WO2024076085A1

WO2024076085A1 - Slit-lamp microscope device for telemedicine

Info

Publication number: WO2024076085A1
Application number: PCT/KR2023/014836
Authority: WO
Inventors: 황호식
Original assignee: 가톨릭대학교 산학협력단
Priority date: 2022-10-06
Filing date: 2023-09-26
Publication date: 2024-04-11
Also published as: KR20240048119A

Abstract

Disclosed is a slit-lamp microscope device for telemedicine, whereby a slit-lamp microscope at a remote location can be controlled and a patient can be examined through a virtual reality device and an input device. A slit-lamp microscope device for telemedicine according to one embodiment of the present invention may comprise: a remote slit-lamp microscope installed to enable the examination of a patient at a remote location; a goggle-type virtual reality device which is worn by a doctor, receives image data about examination results for the patient in real time from the remote slit-lamp microscope, and allows the doctor to view images based on the image data by means of real-time virtual reality; and an input device for inputting control data so that the control data can be transmitted in order for the doctor to control the remote slit-lamp microscope while viewing the images received by the virtual reality device.

Description

Slit lamp microscope device for telemedicine

The present invention relates to a slit lamp microscope device for telemedicine, and more specifically, to a slit lamp microscope device for telemedicine that can control a slit lamp microscope at a remote location and examine a patient through a virtual reality device and an input device.

[National research and development project that supported this invention]

[Assignment number] 1465028599

[Assignment number] HI17C0659000019

[Ministry Name] Ministry of Health and Welfare

[Project management (professional) organization name] Korea Health Industry Development Institute

[Research project name] Disease-centered translational-based research

[Research project title] Development and validation of a meibomian gland imaging system for mice to study meibomian gland dysfunction, an important cause of dry eye syndrome

[Contribution rate] 50/100

[Name of project carrying out organization] Catholic University Industry-Academic Cooperation Foundation

[Research period] 2017.04.10 ~ 2019.12.31

[National research and development project that supported this invention]

[Assignment number] 1711163820

[Assignment number] NRF-2020R1A2C1005009

[Ministry Name] Ministry of Science and ICT

[Name of project management (professional) organization] National Research Foundation of Korea

[Research Project Name] Individual Basic Research (Ministry of Science and ICT)

[Research project title] Development of a simulator that allows patients to experience what the world actually looks like when a multifocal intraocular lens is inserted before cataract surgery

[Contribution rate] 50/100

[Research period] 2020.03.01 ~ 2025.02.28

In general, a slit lamp microscope is an ophthalmic device that inspects the condition of the eye by irradiating a vertically long and thin light (slit beam, measurement light) into the subject's eye and observing the optical cut surface of the eye. Using this slit lamp microscope, not only can the condition of the eyelids, conjunctiva, cornea, lens, and vitreous body be inspected by adjusting the width, length, or angle of the measurement light, but it is also possible to measure the thickness of the cornea and lens.

When a doctor examines a patient using such a slit lamp microscope, he or she faces the patient directly at a hospital equipped with a slit lamp microscope and conducts the examination using equipment. Therefore, since the diagnosis is made while the patient, doctor, and nurse are all face to face, the examination can be performed smoothly by adjusting posture, etc. according to the doctor's instructions.

However, in the case of this conventional slit lamp microscope, there was a problem that the doctor had no choice but to examine the patient's eyes using the slit lamp microscope while the doctor and patient were face to face.

The present invention is intended to solve the above problems, and the purpose of the present invention is to enable a doctor to control a slit lamp microscope at a remote location using a virtual reality device and an input device and perform remote examination using the patient's captured image received from it. The aim is to provide a slit lamp microscope device for telemedicine.

The problems of the present invention are not limited to the problems mentioned above, and other problems not mentioned can be clearly understood by those skilled in the art from the description below.

According to one aspect of the present invention, a remote slit lamp microscope installed to examine a patient at a remote location; A goggle-type virtual reality device worn by a doctor that receives image data about the patient's examination results from the remote slit lamp microscope in real time and allows the doctor to view images according to the image data in real-time virtual reality; and an input device for transmitting control data to control the remote slit lamp microscope while viewing the image received by the virtual reality device.

