System and method for eye examination

Abstract

A system for eye examination is presented, comprising a semi-autonomous system to perform an examination session of an eye and a control system. The semi-autonomous system comprises: an illumination device comprising an optical projector operable to automatically project a sequence of illumination points of a particular shape onto a plurality of locations across an eye region during the examination session; and an imaging device operable to acquire an image of the illuminated eye and generate image data associated with the plurality of positions. The control system is responsive to input data including preset data indicative of the inspection task to define operational data of the semi-autonomous system for defining operational parameters of the inspection session. The control system operates the imaging device in synchronization with the corresponding optical projector, thereby being able to minimize image degradation factors in the image data and minimize the time during which the eye is exposed to the illumination during the examination session.

Description

Technical Field

[0001] This disclosure relates to eye examination techniques, and specifically to slit-lamp type eye examinations. Background and Background Technology

[0002] With timely diagnosis and treatment, approximately 90% of cases of diseases leading to severe visual impairment can be successfully treated to prevent further deterioration or even achieve improvement. Global population growth, increased life expectancy leading to a larger elderly population with more eye diseases, and the spread of various eye diseases in the general population all contribute to the rapid increase in demand for eye care services.

[0003] The population is dispersed across the globe, including rural and surrounding areas. However, ophthalmologists tend to be concentrated in cities and metropolitan areas. Furthermore, limited availability of healthcare services affects a large number of people worldwide, primarily due to factors such as a lack of ophthalmologists, geopolitical circumstances, financial constraints, and a variety of other reasons.

[0004] All of the above circumstances have created a demand for remote ophthalmology and remote optometry solutions to address these issues. The outbreak of pandemics such as COVID-19 has further amplified this demand. As described below, primarily due to technological limitations, there is no suitable solution in the field for remote slit-lamp examination.

[0005] Imaging tissues using projection systems is well known in the art. Examples of imaging and projection systems include magnifying microscopes used for detailed examination. These types of imaging and projection systems produce images or visions that provide detailed information about the object being examined and specific layers of its structure.

[0006] One such system is the "slit-lamp" device used for eye examinations. For nearly a century, this device has been a primary examination tool for ophthalmologists. In this device, a narrow slit of light is projected onto the part of the eye being examined. The projected slit has sharp edges and bends at any structures it encounters along its path. The slit of light partially penetrates the translucent or transparent layers / tissues (such as the tear film, conjunctiva, cornea, aqueous humor, lens, vitreous humor, and the inner layer of the retina). It is partially reflected (and partially absorbed) by the non-transparent layers / tissues (adnexa, sclera, iris, and the pigmented epithelium of the retina).

[0007] An ophthalmologist uses both eyes to observe the reflection and refraction of light through a binocular microscope. The sharp edges, curved at different structures, help the ophthalmologist assess the three-dimensional structure of the examined area. The binocular microscope further aids in the ophthalmologist's three-dimensional interpretation by providing a stereoscopic view of the examined area.

[0008] The slit of light is also useful for measuring structures and discovering the size, depth, boundaries, and scale of results.

[0009] In addition, the slit of light helps ophthalmologists focus their attention on the structure being examined, which is illuminated by the slit, relative to the darker background tissue.

[0010] Because of all the aforementioned properties of the slit, an ophthalmologist's brain can interpret, analyze, and differentiate between normal and pathological findings in parts of the eye being examined.

[0011] During the examination, the ophthalmologist moves a slit across the eye by physically moving certain optical components of the illumination source, while simultaneously aiming and focusing the slit and microscope onto various parts of the eye. This allows the ophthalmologist to assess the overall condition of the eye being examined.

[0012] Ophthalmologists can select various slit properties, such as width, length, color, intensity, and illumination angle. This provides ophthalmologists with additional clinical information, allowing for accurate diagnosis based on findings.

[0013] According to standard techniques, slit-lamp equipment must be operated by a highly skilled ophthalmologist (ophthalmologist or optometrist) to aim and focus light through a slit and binocular microscope, examine areas of interest, and assess pathological and normal findings in various organs of the patient's eye. Therefore, the ophthalmologist must be in contact with the patient throughout the examination and must record their own observations without any visual reference data (no images to refer to). For posterior examinations through the pupil, the ophthalmologist must hold an additional type of lens between the microscope and the eye being examined, and must aim it in addition to aiming the microscope and illumination, requiring a higher level of expertise on their side. Standard slit-lamp equipment is an appropriate tool in a face-to-face examination setup. Overview

[0014] There is a need in the art for an improved system for slit-lamp eye examination of patients that can be easily operated remotely and in the field even by non-experts with only brief training, thereby addressing patient collaboration issues caused by brief and non-blinding bursts of illumination.

[0015] The drawbacks of the aforementioned conventional methods are that they require the ophthalmologist, the patient being examined, and the slit-lamp equipment to be in the same position for every ophthalmological examination, and they lack visual recording and follow-up capabilities. In fact, traditional slit-lamp examination techniques were neither designed nor intended for remote operation and therefore cannot be used in remote examination settings. Ophthalmologists typically need to remember findings while exploring the eye, record them in text form, log them to a storage device, and submit a final report. Even more importantly, conventional methods cannot address patient convenience issues by, for example, reducing "chair time."

[0016] However, during the examination, collaboration between ophthalmologists and patients is required due to the nature of the intense lighting, the patient's sensitivity to it, and the discomfort caused by the illumination entering the eye for up to 2-3 minutes (or even longer in pathological cases). The difficulty in achieving proper collaboration between ophthalmologists and patients is one of the main drawbacks of current slit-lamp-based examination techniques.

[0017] Digital slit-lamp technology has been developed, based on the use of a traditional slit lamp equipped with a digital camera, which allows for recording, visual follow-up, and patient education. Video / image acquisition is performed by ophthalmologists, and the acquired information can be used to obtain additional opinions and for consultations between ophthalmologists, thus allowing for a degree of telemedicine (remote examination). However, in most traditional settings requiring remote examination or consultation, the local operator is a non-physician and therefore not qualified to obtain high-quality examinations on a camera (video / image).

