JP6825042B2 - Ophthalmic equipment - Google Patents

Description

The present invention relates to an ophthalmic apparatus.

Cataract is an eye disease in which visual acuity gradually deteriorates due to opacity of the crystalline lens, which acts as a lens. Cataract surgery is generally performed on optometry with advanced cataracts. For example, in cataract surgery, the opaque crystalline lens is removed and an intraocular lens (IOL) is inserted instead. IOLs include those having only sphericality, toric IOLs capable of correcting astigmatism, and multifocal IOLs capable of focusing on both distant and near areas. Before cataract surgery, it is necessary to measure eyeball information representing the structure of the eye to be inspected, such as the axial length and the radius of curvature of the cornea, with an ophthalmic apparatus, and determine the IOL frequency from the measured eyeball information.

Such an ophthalmic apparatus is disclosed in, for example, Patent Documents 1 to 4. Patent Document 1 includes an optical system for measuring the axial length of the eye and an optical system for measuring the refractive power of the eye to be inspected, and can simultaneously measure the axial length of the eye to be inspected and the refractive power. Various ophthalmic devices are disclosed. Patent Document 2 discloses an ophthalmic apparatus including an optical system for measuring the axial length and an optical system for measuring the corneal shape. Patent Document 3 discloses an ophthalmic apparatus capable of measuring an axial length using a technique of swept source OCT (Optical Coherence Tomography: hereinafter, OCT). Patent Document 4 discloses a method of measuring the axial length with a Michelson interferometer.

Japanese Patent No. 45233338 Japanese Patent No. 5500587 Japanese Unexamined Patent Publication No. 2013-180111 International Publication No. 2013/11090

However, in the past, it was necessary to use a plurality of ophthalmic devices before cataract surgery, and it was necessary to secure the installation space for these devices. Further, even if it is possible to acquire a plurality of eyeball information with one ophthalmic device, the size of the device has been increased.

The present invention has been made to solve the above problems, and an object of the present invention is to provide a technique for realizing miniaturization of an ophthalmic apparatus capable of performing a plurality of measurements performed before cataract surgery. ..

The ophthalmic apparatus according to the embodiment is a first mirror unit and a second mirror unit capable of dividing the light from the light source into reference light and measurement light and setting the reference light to different reference optical path lengths by using the dividing member. By irradiating the eye to be inspected with the measurement light and moving the second mirror unit in the optical axis direction, the first interference between the return light from the eye to be inspected and the reference light via the first mirror unit. The eye to be inspected is based on the interference optical system that simultaneously detects the light and the second interference light of the return light and the reference light that has passed through the second mirror unit, and the detection results of the first interference light and the second interference light. Includes an eyeball information calculation unit that obtains eyeball information representing the structure of. The interference optical system includes a first shutter that can be inserted into and removed from the first optical path between the dividing member and the first mirror unit, and a second optical path between the dividing member and the second mirror unit. The measurement light is emitted in a state in which the first shutter is inserted into the first optical path and the second shutter is retracted from the second optical path, including a second shutter that can be inserted into and removed from the light path. After moving the second mirror unit in the optical axis direction based on the detection result of the interference light obtained by irradiating the eye to be inspected, the first shutter is retracted from the first optical path and the measurement light is emitted. By irradiating the eye to be inspected, the first interference light and the second interference light are detected at the same time.

According to the ophthalmic apparatus according to the present invention, it is possible to miniaturize an ophthalmic apparatus capable of performing a plurality of measurements before cataract surgery.

It is the schematic which shows the structural example of the ophthalmic apparatus which concerns on embodiment. It is the schematic which shows the structural example of the ophthalmic apparatus which concerns on embodiment. It is the schematic which shows the structural example of the ophthalmic apparatus which concerns on embodiment. It is the schematic which shows the structural example of the ophthalmic apparatus which concerns on embodiment. It is the schematic which shows the structural example of the ophthalmic apparatus which concerns on embodiment. It is operation explanatory drawing of the ophthalmic apparatus which concerns on embodiment. It is operation explanatory drawing of the ophthalmic apparatus which concerns on embodiment. It is operation explanatory drawing of the ophthalmic apparatus which concerns on embodiment. It is operation explanatory drawing of the ophthalmic apparatus which concerns on embodiment. It is the schematic which shows the structural example of the ophthalmic apparatus which concerns on embodiment. It is the schematic which shows the structural example of the ophthalmic apparatus which concerns on embodiment. It is a flow figure which shows the operation example of the ophthalmic apparatus which concerns on embodiment. It is the schematic which shows the structural example of the ophthalmic apparatus which concerns on embodiment. It is the schematic which shows the structural example of the ophthalmic apparatus which concerns on embodiment. It is the schematic which shows the structural example of the ophthalmic apparatus which concerns on embodiment.

[First Embodiment]
The ophthalmic apparatus according to the first embodiment is an apparatus capable of performing objective measurement and subjective measurement by one unit. Objective measurement is to obtain information about the eye to be examined mainly by using a physical method without referring to the response from the subject. The objective measurement includes an objective measurement for measuring a value related to the eye to be inspected and an imaging for acquiring an image of the eye to be inspected. Such objective measurements include, for example, objective refraction measurement, corneal shape measurement, intraocular pressure measurement, fundus photography, and OCT measurement using an OCT method. Awareness measurement acquires results based on the response from the subject. The subjective measurement includes, for example, a subjective refraction measurement such as a distance test, a near test, a contrast test, and a glare test, and a visual field test. In the subjective measurement, information (such as a target) is presented to the subject, and the result is acquired based on the subject's response to the information.

In this embodiment, the case where the Fourier domain type OCT method is used in the OCT measurement will be described. In particular, the ophthalmic apparatus according to this embodiment can perform OCT measurement by using the technique of spectral domain OCT. The OCT measurement may be performed by a type other than the spectral domain, for example, a swept source OCT method. Further, for the OCT measurement in this embodiment, it is also possible to use a time domain type OCT method.

In addition, the ophthalmic apparatus according to this embodiment can perform at least one of arbitrary subjective measurement and arbitrary objective measurement. Hereinafter, the ophthalmic apparatus according to this embodiment can perform distance examination, near vision examination, contrast examination, glare examination and the like as subjective measurement, and objective refraction measurement and corneal shape measurement as objective measurement. , It is assumed that the device is capable of performing OCT measurement and the like. In OCT measurement, eyeball information representing the structure of the eye to be inspected, such as axial length, corneal thickness, anterior chamber depth, and lens thickness, is acquired. In this embodiment, the eyeball information includes an intraocular distance indicating a distance between two predetermined parts in the eye such as axial length and lens thickness. However, the configuration of the ophthalmic apparatus according to the embodiment is not limited to this.

(Appearance configuration of ophthalmic equipment)
The external configuration of the ophthalmic apparatus according to the first embodiment is shown in FIG. The ophthalmic apparatus 1000 includes a base 200, a pedestal 300, a head portion 400, a face receiving portion 500, a joystick 800, and a display portion 10.

The gantry 300 is movable back and forth and left and right with respect to the base 200. The head portion 400 is integrally configured with the gantry 300. The face receiving portion 500 is integrally formed with the base 200.

The face receiving portion 500 is provided with a chin receiving portion 600 and a forehead support 700. The face of the subject (not shown) is fixed by the face receiving portion 500. The examiner, for example, is located on the opposite side of the subject across the ophthalmic apparatus 1000 to perform the examination. The joystick 800 and the display unit 10 are arranged at positions on the examiner side. The joystick 800 is provided on the gantry 300. The display unit 10 is provided on the surface of the head unit 400 on the examiner side. The display unit 10 is, for example, a flat panel display such as a liquid crystal display. The display unit 10 has a touch panel type display screen 10a.

The head portion 400 is moved back and forth and left and right by tilting the joystick 800. Further, the head portion 400 is moved in the vertical direction by rotating the joystick 800 with respect to the axis thereof. By these operations, the position of the head portion 400 with respect to the face of the subject held by the face receiving portion 500 is changed. The movement in the left-right direction is performed, for example, to switch the examination target by the ophthalmic apparatus 1000 from the left eye to the right eye or from the right eye to the left eye.

