Non-contact tonometer capable of intelligently adjusting air injection force
The non-contact tonometer with intelligent adjustment of air jet intensity solves the problem of mismatched air jet gears, achieves high-precision and comfortable intraocular pressure measurement, and provides convenient data analysis and diagnostic support.
Patent Information
- Application Number
- CN202510870435.X
- Authority / Receiving Office
- CN · China
- Patent Type
- Applications(China)
- Current Assignee / Owner
- Filing Date
- 2025-06-26
- Publication Date
- 2025-09-12
AI Technical Summary
Existing non-contact tonometers have limited air jet settings, resulting in a mismatch between the air jet intensity and the patient's intraocular pressure, increasing patient discomfort and low measurement efficiency.
It adopts an intelligent air jet force adjustment design that integrates an electromagnetic cylinder and an air pressure detection module, combined with a positioning camera, an infrared measuring light, an eye surface signal receiver and a main control module to achieve automatic adjustment of the air jet force. It is equipped with a piezoelectric air pressure sensor and an analog-to-digital conversion module, an autofocus component and a corneal center recognition algorithm, an integrated signal processing module and a display, and has a distance sensor and environmental calibration function.
It improves the accuracy and comfort of measurement, reduces human errors, ensures the reliability and stability of measurement results, provides rich data support, and facilitates doctors' diagnosis and treatment decisions.
Smart Images

Figure CN120616435A_ABST
Abstract
Description
Technical Field
[0001] The present invention relates to the technical field of tonometers, and in particular to a non-contact tonometer with intelligent air jet adjustment. Background Art
[0002] A tonometer is a professional ophthalmic medical device used to measure the pressure inside the eyeball to assess eye health. Its basic structure usually includes components such as a corneal shape change generator, a corneal deformation measurement system or a contact corneal device, and a pressure sensor. The tonometer can convert and obtain intraocular pressure data through changes in corneal shape (such as applanation and indentation) or direct measurement of corneal blood flow pulsation pressure changes. The tonometer plays an important role in clinical ophthalmic examinations and can be used to assist in the diagnosis of eye diseases such as cataracts and glaucoma, assess the risk of glaucoma, monitor the progression of eye diseases, and guide drug treatment decisions. When using a tonometer, you should maintain a correct posture and avoid excessive pressure on the eyeball to prevent damage. At the same time, doctors or examiners need to choose the appropriate type of tonometer according to the patient's specific situation and follow operating specifications to ensure the accuracy and reliability of the measurement results.
[0003] Current non-contact tonometer devices usually have two air jet gears: 30 air jet gear and 60 air jet gear. However, due to the wide range of patients' intraocular pressure (from 7mmHg to 50mmHg), this limited gear setting may lead to the problem of mismatch between the air jet intensity and the actual intraocular pressure. For example, when measuring lower intraocular pressure (such as 15mmHg), choosing the higher 30 gear, or using the 60 gear when measuring higher intraocular pressure (such as 35mmHg), will lead to increased discomfort. In some cases (such as using the 30mmHg gear for continuous air jet when the intraocular pressure is 33mmHg), it may be impossible to obtain valid measurement results, and multiple attempts are required, which not only increases the patient's discomfort, but also affects the measurement efficiency and accuracy.
[0004] Therefore, a non-contact tonometer with intelligent air jet adjustment is proposed to solve the above problems. Summary of the Invention
[0005] To address these shortcomings, the present invention provides a non-contact tonometer with intelligently adjustable air jet intensity, designed to address the existing problem of a mismatch between air jet intensity and actual intraocular pressure, caused by the limited range of intraocular pressure (from 7 mmHg to 50 mmHg) in the existing technology. For example, selecting the higher 30 gear when measuring lower intraocular pressure (such as 15 mmHg), or using the 60 gear when measuring higher intraocular pressure (such as 35 mmHg), can lead to increased discomfort. In some cases (such as using the 30 mmHg gear for continuous air jets when the intraocular pressure is 33 mmHg), valid measurement results may not be obtained, requiring repeated attempts. This not only increases patient discomfort but also affects measurement efficiency and accuracy.
