JP2019208751A - Ophthalmologic apparatus - Google Patents

Abstract

To provide an ophthalmologic apparatus capable of fogging a subject eye without changing the position of a lens.SOLUTION: The ophthalmologic apparatus comprises a light-projecting optical system, a light-receiving optical system, an eye refractivity measurement unit, a target presentation unit, and a presentation processing unit. The light-projecting optical system is configured to project measurement light toward the eyeground of a subject eye. The light-receiving optical system includes a light-receiving element configured to receive reflection light from the eyeground projected with the measurement light. The eye refractivity measurement unit is configured to measure the eye refractivity of the subject eye on the basis of a signal output from the light-receiving element. The target presentation unit is configured to output an image which is presented to the subject eye. The presentation processing unit causes the target presentation unit to present an image in which the target is blurred to fog the subject eye.SELECTED DRAWING: Figure 9

Description

  The present disclosure relates to an ophthalmologic apparatus for measuring eye refractive power of a subject eye.

  Patent Document 1 discloses an ophthalmologic apparatus that measures the eye refractive power of an eye to be examined. In this type of measuring apparatus, in a subject who has accommodation tension in the eye, a cloud is applied to the eye to be examined in order to remove the accommodation tension. In the measuring apparatus of Patent Document 1, the fixation target is placed at a fixed position, and the position of the lens is changed, whereby a cloud is applied to the eye to be examined.

Japanese Patent No. 3466027

In the method of Patent Document 1 described above, it is necessary to change the position of the lens in order to apply a cloud to the eye to be examined.
One aspect of the present disclosure aims to provide an ophthalmologic apparatus capable of applying fog to an eye to be examined without changing the position of a lens.

  One aspect of the present disclosure is an ophthalmologic apparatus, which includes a light projecting optical system, a light receiving optical system, an eye refractive power measurement unit, a visual target presenting unit, and a presentation processing unit. The light projecting optical system is configured to project measurement light toward the fundus of the subject's eye. The light receiving optical system includes a light receiving element configured to receive reflected light from the fundus corresponding to the measurement light. The eye refractive power measurement unit is configured to measure the eye refractive power of the eye to be examined based on a signal output from the light receiving element. The optotype presenting unit is configured to output an image and present the image to the eye to be examined. The presentation processing unit causes the visual target presenting unit to present an image in which the visual target is blurred in order to apply cloud fog to the eye to be examined.

  According to such a configuration, cloud can be applied to the eye to be examined by outputting an image to the optotype presenting unit. Therefore, clouding can be applied to the eye to be examined without changing the position of the lens.

  In one aspect of the present disclosure, the optotype presenting unit may be capable of presenting an image to each of both eyes of the subject. The presentation processing unit causes the target presentation unit to present an image indicating the same target for each of both eyes, and a left target that is a target presented to the left eye of the subject; The visual target presenting unit may present an image in which the right visual target, which is a visual target presented to the right eye, which is the subject's eye, moves so as to be separated from each other in the eye width direction of the subject.

  According to such a configuration, it is possible to create a state in which the subject is looking at a far point by gazing at the left target and the right target that are separated from each other in the eye width direction. As a result, eye refractive power can be measured in a state where instrumental myopia is removed.

  In one aspect of the present disclosure, the presentation processing unit moves so as to be separated from each other in the eye width direction in a state where the left target and the right target are blurred in order to cloud the left eye and the right eye. The image may be presented on the optotype presenting unit.

According to such a configuration, by outputting an image to the optotype presenting unit, it is possible to remove the adjustment tension of the eye to be examined and to remove instrument myopia.
In one aspect of the present disclosure, the optotype presenting unit may be a display capable of displaying an image.

According to such a configuration, an image showing a visual target can be presented to the eye to be examined with a relatively simple configuration.
In one aspect of the present disclosure, the optotype presenting unit may include a laser light source and a MEMS mirror. The laser light source is configured to emit laser light. The MEMS mirror is configured to scan a region on the fundus by reflecting the laser light emitted from the laser light source.

  According to such a configuration, an image can be drawn directly on the fundus (retina) of the subject. Therefore, a focused target can be presented to the subject's eye regardless of the abnormality of the subject's eye refractive power.

Fig.1 (a) is an external view of the measuring apparatus which concerns on embodiment, FIG.1 (b) is a figure which shows the use condition of the measuring apparatus which concerns on embodiment. It is the block diagram which looked at the optical system of the ophthalmologic apparatus which concerns on embodiment from upper direction. It is the block diagram which looked at the optical system of the ophthalmologic apparatus which concerns on embodiment from the front-back direction. It is the block diagram which looked at the optical system of the ophthalmologic apparatus which concerns on embodiment from the eye width direction. It is a block diagram of a control device concerning an embodiment. It is a figure which shows the imaging range of a pupil observation camera. It is a flowchart of an inspection process. It is a figure which shows pupil diameter DL and DR of both eyes. It is a figure (1) which shows the optotype shown to the eye to be examined by the optotype presenting part. It is a figure (2) which shows the optotype shown by the eye to be examined by the optotype presenting part. It is a figure explaining the timing which performs pupil diameter measurement, eye refractive power measurement, alignment adjustment, and cloud fog. It is a figure which shows the other example of a optotype presenting part. It is FIG. (1) which shows the other example of the structure for switching the optical path of a right-and-left eye. FIG. 14A is a diagram (2) illustrating another example of the configuration for switching the optical paths of the left and right eyes, and FIG. 14B is a diagram illustrating a triangular prism used in the configuration of FIG. It is.

Hereinafter, embodiments for carrying out the present disclosure will be described with reference to the drawings.
[1. Constitution]
The ophthalmologic apparatus according to the present embodiment is an apparatus that measures eye refractive power as an eye characteristic of an eye to be examined. Specifically, the ophthalmologic apparatus is an apparatus that measures the eye refractive power of a child. The ophthalmologic apparatus includes a measuring device 1 shown in FIGS. 1A and 1B and a control device 2 shown in FIG.

[1-1. measuring device]
1 (a) and 1 (b) includes an eyepiece 10, an eye refractive optical system (21-28, 31-35), and an observation optical system (shown in FIGS. 2 to 5). 28, 41-45), target presentation unit 50, alignment detection optical system (28, 42-45, 61-62), alignment drive mechanism (71-75), tilt mechanism 80, transmissive display 91, and sound output unit 92.

