WO2015087436A1 - Lentille de contact et procédé de sélection de cette lentille de contact - Google Patents

Lentille de contact et procédé de sélection de cette lentille de contact Download PDF

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Publication number
WO2015087436A1
WO2015087436A1 PCT/JP2013/083397 JP2013083397W WO2015087436A1 WO 2015087436 A1 WO2015087436 A1 WO 2015087436A1 JP 2013083397 W JP2013083397 W JP 2013083397W WO 2015087436 A1 WO2015087436 A1 WO 2015087436A1
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WIPO (PCT)
Prior art keywords
eye
refractive power
contact lens
fundus
eyeball
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PCT/JP2013/083397
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English (en)
Japanese (ja)
Inventor
山口　剛史
素脩 見川
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株式会社ユニバーサルビュー
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Priority to JP2014532754A priority Critical patent/JP5689208B1/ja
Publication of WO2015087436A1 publication Critical patent/WO2015087436A1/fr

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    • G—PHYSICS
    • G02—OPTICS
    • G02C—SPECTACLES; SUNGLASSES OR GOGGLES INSOFAR AS THEY HAVE THE SAME FEATURES AS SPECTACLES; CONTACT LENSES
    • G02C7/00—Optical parts
    • G02C7/02—Lenses; Lens systems ; Methods of designing lenses
    • G02C7/04—Contact lenses for the eyes
    • G—PHYSICS
    • G02—OPTICS
    • G02C—SPECTACLES; SUNGLASSES OR GOGGLES INSOFAR AS THEY HAVE THE SAME FEATURES AS SPECTACLES; CONTACT LENSES
    • G02C2202/00—Generic optical aspects applicable to one or more of the subgroups of G02C7/00
    • G02C2202/24—Myopia progression prevention

Definitions

  • the present invention provides a myopia in which a refractive power is set for pulling back a hyperopic back focus from the outer position straddling the peripheral retina in the direction that forms an angle ⁇ with respect to the eye axis of the eyeball to the inner side of the peripheral retina.
  • the present invention relates to a contact lens applicable to a contact lens for suppressing progress and a method for selecting the contact lens.
  • myopia In Japan, about 50% of the population is myopic, and the use of glasses, contact lenses, etc. is required for daily life.
  • Pathologic intensity myopia such as axial myopia, which is one of the causes of myopia progression, leads to blindness due to macular degeneration, retinal hemorrhage, etc., and myopia is the fifth leading cause of blindness. Since myopia is a risk factor for major blindness diseases such as glaucoma and retinal detachment, the rate of myopia as a potential cause of blindness is expected to be higher.
  • FIG. 32A is a cross-sectional view showing the structure of a human eye (hereinafter referred to as eye 2 to be examined).
  • eye 2 to be examined 41 is a cornea
  • 42 is a crystalline lens
  • 43 is a pupil
  • 44 is a vitreous body
  • 46 is a retina. Note that description of the structure of the eyeball 2 to be examined is omitted. First, a general depth of focus when a near-sighted person looks far and a presbyopic person looks close will be described.
  • L1 is the axial length of a normal human eye.
  • the axial length L1 refers to a length from the central apex of the cornea 41 to the macular 45 portion of the retina 46.
  • the retina 46 is divided into a central retina which is a peripheral portion of the macular 45 and a peripheral retina which is a peripheral region of the central retina.
  • the axial length L2 extends backward and the shape of the eyeball is distorted when it starts to be myopic, the focus on the central retina shifts forward from the retina 46 (macular 45). The focus on the retina is moved onto the macular 45, and as a result, the axial length L2 further extends backward to match it, and as a result, it is thought that myopia progresses more and more because the focus is not focused on the central retina. .
  • the lens 42 loses its elasticity and becomes hard, so that the image is formed not behind the correct position on the retina 46 but behind the retina 46.
  • glasses, contact lenses, and the like exist as existing visual acuity correction tools, but when the method and purpose are to be viewed by a human, information on the light is transmitted through the cornea 41 and the lens 42, and the pyramidal cells. (Cone cell) is imaged on the macular 45 where the cells are densely distributed.
  • the focal point is in front of or behind the retina 46 and is not imaged on the macular 45, which is the center of the retina 46, and therefore enters the cornea 41 so as to be imaged on the macular 45 by the vision correction tool.
  • the visual acuity is adjusted by changing the refractive power.
  • the function of the crystalline lens 42 is reduced by aging (decrease in adjusting power), and the near vision is reduced.
  • This is called presbyopia, and it aims to improve the near vision that has been reduced (becomes difficult to see) by presbyopia.
  • a convex lens is used to image the near object on the macular 45. is there.
  • the reading glasses are convex lenses, they do not form an image on the macular 45 when looking far away through the convex lenses. For this reason, although the distant view is deteriorated, the eyeball is a part having a movement independent of the head, and only the eyeball can be moved. Therefore, the distance optical unit and the near optical unit are arranged above and below the lens, and the far and near focal points are formed on the macular 45 depending on the lens location, so that the glasses for the near and near use (FIG. 30). Reference).
  • All the correction glasses are configured for the purpose of forming an image of the far or near focal point on the macular 45. Further, as described above, the eyeball is a part having a movement independent of the head. For this reason, in the case of glasses, a wide optical area for obtaining a wide field of view is provided so that an image is formed on the macular 45 even if only the eyeball is moved and the object is changed.
  • the imaging method is configured to form a near-point image on the retina 46 through a concentric arrangement of perspective powers and a near optical part in the periphery of the lens when viewed downward.
  • existing visual acuity correction tools have individual differences in near vision due to distant vision, a decrease in adjustment due to aging, and the like. For this reason, in order to form distant and near images on the macular 45, the actual condition is that the power of the lens is determined by finally confirming how far or near is seen by a subjective refraction test. It is.
  • the existing bilateral contact lens for correcting myopia forms both distant and near images on the macular 45 in which cone cells are densely distributed. This is the purpose, and imaging on the peripheral part of the retina 46 other than the macular 45 is not considered.
  • the contact lens according to the conventional example has the following problems. i. According to the contact lenses for both near and near, as shown in Patent Documents 1 to 3, the far-field optical system can make a far person look better and the near-field optical system can better The purpose is to make it visible. In other words, the refractive power of the far-field optical system is set so that a person can be imaged by the macular 45 in the fovea. For this reason, it is the actual condition that the suppression of the progression of myopia after that is not considered with respect to the eyeball 2 in the myopia state.
  • the lens power is determined for the purpose of improving visibility. For this reason, it is the actual condition that the optimum refractive power corresponding to the visual advancing state cannot be selected for the near-field optical unit.
  • the contact lens according to claim 1 is provided with a distance optical unit set in the central region of the lens body with a refractive power for correcting myopia and a refraction for suppressing myopia progression. And a rear focus control unit provided in the peripheral region of the distance optical unit with the frequency set.
  • the contact lens according to claim 2 is the contact lens according to claim 1, wherein the posterior focus control unit straddles the peripheral retina in a direction that forms an angle ⁇ with respect to an eye axis that connects the approximate center of the pupil of the eyeball to the macula.
  • a refractive power is set for pulling back the hyperopic back focus from the outside position to the inside of the peripheral retina.
  • the contact lens according to claim 3 is the contact lens according to claim 2, wherein when the inner surface shape of the retina including the macula of the eyeball is expressed by the fundus curvature radius with respect to the refractive power of the posterior focus control unit, the fundus curvature radius is The fundus curvature radius of the eyeball to be examined rather than the average retinal eye, based on the retinal eye having the average fundus curvature radius obtained by averaging the smallest retinal eye and the retinal eye having the largest fundus curvature radius Is a retinal eye that is larger than the average refractive power of the retinal eye, and when the retinal eye has a smaller radius of curvature of the fundus of the subject's eye than the average retinal eye, A refractive power higher than the average refractive power of the retinal eye is set.
  • a method for selecting a contact lens comprising a rear focus control unit provided in a peripheral region of a distance optical unit, wherein the refractive power for correcting myopia corresponding to the visual acuity of the eye to be examined is set
  • a plurality of contact lenses, and a post-focus control unit that sets several types of refractive power for suppressing myopia progression in a peripheral region of the distance optical unit, and prescription of the contact lens And selecting one contact lens corresponding to the fundus shape of the subject from the plurality of contact lenses.
  • the method for selecting a contact lens according to claim 5 is the retinal eye having the smallest fundus curvature radius and the fundus oculi when the inner surface shape of the retina including the macular of the eyeball to be examined is represented by the fundus curvature radius.
  • the retinal eye obtained by averaging the retinal eye having the largest radius of curvature is a retinal eye having the fundus curvature radius of the eyeball to be examined larger than the average retinal eye with respect to the average retinal eye
  • a contact lens having a refractive power that is weaker than the refractive power of the average retinal eye and if the retinal eye has a smaller radius of curvature of the fundus of the eyeball than the average retinal eye, A contact lens having a refractive power higher than the average refractive power of the retinal eye is selected.
