WO2020262206A1 - 視覚検査装置及び視覚検査方法 - Google Patents

視覚検査装置及び視覚検査方法 Download PDF

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Publication number
WO2020262206A1
WO2020262206A1 PCT/JP2020/024044 JP2020024044W WO2020262206A1 WO 2020262206 A1 WO2020262206 A1 WO 2020262206A1 JP 2020024044 W JP2020024044 W JP 2020024044W WO 2020262206 A1 WO2020262206 A1 WO 2020262206A1
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Prior art keywords
image
line
sight direction
subject
inspection
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PCT/JP2020/024044
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English (en)
French (fr)
Japanese (ja)
Inventor
柏木　賢治
英昭 足利
鈴木　誠
Original Assignee
株式会社Ｑｄレーザ
国立大学法人山梨大学
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Publication of WO2020262206A1 publication Critical patent/WO2020262206A1/ja

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A61B3/113—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for determining or recording eye movement

Definitions

  • the present invention relates to a visual inspection device and a visual inspection method.
  • the gazing point is presented in a housing that covers the subject's visual field, and with the subject directing the line of sight to the gazing point, bright spots (targets) are randomly displayed in the subject's visual field and displayed.
  • a visual field test device for inspecting whether or not a subject can see is known.
  • the visual inspection apparatus includes a laser projection unit having a light source that emits laser light, a scanning mirror that scans the laser light, and a line-of-sight direction detection unit that detects the line-of-sight direction of the subject.
  • the inspection image is projected onto the retina of the subject, and the inspection is performed on the retina by a control unit that controls the laser projection unit so that the projected inspection image moves and the laser projection unit controlled by the control unit.
  • It includes an inspection processing unit that performs a visual inspection process based on a position on which an image is projected and a line-of-sight direction detected by the line-of-sight direction detection unit.
  • FIG. 1 is a diagram showing a visual inspection device 100 of an embodiment.
  • the visual inspection device 100 includes a frame 102, adjusting members 103, 104, a base 105, support 106a, 106b, an image projection 107a, 107b, a pedestal 108, and an imaging unit 180a, 180b.
  • a pedestal 108 is provided on the base 105, and both ends of the frame 102 are fixed to the upper surface of the base 105.
  • the image projection units 107a and 107b are supported by the support units 106a and 106b, and have a laser irradiation unit and a projection control unit, which will be described later, inside.
  • the image projection units 107a and 107b irradiate the left eye and the right eye of the subject who inspects vision such as visual field, visual acuity, and visual acuity with the laser irradiation unit, and the retina of the subject is inspected. Project a projected image containing.
  • the imaging units 180a and 180b are cameras that capture images of the eyes of the subject's right eye and left eye in order to detect the movement of the subject's eyeball during the examination.
  • the image projection unit 107a and the image projection unit 107b are not distinguished, they are called the image projection unit 107, and when the support units 106a and 106b are not distinguished, they are called the support unit 106, and the image pickup unit 180a.
  • 180b is not distinguished, it is called an imaging unit 180.
  • the adjusting member 103 moves the support portion 106 on which the image projection portion 107 is supported in the Y-axis direction shown on the paper surface.
  • the adjusting member 104 moves the image projection unit 107 along the support unit 106 in the Z-axis direction.
  • the visual inspection device 100 brings the subject's jaw and forehead into contact with each of the pedestal 108 and the frame 102, and the adjusting members 103 and 104 bring the subject into a state of looking into the image projection unit 107.
  • the examination is performed with the 107 close to the eyeball.
  • FIG. 2 is a block diagram showing the configuration of the visual inspection device 100.
  • the visual inspection device 100 includes a laser irradiation unit 110, a communication unit 120, a control unit 130, a storage unit 140, a laser output control unit 150, and an imaging unit 180.
  • control unit 130 the storage unit 140, and the laser output control unit 150 are included in the control device 101.
  • the control device 101 is realized by an information processing device such as a computer including a CPU (Central Processing Unit), a RAM (Random Access Memory), a ROM (Read Only Memory), an internal bus, and the like.
  • the control unit 130 and the laser output control unit 150 show the functions of the program executed by the control device 101 as functional blocks.
  • the storage unit 140 functionally represents the memory of the control device 101.