In the following, the axis parallel to the left-right direction (the eye width direction of the eye EL and ER shown in FIGS. 2 and 6) with respect to the subject is orthogonal to the X-axis and the X-axis, and FIG. 4 and 6, the axis parallel to the vertical direction is perpendicular to the Y-axis, X-axis, and Y-axis, and the axis parallel to the front-rear direction consisting of the front direction approaching the subject and the rear direction moving away from the subject is Z Axis. In other words, the Z axis is an axis parallel to the direction along the eyeball optical axis of the eye to be examined, and the X axis and the Y axis are directions orthogonal to the eyeball optical axis. The orthogonal coordinate system defined by the XYZ axes is a relative coordinate system determined by the attitude of the measuring apparatus 1.
<Eyepiece>
The eyepiece 10 shown in FIGS. 1 (a) and 1 (b) is in contact with the skin around both eyes of the subject, and the subject's eyes EL and ER (FIG. 1 (b), FIG. 2 and FIG. 4) for fixing the position. In the present embodiment, the measuring apparatus 1 does not include a chin rest that supports the subject's chin, and an eyepiece 10 is provided instead of the chin rest. The eyepiece unit 10 is in contact with the skin of the subject at least at three locations under the subject's forehead, under the left eye EL, and under the right eye ER. The skin under the left eye EL and the right eye ER here refers to the skin covering the maxilla or cheekbone under the left eye EL and the right eye ER when the face of the subject is viewed from the front.

  The eyepiece unit 10 used in the present embodiment includes a light shielding unit 11. The light shielding part 11 is a cylindrical part protruding in an oblique direction at the upper part of the housing 2 forming the outer shape of the measuring apparatus 1. The light shielding unit 11 shields light that enters the measuring apparatus 1 from the outside of the measuring apparatus 1. Specifically, the light shielding unit 11 shields light that enters the measuring apparatus 1 from the entire circumference around the Z axis. In particular, the light shielding unit 11 shields light incident from below and above the eyepiece unit 10.

The subject brings his face into contact with the end of the light shielding part 11 on the protruding direction (forward direction) side and looks into the inside of the measuring apparatus 1 with both eyes through the inside of the light shielding part 11.
<Ocular refractive optical system>
The eye refractive optical system includes a light projecting optical system 20 and a light receiving optical system 30 shown in FIG.

  2 to 4, the light projecting optical system 20 includes a measurement light source 21, a condensing lens 22, a perforated mirror 23, a rotating parallel plate 24, a left / right switching mirror 25, total reflection mirrors 26L and 26R, an objective lens. 27L, 27R and a hot mirror 28 are provided.

  The light receiving optical system 30 shares the hot mirror 28, objective lenses 27L and 27R, total reflection mirrors 26L and 26R, left and right switching mirror 25, rotating parallel plate 24 and perforated mirror 23 of the light projecting optical system 20. The light receiving optical system 30 includes a condensing lens 31, a total reflection mirror 32, a condensing lens 33, a ring lens 34, and an eye refractive power measurement camera 35.

The measurement light source 21 used in this embodiment is a super luminescent diode (SLD) with high coherence, and for example, an SLD that emits infrared light having a wavelength of 880 nm is used.
The rotating parallel plate 24 is disposed at a conjugate position with the pupils of the eye EL and ER to be examined on the shared optical path of the light projecting optical system 20 and the light receiving optical system 30. The rotating parallel plate 24 is rotated around the optical axis of the shared optical path by a driving device (not shown). Thereby, since the measurement light beam on the eye to be examined EL and ER is rotated, it becomes possible to perform measurement while avoiding a turbid site due to cataract or the like. In addition, speckle noise generated by using the measurement light source 21 having high coherence can be suppressed.

  The left / right switching mirror 25 is provided at a substantially central portion between the total reflection mirrors 26L and 26R. The left / right switching mirror 25 rotates the optical path of the measurement light, which is a part of the light emitted from the measurement light source 21, by switching 90 degrees between the left eye optical path and the right eye optical path. The left eye optical path here is an optical path incident on the left eye EL of the subject, and the right eye optical path is an optical path incident on the right eye ER of the subject.

  For example, the hot mirror 28 reflects a light beam having a wavelength of 850 nm or more including an eye refraction measurement light source wavelength and transmits a light beam having a wavelength of less than 850 nm. That is, infrared light from pupil illumination light sources 41L and 41R, which will be described later, visible light from the target presentation unit 50, and infrared light from the bright spot creation light sources 61L and 61R are transmitted, and infrared light from the measurement light source 21 is reflected. .

  The measurement light emitted from the measurement light source 21 is reflected by the left / right switching mirror 25 through the condenser lens 22 through the hole in the center of the perforated mirror 23 and the rotating parallel plate 24. The reflected measurement light is reflected by the total reflection mirror 26L or 26R, passes through the objective lens 27L or 27R, is reflected by the hot mirror 28, and is irradiated on the fundus of the eye EL or ER to be examined.

Reflected light from the fundus of the eye EL or ER corresponding to the measurement light is reflected by the hot mirror 28, passes through the objective lens 27L or 27R, is reflected by the total reflection mirror 26L or 26R, and is reflected by the left / right switching mirror 25. . Then, the reflected light passes through the rotating parallel plate 24, is reflected by the ring-shaped mirror of the perforated mirror 23, passes through the condenser lens 31, is reflected by the total reflection mirror 32, and passes through the condenser lens 33 and the ring lens 34. Pass through and guided to the eye refractive power measurement camera 35. The eye refractive power measurement camera 35 includes a light receiving element 35a configured to receive reflected light. When receiving the reflected light, the light receiving element 35a outputs a signal corresponding to the received light quantity distribution to the control device 2 shown in FIG.
<Observation optics>
The observation optical system includes pupil illumination light sources 41L and 41R shown in FIG. 2, hot mirrors 28 and 42, condenser lenses 43 and 44, and a pupil observation camera 45 shown in FIGS.

