JPH0566808B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION [Industrial Field of Application] The present invention relates to an ophthalmological examination machine capable of recording fundus images, intraocular pressure data, etc. on the same recording medium.

[Prior art] Testing for glaucoma, which often leads to blindness, involves (1) measuring intraocular pressure, (2) examining changes in the shape of the papilla and loss of the nerve fiber layer using fundus images, and (3) determining the C/D ratio. The measurement is said to be valid. This C/D ratio is the ratio of the diameter of the fundus papilla (Disk, abbreviated as D) to the diameter of the concave (Cup, abbreviated as C) that occurs inside the fundus papilla (Disk, abbreviated as C), and D is a value specific to the eye being examined. C is said to indicate damage to the optic nerve associated with the advanced state of glaucoma.

The above-mentioned (1) is measured using a contact or non-contact tonometer, (2) is determined by direct fundus images or recorded images such as photography, and (3) is determined by using photographs, etc. It is based on measurements on recorded images and calculations of the measurement results.

Conventionally, in order to determine glaucoma, there is no device that can simultaneously output the status of intraocular pressure and the ratio of the indentation diameter of the nipple and the diameter of the nipple. Optometric tests must be performed, which is extremely uneconomical in terms of space, time, equipment costs, etc., and each test result is output without any relationship, so there is a risk of mix-ups or data loss. It also has

[Object of the Invention] The object of the present invention is to eliminate the drawbacks of the above-mentioned conventional examples, to provide a single device with an intraocular pressure measurement function and a fundus imaging function, and to output an intraocular pressure value and an ocular fundus image at the same time. Provides an ophthalmological examination machine that allows you to simultaneously visualize the intraocular pressure and the ratio of the inverted nipple diameter to the nipple diameter by outputting the output to the section, making it possible to make a comprehensive diagnosis of glaucoma on the spot, and eliminating the risk of misunderstanding the data. It's about doing.

[Summary of the invention] The gist of the present invention for achieving the above object is as follows:
An intraocular pressure measuring means for measuring the intraocular pressure of the eye to be examined, an illumination means for illuminating the fundus of the eye to be examined, and a photographing means for photographing the fundus of the eye to be examined illuminated by the illumination means,
The ophthalmological examination machine is characterized by comprising an output means for outputting the intraocular pressure value measured by the intraocular pressure measuring means and the intraocular pressure image photographed by the photographing means onto the same output section.

[Embodiments of the Invention] The present invention will be described in detail based on illustrated embodiments.

FIG. 1 shows a configuration diagram of an embodiment according to the present invention,
E is the eye to be examined, and T is a known non-contact tonometer. In the non-contact tonometer T, an objective lens 2 having a nozzle 1 is placed facing the eye E to be examined, and a transparent window glass 3 is placed behind the objective lens 2, and a cylinder 4 is connected thereto. A piston 5 is inserted into the cylinder 4, and the piston 5 is actuated by a rotary plunger 8 via a rod 6 and an arm 7. Further, a projection light source 10 is arranged obliquely in front of the eye E to be examined, and the light emitted from this light source 10 is projected onto the cornea Ec of the eye E to be examined through a projection lens 11, and the reflected light is received through a light receiving lens 12. The light is received by the element 13.

Behind the objective lens 2 and the window glass 3, there is an observation lens 14 that can be retracted out of the optical path, a perforated mirror 15,
Focusing lens 16, imaging lens 17, rotating mirror 1
8. Films 19 are sequentially arranged. Note that 20 is a recording display, and the displayed contents are projected onto the film 19 via a lens 21 and a mirror 22. Further, on the reflection side of the perforated mirror 15, a relay lens 23,
Photographing light source 2 consisting of a ring slit plate 24 having a circular opening, a condenser lens 25, and a strobe tube.
6, condenser lens 27, infrared filter 28,
Observation light sources 29 are sequentially arranged. Further, a television camera 30 is provided at a position conjugate with the film 19 on the reflection side of the rotary mirror 18, and the output of this television camera 30 is connected to a television monitor 31 so as to display the fundus image of the eye E to be examined. A measuring means 3 consisting of, for example, a digital caliper with an electric output, etc., is used to measure the part of the fundus image.
2 is being prepared.