[0018] In many cases, local operators are not qualified to aim and focus the illumination and camera on the specific parts of the eye. Furthermore, local operators lack medical training in capturing specific structures or layers of the eye. Most importantly, local operators are not qualified to medically interpret observed normal or pathological findings and therefore cannot proceed with the examination based on these findings, including selecting appropriate parameters for the examination as a trained ophthalmologist would. Consequently, it will be extremely difficult for remote ophthalmologists to make accurate diagnoses based on the received video / images.

[0019] Also known in the art are "manually remotely controlled slit lamps," such as "digital slit lamps" equipped with motors on various motion axes and a network-connected motion controller, allowing commands to be received from a remote ophthalmologist while simultaneously sending live streaming video back to him. This micro-management of the "manually remotely controlled slit lamp" allows remote ophthalmologists to conduct examinations synchronously from different geographical locations. The remote ophthalmologist can manipulate the examination procedure and its various parameters, such as illumination intensity or color in addition to motion control, while simultaneously observing the eye being examined on his screen.

[0020] However, significant limitations exist in this type of synchronous, real-time examination where remote ophthalmologists directly operate the system. These limitations hinder proper medical examination and diagnosis. Such limitations include: (i) Eye movement latency presents an inherent limitation for synchronous remote inspection. Such latency includes latency for two-way communication and high-quality image and video streaming, as well as latency for motor movement.

[0021] These waiting times, combined with various eye movements (such as saccades, blinking, etc.), prevent remote ophthalmologists from aiming and focusing the light slit and microscope on the desired part of the eye. By the time the remote ophthalmologist's instruction to move or focus on a desired location is completed, the eye has already moved and the desired part of the eye is no longer there. Therefore, remote ophthalmologists cannot aim at the desired part of the eye as they would in a traditional slit-lamp examination.

[0022] (ii) Image distortion – In traditional slit-lamp examinations, at each moment of the examination, the ophthalmologist can only see a clear and high-quality fragment of the image, while other parts are blurry, distorted, out of focus, or even invisible. Therefore, the ophthalmologist aims and focuses multiple times on different parts of the eye, gathering all the observed information in order to reconstruct a complete three-dimensional model of the eye being examined in his mind.

[0023] All the limitations described remain within the known technology of "manually controlled slit lamps." Specifically, in many cases, examinations using "manually controlled slit lamps" can last significantly longer than face-to-face examinations (which themselves average 2-3 minutes) due to (i) waiting times and communication delays, and (ii) because it is more difficult for the physician to aim the system at the desired portion of the eye. These difficulties result in longer examination times (far exceeding 2-3 minutes). Furthermore, the clinical quality of the examination decreases due to the extended examination duration, potentially leading to medical legal issues. Specifically, the significantly longer examination duration due to waiting times causes fatigue for both the physician (attempting to focus and track the eye) and the patient (due to lighting intensity and examination duration), resulting in a decline in the clinical quality of the examination. Therefore, when viewing a set of images on a screen, an ophthalmologist cannot mentally compensate for all these distortions, as a bad image remains a bad image.

[0024] This disclosure provides a new technique for eye examinations, including a semi-autonomous system that provides shorter and more convenient eye examinations for local or remote ophthalmologists. As will be further described below, the eye examination technology of this disclosure provides an advanced system for local or remote "slit-lamp based" ophthalmic examinations, which has similar (or better) medical quality, functionality, and operating modes for ophthalmologists to those known in the art.

[0025] In addition, this disclosure provides techniques for capturing, storing, processing, analyzing, and displaying various tissue layers of the anterior and posterior segments and appendages of the eye. According to some aspects of this disclosure, it is intended for use by ophthalmologists in ophthalmic medical devices, including remote examinations (telemedicine).

[0026] From an ophthalmologist's perspective, examination techniques utilizing the principles of this disclosure allow for a focus on the clinical aspects of the examination, rather than the "microscopic management" of the examination equipment, especially in remote settings.

[0027] Furthermore, from an ophthalmologist's perspective, using the eye examination system of this disclosure for examination, data collection, observation, and testing, as well as the experience, is similar to ordinary practice, although the emphasized technical concepts differ. This allows ophthalmologists to have a short learning curve in using the eye examination system of this disclosure.

[0028] Visual recording of medical findings enables reliable and convenient follow-up. Furthermore, the unique method of this disclosure allows for asynchronous dynamic slit scanning controlled by an ophthalmologist, thus allowing for the redoing of previous examinations.

[0029] For example, to perform a standard test, the system should be aimed at 22.5 degrees, with a slit projection width of approximately 300 micrometers, and the imaging portion of the system should be fully frontal oriented. Assume that approximately 100 images should be captured to cover the eye. Asynchronous dynamic slit scanning means that when the capture process is triggered, the system aims itself at the correct position (degree and focus) in front of the eye, and all approximately 100 images are captured automatically without any intervention from the operator or doctor. It is important to note that in this example, the system remains stationary while capturing approximately 100 images, and there is no motor movement during the automatic set of acquisitions itself.

[0030] The images obtained using the system disclosed herein can be used for patient education and for information related to collaboration with patients. It can also be used for public education, such as the education of faculty and professional students.

[0031] Images obtained using the system disclosed herein can be used to obtain second opinions (clinical), share images, share clinical notes or mark images, collaborate on suspicious findings, or conduct asynchronous examinations. Furthermore, the telemedicine providing the second opinion can control the system and synchronously set operating parameters.

[0032] Solutions using still imaging (as opposed to video-based solutions), such as those described in this disclosure, can reduce the required communication bandwidth and allow for higher image quality and resolution. Furthermore, the techniques disclosed herein offer improved resilience to poor network connectivity (both throughput and latency).

[0033] Doctors can view this series of images as a video stream and freeze on a specific image while maintaining its full resolution without image compression. Furthermore, doctors can annotate findings and use digital zoom to scan the images back and forth frame by frame.

[0034] In some embodiments, when saving image acquisition parameters, it is able to recapture the same scene, location, and attributes as in the previous inspection, and is able to compare the same findings captured in two different inspections and visualize them side by side (or transparently overlap them), while simultaneously scrolling / viewing the same slit in both images.

