WO1990008500A1 - Medical apparatus for examining and treating the eye - Google Patents

Medical apparatus for examining and treating the eye Download PDF

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Publication number
WO1990008500A1
WO1990008500A1 PCT/EP1989/001349 EP8901349W WO9008500A1 WO 1990008500 A1 WO1990008500 A1 WO 1990008500A1 EP 8901349 W EP8901349 W EP 8901349W WO 9008500 A1 WO9008500 A1 WO 9008500A1
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WO
WIPO (PCT)
Prior art keywords
eye
scanner system
medical device
radiation
optical deflection
Prior art date
Application number
PCT/EP1989/001349
Other languages
German (de)
French (fr)
Inventor
Erich Weimel
Stefan Pieger
Original Assignee
Aesculap Ag
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Aesculap Ag filed Critical Aesculap Ag
Publication of WO1990008500A1 publication Critical patent/WO1990008500A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/0075—Apparatus for testing the eyes; Instruments for examining the eyes provided with adjusting devices, e.g. operated by control lever
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A61B3/12—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for looking at the eye fundus, e.g. ophthalmoscopes
    • A61B3/1225—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for looking at the eye fundus, e.g. ophthalmoscopes using coherent radiation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser
    • A61F9/00821—Methods or devices for eye surgery using laser for coagulation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser
    • A61F2009/00897—Scanning mechanisms or algorithms

Definitions

  • the invention relates to a medical device for examining and treating the eye with an observation device directed into the patient's eye, as well as a lamp and a laser, which send radiation for illuminating or treating the eye into the eye via an optical deflecting device.
  • a lamp in particular a so-called slit lamp, directs an illuminating radiation into the inside of the eye via an optical deflection element and illuminates a specific area of the eye in such a way that it is monitored by an observation device the inside of the eye can be examined.
  • a generally invisible treatment radiation generated by a laser can be directed into the eye and act there on the tissue, for example in order to achieve coagulation of the tissue.
  • the illuminating and treatment radiation falling into the eye is usually directed into the eye in the direction of observation via an optical deflecting element, for example a semitransparent mirror, so that the observing physician enters the eye in the direction of the radiation falling into the eye sees.
  • an optical deflecting element for example a semitransparent mirror
  • the device can gegen ⁇ above to be examined eye in its distance, -in his "lateral position and possibly also adjust its height. It is also known, the deflection elements that allow lighting and radiation treatment in the The eye is steered in such a way that different areas of the eye can be exposed to the illumination and treatment radiation 7. It has been found in known devices that the accuracy and, in particular, the speed with which different areas of the eye with which radiation can be applied is insufficient.
  • optical deflection device is an electrically controllable scanner system with deflection along two perpendicularly
  • Such scanner or scanning systems make it possible to direct a light beam striking them with a high deflection frequency and high deflection accuracy to every point on a surface.
  • Such scanner systems are known per se and are used, for example, for the optical scanning of printing types, for the exposure of light-sensitive lacquers on a surface or for marking assembly positions on electrical circuit boards.
  • the scanner systems used in a completely different context improve the operation and use of a medical eye examination device in a particularly advantageous manner, since the scanner systems, which are generally very low-inertia and small in size, not only have excellent reproducibility and an extraordinarily rapid change of the eye area to be irradiated, but also have a very small and robust structure, so that a device which is less susceptible to faults and works reliably can be created.
  • a control is assigned to the scanner system, which separately controls optical deflection systems for the deflection along each of the two axes, if each deflection system can be driven by the control to oscillate around a zero position and if the zero position of each deflection element is permanently adjustable.
  • the desired result can then be achieved solely by an appropriate choice of the zero positions, the oscillation frequencies and phase relationships of these deflecting movements, it being additionally possible to first control the shape and position of the irradiated surface solely by the visible illuminating radiation and only then by Switch on the laser beam for the invisible laser radiation.
  • the scanner system comprises two separate deflecting mirrors which can be pivoted about mutually perpendicular axes and at which the radiation is reflected one after the other.
  • the scanner system comprises a deflecting mirror that can be pivoted about two mutually perpendicular axes.
  • the drive of the scanner system is held on a swivel arm which is mounted on the device so as to be rotatable about a vertical axis, for example passing through the eye to be examined.
  • a first drive motor of the scanner system is held in a device-fixed manner, that an optical deflection element is arranged on a holder that can be rotated by the first drive motor, and that a second drive motor is held on this holder which pivots the optical deflection element about an axis of rotation extending perpendicular to the axis of rotation of the holder.
  • Fig. 1 is a schematic view of a medical
  • FIG. 2 shows a view of the scanner system used in the device of FIG. 1.
  • the medical device shown in the drawing comprises a base plate 1, on which two swivel arms 3 and 4 are mounted rotatably about a vertical axis 2 by means of a cross table, not shown in the drawing, which can be displaced in the horizontal plane.