  • the contact lens selection method is the method according to claim 5, wherein at least two or more measurement points are set on the inner peripheral surfaces of the left and right retinas of the eye axis connecting the approximate center of the pupil of the eyeball and the macula. Then, the axial length of the eyeball to be examined and the depth to the measurement point are measured, and the fundus curvature radius is estimated from the information on the axial length and depth.
  • the contact lens according to claim 1 since the rear focus control unit in which the refractive power for suppressing myopia progression is set is provided in the peripheral region of the distance optical unit, the near vision that is the purpose of the bifocal lens It is possible to suppress the subsequent progress of myopia with respect to the subject's eye in a myopic state without depending on the near vision or without depending on the near vision.
  • one contact lens corresponding to the fundus shape of the subject is selected from the plurality of contact lenses.
  • This configuration makes it possible to prescribe an optimum refractive power suitable for the myopia progress state with respect to the subject's back focus control unit.
  • FIG. 1 is a block diagram showing a configuration example of a myopia progression diagnostic apparatus 100 as a first embodiment according to the present invention.
  • 3 is a block diagram illustrating a configuration example of a control system of the myopia progression diagnosis apparatus 100.
  • FIG. It is an intraocular sectional view showing a determination example in which the evaluation formulas A, B, and C are positive values. It is an intraocular sectional view showing a determination example in which evaluation formulas A, B, and C are negative values.
  • 4 is a flowchart showing an example of myopia progress determination (main routine) in the myopia progress diagnosis device 100. It is a flowchart which shows the myopia progress determination example (subroutine).
  • a and B are sectional views showing a configuration example of a contact lens 200 for suppressing myopia progression as a second embodiment according to the present invention.
  • 5 is a cross-sectional view showing an example of wearing a contact lens 200.
  • FIG. It is a graph which shows the example of a relationship between visual acuity and the frequency from a fovea.
  • the present invention makes it possible to suppress the progression of myopia in the near-sighted eyeball without depending on the near vision, which is the purpose of the bifocal lens, and to detect nearsightedness in the eyeball. It is an object of the present invention to provide a contact lens capable of prescribing an optimum refractive power suitable for the progress and a method for selecting the same.
  • a myopia progression diagnosis apparatus 100 shown in FIG. 1 is an apparatus that acquires and analyzes optical data of a peripheral visual field in an eyeball of a subject 1 such as a child or an adult (hereinafter referred to as an eyeball 2 to be examined).
  • the myopia progression diagnostic apparatus 100 is capable of acquiring a wide range of optical data with a focus of ⁇ 2.5 [D] (D: diopter) from the center of the crystalline lens of the human eye to the peripheral visual field shifted by an angle of 40 °. It is.
  • the myopia progression diagnosis apparatus 100 is a device that devises an existing PSF analyzer (registered trademark). For example, whether myopia of a child or the like progresses in the future, and whether myopia that can progress can be suppressed by treatment. Determining whether or not it is possible to treat myopia suppression by adding a refractive lens to the periphery of a distance lens that can progress, and determining the effect after a certain period of treatment Etc. are applicable.
  • the myopia progression diagnosis apparatus 100 includes an optical data acquisition unit 10 and a data analysis apparatus 20.
  • the optical data acquisition unit 10 includes, for example, a main body unit 11, an XYZ stage 12, and an arcuate track 53.
  • the main body 11 is placed on an XYZ stage 12, and the XYZ stage 12 can move on an arc-shaped track 53 in a clockwise direction or a counterclockwise direction.
  • the XYZ stage 12 can move and adjust the main body 11 in the X direction (left-right direction), Y direction (front-rear direction), and Z direction (up-down direction: a direction perpendicular to the paper surface).
  • the XYZ stage 12 is provided with a setting unit 15, which is the same as the optical axis O described in FIG. 3: FIG. 32A and FIG. 32B that connects the approximate center of the pupil of the eye 2 to be examined and the macula.
  • the setting unit 15 includes an angle indicator 51, an operation lever 52, and the like.
  • a digital display is used as the angle display 51, and the angle ⁇ is displayed.
  • the track 53 is attached to the fixed coordinate system.
  • An XYZ stage 12 is movably engaged with the track 53.
  • the angle indicator 51 is provided on the XYZ stage 12, and when the operator (ophthalmologist) sets the angle ⁇ , if the XYZ stage 12 is moved along the track 53 with the operation lever 52, the angle indicator 51 Display as the value counts up sequentially.
  • a method may be employed in which the angle indicator 51 is provided on the track 53, the base line is provided on the XYZ stage 12, and the base line is aligned with the scale displaying the analog angle.
  • a driving mechanism (not shown) may be provided on the XYZ stage 12, the angle ⁇ may be set with a numeric keypad, etc., and the driving mechanism may be operated to automatically rotate the XYZ stage clockwise or counterclockwise.
  • 16 is an existing lever for XYZ stage operation.
  • Reference numeral 54 denotes a fixation card (Landolt ring having a notch in a horizontal direction, a vertical direction, or the like: C symbol).
  • the optical data acquisition unit 10 uses a PSF analyzer (registered trademark), an autorefractometer, or the like.
  • the auto-refractometer irradiates the subject's eyeball 2 with infrared light, and can automatically analyze the refraction state of the eye, mainly the presence or absence of myopia, hyperopia, and astigmatism, and the degree thereof, and the objective eyeball 2 can be objectively viewed. Can be measured numerically and digitized.
  • the data analysis device 20 includes a keyboard 21, a mouse 22, a control unit 23, and a display unit 24.
  • a personal computer information processing device
  • the mouse 22 is a wired type or a wireless type.
  • a liquid crystal display panel is used for the display unit 24.
  • the main body unit 11 includes a light irradiation unit 13, a light detection unit 14, and a data input / output unit 17, and these constitute a control system of the optical data acquisition unit 10.
  • the light irradiation unit 13 is provided with components of a projection system such as a light source, a focusing lens, a polarization beam splitter, and a quarter wavelength plate (not shown).
  • the irradiation control signal S13 Based on the irradiation control signal S13, the light irradiation unit 13 irradiates the retina 46 (see FIG. 3, FIG. 4, etc.) in the direction of the angle ⁇ with respect to the eye axis L with the measurement light.
  • the irradiation control signal S13 is a signal for controlling the light source, the focusing lens, and the like.
  • the light detection unit 14 receives light reflected from the retina 46 in the angle ⁇ direction and generates a light detection signal S14 in the peripheral visual field of the fundus.
  • the light detection unit 14 includes an imaging device (CCD).
  • CCD imaging device
  • the light detection unit 14 generates a light detection signal S14 serving as optical data D17 in a wide refraction range including the defocus components of the front focal line and the rear focal line.
  • the defocus component refers to a luminance component at a non-focus position that is shifted back and forth on the optical axis (direction) from the imaging position of the crystalline lens 42 (see FIG. 3).
  • This defocus component around the visual field can be the first factor for predicting the presence or absence of myopia progression.
  • the existing PSF analyzer registered trademark
  • the existing PSF analyzer can be used for the individual configurations and functions of the light irradiation unit 13, the light detection unit 14, and the data input / output unit 17, a detailed description thereof will be omitted.
  • the data input / output unit 17 controls the light irradiation unit 13 and the light detection unit 14 by transferring the optical data D17 to the data analysis device 20 or receiving the control data D33 from the data analysis device 20.
  • the data input / output unit 17 performs D / A conversion on the control data D33 to create an irradiation control signal S13, and outputs the irradiation control signal S13 to the light irradiation unit 13.
  • the data input / output unit 17 A / D converts the light detection signal S14 to create optical data D17, writes the angle ⁇ in the header, attaches the optical data D17 to the header, and transfers the optical data D17 to the data analyzer 20.
  • Optical data D17 is a point spread function (PSF image) every 0.25 [D] steps in the range of the optical axis ⁇ 2.0 [D] of the reflected light reflected from the retina 46 of the peripheral visual field at an angle ⁇ . ) Is reproduced (imaged) and constitutes 21 double-pass PSF images.
  • the control data D33 includes data for driving the focusing lens every 0.25 [D] steps in the range of ⁇ 2.0 [D].
  • the data input / output unit 17 is provided with an AD converter that converts the light detection signal S14 into digital optical data D17, and a DA converter that converts the control data D33 into the irradiation control signal S13.
  • the AD converter and the DA converter A local central processing unit (CPU) is also provided for controlling input / output such as.
  • the analyzer When a PSF analyzer (registered trademark) is used for the optical data acquisition unit 10, the analyzer is fixed with the eye to be measured by the child, and the optical data D17 of the center of the fundus and its peripheral visual field is ⁇ 2.0 [D ] In a wide range of 0.25 [D] steps.
