WO2019065990A1

WO2019065990A1 - Ophthalmological laser medical treatment device

Info

Publication number: WO2019065990A1
Application number: PCT/JP2018/036303
Authority: WO
Inventors: 慎也水戸; 康寛古内
Original assignee: 株式会社ニデック
Priority date: 2017-09-28
Filing date: 2018-09-28
Publication date: 2019-04-04
Also published as: JPWO2019065990A1

Abstract

Provided is an ophthalmological laser medical treatment device capable of laser irradiation in an appropriate state. The disclosed ophthalmological laser medical treatment device comprises: an irradiation means for irradiating a patient's eye with a medical treatment laser beam; a fundus oculi photography means for photographing an image of the fundus oculi of the patient's eye; an anterior part photography means for photographing an image of the anterior part of the patient's eye; and a control means for controlling the fundus oculi photography means and the anterior part photography means. The control means photographs the fundus oculi image and the anterior part image of the patient's eye during the laser irradiation.

Description

Ophthalmic laser treatment device

The present disclosure relates to an ophthalmic laser treatment apparatus for treating a patient's eye by irradiating a laser beam.

As a conventional laser treatment apparatus, for example, a laser treatment apparatus is known which performs treatment of an eye by irradiating treatment laser light onto a tissue (for example, the fundus) of a patient's eye (see Patent Document 1). When using such a device, the operator observes the fundus of the patient's eye using a slit lamp, a fundus camera or the like, and applies a laser beam to the treatment site of the eye.

For example, Patent Document 1 discloses an ophthalmic laser treatment apparatus in which a contact lens is put on a patient's eye and a laser is irradiated thereon.

JP, 2010-148635, A

By the way, an apparatus for irradiating a laser beam without contacting a contact lens has been proposed. In such an apparatus, the operator irradiates a laser while checking the image of the fundus camera.

However, in the fundus image, it is difficult to confirm the alignment state, the mydriasis state, the open state or the like, and there is a possibility that the laser is irradiated in an inappropriate state.

This indication makes it a technical subject to provide an ophthalmic laser treatment apparatus which can irradiate a laser in a proper state in view of the above-mentioned problem.

In order to solve the above-mentioned subject, the present invention is characterized by having the following composition.

(1) An ophthalmic laser treatment apparatus, comprising: irradiation means for irradiating a patient's eye with treatment laser light; fundus imaging means for photographing a fundus image of the patient's eye; and an anterior segment image of the patient's eye An anterior segment imaging unit for imaging a subject, and a control unit for controlling the fundus imaging unit and the anterior segment imaging unit, wherein the control unit is configured to: It is characterized in that a part image is taken.

It is a schematic block diagram explaining the structure of the laser treatment apparatus which concerns on a present Example. It is a flowchart which shows the control action of the laser treatment apparatus which concerns on a present Example. It is a figure which shows an example of an anterior segment image. It is a figure which shows an example of a fundus oculi image. It is a figure which shows an example of the anterior ocular segment image of the state which alignment shifted. It is a figure which shows the relationship of the working distance and the optical path of a laser beam. It is a figure which shows the relationship of the working distance and the optical path of a laser beam. It is a figure which shows an example of the anterior segment image in the case of the bad state of an open eyelid. It is a figure which shows an example of the display method of a fundus oculi image and an anterior segment image. It is a flow chart which shows control operation of a laser treatment apparatus concerning a modification. It is a flow chart which shows control operation of a laser treatment apparatus concerning a modification.

Embodiment
Hereinafter, embodiments according to the present disclosure will be briefly described. The ophthalmic laser treatment apparatus (for example, the laser treatment apparatus 1) according to the present embodiment includes an irradiation unit (for example, a laser irradiation unit 40), a fundus imaging unit (for example, a fundus imaging unit 60), and an anterior eye imaging unit (for example, , An anterior-eye imaging unit 30), a control unit (for example, a control unit 70), and the like. The irradiation unit, for example, irradiates the patient's eye with therapeutic laser light. The irradiation unit includes, for example, a therapeutic laser light source (for example, a laser light source 41) and a scanning unit (for example, a scanning unit 44) that causes the laser light emitted from the laser light source to scan the patient's eye.