  • the first swivel arm 3 carries on a vertical holder 5 an observation device 6 with an objective 7 and an eyepiece 8, through which a doctor can look into the eye 9 of a patient.
  • the eye is located approximately on the vertical axis 2.
  • the other swivel arm 4 carries a housing 10, from which a holder 11 protrudes, which carries at its free end an optical deflection element in the form of a semi-transparent mirror 12.
  • This mirror 12 deflects radiation 13 coming vertically from above at right angles into the eye 9 to be examined.
  • the mirror 12 is located in front of the objective 7, so that the observing doctor looks through the semitransparent mirror 12 into the eye 9.
  • the radiation 13 comes from an illumination lamp, not shown in the drawing, preferably a so-called slit lamp, which emits visible light.
  • an illumination lamp not shown in the drawing
  • invisible radiation from a treatment laser is also reflected in the beam path in a manner not shown in the drawing, so that this treatment radiation is directed collinearly with the illuminating radiation via the mirror 12 into the eye 9.
  • the holder 11 carrying the mirror 12 is rotatably supported about its longitudinal axis in the housing 10, in which there is a first scanner motor 14 held on the housing, the elongated shaft 15 of which supports the holder 11.
  • a second scanner motor 16 which is preferably located directly in the extension of the shaft 15 and whose motor shaft 18 is perpendicular to the motor shaft 15, is arranged on the side opposite the holder 11 via a holder 17, which is shown only schematically in FIG of the first scanner motor 14 is arranged.
  • the second motor shaft 18 is connected via a linkage 19 'that of the motor shaft 18, for example via an eccentric parallel to its longitudinal direction and is movable up, hinged to the mirror 12, in turn, to the holder 11 about an axis perpendicular of on the longitudinal axis Holder 11 • standing axis is pivotally mounted; this axis of rotation of the mirror is perpendicular to the drawing plane in the illustration in FIG. 2.
  • Both scanner motors 14 and 16 are connected via control lines 20 and 21 to a controller 22 which supplies the control motors separately with different control signals.
  • These control signals can cause permanent rotation of the scanner motor by a certain angle, on the other hand, these signals can cause oscillating rotary movements of each motor, which are superimposed on the permanent rotation. These movements are transmitted to the mirror 12, which, due to the permanent rotation of the motors, directs the radiation 13 striking it into different areas of the eye 9 and thus accordingly
  • the radiation in the eye carries out oscillations along two mutually perpendicular axes, the radiation sweeping over differently shaped areas, for example circles, ellipses or rectangles, in accordance with the respective frequency of these oscillations and the phase relationships thereof.
  • the observing physician can change the extent, shape and size of the swept area on the control by appropriate choice of the frequencies and the phase relationships as well as by the choice of the amplitude of the oscillating movement of the two scanner motors.
  • the position of the surface can be influenced by changing the zero position, this is preferably done by a ball 24, which can be freely rotated about two perpendicular axes on a joy stick-like lever 23, and the rotary pulse generator arranged in the lever 23 when it is rotated actuated, the signals of which are also fed to the control and are used to change the zero positions along the two pivot axes of the mirror.
  • the joystick-like lever 23 itself can be used to operate the cross table, not shown in the drawing, with which the relative position of the two swivel arms 3 and 4 relative to the eye 9 can be varied.
  • the scanner magnets are very inert and therefore extremely fast to move, so that the mirror 12 can be oscillated at high frequencies around the two axes of rotation. This makes it possible to allow the radiation in the eye 9 to sweep over an area so quickly that the eye of the observing doctor sees the area illuminated evenly, so that the movements of the essentially point-focused light beam can no longer be resolved in time.
  • the mechanical arrangement of the scanner motors in the housing 10 and the holder 11 as well as the linkage 19 is shown essentially schematically in the exemplary embodiment. It is of course possible here to find other mechanical configurations with which fixed with the help of two separately controllable scanner motors Angle adjustments and oscillating movements about the two mutually perpendicular axes are transmitted to the deflecting mirror 12. In a modified exemplary embodiment, it would also be possible to use two mirrors connected directly in series instead of one mirror 12, each about an axis

Abstract

An apparatus for examining and treating the eye comprises an observation device (6) which is directed into the patient's eye (9), a lamp and a laser which direct radiation, via an optical deflection device (12), into the eye in order to illuminate and treat the eye. To ensure rapid and precise displacement of the irradiated region of the eye, the optical deflection device is designed as an electrically controlled scanner system (11 ... 19) with deflection along two mutually perpendicular axes.