  • the laser irradiation unit 110 irradiates the retina of the subject with a laser beam based on the projected image data including the inspection image data stored in the storage unit 140 with a preset amount of light. That is, the laser irradiation unit 110 is an eyepiece for the subject, and by observing the laser irradiation unit 110 (looking into the laser irradiation unit 110), the subject can obtain an examination image or the like projected on the retina in the brain. It is possible to perform visual inspections such as visual field and visual acuity inspections and inspections of whether or not to visually check images for inspection.
  • the visual field test is a test for examining the visible range
  • the visual acuity test is a test for examining the central visual acuity or the external visual acuity (peripheral visual acuity).
  • Visual recognition means capturing (seeing) an image with the retina and recognizing it with the brain. Since the visual inspection device 100 projects a projected image on which the inspection image moves on the retina at the laser irradiation unit 110 to perform a visual inspection, the visual inspection performed using the visual inspection device 100 is a visual inspection in which the moving inspection image is used. It is a test that is captured (looked) by the retina and followed, and whether or not it is recognized by the brain.
  • the communication unit 120 is a communication device for communicating between the visual inspection device 100 and an external device. Specifically, for example, the communication unit 120 may communicate with a terminal or the like provided in a medical institution via a network or the like, or communicate with a device connected to the visual inspection device 100 by a wire or the like. You may.
  • the communication method by the communication unit 120 may be any method as long as the visual inspection device 100 and the external device can communicate with each other.
  • the control unit 130 controls the entire operation of the visual inspection device 100.
  • the storage unit 140 stores a program executed by the control unit 130, various values acquired by calculation, and the like.
  • the storage unit 140 stores inspection image data indicating an inspection image used for visual inspection.
  • the laser output control unit 150 irradiates the laser light based on the inspection image data stored in the storage unit 140 from the laser irradiation unit 110 with a set amount of light.
  • the imaging unit 180 is a camera arranged in the vicinity of the laser irradiation unit 110. From the image data captured by the imaging unit 180, the movement of the subject's eyeball 20 and the orientation of the subject's pupil are detected. Therefore, in other words, the imaging unit 180 functions as a pupil position detecting unit that detects the position of the pupil 25 of the subject. Further, the image pickup unit 180 can be said to be a line-of-sight direction detection unit for detecting the line-of-sight direction of the subject.
  • the imaging unit 180 captures an image of the subject and passes the image data to the control unit 130.
  • the visual inspection device 100 may have an output unit (display) for outputting various types of information.
  • the display may display an input screen or the like for inputting the result of the visual acuity test by the subject P based on the test image.
  • the output unit may be for writing out the information indicating the inspection result stored in the storage unit 140 to a recording medium or the like.
  • FIG. 3 is a diagram showing a laser irradiation unit 110.
  • the laser irradiation unit 110 irradiates the retina 22 of the subject's eyeball 20 with laser light using Maxwell vision.
  • the laser irradiation unit 110 includes a light source 111, an adjustment unit 112, and an optical system 113.
  • the optical system 113 includes a scanning unit 114, a flat mirror 115, and lenses 116 and 117.
  • the scanning unit 114 is, for example, a two-axis MEMS (Micro Electro Mechanical Systems) mirror.
  • the numerical aperture (NA) and / or the beam diameter of the laser beam L emitted by the light source 111 in the laser irradiation unit 110 is adjusted in the adjustment unit 112.
  • the laser light L is a visible laser light of a red laser light, a green laser light, and a blue laser light.
  • the laser beam L is reflected by the plane mirror 115 and is scanned two-dimensionally by the scanning unit 114.
  • the scanned laser beam L irradiates the eyeball 20 of the subject through the lens 116 and the lens 117.
  • the laser beam L converges in the vicinity of the crystalline lens 21, passes through the vitreous body 23, and irradiates the retina 22.
  • the scanning unit 114 vibrates at a relatively high frequency such as 28 kHz such that an image of 60 frames is projected per second.
  • FIG. 4 is a diagram showing the configuration of the control unit 130.
  • 5A and 5B are diagrams showing a projected image 10 including the data of the inspection image 50 and an inspection image projected on the retina 22.
  • the control unit 130 includes an image pickup control unit 131, a projection control unit 132, a line-of-sight direction detection unit 133, and an inspection processing unit 134.
  • the image pickup control unit 131, the projection control unit 132, the line-of-sight direction detection unit 133, and the inspection processing unit 134 show the function of the program executed by the control unit 130 as a functional block.
  • the image pickup control unit 131 controls the image pickup by the image pickup unit 180. Specifically, the image pickup control unit 131 may cause the image pickup unit 180 to take an image of the subject at predetermined intervals.