The fundus imaging unit captures, for example, a fundus image of a patient's eye. As the fundus imaging unit, for example, a scanning laser ophthalmoscope, a fundus camera, or the like is used. The anterior eye photographing unit photographs, for example, an anterior eye part image of a patient's eye. The control unit controls, for example, a fundus imaging unit, an anterior eye imaging unit, a laser irradiation unit, and the like. The control unit captures, for example, a fundus image and an anterior segment image of a patient's eye at the time of laser irradiation. By this, the laser treatment apparatus of this embodiment can confirm the alignment state or the state of the eye to be examined by the anterior segment image captured by the anterior segment imaging unit. The laser irradiation does not have to be during laser irradiation, but may be immediately before or after laser irradiation. Further, the control unit may be configured by a plurality of CPUs and the like. For example, a CPU that controls the fundus imaging unit and a CPU that controls the anterior eye imaging unit may be provided.

The control unit may detect the alignment state of the irradiation unit with respect to the patient's eye based on the anterior segment image. The control unit detects, for example, the alignment state in the vertical and horizontal directions (XY direction) or the alignment state in the front and rear direction (Z direction). Thus, the control unit can present the operator with alignment information and can guide the alignment operation.

The control unit may detect at least one of the open eye state and the mydriatic state based on the anterior eye part image. For example, the control unit detects whether the eyelid, eyebrows, iris or the like of the eye to be examined is not in the area through which the laser light passes. This can prevent the laser light from being blocked by eyelids, eyebrows, irises and the like.

The control unit may determine the suitability of the laser use condition based on the anterior segment image. For example, the control unit sets a laser use condition for determining whether or not the laser may be irradiated based on the alignment state of the irradiation unit, the mydriasis state of the eye to be examined, the open eye state, etc. The propriety may be determined. By this, it is possible to reduce the irradiation of the laser beam in an inappropriate state.

If the control unit determines that the laser use condition is not satisfied, the control unit may notify the operator by the notification unit (for example, the display unit 75 or the like) that the laser use condition is not satisfied. By this, the operator can interrupt the use of the laser based on the notification of the notification unit.

The control unit may change the control of the irradiation unit based on the anterior segment image. For example, the control unit may control the irradiation unit, such as changing the light amount of the laser beam or stopping the laser irradiation, according to the alignment state detected from the anterior eye image or the state of the eye to be examined. By this, it is possible to reduce the irradiation of the laser beam in an inappropriate state.

The control unit may cause the display unit to display an anterior segment image at the time of laser irradiation. As a result, the operator can confirm the state of the eye to be examined and perform laser irradiation by viewing the anterior segment image displayed on the display unit.

The present apparatus may also include an index projection unit (index projection unit 10) that projects the alignment index onto the patient's eye. In this case, the anterior eye photographing unit may photograph the alignment index projected onto the patient's eye. The control unit may detect the alignment state of the irradiation unit based on the alignment index captured in the anterior segment image.

The anterior eye photographing unit may be a TOF image sensor. The TOF type image sensor measures the distance to the object by, for example, reflecting the light emitted from the light source by the object and detecting the time of flight (time difference) of the light until it reaches the sensor. is there. By this, the control unit may detect the working distance (the distance between the laser irradiation unit and the eye to be examined) and determine the alignment state in the Z direction.

<Example>
Hereinafter, an embodiment according to the present disclosure will be described based on the drawings. FIG. 1 is a schematic configuration view for explaining the configuration of an optical system 100 and a control system 200 of a laser treatment apparatus 1 according to the present embodiment. In the present embodiment, the axial direction of the patient's eye E is described as Z direction, the horizontal direction as X direction, and the vertical direction as Y direction. The surface direction of the fundus may be considered as the XY direction.

The laser treatment apparatus 1 applies laser light to the fundus oculi Ef to treat the patient's eye E. The laser treatment apparatus 1 includes, for example, an index projection unit 10, an anterior eye imaging unit 30, a laser irradiation unit 40, a fixation target presenting unit 50, a fundus imaging unit 60, a control unit 70, and the like.

