US3777738A - Ophthalmic diagnostic instrument - Google Patents

Ophthalmic diagnostic instrument Download PDF

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Publication number
US3777738A
US3777738A US00201467A US3777738DA US3777738A US 3777738 A US3777738 A US 3777738A US 00201467 A US00201467 A US 00201467A US 3777738D A US3777738D A US 3777738DA US 3777738 A US3777738 A US 3777738A
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Prior art keywords
light
eye
pupil
hemispheric
infrared
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Expired - Lifetime
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US00201467A
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English (en)
Inventor
K Sugita
T Muraoka
T Shimizu
S Ueno
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Tokai Rika Co Ltd
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Tokai Rika Co Ltd
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A61B3/11Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for measuring interpupillary distance or diameter of pupils
    • A61B3/112Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for measuring interpupillary distance or diameter of pupils for measuring diameter of pupils
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/02Subjective types, i.e. testing apparatus requiring the active assistance of the patient
    • A61B3/024Subjective types, i.e. testing apparatus requiring the active assistance of the patient for determining the visual field, e.g. perimeter types
    • HELECTRICITY
    • H03ELECTRONIC CIRCUITRY
    • H03KPULSE TECHNIQUE
    • H03K4/00Generating pulses having essentially a finite slope or stepped portions
    • H03K4/06Generating pulses having essentially a finite slope or stepped portions having triangular shape

Definitions

  • ABSTRACT A device for examining pupillary reflex soconstructed that a spotlight is applied directly or indirectly to an eye of a patient to cause pupillary reflex, an infrared lamp is provided to apply infrared rays to the eye for convenience of camera work, and an infrared camera and television set or screen are provided to catch and reproduce a motion of the pupil into an image. From the image of pupillary motion reproduced on the screen, an ophthalmologist can readily and exactly know the condition of retina, or optic nervous system, without any help of oral answer or sign of the patient.
  • the present invention relates to a device for examining pupillary reflexes, more particularly, to a diagnostic device of diseases in the optic nervous system or retina, through pupillary reflexes to light.
  • the objects of the invention are to provide:
  • a device for examining pupillary reflexes permitting as to check up on diseases to or damages in an optic nervous system or retina and measure a range of the field of vision, through the reflex motion of the pupil responsive to a given light;
  • any person having difficulties of communication including the asphasic, the older person or a child and any patient with general paralysis may be easily examined; to provide a device for examining pupillary reflexes so including a light source for directing a spotlight to the eyeball of a patient with a number of lamps mounted on a rotary arm member, said means to switch them on and off in sequence, and
  • the device of the invention in a design which is very simply manufactured at a low cost.
  • FIG. I is a diagram of an embodiment of the device of the present invention, showing a spotlight applied to a hemispherical screen;
  • FIG. 2 is a plan view of a means to control the direction of a spotlight employed in th device for examining pupillary reflex shown in FIG. 1;
  • FIG. 3 is a cross-sectional view of a light-projecting section of the device shown in FIG. 1;
  • FIG. 4 is a side view of a means to adjust the position ofa chin support employed in the device shown in FIG.
  • FIG. 5 is a perspective view of another form of a device for examining pupillary reflex
  • FIG. 7 is a cross-sectional view of a rotary arm mem-
  • FIG. 8 is a side view of a means for adjusting the height of a pillow employed in the device shown in FIG.
  • FIG. 9 is a view partly in cross section of a means for adjusting the lateral position of a casing employed in the device shown in FIG. 5;
  • FIG. 10 is a diagram of a circuit for controlling a rotation angle of the rotary arm
  • FIG. 11 is a view of a part of a means for driving the rotary arm
  • FIG. 12 is a plan view of a switch panel employed in the device shown in FIG. 5;
  • FIG. 13 is a side view of a part of the switch panel shown in FIG. 12.
  • FIG. 14 is a diagram of a circuit for driving lamps on the rotary arm shown on FIG. 7, showing also the circuit connections between lamps and switches on the switch panel shown in FIG. 12.
  • FIGS. 1 through 4 there is illustrated one embodiment of the present invention, preferably for eye examination of the patient in a standing or sitting position.