The output of this measuring means 32 is sent to the data selection section 33, and is sent to the data output control section 3 via the calculation section 34.
5, and a command signal from an identification command section 36 is also connected to the data selection section 33. The data output control section 35 is connected to the output of the light receiving element 13 via the control measurement section 37 of the non-contact tonometer T, and further connected to the output of the intraocular pressure measurement switch 39 via the command generation section 38. . The command generation unit 38 sends a command signal to operate the rotary plunger 8 via the control measurement unit 37 of the non-contact tonometer T, a command signal to the photography power source 40 to operate the photography light source 26, and a rotation mirror. A command signal to the mirror drive circuit 41 for rotating the film 18, a command signal to the winding motor 42 for winding the film 19, and a command signal to the display power supply 43 for operating the display 20 are outputted. It's summery. and,
Information signals are output from the data output control section 35 to the display 20 and other devices.

In order to properly align the non-contact tonometer T with the eye E to be examined, the anterior segment of the eye E illuminated with the extraocular illumination light L must be aligned with the objective lens 2 of the non-contact tonometer T, the window glass 3, An image is formed on the television camera 30 through an optical system including an observation lens 14 inserted on the optical path, a perforated mirror 15, a focusing lens 16, an imaging lens 17, and a rotating mirror 18 inserted on the optical path, This may be done while observing on the television monitor 31.

When the non-contact tonometer T is properly aligned with the eye E, the intraocular pressure measurement switch 39 is activated to measure intraocular pressure.
When you operate the command generation section 38, control measurement section 37
The plunger 8 rotates through the piston 5, and the piston 5 is driven. Then, the air pressure in the cylinder 4 gradually increases and an air flow is injected from the nozzle 1 to the cornea Ec. On the other hand, the projection lens 11 emits light from the projection light source 10.
Parallel light is projected onto the cornea Ec of the eye E,
The reflected light from the cornea Ec passes through the light receiving lens 12 and is detected by the light receiving element 13. If the air pressure injected from the nozzle 1 is too weak or strong, the cornea Ec becomes convex and concave, and the light receiving element 1
Although the amount of reflected light detected by 3 is small, it reaches its maximum value when the cornea Ec in the middle is almost flat, so from this the intraocular pressure IOP of the eye E to be examined is calculated by the control measurement unit 37, and the data output control unit 35 sent to.

When the observation lens 14 is moved out of the optical path as shown by the solid line and the observation light source 29 is turned on, the light emitted from the observation light source 29 passes through the infrared filter 28, the condenser lenses 27 and 25, the ring slit plate 24, and the relay lens 23. , a perforated mirror 1 at a position substantially conjugate with the ring slit plate 24 with respect to the relay lens 23;
5, the light is reflected in the direction of the eye E to be examined, passes through the window glass 3 and the objective lens 2, and forms an image on the anterior segment of the eye E to illuminate the fundus Ef. This time, the reflected light travels the same optical path backwards. Then, the light passes through the hole of the perforated mirror 15 and forms an image on the television camera 30, and the fundus image is displayed on the television monitor 31. The television camera 3 illuminates with near-infrared light using an infrared filter 28.
If 0 has sensitivity in the same wavelength range, then
The pupil of the eye E to be examined does not undergo miosis due to illumination light. Furthermore, it is advantageous for the same reason that the extraocular illumination light L is also invisible light produced by an infrared diode.

In addition, in order to photograph and record the fundus image, if the rotary mirror 18 is raised and the photographing light source 26 is made to emit light for a very short time, visible light is projected onto the film 19 provided at a position conjugate with the television camera 30. The image is recorded. Note that during fundus observation in this case, the line of sight of the eye E to be examined can be guided by making movable a small fixation lamp such as a light emitting diode placed approximately in the vicinity of the imaging plane of the television camera 30.

Now, on the fundus image displayed on the television monitor 31 while the fundus image is being observed, the measuring means 32 measures the diameter D of the papilla and the diameter C of the concave part, and the data is transmitted according to instructions from the identification command unit 32. It is sent to the arithmetic unit 34 via the selection unit 33 to calculate C÷D, and the result is stored. Next, a fundus image is taken and the intraocular pressure is measured, and this is controlled by commands so that first the image is taken, and then the measurement is performed in this order at extremely short intervals.