<Index projection part>
The index projection unit 10 projects an alignment index on the patient's eye. The index projection unit 10 includes, for example, a plurality of light sources arranged circumferentially around the optical axis L1 of the objective lens 21. The index projection unit 10 has, for example, seven light sources 11 that emit infrared light with a center wavelength of 940 nm, and emits diffused light toward the subject's eye. The index projection unit 10 includes two collimator lenses 12 and emits diffused light of two of the seven light sources 11 as parallel light toward the eye to be examined.

<Front eye photography part>
The anterior eye photographing unit 30 photographs the anterior eye part of the patient's eye. The anterior eye photographing unit 30 includes an imaging device (for example, a CMOS camera) 31, an imaging lens 32, and an imaging diaphragm 33 in the reflection direction of the dichroic mirror 22. The imaging device 31 is disposed at a position optically conjugate with the anterior segment of the patient's eye E. The imaging element 31 has, for example, sensitivity in the infrared region, and captures an image of the anterior segment illuminated by the anterior segment illumination light source 15 that emits infrared light having a central wavelength of 940 nm. Further, the imaging device 31 captures an image of the alignment index projected onto the anterior segment by the index projection unit 10. For example, the reflected light of the anterior segment illuminated by the anterior segment illumination light source 15 is received by the imaging device 31 via the objective lens 21, the dichroic mirror 22, the imaging diaphragm 33, and the imaging lens 32. The light reception signal of the imaging device 31 is output to the control unit 70.

<Laser irradiation part>
The laser irradiation unit 40 oscillates, for example, therapeutic laser light, and irradiates the patient's eye E with the laser light. For example, the laser irradiation unit 40 includes a laser light source 41, a focusing lens 42, a driving unit 43, a scanning unit 44, and the like. The laser light source 41 oscillates a therapeutic laser light (for example, a wavelength of 532 nm). The focusing lens 42 is moved by the drive unit 43 to adjust the focus of the laser light. The scanning unit 48 includes, for example, a driving mirror 44 a and a driving unit 44 b. The drive unit 44b changes the irradiation position of the laser beam on the fundus oculi Ef by changing the angle of the reflection surface of the drive mirror 44a.

The light emitted from the laser light source 41 passes through the focusing lens 42, is reflected by the scanning unit 44 and the dichroic mirror 23 disposed on the optical axis L1, and is focused on the fundus oculi Ef via the objective lens 21. . The laser unit 40 may include an aiming light source that emits aiming light.

<Fixation Target Presentation Unit>
The fixation target presenting unit 50 has an optical system for fixing the patient's eye. The fixation target presenting unit 50 is disposed in the reflection direction of the dichroic mirror 24 disposed on the optical axis L1. The fixation target presenting unit 50 includes, for example, a red light source 51, a visual target plate 52 having a fixation target in which an opening is formed, a relay lens 53, and the like. The light emitted from the light source 51 passes through the aperture of the target plate 52 and the relay lens 53, is reflected by the dichroic mirror 24, and passes through the objective lens 21 to be irradiated to the patient's eye.

As the fixation target presenting unit 50, various configurations may be used, such as a configuration in which light from a light source is scanned using LEDs arranged in a matrix, an optical scanner, and the like. In addition, the fixation target presenting unit 50 may be an internal fixation lamp type or an external fixation lamp type.

<Fundus photographing part>
The fundus imaging unit 60 captures an image of the fundus oculi Ef, for example. The fundus imaging unit 60 is, for example, a scanning laser ophthalmoscope (SLO). For example, the fundus imaging unit 60 includes an SLO light source 61, a beam splitter 62, a focusing lens 63, a scanning unit 64, a relay lens 65, and the like.

The SLO light source 61 is a light source that emits highly coherent light, and for example, a laser diode light source of λ = 780 nm is used. The beam splitter 62 is disposed between the SLO light source 61 and the focusing lens 63. In the reflection direction of the beam splitter 62, a condenser lens 66, a confocal aperture 67 placed at a position conjugate to the fundus, and a light receiving element 68 are provided.