At this time, the remote slit lamp microscope includes a plate for the eye to be examined; a position fixing part for the eye to be examined disposed on the plate for the eye to be examined; A moving frame located on the plate for the eye to be examined and capable of moving in a plane with respect to the plate for the eye to be examined; a lighting unit located on the moving frame and capable of irradiating measurement light; a mirror located on the moving frame, reflecting the measurement light emitted from the illumination unit and guiding it to the subject eye whose position is fixed by the subject eye position fixing unit; an image data generator located on the moving frame and capable of generating image data for the eye to be examined to which measurement light is irradiated; an image data transmitting unit capable of transmitting the image data; and a control data receiving unit.

At this time, the image data receiving unit receives image data from the image data transmitting unit through the Internet, a wired communication network, or a wireless communication network, and the control data receiving unit receives control data from the control data transmitting unit through the Internet, a wired communication network, or a wireless communication network. You can.

At this time, the virtual reality device is equipped with a display on the front, allowing you to view images according to image data reception in real time while worn while communicating with a patient or nurse in a remote location through a speaker installed on the side, and the lower surface. It is possible to transmit a voice signal via the control data to a remote location through a microphone installed in the device.

At this time, a control area and a pointer through the input device may be displayed on the display of the virtual reality device on an image according to the received image data.

At this time, the input device may be equipped with a plurality of buttons for determining the type of input data and a fine adjuster for fine adjustment of the pointer.

At this time, the fine adjuster can be used to move the pointer by tilting the stick in one direction out of 360 degrees.

At this time, the remote slit lamp microscope includes a display unit, and the display unit may display a mixture of images of the microscope captured in real time and pointers according to control data input through the input device.

At this time, the eye position fixing unit may be equipped with a pressure sensor or a contact sensor at a portion where the patient's chin and forehead come into close contact.

At this time, the eye position fixing unit is provided with a plurality of guide protrusions that can move forward and backward around the eyeball, and the corresponding guide protrusions contact or apply pressure to the patient's skin according to the control data input from the input device. It can guide eye movements.

According to the above configuration, in the slit lamp microscope device for remote medical treatment according to an embodiment of the present invention, the patient sits in the slit lamp microscope device and assumes an examination posture, and the doctor at a remote location transmits images in real time while wearing a virtual reality device. You can treat patients from a remote location by controlling the slit lamp microscope, patient location, and nurse through an input device while viewing images based on data.

Figure 1 is a perspective view showing a remote slit lamp microscope, which is a component of a slit lamp microscope device for telemedicine according to an embodiment of the present invention.

Figure 2 is a perspective view showing a virtual reality device and an input device, which are some components of a slit lamp microscope device for telemedicine according to an embodiment of the present invention.

Figure 3 is a front view of a virtual reality device and an input device, which are some components of a slit lamp microscope device for telemedicine according to an embodiment of the present invention.

Figure 4 is a front view of the position fixing part of the eye to be examined, which is a component of the slit lamp microscope device for telemedicine according to an embodiment of the present invention.

Figure 5 is a perspective view showing a display unit of a remote slit lamp microscope, which is a component of a slit lamp microscope device for telemedicine according to an embodiment of the present invention.

Figure 6 is a front view of a position fixing part of the eye to be examined, which is a component of a slit lamp microscope device for telemedicine according to another embodiment of the present invention.

Hereinafter, with reference to the attached drawings, embodiments of the present invention will be described in detail so that those skilled in the art can easily implement the present invention. The present invention may be implemented in many different forms and is not limited to the embodiments described herein. In order to clearly explain the present invention, parts not related to the description have been omitted in the drawings, and identical or similar components are given the same reference numerals throughout the specification.

The words and terms used in this specification and claims are not to be construed as limited in their usual or dictionary meanings, but according to the principle that the inventor can define terms and concepts in order to explain his or her invention in the best way. It must be interpreted with meaning and concepts consistent with technical ideas.

Therefore, the embodiments described in this specification and the configuration shown in the drawings correspond to a preferred embodiment of the present invention, and do not represent the entire technical idea of the present invention, so the configuration may be replaced by various alternatives at the time of filing of the present invention. There may be equivalents and variations.

In this specification, terms such as “comprise” or “have” are intended to describe the presence of features, numbers, steps, operations, components, parts, or combinations thereof described in the specification, but are not intended to describe the presence of one or more other features. It should be understood that it does not exclude in advance the possibility of the existence or addition of elements, numbers, steps, operations, components, parts, or combinations thereof.