  • the measurement light (light beam) incident on the subject's eyeball 2 is changed from convergent to parallel and divergent by driving the focusing lens of the light irradiating unit 13.
  • a double-pass PSF image can be acquired by optically changing the distance to the light source in 0.25 [D] steps.
  • a data analysis device 20 is connected to the optical data acquisition unit 10, and the data analysis device 20 analyzes the optical data D17.
  • a point image intensity distribution characteristic (hereinafter referred to as a PSF characteristic) at a focus position of the measurement light at an angle ⁇ and positions before and after the focus (step 0.25 [D]) is obtained, and based on the PSF characteristic. It is determined whether or not there is a hyperopic post-focal point in the peripheral visual field of the fundus of the optometry ball 2.
  • the back focal point refers to a non-focal point located on the rear focal line when the rear side of the focal point of the measurement light focused most on the optical axis L ′ at the angle ⁇ is defined as the rear focal line.
  • the data analysis apparatus 20 includes a control unit 23, and the control unit 23 includes, for example, a calculation unit 31, a determination unit 32, a data input / output unit 33, and a memory unit 34.
  • a central processing unit (CPU) is used for the calculation unit 31 and the determination unit 32.
  • the calculation unit 31 obtains the position of the focus of the measurement light at the angle ⁇ and the PSF characteristics of the positions before and after the focus from the optical data D17 related to the single pass PSF image. For example, the calculation unit 31 has the position of the focus of the measurement light most focused on the optical axis L ′ at the angle ⁇ , the position of the astigmatism on the front focal line located on the front side of the focus on the optical axis L ′, Then, the PSF characteristic of the position of the astigmatism on the rear focal line located behind the focal point on the optical axis L ′ is obtained.
  • the calculation unit 31 calculates the refractive power of the PSF image at the focal position at the angle ⁇ , the refractive power of the front focal point, and the refractive power of the rear focal point for each angle ⁇ . As a result, it is possible to predict the presence or absence of myopia from the refractive powers of the front focus and the back focus.
  • the calculation unit 31 sets the refractive power of the PSF image at the most focused position at the angle ⁇ as BFR ⁇ , and the same angle ⁇ .
  • the refractive power of the astigmatic image blurred on the front focal line is AFLR ⁇
  • the refractive power of the astigmatic image blurred on the rear focal line is PFLR ⁇
  • the most focused on the eye axis L ( ⁇ 0 °).
  • the discriminating unit 32 discriminates whether or not the hyperopic back focal point exists in the peripheral visual field of the fundus of the eye 2 to be examined based on the calculation results of the above-described equations (1) to (3). For example, the determination unit 32 determines whether the refractive power of the PSF image at the focus position of the measurement light, the refractive power of the astigmatism on the front focal line, and the refractive power of the astigmatism on the rear focal line are both positive values. Determine whether the value is negative.
  • the discriminating unit 32 When all of the three evaluation values A, B, and C are positive values, the discriminating unit 32 “has a far-focused back focal point outside the retina from the front focal line to the rear focal line. It will be possible to diagnose. On the other hand, if any one of the three evaluation values A, B, and C is negative, it is determined that “no hyperfocal rear focus exists at a position from the front focal line to the rear focal line”. become able to.
  • the optical data acquisition unit 10, the keyboard 21, the mouse 22, and the display unit 24 are connected to the data input / output unit 33 described above.
  • the data input / output unit 33 receives the optical data D17 from the optical data acquisition unit 10, and transfers the control data D33 to the optical data acquisition unit 10.
  • the data input / output unit 33 outputs display data D 24 to the display unit 24, inputs key data D 21 from the keyboard 21, and inputs operation data D 22 from the mouse 22.
  • a refractometer can be connected to the data input / output unit 33 instead of the optical data acquisition unit 10, and the fundus of the eyeball 2 to be examined is determined by the determination unit 32 based on the fundus shape data DIN obtained from the refractometer. It may be determined whether or not there is a hyperopic back focal point in the peripheral visual field.
  • the memory unit 34 constitutes an example of a storage medium and describes a computer-readable program for executing the myopia progress determination method.
  • a hard disk device is used for the memory unit 34.
  • the ROM stores program data readable by a computer for executing the myopia progress determination method.
  • the program data includes, for example, a step of irradiating measurement light to the retina 46 in the direction of an angle ⁇ with respect to the eye axis L connecting the approximate center of the crystalline lens of the eyeball 2 to be examined and the macula, and light reflected from the retina 46.
  • a program for a main routine for executing a step (see FIG. 5) for determining whether or not a hyperopic back focus exists in the peripheral visual field of the fundus of the eyeball 2 to be examined based on the PSF characteristics. Is.
  • the refractive power AFLR ⁇ of the astigmatism on the front focal line and the refraction of the focus on the axial length are a subroutine for determining whether or not a hyperopic back focus exists in the peripheral visual field of the fundus of the eye 2 to be examined.
  • the optical data D17 after conversion is developed at the time of frequency transfer function (Modulation Transfer Function: MTF) analysis.
  • MTF Modulation Transfer Function
  • the hard disk device stores optical data D17 before and after conversion, display data D24, control data D33, and the like.
  • the display data D24 is simulation image display data for displaying a thumbnail image for each angle ⁇ .
  • Ds in the figure is S curve data, which is image data for drawing the rear focal contour S of the radius rs, and is used when selecting a contact lens.
  • the display unit 24 displays the PSF image at the most focused position calculated by the calculation unit 31, the astigmatic image on the front focal line, and the astigmatic image on the rear focal line for each angle ⁇ .
  • the display data D24 is received from the data input / output unit 33, and the PSF image at the most focused position, the astigmatic image on the front focal line, and the thumbnail image of the astigmatic image on the rear focal line are displayed on one screen.
  • the display unit 24 may display a schematic section of the eyeball 2 to be superposed with the optical axis L ′ at the angle ⁇ (see FIGS. 3 and 4).
  • a liquid crystal display panel is used for the display unit 24. These constitute the myopia progression diagnostic apparatus 100.
  • 3 and 4 are schematic cross sections of the eyeball 2 to be superposed with the optical axis L ′ at an angle ⁇ , and the position (focus point) on the optical axis L ′ is a 0.25 [D] scale. And unfocused depth).
  • the evaluation formulas A, B, and C shown in FIG. 3 are positive values
  • the determination example in which the evaluation formulas A, B, and C shown in FIG. 3 are positive values
  • the determination example in which the evaluation formulas A, B, and C shown in FIG. 3 are positive values
  • the child whose myopia has progressed is more likely to have the eyeball 2 to be examined compared to the child with normal vision shown in FIG.
  • the axial length Lx extends.
  • the measurement light (light beam) incident on 2 is changed, the positions of the non-focal point and the focal point are described for each 0.25 [D] step.
  • the most focused position (black circle mark) is BFp
  • the position of the astigmatism on the front focal line (black rhombus mark) is AFp
  • the astigmatism on the rear focal line The position BFp and the position RFp straddle the retina 46 and are located on the far vision side when the position (white diamond mark) is set to RFp.
  • the position AFp corresponds to -3.45 [D] shown in FIG. 8E
  • the position BFp corresponds to -1.95 [D] shown in FIG. 8K
  • the position RFp is This corresponds to -0.45 [D] shown in FIG. 9E.
  • the evaluation formulas A, B, and C are positive values, and myopia of the eyeball 2 progresses. It can be determined that
  • the evaluation formulas A, B, and C shown in FIG. 4 are negative values
  • a normal-sighted child has an eye of the eyeball 2 to be examined as compared to a myopic child shown in FIG.
  • the axial length Lx does not extend.
  • the most focused position BFp and the astigmatic position AFp on the front focal line are located on the myopia side without straddling the retina 46.
  • the evaluation formulas A, B, and C are negative, and it is determined that the myopia of the test eyeball 2 is not progressing. can do.
  • the myopia progression diagnosis apparatus 100 shown in FIG. 1 fixes the head of the subject 1 to its chin and causes the fixation card 54 to be fixed with a non-inspection eye. It is assumed that the optical data D17 in the peripheral visual field is measured by the myopia progression diagnostic apparatus 100.
  • the myopia progress diagnosis device 100 executes the following steps ST1 to ST7, and in step ST5, the control unit 23 determines the progress of myopia of the eyeball 2 to be diagnosed to diagnose the progress of myopia of the eyeball 2 to be examined. To take.
  • step ST1 of the flowchart shown in FIG. 5 first, the control unit 23 accepts the setting of the angle ⁇ .
  • the angle ⁇ is an irradiation angle of the measurement light with respect to the eye axis L connecting the approximate center of the crystalline lens 42 of the eyeball 2 to be examined and the macula 45.