The focusing lens 63 is movable in the optical axis direction in accordance with the refractive error of the patient's eye. The scanning unit 64 includes, for example, a driving mirror 64 a and a driving unit 64 b. The scanning unit 64 drives the drive mirror 64 a by the drive unit 64 b to scan the measurement light at high speed in the X and Y directions on the fundus. The drive mirror 64a may be, for example, a combination of a galvano mirror and a polygon mirror. The relay lens 65 relays the measurement light reflected by the scanning unit 64 to the objective lens 10.

The measurement light emitted from the SLO light source 61 passes through the beam splitter 62, and then enters the scanning unit 64 through the focusing lens 63. Then, the measurement light reflected by the scanning unit 64 is focused on the fundus oculi Ef of the patient's eye via the relay lens 65 and the objective lens 21.

The measurement light reflected by the fundus passes through the objective lens 21, the relay lens 65, the scanning unit 64, and the focusing lens 63, and is reflected by the beam splitter 62. Thereafter, the light is condensed by the condenser lens 66 and then detected by the light receiving element 68 through the confocal aperture 67. The light reception signal detected by the light reception element 68 is output to the control unit 70.

<Control unit>
The control unit 70 is connected to each unit of the laser treatment apparatus 1 and controls the entire apparatus. For example, the control unit 70 is realized by a general central processing unit (CPU) 71, a ROM 72, a RAM 73, and the like. The ROM 72 stores various programs for controlling the operation of the laser treatment apparatus, an image processing program for processing an image, initial values and the like. The RAM 73 temporarily stores various information. The control unit 70 may be configured by a plurality of control units (that is, a plurality of processors).

The control unit 70 includes, for example, an index projection unit 10, an anterior eye imaging unit 30, a laser irradiation unit 40, a fixation target presenting unit 50, a fundus imaging unit 60, a storage unit (for example, non-volatile memory) 74, a display unit 75, It is electrically connected to the operation unit 76 and the like.

For example, the control unit 70 acquires an anterior segment image or a fundus image of a patient's eye based on a signal output from the imaging device 31 or the light receiving device 68. In addition, the control unit 70 detects an alignment index from the anterior segment image of the patient. The control unit 70 can determine the propriety of the alignment state between the device 1 and the patient's eye based on the position at which the alignment index is detected. Also, for example, the control unit 70 controls the scanning unit 44, the scanning unit 64, and the like to change the irradiation position of the measurement light or the laser light.

The storage unit 74 is a non-transitory storage medium capable of retaining stored contents even when the supply of power is shut off. For example, a hard disk drive, a flash ROM, a removable USB memory, or the like can be used as the storage unit 74. The control unit 70 causes the storage unit 74 to store, for example, an anterior segment image captured by the anterior eye capturing unit 30, a fundus image captured by the fundus capturing unit 60, and the like.

The display unit 75 may be a display mounted on the apparatus main body, or may be a display connected to the main body. A display of a personal computer may be used. Multiple displays may be used together. In addition, the display unit 75 may be a touch panel.

Control unit 70 controls the display screen of display unit 75. For example, the control unit 70 outputs an anterior segment image captured by the anterior eye capturing unit 30, a fundus image captured by the fundus capturing unit 60, or the like to the display unit 75 as a still image or a moving image.

Various operation instructions by the operator are input to the operation unit 76. The operation unit 76 outputs a signal corresponding to the input operation instruction to the control unit 70. For the operation unit 76, for example, at least one of user interfaces such as a mouse, a joystick, a keyboard, and a touch panel may be used. Control unit 70 may acquire an operation signal based on the operation of the operator received by operation unit 76. When the operation unit 76 is a touch panel, the operation unit 76 may function as the display unit 75.

In the present embodiment, the optical system 100 is provided movably in the X, Y, and Z directions by a drive mechanism (not shown). For example, the operator moves the optical system 100 relative to the patient's eye by operating the operation unit 76 such as a joystick. Thereby, the operator aligns the optical system 100 with respect to the patient's eye.

<Control action>
Hereinafter, the procedure for treating a patient's eye using the laser treatment apparatus of the present embodiment will be described together with the control operation of the apparatus using the flowchart of FIG.