[0006] In order to achieve the above object, the present invention adopts the following technical solutions:
[0007] A non-contact tonometer with intelligent air jet force adjustment comprises: a chamber, the bottom of the chamber being connected to an electromagnetic cylinder, the top of the chamber being fixedly mounted with an air pressure detection module, the top of the air pressure detection module being fixedly mounted with a barometer, a positioning camera being provided on the right side of the chamber, the top of the positioning camera being provided with an infrared measuring lamp, the bottom of the positioning camera being provided with an ocular surface signal receiver, the right side of the ocular surface signal receiver being electrically connected to a display screen, and the left side of the ocular surface signal receiver being provided with a main control module.
[0008] Through the above technical solution, by integrating an electromagnetic cylinder and an air pressure detection module, the tonometer can automatically adjust the air pressure based on the patient's ocular surface characteristics, ensuring both measurement accuracy and patient comfort. The combination of a positioning camera and an infrared measurement light enables the tonometer to quickly and accurately locate the eye, further improving measurement accuracy. The ocular surface signal receiver receives and analyzes ocular surface information in real time, providing critical data support to the main control module and ensuring a safe and reliable measurement process. Furthermore, the addition of a display makes measurement results intuitive, enabling doctors to quickly diagnose the condition.
[0009] As a further description of the above technical solution: the air pressure detection module is a piezoelectric air pressure sensor, the sensing surface of which is arranged facing the top opening of the chamber, and the pressure gauge is connected to the analog-to-digital conversion module via a data line.
[0010] Through the above technical solution, a piezoelectric air pressure sensor is used as the air pressure detection module, which significantly improves the sensitivity and accuracy of the measurement. The piezoelectric sensor, with its fast response and high-precision measurement characteristics, can accurately capture tiny changes in air pressure in the chamber, thereby ensuring the accuracy of intraocular pressure measurement. Secondly, by connecting the output of the barometer to the analog-to-digital conversion module through a data line, the conversion of analog signals to digital signals is realized. This design not only simplifies the data processing process, but also improves the signal's anti-interference ability and transmission efficiency, further enhancing the stability and reliability of the tonometer. In addition, the combination of the piezoelectric air pressure sensor and the analog-to-digital conversion module enables the tonometer to monitor air pressure changes in real time and continuously, providing doctors with richer data support and helping to more accurately assess the patient's eye health.
[0011] As a further description of the above technical solution: the positioning camera is equipped with an autofocus component and a cornea center recognition algorithm module, and its lens axis is set at an angle of 5-15 degrees to the center axis of the chamber.
[0012] Through the above technical solution, the autofocus component configured in the positioning camera ensures that the camera can focus on the patient's cornea quickly and accurately, and maintain clear imaging quality even when the light changes or the patient moves slightly. Secondly, the addition of the corneal center recognition algorithm module enables the tonometer to automatically identify and lock the corneal center position, thereby further improving the accuracy of the measurement. It not only simplifies the operation process, but also reduces the errors caused by human factors, making the measurement results more reliable. In addition, the lens axis of the positioning camera is set at an angle of 5-15 degrees to the center axis of the chamber. This design not only ensures that the camera can clearly capture the corneal image, but also avoids the discomfort that may be caused by the lens directly pointing at the patient's eyes. This humanized design makes the patient more relaxed during the measurement process, thereby improving the comfort and accuracy of the measurement.
[0013] As a further description of the above technical solution: the signal processing module is respectively connected to the ocular surface signal receiver and the air pressure detection module, is configured with an intraocular pressure calculation algorithm and generates a visual report and outputs it to the display screen.
[0014] Through the above technical solution, the introduction of the signal processing module realizes the real-time processing and analysis of the data collected by the ocular surface signal receiver and the air pressure detection module. This design not only improves the data processing speed, but also ensures the accuracy and completeness of the data, providing a solid foundation for the subsequent intraocular pressure calculation. Secondly, the built-in intraocular pressure calculation algorithm of the signal processing module can accurately calculate the patient's intraocular pressure value based on the collected data, ensuring the accuracy and reliability of the measurement results. In addition, the signal processing module can also generate a visual report and output the report to the display screen. This function enables doctors to intuitively understand the patient's intraocular pressure condition, facilitating rapid diagnosis and treatment decisions. The visual report not only contains key data such as intraocular pressure values, but may also include additional information such as intraocular pressure change trend charts, providing doctors with a more comprehensive diagnostic basis.