A component being “in front,” “rear,” “above,” or “below” another component means that it is in direct contact with the other component, unless there are special circumstances. This includes not only those placed at the “bottom” but also cases where another component is placed in the middle. In addition, the fact that a component is "connected" to another component includes not only being directly connected to each other, but also indirectly connected to each other, unless there are special circumstances.

Hereinafter, a slit lamp microscope device for telemedicine according to an embodiment of the present invention will be described with reference to the drawings.

Referring to FIGS. 1 to 5 , the slit lamp microscope device for telemedicine according to an embodiment of the present invention may include a remote slit lamp microscope 100, a virtual reality device 10, and an input device 30.

Referring to FIGS. 1, 4, and 5, the remote slit lamp microscope 100 can be installed to examine a patient at a remote location.

At this time, referring to FIG. 1, the remote slit lamp microscope 100 includes a plate for the eye to be examined 101, a position fixing part for the eye to be examined 140, a moving frame 130, an illumination unit 110, a mirror 118, and image data. It may be provided with a generating unit 120, an image data transmitting unit, and a control data receiving unit. In Figure 1, it is shown as being provided with a transmitting and receiving unit 150 in which an image data transmitting unit and a control data receiving unit are integrated.

At this time, the plate 101 for the examined eye serves as a base plate of the slit lamp microscope for the examined eye.

At this time, the eye position fixing unit 140 is disposed on the plate 101 for the eye to be examined. Here, the fact that the eye position fixing part 140 is disposed on the plate 101 for the eye being examined means that the eye position fixing part 140 is fixed to the plate 101 for the eye being examined, and the eye position fixing part 140 is Various modifications are possible, such as it may be fixed on the upper surface of the plate 101 for the eye to be examined, or it may be fixed on the side of the plate 101 for the eye to be examined, as shown in FIG. 1. The subject eye position fixing unit 140 includes a forehead fixing unit 142 and a chin fixing unit 144 that support the subject's forehead and chin, respectively.

At this time, the eye position fixing unit 140 can adjust the vertical position of the forehead fixing unit 142 in the z-axis direction or the vertical position of the chin fixing unit 144 in the z-axis direction using a screw or lever.

At this time, the moving frame 130 is located on the plate 101 for the eye to be examined. This moving frame 130 is capable of plane movement within the xy plane with respect to the plate 101 for the eye to be examined. In Figure 1, the moving frame 130 can move in the +y direction or -y direction along the horizontal bar 131, and the horizontal bar 131 moves along the guide frame 133 on the plate 101 for the eye to be examined. As it is possible to move in the x-direction or -x-direction, the moving frame 130 is shown to be able to move in the +x-direction or -x-direction. The moving frame 130 can be moved within the xy plane by a motor mounted inside or outside the moving frame 130.

At this time, various components such as the lighting unit 110, mirror 118, or image data generating unit 120 are placed on the moving frame 130. These components may be placed directly on the moving frame 130. , as shown in FIG. 1, the first upper and lower frames 135 are located on the moving frame 130 and the first vertical rotation axis 137 is located on the first upper and lower frames 135, and this first vertical rotation axis ( 137), various components can be placed.

At this time, the lighting unit 110 is located on the moving frame 130. Specifically, the lighting unit 110 is rotatably coupled to the first vertical rotation axis 137 on the first upper and lower frames 135 located on the moving frame 130. 1 It can be located on the lighting rotation arm (119). Accordingly, the lighting unit 110 can move in the same plane as the moving frame 130 moves in the xy plane. In addition, since the lighting unit 110 is mounted on the first upper and lower frames 135 on the moving frame 130, the lighting unit ( 110) It can also be made to move in the +z direction or -z direction along the z-axis. The first lighting rotation arm 119 can also rotate in the horizontal direction around the first vertical rotation axis 137 by using a motor mounted inside and/or outside the light.

At this time, the lighting unit 110 can irradiate measurement light. In FIG. 1, the lighting unit 110 is shown as being able to irradiate measurement light generated within the housing 112 in the -z direction. The measurement light emitted from the lighting unit 110 is reflected by the mirror 118 located at the bottom of the lighting unit 110 and is guided to the subject eye whose position is fixed by the subject eye position fixing unit 140. The mirror 118 may be disposed on the first lighting rotation arm 119 like the lighting unit 110. As described above, since the first lighting rotation arm 119 can rotate around the first vertical rotation axis 137, the light emitted from the lighting unit 110 is reflected from the mirror 118 and then irradiated to the eye to be examined. The subject eye can be irradiated from various angles.