<Step S101: Anterior Segment Shooting>
First, the operator causes the patient's face to be supported by the face support unit (not shown). The control unit 70 causes the fixation target presenting unit 50 to present the fixation target to the patient. The operator instructs the patient to fixate on the fixation target. The anterior eye photographing unit 30 picks up an image of the anterior eye illuminated by the anterior eye illumination light source 15 and the alignment index by the index projection unit 10, and outputs the result to the control unit 70. The control unit 70 causes the display unit 75 to display the anterior eye part image acquired from the anterior eye photographing unit 30.

<Step S102: Alignment>
The operator aligns the optical system 100 while observing the anterior segment image displayed on the display unit 75. For example, as shown in FIG. 3, seven index images Ma, Mb, Mc, Md, Me, Mf, and Mg from the light source 11 are formed in the anterior segment image 39 displayed on the display unit 75. The index images Mb and Mf are index images of parallel light having passed through the collimator lens 12. The control unit 70 electrically forms a circular reticle mark N and a ring mark T indicating the pupil diameter necessary for photographing on the anterior eye image. The operator operates the operation unit 76 to move the optical system 100 vertically and horizontally so that the reticle marks N have the index images Ma, Mb, Mc, Md, Me, Mf and Mg. Further, in the front-rear direction (working distance direction), the optical system 100 is such that the index images Ma, Mc, Md, Me, Mg by diffused light and the index images Mb, Mf by parallel light have a predetermined positional relationship. Move

<Step S103: fundus image photography>
When the alignment is completed, the control unit 70 controls the fundus imaging unit 60 to capture the fundus Ef of the patient's eye E. The control unit 70 causes the scanning unit 64 to scan the patient's eye E with the measurement light, and acquires an image of the fundus oculi Ef.

<Step S104: Setting of Laser Irradiation Area>
Next, the operator sets the irradiation area of the laser based on the fundus oculi image photographed by the fundus oculi photographing unit 60. For example, as shown in FIG. 4, the control unit 70 causes the fundus image 69 to display an aiming mark G indicating the irradiation area of the laser light. The operator operates the operation unit 76 to move the aiming mark G to a desired position while confirming the position of a macula or the like shown in the fundus image 69. The control unit 70 moves the position of the aiming mark G displayed on the fundus image based on the operation signal from the operation unit 76. Then, the control unit 70 sets the designated position as a laser irradiation area. In addition, it is good also as a structure which sets the area | region (irradiation prohibition area | region) which does not irradiate, and irradiates the area | region except an irradiation prohibition area | region with a laser.

<Step S105: Reception of Irradiation Start Signal>
After setting the laser irradiation area, the operator presses the irradiation start button 76 a provided on the operation unit 76. When the irradiation start button 76 a is pressed, the operation unit 76 outputs an irradiation start signal. Control unit 70 receives the irradiation start signal output from operation unit 76.

<Step S105: Laser Use Condition Determination>
When the control unit 70 receives the irradiation start signal, the control unit 70 determines whether the use condition of the laser is satisfied. For example, the control unit 70 determines whether the use condition of the laser is satisfied based on the alignment, the mydriasis state, the suitability of the open eye state, and the like.

FIG. 5 shows a state in which the alignment in the XY directions is shifted. As described above, when the alignment in the XY directions is deviated, the laser light may be blocked by the iris, and the laser light may not sufficiently reach the fundus. Also, FIG. 6A shows the case where the laser is irradiated to the fundus at an appropriate working distance, and FIG. 6B shows the case where the laser is irradiated at an incorrect working distance. As shown in FIG. 6A, when the working distance is appropriate, laser light is emitted to the fundus through the pupil P. However, as shown in FIG. 6B, if the working distance is incorrect, the laser light may be blocked by the iris. Therefore, the control unit 70 determines the propriety of the alignment state before irradiating the fundus with laser light.

FIG. 7 shows that the open eye condition is bad and the eyelid is on the pupil P. In such a case, the laser beam may not reach the fundus sufficiently because the laser beam is blocked by the eyelid. In addition, when the mydriasis state is bad and the pupil P is smaller than the area through which the laser light passes, the laser light is blocked by the iris. Therefore, the control unit 70 determines the suitability of the open eye status or mydriatic status.