[0035] From the patient's perspective, undergoing an eye examination using the techniques of this disclosure is simpler and more comfortable, at least because the techniques of this disclosure allow for a significant reduction in the duration of the examination session during which the eyes are exposed to high-intensity lighting, while the patient needs to minimize eye movements.

[0036] The combination of all the above-described features of the disclosed technique for eye examination enables reliable and efficient remote slit-lamp examinations to conserve vision, improve eye care services, and result in time savings for doctors, local operators, and patients.

[0037] Therefore, according to a broad aspect of this disclosure, a system for eye examination is provided, comprising: An illumination device comprising at least one optical projector, each of the at least one optical projector being configured and controllably operable to automatically project a sequence of illumination points of a predetermined shape onto a plurality of locations extending across the eye region in a spaced-apart relationship during the eye examination session; and At least one imaging device, each of which is configured and operable to acquire images of the eye including locations illuminated by the illumination point during the examination session, and to generate image data associated with the plurality of locations, the image data indicating anomalies with respect to each of the locations within the eye region, and The control system includes a manager utility and a controller, wherein the manager utility is configured and operable to define operational data of the semi-autonomous system controlled by the controller in response to input data including preset data indicating an examination task, the operational data defining operational parameters of the examination session of the eye, and the controller is configured to operate each of the at least one imaging device in synchronization with a corresponding at least one optical projector, thereby enabling the minimization of image degradation factors in the image data and minimizing the time the eye is exposed to illumination during the examination session.

[0038] It should be noted that the preset data input may include (i) pre-stored data (associated with corresponding operational data for the semi-autonomous system) indicating examination tasks aimed at identifying specific pathologies and / or imaging specific parts of the eye region, and / or (ii) dynamically provided input from physicians at remote physician-related stations.

[0039] Preset data may include a list / sequence of patterns used in eye examinations and / or various image acquisition parameters (light intensity, light type, light spectrum, focal conditions, etc.), each associated with a specific pathological type of the eye region and / or the examination of a specific part (organ).

[0040] Preset data can be designed / configured for each clinical examination (to detect / analyze pathology) and may include predefined or dynamically updated data regarding one or more of the following: illumination angle, imaging angle, illumination intensity, slit shape, etc. In some embodiments, the preset includes parameters regarding the desired focal location, specifying the precise point in the eye that the system should focus on.

[0041] Preset data may include data specifically used for pathological detection and / or data used for the use of specific focus mechanisms.

[0042] It should also be noted that the term " Semi-autonomous system "This should be interpreted broadly, also encompassing fully autonomous systems. This is because the technology of this disclosure, related to the implementation of eye examinations, can indeed be implemented by fully autonomous equipment. For example, the system includes pre-stored information about the examination to be performed for a particular patient. Thus, the patient can enter their ID, etc., and operate the system to begin the examination by pressing an operation button. As will be further described below, the system will first perform a security check to ensure the patient is in the correct registration position, etc."

[0043] In some embodiments, the eye examination system of this disclosure is configured and operable to perform general examinations using a so-called “asynchronous mode,” that is, to perform a number (one or more) of predefined examinations fully automatically according to corresponding examination-related presets, enabling the automatic execution of sequences of two or more examinations across different areas of the eye and providing data indicating a broad overview of the eye or eye condition. Such procedures can be initiated even by personnel without clinical training.

[0044] In some embodiments, the system is configured and operable to define operational data based on selecting examination configurations from input data using synchronous or asynchronous modes. For example, the system performs selections from a list (pre-stored data) of examinations designed to address specific parts of the eye (eye regions) or suspected pathologies. Thus, a set / number of predefined examinations optimized for the selected eye and / or pathology are provided. This can be done with or without the real-time observation of an ophthalmologist. In another example, a synchronous mode is used to perform selections, where examinations are performed while the ophthalmologist observes the eye in real-time (typically at a remote station), allowing the physician to preview the expected image acquisition. This allows the physician to select and provide various examination parameters (as part of the preset input data).

[0045] In some embodiments, the system is configured and operable to implement a so-called "hybrid mode" that combines the above-described synchronous and asynchronous modes.

[0046] It should be noted that the term "synchronous mode," which refers to system operation as one possible implementation method, should not be confused with the "synchronous" operation of optical projectors and imaging devices. The latter remain in any system operating mode and present synchronized image acquisition.

[0047] Therefore, in some embodiments, the input data includes preset data, which comprises a list of records associated with at least one of a specific pathological type, function, and examination of a specific portion of the eye region, wherein the records include multiple data records associated with various types of operational data to be used in the examination session. Additionally, the input data may include data received from a physician's remote station, based on the physician's review of initial image data provided by the control system, indicating physician preview data for expected image acquisition during the examination session, wherein the physician preview data may include data indicating one or more examination parameters. Alternatively or additionally, the input data includes preset data, which includes data indicating two or more examination tasks across different regions of the eye. The control system is adapted to operate the semi-autonomous system in a fully automatic mode, which enables the automatic execution of sequences of two or more examination tasks, thereby providing data indicating a broad overview of the eye's condition.

[0048] The semi-autonomous system disclosed herein is preferably configured to prevent any movement of any physical components of the system after an activation signal for initiating a check session is generated (e.g., in response to pressing a button). In other words, the positions of the system components are fixed during the check session.

[0049] The technology disclosed herein utilizes eye examination by electronically scanning the eye region with projected images. This allows different or varying patterns to be projected onto the eye region during the examination session (while maintaining the system's "physical stillness").

[0050] The system may include an optical projector of number N (N≥1) and an imaging device of number M (M≥1), wherein the number N and M may be the same or different.

[0051] For example, a pair of optical projectors associated with one or two imaging devices (operating synchronously with one or two imaging devices) can be used to perform examinations of both eyes simultaneously or for stereoscopic imaging of one eye. Alternatively or additionally, different optical projectors configured to operate with different operating parameters (e.g., focus conditions, intensity, spectrum, etc.) can be used to perform examinations simultaneously or sequentially on different parts of the eye (e.g., the anterior (cornea and / or lens and / or iris) and posterior (retina) parts).