At this time, the image data generator 120 is also located on the moving frame 130, and specifically, can be rotated on the first vertical rotation axis 137 on the first upper and lower frames 135 located on the moving frame 130. It may be located on the combined imaging rotation arm 124. Accordingly, the image data generator 120 can move in the same plane as the moving frame 130 moves in the xy plane. In addition, since the image data generator 120 is mounted on the first upper and lower frames 135 on the moving frame 130, the first upper and lower frames 135 move in the +z direction or -z direction along the z axis. Accordingly, the image data generator 120 can also be moved in the +z direction or -z direction along the z-axis.

At this time, the image data generator 120 may include an imaging device such as a CCD or CMOS, and may generate image data for the eye to be examined to which measurement light is irradiated. As described above, since the imaging rotation arm 124 can rotate around the first vertical rotation axis 137, the image data generator 120 can photograph the subject's eye at various angles.

At this time, the image data generator 120 may include an image data generator 120a for the left eye and an image data generator 120b for the right eye. Here, the image data for the left eye and the image data for the right eye do not mean image data for the patient's left eye and image data for the patient's right eye, but rather mean image data for the doctor's left eye and image data for the doctor's right eye. . For example, as described later, when a doctor observes the patient's left eye, both the left eye image data generator 120a and the right eye image data generator 120b generate image data for the patient's left eye. At this time, the center of the image data generation unit 120a for the left eye and the center of the image data generation unit 120b for the right eye have a certain gap, like the doctor's left eye and right eye. In such a state, the left eye image data generator 120a generates image data for the left eye and the right eye image data generator 120b generates image data for the right eye.

And the first observation unit 22 of the virtual reality device 10 used by the doctor, which will be described later, displays an image for the left eye using image data for the left eye, and the second observation unit 23 displays an image for the right eye using image data for the right eye. Display the image. Accordingly, both eyes of the doctor recognize the image for the left eye displayed in the first observation unit 220a and the image for the right eye displayed in the second observation unit 220b. Here, the images are formed separately, but the corresponding observation eye can be displayed as one image in the center.

At this time, the transmitting and receiving unit 150 includes an image data transmitting unit and a control data receiving unit. The image data transmitting unit can transmit image data generated by the image data generating unit 120, and the control data receiving unit is an input device (described later). Control data from 30) can be received. In Figure 1, the transmitting and receiving unit 150 is shown as being located on the plate 101 for inspection.

At this time, with reference to FIGS. 1 and 5, the remote slit lamp microscope 100 includes a separate display unit 180, and the display unit 180 displays images of the microscope captured in real time and the input device 30. ) may be displayed mixed with pointers according to the control data input.

Referring to FIGS. 2 to 5, the virtual reality device 10 is worn by a doctor and receives image data about the patient's examination results from the remote slit lamp microscope 100 in real time, and allows the doctor to use real-time virtual reality. It may be of a type of goggles provided to view images according to the image data.

At this time, the virtual reality device 10 has a goggle-shaped exterior like a typical VR device, and the main body 11 can be worn by a doctor using a band at the rear. The virtual reality device is designed to be worn so that it completely seals around both eyes.

At this time, the virtual reality device 10 is equipped with a display 20 on the inner front, and can convert image data transmitted in real time into images and display them. That is, the virtual reality device 10 is equipped with a display 20 on the front, so that when worn, images can be viewed in real time based on image data reception, and at the same time, the virtual reality device 10 can be connected to a remote patient or nurse through the speaker 12 installed on the side. It is possible to communicate with, and a voice signal can be transmitted via the control data to a remote location through the microphone 12a installed on the lower surface.

At this time, the display 20 of the virtual reality device 10 may display a control area and a pointer through the input device on an image according to the received image data. That is, various types of motors that are currently being controlled, for example, motors, and control objects controlled by the motors can be displayed, and the pointers can be used to point to them.

Referring to FIGS. 2 to 4, the input device 30 allows a doctor to transmit control data to control the remote slit lamp microscope 100 while viewing the image received by the virtual reality device 10. You can enter it.