  • the projection control unit 132 controls the projection of the inspection image by the laser irradiation unit 110. Specifically, the projection control unit 132 reads out the data of the projection image 10 including the data of the inspection image 50 from the storage unit 140 as shown in FIG. 5A and passes it to the laser output control unit 150. The laser output control unit 150 causes the laser irradiation unit 110 to irradiate the subject's retina 22 with a laser beam based on the data of the projected image 10 with a preset amount of light.
  • FIG. 5B is a diagram schematically showing a state in which the data of the inspection image 50 is projected on the retina 22.
  • the inspection image 50 can be projected at an arbitrary position on the retina 22.
  • FIGS. 5A and 5B the vertical and horizontal resolutions are roughly described for the sake of explanation, but in reality, 1278 pixels in the horizontal direction and 720 pixels in the vertical direction are examples, and the inspection image 50 is usually drawn with a plurality of pixels. To.
  • the line-of-sight direction detection unit 133 analyzes the image data of the images of the pupil 25, the iris 26, etc. captured by the image pickup unit 180, and detects the line-of-sight direction and movement of the subject's eyeball 20. Specifically, the line-of-sight direction detection unit 133 captures an image of the eyeball such as the subject's pupil and eyelid and its surroundings, and detects the line-of-sight direction from the shape of the pupil and the positional relationship between the pupil and the eyelid. By performing the detection a plurality of times and comparing the results, it is determined whether or not the subject's eyeball has moved.
  • the line-of-sight direction detection unit 133 compares the pixel values for each pixel of a plurality of images, and when there are a certain number of pixels whose pixel value difference is equal to or greater than a predetermined value, the subject's eyeball 20 moves. You may judge.
  • the position information (data) of the inspection image 50 in each grid on the projected image 10 shown in FIG. 5A includes standard and reference line-of-sight direction information (data) when the subject is visually recognizing this position. I have the data) in correspondence.
  • the inspection processing unit 134 includes a position where the inspection image is projected on the retina by the laser irradiation unit 110 controlled by the projection control unit 132, the line-of-sight direction data corresponding to the position, and the line-of-sight direction detected by the line-of-sight direction detection unit 133. Based on the above, the visual inspection process is performed.
  • FIGS. 6 and 7 are diagrams showing an inspection image 50.
  • the laser irradiation unit 110 projects the projection image 10 including the examination image 50 onto the retina 22 by being controlled by the projection control unit 132.
  • FIG. 6 shows a projection pattern in which the inspection image 50 is projected onto the retina 22 and then disappears, and is repeatedly projected at different positions.
  • FIG. 6 shows a projection pattern in which the inspection image 50 is repeatedly projected onto the retina 22 while changing its position (moving).
  • FIG. 7 shows a projection pattern in which the position of the inspection image 50 projected on the retina 22 is moved as indicated by an arrow.
  • the data representing these projection patterns may be stored in the storage unit 140, and the projection control unit 132 reads the projection pattern from the storage unit 140 and controls the laser irradiation unit 110 according to the read projection pattern. It can be projected onto the retina 22. Further, the projection control unit 132 outputs data representing the projection pattern to the inspection processing unit 134.
  • the inspection processing unit 134 recognizes the position where the inspection image is projected on the retina 22 based on the position information of the inspection image 50 on the projected image 10, and when the position of the inspection image changes, the line-of-sight direction.
  • the visual inspection process is performed based on whether or not the line-of-sight direction detected by the detection unit 133 changes.
  • the projection image 10 is projected from the image data in which the inspection image 50 is displayed at the position on the projection image 10 corresponding to that position.
  • a visual inspection process is performed to determine whether or not the subject is visually recognizing the inspection image 50.
  • the visual inspection process can also be performed based on whether or not the projection images 10 having different positions of the inspection image 50 are sequentially projected and the line-of-sight direction detected by the line-of-sight direction detection unit 133 changes.
  • the inspection processing unit 134 changes the position where the inspection image is projected on the retina 22 based on the position information of the inspection image 50 on the projection image 10 input from the projection control unit 132. Detect direction and timing. Further, the inspection processing unit 134 detects the direction and timing at which the line-of-sight direction changes, which is detected by the line-of-sight direction detection unit 133.