[0015] As a further description of the above technical solution: the display screen is a capacitive touch screen, integrated with a data storage module and a USB interface, and supports historical query and export functions of measurement data.
[0016] Through the above technical solution, the adoption of a capacitive touch screen enables the display screen to not only have high-definition display capabilities, but also support touch operations. Doctors can browse measurement results, adjust settings or export data through simple touch operations, greatly improving the convenience of operation and user experience. Secondly, the integrated data storage module enables the tonometer to automatically save data from all previous measurements, including key information such as intraocular pressure values and measurement time. This function provides doctors with rich historical data support, making it easier to track the patient's intraocular pressure change trends and evaluate treatment effects. In addition, the addition of a USB interface allows the measurement data to be easily exported to a computer or other storage device for further analysis and processing of the data. Doctors can use the exported data to write research reports, make medical records or share them with other doctors, thereby improving work efficiency and collaboration capabilities.
[0017] As a further description of the above technical solution: a distance sensor module is provided on the right side of the chamber, and the distance sensor module is equipped with a laser ranging unit and an audio-visual prompt component. When it is detected that the distance between the device and the eyes exceeds the safety range of 3-10mm, a buzzer alarm is triggered and the jet operation is suspended.
[0018] Through the above technical solution, the introduction of the distance sensor module, especially the laser ranging unit configured therein, can accurately measure the distance between the device and the eye. This function ensures that the distance between the device and the eye is always maintained within a safe and effective range when measuring intraocular pressure, thereby avoiding measurement errors or patient discomfort caused by improper distance. Secondly, the addition of the sound and light prompt component enables the immediate triggering of a buzzer alarm when the distance between the device and the eye exceeds the preset safety range (3-10mm). This instant feedback mechanism not only reminds the operator to pay attention to adjusting the distance between the device and the eye, but also ensures the smooth progress of the measurement process and avoids measurement interruption or failure due to improper operation. In addition, when the distance sensor detects that the distance exceeds the safe range, the tonometer automatically suspends the air jet operation, further enhancing the safety of the device and avoiding potential risks caused by improper distance.
[0019] As a further description of the above technical solution: an environmental calibration module is provided on the inner wall of the chamber, and the environmental calibration module includes a temperature sensor and a humidity sensor, which communicates data with the signal processing module and is configured with an air pressure compensation algorithm to eliminate the measurement error of the jet pressure caused by the ambient temperature and humidity.
[0020] The above-mentioned technical solution introduces an environmental calibration module, specifically the temperature and humidity sensors it contains, which enable real-time monitoring of the ambient temperature and humidity conditions within the chamber. Through data exchange with the signal processing module, the environmental calibration module transmits the real-time monitored temperature and humidity data to the signal processing module. The signal processing module, in turn, utilizes a built-in air pressure compensation algorithm to adjust the air jet pressure in real time based on this data, thereby eliminating the effects of ambient temperature and humidity on measurement errors. This design ensures that the tonometer can provide accurate and reliable measurement results under varying environmental conditions. Furthermore, the adoption of the air pressure compensation algorithm improves the tonometer's adaptability and stability. Whether in high-temperature and high-humidity environments or low-temperature and low-humidity environments, the tonometer maintains measurement accuracy by automatically adjusting the air jet pressure, thereby increasing the device's reliability and service life.
[0021] As a further description of the above technical solution: the main control module is integrated with a dynamic feedback adjustment unit, which dynamically adjusts the jet pressure and duration of the electromagnetic cylinder through a closed-loop control algorithm based on the real-time data of the air pressure detection module and the corneal deformation signal of the ocular surface signal receiver to adapt to the corneal hardness characteristics of different patients.
[0022] Through the above technical solution, the dynamic feedback adjustment unit integrated into the main control module enables the tonometer to dynamically adjust the jet pressure and duration of the electromagnetic cylinder based on the real-time data from the air pressure detection module and the corneal deformation signal captured by the ocular surface signal receiver. This design ensures that the jet force during the measurement process can accurately match the patient's corneal hardness, thereby improving the accuracy and comfort of the measurement. Secondly, the adoption of a closed-loop control algorithm enables the dynamic feedback adjustment unit to make precise adjustments based on real-time feedback data. This algorithm continuously compares the difference between the actual measurement value and the preset target value and adjusts the jet force accordingly until the optimal measurement effect is achieved. This feature not only improves measurement accuracy, but also enables the tonometer to automatically adapt to the corneal hardness characteristics of different patients, eliminating the need for manual adjustment of settings. In addition, the combination of the dynamic feedback adjustment unit and the closed-loop control algorithm enables the tonometer to maintain high stability and consistency during the measurement process. Regardless of how the patient's corneal hardness changes, the tonometer can ensure the accuracy and reliability of the measurement results by automatically adjusting the jet force.