  • the ophthalmologist operates the setting unit 15 to set the angle ⁇ .
  • the setting unit 15 notifies the control unit 23 via the data input / output units 17 and 33 of the optical data D17 indicating the angle ⁇ setting.
  • the optical data D17 indicating the angle ⁇ setting may be input to the control unit 23 by operating the keyboard 21 or the mouse 22.
  • step ST2 the control unit 23 controls the light irradiation unit 13 to irradiate the measurement light to the retina 46 in the direction of the angle ⁇ set previously. Based on the irradiation control signal S13 input from the data input / output unit 17, the light irradiation unit 13 irradiates the retina 46 (see FIG. 3, FIG. 4, etc.) in the direction of the angle ⁇ with respect to the eye axis L.
  • step ST3 the control unit 23 controls the data input / output unit 17 so as to acquire the optical data D17.
  • the light detection unit 14 receives light reflected from the retina 46 in the direction of the angle ⁇ and generates a light detection signal S14 having a wide refraction range including defocus components of front focal lines and rear focal lines in the peripheral visual field of the fundus. To do.
  • the data input / output unit 17 receives the photodetection signal S14 from the photodetection unit 14, A / D converts the photodetection signal S14, and has a wide refraction range optical data including defocus components of the front focal line and the rear focal line. D17 is acquired.
  • the optical data D17 is data constituting a double-pass PSF image shown in FIG.
  • the double-pass PSF image is a point image formed on the retina 46 when a point light source is projected onto the eyeball optical system, and includes all the optical information (optical data D17) of the eyeball optical system.
  • optical data D17 By acquiring the optical data D17, it is possible to acquire the optical characteristics of the defocused component not only in the most focused portion in the peripheral portion of the visual field but also in a fine and wide range such as 0.25 [D].
  • step ST4 the control unit 23 analyzes the optical data D17.
  • the control unit 23 obtains the PSF characteristics of the focus position of the measurement light at the angle ⁇ and the positions before and after the focus. Since the measurement light passes through the eyeball optical system twice in the above-described double-pass PSF image, the double-pass PSF image shown in FIG. ) Convert to PSF image.
  • the optical data D17 indicating the double pass PSF image is converted into the optical data D17 indicating the single pass PSF image by the same method as the conventional method.
  • the converted optical data D17 is analyzed and used to determine whether or not a hyperopic back focal point exists in the peripheral visual field of the fundus of the eye 2 to be examined.
  • requires MTF as a function showing the transfer characteristic of a single path
  • optical Transfer Function Optical Transfer Function: OTF
  • OTF optical Transfer Function
  • the calculation unit 31 calculates contrast data (MTF data) reflecting low-order and high-order aberrations from the optical data D17.
  • the unfocused blur of the peripheral visual field is analyzed (MTF analysis) by calculating MTF (fx, fy) in the PSF image at the most focused position.
  • MTF the optical transfer function of the eyeball optical system of the eye 2 to be examined
  • the frequency transfer function is MTF (fx, fy)
  • the luminance signal component of the optical data D17 for non-focus and focus is S. (Fx, fy), S (0, 0)
  • the horizontal spatial frequency is fx
  • the vertical spatial frequency is fy.
  • MTF (fx, fy) is calculated from the above.
  • step ST42 the control unit 23 displays the focus and non-focus images for each 0.25 [D] step as thumbnail images on the display unit 24 in the range of ⁇ 2.0 [D] at the angle ⁇ .
  • the display unit 24 receives the display data D24 from the data input / output unit 33, and displays the PSF image at the most focused position, the astigmatic thumbnail image on the front focal line, and the thumbnail image of the astigmatic image on the rear focal line. It is displayed on the screen (see FIGS. 8A to 8L and FIGS. 9A to 9I).
  • the range of the optical axis ⁇ 2.0 [D] of the reflected light reflected from the retina 46 at the periphery of the visual field at an angle ⁇ 20 °.
  • 21 single-pass PSF images reproduced (captured) every 0.25 [D] steps are constructed, and optical data D17 (contrast) of the single-pass PSF image converted from the double-pass PSF image shown in A of FIG. Data: MTF data)).
  • the refractive powers shown in FIGS. 8A to 8L are ⁇ 4.45 [D], ⁇ 4.20 [D], ⁇ 3.95 [D], ⁇ 3.70 [D], ⁇ 3.45 [D], -3.20 [D], -2.95 [D], -2.70 [D], -2.45 [D], -2.20 [D], -1.95 [D], -1
  • the non-focus images shown in FIGS. 8A to 8J have a long and narrow elliptical shape with a width and a length that are large and small.
  • the non-focus images shown in FIG. 8L and FIGS. 9A to 9I also have large and small widths and lengths, and have a long and narrow elliptical shape.
  • the selection criterion for the non-focus image on the front focal line and the non-focus image on the rear focal line is, for example, a front focus at a position shifted by ⁇ 0.25 [D] before and after the PSF image at the most focused position BFp.
  • the non-focus image on the front focal line and the rear at the symmetrical positions AFp and RFp that become the light intensity of the PSF image is extracted.
  • the other angles ⁇ 10 °, 30 °, and 40 ° are obtained in the same manner.
  • the vertical axis is the MTF of the intraocular lens (the crystalline lens 42), and the contrast reduction corresponding to the spatial frequency (Spatial Frequency) indicating the fineness of the PSF image. Shows the percentage.
  • the horizontal axis is the spatial frequency [c / deg].
  • the broken line is the horizontal MTF vs. spatial frequency characteristic of the PSF image
  • the alternate long and short dash line is the vertical MTF vs. spatial frequency characteristic of the PSF image
  • the MTF (contrast) rapidly decreases as the spatial frequency increases (becomes a fine image). From this MTF characteristic, the optical characteristic of the crystalline lens 42 of the eye 2 to be examined can be grasped.
  • the solid line in the figure is the MTF characteristic of the crystalline eye.
  • step ST53 the calculation unit 31 inputs the refractive power BFR ⁇ at the most focused position and the refractive power BFR0 of the focal point on the axial length.
  • step ST55 the calculation unit 31 inputs the refractive power PFLR ⁇ of the astigmatism on the rear focal line and the refractive power BFR0 of the focal point on the eye axis L.
  • step ST57 the determination unit 32 determines whether the evaluation values A, B, and C are all positive values.
  • A, B, C> 0 is satisfied (YES)
  • the process returns to step ST5 “the peripheral visual field has a hyperopic back focal point”.
  • A, B, C ⁇ 0 NO
  • the process returns to step ST5 “No hyperopic back focus in the peripheral visual field”.
  • the refractive power BFR0 of the focal point on the eye axis L is ⁇ 0.3 [D]
  • the refractive power of the PSF image at the most focused position at an angle ⁇ 20 °.
  • BFR ⁇ is ⁇ 1.5 [D]
  • the refractive power AFLR ⁇ of the astigmatism on the front focal line is 0.0
  • the refractive power PFLR ⁇ of the astigmatism on the rear focal line is ⁇ 3.0
  • the evaluation value A is +3
  • the evaluation value B is +1.5
  • the evaluation value C is 0.0
  • the evaluation values A and B are positive values. Therefore, it can be determined that all hyperopic defocuses from the front focal line to the rear focal line exist.
  • the child who has progressed myopia can expect that the focal point at the angle ⁇ and the astigmatism on the back focal line straddle the retina 46 and be located on the farsighted side.
  • the refractive power BFR0 of the focal point on the eye axis L is 0.0 [D]
  • the refractive power BFR ⁇ of the PSF image at the most focused position at an angle ⁇ 20 °.
  • the refractive power AFLR ⁇ of the astigmatic image on the front focal line is 0.0
  • the refractive power PFLR ⁇ of the astigmatic image on the rear focal line is -2.0
  • evaluation value C is ⁇ 2.0
  • evaluation values B and C are negative values
  • a child who has not progressed myopia can be expected to be positioned on the myopic side of the retina 46 without the front focal line and the rear focal line at the angle ⁇ straddling the retina 46.
  • astigmatism on the myopia side of the retina 46 as shown in FIG. 4 is present on the focal point and the front focal line, and it can be predicted that the eyeball 2 is not subject to myopia progression. .
  • control unit 23 determines that “the myopia 2 does not progress myopia” in step ST5 described above, the control unit 23 informs the display unit 24 of “exclude from addition power introduction treatment” in step ST6. Is displayed.
  • control unit 23 determines in step ST5 that “the eyeball 2 to be examined has a progress of myopia”, in step ST7, the control unit 23 displays “Apply prescription introduction of addition power” on the display unit 24.
  • treatment with spectacles or a contact lens that introduces an addition power for suppressing myopia progression is prescribed from the analysis result of the degree of blurring of the point image of the focal position of the measurement light at the angle ⁇ .