The pupil irradiation light sources 41L and 41R irradiate, for example, infrared light having a wavelength of 780 nm to the eyes EL and ER, respectively.
For example, the hot mirror 42 reflects a light beam having a wavelength of 850 nm or more including an eye refraction measurement light source wavelength and transmits a light beam having a wavelength of less than 850 nm. That is, the infrared light from the pupil irradiation light sources 41L and 41R and the visible light from the target presentation unit 50 described later are transmitted, and the infrared light from the bright spot creation light sources 61L and 61R described later is reflected.

  A light beam emitted from the pupil illumination light sources 41L and 41R and reflected by the anterior eye portion of the eye to be examined EL and ER is transmitted through a transmissive display 91 and hot mirrors 28 and 42, which will be described later, via the condenser lenses 43 and 44. Then, the light is guided onto the image sensor 45a of the pupil observation camera 45.

The pupil observation camera 45 images (monitors) a range including both eyes EL and ER of the subject. In the present embodiment, the pupil observation camera 45 images a rectangular range having a width of 100 mm in the X-axis direction and a width of 25 mm in the Y-axis direction as indicated by a broken line in FIG. 6 as an imaging range.
<Target presentation part>
The optotype presenting unit 50 is disposed at a position that is a fixed distance away from the eye to be examined EL and ER and that faces the eye to be examined EL and ER. The optotype presenting unit 50 presents the optotype to the test eyes EL and ER by irradiating the test eyes EL and ER with visible light. The optotype presenting unit 50 used in the present embodiment is a display that can display an image, and is specifically a smartphone. The optotype presenting unit 50 is a left display region 50L, which is a region where an image presented to the subject's left eye EL is displayed, and a region where an image presented to the subject's right eye ER is displayed. A right display area 50R, and an image showing a visual target is displayed in each of the display areas 50L and 50R.
<Alignment detection optical system>
The alignment detection optical system includes light source 61L and 61R for creating bright spots and collimating lenses 62L and 62R. The alignment detection optical system shares the hot mirror 28 of the light projecting optical system 20 and the light receiving optical system 30, the hot mirror 42 of the observation optical system, the condensing lenses 43 and 44, and the pupil observation camera 45.

The bright spot creating light sources 61L and 61R irradiate light fluxes toward the corneal apexes of the eye to be examined EL and ER, respectively. The luminous fluxes emitted from the bright spot creating light sources 61L and 61R pass through the collimating lenses 62L and 62R, are reflected by the hot mirror 42, enter the eye EL and ER, respectively, and reach the apex of the cornea of the eye EL and ER to be examined. Create bright spots.
<Alignment drive mechanism>
The alignment drive mechanism includes an X-axis drive device 71 shown in FIG. 2, Y-axis drive devices 72L and 72R shown in FIG. 4, Z-axis drive devices 73 and 74 shown in FIG. 2, and a left-right switching drive device 75 shown in FIG. . In FIG. 4, the Y-axis drive device 72L is located in the back of the Y-axis drive device 72R and has a blind spot. The X-axis drive device 71, the Y-axis drive devices 72L and 72R, the Z-axis drive devices 73 and 74, and the left / right switching drive device 75 used in this embodiment are all stepping motors.

  The X-axis drive device 71 shown in FIG. 2 is controlled by the control unit 95 of the control device 2 so that some of the optical components of the light projecting optical system 20 and the light receiving optical system 30 are moved in the eye width direction (X-axis direction). Move to. Specifically, the X-axis drive device 71 moves the total reflection mirrors 26L and 26R and the objective lenses 27L and 27R in the X-axis direction. Thereby, the total reflection mirrors 26L and 26R and the objective lenses 27L and 27R are arranged at positions corresponding to the distance between the left eye EL and the right eye ER.

  The Y-axis drive devices 72L and 72R shown in FIG. 4 are controlled by the control unit 95, so that the total reflection mirrors 26L and 26R, which are some optical components of the light projecting optical system 20 and the light receiving optical system 30, and the objective lens. 27L and 27R are moved in the front-rear direction (Z-axis direction). When the total reflection mirrors 26L and 26R and the objective lenses 27L and 27R move in the Z-axis direction, the incident position of the measurement light reflected by the total reflection mirrors 26L and 26R on the hot mirror 28 is shifted in the Z-axis direction. Since the hot mirror 28 is inclined, the incident position is shifted downward as the incident position on the hot mirror 28 is shifted in the forward direction approaching the subject. In addition, the incident position shifts upward as the incident position shifts backward from the subject. Thereby, the position (height) in the Y-axis direction of the measurement light incident on the eye to be examined EL and ER is adjusted.

  The Z-axis drive devices 73 and 74 shown in FIG. 2 are controlled by the control unit 95 to move some optical components of the light projecting optical system 20 and the light receiving optical system 30 in the front-rear direction (Z-axis direction). . Specifically, the Z-axis driving device 73 includes the measurement light source 21, the condensing lens 22, the perforated mirror 23, the rotating parallel plate 24, the condensing lens 31, the total reflection mirror 32, the condensing lens 33, the ring lens 34, and the like. The optical components of the eye refractive power measurement camera 35 are simultaneously moved in the Z-axis direction. The Z-axis drive device 74 simultaneously moves the optical components of the measurement light source 21, the condensing lens 33, the ring lens 34, and the eye refractive power measurement camera 35 in the Z-axis direction. As a result, the optical path length from the measurement light source 21 to the eye to be examined EL and ER and from the eye to be examined EL and ER to the eye refractive power measurement camera 35 is corrected.

The left / right switching drive device 75 shown in FIG. 3 is controlled by the control unit 95 to rotate the left / right switching mirror 25 around the Y axis. As a result, the optical path of the measurement light is switched between the left eye optical path and the right eye optical path.
<Tilt mechanism>
A tilt mechanism 80 shown in FIG. 4 is a mechanism for adjusting the tilt angle of the measuring apparatus 1 in the YZ plane. The tilt mechanism 80 has the axis parallel to the X-axis direction as a turning axis, and the measuring apparatus 1 (and thus the eye refractive optical systems (21 to 28, 31 to 35), the observation optical system (28) with respect to the eye EL and ER to be examined. , 41-45), the target presentation unit 50, the alignment detection optical system (28, 42-45, 61-62), the alignment drive mechanism (71-75), the transmissive display 91, etc.) are rotated in the YZ plane. . Thereby, the height of the measuring apparatus 1 is adjusted to the height suitable for the sitting height of the child who is the subject.
<Transparent display>
The transmissive display 91 is a well-known liquid crystal display whose back can be seen through, and is disposed in front of the eyes EL and ER to be examined. More specifically, the transmissive display 91 is between the optotype presenting unit 50 and the subject's eyes EL and ER, that is, in the middle of the optical path from the light emitted from the optotype presenting unit 50 to the subject's eyes EL and ER. Placed in. That is, the subject can visually recognize an image indicating the target displayed on the target presenting unit 50 via the transmissive display 91.
<Sound output part>
The sound output unit 92 shown in FIG. 5 is configured to output sound by being controlled by the control unit 95.