[0023] The present invention has the following beneficial effects:
[0024] 1. The present invention achieves precise positioning of the corneal vertex by using a positioning camera. Once positioning is completed, the system activates the electromagnetic cylinder to generate a precisely controlled airflow. The airflow is directed to the surface of the eye, applying moderate pressure to cause a certain degree of deformation of the ocular surface. At the same time, the infrared measuring lamp emits infrared light to the ocular surface, which is reflected by the ocular surface and captured by the signal receiver. As the ocular surface deforms due to the airflow, the reflected light signal changes accordingly. The signal receiver monitors and records these changes in real time, generates an electrical signal curve representing the dynamic changes of the ocular surface, and displays it efficiently on the display screen. By analyzing the relationship between this electrical signal curve and the different applied air pressures, the system can calculate the accurate intraocular pressure value.
[0025] 2. The present invention utilizes a closed-loop control algorithm to enable the dynamic feedback adjustment unit to make precise adjustments based on real-time feedback data. This algorithm continuously compares the difference between the actual measured value and the preset target value, and adjusts the air jet force accordingly until the optimal measurement effect is achieved. This feature not only improves the measurement accuracy, but also enables the tonometer to automatically adapt to the corneal hardness characteristics of different patients without the need for manual adjustment of settings. In addition, the combination of the dynamic feedback adjustment unit and the closed-loop control algorithm also enables the tonometer to maintain high stability and consistency during the measurement process. Regardless of how the patient's corneal hardness changes, the tonometer can ensure the accuracy and reliability of the measurement results by automatically adjusting the air jet force. BRIEF DESCRIPTION OF THE DRAWINGS
[0026] Figure 1 A schematic diagram of the structural positioning camera of the present invention;
[0027] Figure 2 This is a schematic diagram of the algorithm of the main control module structure of the present invention.
[0028] Legend:
[0029] 1. Chamber; 2. Electromagnetic cylinder; 3. Air pressure detection module; 4. Barometer; 5. Positioning camera; 6. Infrared measuring light; 7. Eye meter signal receiver; 8. Display; 9. Main control module; 10. Signal processing module; 11. Distance sensor module; 12. Environmental calibration module. DETAILED DESCRIPTION
[0030] The following will clearly and completely describe the technical solutions in the embodiments of the present invention in conjunction with the accompanying drawings. Obviously, the described embodiments are only part of the embodiments of the present invention, not all of the embodiments. Based on the embodiments of the present invention, all other embodiments obtained by ordinary technicians in this field without making creative efforts are within the scope of protection of the present invention.
[0031] Reference Figure 1-2 The present invention provides an embodiment of a non-contact tonometer with intelligently adjustable air jet force, comprising: a chamber 1, an electromagnetic cylinder 2 connected to the bottom of the chamber 1, an air pressure detection module 3 fixedly mounted on the top of the chamber 1, a barometer 4 fixedly mounted on the top of the air pressure detection module 3, a positioning camera 5 disposed on the right side of the chamber 1, an infrared measurement lamp 6 disposed on the top of the positioning camera 5, an ocular surface signal receiver 7 disposed on the bottom of the positioning camera 5, a display screen 8 electrically connected to the right side of the ocular surface signal receiver 7, and a main control module 9 disposed on the left side of the ocular surface signal receiver 7. By integrating the electromagnetic cylinder 2 and the air pressure detection module 3, the tonometer can automatically adjust the air jet force according to the patient's ocular surface characteristics, ensuring measurement accuracy and effectively improving patient comfort. The positioning camera 5 and the infrared measurement lamp 6 cooperate to enable the tonometer to quickly and accurately locate the eyeball, thereby further improving measurement accuracy. The ocular surface signal receiver 7 can receive and analyze ocular surface information in real time, providing key data support to the main control module 9, ensuring the safety and reliability of the measurement process. In addition, the addition of the display screen 8 makes the measurement results intuitively visible, which is convenient for doctors to quickly judge the condition.