  • the inspection processing unit 134 inspects that the difference between the direction in which the position where the inspection image is projected changes and the direction in which the line-of-sight direction changes detected by the line-of-sight direction detection unit 133 is equal to or less than a predetermined angle.
  • the delay of the timing of the change of the line-of-sight direction detected by the line-of-sight direction detection unit 133 with respect to the timing of the change of the position where the image is projected is equal to or less than a predetermined time, it is determined that the subject's vision is normal.
  • the subject's vision is normal means that the subject is correctly viewing the inspection image.
  • Visualizing a moving inspection image means that it is considered that the inspection image is captured (looked at) by the retina and followed, and the inspection image is recognized.
  • the predetermined speed may be set to a speed obtained by adding a certain margin (margin) to the average speed of line-of-sight walking when a visually healthy person reacts to a moving object.
  • FIG. 8 is a diagram showing a flowchart showing a process executed by the control unit 130.
  • the projection control unit 132 of the control unit 130 reads the projection pattern from the storage unit 140, controls the laser irradiation unit 110 according to the read projection pattern, and projects the projection pattern.
  • the data representing the pattern is output to the inspection processing unit 134 (step S101).
  • the examination image 50 (see FIGS. 6 and 6) is projected on the retina 22.
  • the data representing the position of the inspection image 50 is the position information indicated by the coordinates on the projected image 10.
  • the line-of-sight direction detection unit 133 detects the line-of-sight direction by the imaging unit 180 based on the eyeball images of the subject's pupil 25, iris 26, and the like (step S102).
  • the line-of-sight direction detection unit 133 uses the projection angle information of the inspection image 50 projected in step S101 and the line-of-sight direction angle information detected in step S102 to obtain the projection angle and the line-of-sight direction angle of the inspection image 50. It is determined whether or not the difference between the two is equal to or less than a predetermined angle (step S103).
  • the projection control unit 132 reads the projection pattern from the storage unit 140, controls the laser irradiation unit 110 according to the read projection pattern, and outputs data representing the projection pattern to the inspection processing unit 134 (step S104).
  • the line-of-sight direction detection unit 133 detects the line-of-sight direction by the imaging unit 180 based on the eyeball images of the subject's pupil 25, iris 26, and the like (step S105).
  • the inspection processing unit 134 determines whether or not the difference between the direction in which the position where the inspection image is projected changes and the direction in which the line-of-sight direction changes is equal to or less than a predetermined angle (step S106). First, by determining the difference in direction, it is intended to determine whether the subject's retina is capturing (or seeing) the test image.
  • the inspection processing unit 134 determines whether or not the delay of the timing at which the line-of-sight direction changes with respect to the timing at which the position where the inspection image is projected changes is not more than the predetermined time. Determine (step S107). The purpose is to determine the responsiveness when the subject recognizes the image captured by the retina.
  • the inspection processing unit 134 determines that the timing delay is equal to or less than the predetermined time (S107: YES). In this case, the subject captures and follows the moving examination image with the retina (looking at the examination image and tracking the examination image), and the subject captures the image with the retina in the brain. This is the case where the responsiveness at the time of recognition is good, and the case where the subject is visually recognizing (seeing and following and recognizing) the inspection image.
  • step S103 when the line-of-sight direction detection unit 133 determines that the difference between the projection angle of the inspection image 50 and the angle in the line-of-sight direction is not less than or equal to a predetermined angle (S103: NO), the inspection image 50 Since there is a difference between the projection position and the line-of-sight direction of the subject, the inspection processing unit 134 determines that the subject is normally viewing the inspection image (step S109).
  • step S109 determines that the subject does not normally visually recognize the inspection image.
  • the flow proceeds to step S109, it is a case where the subject does not visually recognize the moving inspection image and the subject's visual sense is abnormal.
  • Visual abnormality means that the subject does not capture the test image on the retina (NO in step S106), or the subject has a slow response when recognizing the image captured on the retina by the brain. This is the case (when NO is obtained in step S107).