[0052] In some embodiments, the at least one optical projector and the at least one imaging device are configured with extended depth of field, such that illumination points automatically projected onto the plurality of locations are focused at the respective plurality of locations, and the image data indicates the corresponding focused image at the location.

[0053] In some embodiments, the at least one optical projector and the at least one imaging device are configured with an extended depth of field that is independently controlled by the controller.

[0054] More specifically, the extended depth of field can be selected to include multiple anterior segment parts and appendages of the eye in simultaneous focus.

[0055] In some embodiments, the semi-autonomous system includes a focusing mechanism configured and operable to initially focus at least one of an optical projector and an imaging device on a relatively high-contrast portion of the eye (such as the iris), and then move the focus forward or backward toward the portion to be examined (e.g., the cornea) based on a known distance between the high-contrast portion and the portion being examined.

[0056] For example, in order to focus on the transparent cornea of ​​a healthy person, the system uses autofocus on the iris (a high-contrast area) and then moves back a few millimeters to position the focus near the cornea.

[0057] In some embodiments, the system analyzes the 3D structure of the eye portion relative to the examination area (e.g., by using a slit as a structured light element) to focus on the desired area.

[0058] In some embodiments, the semi-autonomous system includes an autofocus mechanism that is automatically operated by the controller according to the operating parameters of the eye examination session. At least one of an optical projector and an imaging device may include the autofocus mechanism.

[0059] In some embodiments, the lighting system is configured to enable electronic iris and / or electronic zoom functions.

[0060] Preferably, the predetermined shape of the illumination point is a slit shape.

[0061] The at least one optical projector can be configured and controlled to automatically project the sequence of slit-shaped illumination points in a single-slit continuous manner, the image data comprising corresponding continuous image data segments, each image data segment comprising a single-slit image.

[0062] The at least one optical projector may be configured and controllably operated to automatically and simultaneously project at least a first array of spaced-apart slit-shaped illumination points in at least a first multi-slit manner; the image data includes at least one first image, each first image being an image of the at least first array at spaced-apart locations.

[0063] The optical projector is operable to sequentially project a first array of illumination points in a slit-shaped configuration (first multi-slit arrangement) and a second array of illumination points in a slit-shaped configuration (second multi-slit arrangement) onto corresponding first and second arrays at the locations, wherein the first and second arrays at the locations are arranged in an alternating manner; the image data includes first and second images of the first and second arrays at the locations, respectively. The first and second locations may partially overlap.

[0064] In some embodiments, the at least one optical projector is configured and operable to automatically change the projection spherical angle of the illumination point relative to the eye, and the image data includes image data segments at corresponding positions associated with data indicating the projection spherical angle.

[0065] In some embodiments, the system further includes an imaging unit configured and operable to obtain a wide field-of-view image of the eye, thereby enabling alignment of a foreground image formed from the image data with a background image formed from the wide field-of-view image of the eye.

[0066] In some embodiments, the system further includes a registration component for registering the position of a user's face during the inspection session. For example, the control system further includes an activation utility configured and operable to activate the semi-autonomous system to perform the inspection session in response to a control signal indicating a safe condition in which the user's face is in the registration position; and / or the system includes a sensing system configured and operable to monitor the user's facial position and generate corresponding sensing data to be analyzed in order to determine the user's facial position relative to the registration position, selectively generating the control signal.

[0067] The sensing system can be configured and operable to transmit the sensing data to a security controller at a remote control station, where the sensing data is analyzed and the control signal is selectively generated and transmitted to the controller. For example, the system includes a security controller that is responsive to the sensing data and configured and operable to analyze the sensing data and generate the control signal to the controller upon recognizing the registration location of a user's face.

[0068] In some embodiments, the lighting device includes a flash illuminator.

[0069] In some embodiments, the semi-autonomous system includes an eye-aiming device that is automatically operated by the controller according to the operating parameters of the eye examination session.

[0070] In some embodiments, the semi-autonomous system includes an eye-tracking mechanism that is automatically operated by the controller during the inspection session.

[0071] The semi-autonomous system may include one or more movement mechanisms for controlling the movement of one or more components of the system; and may include a safety controller configured and operable to control the one or more movement mechanisms.

[0072] The at least one imaging device can be configured and operated to capture 3D images.

[0073] The at least one imaging device may include a color or monochrome sensor.

[0074] The at least one imaging device may include a monocular and / or multispectral sensor.

[0075] The control system may also include an image processor utility configured and operable to analyze the image data and generate data indicating the number of anomalies in a corresponding number of locations.

[0076] The control system is preferably configured and operable to transmit data indicating the image data to a remote control station for further processing to identify and analyze abnormalities in the eye.

[0077] The control system may include an image processor utility configured and operable to: extract the single-slit image from each of the consecutive image data segments at corresponding locations, crop the extracted single-slit images, and paste the cropped extracted single-slit images onto a background image serving as a wide field-of-view image of the eye. For example, the control system may include an image processor utility configured and operable to segment the at least first multi-slit image into a set of corresponding single-slit images.

[0078] The image processor utility can also be configured and operable to paste each of the single slit images extracted from the at least first multi-slit image onto a background image serving as a wide field-of-view image of the eye.

[0079] The image processor utility can be configured and operated to generate data indicating the dynamic movement of the single slit image above the eye, thereby enabling a human to pause the data presented for a particular slit view.

[0080] The image processor can be configured and operated to use the image data to generate a 3D reconstruction of the acquired data in the acquired image.

[0081] In embodiments where the lighting device includes at least one pair of optical projectors, each pair of optical projectors is associated with one or two imaging devices for performing stereoscopic imaging of the eye and providing stereoscopic image data of the eye region. The image processor is configured and operable to: generate a 3D reconstructed image from two multi-slit images using the stereoscopic image data; identify at least one 3D single-slit image in the 3D reconstructed image; project the at least one 3D single-slit image onto a 2D image to obtain a 2D projected image including the at least one single-slit image; extract the at least one single-slit image from the 2D projected image; crop the extracted single-slit image; and paste the cropped extracted single-slit image onto a background image serving as a wide field-of-view image of the eye.