Description

B E S C H R E I B U N G DESCRIPTION
Medizinisches Gerät zur Untersuchung und Behandlung des AugesMedical device for examining and treating the eye
Die Erfindung betrifft ein medizinisches Gerät zur Unter¬ suchung und Behandlung des Auges mit einer in das Auge des Patienten gerichteten Beobachtungsvorrichtung sowie einer Lampe und einem Laser, die Strahlung zur Beleuchtung bzw. Behandlung des Auges über eine optische Umlenkein¬ richtung in das Auge senden.The invention relates to a medical device for examining and treating the eye with an observation device directed into the patient's eye, as well as a lamp and a laser, which send radiation for illuminating or treating the eye into the eye via an optical deflecting device.
Derartige medizinische Geräte werden verwendet, um das Innere des Auges untersuchen zu können, über eine Lampe, insbesondere eine sogenannte Spaltlampe, wird eine Be¬ leuchtungsstrahlung über ein optisches Umlenkelement in das Innere des Auges gelenkt und beleuchtet einen bestimmten Augenbereich so, daß über eine Beobachtungsvorrichtung das Innere des Auges untersucht werden kann. Gleichzeitig kann zusammen mit der Beleuchtungsstrahlung eine von einem Laser erzeugte, in der Regel unsichtbare Behandlungsstrahlung in das Auge gelenkt werden und dort auf das Gewebe einwirken, beispielsweise um eine Koagulation des Gewebes zu erreichen, Medical devices of this type are used in order to be able to examine the inside of the eye. A lamp, in particular a so-called slit lamp, directs an illuminating radiation into the inside of the eye via an optical deflection element and illuminates a specific area of the eye in such a way that it is monitored by an observation device the inside of the eye can be examined. At the same time, together with the illuminating radiation, a generally invisible treatment radiation generated by a laser can be directed into the eye and act there on the tissue, for example in order to achieve coagulation of the tissue.
Üblicherweise wird die in das Auge fallende Beleuchtungs¬ und BehandlungsStrahlung über ein optisches Umlenkelement, beispielsweise einen halbdurchlässigen Spiegel,, in der Be¬ obachtungsrichtung in das Auge gelenkt, so daß der beobach¬ tende Arzt in Richtung der in das Auge fallenden Strahlung in das Auge sieht.The illuminating and treatment radiation falling into the eye is usually directed into the eye in the direction of observation via an optical deflecting element, for example a semitransparent mirror, so that the observing physician enters the eye in the direction of the radiation falling into the eye sees.
Bei bekannten Geräten dieser Art läßt sich das Gerät gegen¬ über dem zu untersuchenden Auge in seinem Abstand, -in seiner" seitlichen Position und gegebenenfalls auch in seiner Höhe verstellen. Es ist darüberhinaus bekannt, die Umlenkelemente, mit denen Beleuchtungs- und Behandlungsstrahlung in das Auge gelenkt werden, derart zu verstellen, daß unterschiedliche Bereiche des Auges mit der Beleuchtungs- und Behandlungs7 Strahlung beaufschlagt werden können. Dabei hat es sich bei bekannten Geräten herausgestellt, daß die Genauigkeit und insbesondere die Schnelligkeit, mit welcher unterschied¬ liche Bereiche des Auges mit der Strahlung beaufschlagt werden können, unzureichend ist.In known devices of this type, the device can gegen¬ above to be examined eye in its distance, -in his "lateral position and possibly also adjust its height. It is also known, the deflection elements that allow lighting and radiation treatment in the The eye is steered in such a way that different areas of the eye can be exposed to the illumination and treatment radiation 7. It has been found in known devices that the accuracy and, in particular, the speed with which different areas of the eye with which radiation can be applied is insufficient.
Es ist daher Aufgabe der Erfindung, ein gattungsgemäßes Gerät derart zu verbessern, daß die Genauigkeit und die Schnelligkeit erhöht werden, mit denen Strahlung in ein bestimmtes Zielgebiet im Auge gerichtet werden kann.It is therefore an object of the invention to improve a generic device in such a way that the accuracy and the speed with which radiation can be directed into a specific target area in the eye are increased.
Diese Aufgabe wird bei einem medizinischen Gerät der eingangs beschriebenen Art erfindungsgemäß dadurch gelöst, daß die optische Umlenkeinrichtung ein elektrisch ansteuerbares Scannersystem mit Ablenkung entlang zweier senkrecht auf- This object is achieved according to the invention in a medical device of the type described in the introduction in that the optical deflection device is an electrically controllable scanner system with deflection along two perpendicularly
einanderstehender Achsen ist.mutually opposed axes.
Derartige Scanner- oder Abtastsysteme ermöglichen es, einen auf sie auftreffenden Lichtstrahl mit hoher Ablenkfreguenz und hoher Ablenkgenauigkeit auf jeden Punkt einer Fläche zu richten. Solche Scannersysteme sind an sich bekannt und werden verwandt beispielsweise zur optischen Abtastung von Drucktypen, zur Belichtung von lichtempfindlichen Lacken auf einer Oberfläche oder zur Markierung von Bestückungs¬ positionen auf elektrischen Leiterplatten.Such scanner or scanning systems make it possible to direct a light beam striking them with a high deflection frequency and high deflection accuracy to every point on a surface. Such scanner systems are known per se and are used, for example, for the optical scanning of printing types, for the exposure of light-sensitive lacquers on a surface or for marking assembly positions on electrical circuit boards.