[0032] Reference Figure 1-2, the air pressure detection module 3 is a piezoelectric air pressure sensor, and its sensing surface is arranged facing the top opening of the chamber 1. The barometer 4 is connected to the analog-to-digital conversion module through a data line. The use of a piezoelectric air pressure sensor as the air pressure detection module 3 significantly improves the sensitivity and accuracy of the measurement. The piezoelectric sensor, with its fast response and high-precision measurement characteristics, can accurately capture the slight changes in the air pressure in the chamber 1, thereby ensuring the accuracy of the intraocular pressure measurement. Secondly, by connecting the output of the barometer 4 to the analog-to-digital conversion module through a data line, the conversion of analog signals to digital signals is realized. This design not only simplifies the data processing process, but also improves the signal's anti-interference ability and transmission efficiency, further enhancing the stability and reliability of the tonometer. In addition, the combination of the piezoelectric air pressure sensor and the analog-to-digital conversion module enables the tonometer to monitor air pressure changes in real time and continuously, providing doctors with richer data support, which helps to more accurately assess the patient's eye health and positioning camera 5 is equipped with an autofocus component and a corneal center recognition algorithm module, and its lens axis is set at an angle of 5-15 degrees to the central axis of chamber 1. The autofocus component configured for positioning camera 5 ensures that the camera can focus on the patient's cornea quickly and accurately, and maintains clear imaging quality even when the light changes or the patient moves slightly. Secondly, the addition of the corneal center recognition algorithm module enables the tonometer to automatically identify and lock the corneal center position, thereby further improving the measurement accuracy, not only simplifying the operation process, but also reducing errors caused by human factors, making the measurement results more reliable. In addition, the lens axis of positioning camera 5 is set at an angle of 5-15 degrees to the central axis of chamber 1. This design not only ensures that the camera can clearly capture the corneal image, but also avoids the discomfort that may be caused by the lens directly pointing at the patient's eyes. This humanized design makes the patient more relaxed during the measurement process, thereby improving the comfort and accuracy of the measurement.
[0033] Reference Figure 1-2The signal processing module 10 is respectively connected to the ocular surface signal receiver 7 and the air pressure detection module 3, and is equipped with an intraocular pressure calculation algorithm and generates a visual report and outputs it to the display screen 8. The introduction of the signal processing module 10 realizes the real-time processing and analysis of the data collected by the ocular surface signal receiver 7 and the air pressure detection module 3. This design not only improves the data processing speed, but also ensures the accuracy and integrity of the data, providing a solid foundation for subsequent intraocular pressure calculation. Secondly, the built-in intraocular pressure calculation algorithm of the signal processing module 10 can accurately calculate the patient's intraocular pressure value based on the collected data, ensuring the accuracy and reliability of the measurement results. In addition, the signal processing module 10 can also generate a visual report and output the report to the display screen 8. This function enables doctors to intuitively understand the patient's intraocular pressure condition, making it easier to make diagnosis and treatment decisions quickly. The visual report not only contains key data such as intraocular pressure values, but may also include additional information such as intraocular pressure change trend charts. , providing doctors with a more comprehensive basis for diagnosis. The display screen 8 is a capacitive touch screen, integrated with a data storage module and a USB interface, supporting historical query and export functions of measurement data. A distance sensor module 11 is provided on the right side of the chamber 1. The distance sensor module 11 is equipped with a laser ranging unit and an audio-visual prompt component. When it is detected that the distance between the device and the eye exceeds the safety range of 3-10mm, a buzzer alarm is triggered and the jet operation is suspended. An environmental calibration module 12 is provided on the inner wall of the chamber 1. The environmental calibration module 12 includes a temperature sensor and a humidity sensor. It communicates data with the signal processing module 10 and is equipped with an air pressure compensation algorithm to eliminate the measurement error caused by the ambient temperature and humidity on the jet pressure. The main control module 9 is integrated with a dynamic feedback adjustment unit, which is based on the real-time data of the air pressure detection module 3 and the corneal deformation signal of the ocular surface signal receiver 7. It dynamically adjusts the jet pressure and duration of the electromagnetic cylinder 2 through a closed-loop control algorithm to adapt to the corneal hardness characteristics of different patients.