At this time, the input device 30 may be provided with a plurality of buttons 31 for determining the type of input data and a fine adjuster 32 for fine adjustment of the pointer.

At this time, the fine adjuster 32 can be configured to move the pointer by tilting the stick in one direction out of 360 degrees.

At this time, the doctor can determine the type of menu to be controlled by adjusting the button 31 of the input device 30, or can determine the control target by selecting from the menu using the fine adjuster 32.

Referring to Figure 1, a perspective view showing a remote slit lamp microscope 100, which is a component of a slit lamp microscope device for telemedicine according to an embodiment of the present invention, is shown. On the left is a slit lamp microscope 100, and on the right is a display unit 180 on which images of the observed eye and control-related menus are displayed. In the eye position fixing unit 140, the patient fixes the face using the chin and forehead. With the patient's head fixed in this way, the position of the image data generator 120 is adjusted in a three-dimensional direction so that it is placed in an appropriate position for examination. At this time, the doctor adjusts the position of the image data generator 20 by inputting control data using the input device 30 while wearing the virtual reality device 10. The lighting unit 110 is controlled in the same way and then the eye examination is started. Here, since three-dimensional surrounding observation cameras (161, 162, 163) are provided outside the remote slit lamp microscope (100), the doctor can acquire images of the surrounding environment through them and use the patient's posture and the image data generator ( 120) can be checked to see if it is properly placed. If necessary, it is possible to communicate with the patient or nurse through the microphone 12a and

speakers

12 and 170. The observed image is expressed as an image on the display unit 180 in front of the patient, and based on the display unit 180, the doctor can explain the condition to the patient at a remote location. Of course, you can use a pointer to point to important points and explain the status. Additionally, the image displayed on the display unit 180 can be mirrored to display the same image as the display 20 of the virtual reality device 10.

Referring to FIG. 2, a perspective view of the virtual reality device 10 and the input device 30, which are some components of the slit lamp microscope device for telemedicine according to an embodiment of the present invention, is shown. Referring to FIG. 3, the present invention A front view of a virtual reality device 10 and an input device 30, which are some components of a slit lamp microscope device for telemedicine according to an embodiment, is shown. The virtual reality device 10 is of a goggle type so that a doctor can wear it. The input device 10 is equipped with a plurality of buttons 31 and a fine adjuster 32 so that the doctor can generate control data while looking at the display 20 of the virtual reality device 10. The doctor can select a menu 21 or a component to be controlled using the button 31, and can select a menu or finely adjust the movement of the selected component using the fine adjuster 32. The image displayed on the display 20 of the virtual reality device 10 may include an eye image observed by the image data generator 120 and an optional virtual menu for controlling it, and a fine adjuster 32 may be provided. The operating position can also be displayed in real time (24). The virtual reality device 10 may have speakers 12 installed in a headset that covers the ears, and a microphone 12a is built into the lower side so that the doctor's voice signal is transmitted to the patient or nurse through the remote speaker 170. It can be.

Referring to Figure 4, a front view of the eye to be examined position fixing unit 140, which is a component of a slit lamp microscope device for telemedicine according to an embodiment of the present invention, is shown. The forehead fixing part 142 and the chin fixing part 144 are installed so that they can be supported by pillar members 141 on both sides, and their heights can be adjusted as described above. A contact sensor 144a or

pressure sensors

142a and 144b are installed in the forehead fixing part 142 and the chin fixing part 144 to determine the patient's posture. That is, if there is no contact or pressure abnormality occurs, the patient's posture can be observed using the surrounding observation cameras 161-163, and then control data or voice signals can be transmitted to adjust the patient's head position. By doing this, the patient's posture can be changed and maintained in a comfortable and suitable position for examination.

Figure 5 is a perspective view showing the display unit 180 of the remote slit lamp microscope 100, which is a component of the slit lamp microscope device for telemedicine according to an embodiment of the present invention. At this time, the image displayed on the display 20 of the virtual reality device 10 worn by the doctor may be displayed in real time in synchronization with the image displayed on the display unit 180. The display unit 180 shows an image of the observed left or right eye, and control signals, status,

menus

182, 183, etc. can be displayed along the border along the horizontal and vertical directions.