Es hat sich überraschenderweise herausgestellt, daß die in ganz anderem Zusammenhang eingesetzten Scannersysteme in besonders vorteilhafter Weise die Bedienung und den Einsatz eines medizinischen Augenuntersuchungsgerätes verbessern, da die in der Regel sehr trägheitsarmen und kleinbauenden Scannersysteme nicht nur eine hervorragende Reproduzier¬ barkeit und eine außerordentlich schnelle Veränderung des zu bestrahlenden Augengebietes ermöglichen, sondern auch sehr klein und robust aufgebaut sind, so daß ein wenig störungs¬ anfälliges und zuverlässig arbeitendes Gerät geschaffen werden kann.It has surprisingly been found that the scanner systems used in a completely different context improve the operation and use of a medical eye examination device in a particularly advantageous manner, since the scanner systems, which are generally very low-inertia and small in size, not only have excellent reproducibility and an extraordinarily rapid change of the eye area to be irradiated, but also have a very small and robust structure, so that a device which is less susceptible to faults and works reliably can be created.
Insbesondere ist es vorteilhaft, wenn dem Scannersystem eine Steuerung zugeordnet ist, die optische Ablenksysteme für die Ablenkung entlang jeder der beiden Achsen getrennt ansteuert, wenn jedes Ablenksystem von der Steuerung um eine Nullage ostzillierend antreibbar ist und wenn die Nullage jedes Ablenkelementes dauerhaft verstellbar ist. In particular, it is advantageous if a control is assigned to the scanner system, which separately controls optical deflection systems for the deflection along each of the two axes, if each deflection system can be driven by the control to oscillate around a zero position and if the zero position of each deflection element is permanently adjustable.
Aufgrund der geringen Trägheit und der dadurch bedingten hohen Ablenkgeschwindigkeit derartiger Scannersysteme ist es möglich, durch sehr hochfrequente oszillierende Ver- schwenkung der optischen Ablenkelemente um zwei senkrecht zueinanderstehende Achsen Figuren unterschiedlicher Form und Fläche mit der Strahlung, die in der Augenebene an¬ nähernd punktförmig fokussiert ist, zu beaufschlagen. So können beispielsweise durch geeignete Frequenz- und Phasenbeziehungen zwischen den Ablenkbewegungen längs der beiden Achsen Kreise, Ellipsen oder Rechtecke flächig von der Strahlung überstrichen werden, wobei die Lage der jeweiligen Flächen durch eine Voreinstellung der Nullage beliebig eingestellt werden kann. Der Arzt kann also bei der Untersuchung entscheiden, wie groß die beispielsweise mit der Laserstrahlung zu beaufschlagende Fläche sein soll, welche Form diese Fläche haben soll und welche Ausrichtung. Allein durch eine entsprechende Wahl der Nullagen, der Oszillationsfrequenzen under Phasenbeziehungen dieser Ab¬ lenkbewegungen läßt sich dann das gewünschte Ergebnis erzielen, wobei es zusätzlich möglich ist, die Form und Lage der bestrahlten Fläche zunächst allein durch die sichtbare BeleuchtungsStrahlung zu kontrollieren und erst dann auch durch Einschalten des Laserstrahles für die un¬ sichtbare Laserstrahlung einzustellen.Because of the low inertia and the resulting high deflection speed of such scanner systems, it is possible, by means of very high-frequency oscillating pivoting of the optical deflection elements about two mutually perpendicular axes, of figures of different shape and area with the radiation, which is focused approximately point-like in the eye plane to act upon. For example, suitable frequency and phase relationships between the deflection movements along the two axes can sweep across the surface circles, ellipses or rectangles, the position of the respective surfaces being able to be set as desired by presetting the zero position. During the examination, the doctor can therefore decide how large the area to be exposed to the laser radiation, for example, what shape this area should have and what orientation. The desired result can then be achieved solely by an appropriate choice of the zero positions, the oscillation frequencies and phase relationships of these deflecting movements, it being additionally possible to first control the shape and position of the irradiated surface solely by the visible illuminating radiation and only then by Switch on the laser beam for the invisible laser radiation.
Besonders vorteilhaft ist es, wenn das Scannersystem zwei getrennte, um senkrecht zueinanderstehende Achsen ver¬ schwenkbare Umlenkspiegel umfaßt, an denen die Strahlung nacheinander reflektiert wird. It is particularly advantageous if the scanner system comprises two separate deflecting mirrors which can be pivoted about mutually perpendicular axes and at which the radiation is reflected one after the other.