An external device 900 is connected to the ophthalmic device 1000. The external device 900 may be any device, and the connection mode (communication mode, etc.) between the ophthalmic device 1000 and the external device 900 may be arbitrary. The external device 900 includes, for example, a spectacle lens measuring device for measuring the optical characteristics of the lens. The spectacle lens measuring device measures the power of the spectacle lens worn by the subject, and inputs this measurement data to the ophthalmic device 1000. Further, the external device 900 may be any other ophthalmic device. Further, the external device 900 may be a device (reader) having a function of reading information from the recording medium or a device (writer) having a function of writing information to the recording medium.

Another example of the external device 900 is a computer used in the medical institution. Such in-hospital computers include, for example, a hospital information system (HIS) server, a DICOM (Digital Imaging and Communications in Medicine) server, a doctor's terminal, and the like. The external device 900 may include a computer used outside the medical institution. Such out-of-hospital computers include, for example, mobile terminals, personal terminals, servers and terminals on the manufacturer side of the ophthalmic apparatus 1000, cloud servers, and the like.

(Composition of optical system)
The ophthalmic apparatus 1000 has an optical system for inspecting the eye to be inspected. A configuration example of this optical system will be described with reference to FIGS. 2 to 5B. The optical system is provided in the head portion 400. The optical systems are an observation system 5, a fixation and awareness measurement system 4, a glare light projection system 8, a reflex measurement light projection system 6, a reflex measurement light receiving system 7, a Z alignment projection system 1, and an XY alignment spot projection. It includes a system 2, a ring projection system 3 for kerato measurement, and an interference optical system 14. The processing unit 9 executes various processes.

The observation system 5 is an optical system for observing the anterior segment of the eye E to be inspected. The fixation and awareness measurement system 4 is an optical system for presenting the fixation target and the target for awareness measurement to the eye E to be inspected. The glare light projection system 8 is an optical system for projecting glare light onto the eye to be inspected together with the above-mentioned optotype. The reflex measurement light projection system 6 is an optical system for projecting a luminous flux for objectively measuring the optical refractive power onto the eye to be inspected. The reflex measurement light receiving system 7 is an optical system for receiving the fundus reflected light of the light projected on the eye to be inspected by the reflex measurement light projection system 6. The reflex measurement light receiving system 7 forms a plurality of point-like luminous fluxes from the return light (reflected light, reflected luminous flux) in the fundus Ef with respect to the measurement light output from the light source (common) in the interference optical system 14, and the plurality of points. It has a function of detecting an image formed by a light flux. The fixation and awareness measurement system 4 is an optical system for performing awareness measurement. The fixation and awareness measurement system 4 of this example has a function of presenting an optotype to the eye E to be inspected. The Z alignment projection system 1 and the XY alignment spot projection system 2 are optical systems for projecting light necessary for aligning the optical system with respect to the eye E to be inspected (XYZ alignment). The Z-alignment projection system 1 has a function for aligning in a direction (front-back direction) along the optical axis of the observation system 5. The XY alignment spot projection system 2 has a function of projecting a spot for alignment in a direction (vertical direction, horizontal direction) orthogonal to the optical axis of the observation system 5. The interference optical system 14 is an optical system for projecting measurement light onto the fundus Ef for objective measurement and performing OCT measurement. The interference optical system 14 has a function of projecting the measurement light output from the light source 141 onto the fundus Ef and a function of detecting the return light of the measurement light.

(Observation system 5)
The observation system 5 includes an objective lens 51, a dichroic mirror 52, an aperture 53, a half mirror 54, relay lenses 55 and 56, an imaging lens 57, and an image sensor (CCD) 58. The output of the image sensor 58 is input to the processing unit 9. The processing unit 9 causes the display unit 10 to display the anterior segment image E'based on the signal input from the image sensor 58.

A kerato plate 31 is provided between the objective lens 51 and the eye E to be inspected. The kerato plate 31 is used to project a ring-shaped luminous flux for measuring the corneal shape onto the cornea C of the eye E to be inspected.

(Z alignment projection system 1 and XY alignment spot projection system 2)
A Z alignment projection system 1 is provided around the kerato plate 31. As described above, the Z alignment projection system 1 is used for the alignment of the observation system 5 in the anteroposterior direction of the optical axis. The Z-alignment projection system 1 has a Z-alignment light source 11. The light from the Z alignment light source 11 is projected onto the cornea C. The light projected on the cornea C is reflected by the cornea C and projected onto the line sensor 13 via the imaging lens 12. When the position of the apex of the cornea moves in the front-rear direction with respect to the optical axis of the observation system 5, the position of the light flux projected on the line sensor 13 changes. By analyzing this change in position, the position of the corneal apex of the eye E to be inspected with respect to the objective lens 51 can be measured, and alignment can be performed based on the measured value.

The XY alignment spot projection system 2 forms an optical path branched from the observation system 5 via the half mirror 54. As described above, the XY alignment spot projection system 2 is used for vertical and horizontal alignment. The XY alignment spot projection system 2 has an XY alignment light source 21. A part of the light output from the XY alignment light source 21 is reflected by the half mirror 54, passes through the aperture 53, passes through the dichroic mirror 52, passes through the objective lens 51, and is projected onto the eye E to be inspected. .. The light projected on the eye E to be inspected is reflected by the cornea C, passes through the objective lens 51, and is projected onto the image sensor 58 via the same optical path as the observation system 5.

As shown in FIG. 2 and the like, the front eye portion image E'and the alignment mark AL and the bright spot image Br reflected by the cornea C are displayed on the display screen 10a. When manually aligning, the user operates the joystick 800 while referring to the information displayed on the display screen 10a, for example, to adjust the position of the head portion 400. At this time, the processing unit 9 calculates, for example, the amount of deviation in the vertical and horizontal directions from the amount of deviation between the alignment mark AL and the bright spot image Br reflected by the cornea C, and based on the processing information from the Z alignment projection system 1. The amount of deviation in the optical axis direction may be displayed on the display screen 10a. The processing unit 9 can control to start the measurement in response to the completion of the alignment.

When the alignment is performed automatically, the head portion 400 is moved by controlling the electric mechanism so that the above-mentioned deviation amount is cancelled. This mechanism includes an actuator that generates a driving force and a member that transmits the driving force to the head portion 400. The processing unit 9 can control to start the measurement in response to the completion of the alignment.

(Fixation and awareness measurement system 4)
The fixation and awareness measurement system 4 includes a self-luminous liquid crystal panel 41, a relay lens 42, a reflection mirror 43, a half mirror 44, a focusing lens 45, a relay lens 46, and a variable cross cylinder (hereinafter referred to as a variable cross cylinder). The VCS) lens 47, the reflection mirror 48, the dichroic mirrors 49 and 52, and the objective lens 51 are included.

The glare light projection system 8 includes a glare light source 81 that irradiates the eye E to be inspected with glare light, and a relay lens 82. The glare light source 81, the relay lens 82, the half mirror 44, the focusing lens 45, the relay lens 46, the VCS lens 47, the reflection mirror 48, the dichroic mirrors 49 and 52, and the objective lens 51 constitute a glare light projection system. The glare light projection system 8 irradiates the eye E to be inspected with glare light together with the projection of the optotype by the fixation and the awareness measurement system 4.

The fixation and awareness measurement system 4 can project an optotype for visual acuity measurement onto the fundus Ef of the eye E to be inspected. In addition, the fixation and awareness measurement system 4 can change the contrast of the optotype.

In objective measurement (objective refraction measurement, etc.), a landscape chart is projected on the fundus Ef. Alignment is performed while the subject is staring at this landscape chart, and the optical power is measured in a cloud-fog state.

The fixation and awareness measurement system 4 can also project an optotype for visual acuity measurement onto the fundus Ef using an optical chart.