[0082] In some embodiments, the image processing utility is configured and operable to analyze the image data by applying algorithmic techniques, including one or more of artificial intelligence, image enhancement, image recognition, image sharpening and image restoration, and encoding.

[0083] The image processing utility can be integrated with at least one of the optical projector and the imaging device.

[0084] In some embodiments, a control system (e.g., a manager utility) is configured to communicate data with an image processor at a remote control station. This data communication may include data transmission using encrypted, secure communication. The control system (e.g., the manager utility) may be configured and operated to generate a compressed representation of the image data and transmit the compressed representation to the image processor at the remote control station.

[0085] The control system can be configured and operated to independently control the automatic variation of one or more of the following operating parameters: the size of the illumination point, the illumination wavelength, the illumination intensity, the illumination angle, the imaging angle, the focus shift of the illumination and / or imaging device, the eye turn, and the background illumination.

[0086] According to another broad aspect of this disclosure, a control system for managing and controlling eye examinations via a semi-autonomous examination system is provided. The control system includes at least one optical projector and at least one imaging device. The optical projector is operable to automatically project a sequence of illumination points of a predetermined shape onto a plurality of locations extending across the eye region at intervals during an eye examination session. The imaging device is operable to acquire images of the plurality of locations and generate image data associated with the plurality of locations during the examination session. The control system is configured as a computerized system having data input and output utilities, memory, and image processor utilities. The control system includes: A manager utility, configured and operable to define operational data for the semi-autonomous system in response to input data including preset data indicating inspection tasks, the operational data defining operational parameters for the eye's inspection session, and A controller is configured to operate the at least one imaging device using the operational data and in synchronization with the optical projector, thereby minimizing image degradation factors in the image data and minimizing the time the eyes are exposed to illumination during the examination session.

[0087] The control system can be configured as an electronic unit to be installed in the semi-autonomous inspection system.

[0088] The control system can be configured and operated to communicate with a remote control station, the manager utility responding to instructions from the remote control station to update at least one of the preset data and the operational data.

[0089] In another aspect, this disclosure provides a server control system, which is a computerized system (including input and output utilities, memory, processor, etc.) connectable via a communication network to a subscriber eye examination system of the type performing a semi-autonomous eye examination procedure. Such a server control system is configured and operable to perform model-based processing (AI-based processing) of input image data received from each subscriber system (identified by a subscriber ID) and generate output data including: (i) data indicating suspicious portions in the examined eye region and observations to enable the detection of abnormalities and / or pathologies; (ii) data indicating abnormalities and / or pathologies in one or more portions of the examined eye region; and / or (iii) the quality level of the image data provided by the subscriber system; and / or (iv) data indicating recommended preset data (e.g., system operating parameters, such as patterns to be used) for an examination session performed by a particular subscriber system (regarding a specific portion of the eye and / or a specific abnormality to be detected and / or a particular patient). Brief description of the attached diagram

[0090] To better understand the subject matter disclosed herein and to illustrate how it can be implemented in practice, embodiments will now be described by way of non-limiting example with reference to the accompanying drawings, in which: Figure 1 The general principle of the eye examination technique disclosed herein is illustrated. Figure 2 The eye examination system of this disclosure is illustrated in block diagram form; Figure 3 An example of an eye examination system based on the principles of this disclosure is shown; Figures 4A to 4C An example of a single-slit image obtained using the eye examination system of this disclosure is shown; Figure 5A A general technical example of a single slit image with clear pathological results is shown; Figure 5B and Figure 5C An example is a single-slit image obtained using the techniques of this disclosure, which enables the extraction of pathologically relevant data; Figure 6 A multi-slit image of a multi-slit pattern projected onto a real human eye is shown; Figure 7 An example is shown of separating a set of multi-slit images into single slits, pasting them onto a background image, and the resulting single-slit image. Figure 8A and Figure 8BThe present disclosure illustrates a technique for projecting a first and second set of illumination points of a multi-slit shape onto a corresponding first and second set of positions on an eye, wherein the first and second positions are arranged in an alternating manner, and illustrates subsequent reconstruction of a multi-slit image into a single-slit image set. Figure 9 This illustrates a stereoscopic single-slit view of the eye being examined, displayed to a remote ophthalmologist; each image was generated by pasting the same slit onto a background image taken from its respective angle; both images were interpreted by the ophthalmologist as stereoscopic single-slit images, similar to an examination performed using a conventional binocular slit-lamp device; and Figure 10A and Figure 10B The flowcharts illustrate the asynchronous (store and forward) and synchronous (real-time) examination processes implemented by the eye examination system of this disclosure. Detailed Implementation

[0091] refer to Figure 1 The illustration depicts a concept for an eye examination technique of this disclosure that provides high-confidence remote examination, wherein the quality of the examination is independent of the operator's (non-physician) skill. The eye examination technique of this disclosure enhances the detailed visual information displayed to ophthalmologists.

[0092] The technology disclosed herein utilizes a real-time, remote, automated or semi-automated eye examination system 100 configured and operated according to the present disclosure, which enables an ophthalmologist at a remote station 102 to handle several system sites and enables short-term or long-term medical follow-ups of specific patients.

[0093] The examination system 100 and the doctor-related station 102 can also communicate with the cloud computing (server) system 105 (via a communication network and any known suitable protocol). As described below, the doctor-related station 102 is used for viewing and remote parameter settings, while the heavy computational / data processing can be handled by the cloud computing server 105. The server 105 can be used for examination management, examination metadata and visual recording, and advanced processing. Such a server 105 can serve as an intermediary layer between the components of system 100 and the doctor-related system 102. Cloud computing can be implemented on a physical cloud server, a remote PC, or even on a local PC of system 100 or system 102.