The appropriateness determination of alignment will be described. When determining the suitability of alignment, the control unit 70 determines the suitability of alignment based on, for example, the anterior segment image 39 captured by the anterior segment imaging unit 30. For example, when seven index images Ma to Mg captured by the imaging device 31 are detected, the control unit 70 determines the displacement amount (displacement) with respect to the alignment reference based on these index images.

When determining the suitability of the alignment in the XY direction, for example, the control unit 70 determines the amount of deviation between the center of the circle Q passing the index images Ma to Mg and the alignment reference position C in the XY direction. Then, the propriety of the alignment in the X and Y directions is determined based on whether the amount of deviation falls within a predetermined allowable range and continues for a fixed time (for example, 10 frames or 0.3 seconds of image processing).

In addition, when determining the appropriateness of the alignment in the Z direction, for example, the control unit 70 obtains the size of the circle Q. For example, the size of the circle Q changes according to the working distance, and the circle Q becomes larger as the patient's eye and the device 1 approach, and becomes smaller as the patient's eye and the device 1 move closer. Therefore, the control unit 70 determines whether the alignment in the Z direction is appropriate or not by comparing the size of the circle Q at the appropriate working distance stored in the storage unit 74 with the size of the circle Q on the image. Good. Of course, the suitability of alignment in the Z direction may be determined based on not only the size of the circle Q but also the sharpness of the image, for example.

Also in the Z direction, the deviation amount with respect to the alignment reference position in the Z direction may be determined, and the suitability of the alignment in the Z direction may be determined based on whether the deviation amount falls within a predetermined allowable range for a predetermined time.

The appropriateness determination of the mydriatic state will be described. The propriety of the mydriatic state is determined by whether or not the edge of the pupil P detected from the anterior eye image 39 by the imaging element 31 is out of the ring mark T shown in FIG. The size of the ring mark T is set based on the alignment reference position C as a diameter (for example, a diameter of 4 mm) through which the laser beam can pass. When the edge of the pupil P is outside the ring mark T, the light amount at the time of laser irradiation is sufficiently secured. It should be noted that the suitability of the mydriasis state may also be determined to be appropriate when the appropriate condition continues continuously for a fixed time, as in the determination of the alignment completion.

The appropriateness determination of the open condition will be described. Whether the open condition is appropriate or not is determined based on the anterior segment image 39 captured by the imaging device 31. For example, if the eyelid detected from the anterior segment image 39 is outside the ring mark T, the control unit 70 determines that the open condition is appropriate, and the eyelid is inside the ring mark T as shown in FIG. If it is determined that the open condition is inappropriate.

<Step S107: Laser Irradiation>
When it is determined in step 106 that the use condition is satisfied, the control unit 70 controls the operation of the laser irradiation unit 40, and irradiates the set irradiation area with the laser light. For example, each position on the fundus image is associated with the movable position of the scanning unit 44, and the control unit 70 controls the scanning unit 44 so that the irradiation region in the fundus image is irradiated with the laser light. . When there are a plurality of irradiation areas, the control unit 70 sequentially irradiates each irradiation area with laser light.

The control unit 70 acquires the fundus oculi image 69 photographed by the fundus oculi photographing unit 60 as needed, and displays the fundus oculi image 69 on the display unit 75 in real time. In addition, the control unit 70 may cause the display unit 75 to display the anterior segment image 39. By this, the operator can easily confirm the state of the patient's eye E at the time of laser irradiation. As a display method, for example, as shown in FIG. 8, the images may be displayed side by side on the screen of the display unit 75, or one image may be displayed superimposed on the position of the other image.

<Step S108: Warning>
When it is determined in step S106 that at least one of the alignment and the state of the eye to be examined is not appropriate, the control unit 70 causes the display unit 75 to display a warning K (see FIGS. 4, 5 and 7), for example. Inform. The warning indication K may be displayed on the anterior segment image or may be displayed on the fundus image. Of course, the operator may be notified by an alarm or lighting of a lamp instead of display.

The control unit 70 causes the anterior eye photographing unit 30 to detect an alignment state, a mydriasis state, or an open eye state, as needed, even during a warning. Then, when it is determined that the laser use condition is satisfied by the treatment of the operator, the control unit 70 proceeds to step 107 and starts the laser irradiation.