  • a screen of a hemispherical shape or a substantially hemispherical shell extending to cover the entire range of the visual angle of the eyeball, is mounted relative to the unit 2 for applying a spotlight, and controlling its direction to any desirable spot visible within the extension of the internal wall of said screen 1. The amount of light and the time of lighting can be controlled.
  • Means to control the direction of illumination a vertical arm of the unit 2 is pivotally connected to the body thereof with the pivotal connecting point positioned in alignment with an imaginary line between the center and the apex of the hemispherical screen 1.
  • the unit 2 is adapted to rotate by to permit the pivotal connecting point as a fulcrum over the head of a patient by the operation of a handle 2f.
  • a line 20 is stretched across a wheel 2d and a wheel 2b through pulleys.
  • the wheel 2b is connected to a frame of a light projecting section 2a of the unit 2 and adapted to move with it.
  • the wheel 2d is connected to a control wheel 2e and adapted to be rotated by it.
  • the unit 2 for applying the spotlight comprises a lamp 2g, a lens 2h for focusing the light from the lamp 2g, a stop 2 i for controlling the amount of the light and a reflective element 2j adapted to reflect and direct the light transmitted through the stop 21'.
  • a timer is connected to control the duration of illumination of the spotlight on the screen 1.
  • a spotlight is applied to any desirable location of the screen by operations of the control wheel 2e and the handle 2f.
  • a chain support 3 for the patient 4 is adjustable to set the patients eye 4a to the level in alignment with a camera lens.
  • the chin support 3 is disposed at the top end of a shaft 3f which has a handling wheel 32 at its other end.
  • the shaft 3f has a threaded portion and is inserted, through a threaded bore of a sliding plate 3a engaged with the threaded portion of the shaft 3f, in a guiding groove formed on the frame of the unit 2.
  • the handling'wheel 3e By-operating the handling'wheel 3e, the chin support 3 can be moved upwardly or downwardly to adjust the patients eye to a required position.
  • the chin support is free from the rotation of the shaft 3f.
  • a shaft 3b is inserted, which has a threaded portion on either end portion of the shaft 3b.
  • Two blocks 3c are fixed to the frame of the unit 2 and each has a threaded bore engageable with the threaded portion of the shaft 3b.
  • Handling wheels 3d are provided on the ends of the shaft 3b, respectively.
  • the shaft 3b is freely rotatable relative to the sliding plate 3a but is fixed with reference to the axial direction of the shaft 3b by a stop rings 3g. Accordingly, by operation of the handling wheel 3d, the sliding plate 3a is moved to adjust the lateral position of the chin support 3.
  • An infrared ray television camera 5 is mounted on the hemispherical screen 1 at the apex thereof, and, an infrared lamp 6 is spaced therefrom to emit, from which infrared rays directed to the pupil of the patients eyeball, so that the television camera can detect a transient motion of the pupil responsive to the light given thereto.
  • An image receiving section 7 or a reproducing screen such as a Braun tube is aligned with by the television camera to reproduced the pupillary reflexes into an image.
  • the operation The chin rest 3 is adjusted to set the patients eye into alignment with the center of the screen 1 and the television camera 5, and the spotlight is applied to the eye through the screen 1.
  • the infrared rays are applied to the eye, so that the pupillary reflex to a given illumination by the spotlight is detected by the infrared camera and reproduced into an image on the screen of the image receiving or reproducing section 7.
  • a pupil is sensitive to ambient visible light and therefore the inner part of the screen 1 covering the entire visual field of patient must be kept dark.
  • a spotlight illumination is applied from the spotlight applying unit 2. To one or an other spot along and on the internal surface of the screen 1.
  • the lamp 2g is not lit before the shifting operation of the spotlight applying unit 2 has been finished. After completion of the shifting operation, the lamp 2g is energized for a period of time determined by the timer, for examples, for 4 seconds.
  • the pupil does not respond to the infrared rays, but responds only to the visible light of spotlights.