[0094] Automatic image acquisition performed by system 100 can be initiated locally by the local controller of system 100 or from a remote control station (e.g., at doctor's station 102), thus eliminating the need for micromanagement (i.e., no direct and continuous micromanagement control of specific motors and system components is required). Slit movement and capture micromanagement are performed automatically by system 100.

[0095] From the patient's perspective, the system of this disclosure advantageously reduces the improved patient cooperation resulting from the short duration (e.g., <1 second) of the patient's eye exposure to intense slit lamp illumination, thereby further reducing the duration of eye examinations. The short exposure duration also addresses a major limitation of slit lamp devices known in the art, caused by patient eye movements (voluntary and involuntary), which prevents aiming at the desired portion of the eye during an eye examination session. Attempts to achieve "manual remote control of the slit lamp" by connecting motors for controlling various slit lamp movements and a digital camera for capturing video or images of the eye being examined are limited in power due to communication and motor movement delays.

[0096] The short exposure duration provided by the system of this disclosure is achieved through a novel optical setup of the semi-autonomous system of the eye examination system of this disclosure. As will be further described below, such an optical setup includes at least one illumination device configured and operable to automatically project a sequence of illumination points of a predetermined shape (e.g., a slit shape) onto the eye while electronically moving the position of the slit on the eye. This movement (scanning) of the slit position is performed electronically, i.e., without requiring the movement of any light source component by a motor, which inevitably introduces motor movement delay / artifacts. The system of this disclosure also includes at least one imaging device, such as one or more cameras, which can be stationary during the examination session, i.e., during the acquisition of the slit image sequence. It should be noted that in some embodiments, motor movement may be used, provided that micromanagement is performed automatically.

[0097] The projection of the illumination point and the acquisition of the corresponding image sequence can be performed synchronously and quickly enough to provide a continuous view of the examination area, avoiding discontinuous slit coverage due to blinking, occlusion, pupil structure, etc., and eliminating image blurring caused by motion artifacts, such as minimizing eye movement. It should be noted that the techniques disclosed herein allow the necessary image acquisition for the examination session to be performed before the eye moves (including blinking) to another location, thus causing discontinuities.

[0098] Therefore, all the necessary data for examining the desired portion of the eye can be obtained during a short period of time during which image freezing technology can be implemented.

[0099] Specifically, the technology disclosed herein allows for a real-time preview of an eye scene to the operator / remote doctor so that the system can be aimed at the desired area, while at the moment the acquisition button is pressed, the preview state is frozen and the image series is captured as still images (i.e., frozen image technology).

[0100] As will be further described below, the system disclosed herein allows physicians to modify capture parameters such as illumination angle, capture angle, slit size (width, height, shape, orientation), slit strength, etc. However, whenever the physician presses the capture button, the system automatically performs all acquisition micro-management. The system is capable of independently controlling observation parameters such as zoom (optical and / or digital) and observation angle.

[0101] refer to Figure 2 The diagram illustrates the eye examination system 100 of this disclosure in block form. System 100 includes, in particular, a semi-autonomous system 110 and a control system 150. System 100 is also configured to communicate with at least one remote system at a remote control station 160 (using any known suitable communication technology), which can be used, in particular, as a tool for ophthalmologists to remotely operate the semi-autonomous system 110.

[0102] As also shown in the figure, system 100 and / or remote control station 160 communicate with server system 105 via data (using any known suitable communication technology).

[0103] System 100 may also include a technician screen 176, a sensing system 170, and a safety controller 172. Similar to the remote control system 160, the technician screen 176 can be used to control the system and its parameters.

[0104] The remote control system 160 may include a data processor unit 158, which may also reside on an external server (remote control system).

[0105] The semi-autonomous system 110 is configured and operable to perform multiple examination sessions of a patient's eye and provide corresponding image data. The semi-autonomous system 110 includes at least one illumination device 130 and at least one imaging device 120. In some embodiments, the semi-autonomous system 110 may further include an eye aiming device 144, a master motion controller 146, and a registration component 174.

[0106] The lighting device 130 includes at least one optical projector 132, each optical projector 132 being configured and controllably operable to automatically project a sequence of illumination points of a predetermined shape onto multiple locations extending across the eye region in a spaced-out relationship during an eye examination session. The optical projector 132 includes a scanning unit 134 (e.g., a scanning mirror) associated with the illumination source 136, and may also include various optics 138. In some embodiments, the projector 132 may include a motion controller 140.

[0107] In some embodiments, the projector 132 may include a scanning mirror mechanism (DMD), an LCD, an electronic DOE, or a combination thereof, which enables projection at various locations within its field of view without moving the lighting device 130.

[0108] As also shown in the figure, system 110 preferably includes an additional lighting unit 142, which may or may not be part of lighting device 130. The additional lighting unit 142 provides backlighting and / or background lighting.

[0109] An optical projector 132 is configured and controllably operated to automatically project a sequence of illumination points of a predetermined shape onto multiple locations extending across the eye region in a spaced-out relationship during an eye examination session. The sequence of illumination points of the predetermined shape can be focused onto multiple locations within the field of view of the optical projector 132. In some embodiments, the projector 132 can be configured to project radial patterns, concentric patterns, and multiple patterns (such as multiple slits).

[0110] In some embodiments, the sequence of illumination points can be projected at time intervals to enable specific examinations, such as pupillary response to illumination, strabismus testing, tear breakup time, and dynamic movement of contact lenses.

[0111] In some embodiments, the optical projector 132 is configured and operable to automatically change the projection spherical angle of the illumination point sequence relative to the eye. The movement control 140 of the optical projector 132 can automatically or manually change the projection angle to any feasible angle relative to the field of view. Therefore, the image data provided by the semi-autonomous system 110 includes image data segments associated with data indicating the orientation of the spherical angle of the projection.

[0112] In some embodiments, the illumination device 130 and the imaging device 120 may include optics that support depth of field, which can be focused on an area including the entire front portion (~13 mm) of the eye. To achieve this depth of field, the illumination device and the imaging device may each have their own optics. However, in some embodiments, they may partially or completely share the same optical path axis.

[0113] The imaging device 120 of the semi-autonomous system 110 includes an imaging sensor 122 associated with or including the built-in optics 124, typically one or more cameras.