Meanwhile, referring to FIG. 6, a front view of the eye-to-be-examined position fixing unit 140, which is a component of a slit lamp microscope device for telemedicine according to another embodiment of the present invention, is shown. Here, the difference from the previous embodiment is that the eye-to-be-examined position fixing unit 140 is provided with a plurality of guide protrusions 191-193 that can move forward and backward around the eyeball, according to the input of control data from the input device 30. It is possible to guide eye movement by allowing the corresponding guide protrusions 191-193 to contact or apply pressure to the patient's skin.

At this time, the guide protrusions 191-193 may be installed so as to be supported on the guide frame 190, one end of which is fixed to the forehead fixing part 142. The guide frame 190 has a semicircular shape, and a total of five guide protrusions 191-193 may be installed on the forehead fixing part 142, one on the left and right sides, and one on the lower side. Of course, the number of guide protrusions 191-193 installed is not limited to this.

At this time, the guide protrusions 191-193 are installed and operated forward and backward by the operation of various actuators, and the control signal can be input by the doctor as control data using the input device 30. When the corresponding guide projections 191-193 advance according to the doctor's control data input and lightly press the patient's skin, the patient adjusts the position of the eyeball by looking at that area. In this way, you can respond more intuitively than if the doctor tells you the direction to look by voice.

Although the embodiments of the present invention have been described, the spirit of the present invention is not limited to the embodiments presented in this specification, and those skilled in the art who understand the spirit of the present invention can add or change components within the scope of the same spirit. , deletion, addition, etc., other embodiments can be easily proposed, but this will also be said to fall within the scope of the present invention.

The present invention can be applied to a slit lamp microscope for telemedicine, which is one of the medical devices.

Claims

A remote slit lamp microscope installed to examine patients in remote locations;

A goggle-type virtual reality device worn by a doctor that receives image data about the patient's examination results in real time from the remote slit lamp microscope and allows the doctor to view images according to the image data in real-time virtual reality; and

An input device for transmitting control data to control the remote slit lamp microscope while viewing the image received by the virtual reality device.
According to claim 1,

The remote slit lamp microscope,

Plate for the eye to be examined;

a position fixing part for the eye to be examined disposed on the plate for the eye to be examined;

A moving frame located on the plate for the eye to be examined and capable of moving in a plane with respect to the plate for the eye to be examined;

a lighting unit located on the moving frame and capable of irradiating measurement light;

a mirror located on the moving frame, reflecting the measurement light emitted from the illumination unit and guiding it to the subject eye whose position is fixed by the subject eye position fixing unit;

an image data generator located on the moving frame and capable of generating image data for the eye to be examined to which measurement light is irradiated;

an image data transmitting unit capable of transmitting the image data; and

A slit lamp microscope device for telemedicine, including a control data receiver.
According to claim 1,

The image data receiving unit receives image data from the image data transmitting unit through the Internet, a wired communication network, or a wireless communication network, and the control data receiving unit receives control data from the control data transmitting unit through the Internet, a wired communication network, or a wireless communication network. Slit-lamp microscopy device for clinical use.
According to claim 1,

The virtual reality device is equipped with a display on the front, allowing you to view images based on image data received in real time while worn while communicating with patients or nurses in remote locations through speakers installed on the side, and installed on the bottom. A slit lamp microscope device for telemedicine that transmits a voice signal via the control data to a remote location through a microphone.
According to clause 4,

A slit lamp microscope device for telemedicine in which a control area and a pointer through the input device are displayed on the display of the virtual reality device on an image according to received image data.
According to claim 1,

The input device is a slit lamp microscope device for telemedicine, including a plurality of buttons for determining the type of input data and a fine adjuster for fine adjustment of the pointer.
According to clause 6,

The fine adjuster is a slit lamp microscope device for telemedicine where the pointer moves by tilting the stick in one direction out of 360 degrees.
According to claim 1,

The remote slit lamp microscope includes a display unit, and the display unit displays a mixture of images of the microscope captured in real time and a pointer according to control data input through the input device.
According to clause 2,

A slit-lamp microscope device for telemedicine, wherein the eye position fixing unit is equipped with a pressure sensor or a contact sensor at a portion where the patient's chin and forehead are in close contact.
According to clause 2,

The eye position fixing unit is provided with a plurality of guide protrusions that can move forward and backward around the eyeball, and the corresponding guide protrusions contact or apply pressure to the patient's skin according to control data input from the input device, thereby adjusting the pupil of the eye. A slit-lamp microscope device for telemedicine that guides movement.