[1-2. Control device]
The control device 2 illustrated in FIG. 5 includes a monitor 93, operation buttons 94, and a control unit 95.
<Monitor>
The monitor 93 is configured to display an image under the control of the control unit 95. <Operation buttons>
The operation button 94 is a button operated by the examiner. The operation button 94 includes a left / right switching button for switching the optical path of the measurement light between the left eye optical path and the right eye optical path, a measurement start button for starting an inspection process shown in FIG. 7 described later, and an inspection process. A measurement end button for ending the measurement.
<Control unit>
The control unit 95 is connected to the optotype presenting unit 50, the alignment drive mechanism (71 to 75), the transmissive display 91, the sound output unit 92, the monitor 93, and the operation buttons 94. The control unit 95 is configured around a known microcomputer having a CPU 951 and a semiconductor memory (hereinafter referred to as a memory 952) such as a RAM, a ROM, and a flash memory. Various functions of the control unit 95 are realized by the CPU 951 executing a program stored in a non-transitional physical storage medium. In this example, the memory 952 corresponds to a non-transitional tangible storage medium that stores a program. Further, by executing this program, a method corresponding to the program is executed.

  The anterior segment image captured by the pupil observation camera 45 is input to the control unit 95, and the control unit 95 displays the input anterior segment image on the monitor 93. Then, an electrical signal of the corneal reflection light detected by the pupil observation camera 45 is input to the control unit 95, and the control unit 95 controls the alignment driving mechanism (71 to 75) based on the input electrical signal. Thus, the optical system of the measuring apparatus 1 is aligned with the eye to be examined EL and ER.

  The control unit 95 receives a ring image captured by the eye refractive power measurement camera 35. The control unit 95 calculates a refraction value from the ring image, displays the refraction value on the monitor 93, and also stores the memory 952. To enter. Further, the control unit 95 displays an image indicating the target on the target display unit 50. Further, the control unit 95 displays a moving image on the transmissive display 91 and changes the transparency of the transmissive display 91. Further, the control unit 95 causes the sound output unit 92 to output sound.

[2. processing]
Next, the inspection process executed by the control unit 95 will be described with reference to the flowchart of FIG. The inspection process is started when the inspector operates the measurement start button.

  In S <b> 101, the control unit 95 displays a moving image on the transmissive display 91 and causes the sound output unit 92 to output sound. Here, in order to attract the child who is the subject, the control unit 95 displays a moving image such as an animation on the transmissive display 91 and causes the sound output unit 92 to output a sound that matches the moving image.

  In step S <b> 102, the control unit 95 determines whether the subject has contacted the face with the eyepiece unit 10. In S <b> 102, when the eye to be examined EL and ER are detected by the pupil observation camera 45, the control unit 95 determines that the subject has contacted the face with the eyepiece unit 10.

In S103, the control unit 95 (1) start of automatic alignment adjustment, (2) start of continuous measurement of pupil diameter, (3) start of continuous measurement of eye refractive power, (4) complete transmission of the transmissive display 91 And (5) display of a moving image by the visual target presenting unit 50. Hereinafter, it demonstrates in order.

(1) Start of automatic alignment adjustment The control part 95 performs alignment adjustment of XY plane as follows. That is, first, when the subject's eyes EL and ER approach the measurement position, a reflected image (hereinafter referred to as “bright spot”) of the irradiation light of the bright spot creating light sources 61L and 61R is centered on the subject's eyes EL and ER. It is detected by the observation camera 45.

  Hereinafter, the difference between the coordinate of the bright point of the left eye EL in the X-axis direction and the reference position of the left eye in the prescribed Y-axis direction is defined as dXL. Also, the difference between the Y-axis coordinate of the bright spot of the left eye EL and the reference position of the left eye in the prescribed Y-axis direction is defined as dYL.

  Similarly, the difference between the coordinate in the X axis direction of the bright spot of the right eye ER and the reference position of the right eye in the prescribed X axis direction is defined as dXR. The difference between the Y-axis coordinate of the bright spot of the right eye ER and the reference position of the right eye in the specified Y-axis direction is defined as dYR.

  When measuring the left eye EL, the control unit 95 first rotates the left / right switching mirror 25 so that the measurement light from the measurement light source 21 enters the left eye EL. Then, the control unit 95 gives a command for moving the total reflection mirror 26L and the objective lens 27L by dXL in the X-axis direction to the X-axis drive device 71. Further, the control unit 95 moves the total reflection mirror 26L and the objective lens 27L with respect to the Y-axis driving device 72L so that the position in the Y-axis direction of the measurement light incident on the subject's eyes EL and ER changes by dYL. Give instructions.

  On the other hand, when measuring the right eye ER, the controller 95 first rotates the left / right switching mirror 25 so that the measurement light from the measurement light source 21 enters the right eye ER. Then, the control unit 95 gives a command for moving the total reflection mirror 26R and the objective lens 27R by dxR in the X-axis direction to the X-axis drive device 71. Further, the control unit 95 moves the total reflection mirror 26R and the objective lens 27R with respect to the Y-axis drive device 72R so that the position in the Y-axis direction of the measurement light incident on the subject's eyes EL and ER changes by dYR. Give instructions. Thus, automatic alignment adjustment of the XY plane is performed.

(2) Start of Continuous Measurement of Pupil Diameter The control unit 95 continuously images the imaging range shown in FIG. 6 with the pupil observation camera 45, and continuously measures the pupil diameters of both eyes EL and ER. Thereby, the pupil diameter DL of the left eye EL and the pupil diameter DR of the right eye ER shown in FIG. 8 are continuously measured.