(Ref measurement light projection system 6 and reflex measurement light receiving system 7)
The reflex measurement system is composed of the reflex measurement light projection system 6 and the reflex measurement light receiving system 7. The reflex measurement light projection system 6 has a function of projecting the light emitted from the light source 141 of the interference optical system 14 onto the fundus Ef of the eye E to be inspected. The light emitted from the light source 141 becomes a parallel light beam by the fiber coupler 142 and the collimator lens 61, passes through the center of the focusing lens 62, the relay lens 63, the reflection mirror 64, the pupil lens 65, and the perforated prism 66, and enters the optical path. On the other hand, it is eccentric by a light beam eccentric prism 67 (eccentric member) with a rotatable mechanism that can be inserted and removed, is reflected by the dichroic mirrors 49 and 52, passes through the objective lens 51, and is projected onto the fundus Ef of the eye E to be inspected. Here, the surface of the pupil lens 65 arranged near the position conjugate with the pupil of the eye E to be inspected is etched so that light can pass only in the central portion. The effect of the eccentric prism 67 is to reduce the deterioration of measurement accuracy by changing or decreasing the light amount distribution of the measurement light when the measured luminous flux projected on the fundus of the eye to be inspected is affected by a blood vessel or a disease. .. When the eccentric prism 67 is rotated, the degree of application to the measured luminous flux of blood vessels and diseases can be averaged, and the measurement accuracy can be improved. Further, when the eccentric prism 67 is rotated by setting the position in the vicinity, the center of the luminous flux is eccentric with respect to the center of the pupil of the eye E to be inspected, so that the measurement light passes through the pupil even if the pupil of the eye to be inspected is small. Is possible. However, even if it is arranged at the conjugate position with the pupil, the effect of improving the measurement accuracy can be obtained, so that it can be selected according to the specifications of the apparatus. The center of the light flux that has passed through the perforated prism 66 and the eccentric prism 67 is eccentric and is projected onto the fundus Ef from a position separated by a predetermined distance from the pupil of the eye E to be inspected. The light flux is returned to the eccentric prism 67 of the same optical path, so that the eccentric prism 67 is absent, and the light flux is projected onto the image pickup element 77 by the reflex measurement light receiving system 7.

In the reflex measurement light receiving system 7, the light reflected from the fundus Ef is reflected by the objective lens 51, the dichroic mirrors 52 and 49, eccentric by the eccentric prism 67, and reflected by the peripheral portion of the perforated prism 66. The light reflected by the peripheral portion of the perforated prism 66 is converted into a parallel luminous flux by the pupil lens 71, the relay lens 72, and the focusing lens 73, and is incident on the opening of the 6-hole opening plate 74, each of which has 6 beams. Separated into luminous flux. As shown in FIG. 2B, the wedge-shaped hexagonal prism 75 is composed of six prisms having slopes on the outside when viewed from the direction of the optical axis OP. The six luminous fluxes separated by the six-hole opening plate 74 are deflected by a predetermined angle by the wedge-shaped hexagonal prism 75. The imaging lens 76 projects six light fluxes onto the image sensor 77 to form six point images at the center of the optical axis OP as shown in FIG. 2C.

The focusing lens 73, the 6-hole opening plate 74, and the wedge-shaped hexagonal prism 75 are mounted on the measuring unit 73A configured to be movable in the optical axis direction. At the time of measuring the refractive power, the focusing lens 62 and the measuring unit 73A are moved in the optical axis direction in cooperation with each other.

The reflex measurement light receiving system 7 may include a conical prism instead of the wedge-shaped hexagonal prism 75. The conical prism is used to detect the light source image projected on the fundus Ef as a ring pattern that passes through a peripheral portion separated from the center of the pupil or the optical center of the eyeball of the eye E to be inspected by a predetermined distance.

(Interference optical system 14)
The interference optical system 14 has the same configuration as the ref measurement light projection system 6. The luminous flux emitted from the light source 141 passes through the same optical path and is projected onto the fundus Ef of the eye E to be inspected. When measuring eyeball information, the eccentric prism 67 is retracted from the optical path, and the measured luminous flux is projected onto the fundus Ef through the pupil center (or eyeball optical center) of the eye E to be inspected.

Further, the interference optical system 14 functions as a light receiving system for detecting the return light of the measurement light projected on the fundus Ef in the OCT measurement. This light receiving system includes an objective lens 51, a dichroic mirror 52 and 49, a light beam eccentric prism 67 with a rotation mechanism that can be inserted and removed from the optical path, a perforated prism 66, a pupil lens 65, a reflection mirror 64, a relay lens 63, and focusing. It includes a lens 62, a collimator lens 61, a fiber coupler 142, and a spectroscope 143.

Each part of the ophthalmic apparatus 1000 is controlled by the processing unit 9. For example, the processing unit 9 includes a liquid crystal panel 41, a light source 141, a glare light source 81, a Z alignment light source 11, an XY alignment light source 21, a keratling light source 32 of a kerato plate 31, and focusing lenses 45, 62, and 73 (focusing lens 73). Measurement unit 73A), VCS lens 47, retinal and anterior chamber depth shutter 154, corneal shutter 157, reference mirrors 156 and 159, display unit 10, light source eccentric prism 67 with removable rotation mechanism, etc. Control.

(Corneal shape measurement function)
When performing kerato measurement, the processing unit 9 turns on the kerat ring light source 32. The reflected light flux from the cornea of the ring-shaped light flux (kerato plate 31) for measuring the shape of the cornea projected on the cornea C is projected onto the image pickup element 58 by the observation system 5 together with the anterior segment image. The processing unit 9 calculates a parameter representing the shape of the cornea by performing a predetermined arithmetic process on the image acquired by the image sensor 58.

(Objective measurement function)
When performing the ref measurement, the processing unit 9 turns on the light source 141. The light from the light source 141 passes through the fiber coupler 142 and becomes parallel light by the collimator lens 61 as described above, and is projected onto the fundus by the reflex measurement light projection system 6. When the eye E to be inspected is emmetropic (= 0D), the fiber end face (focal position of the collimator lens 61) and the position where the fundus Ef of the eye E to be inspected are conjugate are the reference positions of the focusing lens 62. The luminous flux projected on the fundus Ef in this state is reflected by the fundus Ef, passes through the reflex measurement light receiving system 7, and is formed by the opening of the 6-hole opening plate 74 and the wedge-shaped hexagonal prism 75 arranged in the middle. It is polarized by the separated luminous flux and projected onto the image sensor 77. Since the eye E to be inspected is emmetropic, each luminous flux projected on the image sensor 77 is projected at a reference position (all at equal intervals from the center).

When the eye to be inspected is myopia, each light flux projected on the image sensor 77 moves toward the center of each point. When the eye to be inspected is hyperopia, each light flux projected on the image sensor 77 moves outward from the center of each point. The processing unit 9 detects the amount of movement from the reference position and calculates the refractive power of the eye E to be inspected (a known method). Alternatively, the processing unit 9 may move the focusing lens 62 and the measuring unit 73A (focusing lens 73, 6-hole opening plate 74, wedge-shaped hexagonal prism 75) to obtain the refractive power of the eye E to be inspected from the amount of movement. it can.

(OCT measurement function)
Here, as an example of OCT measurement, a case where the axial length (distance between the apex of the cornea and the retina) of the eye E to be examined is obtained will be described. When performing OCT measurement, the processing unit 9 turns on the light source 141. In synchronization with the lighting of the light source 141, the corneal shutter 157 is inserted into the optical path between the beam splitter 153 and the corneal reference mirror unit 161, and the retina and anterior chamber depth shutter 154 are inserted into the beam splitter 153 and the retina and the retina. It is retracted from the optical path between the reference mirror unit 160 for the depth of the anterior chamber. The light L0 from the light source 141 is separated into the measurement light LS and the reference light LR by the fiber coupler 142. The measurement light LS passes through the same optical path as the reflex measurement light projection system 6 and is projected onto the fundus Ef of the eye E to be inspected. At this time, the eccentric prism 67 is retracted out of the optical path. Further, from the above-mentioned refractive power measurement result of the eye E to be inspected, the focusing lens 62 is moved so that the fiber end face is conjugated with the fundus Ef of the eye E to be inspected. The light reflected by the fundus Ef returns from the same optical path and is projected onto the fiber end face to reach the fiber coupler 142.