  • the spotlight applying unit 2 is operated to shift a spot of light from one position to another within the internal surface of the screen 1, with variations of intensity of light, and an image of a transient reflex motion of the pupil is received on the screen of the receiving section 7. From this, any one can make a diagnosis whether there is something abnormal in the retina at the location-corresponding to the position of the spot-. light.
  • FIGS. 5 through 14 another embodiment of the present invention is shown.
  • a bed 11 is provided for a patient, with an operation table 12, on which is mounted a casing 13 having one open end at its front side and by which the upper half of the patient body is covered.
  • the open end 13a has a shielding curtain 13b for preventing the outer light from entering the casing 13.
  • the casing 13 has a television camera 15 mounted on its top and lined up to detect the motion of the pupil by the employment of infrared ray emitted from units 16, which are mounted on a slanted wall of the casing 13.
  • a rotary arm control of illumination An arch-shaped rotary arm 17 secured to the upper internal wall of the casting 13, has an arm portion, a central hole 17a through which a lens barrel 15a of the television camera 15 protrudes into the casing 13, and an upper disc portion 17b provided with annular racks 170.
  • the rotary arm portion 17 has an internal surface provided with a number of lamps grouped in sets of three and arranged radially in three rows, lamps in one row having diameters different from those of the other two rows, the left lamps being the largest, the right lamps being the smallest in diameter and those of the mid row being of an intermediate size as shown in FIG. 7.
  • a driving mechanism 18 consisting of a motor 18a and a gearing mechanism 18!), including a spur gear 180, meshing with racks is mounted on the disc portion 17b of the rotary arm 17 in meshed relation through gears, so that one rotation of the motor 18a causes a full turn of the rotary arm 17.
  • the spur gear engages with a gear 18d as shown in FIG. 11.
  • a potentiometer 182 To the shaft of the gear 18d is connected a potentiometer 182 for detecting the position of the rotary arm 17.
  • the switch panel Two infrared lamps are provided in such arrangement that one of the infrared lamps still applies its rays to the pupil, when rays of another lamp are instantaneously intercepted by the rotary arm during rotation thereof.
  • a switch panel 19 or an operation panel including a dial plate 19a is provided rotatably operative to drive the rotary arm 17 through the driving mechanism 18, by the same angular extent that said dial plate 19a is turned, and push buttons which are pressed to turn on a desired lamp 17d of the rotary arm 17, through a shift register 19:1 shown in FIG. 14.
  • the push buttons comprise a illumination switch 19s, a switch l9ffor shifting the position ofa light inwardly, a switch 19g for shifting the position of the light outwardly, a resetting switch 19h, a switch 191' for selecting the size of the light, a switch l9j for switching the illumination'of the lamps from one arm portion of its rotary arm 17 to the other arm portion, an indicator 19k for indicating the size of the lamp and a switch 19! for selecting the intensity of the light.
  • the energized lamps are indicated on the switch panel 19.
  • the dial plate 19a and an indicator 19m provided on the switch panel 19 for indicating the position of an energized lamp on the rotary arm 17 are connected through pulleys and belts as shown in FIG. 12.
  • a potentiometer 19d for detecting the position or rotation angle of the indicator 19m.
  • the dial plate 19a is turned, the potentiometer 19d is rotated and a voltage corresponding to the rotation angle of the dial plate 19a is produced. Due to this voltage, the balance between the resistances of the potentiometers 19d and 18e are broken, producing a difference in voltage,
  • a plurality of lamps l 1, having the largest diameter, lamps 1 I 1 having the intermediate diameter and lamps 1 I having the smallest diameter are arranged in three rows on one arm portion of the rotary arm 17.
  • a plurality of lamps 1, of the largest diameter, lamps 121 122' 1212' of the intermediate diameter and lamps, 131', 1 2 1 12' of the smallest diameter are arranged on the other arm of the rotary arm 17.
  • the switch 19g for shifting the position of the light outwardly is connected to a NAND gate 190 and one pulse is produced by one operation of the switch 19g through said NAND gate 190.
  • the shift register 19n is connected to said NAND gate 190 and adapted to outwardly shift the position of a terminal in to a high level by operating the switch 19g.