Es kann aber auch vorgesehen sein, daß das Scannersystem einen um zwei senkrecht zueinanderstehende Achsen ver¬ schwenkbaren Umlenkspiegel umfaßt.However, it can also be provided that the scanner system comprises a deflecting mirror that can be pivoted about two mutually perpendicular axes.
Günstig ist es weiterhin, wenn der Antrieb des Scanner¬ systems an einem Schwenkarm gehalten ist, der um eine senkrechte, etwa durch das zu untersuchende Auge hindurch¬ gehende Achse drehbar an dem Gerät gelagert ist.It is also expedient if the drive of the scanner system is held on a swivel arm which is mounted on the device so as to be rotatable about a vertical axis, for example passing through the eye to be examined.
Bei einer besonders bevorzugten Ausführungsform ist vor¬ gesehen, daß ein erster Antriebsmotor des Scannerssystems gerätefest gehalten ist, daß an einem von dem ersten Antriebs¬ motor verdrehbaren Halter ein optisches Umlenkelement ange¬ ordnet ist und daß an diesem Halter ein zweiter Antriebs- otor gehalten ist, der das optische Umlenkelement um eine senkrecht zur Drehachse des Halters verlaufende Drehachse verschwenkt.In a particularly preferred embodiment it is provided that a first drive motor of the scanner system is held in a device-fixed manner, that an optical deflection element is arranged on a holder that can be rotated by the first drive motor, and that a second drive motor is held on this holder which pivots the optical deflection element about an axis of rotation extending perpendicular to the axis of rotation of the holder.
Die nachfolgende Beschreibung einer bevorzugten Ausführungs¬ form der Erfindung dient im Zusammenhang mit der Zeichnung der näheren Erläuterung. Es zeigen:The following description of a preferred embodiment of the invention serves in conjunction with the drawing to provide a more detailed explanation. Show it:
Fig. 1 eine schematische Ansicht eines medizinischenFig. 1 is a schematic view of a medical
Gerätes zur optischen Untersuchung und Behandlung eines Auges undDevice for the optical examination and treatment of an eye and
Fig. 2 eine Ansicht des in dem Gerät der Fig. 1 ver¬ wendeten Scannersystems. FIG. 2 shows a view of the scanner system used in the device of FIG. 1.
Das in der Zeichnung dargestellte medizinische Gerät umfaßt eine Fußplatte 1 , an welcher mittels eines in der Zeichnung nicht dargestellten, in der Horizontalbene verschiebbaren Kreuztisches um eine senkrechte Achse 2 verdrehbar zwei Schwenkarme 3 und 4 gelagert ist. Der erste Schwenkarm 3 trägt an einem senkrechten Halter 5 eine Beobachtungseinrich- tung 6 mit einem Objektiv 7 und einem Okkular 8, durch welches ein Arzt in das Auge 9 eines Patienten blicken kann. Das Auge befindet sich etwa auf der senkrechten Achse 2.The medical device shown in the drawing comprises a base plate 1, on which two swivel arms 3 and 4 are mounted rotatably about a vertical axis 2 by means of a cross table, not shown in the drawing, which can be displaced in the horizontal plane. The first swivel arm 3 carries on a vertical holder 5 an observation device 6 with an objective 7 and an eyepiece 8, through which a doctor can look into the eye 9 of a patient. The eye is located approximately on the vertical axis 2.
Der andere Schwenkarm 4 trägt ein Gehäuse 10, aus dem ein Halter 11 herausragt, der an seinem freien Ende ein optisches Umlenkelement in Form eines halbdurchlässigen Spiegels 12 trägt. Dieser Spiegel 12 lenkt eine senkrecht von oben kom¬ mende Strahlung 13 rechtwinklig um in das zu untersuchende Auge 9. Der Spiegel 12 befindet sich dabei vor dem Objektiv 7, so daß der beobachtende Arzt durch den halbdurchlässigen Spiegel 12 hindurch in das Auge 9 blickt.The other swivel arm 4 carries a housing 10, from which a holder 11 protrudes, which carries at its free end an optical deflection element in the form of a semi-transparent mirror 12. This mirror 12 deflects radiation 13 coming vertically from above at right angles into the eye 9 to be examined. The mirror 12 is located in front of the objective 7, so that the observing doctor looks through the semitransparent mirror 12 into the eye 9.
Die Strahlung 13 stammt dabei von einer in der Zeichnung nicht dargestellten Beleuchtungslampe, vorzugsweise einer sogenannten Spaltlampe, die sichtbares Lichb aussendet. Außerdem ist in aus der Zeichnung ebenfalls nicht ersichtliche Weise unsichtbare Strahlung eines Behandlungslasers in den Strahlengang eingespiegelt, so daß diese Behandlungs¬ strahlung kollinear mit der Beleuchtungsstrahlung über den Spiegel 12 in das Auge 9 gerichtet wird. The radiation 13 comes from an illumination lamp, not shown in the drawing, preferably a so-called slit lamp, which emits visible light. In addition, invisible radiation from a treatment laser is also reflected in the beam path in a manner not shown in the drawing, so that this treatment radiation is directed collinearly with the illuminating radiation via the mirror 12 into the eye 9.