On the other hand, the reference light LR becomes parallel light by the collimator lens 151, is split into two light beams (for the cornea and the retina) by the 50:50 beam splitter 153, and is separated by the imaging lens 155 and 158, respectively, and the reference mirror (reflection mirror). ) 156, 159 are focused. Here, as described above, since the corneal shutter 157 is inserted into the optical path and the retina and the anterior chamber depth shutter 154 are retracted from the optical path, the light reflected from the reference mirror (retina reference mirror) 156. Only return through the same optical path to reach the fiber coupler 142. The light reflected by the fundus Ef and the reference mirror 156 is combined by the fiber coupler 142 and guided to the spectroscope 143 as an interference signal (interference light LC). In the spectroscope 143, spatially wavelength-separated light is projected onto the line sensor. The processing unit 9 can extract information in the depth direction by applying a known FFT (Fast Fourier Transform: hereinafter, FFT) to the signal output from the line sensor.

The reference mirror unit 160 for the depth of the retina and the anterior chamber and the reference mirror unit 161 for the cornea are moved so that the position of the interference signal becomes a predetermined position in the depth direction according to the axial length of the eye E to be inspected. For example, when the intensity change of the interference signal after FFT with respect to the depth direction is represented as shown in FIG. 4B, the retina and the reference mirror unit 160 for anterior chamber depth are moved in the optical axis direction as shown in FIG. 4A. As shown in 4B, the position of the interference signal SC0 by the retina can be moved so as to be a predetermined position within a predetermined range. Here, the position of the corneal reference mirror 159 may be fixed.

Further, since the coordinates of the corneal apex are detected by the Z alignment projection system 1 described above, the distance (working distance) between the corneal apex and the objective lens 51 can always be adjusted within a certain distance. Here, when the corneal shutter 157 is retracted from the optical path, an interference signal with the light reflected by the cornea C among the light projected on the eye E to be examined is simultaneously projected onto the spectroscope 143. When the working distance is within a predetermined range, the corneal reference mirror 159 is arranged so as to be separated from the corneal position by a distance d so as not to overlap with the interference signal SC1 by the retina (FIG. 5A). Therefore, as shown in FIG. 5B (representing the change in the intensity of the interference signal after FFT in the depth direction as in FIG. 4B), two interference signals (interference signal SC1 by the retina and interference signal SC1 by the retina) are simultaneously within the interference signal measurement range R. It becomes possible to acquire the interference signal SC2) by the cornea. In particular, when the signal sensitivity S changes as shown in FIG. 5B, the interference signal SC1 by the retina with a weak signal component is detected in the measurement range R1 with a high signal sensitivity, and the interference signal SC2 by the cornea with a strong signal component is detected by the signal sensitivity. By detecting in the weak measurement range R2, two interference signals can be acquired at the same time with high accuracy.

When the interference optical system 14 has the same configuration as the swept source type OCT device, a wavelength sweep light source is provided instead of the light source 141 that outputs low coherence light, and an optical member that spectrally decomposes the interference light is provided. I can't. For the configuration of the interference optical system 14, known techniques depending on the type of optical coherence tomography can be arbitrarily applied.

The light source 141 outputs a wide band low coherence light L0 such as SLD (Super Luminescent Diode). The light source 141 is, for example, a low coherence light source having a center wavelength in the range of 820 nm to 880 nm. This makes it possible to perform both reflex measurement and OCT measurement with the same light source while reducing the burden on the subject due to the visual recognition of the measurement light.

A glass block or a density filter may be arranged in the optical path of the reference light LR between the collimator lens 151 and the reference mirrors 156 and 159. The glass block and the density filter serve as a delay means for matching the optical path length (optical distance) of the reference light LR and the measurement light LS, and the dispersion characteristics of the reference light LR and the measurement light LS, and the reference system for the corneum (161) and the retina. It also acts as a means to match the dispersion characteristics of the anterior chamber depth reference system (160).

The spectroscope 143 includes, for example, a collimator lens, a diffraction grating, an imaging lens, and a CCD. The interference light LC incident on the spectroscope 143 is converted into a parallel light beam by a collimator lens, and then separated (spectral decomposition) by a diffraction grating. The spectroscopic interference light LC is imaged on the imaging surface of the CCD by the imaging lens. The CCD receives the interference light LC, converts it into an electrical detection signal, and outputs this detection signal to the processing unit 9. The processing unit 9 generates OCT information (for example, image data) of the tomography of the eye E to be inspected based on the detection signal from the CCD. This process includes processing such as noise removal (noise reduction), filtering, and FFT, as in the conventional spectral domain type optical coherence tomography.

Further, when the interference optical system 14 has a configuration similar to that of the swept source type OCT apparatus, the spectroscope 143 is configured to include, for example, an optical turnout and a balanced photodiode (BPD). To. The interference light LC incident on the spectroscope 143 is divided by an optical turnout and converted into a pair of interference lights. The BPD has a pair of photodetectors that detect each pair of interference lights, and outputs the difference between the detection signals (detection results) by these to the processing unit 9.

In this embodiment, a Michelson type interferometer is adopted, but any type of interferometer such as a Mach-Zehnder type can be appropriately adopted.

(Awareness measurement function)
When performing subjective measurement, the processing unit 9 drives a self-luminous liquid crystal panel 41 to display a desired optotype. Further, the processing unit 9 moves the focusing lens 45 to a position according to the result of the objective measurement. Similarly, the processing unit 9 can control the VCS lens 47 so that this astigmatic state is corrected based on the astigmatic state (astigmatism power, astigmatic axis angle) of the eye E to be inspected obtained by objective measurement. It is possible. The astigmatic power can be changed by independently rotating the two cylinder lenses constituting the VCS lens 47 in opposite directions. The astigmatic axis angle can be changed by rotating the two cylinder lenses constituting the VCS lens 47 in the same direction by the same angle.

When the optotype is selected by the examiner or the processing unit 9, the processing unit 9 drives the liquid crystal panel 41 to display a desired optotype. The light from this optotype passes through the relay lens 42, the reflection mirror 43, the half mirror 44, the focusing lens 45, the relay lens 46, the VCS lens 47, the reflection mirror 48, the dichroic mirrors 49 and 52, and the objective lens 51. It is projected on the fundus Ef.

The subject responds to the optotype projected on the fundus Ef. For example, in the case of a visual acuity chart, the visual acuity value of the eye to be examined is determined by the response of the subject. For example, in the case of an astigmatism test, a dot chart is driven and displayed, and the astigmatism power of the subject's eye is determined by the response of the subject. The selection of the optotype and the response of the subject to it are repeated at the discretion of the examiner or the processing unit 9. The examiner or the processing unit 9 determines the visual acuity value or the prescription value (S, C, A) based on the response from the examinee.

Further, when the glare inspection is performed, the processing unit 9 turns on the glare light source 81. Then, the subjective measurement is performed in this state. When the contrast inspection is performed, the processing unit 9 drives the liquid crystal panel 41 to change the contrast of the target to be displayed.

In this embodiment, the configuration of the fixation and awareness measurement system 4, the configuration of the Z alignment projection system 1 and the XY alignment spot projection system 2, the configuration of the kerato system, the measurement principle of the optical power (ref), the measurement principle of the awareness measurement. Since the measurement principle of the corneal shape is known, detailed description thereof will be omitted.

(Configuration of information processing system)
The information processing system of the ophthalmic apparatus 1000 will be described. Examples of the functional configuration of the information processing system of the ophthalmic apparatus 1000 are shown in FIGS. 6 and 7. The information processing system includes a control unit 110, an arithmetic processing unit 120, a display unit 170, an operation unit 180, and a communication unit 190. The control unit 110 includes an arithmetic processing unit 120, a Z alignment projection system 1 (Z alignment light source 11), an XY alignment spot projection system 2 (XY alignment light source 21), a ring projection system 3 for kerato measurement (kerat ring light source 32), and a solid body. Visual and subjective measurement system 4, observation system 5, reflex measurement light projection system 6 (eccentric prism 67), reflex measurement light receiving system 7, glare light projection system 8 (glare light source 81), interference optical system 14, display unit 170 and communication. Control unit 190. The processing unit 9 includes, for example, a control unit 110 and an arithmetic processing unit 120.

(Control unit 110)
The control unit 110 includes a main control unit 111 and a storage unit 112. The control unit 110 includes, for example, a microprocessor, a RAM (Random Access Memory), a ROM (Read Only Memory), a hard disk drive, and the like.