  • switch l9ffor shifting the position of the light inwardly 3 is connected to a NAND gate 19p and one pulse is produced by every operation of said switch 19f through said NAND gate 19
  • the shift register l9n is further adapted to inwardly shift the position ofa terminal into a high level by the operation of the switch 19f.
  • a timer lamps symmetrically arranged on the indicator 19m. tan jsmts Toan ina a e. I. .n 9s1. at.tl1qir respective bases to a first terminal of the shift register 19:1 and adapted to be turned on when the terminal is in a high level.
  • Transistors Tr and TF2, transistorsjlfr; and ry are nne t t rqu h e Q$RY12 to a second and a third terminal of the shift register l9n, respectively. Similarly, the remaining transistors are connected to the corresponding terminals of the shift registers, respectively. The transistors are turned on when the respective corresponding terminals are in a high level.
  • the lamp 1 is lit to indicate the position of the lamp 1 to be lit on the arm 17.
  • the switch 19:; is closed, the timer 19b is operated for the determined period of time.
  • the transistor Tr connected to the first terminal of the shift register l9n in a high level is turned on and a current is applied through the switches 19!, l9j and 191' to light the lamp 1 for the determined period of time.
  • the switch 193 is operated, the position of the terminal in a high level is shifted outwardly to the next terminal through i ,ENpw at fio and h ttat istotlrzt s tu ned on to light the lamp 1 on the indicator 19m for indication of the position of the lamp to be lit.
  • the switch 192 is closed, the lamp on the rotary arm 17 is lit in the same manner as mentioned above.
  • the switch 19g the lamp to be lit is thus shifted outwardly, while by operating the switch 19f, the light to be lit is shifted inwardly due to the action of the NAND gate 19p.
  • the position of the lamp to be lit is controlled by the switches on the switch panel 19 and the lamp energized is identifiable on the switch panel 19.
  • the indicator 19m can be seen a longitudinal position of the lamp energized or to be energized on the rotary arm 17 and from the indicator 19k can be seen the size of the lamp energized or to be energized, or a lateral position thereof on the rotary shaft 17.
  • a television set 20 transmits a motion of the pupillary reflex detected by the infrared ray camera 15 into an image.
  • Knobs 21 and 22 are provided adjacent each other on the upper surface of the operation table 12, knob 21 operable for moving the pillow 12a vertically to adjust th level of the patients eye; and knob 22 operable for moving the casing 13 in a transverse direction according to the position of the patient's eye.
  • Means to position patient for diagnostic examination As shown in FIG. 8, when the knob 21 is turned, a gear 21a fixed to it is rotated, to rotate in turn a gear 21b meshed with the gear 21a. This rotation of the gear 21b is conveyed to bevel gears 21d and 12d through a universal joint 21c.
  • a pillow shaft 12c has a threaded portion and a nut 12b, fixed to the operation table 12, has a threaded bore engageable with it. By turning the knob 21 (FIGS. 5 and 9) the pillow shaft 12c is rotated to move the pillow 12a upwardly or downwardly for adjusting the patients eye to the required vertical position.
  • th knob 22 (FIGS. 5 and 9) is turned to move the casing 13 laterally.
  • a shaft 22a connected thereto is rotated. It has a threaded portion and a sliding means 22b with a threaded bore engageable with the threaded portion of the shaft 22a. Accordingly, the rotation of the shaft 22a moves the sliding means 22b laterally.
  • the casing 13 is moved laterally according to the movement of the sliding means 22b.
  • a guiding means 12e is provided for the lateral movements of the casing 13.
  • the operation The patient 14 lays on his back on the bed 11; his head is moved into the casing 13 on the operation table 12 through the opening 13a and rests stationary on the pillow 12a.
  • the knob 22 is operated to move the casing 13 transversely to the position where the television camera 15 can scan exactly the eye to be examined.
  • knob 21 is operated to adjust the level of the pillow 12a, so as to locate the patients eyeball at the center of said rotary arm 17.
  • buttons of switch panel 19 are pressed to an operative position to energize three lamps 17d positioned at the end portion of the rotary arm 17, and the dial 19a is turned to cause rotation of said rotary arm 17.