  • this step ST7 it may be determined whether or not the myopia that can be progressed can be suppressed by treatment, and how much refractive correction can be treated in the peripheral portion by adding the refractive correction to the peripheral portion.
  • the addition power for returning the rear focal point outside the retina 46 at the angle ⁇ to the myopia (intraocular) side is set around the far optical part (myopia correction lens).
  • the optical data D17 in the peripheral visual field of the fundus obtained by receiving the light reflected from the retina 46 in the direction of the angle ⁇ is analyzed.
  • the data analysis device 20 is provided, and the data analysis device 20 has a hyperopic back focal point in the peripheral visual field of the fundus of the eye 2 based on the position of the focus of the measurement light at the angle ⁇ and the PSF characteristics of the positions before and after the focus. It will be determined whether or not it exists.
  • the myopia progress diagnosis device 100 it is useful for preventing or suppressing myopia progression, such as periodically performing myopia progression determination and appropriately performing refractive correction while monitoring changes in the optical data D17 in the peripheral visual field. It can. Thereby, in the effect determination performed after a certain period of treatment, the treatment criteria can be clearly defined.
  • the myopia progression determination method in the optical characteristics of the peripheral visual field of the fundus, the refraction of the front focal line and the rear focal line is taken into consideration, and in step ST4, the degree of blur of the point image at the focal position of the measurement light at the angle ⁇ is determined.
  • the subject eyeball 2 in which the point image of the focus position of the measurement light is largely blurred can be identified (classified) as an exclusion group that cannot be treated in this intervention test or can be treated in this intervention test. Become.
  • the IOL eye intraocular lens eye
  • the IOL eye has been subjected to a method (lasik or the like) in which the crystalline lens 42 is removed by cataract surgery and an artificial crystalline lens is inserted (embedded) instead.
  • a method lasik or the like
  • the crystalline lens 42 is removed by cataract surgery and an artificial crystalline lens is inserted (embedded) instead.
  • FIG. 14 shows an example of MTF characteristics of the IOL eye.
  • the solid line in the figure is the MTF characteristic of the IOL eye.
  • the MTF characteristic of the IOL eye is flatter than that of the crystalline eye.
  • the overall image diameter of the PSF image of the IOL eye is larger than that of the lens eye PSF image. It can be seen that the MTF is significantly degraded in the IOL eye.
  • the above-described aberration component can also be identified by performing MTF analysis on the optical data D17. Since myopia progresses in IOL eyes in past reports, the introduction of the discrimination method of the present invention is effective as a method for distinguishing examples that should be excluded from intervention tests.
  • the head of the subject 1 is fixed to the chin stand of the inspection device, and the optical data acquisition unit 10 is trajected while the fixation card 54 is fixed with a non-inspection eye.
  • the angle ⁇ optical axis
  • the present invention is not limited to this.
  • the optical data acquisition unit 10 is fixed with a child's eye to be measured, and an optical system including a point light source, a half mirror, a CCD, or the like inside the optical data acquisition unit 10 is mounted on a stage or the like.
  • the optical system is fixed independently to the rotating coordinate system with respect to the fixed coordinate system in which the subject 1 and the data acquisition unit main body are fixed, and the stage or the like in the rotating coordinate system is set at an angle ⁇ (optical axis).
  • a method may be adopted in which a reflecting mirror is disposed on the optical axis of the optical system, and the angle ⁇ (optical axis) is displaced by rotationally driving the reflecting mirror.
  • accurate optical data D17 including the front focal line and the rear focal line at the angle ⁇ can be acquired.
  • the correction power necessary for myopia suppression can be measured from the hyperopia power obtained from the data analysis device 20 (see step ST7).
  • the axial length Lx extends rearward and the eyeball shape is distorted.
  • the angle ⁇ is set to the eye axis L that connects the approximate center vertex of the crystalline lens 42 of the eyeball 2 to the macular 45.
  • myopia progression suppression theory By pulling back the hyperopic back focus from the outer position straddling the peripheral retina in the direction of formation to the inside (intraocular) of the peripheral retina, it becomes possible to suppress the progression of myopia (hereinafter referred to as myopia progression suppression theory) ).
  • a contact lens 200 for suppressing myopia progression as a second embodiment shown in FIGS. 15A and 15B is an example of a contact lens, and a rear focus control unit (hereinafter referred to as a refractive index for suppressing myopia progression) is set.
  • the rear focal point control area 63 is provided in the peripheral region of the distance optical unit 62.
  • the contact lens 200 according to the present invention is based on the following design basis.
  • the contact lens 200 has a bowl-shaped lens main body 61 having a concave central portion and a convex shape around the concave portion.
  • a member constituting a soft contact lens can be used conventionally.
  • the lens body 61 is provided with a frequency setting area I (additional area: ADD).
  • the diameter D ⁇ 2 of the frequency setting region I is set to about 7.0 mm because the pupil diameter D ⁇ 3 shown in FIG. 16 is 4.6 mm on average.
  • FIG. 16 shows an example in which the contact lens 200 is mounted on the cornea 41.
  • the frequency setting area I includes a distance optical unit 62 and a rear focus control area 63.
  • the distance optical unit 62 is provided in the central region of the lens body 61, and a concave lens having a predetermined minus power for correcting myopia is disposed.
  • the width of the distance optical unit 62 is indicated by OZ and is designed at the center of the lens when viewed from the front, and the width OZ of the distance optical unit 62 is set to about 2.5 mm.
  • the second object is to make the incident angle of light with little influence on the back of the retina 46 even in the vicinity of the macular 45.
  • the remaining area obtained by subtracting the area area with the width OZ of the distance optical unit 62 from the frequency setting area I is referred to as a back focus control area 63.
  • the power of the back focus control area 63 is determined based on the calculation formula created for the retinal curvature and the myopia progression suppression theory, regardless of the power of the myopic eye and how it is viewed.
  • the rear focus control area 63 is set within an angle of 30 ° (see FIG. 16) to control the light incident on the eye at this angle of 30 ° in order to provide power.
  • the angle 30 ° is defined as an angle 0 ° with respect to the eye axis L connecting the substantially central vertex of the crystalline lens 42 of the eyeball 2 shown in FIG. , 24 °, 36 °, 48 ° and 60 °.
  • the rear focus control area 63 is provided around the distance optical unit 62.
  • a convex lens having a predetermined plus power for suppressing myopia progression is arranged, and an eye axis L that connects the approximate center of the pupil 43 of the eyeball 2 to be examined (substantially the central vertex of the crystalline lens 42) and the macular 45.
  • the far-focused back focus is pulled back from the outside position across the peripheral retina in the direction forming the angle ⁇ to the inside (intraocular) of the peripheral retina.
  • the contact lens 200 represents the inner surface shape of the retina 46 including the macular 45 of the eye 2 to be examined by the fundus curvature radius, and the retina eye having the smallest fundus curvature radius and the fundus curvature radius are the smallest. If the retinal eye has a larger radius of curvature of the eyeball than the average retinal eye, based on the average retinal eye obtained by averaging the largest retinal eye, the average retinal eye If the retinal eye has a smaller radius of curvature of the fundus of the eye than the average retinal eye, a refractive power stronger than that of the average retinal eye is set. Is.
  • the area outside the frequency setting area I is an area having no frequency
  • the area between the area having no frequency and the area where the frequency is set is a loose junction (connection part; boundary part). ing.
  • the sudden change in shape and frequency is to cause image jumps and distortions in the peripheral part of the field of view.
  • the design has a zone (transition zone) in which the lens tip (outermost side) is gradually changed.
  • the above-described contact lens 200 for suppressing myopia progression can be manufactured based on the basic data on the optical characteristics of the peripheral visual field of the eyeball 2 to be examined and the calculation formula.
  • the myopia power of the distance optical unit 62 is arranged at the center, and the rear focus control area 63 obtained by the calculation formula is arranged at the periphery thereof.
  • the distance OZ (area) of the distance optical unit 62 is set too wide, a large amount of light that has entered the eye from the distance optical unit 62 reaches the periphery of the retina. In order to prevent this light from reaching the periphery of the retina, it is desirable to make the width OZ of the distance optical unit 62 as narrow (small) as possible.
  • the width OZ is designed based on the data calculated by the calculation formula.
  • the feature of the present invention is that the area of the distance optical unit 62 in which the refractive power for the distance vision is contained is significantly smaller than the conventional contact lens for vision correction.
  • halo refers to the after-effects translated as annulus, accompanied by the symptoms that a ring-like light can be seen around the light.
  • the light itself may appear round and blurred. In any case, it feels dazzling because it is larger than the original light.
  • Glare is a sequelae translated as radiance, and is accompanied by symptoms in which the light is more glaring and dazzling. Some people say that it looks blurred.
  • the refractive index for suppressing myopia progression is set, and the rear focus control area 63 provided in the peripheral region of the distance optical unit 62 is provided.