(Main control unit 111)
The main control unit 111 controls the ophthalmic apparatus 1000 in various ways. In particular, the main control unit 111 controls the Z alignment light source 11, the XY alignment light source 21, the keratling light source 32, the liquid crystal panel 41, the focusing lens 45, and the VCS lens 47. The main control unit 111 includes a focusing lens 62, an eccentric prism 67, a measuring unit 73A, a glare light source 81, a light source 141, a shutter for retina and anterior chamber depth 154, a shutter for cornea 157, and a reference mirror for retina and anterior chamber depth. It controls the unit 160, the reference mirror unit 161 for the cornea, and the like. In particular, the main control unit 111 controls the rotation and insertion / removal of the eccentric prism 67. Further, the main control unit 111 moves the measurement unit 73A and the focusing lens 62 in the optical axis direction in cooperation with each other. As a result, the focusing position of the reflex measurement light receiving system 7 is changed. Further, the main control unit 111 controls the image pickup devices 58 and 57 and the spectroscope 143 to capture the signals acquired by these, and causes the arithmetic processing unit 120 to form an image and the like.

Further, the main control unit 111 performs a process of writing data to the storage unit 112 and a process of reading data from the storage unit 112.

(Storage unit 112)
The storage unit 112 stores various types of data. The data stored in the storage unit 112 includes, for example, setting information of the optical element in each mode, image data of OCT information, image data of the fundus image, eye information to be inspected, and the like. The eye test information includes information about the subject such as the patient ID and name, and information about the test eye such as left eye / right eye identification information. In addition, various programs and data for operating the ophthalmic apparatus 1000 are stored in the storage unit 112.

(Display unit 170, operation unit 180)
The display unit 170 displays information under the control of the control unit 110. The display unit 170 includes the display unit 10 shown in FIG. 1 and the like.

The operation unit 180 is used to operate the ophthalmic apparatus 1000. The operation unit 180 includes various hardware keys (joystick 800, buttons, switches, etc.) provided in the ophthalmic apparatus 1000. Further, the operation unit 180 includes various software keys (buttons, icons, menus, etc.) displayed on the touch panel type display screen 10a.

At least a part of the display unit 170 and the operation unit 180 may be integrally configured. A typical example thereof is a touch panel type display screen 10a.

(Communication unit 190)
The communication unit 190 has a function for communicating with the external device 900 shown in FIG. The communication unit 190 may be provided in, for example, the processing unit 9. The communication unit 190 has a configuration according to the form of communication with the external device 900.

(Calculation processing unit 120)
As shown in FIG. 7, the arithmetic processing unit 120 includes an eye refractive power calculation unit 121, an eyeball information calculation unit 122, a self-awareness power calculation unit 123, and a self-aware visual acuity value calculation unit 124.

The eye refractive power calculation unit 121 calculates the optical power of the eyeball optical system of the eye E to be inspected by irradiating the fundus Ef of the eye E to be inspected with light from the light source 141 and detecting the return light. For example, the eye refractive power calculation unit 121 calculates the eye refractive power by performing a predetermined arithmetic process on the images of the six light fluxes acquired by the image pickup device 77 in the reflex measurement light receiving system 7. As a specific example thereof, as described above, the eye refractive power calculation unit 121 obtains the amount of movement of the positions of the images of the six luminous fluxes projected on the image sensor 77 from the reference position, and the eye moves from the obtained amount of movement. It is possible to determine the refractive power. When the conical prism is applied, the optical power calculation unit 121 obtains the deformation or displacement of the ring pattern image acquired by the image pickup element 77 from the reference pattern, and the eye is obtained from the obtained deformation or displacement. It is possible to determine the refractive power.

The eyeball information calculation unit 122 irradiates the eye E to be inspected with light from the light source 141 and detects the return light to acquire eyeball information representing the structure of the eye E to be inspected. Eye information includes at least one of axial length, corneal thickness, anterior chamber depth, and lens thickness.

Further, the eyeball information calculation unit 122 calculates the corneal radius of curvature of the strong main corneal line and the weak main meridian line on the front surface of the cornea by performing arithmetic processing on the keratling image acquired by the image pickup element 58 in the observation system 5, for example. Then, it is possible to calculate the corneal refractive force, the degree of corneal astigmatism, and the angle of the corneal astigmatism axis from the calculated radius of curvature of the cornea.

Further, the control unit 110 causes the interference optical system 14 and the eyeball information calculation unit 162 to acquire eyeball information such as the axial length based on the signal input in response to the response from the subject in the visual acuity measurement. It is possible. The signal input in response to the response from the subject includes a signal for the control unit 110 to start eyeball information measurement (axis length measurement) based on the response input of the subject in the visual acuity measurement, and a response. It was generated based on a signal generated when the visual acuity value at the time is equal to or higher than a predetermined threshold, or an instruction for the examiner or the subject in the visual acuity measurement to start the eyeball information measurement (eye axis length measurement). There are signals and so on.

Further, when the eyeball information measurement is started, the control unit 110 causes the interference optical system 14 and the eyeball information calculation unit 162 when the visual acuity value corresponding to the target projected at the time of the response from the subject is equal to or higher than the threshold value. It is also possible to execute the acquisition of eyeball information. The threshold value includes a predetermined value, a value determined based on the past visual acuity measurement value of the eye to be inspected, and the like.

The interference optical system 14 and the eyeball information calculation unit 122 are examples of the “eyeball information measurement unit” according to this embodiment. The observation system 5, the kerato plate 31, the Z alignment projection system 1, the XY alignment spot projection system 2, and the eyeball information calculation unit 122 are examples of the “corneal shape measurement unit” according to this embodiment.

The awareness power calculation unit 123 obtains the power of IOL by a known calculation formula using the optical power of the eyeball optical system of the eye E to be inspected and the eyeball information representing the structure of the eye E to be inspected. For example, the awareness power calculation unit 123 obtains the IOL power obtained by a known calculation formula using the axial length, corneal thickness, anterior chamber depth, and lens thickness.

The subjective visual acuity value calculation unit 124 obtains the visual acuity value of the subject's eye based on the response of the subject based on the target projected on the fundus Ef of the subject.

(Operation example)
An operation example of the ophthalmic apparatus 1000 according to this embodiment will be described.

FIG. 8 shows a flow chart of an operation example of the ophthalmic apparatus 1000 according to the first embodiment.

(S1)
First, after fixing the face of the subject with the face receiving portion 500, the head portion 400 is moved to the examination position of the eye E to be inspected. The examination position is a position where the examination of the eye E to be inspected can be performed. The eye E to be inspected is placed at the examination position via the above-mentioned alignment (by the Z alignment projection system 1, the XY alignment spot projection system 2 and the observation system 5). The movement of the head unit 400 is executed by the control unit 110 in accordance with an operation or instruction by the user or an instruction by the control unit 110. That is, the head portion 400 is moved to the examination position of the eye E to be inspected, and preparations for performing objective measurement are performed.

The control unit 110 can prepare for the next kerato measurement after turning off the Z alignment light source 11 and the XY alignment light source 21, for example.

(S2)
When the alignment state of S1 becomes appropriate, the ophthalmologic apparatus 1000 shifts to the kerato measurement mode. The transition to the kerato measurement mode is performed by an instruction from the control unit 110 or a user operation or instruction to the operation unit 180.

When the mode shifts to the kerato measurement mode, the control unit 110 turns on the kerat ring light source 32. When light is output from the keratling light source 32, a ring-shaped luminous flux light for measuring the shape of the cornea is projected onto the cornea C. The eyeball information calculation unit 122 calculates the radius of curvature of the cornea by performing arithmetic processing on the image acquired by the image pickup element 58, and the corneal refractive power, the degree of corneal astigmatism, and the axis of corneal astigmatism are calculated from the calculated radius of curvature of the cornea. Calculate the angle. In the control unit 110, the calculated corneal refractive power and the like are stored in the storage unit 112.

(S3)
Next, the ophthalmic apparatus 1000 shifts to the ref measurement mode. The transition to the ref measurement mode is performed by an instruction from the control unit 110 or a user operation or instruction to the operation unit 180. In S3, the refraction measurement is performed as described above, and the eye refractive power calculation unit 121 calculates the eye refractive power. In the control unit 110, the calculated eye refractive power and the like are stored in the storage unit 112.