Der den Spiegel 12 tragende Halter 11 ist um seine Längsachse drehbar in dem Gehäuse 10 gelagert, in dem sich ein am Gehäuse gehaltener erster Scannermotor 14 befindet, dessen verlängerte Welle 15 den Halter 11 biluet. An der dem Halter 11 gegenüber¬ liegenden Seite ist über eine in Fig. 2 nur schematisch dar¬ gestellte Halterung 17 ein zweiter Scannermotor 16 angeord¬ net, der sich vorzugsweise unmittelbar in der Verlängerung der Welle 15 befindet und dessen Motorwelle 18 senkrecht zur Motorwelle 15 des ersten Scannermotors 14 angeordnet ist. Die zweite Motorwelle 18 ist über ein Gestänge 19, 'das von der Motorwelle 18 beispielsweise über einen Exzenter parallel zu seiner Längsrichtung auf und ab bewegbar ist, gelenkig mit dem Spiegel 12 verbunden, der seinerseits an dem Halter 11 um eine senkrecht auf der Längsachse des Halters 11• stehende Achse verschwenkbar gelagert ist; diese Drehachse des Spiegels steht in der Darstellung der Fig. 2 senkrecht auf der Zeichen¬ ebene.The holder 11 carrying the mirror 12 is rotatably supported about its longitudinal axis in the housing 10, in which there is a first scanner motor 14 held on the housing, the elongated shaft 15 of which supports the holder 11. A second scanner motor 16, which is preferably located directly in the extension of the shaft 15 and whose motor shaft 18 is perpendicular to the motor shaft 15, is arranged on the side opposite the holder 11 via a holder 17, which is shown only schematically in FIG of the first scanner motor 14 is arranged. The second motor shaft 18 is connected via a linkage 19 'that of the motor shaft 18, for example via an eccentric parallel to its longitudinal direction and is movable up, hinged to the mirror 12, in turn, to the holder 11 about an axis perpendicular of on the longitudinal axis Holder 11 • standing axis is pivotally mounted; this axis of rotation of the mirror is perpendicular to the drawing plane in the illustration in FIG. 2.
Beide Scannermotoren 14 und 16 sind über Steuerleitungen 20 bzw. 21 mit einer Steuerung 22 verbunden, welche den Scanner¬ motoren jeweils getrennt voneinander unterschiedliche Steuer¬ signale zuführt. Diese Steuersignale können einmal eine blei¬ bende Verdrehung des Scannermotores um einen bestimmten Winkel hervorrufen, zum anderen können diese Signale oszillierende Drehbewegungen jedes Motors hervorrufen, die der bleibenden Verdrehung überlagert sind. Diese Bewegungen übertragen sich auf den Spiegel 12, der durch die bleibende Verdrehung der Motoren die auf ihn auffallende Strahlung 13 in unterschied¬ liche Bereiche des Auges 9 lenkt und somit entsprechend Both scanner motors 14 and 16 are connected via control lines 20 and 21 to a controller 22 which supplies the control motors separately with different control signals. These control signals can cause permanent rotation of the scanner motor by a certain angle, on the other hand, these signals can cause oscillating rotary movements of each motor, which are superimposed on the permanent rotation. These movements are transmitted to the mirror 12, which, due to the permanent rotation of the motors, directs the radiation 13 striking it into different areas of the eye 9 and thus accordingly
der jeweiligen Verdrehung des Spiegels unterschiedliche Nu— punkte definiert. Um diesen Nullpunkt führt die Strahlung im Auge Oszillationen längs zweier senkrecht aufeinanderstehender Achsen aus, wobei entsprechend der jeweiligen Frequenz dieser Oszillationen und der Phasenbeziehungen derselben unter¬ schiedlich geformte Flächen von der Strahlung überstrichen werden, beispielsweise Kreise, Ellipsen oder Rechtecke.different nuances are defined for the respective rotation of the mirror. At this zero point, the radiation in the eye carries out oscillations along two mutually perpendicular axes, the radiation sweeping over differently shaped areas, for example circles, ellipses or rectangles, in accordance with the respective frequency of these oscillations and the phase relationships thereof.
