means. A corneal endothelial cell observation and imaging device, comprising: a driving unit that drives the device main body so that the device optical system is aligned.