[0114] Imaging device 120 is configured and operable to acquire focused images of multiple locations illuminated by a point of illumination during an examination session, and to generate image data comprising at least multiple image data fragments associated with the respective multiple locations. The image data indicates abnormalities in locations within the eye region, enabling the extraction of abnormality-related information through further image processing and / or manually by the physician. For example, deformation of the slits can indicate a pathology or condition in the eye structure. The physician examines the edges of the slits; therefore, they should be as sharp as possible at the focal point of the illumination and view-parallel system.

[0115] The same imaging device 120 or the separate imaging unit 128 is preferably further configured to operate together with the illumination device 130 or the additional illumination unit 142 to achieve a wide field-of-view imaging mode.

[0116] During the inspection session, at least one imaging device 120 may operate synchronously with at least one optical projector 132 (using SW and / or HW synchronization) to properly acquire images of the sequence of projected illumination points.

[0117] It should be noted that, typically, system 110 includes an N (N≥1) number of optical projectors and an M (M≥1) number of imaging devices, wherein the number N and M may be the same or different.

[0118] Image data can be processed by a control system 150 integrated with or connectable to the semi-autonomous system 110. The results of data analysis obtained by the control system or the raw image data provided by the imaging device 120, or both, can be appropriately stored and transmitted / forwarded in a timely manner to a remote control system and / or server at the physician-related station 160.

[0119] A local operator or physician can perform asynchronous examinations of a patient's eye (“store and forward”) by executing a set of fully autonomous, predefined examinations and then scrolling between the generated images and findings reports of the examination session. This examination scenario does not require simultaneous interaction with the patient / examination equipment. Medical information, including images and data acquired by system 110, is stored and then forwarded to a physician / expert for review and interpretation of the data. Alternatively, a physician can perform a synchronous (“real-time”) examination, where he / she controls the examination parameters of the semi-autonomous system 110 and / or views the findings in real time. In this case, the examination is dynamically guided by the physician. For example, the physician can select in real time the angle of a subsystem of imaging device 120, the projection angle of optical projector 132, the slit / projection type, width, and intensity level, and then the semi-autonomous system 110 autonomously executes the selected illumination and imaging parameters. Therefore, the technology of this disclosure provides an optimal method for combining synchronous (real-time) examination flows with asynchronous (“store and forward”) examination flows. The control system 150 is configured as a computerized system, particularly featuring data input and output utilities (not shown), a memory 153, and a processor 152. According to the technology disclosed herein, the control system includes a manager utility 155 and a controller 151. The latter may include or be associated with an actuator utility 154 to actuate / trigger the operation of lighting and imaging equipment, as will be further described below. Furthermore, the control system is suitably equipped with a communication utility 156 for data communication with a telemedicine-related station 160, and may also communicate with system 110, as appropriate. The control system 150 may also be associated with (or may be connected to) a sensing system 170 and a safety controller 172, as will be further described below.

[0120] The manager utility 155 is configured and operable to identify data indicating examination tasks related to a specific eye examination prescribed for a particular patient and to define operational data for the semi-autonomous system 110. To this end, the manager utility can select examination task data in response to input data including patient-related data and from data pre-stored in memory associated with corresponding operational data, or in response to input data including examination task data and selecting operational data pre-stored in memory. The operational data is used by the controller 151 to control the corresponding operation of the system 110. The operational data defines the operational parameters of the eye examination session.

[0121] As will be described in further detail below, the eye examination system 100 can operate autonomously and is capable of performing a series of examinations entirely on its own. A predefined set of examinations is stored, for example, in the memory 153 of the control system 150. Each predefined examination, having its corresponding pre-stored operational data, is referred to herein as a “preset” and is specific to each clinical examination (e.g., designed to detect / analyze a specific pathology or eye condition). Presets can be directly retrieved from station 160 ( Figure 1 The doctor at 102) obtains / updates data from and / or obtains data from server 105. Manager utility 155 is responsible for selecting pre-stored operational data based on the specific examination task. For example, predefined presets may include, but are not limited to, predefined values ​​for illumination angle, imaging angle, slit shape, and intensity required for a specific examination in corneal pathology.

[0122] Presets can be predefined on the server and can be set by system administrators and doctors as a set of operations for repeatable future examinations.

[0123] The technology disclosed herein provides for the management and execution of optimized examination procedures (image acquisition and image data evaluation modes). In this regard, it should be noted that there are two main operating modes in the field of telemedicine—synchronous (real-time) and asynchronous (“store and forward”).

[0124] In a synchronous (real-time) examination procedure, the physician controls the examination parameters of the device and views the findings in real time. The examination is dynamically guided by the physician. Suitable examples may include those known as the da Vinci Surgical System, as well as devices used for remote eyeglass fitting (subjective refraction).

[0125] During an asynchronous review (“store and forward”) process, a patient’s medical information is collected and recorded for later interpretation by a healthcare provider. This unique model allows for geographical and temporal separation between doctors and patients. Medical information, including images and data, is stored and then forwarded to a specialist who reviews and interprets it at a later time, without requiring simultaneous interaction.

[0126] The eye examination system 100 disclosed herein is capable of operating autonomously or at least semi-autonomously to perform a series of examinations entirely on its own. The system can track and adjust accordingly to guide the subject's eyes to optimal orientation, perform autofocus tailored to the specific examination required, and autonomously and rapidly capture all necessary images.

[0127] For example, since it is difficult to focus on the transparent cornea of ​​a healthy person, the system can operate as follows: the system can focus a slit projection onto a high-contrast element within the FOV (e.g., on the iris), and then modify the focus to be in an optimal position so that the optimal focus is at the average distance from the iris, i.e., the examination location and examination point. For example, the system can use the distance from the iris as data input for a specific patient. Note that the average distance from the iris derived from the general population may not be applicable to myopic patients. In some embodiments, to detect the optimal focus, the system uses a slit projection (or multiple slit projections) to analyze the curvature of the examined portion and uses the understanding of the curvature of the examined object to adjust the focus position.