(S4)
Next, the ophthalmic apparatus 1000 shifts to the OCT measurement mode. The transition to the OCT measurement mode is performed by an instruction from the control unit 110 or a user operation or instruction to the operation unit 180. In S4, OCT measurement is performed as described above, and the eyeball information calculation unit 122 calculates eyeball information such as the axial length. In the control unit 110, the calculated eyeball information is stored in the storage unit 112.

(S5)
Next, the awareness power calculation unit 123 obtains the power of the IOL from the optical power of the eyeball optical system of the eye E to be inspected and the eyeball information representing the structure of the eye E to be inspected obtained in S2 to S4.

(S6)
Next, the ophthalmic apparatus 1000 shifts to the subjective measurement mode. The transition to the subjective measurement mode is performed by an instruction from the control unit 110 or a user's operation or instruction to the operation unit 180. In S6, the subjective measurement is performed as described above, and the subjective visual acuity value calculation unit 124 obtains the visual acuity value. In the control unit 110, the obtained visual acuity value is stored in the storage unit 112.

The subjective measurement in S6 may be performed at the same time as the axial length measurement in S4. In this case, in the eye to be inspected, as shown in FIG. 2, the optical axis of the optical system (fixation and awareness measurement system 4) for performing subjective measurement and the optical system (interference optical system) for measuring the optical axis length. It almost coincides with the optical axis. That is, the axial length measurement is performed in a state where the visual axis substantially coincides with these optical axes. Conventionally, it has not been possible to measure in a state where the positional relationship between the measurement optical axis and the visual axis is constant. However, according to this embodiment, it is possible to measure in a state where the positional relationship between the measurement optical axis and the visual axis is constant, so that the positional relationship between the eye to be inspected and the measurement optical system is appropriate. It becomes possible to measure the axial length. As a result, the measurement accuracy of the axial length is improved, and the IOL power can be obtained with high accuracy.

Further, in S6, a contrast inspection or a glare inspection may be performed. For example, it is assumed that the user inputs an instruction for performing a contrast test on the eye to be inspected to the operation unit 180 after the subjective measurement of the eye to be inspected is completed. Upon receiving this instruction, the control unit 110 prepares for performing the contrast inspection. Then, a contrast test of the eye to be inspected is performed. In the contrast inspection, the contrast of the optotype and the line thickness and density of the striped optotype are changed, and the degree to which the optotype can be discriminated is inspected. The control unit 110 stores the acquired contrast visual acuity value in the storage unit 112. As a result, the contrast visual acuity value after applying the IOL can be acquired, and the subject or the examiner can determine whether or not the IOL can be applied.

After the contrast test is completed, when the user inputs an instruction for performing the glare test on the eye to be inspected to the operation unit 180, the control unit 110 that receives this instruction prepares for performing the glare test. This preparation includes lighting the glare light source 81 and the like. Then, a glare test of the eye to be inspected is performed. In the glare inspection, it is inspected to what extent the optotype can be discriminated while the light from the glare light source 81 is applied to the optotype. The control unit 110 stores the acquired glare visual acuity value in the storage unit 112. As a result, the glare visual acuity value after applying the IOL can be acquired, and the subject or the examiner can determine whether or not the IOL can be applied.

This completes the operation of the ophthalmic apparatus 1000 (end).

(Action / effect)
The operation and effect of the ophthalmic apparatus 1000 according to the embodiment will be described.

The ophthalmic apparatus includes an eye refractive power measuring unit (for example, a projection system of measurement light of the interference optical system 14, a ref measurement light receiving system 7 and an eye refractive power calculation unit 121), and an eyeball information measuring unit (for example, the interference optical system 14 and Includes eyeball information calculation unit 122). The optical power measuring unit acquires the optical power of the eyeball optical system of the eye E by irradiating the eye E to be inspected with light from a light source (for example, the light source 141) and detecting the return light. The eyeball information measuring unit irradiates the eye E to be inspected with light from a light source (for example, the light source 141) and detects the return light to acquire eyeball information representing the structure of the eye E to be inspected.

According to such a configuration, since the light source for acquiring the refractive power and the light source for acquiring the eyeball information can be shared, a plurality of times are performed to determine the power of the IOL before the cataract surgery. It is possible to reduce the size of the ophthalmic device capable of measuring.

Further, a part of the optical path of light from the light source formed by the optical power measuring unit and a part of the optical path of light from the light source formed by the eyeball information measuring unit may be common.

According to such a configuration, the light source for acquiring the refractive power, the light source for acquiring the eyeball information, and a part of the optical path can be shared, so that the IOL frequency is determined before the cataract surgery. It is possible to reduce the size of an ophthalmic apparatus capable of performing a plurality of measurements.

Further, the eye refractive force measuring unit includes a projection system (for example, a projection system of the measurement light of the interference optical system 14) that projects the light from the light source onto the fundus of the eye to be inspected through the center of the pupil or the optical center of the eyeball to be examined, and the fundus of the eye. A light receiving system (for example, a ref measurement light receiving system 7) that receives light that has passed through a peripheral portion of the light reflected by the eye that has passed a predetermined distance from the center of the pupil or the optical center of the eyeball, and a projection system and a light receiving system. An eccentric member (for example, an eccentric prism 67) provided at a position substantially conjugate with the pupil of the eye to be inspected in the common optical path of the eye may be included.

According to such a configuration, in the ophthalmologic apparatus capable of multiple measurements performed to determine the IOL frequency before cataract surgery as described above, the fundus on which the measurement light for acquiring the refractive power is projected. The unevenness of the received light beam due to a disease or the like existing on the surface can be averaged, and the measurement accuracy can be improved.

Further, the light receiving system may include a wedge-shaped prism (for example, a wedge-shaped hexagonal prism 75) for detecting a light source image projected on the fundus as a plurality of point images that have passed through the peripheral portion.

According to such a configuration, the measurement light can be projected from the center of the pupil of the eye E to be inspected in the reflex measurement, so that the crystalline lens becomes opaque as compared with the case where the ring-shaped light beam is projected as the measurement light from the periphery of the pupil. It is possible to suppress the resulting scattering of measurement light and improve the measurement accuracy of the ocular refractive force.

Further, the light receiving system may include a conical prism for detecting the light source image projected on the fundus as a ring pattern passing through the peripheral portion.

Even in such a configuration, since the measurement light can be projected from the center of the pupil of the eye E to be inspected in the reflex measurement, it is caused by opacity of the crystalline lens as compared with the case where a ring-shaped light beam is projected from the periphery of the pupil as the measurement light on the fundus of the eye. It is possible to suppress the scattering of the measured light and improve the measurement accuracy of the ocular refractive force.

Further, the eyeball information measuring unit may include an interference optical system (for example, an interference optical system 14) and an eyeball information calculation unit (for example, an eyeball information calculation unit 122). The interference optical system divides the light from the light source into a reference light and a measurement light, irradiates the test eye with the measurement light, and detects the interference light between the return light and the reference light. The eyeball information calculation unit obtains eyeball information based on the detection result of the interference light by the interference optical system.

According to such a configuration, eyeball information can be obtained by an OCT method using a light source for acquiring a refractive power.

Further, the eyeball information measuring unit includes a dividing member (for example, a fiber coupler 142 and a beam splitter 153) for generating a plurality of reference lights from the light from the light source, and reflects the measured light from a plurality of positions of the eye to be inspected. Eyeball information may be acquired from the detection result of the interference light between the light and the plurality of reference lights.

With such a configuration, it becomes possible to easily acquire eyeball information regarding a plurality of positions of the eye to be inspected.

In addition, the eyeball information may include at least one of axial length, corneal thickness, anterior chamber depth, and lens thickness.

With such a configuration, it is possible to reduce the size of the ophthalmic apparatus capable of measuring the parameters required for a known calculation formula (for example, SRK formula) for determining the power of the IOL.

In addition, a power calculation unit (for example, awareness power calculation unit 123) that calculates the power of the intraocular lens based on the refractive power acquired by the eye refractive power measurement unit and the eyeball information acquired by the eyeball information measurement unit. May include.