  • infrared rays are applied to the pupil of the patient 14 through the infrared lamps 16 to permit the television camera to work, whereby the motion of the pupil or pupillary reflex is transmitted to the television screen 20. If light of the lamps enters to the diseased or damaged part of the optic nerves, the pupil does not contract and shows no response to the light. In such a case, the position of the light is recorded on a recording-paper.
  • Push buttons are turned on or off in the similar manner to energize or deenergize lamps 17d in sequence, and at the same time the rotary arm 17 is rotated a full turn, thereby permitting examination of the patient response to rays of various angles.
  • the device for examining pupillary reflex of the present invention as set forth hereinabove is so adapted that diseases or damages in the retina or optic nervous system are detected and a range of visual field is also observed through the reflex motion of th pupil to the lights rays applied from various angle.
  • Such a pupillary reflex is detected by the infrared camera and reproduced into a visible image on the television screen, so that the motion of the pupil is exactly observed in detail, without any communication from the patient.
  • any person including an aphasic, an older person or child, having speech difficulties, and any patient with general paralysis may be readily examined.
  • An optical device for diagnosis of reflexes of the pupil of an eye of an individual comprising:
  • said shell provided at its apex with an opening for a TV camera and an infra-red source of light opening spaced from said apex;
  • a TV infra-red camera mounted with its lens at the apex of said hemispheric shell directed toward the fulcrum of said hemispheric screen;
  • G means for moving said spot of light in said hemispheric shell to vary the direction from which said spot of light appears to originate to said pupil.
  • a device for examining pupillary reflex of a patient in an erect position as claimed in claim 1 further comprising a casing for covering the upper portion of a patients body and having the said hemispheric shell therein and switch means for controlling the position, size, intensity and period of the said illumination located outside of the said casing.
  • An optical device for diagnosis of reflexes of the pupil of an eye of an individual comprising:
  • said illuminating means being mounted on the concave side of said arm, whereby movements of said spot of visible light cause a pattern of reflex responses by said pupil in dependence upon the varying apparent angle of said spot as viewed from the position of said eye, allowing said pattern of reflex responses to be viewed as televised under said infrared light.
  • An optical device for diagnosis of reflexes of the pupil of an eye of an individual comprising:
  • C. means to vary the direction, intensity and duration of said beam
  • E. means connected to said screen to direct the emanation of infrared rays from the infrared source
  • G means to position said chin support
  • H. means to align said means to vary the direction of said beam and said means to position said chin support with each other and with said means to direct the emanation of infrared rays and with said hemispheric screen to permit positioning of said pupil at about the center point of said hemispheric screen, thereby permitting travel of said directional beam of visible light over the'interior of said hemispheric screen such that both the visible light and the infrared rays illuminate the center point of said hemispheric screen, said means to vary the direction of said beam including means to do so at varying angles thereof within the range of a normal visual field of the individual, whereby the pupil is examined at different angles in different areas, and
  • optical detecting means in optical alignment with said center point of said hemisphere for photographing said eye by infrared light to observe the responses of the eye to visible light.
  • a diagnostic optical device as claimed in claim 4 said at least one source of infrared light comprising two infrared sources.
  • said at least one source of infrared light being a source of a single infrared beam
  • said means to align including means to align said infrared beam for continuous intersection with said illuminating light beam.
  • optical detecting means comprises a television camera.