(3) Start of continuous measurement of eye refractive power The control unit 95 turns on the measurement light source 21 and rotates the rotating parallel plate 24. Infrared light emitted from the measurement light source 21 passes through a condenser lens 22, a perforated mirror 23, a rotating parallel plate 24, a left / right switching mirror 25, total reflection mirrors 26 </ b> L and 26 </ b> R, objective lenses 27 </ b> L and 27 </ b> R, and a hot mirror 28. Thus, a spot-like point light source image is formed on the fundus of the eye to be examined EL and ER. At this time, the measurement light beam is incident at a predetermined distance from the center of the pupil of the eye to be examined EL and ER by the rotating parallel plate 24 that is disposed at an inclination and rotates around the optical axis, and the light beam on the pupil is rotated. .

  The point light source image projected on the fundus is reflected and the hot mirror 28, objective lenses 27L and 27R, total reflection mirrors 26L and 26R, left and right switching mirror 25, rotating parallel plate 24, perforated mirror 23, condenser lens 31, It passes through the total reflection mirror 32 and the condenser lens 33. The point light source image is formed in a ring shape on the image sensor 35 a of the eye refractive power measurement camera 35 by the ring lens 34.

  The control unit 95 obtains the eye refractive power from the ring image input by the image sensor 35a. Specifically, the control unit 95 detects the ring image coordinates in each meridian direction of the ring image input by the image sensor 35a. Then, the control unit 95 approximates an ellipse using a least square method or the like based on the detected position of the ring image. Then, the control unit 95 calculates refraction values of S (spherical power), C (astigmatic power), and A (astigmatic axis angle) from the approximate ellipse shape.

(4) Complete transmission of the transmissive display 91 The control unit 95 stops displaying the moving image on the transmissive display 91, and makes the transmissive display 91 completely transparent (sets the transmittance to 100%). Thereby, the light from the optotype presenting unit 50 passes through the transmissive display 91 and enters the eye to be examined EL and ER, and the optotype is presented to the eye to be examined EL and ER.

(5) Display of moving image by the target presentation unit 50 The control unit 95 causes the target presentation unit 50 to display an image indicating the target as the transmissive display 91 is made completely transparent. Specifically, as shown in FIG. 9, the control unit 95 displays an image showing a visual target (hereinafter referred to as a left visual target) 81 </ b> L presented to the left eye EL in the left display region 50 </ b> L of the visual target presenting unit 50. indicate. In addition, the control unit 95 displays an image showing a target (hereinafter referred to as a right target) 81R presented to the right eye ER in the right display area 50R of the target presenting unit 50. Note that the left visual target 81L and the right visual target 81R are the same visual target.

  In this embodiment, the optotype presenting unit 50 (smart phone) and the control unit 95 are electrically connected by a cable (not shown), and a command from the control unit 95 is transmitted to the optotype presenting unit 50 via the cable. Is done. However, the method for transmitting the command from the control unit 95 to the optotype presenting unit 50 is not limited to this, and may be transmitted by wireless communication, for example.

  Further, in the present embodiment, as shown in FIG. 10, an image obtained by blurring the left and right visual targets 81 </ b> L and 81 </ b> R is displayed on the visual target presenting unit 50 in order to apply fog to the eye to be examined EL and ER. Further, an image (moving image) in which the blurred left and right visual targets 81L and 81R move away from each other in the eye width direction (X-axis direction) is displayed on the visual target presenting unit 50. Thereby, the eye to be examined EL and ER change from the congested state to the spread state.

  Moreover, in this embodiment, frequent cloud fog is avoided so that the child who is a subject may not get bored. Specifically, cloud fog, (1) automatic alignment adjustment, (2) pupil diameter measurement, and (3) eye refractive power measurement are executed at the following timing.

  That is, as shown in FIG. 11, the control unit 95 performs automatic alignment adjustment, pupil diameter measurement, eye refractive power measurement, and cloud fog at regular time intervals. In the figure, each square indicates the timing at which automatic alignment adjustment or the like is performed.

  Specifically, cloud fog is performed at a lower frequency (at longer time intervals) than pupil diameter measurement, eye refractive power measurement, and automatic alignment adjustment. Further, pupil diameter measurement, eye refractive power measurement, and automatic alignment adjustment are executed at the same time interval T1, and cloud fog is executed at a time interval T2 longer than T1. Further, the pupil diameter measurement and the eye refractive power measurement are executed at substantially the same timing, and the automatic alignment adjustment is performed between the pupil diameter measurements or the eye refractive power measurements that are continuously performed. Moreover, cloud fog is executed at a timing overlapping with pupil diameter measurement and eye refractive power measurement.

  In subsequent S104, the control unit 95 determines that the difference | DL−DR | / (DL + DR) between the pupil diameters of both eyes EL and ER is less than the specified value based on the measurement result of the pupil diameters of the eye EL and ER in S103. It is determined whether or not. Here, | DL-DR | represents the absolute value of DL-DR.

If the controller 95 determines in S104 that the difference between the pupil diameters of both eyes EL and ER | DL-DR | / (DL + DR) is not less than the specified value, that is, greater than or equal to the specified value, the control unit 95 proceeds to S105.
In S105, the control unit 95 adjusts the brightness of the visual targets 81L and 81R. In S105, the brightness of the visual targets 81L and 81R is adjusted by changing the brightness (luminance) of the visual target presenting unit 50 itself. The control unit 95 brightens the visual target presented to the eye with the larger pupil diameter among the visual targets 81L and 81R by an amount corresponding to the pupil diameter difference | DL-DR | / (DL + DR). In addition, the control unit 95 darkens the visual target presented to the eye with the smaller pupil diameter among the visual targets 81L and 81R by an amount corresponding to the pupil diameter difference | DL-DR | / (DL + DR). In other words, the control unit 95 adjusts the brightness of the visual targets 81L and 81R presented to both eyes EL and ER so that the pupil diameter difference | DL−DR | / (DL + DR) is less than the specified value. . When executing S105, the control unit 95 returns to S104 described above.

On the other hand, if the control unit 95 determines in S104 that the pupil diameter difference | DL-DR | / (DL + DR) is less than the specified value, the control unit 95 proceeds to S106.
In S106, the control unit 95 adds reliability to the measurement result of the eye refractive power currently being measured. The measurement result here is a measurement result measured after the determination that the pupil diameter difference | DL−DR | / (DL + DR) is less than the specified value in S104. The reliability indicates the reliability of the measurement result (in other words, measurement accuracy). The reliability may be a coefficient indicated in a plurality of stages.