  • the far-focused back focus is pulled back from the outer position across the peripheral retina in the direction forming the angle ⁇ of the optometry ball 2 to the inner side (intraocular) of the peripheral retina.
  • the contact lens 200 according to the present invention is intended to suppress myopia progression, it is designed so that the light from the distance optical unit 62 is imaged on the macular 45 which is the center of the retina 46 in the distance vision. However, it is not intended to image the focal point of the back focus control area 63 on the macular 45.
  • the refractive power of the rear focus control area 63 is determined by an objective examination by the myopia progression diagnostic apparatus 100, the visual appearance of the distance optical unit 62 is not improved. This is a major difference from the target existing bilateral contact lens.
  • the existing bilateral contact lenses for vision correction aim to improve the perceptual distance and near vision and how clear images can be obtained, preventing ghosts and glare.
  • the distance optical unit 62 ′ and the near optical unit 63 ′ are designed for the purpose of preventing image jump (see FIG. 30).
  • the existing vision correction and far-distance contact lenses must be prescribed a power corresponding to individual differences.
  • the human eyeball has an average size, it is possible to determine the specifications by performing several types of frequency designs based on the average eyeball size. Then, there is a merit that it leads to simplification of manufacturing.
  • the soft contact lens is formed by, for example, injection molding by injecting a lens resin material into a mold that integrally represents the concave lens of the distance optical unit 62, the convex lens of the back focus control area 63, and the surrounding area. It is obtained by doing.
  • the contact lens 200 described above is completely different from a general contact lens for correcting visual acuity, and the power provided in the rear focus control area 63 has nothing to do with the power of the distance optical unit 62 provided in the center. Neither is it related to the correction power required by the user. It is determined only by the difference in retinal curvature. Therefore, even if the eyes have the same myopia power and the same accommodation power, when the retinal curvature is different, the power of the rear focus control area 63 installed in the lens body 61 is different. For this reason, it is not intended to improve the near vision according to the frequency of the rear focus control area 63.
  • the contact lens according to the present invention is a contact lens for suppressing myopia
  • the distance optical unit 62 in front view also has a back focal point of the retina 46 around the macular 45 based on the myopia progression suppression theory. It is also characterized in that the distance optical unit 62 is remarkably narrow as compared with a general contact lens for correcting visual acuity in order to obtain a minimum angle with little influence on the back.
  • the frequency provided in the back focus control area 63 must be determined based on the myopia progression suppression theory. If the addition power is determined easily, the back focus cannot be moved to the front of the retina, and the purpose of suppressing the progression of myopia cannot be exhibited.
  • FIG. 17 is a graph showing the relationship between the angle from the macular 45, which is the center of the retina 46, and visual acuity.
  • the vertical axis represents the relative value of visual acuity and indicates visual acuity 0.025 to 1.0.
  • the horizontal axis is the frequency (angle) from the fovea (macular 45), and the position of the macular 45 on the eye axis L is 0 °.
  • the nasal side has a frequency of 0 ° to 70 ° and the ear side has a frequency of 0 ° to 60 °.
  • the visual acuity shows the highest value near the power of 0 °. Since the density of pyramidal cells decreases rapidly when the fovea is off, the visual acuity also decreases.
  • the oblique line near the frequency of 14 ° to 18 ° indicates a blind spot. The image cannot be recognized with this blind spot as a boundary. In other words, the image is not recognized as an image even when focused on the peripheral retina. This phenomenon is applied to the contact lens 200 of the present invention.
  • the contact lens 200 of the present invention is intended to suppress myopia, in the distance vision, the light from the distance optical unit 62 is imaged around the macular 45 where cone cells are densely distributed. Designed to. However, the contact lens 200 does not have an optical area for designing a wide field of view. The reason for this is that, as shown in FIG. 17, the visual acuity is the best in the central fovea of the macular 45, and the visual acuity drops rapidly when it is off the center.
  • the central visual acuity is the most sensitive and worse in the peripheral retina.
  • the visual acuity is about 0.4 when the line of sight is shifted by 2 degrees (angle), and is about 0.1 when the line is shifted by 5 degrees. It is known to decline.
  • myopia is a state in which the focal point f is in front of the macular 45, which is the center of the retina 46.
  • the front focal point a and the rear focal point b that enter the eye from the peripheral part of the cornea 41 and appear in the peripheral part of the retina are both connected to the front of the retina 46.
  • the focal point f is moved to f ′ so as to form an image on the macular 45 of the part, the front focal point a moves to a ′, and the rear focal point b moves to b ′.
  • the back focal point b ′ is connected behind the retina 46.
  • a front focal contour T indicated by a one-dot chain line and a rear focal contour S indicated by a broken line are generated depending on an incident angle (angle ⁇ ; actually a solid angle) of light into the eye.
  • the front focal contour T refers to an arc drawn by sequentially connecting non-focal points having the same PSF characteristic on the front focal line obtained for each angle ⁇ .
  • the rear focal contour S is an arcuate shape in which non-focal points having the same PSF characteristic are connected in order on the rear focal line obtained for each angle ⁇ .
  • the lowest point of each arc of the rear focal contour S and the front focal contour T slides on the eye axis L and moves to the position of the macular 45.
  • rs is the radius of the rear focal contour S, and is the length from the origin Ox on the eye axis to the rear focal contour S.
  • the degree of progress of myopia can be grasped by the difference in the shape of the fundus curvature of the eyeball 2 to be examined, for example, the size of the fundus curvature radius rx.
  • the degree of myopia progression can be determined.
  • the rear focus isoline S may be moved before the retina 46 of the myopic eye after myopia correction.
  • a rear focus control area 63 having a frequency completely irrelevant to the hyperopia correction may be provided in the periphery of the distance optical unit 62.
  • the fundus curvature radius ra is a length from the origin Oa on the eye axis to the retina 46.
  • the prefocus control area 63 for suppressing myopia progression is hardly required. According to this case, even when a mildly convex lens is set in the rear focus control area 63, the rear focus contour S can be easily moved to the front of the retina 46.
  • the fundus curvature radius rc is a length from the origin Oc on the eye axis to the retina 46.
  • prescription of the rear focal point control area 63 for suppressing myopia progression is indispensable.
  • a prescription for setting (inserting) a light lens having a light power is set as type Ta
  • a prescription for setting a convex lens having a power higher than that of type Ta is set as type Tb
  • a prescription for setting a convex lens having a higher power is referred to as type Tc.
  • the refractive power of type Ta is set to +1
  • the refractive power of type Tb is +3
  • the refractive power of type Tb is set to +5, and the like.
  • the fundus curvature radius rx of the eyeball 2 to be examined obtained from the myopia progression diagnosis apparatus 100 it is possible to determine which type Ta, type Tb, or type Tc back focus control area 63 is suitable. It becomes like this.
  • the prescription example of the contact lens 200 of type Ta shown in FIG. 21 the rear focal contour S generated in the peripheral portion of the retina due to the correction of myopia is immediately in front of the retina 46. This is a case of a retinal eye having a large (loose) fundus curvature radius ra compared to the fundus curvature radius rx of the myopic eye shown in FIG.
  • the refractive index provided in the rear focal point control area 63 moves the rear focal contour S forward of the retina 46 even if the degree of refraction is extremely slight. be able to. Accordingly, a contact lens 200 of type Ta is prescribed. In this example, it is also a case that does not require prescription.
  • the rear focal contour S generated in the peripheral portion of the retina due to the correction of myopia is immediately behind the retina 46, and the rear focal contour S and
  • This is the case of a retinal eye that is close to the retina 46 and that has the fundus curvature radius rx and the fundus curvature radius rb of the myopic eye shown in FIG.
  • the refractive power provided in the back focal point control area 63 can be moved to the front of the retina 46 by setting a power higher than that of the retinal eye having a large fundus curvature radius ra. Therefore, a contact lens 200 of type Tb is prescribed.
  • the rear focal contour S generated in the peripheral portion of the retina due to the correction of myopia is located farther from the retina 46, and the rear focus
  • the distance between the contour line S and the retina 46 is long, and the fundus curvature radius rc is smaller (tight) than the fundus curvature radius rx of the myopic eye shown in FIG.
  • the refractive power provided in the back focus control area 63 is set to a higher power than that of the retinal eye having a large fundus curvature radius ra, so that the back focal contour S can be moved in front of the retina 46. Therefore, a contact lens 200 of type Tc is prescribed.
  • the refractive power for correcting myopia corresponding to the visual acuity of the eyeball 2 to be examined is set in the center region of the lens main body 61 to form the distance optical unit 62, and type in the peripheral region of the distance optical unit 62.
  • a plurality of contact lenses 200 having a refractive index for suppressing myopia progression selected from Ta to Tc and set as a back focus control area 63 are prepared in advance. It is assumed that one optimal contact lens 200 is prescribed.