According to such a configuration, it is possible to reduce the size of an ophthalmic apparatus capable of performing a plurality of measurements before cataract surgery and determining the IOL frequency based on these measurement results.

In addition, the ophthalmic apparatus irradiates the cornea of the eye to be inspected with a predetermined pattern of light, and based on the detection result of the return light, the corneal shape measuring unit (for example, observation system 5, kerato) acquires a parameter representing the shape of the cornea. The plate 31, the Z alignment projection system 1, the XY alignment spot projection system 2, and the eyeball information calculation unit 122) may be included.

With such a configuration, it is possible to reduce the size of an ophthalmic apparatus capable of kerato measurement as a plurality of measurements performed before cataract surgery.

In addition, the ophthalmic apparatus may include an optotype projection unit (for example, fixation and awareness measurement system 4) that projects an optotype for visual acuity measurement onto the fundus of the eye to be inspected.

With such a configuration, it is possible to reduce the size of an ophthalmic apparatus capable of subjective measurement as a plurality of measurements performed before cataract surgery.

Further, the light source may be a low coherence light source whose center wavelength is in the range of 820 nm to 880 nm.

According to such a configuration, it is possible to provide an ophthalmic apparatus capable of acquiring aberration information and eyeball information with the same light source while reducing the burden on the subject due to the visual recognition of the measurement light. become.

In addition, the ophthalmic apparatus receives light from a target projection unit (for example, fixation and awareness measurement system 4) that projects a target for visual acuity measurement on the fundus of the eye to be inspected and light from a light source (for example, light source 141). It may include an eyeball information measuring unit (for example, an interference optical system 14 and an eyeball information calculating unit 122) that acquires eyeball information representing the structure of the eye to be inspected by irradiating the eyeball with the light source and detecting the return light thereof.

With such a configuration, it is possible to reduce the size of an ophthalmic apparatus capable of performing subjective measurement and acquisition of eyeball information. Since it is possible to perform subjective measurement and acquisition of eyeball information with one ophthalmic device, for example, the eye to be inspected is maintained in a positional relationship between the eye to be inspected for which subjective measurement is being performed and the measurement optical system. It becomes possible to acquire eyeball information.

Further, the ophthalmic apparatus includes an optical path synthesizer (for example, dichroic mirrors 49 and 52) that synthesizes an optical path for projecting an optotype and an optical path for acquiring eyeball information, and the optical path synthesized by the optical path synthesizer. Through, the light for projecting the optotype and the light for acquiring the eyeball information may be guided to the eye to be inspected.

According to such a configuration, in the eye to be inspected, the optical axis of the optical system for performing subjective measurement and the optical axis of the optical system for acquiring eyeball information are coaxial with each other. Is performed in a state where is almost aligned with these optical axes. As a result, it becomes possible to acquire eyeball information in a state where the positional relationship between the eye E to be inspected and the measurement optical system thereof is appropriate. Therefore, the measurement accuracy of the eyeball information is improved, and the IOL power can be obtained with high accuracy.

In addition, the eyeball information measuring unit may acquire the eyeball information of the eye to be inspected when the visual acuity measurement using the visual acuity projected by the visual acuity projection unit is performed or immediately after the visual acuity measurement.

According to such a configuration, it is possible to acquire eyeball information while maintaining the positional relationship between the eye to be inspected for which subjective measurement is being performed and the measurement optical system.

In addition, the ophthalmic apparatus may include a control unit that causes the eyeball information measuring unit to acquire eyeball information based on a signal input in response to a response from the subject in the visual acuity measurement.

According to such a configuration, it is possible to acquire eyeball information while maintaining the positional relationship between the eye to be inspected and the measurement optical system according to the situation of subjective measurement.

Further, the control unit may cause the eyeball information measuring unit to acquire the eyeball information when the visual acuity value corresponding to the visual acuity projected at the time of the response from the subject is equal to or greater than the threshold value.

According to such a configuration, it is possible to acquire eyeball information while maintaining the positional relationship between the eye to be inspected and the measurement optical system according to the situation of subjective measurement.

Further, the ophthalmic apparatus may include a glare light projection system (for example, a glare light projection system 8) that irradiates the eye to be inspected with glare light together with the projection of the optotype by the optotype projection unit.

With such a configuration, it is possible to further reduce the size of the ophthalmic apparatus capable of performing glare examination.

Further, the optotype projection unit may be able to change the contrast of the optotype projected on the eye to be inspected.

With such a configuration, it is possible to further reduce the size of the ophthalmic apparatus capable of performing a contrast examination.

[Second Embodiment]
In the first embodiment, the case where the measurement is performed based on the image of the return light of the measurement light acquired by the reflex measurement light receiving system 7 in the reflex measurement has been described, but the configuration of the ophthalmic apparatus according to the embodiment is limited to this. It is not something that is done. In the second embodiment, the Hartmann plate and the area sensor are used in the reflex measurement. Hereinafter, the ophthalmic apparatus according to the second embodiment will be described focusing on the differences from the first embodiment.

FIG. 9 shows a configuration example of the ophthalmic apparatus according to the second embodiment. In FIG. 9, the same parts as those in FIG. 2 are designated by the same reference numerals, and the description thereof will be omitted as appropriate.

The configuration of the ophthalmic apparatus 1000a according to the second embodiment is different from the configuration of the ophthalmic apparatus 1000 according to the first embodiment shown in FIG. 2 in that a wave surface measurement optical system 7a is provided instead of the reflex measurement light receiving system 7. Is. The wave surface measurement optical system 7a includes an area sensor 76a, a Hartmann plate 75a, an imaging lens 74a, an aperture 73a, a relay lens 72, a pupil lens 71, a beam splitter 66a, a dichroic mirror 49 and 52, and an objective lens 51. There is. The diaphragm 73a, the imaging lens 74a, the Hartmann plate 75a, and the area sensor 76a are mounted on the measurement unit 73B configured to be movable in the optical axis direction. At the time of measuring the refractive power, the focusing lens 62 and the measuring unit 73B are moved in the optical axis direction in cooperation with each other.

The Hartmann plate 75a is an optical element provided in the optical path of the return light from the eye E to be inspected and divides the light flux from the imaging lens 74a into a plurality of light fluxes. The Hartmann plate 75a is a diaphragm in which a plurality of pinholes are formed in a predetermined arrangement on a plate having a light-shielding property. When a parallel luminous flux of the measurement light is incident on the Hartmann plate 75a, an image of the return light corresponding to the arrangement state of the plurality of pinholes is formed on the area sensor 76a. A plurality of image pickup elements are arranged on the reflection surface of the area sensor 76a, and the detection result of the image of the return light by each image pickup element is sent to the processing unit 9.

The return light from the eye E to be inspected is collected by the objective lens 51, passes through the dichroic mirrors 52 and 49, and is partially reflected by the beam splitter 66a. The return light reflected by the beam splitter 66a passes through the pupil lens 71, the relay lens 72, the diaphragm 73, and the imaging lens 74a, and is divided into a plurality of luminous fluxes by the Hartmann plate 75a, and the area sensor 76a is divided into a plurality of luminous fluxes in a predetermined area unit. Detect the image of the return light.

10 and 11 show a functional configuration example of the information processing system according to the second embodiment. In FIG. 10, the same parts as those in FIG. 6 are designated by the same reference numerals, and the description thereof will be omitted as appropriate. In FIG. 11, the same parts as those in FIG. 7 are designated by the same reference numerals, and the description thereof will be omitted as appropriate.

In this embodiment, the arithmetic processing unit 120a is provided in place of the arithmetic processing unit 120 of FIG. The arithmetic processing unit 120a (processing unit 9) acquires the detection result of the image of the return light by the area sensor 76a. Further, the main control unit 111 moves the measurement unit 73B and the focusing lens 62 in the optical axis direction in cooperation with each other. As a result, the focusing position of the wave surface measurement optical system 7a is changed. Further, the main control unit 111 controls the image sensor 58, the area sensor 76a, and the spectroscope 143 to capture the signals acquired by these, and causes the arithmetic processing unit 120a to form an image or the like.