  In the present embodiment, the pupil diameter difference | DL-DR | / (DL + DR) and the binocular pupil diameter temporal change (dD / dt) / D (where D is the left) are parameters for determining the reliability. The pupil diameter DL of the eye EL or the pupil diameter DR of the right eye ER.) Is used. Further, as the above parameters, alignment shift amounts dx, dy, dz, a time interval between eye refractive power measurement and cloud fog, and an average diameter of the measurement ring are used. The alignment deviation amounts dx, dy, dz represent the difference between the alignment position at the time of measurement and the reference position.

  Specifically, the control unit 95 lowers the reliability as the difference between the binocular pupil diameters at the time of measurement of the measurement result | DL−DR | / (DL + DR) is larger. In addition, the control unit 95 decreases the reliability as the time change (dD / dt) / D of the pupil diameter before and after measurement of the measurement result increases (in other words, the pupil diameter is not stable).

Further, the control unit 95 lowers the reliability as the alignment shift amounts dx, dy, dz at the time of measuring the measurement result are larger.
Moreover, the control part 95 makes reliability low, so that the time interval of the time of the measurement result measurement and the cloud fog performed just before that is large.

  In subsequent S107, the control unit 95 displays the measurement result and the reliability of the measurement result in the measurement result display field of the monitor 93. In S107, only the latest measurement result and its reliability among the continuously measured measurement results are displayed in the measurement result display column.

  In subsequent S <b> 108, the control unit 95 displays the measurement result and the reliability of the measurement result in the result list display field of the monitor 93. In S108, a plurality of measurement results measured after the determination that the pupil diameter difference | DL-DR | / (DL + DR) is less than the specified value in S104 and their reliability are displayed. In addition, a plurality of measurement results are displayed classified by reliability. For example, a plurality of measurement results are arranged and displayed in descending order of reliability. If the number of measurement results exceeds the prescribed displayable number, only some measurement results are displayed. In this embodiment, those with low reliability and those with the oldest measurement time are deleted.

In subsequent S109, the control unit 95 determines whether or not the operation button 94 has been operated.
If the control unit 95 determines in S109 that the operation button 94 has not been operated, the control unit 95 returns to S104 described above.

  On the other hand, if the control unit 95 determines in S109 that the left / right switching button of the operation buttons 94 has been operated, the left / right switching mirror 25 is rotated by the left / right switching drive device 75 in S110, and the optical path of the measurement light is changed to the left eye light. Switch between road and right eye light path. Thereafter, the control unit 95 returns to S104 described above.

On the other hand, if the control unit 95 determines in S109 that the measurement end button of the operation buttons 94 has been operated, the inspection process in FIG. 7 ends.
[3. effect]
According to the embodiment detailed above, the following effects can be obtained.

  (1) In the present embodiment, the control unit 95 causes the visual target presenting unit 50 to present an image in which the visual target is blurred in order to apply fog to the eye EL and ER to be examined. That is, by outputting (displaying) the image on the optotype presenting unit 50, it is possible to apply cloud to the eye to be examined EL and ER. Therefore, clouding can be applied to the eye to be examined EL and ER without changing the position of the lens.

  (2) In the present embodiment, the control unit 95 causes the visual target presenting unit 50 to present images showing the same visual targets 81L and 81R for both eyes EL and ER. In addition, the control unit 95 causes the visual target presenting unit 50 to present an image in which the left visual target 81L and the right visual target 81R move so as to be separated from each other in the eye width direction of the subject.

  Therefore, it is possible to create a state in which the subject is looking at the far point by gazing at the left visual target 81L and the right visual target 81R that are separated from each other in the eye width direction. As a result, eye refractive power can be measured in a state where instrumental myopia is removed.

  (3) In the present embodiment, the control unit 95 is separated from each other in the eye width direction in a state where the left visual target 81L and the right visual target 81R are blurred in order to fog the left eye EL and the right eye ER. The target moving part 50 is made to present the moving image.

Accordingly, by outputting the image to the optotype presenting unit 50, it is possible to remove the adjustment tension of the eye to be examined EL and ER and remove the instrument myopia.
(4) In this embodiment, the optotype presenting unit 50 is a display capable of displaying an image. Therefore, for example, an image showing the targets 81L and 81R can be presented to the subject's eyes EL and ER with a relatively simple configuration as compared to the configuration using the MEMS mirror shown in FIG.

  In particular, in this embodiment, a smartphone is used as the optotype presenting unit 50. A smartphone incorporates each component of a display, a speaker, a microphone, and a control device. Therefore, by substituting each of these components with a smartphone, the measurement device 1 can be made compact compared to a configuration in which these components are individually provided in the measurement device.

(5) In this embodiment, the control unit 95 measures the eye refractive power when it is determined that the difference in pupil diameter | DL-DR | / (DL + DR) between both eyes EL and ER is less than a specified value. Is displayed on the monitor 93. In particular, the control unit 95 displays only the measurement result measured while determining that the difference in pupil diameter | DL−DR | / (DL + DR) is less than the specified value on the monitor 93. In other words, the control unit 95 determines that the displayed measurement result is a difference in pupil diameter | DL−DR | / (DL +
(DR) is displayed on the monitor 93 so that it can be determined that the measurement result is measured while it is determined to be less than the specified value. Accordingly, it is possible to obtain the measurement result of the eye refractive power when the eye to be examined EL and ER are closer to the natural state.

  (6) In the present embodiment, the control unit 95 is configured so that when the difference between the pupil diameters of the subject eyes EL and ER is not less than the specified value, the difference between the pupil diameters is less than the specified value. The brightness of the visual targets 81L and 81R presented in both EL and ER is adjusted.

  Therefore, when the pupil diameters of both eyes EL and ER of the subject are different, the difference between the pupil diameters of both eyes EL and ER can be reduced. Therefore, the eye refractive powers of the eye EL and ER can be measured in a state where the difference in pupil diameter is reduced, in other words, in a state where the eye EL and ER are closer to the natural state.

  (7) In the present embodiment, the control unit 95 outputs both the measurement result of the eye refractive power measurement and the reliability. Therefore, the inspector can recognize whether the output measurement result is highly reliable or low.