That is, when the measurement switch 39 is pressed, the contact closes,
The command generation unit 38 operates the mirror drive circuit 41 to raise the rotary mirror 18, while operating the photographing power source 40 to light the photographing light source 26.
A fundus image of the fundus Ef is recorded on the film 19.
Furthermore, the non-contact tonometer T is also activated, and the measured value of intraocular pressure is sent to the data output control section 35 and the calculation section 34
In addition to the recorded contents, the display power source 4 controls the light emission.
3, the image is displayed on the display 20, and an image near the fundus image on the film 19 is recorded by the lens 21 and mirror 22. Further, after this recording is completed, the film winding motor 42 is activated to wind up the film 19 by one frame. FIG. 2 shows an example of recording on the film 19, in which numerical data of the intraocular pressure value and the C/D ratio are imprinted near the fundus image.

The reason why photography and intraocular pressure measurement are performed in the above order is that photography, which can be performed in about 1 mS, must be performed first before the deformation of the eyeball and slight movement of the eyeball due to air injection for measuring intraocular pressure. This is because the measurement ends before alignment shifts occur due to blinking or slight movement of the eyeballs due to optical stimulation.

FIG. 3 shows an embodiment in which the fundus image measuring method in FIG. 1 is modified. In front of the television camera 30 in FIG. 1, there is a line mark 50 as shown in FIG.
A transparent plate 50 having a diameter of 1.a can be inserted therein, and an image thereof is formed on the television camera 30 via a re-imaging lens 51. A rack 50b is provided at one end of the transparent plate 50, and this rack 50b
The pinion 52 meshes with the knob 54 via the shaft 53.
By turning the line mark 50a, the line mark 50a can be made movable in the direction perpendicular to the plane of the paper in FIG. 3, that is, in the left-right direction in FIG.

The image of the line mark 50a is superimposed on the fundus image, and a line mark image 50A is displayed on the television monitor 31.
By aligning this with the edge of the nipple image or recess image, the position can be detected by the potentiometer 55 and sent to the data selection section 33. In this case, it goes without saying that the identification command section 36 not only distinguishes between the nipple image and the recess image but also commands such as which end is the left or right end. Furthermore, by rotating the transparent plate 50 in any direction within a required range around the optical axis, the dimensions of the nipple image and the recess image in any radial direction can be measured.

In the above embodiment, the fundus part is measured, but the pupil diameter and corneal diameter of the anterior segment may also be measured.

[Effects of the Invention] As explained above, the ophthalmological examination machine according to the present invention is capable of measuring intraocular pressure and photographing the fundus with one machine, so it can be installed in a small space and requires only one operator. , it has the advantage of being able to prevent result data from being dissipated and data storage being easy.

[Brief explanation of the drawing]

The drawings show an embodiment of the ophthalmological examination machine according to the present invention, FIG. 1 is a configuration diagram of the embodiment, FIG. 2 is a front view of a film, FIG. 3 is a configuration diagram of main parts of another embodiment, and FIG. This figure is a front view of the transparent plate shown in FIG. 2 as viewed from the optical axis direction. Symbol T is a non-contact tonometer, 1 is a nozzle, 2 is an objective lens, 3 is a window glass, 4 is a cylinder, 5 is a piston, 10 is a projection light source, 13 is a light receiving element, 14 is an observation lens, 15 is a perforated lens , 16 is a focusing lens, 17 is a target lens, 18 is a rotating mirror, 19
is a film, 24 is a ring slit plate, 25 is a photographing light source, 28 is an infrared filter, 29 is an observation light source,
30 is a TV camera, 31 is a TV monitor, 32
34 is a measuring means, 34 is a calculation section, 35 is a data output control section, 37 is a control measurement section, 39 is an intraocular pressure measurement switch, 50 is a transparent plate, and 50a is a line mark.

Claims (1)

[Scope of Claims] 1. An intraocular pressure measuring means for measuring the intraocular pressure of the eye to be examined, an illumination means for illuminating the fundus of the eye to be examined, and a photographing means for photographing the fundus of the eye to be examined illuminated by the illumination means, An ophthalmological examination machine comprising: an output means for outputting the intraocular pressure value measured by the intraocular pressure measuring means and the fundus image photographed by the photographing means onto the same output section. 2. Scope of claims, comprising a dimension measuring means for measuring the dimensions of a desired part of the fundus from a fundus image of the eye to be examined, and the output means outputs the measurement results by the dimension measuring means on the same output section. The ophthalmological examination machine according to paragraph 1. 3. The ophthalmological examination machine according to claim 2, wherein the fundus image of the eye to be examined, the intraocular pressure value, and the measurement results are sequentially outputted onto the same output section. 4. The ophthalmological examination machine according to claim 1, wherein the photographing means completes photographing of the fundus image before the cornea is deformed by the intraocular pressure measuring means.