  • step S107 A mode for determining whether or not the delay in the timing at which the line-of-sight direction changes with respect to the timing at which the position on which the inspection image is projected changes is equal to or less than a predetermined time has been described.
  • step S108 the subject proceeds to step S108 to determine that the subject's vision is normal, and if NO in step S106, the subject proceeds to step S109. It may be determined that the vision is not normal.
  • the inspection image is projected onto the retina by the laser beam irradiating the retina of the subject, and the inspection image is moved as an example in the pattern shown in FIGS. 6 and 7. Whether or not the inspection image is normally visually recognized is determined by whether or not the line-of-sight direction detected by the line-of-sight direction detection unit 133 follows the inspection image.
  • the visual field test can be performed by following the line-of-sight direction of the subject, and the visual field test can be performed in a direction deviating from the line-of-sight direction of the subject. It is also possible to inspect the external visual acuity by projecting an image for inspection.
  • the visual inspection device 100 and the visual inspection method of the embodiment do not force the subject to face a specific direction, detect the line-of-sight direction of the subject, and move the test image within a predetermined range of the detected line-of-sight direction. .. Therefore, the visual examination can be easily performed regardless of the direction in which the subject is looking.
  • the visual inspection device 100 and the visual inspection method of the embodiment can significantly reduce the burden on the subject when performing a visual inspection such as visual field, visual acuity, and visual perception.
  • the subject when the subject has dementia, it may not be possible to recognize that the visual examination is to be performed, and it may not be possible to recognize the image for examination. Even for such a subject, as long as the eyes are opened, the retina can be irradiated with a laser beam to project an examination image, so that a visual examination can be performed very easily. In addition, the physical and mental burden on the subject at this time can be significantly reduced.
  • a visual examination should be performed in the same manner as a subject who does not have such a disease. And it is possible to determine whether the image can be captured by the retina. Even if a patient with a disease such as cataract or corneal opacity undergoes surgery to cure the disease such as cataract or corneal opacity, if retinal detachment or the like occurs, the visual acuity does not recover even if the surgery is performed.
  • step S106 or S107 when NO is determined in step S106 or S107, the mode in which the subject determines that the inspection image is not normally visually recognized has been described, but YES is determined in step S106 and step S107 is performed.
  • the result is NO, the subject captures the test image on the retina, but the response to recognize the test image on the brain is slow. Therefore, when it is determined as NO in step S107, it may be determined that the recognition of the image in the subject's brain is not normal.
  • the conventional visual field inspection device is a device that measures only the brightness of the image for inspection as a point-like image, it was an evaluation of the rod function for distinguishing the lightness and darkness of the retina.
  • a test image having spatial resolution and a color vision component can also be projected on the retina. Therefore, it is possible to easily evaluate the spatial discrimination (out-of-center visual acuity) and color vision in the vicinity of the fixed viewpoint, which are important visual functions of the retina.
  • FIG. 9 is a diagram showing a modified example of the inspection image 50.
  • FIG. 9 shows an image of a dog as an image for inspection. By using such an examination image, it is possible to easily attract the interest of the child, so that the visual examination can be performed more easily and the burden on the subject can be reduced.
  • the inspection image is not limited to dogs, and may be other animals such as cats or non-animals. Images that are easy to attract the interest of not only children but also elderly people may be used.
  • the image pickup unit 180 captures an image including the eyeball of the subject, but the method of detecting the movement of the eyeball is limited to this. Not done.
  • electrodes may be attached to the subject's face (upper and lower eyelids, etc.), and the movement of the facial muscles may be detected by an electromyogram to detect the movement of the subject's eyeballs. In this case, the imaging unit 180 becomes unnecessary.

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PCT/JP2020/024044 2019-06-24 2020-06-18 視覚検査装置及び視覚検査方法 WO2020262206A1 (ja)

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JP2018101137A (ja) * 2016-12-21 2018-06-28 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． 静電容量検知回路及びそれを用いてまぶたの位置を判定するための方法

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WO2024135730A1 (ja) * 2022-12-22 2024-06-27 株式会社Ｑｄレーザ 視野検査装置、視野検査方法およびプログラム
JP7575752B1 (ja) 2022-12-22 2024-10-30 株式会社Ｑｄレーザ 視野検査装置、視野検査方法およびプログラム

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