  (8) In this embodiment, the ophthalmologic apparatus is arranged in the middle of the optical path from the light emitted from the optotype presenting unit 50 to the eye to be examined EL and ER, and can transmit the light from the optotype presenting unit 50. A transparent display 91 is provided.

  Therefore, for example, by displaying an image preferred by the child who is the subject on the transmissive display 91, the child can be attracted. Then, by guiding the child's line of sight to the transmissive display 91 and transmitting the visible light from the visual target presenting unit 50 while the child is gazing at the transmissive display 91, the child can receive the visual targets 81L and 81R. It can be made to pay attention to nature.

Further, for example, in an eye position examination or the like, it is possible to block one eye by reducing the transmittance of a portion of the transmissive display 91 positioned in front of one eye of the eye to be examined EL and ER.
(9) In the present embodiment, the measuring apparatus 1 includes the eyepiece 10 and some optical components of the light projecting optical system 20 and the light receiving optical system 30 with respect to the eyepiece 10 (and thus the eye to be examined EL and ER). Driving devices 71 to 73 to be moved.

  Therefore, when the subject places a face on the eyepiece 10, the approximate ranges of the eye EL and ER to be examined with respect to the light projecting optical system 20 and the light receiving optical system 30 can be limited. Then, alignment adjustment can be performed only by moving some optical members of the light projecting optical system 20 and the light receiving optical system 30. Therefore, the alignment range can be reduced as compared with a configuration in which the alignment is adjusted by moving the measuring device itself, and thus the measuring device can be downsized.

  (10) In the present embodiment, the eyepiece unit 10 contacts the skin of the subject at least at the three locations below the forehead, the left eye, and the right eye. Therefore, for example, the positions of the eye to be examined EL and ER can be stably fixed as compared with a configuration in which the eyepiece is in contact with the face of the subject only at one place (for example, only the forehead).

  (11) In the present embodiment, the eyepiece unit 10 includes the light blocking unit 11. Therefore, the eye characteristics of the eye EL and ER to be examined can be measured in a more stable state without being affected by light incident from the outside, compared to a configuration without the light shielding unit 11. In addition, since the light shielding unit 11 can create a space similar to a dark room inside the measuring apparatus 1, the need for a room in which the ophthalmologic apparatus is placed to be a dark room can be reduced.

(12) In the present embodiment, the measurement apparatus 1 drives the X-axis drive device 71 to move some optical components, so that the measurement light incident position on the eye to be examined EL and ER is along the X-axis direction. Change. Accordingly, it is possible to adjust the incident position of the measurement light in the eye to be examined EL and ER along the X-axis direction. Similarly, the measurement apparatus 1 drives the Y-axis drive devices 72L and 72R to move some optical components, thereby changing the incident position of the measurement light in the eye to be examined EL and ER along the Y-axis direction. . Accordingly, it is possible to adjust the incident position of the measurement light in the eye to be examined EL and ER along the Y-axis direction.

(13) In the present embodiment, the measurement apparatus 1 includes the left / right switching mirror 25 configured to switch the optical path of the measurement light between the left eye optical path and the right eye optical path.
Therefore, the optical path can be switched in a shorter time compared to the configuration in which the entire measuring apparatus 1 is moved between the left and right eyes EL and ER to switch the optical path.

(14) In the present embodiment, the measuring apparatus 1 includes a tilt mechanism 80. Therefore, the inclination angle of the measuring apparatus 1 can be adjusted according to the height of the subject's sitting height.
(15) In the present embodiment, the measuring device 1 does not include a chin rest. Therefore, it is not necessary to adjust the position of the chin rest. Therefore, the time for fixing the position of the eye to be examined can be shortened.

In the present embodiment, S103 corresponds to processing as an eye refractive power measurement unit and a presentation processing unit.
[4. Other Embodiments]
As mentioned above, although the form for implementing this indication was demonstrated, this indication is not limited to the above-mentioned embodiment, and can carry out various modifications.

  (1) In the above embodiment, the control unit 95 determines that the pupil diameter difference | DL−DR | / (DL + DR) is not less than the specified value, and the visual target 81L, which is presented to the binocular EL and ER. Although the brightness of 81R is adjusted, the target whose brightness is adjusted is not limited to this. For example, when it is determined that the pupil diameter difference | DL−DR | / (DL + DR) is not less than the specified value, the control unit 95 adjusts only the brightness of one of the visual targets 81L and 81R. Good.

  (2) In the above embodiment, the brightness of the visual targets 81L and 81R presented to the binocular EL and ER is changed by changing the transmittance of the transmissive display 91 that transmits the visible light from the visual target presenting unit 50. May be adjusted.

  (3) In the above embodiment, the eye refractive power measurement is performed only while the difference between the pupil diameters of both eyes EL and ER | DL-DR | / (DL + DR) is determined to be less than the specified value, and the measurement result is obtained. You may output to the monitor 93.

  In the above embodiment, the measurement result measured while the difference between the pupil diameters of both eyes EL and ER is determined to be less than the specified value and the difference between the pupil diameters are determined to be greater than or equal to the specified value. Both of the measurement results measured during the measurement may be displayed on the monitor 93. In this case, the measurement results of the former and the latter may be displayed on the monitor 93 in such a manner that they can be distinguished from each other.

  (4) In the above embodiment, the transmissive display 91 may be disposed at a place other than the front of the eye to be examined EL and ER. Then, the visible light irradiated from the transmissive display 91 may be reflected by a mirror and incident on the eye to be examined EL and ER.

(5) In the said embodiment, although a smart phone is used as the optotype presentation part 50, the optotype presentation part 50 is not restricted to this, A display other than a smart phone may be sufficient.
In addition, for example, the optotype presenting unit includes a MEMS (Micro Electro Mechanical) as shown in FIG.
System) A mirror may be used.

That is, the optotype presenting unit 51 shown in FIG. 12 includes laser light sources 82L and 82R, MEMS mirrors 83L and 83R, total reflection mirrors 84L and 84R, and condenser lenses 85L and 85R.

The laser light sources 82L and 82R are configured to emit laser light.
The MEMS mirrors 83L and 83R are configured to swing and reflect the laser light emitted from the laser light sources 82L and 82R to scan areas on the eye EL and ER fundus, respectively.