Der beobachtende Arzt kann an der Steuerung durch entsprechen¬ de Wahl der Frequenzen und der Phasenbeziehungen ebenso wie durch die Wahl der Amplitude der oszillierenden Bewegung der beiden Scannermotoren Ausdehnung, Form und Größe der überstrichenen Fläche verändern. Außerdem kann die Lage der Fläche durch Veränderung der Nullage beeinflußt werden, dies erfolgt vorzugsweise durch eine um zwei senkrecht ver¬ laufende Achsen frei verdrehbar an einem Joy-Stick-artigen Hebel 23 gelagerte Kugel 24, die bei ihrer Verdrehung in den Hebel 23 angeordnete Drehimpulsgeber betätigt, deren Signale ebenfalls der Steuerung zugeführt und zur Veränderung der Nullagen längs der beiden Schwenkachsen des Spiegels ver¬ wendet werden. Der Joy-Stick-artige Hebel 23 selbst kann zur Bedienung des in der Zeichnung nicht eigens dargestellten Kreuztisch.es dienen, mit dem die relative Position der beiden Schwenkarme 3 und 4 gegenüber dem Auge 9 variierbar ist.The observing physician can change the extent, shape and size of the swept area on the control by appropriate choice of the frequencies and the phase relationships as well as by the choice of the amplitude of the oscillating movement of the two scanner motors. In addition, the position of the surface can be influenced by changing the zero position, this is preferably done by a ball 24, which can be freely rotated about two perpendicular axes on a joy stick-like lever 23, and the rotary pulse generator arranged in the lever 23 when it is rotated actuated, the signals of which are also fed to the control and are used to change the zero positions along the two pivot axes of the mirror. The joystick-like lever 23 itself can be used to operate the cross table, not shown in the drawing, with which the relative position of the two swivel arms 3 and 4 relative to the eye 9 can be varied.
Wenn die Oszillation des Spiegels 12 abgeschaltet ist, kann eine im wesentlichen punktförmig fokussierter Strahl When the oscillation of the mirror 12 is switched off, an essentially point-focused beam can be produced
in das Auge gelenkt werden, der mit Hilfe der Kugel 24 im Auge verschoben werden kann, der Arzt ist dann jederzeit in der Lage, an einer beliebigen Stelle durch Zuschaltung der oszillierenden Bewegung den Bestrahlungsfleck in der gewünschten Größe, Form und Orientierung auszudehnen.are directed into the eye, which can be shifted in the eye with the aid of the ball 24, the doctor is then in a position at any time to expand the radiation spot in the desired size, shape and orientation by switching on the oscillating movement.
Wesentlich ist dabei, daß die Scannermagnete sehr trägheits¬ arm und daher außerordentlich schnell bewegbar sind, so daß der Spiegel 12 mit hohen Frequenzen um die beiden Drehachsen oszilliert werden kann. Dadurch ist es möglich, die Bestrahlung im Auge 9 so schnell eine Fläche überstreichen zu lassen, daß dem Auge des beobachtenden Arztes die Fläche gleichmä g beleuchtet erscheint, daß also die Bewegungen des im wesentlichen punktförmig fokussierten Lichtstrahles nicht mehr zeitlich aufgelöst werden können.It is essential that the scanner magnets are very inert and therefore extremely fast to move, so that the mirror 12 can be oscillated at high frequencies around the two axes of rotation. This makes it possible to allow the radiation in the eye 9 to sweep over an area so quickly that the eye of the observing doctor sees the area illuminated evenly, so that the movements of the essentially point-focused light beam can no longer be resolved in time.
Die mechanische Anordnung der Scannermotoren im Gehäuse 10 und des Halters 11 sowie des Gestänges 19 ist im Ausfuhrungs¬ beispiel im wesentlichen schematisch gezeigt, es ist hier selbstverständlich möglich, andere mechanische Ausgestaltungen zu finden, mit denen mit Hilfe von zwei separat ansteuer¬ baren Scannermotoren feste Winkelverstellungen und oszillieren¬ de Bewegungen um die zwei senkrecht aufeinanderstellenden Achsen auf den Umlenkspiegel 12 übertragen werden. Bei einem abgewandelten Ausführungsbeispiel wäre es auch möglich, statt des einen Spiegels 12 zwei unmittelbar hintereinander geschaltete Spiegel zu verwenden, die jeweils um eine Achse The mechanical arrangement of the scanner motors in the housing 10 and the holder 11 as well as the linkage 19 is shown essentially schematically in the exemplary embodiment. It is of course possible here to find other mechanical configurations with which fixed with the help of two separately controllable scanner motors Angle adjustments and oscillating movements about the two mutually perpendicular axes are transmitted to the deflecting mirror 12. In a modified exemplary embodiment, it would also be possible to use two mirrors connected directly in series instead of one mirror 12, each about an axis
verschwenkbar sind und jeweils von einem Scannermotor ent¬ sprechend angetrieben werden, wobei die Bestrahlung dann nacheinander an den beiden Umlenkspiegeln umgelenkt wird. Die Verwendung der dargestellten Lösung mit nur einem Spiegel hat den Vorteil, daß weniger optische Fehler bei der Reflexion an nur einem Spiegel auftreten und daß die Ablenkungen in beiden Richtungen bei einer gleich großen Verschwenkung des Spiegels gleich groß sind, während bei der Verwendung von zwei Spiegeln durch den unterschied¬ lichen Abstand der jeweiligen Reflexionsstelle vom Auge bei gleicher Schwenkbewegung der Spiegel unterschiedliche Ablenkungen auftreten. are pivotable and are each driven accordingly by a scanner motor, the radiation then being deflected one after the other at the two deflecting mirrors. The use of the solution shown with only one mirror has the advantage that fewer optical errors occur when reflecting on only one mirror and that the deflections in both directions are the same with the same amount of pivoting of the mirror, while when using two mirrors due to the different distance of the respective reflection point from the eye, different deflections occur with the same pivoting movement of the mirror.