  • types Ta to Tc of the back focus control area 63 are determined based on whether the fundus curvature shape of the eyeball 2 to be examined is on the inside or the outside with reference to the leveled back focal contour S.
  • the inner surface shape of the retina 46 including the macular 45 of the eye 2 to be examined is represented by the fundus curvature radius rx
  • the retinal eye having the smallest fundus curvature radius rx and the retinal eye having the largest fundus curvature radius rx Are obtained to obtain a retinal eye having an average fundus curvature radius rx
  • the average retinal eye obtained here is used as a reference (leveling) (FIG. 22).
  • the posterior focal contour S of the average retinal eye is used as a comparison reference line when selecting types Ta to Tc. It is assumed that the rear focal contour S is reproduced from the leveled S curve data Ds.
  • the S curve data Ds is image data for drawing the rear focal contour S of the radius rs.
  • the control unit 23 is called from step ST7 shown in FIG. 5 and the control unit 23 in step ST71 shown in FIG. 24, the refractive power Rx of the far-field optical unit 62 of the eye 2 to be examined, fundus shape data Input DIN and S curve data Ds.
  • the refractive power Rx, the fundus shape data DIN, and the S curve data Ds are read from, for example, the memory unit 34 and input to the calculation unit 31 and the determination unit 32.
  • the control unit 23 calculates the fundus curvature radius rx of the eyeball 2 to be examined.
  • the calculation unit 31 has at least two or more measurement points (symmetric positions) on the inner peripheral surface of the left and right retinas 46 of the eye axis L connecting the substantially central vertex (see FIG. 2) of the crystalline lens 42 of the eyeball 2 to be examined and the macular 45. )
  • the fundus curvature radius rx is obtained by obtaining an arc (fundus curvature) having an arc length La and an arrow height h shown in FIG. 25A, superposing them using a known arc as a parameter, and matching the two arcs with each other. It is obtained by reading '.
  • step ST73 the control unit 23 determines whether the refractive power type of the back focus control area 63 of the eye 2 to be examined is Ta or other than Ta.
  • the discrimination unit 32 compares the rear focal contour S of the radius rs and the fundus curvature radius rx of the eyeball 2 to be examined. For this comparison, a pattern recognition method may be employed.
  • step ST74 the control unit 23 performs display control for prescribing a contact lens of refractive power Rx + type Ta.
  • the display unit 24 receives the display data D24 from the data input / output unit 33, and based on the display data D24, “the refractive power Rx of the distance optical unit 62 + the refractive power of the rear focus control area 63 is type Ta”. Is displayed. As a result, it is possible to automatically select (prescribe) the contact lens 200 having a refractive power that is weaker than the average refractive power of the retinal eye.
  • the control unit 23 proceeds to step ST75 and the control unit 23 performs the back focal point radius rx of the eyeball 2 to be examined. It is determined whether the type of the control area 63 is Tb or Tc. At this time, as a result of comparing the radius rs of the back focus isoline S and the fundus curvature radius rx of the eyeball 2 to be examined, the radius rs of the back focus isoline S and the fundus curvature radius rx are almost as shown in FIG. If they are equal (average curvature shown in FIG.
  • the determination unit 32 determines that the type of the fundus curvature radius rb is Tb, and the process proceeds to step ST76.
  • the control unit 23 performs display control for prescribing the contact lens 200 of refractive power Rx + type Tb.
  • the display unit 24 displays based on the display data D24 that “the refractive power Rx of the distance optical unit 62 + the refractive power of the rear focus control area 63 is type Tb”. As a result, it is possible to automatically select (prescribe) the contact lens 200 in which the refractive power substantially equal to the refractive power of the average retinal eye is set.
  • the determination unit 32 determines the eyeball to be examined. Since it is determined that the type of the back focus control area 63 of the fundus curvature radius rc of 2 is Tc, the process proceeds to step ST77. In step ST77, the control unit 23 performs display control for prescribing the contact lens 200 of refractive power Rx + type Tc.
  • the display unit 24 displays based on the display data D24 that “the refractive power Rx of the distance optical unit 62 + the refractive power of the rear focus control area 63 is type Tc”.
  • the contact lens 200 having a refractive power higher than the average refractive power of the retinal eye can be easily and automatically selected (prescription). Thereafter, the process returns to step ST7 shown in FIG.
  • ⁇ 40 ° ( ⁇ max)
  • the types Ta to Tc of the rear focus control area 63 are determined based on the optical data D17 (refer to FIG. 2) indicating the position RFp of the focal point b ′) and the optical data D17 indicating the position Mp of the retina 46.
  • the type Ta is used, and when the rear focal point b ′ is located outside the retina b ′, the retina is located.
  • the remaining types Tb and Tc are determined based on the degree of separation of the rear focal point b ′ with respect to the 46 position Mp.
  • the optical data D17 indicating the position RFp and the position Mp of the retina 46 are input.
  • the data of the position RFp and the position Mp is obtained from the optical data D17, and is, for example, information indicating the optical axis length (depth) from the surface apex portion of the crystalline lens 42 to the position RFp, the position Mp, and the like.
  • the optical axis length from the surface apex part to the position RFp is set as the depth Lr
  • the optical axis length from the surface apex part to the position Mp is set as the depth Lm (see FIG. 26).
  • the depth difference ⁇ d means a difference distance between the position Mp of the retina 46 and the position RFp of the back focal point b ′ at the angle ⁇ .
  • step ST73 ' the control unit 23 determines whether the refractive power type of the back focal point control area 63 of the eye 2 to be examined is Ta or other than Ta.
  • the determination unit 32 determines whether the depth difference ⁇ d is plus (+) or minus ( ⁇ ), and the control unit 23 branches the control.
  • the depth difference ⁇ d is plus (+)
  • the rear focal point b ′ exists outside the retina 46
  • the depth difference ⁇ d is minus
  • the rear focal point b ′ does not exist outside the retina 46. Is the case.
  • step ST74 ′ the control unit 23 performs display control for prescribing a contact lens of refractive power Rx + type Ta.
  • the display unit 24 receives the display data D24 from the data input / output unit 33, and based on the display data D24, “the refractive power Rx of the distance optical unit 62 + the refractive power of the rear focus control area 63 is type Ta”. Is displayed. As a result, it is possible to automatically select (prescribe) the contact lens 200 having a refractive power that is weaker than the average refractive power of the retinal eye.
  • step ST75 ′ the control unit 23 determines whether the refractive power R ⁇ type of the rear focus control area 63 is Tb or Tc. .
  • the back focal point b ′ is present outside the retina 46.
  • a value (1/2) of the average retinal eye depth difference ⁇ d is used as a reference (threshold value ⁇ dth). To make a decision.
  • the depth difference ⁇ d of the eye 2 to be examined is compared with the threshold value ⁇ dth, and if it is smaller than the threshold value ⁇ dth, it is set as type Tb, and if the depth difference ⁇ d is larger than the threshold value ⁇ dth, it is set as type Tc.
  • step ST76 ' the control unit 23 performs display control to prescribe a contact lens of refractive power Rx + type Tb. Based on the display data D24, the display unit 24 displays that “the refractive power Rx of the distance optical unit 62 + the refractive power of the rear focus control area 63 is type Tb”. As a result, it is possible to automatically select (prescribe) the contact lens 200 in which the refractive power substantially equal to the refractive power of the average retinal eye is set.
  • step ST75 If the depth difference ⁇ d is larger than the threshold value ⁇ dth in step ST75 'described above, it is determined that the type of the back focus control area 63 is C, and the process proceeds to step ST77'.
  • the control unit 23 performs display control for prescribing the contact lens 200 of refractive power Rx + type Tc.
  • the display unit 24 displays based on the display data D24 that “the refractive power Rx of the distance optical unit 62 + the refractive power of the rear focus control area 63 is type Tc”.
  • the contact lens 200 having a refractive power higher than the refractive power of the average retinal eye can be easily and automatically selected (prescription). Thereafter, the process returns to step ST7 shown in FIG.
  • the axial length based on fundus shape data DIN obtained from a fundus image acquisition apparatus such as a refractometer instead of the optical data acquisition unit 10 or a posterior eye OCT (Optical Coherence Tomography).
  • Lx was measured, and the types Ta, Tb, and Tc of the back focus control area 63 were determined from the axial length Lx and the average fundus curvature shape.
  • type Ta is prescribed. This makes it possible to prescribe the contact lens 200 having a refractive power that is weaker than the refractive power of the average retinal eye.
  • type Tb is prescribed. This makes it possible to prescribe the contact lens 200 having a refractive power that is approximately equal to the refractive power of the average retinal eye.
  • the back focus control area 63 is based on the minimum fundus shape data DIN obtained from the optical data acquisition unit such as a refractometer. Types Ta, Tb, and Tc can be determined.