The arithmetic processing unit 120a includes an aberration calculation unit 121a, an eyeball information calculation unit 122, an awareness power calculation unit 123, and a subjective visual acuity value calculation unit 124.

The aberration calculation unit 121a calculates the aberration information of the eyeball optical system of the eye E to be inspected based on the form of the image of the return light acquired by the area sensor 76a. For example, the storage unit 112 stores in advance data corresponding to the reference form corresponding to the Hartmann plate 75a. The aberration calculation unit 121a acquires the data of the image of the return light acquired by the area sensor 76a from the area sensor 76a. The aberration calculation unit 121a compares the form of the return light image with the reference form based on the data of the return light image and the data corresponding to the reference form stored in advance in the storage unit 112 to examine the eye. Aberration information for making E the same state as optometry is calculated. As a result, the wave surface measurement optical system 7a and the aberration calculation unit 121a can acquire the aberration information of the eyeball optical system of the eye E to be inspected. The wave surface measurement optical system 7a and the aberration calculation unit 121a are examples of the “aberration measurement unit” according to this embodiment. The "aberration measuring unit" may be configured to further include a projection system of the measurement light of the interference optical system 14.

(Action / effect)
The operation and effect of the ophthalmic apparatus 1000a according to the embodiment will be described.

In the ophthalmic apparatus, the aberration measuring unit (for example, wave surface measurement optical system 7a and aberration calculation unit 121a) includes a Hartmann plate (for example, Hartmann plate 75a), an area sensor (for example, area sensor 76a), and an aberration calculation unit (for example,). , Aberration calculation unit 121a). The Hartmann plate is provided in the optical path of the return light from the eye to be inspected. The area sensor detects the return light that has passed through the Hartmann plate. The aberration calculation unit calculates the aberration information by comparing the form of the image of the return light acquired by the area sensor with the reference form based on the Hartmann plate.

With such a configuration, it is possible to obtain even higher-order aberrations from the aberration information of the eyeball optical system of the eye E to be inspected.

(Other variants)
The embodiments shown above are merely examples for carrying out the present invention. A person who intends to carry out the present invention can make arbitrary modifications, omissions, additions, etc. within the scope of the gist of the present invention.

In the above embodiment, an example in which the eyeball information calculation unit mainly calculates the axial length has been described, but the eyeball calculation unit according to the embodiment is not limited to this, and the corneal thickness, the anterior chamber depth, and the like. The crystalline lens thickness can be calculated in the same manner.

The present invention is not limited to the optical elements described in the above embodiment and their arrangement. For example, a beam splitter may be provided instead of the half mirror in the above embodiment.

The above-described embodiment for an apparatus having an arbitrary function that can be used in the field of ophthalmology, such as an intraocular pressure measurement function, a fundus photography function, an anterior ocular segment imaging function, an optical coherence tomography (OCT) function, and an ultrasonic examination function. It is possible to apply the invention according to. The intraocular pressure measurement function is realized by a tonometer or the like, the fundus photography function is realized by a fundus camera or a scanning ophthalmoscope (SLO) or the like, the anterior ocular segment imaging function is realized by a slit lamp or the like, and the OCT function is optical. It is realized by an interference tomometer or the like, and the ultrasonic inspection function is realized by an ultrasonic diagnostic apparatus or the like. It is also possible to apply the present invention to a device (multifunction device) having two or more of such functions.

Further, in a system to which the first embodiment and the second embodiment can be applied, it is possible to selectively apply the desired embodiment of the two embodiments by switching the operation mode.

1 Z alignment projection system 2 XY alignment spot projection system 3 kerato measurement ring projection system 4 fixation and awareness measurement system 5 observation system 6 reflex measurement optical projection system 7 reflex measurement light receiving system 7a wave surface measurement optical system 8 glare optical projection system 9 Processing unit 10, 170 Display unit 14 Interference optical system 51 Objective lens 67 Eccentric prism 110 Control unit 111 Main control unit 112 Storage unit 120, 120a Arithmetic processing unit 121 Eye refractive force calculation unit 121a Abrasion calculation unit 122 Eyeball information calculation unit 123 Awareness Frequency calculation unit 124 Perceived visual value calculation unit 141 Light source 142 Fiber coupler 143 Spectrometer 180 Operation unit 190 Communication unit 200 Base 300 Stand 500 Face support unit 600 Jaw support 700 Forehead pad 800 Joystick 900 External device 1000, 1000a Ophthalmic device C Corneal E Eye to be inspected Ef Fundus L0 Low coherent light LC Interference light LR Reference light LS Measurement light

Claims (12)

The light from the light source is divided into reference light and measurement light, and the reference light is guided to a first mirror unit and a second mirror unit that can be set to different reference light path lengths by using a dividing member, and the measurement light is covered. By irradiating the eye examination and moving the second mirror unit in the optical axis direction, the first interference light between the return light from the eye to be inspected and the reference light passing through the first mirror unit, and the return light and the said An interference optical system that simultaneously detects the second interference light with the reference light that has passed through the second mirror unit,
An eyeball information calculation unit that obtains eyeball information representing the structure of the eye to be inspected from the detection results of the first interference light and the second interference light.
Only including,
The interference optical system is
A first shutter that can be inserted and removed from the first optical path between the dividing member and the first mirror unit,
A second shutter that can be inserted and removed from the second optical path between the dividing member and the second mirror unit, and
Including
Detection result of interference light obtained by irradiating the eye to be inspected with the measurement light in a state where the first shutter is inserted into the first optical path and the second shutter is retracted from the second optical path. After moving the second mirror unit in the optical axis direction based on the above, the first shutter is retracted from the first optical path and the measurement light is irradiated to the eye to be inspected to obtain the first interference light and the first interference light. An ophthalmic device that simultaneously detects two interference lights . The first aspect of the present invention includes an eye refractive power measuring unit that acquires the refractive power of the eyeball optical system of the eye to be inspected by irradiating the eye to be inspected with light from the light source and detecting the return light thereof. The described ophthalmic device. The second aspect of the present invention is characterized in that a part of the optical path of light from the light source formed by the eye refractive force measuring unit and a part of the optical path of light from the light source in the interference optical system are common. The described ophthalmic device. The ocular refractive power measuring unit
A projection system that projects light from the light source onto the fundus of the eye to be inspected through the center of the pupil or the optical center of the eyeball.
A light receiving system that receives light that has passed through a peripheral portion of the light reflected by the fundus of the eye, which is separated from the center of the pupil or the optical center of the eyeball by a predetermined distance.
The ophthalmologic apparatus according to claim 2 or 3, wherein an eccentric member provided at a position substantially conjugate with the pupil of the eye to be inspected is included in a common optical path between the projection system and the light receiving system. The ophthalmic apparatus according to claim 4, wherein the light receiving system includes a wedge-shaped prism for detecting a light source image projected on the fundus as a plurality of point images that have passed through the peripheral portion. The ophthalmic apparatus according to claim 4, wherein the light receiving system includes a conical prism for detecting a light source image projected on the fundus as a ring pattern passing through the peripheral portion. The ophthalmic apparatus according to any one of claims 2 to 6, further comprising an optotype projection unit that projects an optotype for visual acuity measurement onto the fundus of the eye to be inspected. The ophthalmic apparatus according to claim 7, wherein the eye refractive power measuring unit acquires the refractive power of the eyeball optical system of the eye to be inspected to which the target is projected by the target projection unit. It is characterized by including a power calculation unit that calculates the power of the intraocular lens based on the refractive power acquired by the eye refractive power measuring unit and the eyeball information calculated by the eyeball information calculation unit. The ophthalmic apparatus according to any one of claims 2 to 8. Any one of claims 1 to 9, wherein the eyeball information calculation unit calculates at least one of the axial length, corneal thickness, anterior chamber depth, and crystalline lens thickness as the eyeball information. The ophthalmic apparatus described in. Claims 1 to claim that include a corneal shape measuring unit that irradiates the cornea of the eye to be inspected with a predetermined pattern light and acquires a parameter representing the shape of the cornea based on the detection result of the return light. Item 3. The ophthalmic apparatus according to any one of Item 10. The ophthalmic apparatus according to any one of claims 1 to 11, wherein the light source is a low coherence light source having a center wavelength in the range of 820 nm to 880 nm.

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