  • An optical device for diagnosis of reflexes of the pupil of an eye of an individual comprising:
  • a television camera including a lens barrel of said television camera protruding through said opening
  • G means to position said pupil in alignment with a center line of said lens barrel in said chamber
  • H means to move the head of said individual vertically in alignment with the geometric center of said hemispherical arm
  • a plurality of sources of visible light beams in said arm symmetrically arranged in rows with sequentially decreasing light intensities in each row

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US00201467A 1968-06-22 1971-11-23 Ophthalmic diagnostic instrument Expired - Lifetime US3777738A (en)

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JP5259568 1968-06-22
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Cited By (12)

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Publication number Priority date Publication date Assignee Title
US4283124A (en) * 1974-06-19 1981-08-11 Canon Kabushiki Kaisha Eye fundus camera
US4331132A (en) * 1979-04-05 1982-05-25 Olympus Optical Company Ltd. Angioscope
US4570638A (en) * 1983-10-14 1986-02-18 Somanetics Corporation Method and apparatus for spectral transmissibility examination and analysis
USRE32718E (en) * 1976-12-03 1988-07-26 Sinus Medical Equipment Ab Transillumination diagnostic method and apparatus
US4798214A (en) * 1987-11-24 1989-01-17 The United States Of America As Represented By The Secretary Of The Air Force Stimulator for eye tracking oculometer
US4817623A (en) 1983-10-14 1989-04-04 Somanetics Corporation Method and apparatus for interpreting optical response data
US4854329A (en) * 1987-07-21 1989-08-08 Walruff James C Apparatus and method for noninvasive testing of voluntary and involuntary motor response patterns
US5140989A (en) * 1983-10-14 1992-08-25 Somanetics Corporation Examination instrument for optical-response diagnostic apparatus
US5141305A (en) * 1991-01-31 1992-08-25 Texas Tech University Health Sciences Center Method and apparatus for evaluation of phasic visual neurons in humans
US5349961A (en) * 1983-10-14 1994-09-27 Somanetics Corporation Method and apparatus for in vivo optical spectroscopic examination
US5387952A (en) * 1994-01-31 1995-02-07 Byer; Harold Feedback apparatus for sensing head position
US7204590B1 (en) 2003-10-10 2007-04-17 Andrew Lenoir System and method for inducing and measuring a consensual pupillary response

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FR1104990A (fr) * 1954-05-21 1955-11-25 Guilbert Dispositif d'examen ophtalmologique
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US3036568A (en) * 1958-01-20 1962-05-29 Stark Lawrence Pupillometer
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US3288546A (en) * 1965-03-30 1966-11-29 Jerome A Gans Automatic self-recording visual field tester
US3473868A (en) * 1967-04-27 1969-10-21 Space Sciences Inc Eye position and movement monitor
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Cited By (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4283124A (en) * 1974-06-19 1981-08-11 Canon Kabushiki Kaisha Eye fundus camera
USRE32718E (en) * 1976-12-03 1988-07-26 Sinus Medical Equipment Ab Transillumination diagnostic method and apparatus
US4331132A (en) * 1979-04-05 1982-05-25 Olympus Optical Company Ltd. Angioscope
US5349961A (en) * 1983-10-14 1994-09-27 Somanetics Corporation Method and apparatus for in vivo optical spectroscopic examination
US4817623A (en) 1983-10-14 1989-04-04 Somanetics Corporation Method and apparatus for interpreting optical response data
US5140989A (en) * 1983-10-14 1992-08-25 Somanetics Corporation Examination instrument for optical-response diagnostic apparatus
US4570638A (en) * 1983-10-14 1986-02-18 Somanetics Corporation Method and apparatus for spectral transmissibility examination and analysis
US4854329A (en) * 1987-07-21 1989-08-08 Walruff James C Apparatus and method for noninvasive testing of voluntary and involuntary motor response patterns
US4798214A (en) * 1987-11-24 1989-01-17 The United States Of America As Represented By The Secretary Of The Air Force Stimulator for eye tracking oculometer
US5141305A (en) * 1991-01-31 1992-08-25 Texas Tech University Health Sciences Center Method and apparatus for evaluation of phasic visual neurons in humans
US5387952A (en) * 1994-01-31 1995-02-07 Byer; Harold Feedback apparatus for sensing head position
US7204590B1 (en) 2003-10-10 2007-04-17 Andrew Lenoir System and method for inducing and measuring a consensual pupillary response
US7452079B1 (en) 2003-10-10 2008-11-18 Andrew Lenoir System and method for inducing and measuring a consensual pupillary response

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DE1932278A1 (de) 1970-02-12
DE1932278C3 (de) 1975-10-30
DE1932278B2 (de) 1975-03-20
FR2011468A1 (no) 1970-02-27

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