  • the axial length Lx is about 23.0 mm
  • the diameter of the cornea 41 is about 12.0 mm
  • the thickness of the central part of the cornea 41 is about 0.5 mm
  • the thickness of the peripheral part is about 0.7 mm.
  • the diameter of the crystalline lens 42 is about 9.0 mm, the thickness of the crystalline lens 42 is about 3.6 mm, and the thickness of the anterior chamber 47 is about 3.3 mm.
  • the corneal refractive power is 43.0 [D]
  • the crystalline lens refractive power is 20.0 [D].
  • the myopia progression diagnostic apparatus 100 uses optical data indicating corneal refractive power and refractive power such as myopia (myopia power) based on fundus shape data DIN obtained from a refractometer or the like instead of the optical data acquisition unit 10.
  • the eye axis length Lx is predicted, and the types Ta, Tb, and Tc of the back focus control area 63 corresponding to the fundus curvature described with reference to FIGS. 28A to 28D are further determined from the eye axis length Lx.
  • the corneal refractive power of the eyeball 2 to be examined shown in FIG. 29A is 43.0 [D]
  • type Ta is prescribed.
  • the fundus has a fundus curvature shape C24 as shown by a broken line in FIG. 28D.
  • type Tb is prescribed.
  • the corneal refractive power of the eyeball 2 to be examined shown in FIG. 29C is 40.0 [D]
  • the fundus has a fundus curvature shape C25 as shown by a two-dot chain line in FIG. 28D.
  • type Tc is prescribed.
  • the types Ta, Tb, and Tc of the back focus control area 63 are changed based on the fundus shape data DIN obtained from the refractometer or the like. You can decide.
  • a spectacle lens 300 shown in FIG. 30 is designed based on the myopia progression suppression theory according to the present invention, and has a lens body portion 61 ′ having a distance optical portion 62 ′ and a near optical portion 63 ′. Yes.
  • the spectacle lens 300 when the focal point of light from the center is at the center of the macular 45 when viewed from the front, the front focal point a and the rear focal point b at the periphery of the retina are also in front of the retina 46, and there is no problem. Does not occur.
  • the eyeball is a part having a movement independent of the head, so that only the eyeball is moved to change the line of sight as shown in FIG.
  • the focal point of the light from the area of the distance optical unit 62 ′ provided in the center of the lens is in the vicinity of the retina 46, rather than the back of the retina, It moves quite far away.
  • the spectacle lens 300 when assuming the purpose of suppressing myopia progression due to the extension of the axial length Lx, the spectacle lens 300 not only provides the effect, but also gives an uncomfortable feeling to the appearance such as image distortion and jumping, There are concerns about problems such as eye strain that can cause visual impairment.
  • the contact lens 200 of the present invention even if only the eyeball is moved and the object is changed, such as the contact lens 200, the correction tool that continuously forms light on the macular 45 from the distance optical unit 62 provided at the center. Therefore, the above-mentioned problem does not occur.
  • one contact lens 200 is selected from the plurality of contact lenses 200 corresponding to the fundus curvature shape of the subject 1. Will come to do.
  • This configuration makes it possible to select (prescribe) a contact lens 200 having an optimum refractive power suitable for the progress of myopia. Accordingly, the contact lens 200 having a refractive power weaker than the refractive power of the average retinal eye is easily prescribed for the subject 1 who is a retinal eye having a fundus curvature radius rx larger than that of the average retinal eye.
  • the contact lens 200 having a refractive power stronger than the refractive power of the average retinal eye can be easily prescribed for the subject 1 who is a retinal eye having a fundus curvature radius rx smaller than that of the average retinal eye. It becomes like this.

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  • Health & Medical Sciences (AREA)
  • Ophthalmology & Optometry (AREA)
  • Physics & Mathematics (AREA)
  • General Health & Medical Sciences (AREA)
  • General Physics & Mathematics (AREA)
  • Optics & Photonics (AREA)
  • Eye Examination Apparatus (AREA)

Abstract

La présente invention a trait à une lentille de contact qui peut ralentir la future progression de la myopie pour un œil myope examiné, et qui peut imposer une réfraction optimale proportionnée à la progression de la myopie de l'œil examiné sans qu'une lentille bifocale ne soit nécessaire. Comme le montrent les figures 15A et 15B, la lentille de contact est munie d'une partie optique pour l'hypermétropie (62) dotée, dans une région centrale d'un corps de lentille (61), d'une réfraction pour la correction de la myopie, et d'une zone de réglage de point focal arrière (63) dotée, dans la région périphérique de la partie optique pour l'hypermétropie (62), d'une réfraction permettant de ralentir la progression de la myopie. La zone de réglage de point focal arrière (63) possède une réfraction destinée à déplacer un point focal arrière pour l'hypermétropie, depuis un point extérieur sur une rétine périphérique dans la direction formant un angle θ avec la ligne axiale d'œil qui relie une macula à un vertex sensiblement central du cristallin d'un globe oculaire (2) à examiner, jusqu'à l'intérieur de la rétine périphérique.
PCT/JP2013/083397 2013-12-09 2013-12-12 Lentille de contact et procédé de sélection de cette lentille de contact WO2015087436A1 (fr)

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JP2014532754A JP5689208B1 (ja) 2013-12-09 2013-12-12 コンタクトレンズの組み合わせシリーズ及びその選定方法。

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JP2018183590A (ja) * 2017-04-25 2018-11-22 ジョンソン・アンド・ジョンソン・ビジョン・ケア・インコーポレイテッドＪｏｈｎｓｏｎ ＆ Ｊｏｈｎｓｏｎ Ｖｉｓｉｏｎ Ｃａｒｅ， Ｉｎｃ． 非正視治療の追跡方法及びシステム
CN109313360A (zh) * 2016-06-07 2019-02-05 郑惠川 眼科镜片和其制造方法
WO2022168259A1 (fr) * 2021-02-05 2022-08-11 株式会社トプコン Dispositif de traitement d'informations ophtalmiques, dispositif ophtalmique, procédé de traitement d'informations ophtalmiques et programme
WO2023186999A1 (fr) * 2022-03-31 2023-10-05 Essilor International Procédé de détermination de l'adaptation d'une lentille optique de commande de la myopie

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JP2007511803A (ja) * 2003-11-19 2007-05-10 ヴィジョン・シーアールシー・リミテッド 相対像面湾曲および周辺軸外焦点の位置を変える方法および装置
US20090268154A1 (en) * 2008-04-28 2009-10-29 Crt Technology, Inc. System and method to treat and prevent loss of visual acuity
JP2009540373A (ja) * 2006-06-08 2009-11-19 ヴィジョン・シーアールシー・リミテッド 近視の進行をコントロールするための手段
JP2011518355A (ja) * 2008-04-18 2011-06-23 ノバルティス アーゲー 近視制御手段
JP2011530726A (ja) * 2008-08-11 2011-12-22 ノバルティス アーゲー 近視の進行を防止または緩和するためのレンズ設計および方法

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JP2007511803A (ja) * 2003-11-19 2007-05-10 ヴィジョン・シーアールシー・リミテッド 相対像面湾曲および周辺軸外焦点の位置を変える方法および装置
JP2009540373A (ja) * 2006-06-08 2009-11-19 ヴィジョン・シーアールシー・リミテッド 近視の進行をコントロールするための手段
JP2011518355A (ja) * 2008-04-18 2011-06-23 ノバルティス アーゲー 近視制御手段
US20090268154A1 (en) * 2008-04-28 2009-10-29 Crt Technology, Inc. System and method to treat and prevent loss of visual acuity
JP2011530726A (ja) * 2008-08-11 2011-12-22 ノバルティス アーゲー 近視の進行を防止または緩和するためのレンズ設計および方法

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109313360A (zh) * 2016-06-07 2019-02-05 郑惠川 眼科镜片和其制造方法
JP2018183590A (ja) * 2017-04-25 2018-11-22 ジョンソン・アンド・ジョンソン・ビジョン・ケア・インコーポレイテッドＪｏｈｎｓｏｎ ＆ Ｊｏｈｎｓｏｎ Ｖｉｓｉｏｎ Ｃａｒｅ， Ｉｎｃ． 非正視治療の追跡方法及びシステム
JP7175626B2 (ja) 2017-04-25 2022-11-21 ジョンソン・アンド・ジョンソン・ビジョン・ケア・インコーポレイテッド 非正視治療の追跡方法及びシステム
WO2022168259A1 (fr) * 2021-02-05 2022-08-11 株式会社トプコン Dispositif de traitement d'informations ophtalmiques, dispositif ophtalmique, procédé de traitement d'informations ophtalmiques et programme
WO2023186999A1 (fr) * 2022-03-31 2023-10-05 Essilor International Procédé de détermination de l'adaptation d'une lentille optique de commande de la myopie

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