As described above, with the anterior segment image, it is possible to confirm whether the alignment state, the mydriasis state of the eye, and the open eye state are appropriate. By this, it is possible to reduce that the laser light is blocked by the iris or eyelid or the like, and the amount of irradiation light is insufficient, or that the irradiation unevenness is generated.

Note that the control unit 70 may display the reason for determining that it is not appropriate as the warning display K. As a result, the operator refers to the display information on the display unit 75 and warns the patient to open the eye widely, or takes a break to enlarge the pupil diameter, etc. Can be applied.

Although the optical system 100 is manually aligned with the patient's eye in the above embodiments, the present invention is not limited to this. For example, as shown in FIG. 9, the control unit 70 detects the index images Ma to Mg in the anterior eye image 39 in step S106, and if alignment is shifted, the control unit 70 automatically illustrates based on the position of the index image. The drive unit may be controlled to align the optical system 100 (step S208).

The control unit 70 may perform irradiation control of the laser light based on the information of the anterior eye image 39. For example, as shown in FIG. 10, when it is determined in step S106 that the eyebrows or eyelids are applied to the pupil, the light amount of the laser light is increased, or the irradiation of the laser light is stopped. Control may be performed (step S308). This can prevent the laser from being irradiated inappropriately.

Although the control unit 70 simultaneously displays the anterior eye image 39 and the fundus image 69 of the patient's eye on the display unit 75, the anterior eye image 39 and the fundus image 69 may be displayed separately. Good. In this case, for example, when the patient's eye E moves largely, the display on the display unit 75 may be switched from the fundus image 69 to the anterior segment image 39. By this, the alignment by the anterior segment image 39 can be smoothly performed.

In the above-mentioned example, although the propriety of the working distance was judged based on the alignment index, it does not restrict to this. For example, the suitability of the working distance may be determined using a TOF image sensor. The TOF image sensor is, for example, a device that measures the distance at the time of light reaching the CCD.

Reference Signs List 1 laser treatment apparatus 10 index projection unit 30 anterior eye imaging unit 40 laser irradiation unit 50 fixation target projection unit 60 fundus imaging unit 70 control unit 71 CPU
72 ROM
73 RAM
74 storage unit 75 display unit 76 operation unit

Claims

An ophthalmic laser treatment apparatus,
Irradiation means for irradiating a patient's eye with a therapeutic laser beam;
Fundus imaging means for capturing a fundus image of the patient's eye;
Anterior segment imaging means for capturing an anterior segment image of the patient's eye;
And a control unit that controls the fundus imaging unit and the anterior segment imaging unit.
An ophthalmic laser treatment apparatus, wherein the control means takes a fundus image and an anterior segment image of the patient's eye at the time of laser irradiation.
The ophthalmic laser treatment apparatus according to claim 1, wherein the control unit detects an alignment state of the irradiation unit with respect to the patient's eye based on the anterior segment image.
The ophthalmic laser treatment apparatus according to claim 1 or 2, wherein the control means detects at least one of an open eye state and a mydriatic state based on the anterior segment image.
The ophthalmic laser treatment apparatus according to any one of claims 1 to 3, wherein the control means determines the suitability of the laser use condition based on the anterior segment image.
5. The ophthalmic laser treatment apparatus according to claim 4, wherein the control means informs the operator by the notifying means that the laser use condition is not satisfied when it is determined that the laser use condition is not satisfied.
The ophthalmic laser treatment apparatus according to claim 4 or 5, wherein the control unit changes control of the irradiation unit based on the anterior segment image.
The ophthalmic laser treatment apparatus according to any one of claims 1 to 6, wherein the control means causes the display means to display the anterior segment image upon laser irradiation.
Index projection means for projecting an alignment index onto the patient's eye;
The ophthalmic laser treatment apparatus according to any one of claims 1 to 7, wherein the anterior segment imaging means captures the alignment index projected onto the patient's eye.
The ophthalmic laser treatment apparatus according to any one of claims 1 to 8, wherein the anterior segment imaging unit is a TOF image sensor.