Claims

P A T E N T A N S P R Ü C H E PATENT CLAIMS
1. Medizinisches Gerät zur Untersuchung und Behandlung des Auges mit einer in das Auge des Patienten gerichteten Beobachtungsvorrichtung, einer Lampe und einem Laser, die Strahlung zur Beleuchtung bzw. Behandlung des Auges über eine optische Umlenkeinrichtung in das Auge senden, dadurch gekennzeichnet, daß die optische Umlenkeinrichtung ein elektrisch ansteuer¬ bares Scannersystem (12, 14, 16) mit Ablenkung entlang zweier senkrecht aufeinanderstehender Achsen ist.1. Medical device for examining and treating the eye with an observation device directed into the patient's eye, a lamp and a laser that send radiation for illuminating or treating the eye via an optical deflection device in the eye, characterized in that the optical Deflection device is an electrically controllable scanner system (12, 14, 16) with deflection along two mutually perpendicular axes.
2. Medizinisches Gerät nach Anspruch 1, dadurch gekennzeichnet, daß dem Scannersystem (12, 14, 16) eine Steuerung (22) zugeordnet ist, die optische Ablenkelemente (12) für die Ablenkung entlang jeder der beiden Achsen getrennt an¬ steuert, daß jedes Ablenkelement (12) von der Steuerung (22) um eine Nullage oszillierend antreibbar ist und daß die Nullage jedes Ablenkelementes (12) dauerhaft verstellbar ist.2. Medical device according to claim 1, characterized in that the scanner system (12, 14, 16) is assigned a controller (22) which separately controls optical deflection elements (12) for the deflection along each of the two axes, that each Deflection element (12) can be driven by the control (22) to oscillate around a zero position and that the zero position of each deflection element (12) is permanently adjustable.
3. Medizinisches Gerät nach Anspruch 1 oder 2, dadurch gekennzeichnet, daß das Scannersystem zwei getrennte, um senkrecht zu¬ einanderstehende Achsen verschwenkbare Umlenkspiegel umfaßt, an denen die Strahlung nacheinander reflektiert wird. 3. Medical device according to claim 1 or 2, characterized in that the scanner system comprises two separate deflecting mirrors which can be pivoted about mutually perpendicular axes and at which the radiation is reflected one after the other.
4. Medizinisches Gerät nach Anspruch 1 oder 2, dadurch gekennzeichnet, daß das Scannersystem einen um zwei senkrecht zueinander stehender Achsen verschwenkbaren Umlenkspiegel (12) um¬ faßt.4. Medical device according to claim 1 or 2, characterized in that the scanner system comprises a deflecting mirror (12) which can be pivoted about two mutually perpendicular axes.
5. Medizinisches Gerät nach einem der voranstehenden Ansprüche, dadurch gekennzeichnet, daß der Antrieb (14, 16) des Scannersystems an einem Schwenkarm (4) gehalten ist, der um eine senkrechte, etwa durch das zu untersuchende Auge (9) durchgehende Achse drehbar an dem Gerät gelagert ist.5. Medical device according to one of the preceding claims, characterized in that the drive (14, 16) of the scanner system is held on a swivel arm (4) which is rotatable about a vertical axis, for example through the eye (9) to be examined, which is continuous the device is stored.
6. Medizinisches Gerät nach einem der voranstehenden Ansprüche, dadurch gekennzeichnet, daß ein erster Antriebsmotor (14) des Scannersystems gerätefest gehalten ist, daß an einem von dem ersten Antriebsmotor (14) verdrehbaren Halter (11) ein opti¬ sches Umlenkelement (12) angeordnet ist, und daß an diesem Halter (11) ein zweiter Antriebsmotor (16) gehalten ist, der das optische Umlenkelement (12) um eine senkrecht zur Drehachse des Halters (11) verlau¬ fende Drehachse verschwenkt. 6. Medical device according to one of the preceding claims, characterized in that a first drive motor (14) of the scanner system is held in a device-fixed manner that an optical deflection element (12) is arranged on a holder (11) which can be rotated by the first drive motor (14) and that a second drive motor (16) is held on this holder (11) and pivots the optical deflection element (12) about an axis of rotation extending perpendicular to the axis of rotation of the holder (11).
PCT/EP1989/001349 1989-01-27 1989-11-11 Medical apparatus for examining and treating the eye WO1990008500A1 (en)

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