Total reflection mirrors 84L and 84R reflect the laser beams reflected by MEMS mirrors 83L and 83R, respectively.
The condensing lenses 85L and 85R converge the laser beams reflected by the total reflection mirrors 84L and 84R on the fundus of the eye to be examined EL and ER, respectively.

  According to such a configuration, it is possible to draw an image indicating a visual target (an image indicating the letter “A” in FIG. 12) directly on the fundus (retina) of the subject. Therefore, a focused target can be presented to the subject's eye regardless of the abnormality of the subject's eye refractive power. In addition, cloud fog can be applied to the eye to be examined EL and ER only by image processing.

  (6) In the above-described embodiment, the images that are separated from each other in the width direction of the eye with the left and right targets 81L and 81R blurred are presented, but the presented images are not limited to this. For example, images that are separated from each other may be presented in a state where the left and right visual targets 81L and 81R are not blurred.

  (7) In the above embodiment, the eyepiece unit 10 contacts the subject's skin at the three positions below the forehead, the left eye EL, and the right eye ER. Not limited to. For example, the eyepiece may be configured to contact the subject's skin at a single location, such as only the forehead.

(8) In the above-described embodiment, the eyepiece unit may not include the light shielding unit.
(9) In the above embodiment, the measurement device may not be provided with the left / right switching mirror 25, and the left eye measurement or the right eye measurement may be switched by moving the entire measurement device.

(10) In the above embodiment, the measuring device may include a chin rest.
(11) In the above embodiment, the left / right switching mirror 25 is illustrated as the left / right switching unit, but the left / right switching unit is not limited thereto. For example, as shown in FIG. 13, one triangular prism 86 is provided between the total reflection mirrors 26L and 26R. Then, the optical path of the measurement light may be switched between the left-eye optical path and the right-eye optical path by translating the triangular prism 86 along the X-axis direction by a driving device (not shown).

  Further, for example, as shown in FIGS. 14A and 14B, the optical path of the measurement light may be switched by exchanging two triangular prisms 87 and 88 having different side surface orientations. The side surface referred to here is a surface on which the measurement light from the measurement light source 21 or the reflected light from the eye EL or ER is incident, or the surface that transmits or reflects the incident light.

  Specifically, as shown in FIGS. 14A and 14B, two triangular prisms 87 and 88 are arranged such that the side surfaces 87a and 88a on which the measurement light from the measurement light source 21 is incident are on the YZ plane. It arrange | positions up and down along a Y-axis direction so that it may become plane symmetry. Then, the two triangular prisms 87 and 88 are translated along the Y-axis direction, and the triangular prism located between the total reflection mirrors 26L and 26R is replaced, so that the optical path of the measurement light is changed to the left eye optical path and the right eye optical path. You may switch between.

(12) In the above embodiment, when the left / right switching button is operated, the optical path of the measurement light is switched between the left eye optical path and the right eye optical path. However, the condition for switching the optical path of the measurement light is limited to this. I can't. For example, when a specified number of measurement results with high reliability (in other words, measurement results with reliability equal to or higher than a specified value) are obtained, the optical path of the measurement light is automatically changed between the left eye optical path and the right eye optical path. The structure which switches to may be sufficient.

(13) In the above embodiment, some or all of the functions executed by the control unit 95 may be configured in hardware by one or a plurality of ICs.
(14) In addition to the control unit 95 described above, a system including the control unit 95 as a constituent element, a program for causing a computer to function as the control unit 95, a non-transitional physical storage such as a semiconductor memory storing the program The present disclosure can also be realized in various forms, such as a method for measuring eye refractive power based on a difference between a medium and a pupil diameter, and a method for performing cloud fogging by image processing.

  (15) A plurality of functions of one constituent element in the above embodiment may be realized by a plurality of constituent elements, or a single function of one constituent element may be realized by a plurality of constituent elements. . Further, a plurality of functions possessed by a plurality of constituent elements may be realized by one constituent element, or one function realized by a plurality of constituent elements may be realized by one constituent element. Moreover, you may abbreviate | omit a part of structure of the said embodiment. Further, at least a part of the configuration of the above embodiment may be added to or replaced with the configuration of the other embodiment. In addition, all the aspects included in the technical idea specified by the wording described in the claims are embodiments of the present disclosure.

  DESCRIPTION OF SYMBOLS 1 ... Measuring apparatus, 2 ... Control apparatus, 10 ... Eyepiece part, 20 ... Light projection optical system, 30 ... Light-receiving optical system, 45 ... Pupil observation camera, 50 ... Visual target presentation part, 71 ... X-axis drive device 71, 72R ... Y-axis drive device, 73,74 ... Z-axis drive device, 80 ... tilt mechanism, 91 ... transmissive display.

Claims (5)

A projection optical system configured to project measurement light toward the fundus of the eye to be examined; and
A light receiving optical system including a light receiving element configured to receive reflected light from the fundus corresponding to the measurement light;
An eye refractive power measurement unit configured to measure an eye refractive power of the eye to be examined based on a signal output from the light receiving element;
An optotype presenting unit configured to output an image and present the image to the eye to be examined;
A presentation processing unit that causes the visual target presenting unit to present an image in which the visual target is blurred in order to apply fog to the eye to be examined;
An ophthalmic device comprising: The ophthalmic device according to claim 1,
The optotype presenting unit can present an image for each of both eyes of the subject,
The presenting processing unit causes the visual target presenting unit to present an image showing the same visual target for each of the two eyes, and the left visual target that is the visual target presented to the left eye of the subject. An image in which the target and the right target that is the target presented to the right eye that is the subject's eye move so as to be separated from each other in the eye width direction of the subject is presented to the target presenting unit Let the ophthalmic device. The ophthalmic device according to claim 2,
The presenting processing unit is an image that moves away from each other in the eye width direction in a state where the left target and the right target are blurred in order to apply fog to the left eye and the right eye. Is presented on the optotype presenting unit. The ophthalmic apparatus according to any one of claims 1 to 3,
The optotype presenting unit is an ophthalmologic apparatus that is a display capable of displaying an image. The ophthalmic apparatus according to any one of claims 1 to 3,
The optotype presenting unit includes a laser light source configured to emit laser light, a MEMS mirror configured to scan the region on the fundus by reflecting the laser light emitted from the laser light source, and An ophthalmic device.