[0034] Working Principle: The positioning camera 5 precisely locates the corneal vertex. Once located, the system activates the electromagnetic cylinder 2, generating a precisely controlled airflow. This airflow is directed onto the surface of the eye, applying moderate pressure to cause a specific degree of deformation. Simultaneously, an infrared measuring lamp 6 emits infrared light toward the ocular surface, which is reflected by the ocular surface and captured by a signal receiver. As the ocular surface deforms due to the airflow, the reflected light signal changes accordingly. The signal receiver monitors and records these changes in real time, generating an electrical signal curve representing the dynamic changes in the ocular surface. This is efficiently displayed on the display screen 8. By analyzing the relationship between this electrical signal curve and the applied air pressure, the system can calculate the accurate intraocular pressure value.
[0035] Finally, it should be noted that the above is only a preferred embodiment of the present invention and is not intended to limit the present invention. Although the present invention has been described in detail with reference to the aforementioned embodiments, those skilled in the art can still modify the technical solutions described in the aforementioned embodiments or make equivalent substitutions for some of the technical features therein. Any modifications, equivalent substitutions, improvements, etc. made within the spirit and principles of the present invention should be included in the scope of protection of the present invention.
Claims
1. A non-contact tonometer with intelligent air jet adjustment, comprising: A chamber (1), characterized in that: the bottom of the chamber (1) is connected to an electromagnetic cylinder (2), the top of the chamber (1) is fixedly installed with an air pressure detection module (3), the top of the air pressure detection module (3) is fixedly installed with a barometer (4), a positioning camera (5) is provided on the right side of the chamber (1), an infrared measuring lamp (6) is provided on the top of the positioning camera (5), an eye surface signal receiver (7) is provided at the bottom of the positioning camera (5), the right side of the eye surface signal receiver (7) is electrically connected to a display screen (8), and the left side of the eye surface signal receiver (7) is provided with a main control module (9).
2. The non-contact tonometer with intelligent air jet adjustment according to claim 1, characterized in that: The air pressure detection module (3) is a piezoelectric air pressure sensor, the sensing surface of which is arranged facing the top opening of the chamber (1), and the pressure gauge (4) is connected to the analog-to-digital conversion module via a data line.
3. The non-contact tonometer with intelligent air jet adjustment according to claim 1, characterized in that: The positioning camera (5) is equipped with an autofocus component and a cornea center recognition algorithm module, and its lens axis is set at an angle of 5-15 degrees to the central axis of the chamber (1).
4. The non-contact tonometer with intelligent air jet adjustment according to claim 1, characterized in that: The bottom of the ocular surface signal receiver (7) is electrically connected to a signal processing module (10), and the signal processing module (10) is respectively data-connected to the ocular surface signal receiver (7) and the air pressure detection module (3), is configured with an intraocular pressure calculation algorithm, and generates a visual report and outputs it to a display screen (8).
5. The non-contact tonometer with intelligent air jet adjustment according to claim 1, characterized in that: The display screen (8) is a capacitive touch screen, integrated with a data storage module and a USB interface, and supports historical query and export functions of measurement data.
6. The non-contact tonometer with intelligent air jet adjustment according to claim 1, characterized in that: A distance sensor module (11) is provided on the right side of the chamber (1). The distance sensor module (11) is equipped with a laser distance measuring unit and an acousto-optic prompt component. When it is detected that the distance between the device and the eyes exceeds a safety range of 3-10 mm, a buzzer alarm is triggered and the jetting operation is suspended.
7. The non-contact tonometer with intelligent air jet adjustment according to claim 1, characterized in that: An environmental calibration module (12) is provided on the inner wall of the chamber (1). The environmental calibration module (12) comprises a temperature sensor and a humidity sensor, is in data communication with the signal processing module (10), and is equipped with an air pressure compensation algorithm for eliminating measurement errors caused by ambient temperature and humidity on the jet pressure.
8. The non-contact tonometer with intelligent air jet adjustment according to claim 1, characterized in that: The main control module (9) is integrated with a dynamic feedback adjustment unit, which dynamically adjusts the jet pressure and duration of the electromagnetic cylinder (2) through a closed-loop control algorithm based on the real-time data of the air pressure detection module (3) and the corneal deformation signal of the ocular surface signal receiver (7) to adapt to the corneal hardness characteristics of different patients.