[0128] Additionally, the control system 150 can assess the quality of the images being acquired and allow transition to the next examination, continuing the process until the entire series of tests is completed. Three image quality categories can be defined: good, acceptable, and poor, where images found to be of poor quality will need to be recaptured. Therefore, for asynchronous examinations, the local operator can simply press a button to initiate a series of tests and then send it for the doctor's analysis. Alternatively, the doctor can set the examination parameters and manage it synchronously in real time while monitoring the subject's eyes. Alternatively, the system can be configured to acquire multiple sets with the same preset and forward the best set, or forward a new set created using the best images from all acquired sets, thus providing the same continuous coverage as a single set.

[0129] It should be noted that image quality can be controlled using image processing heuristics known in the art, contrast level estimation, hue saturation measurement, or by using a dedicated deep neural network for image quality estimation (e.g., a CNN designed to classify several quality categories). Furthermore, in some embodiments, the system ensures that all slit images in the set have been captured and that they provide complete coverage of the inspection area using image processing methods, DNN models, etc., known in the art.

[0130] Due to their fully or at least semi-autonomous inspection capabilities, the technology disclosed herein offers different levels of control and automation to be selected based on the required use case. This includes the following: General examination (asynchronous) – Performs several predefined examinations entirely autonomously, each with different presets. This can be initiated by personnel without clinical training. These examinations are performed in different areas of the eye, enabling ophthalmologists to gain a broad understanding of the eye's condition and identify potential pathologies (if any).

[0131] Examination configuration selection (synchronous / asynchronous) - Select from the examination list, designed for a specific part of the eye or suspected pathology. Upon selection, a set of predefined examinations optimized for the selected eye or pathology are performed. This can be done with or without the real-time observation of an ophthalmologist.

[0132] Selection of Examination Parameters (Synchronous) - In this mode, the examination is performed while the ophthalmologist observes the eye in real time. This allows the doctor to obtain a "preview" of the desired acquisition. The doctor can select various examination parameters, such as: illumination and imaging angle, slit parameters—width, height, color, shape, zoom, aperture, and intensity. The position of the slit beam can also be controlled. Once satisfied with the preview, a series of images of the entire region of interest are acquired.

[0133] Fully manual control (synchronous) – “Micro-management mode”, generally similar to other remote-controlled slit lamp solutions. This involves complete manual control of the inspection equipment, including various mechanical degrees of freedom and slit positioning on the eye being inspected. This process is primarily suitable for field inspection scenarios.

[0134] One or more alternative routes may include the following: the local operator manually aligns the system in front of the eye, and then the system operates to perform autofocus (AF) (or manually adjust the focus), angle, and slit properties; and only then is the automation of image acquisition used.

[0135] The system can operate in a so-called “hybrid check mode” that combines synchronous and asynchronous modes as well as one or more of the aforementioned optional routes.

[0136] The operation can be briefly described as follows: When a new patient arrives at the examination location, the local operator initiates a default general examination series automatically acquired by system 110. The acquired examination series is sent to the ophthalmologist at station 160. The ophthalmologist reviews the examination series while dynamically positioning the slit during each examination. If the doctor locates or suspects a finding and wants to further examine the suspected area / pathology, the doctor can examine the eye in real time while obtaining relevant examination series, such as a corneal examination series. In extreme cases, when relevant examination series do not provide satisfactory answers, the doctor can request an examination with a specific set of parameters. A manual mode can also be used for face-to-face examinations.

[0137] It should be noted that the system 110 of this disclosure is configured to support physician viewing mode. The system is designed to provide a continuous experience and is intuitive for physicians, similar to a traditional slit-lamp examination. Therefore, the transition between the acquisition process and viewing the acquisition results is intuitive and smooth. Switching between examinations with different parameters is also intuitive. For example, when switching to another examination with a wider slit, the initial slit position will remain where it was left in the previous examination, so the physician's experience is as if the slit were widened during a conventional examination.

[0138] In addition, the acquisition results can be viewed through several user-friendly modes, including video mode, slit position change mode, and frame-by-frame transition mode. Video mode provides automatic and sequential transitions between multiple slit frames, with the slit position in each frame slightly different from the previous frame, collectively covering the region of interest (potentially the entire anterior segment of the eye). The doctor gets an impression of the slit transitioning across the eye via video. The doctor can control the "video speed" as needed. Slit position change mode allows the doctor to perform controlled slit scans of the eye using a slider. Using this slider, the slit can also be "aimed" at the desired area of ​​the eye being examined. Frame-by-frame transition mode allows selection of frames with the desired slit position from a library. This mode is useful whenever a result has been located and the doctor is interested in observing it with a slightly different slit position. The aforementioned modes can be used interchangeably to allow for efficient video viewing while ensuring examination quality, as doctors can remain in one location at any given moment to reflect, mark findings, and digitally zoom in on desired areas. The system also offers more advanced viewing modes for recording, comparing with previous examinations, and referrals for second opinions.

[0139] The above and other details of the technology disclosed herein are described in further detail below.

[0140] Lighting and imaging devices can typically have any known suitable configuration. Light source 136 can be one or a combination of the following: halogen / xenon, LED, laser, or any light / energy source known in the art. Light source 136 can use narrow-spectrum or broad-spectrum light. The color of the illumination can be monochromatic or a combination of monochromatic and a wide range of colors. The color can be outside the visible spectrum, i.e., infrared or a combination of several wavelengths. Light source 136 may include bandpass or cutoff filters. In some embodiments, the lighting source may include a DMD, LCD, electrical DOE, and other subsystems that can produce attributes as points of projection.

[0141] Optical device 138 may include one or more lenses for obtaining a desired region of interest (ROI) on the eye being examined and / or one or more apertures for obtaining a desired depth of field (DOF). The aperture size may be constant or variable, controlled manually or by software. Changes in aperture size may be triggered by another system component or manually. The aperture size can be configured manually according to predefined presets or as requested by the physician. Optical device 138 may additionally include polarizers and / or filters.

[0142] The scanning unit (illumination projection device) 134 can be configured using one or more of the following techniques: programmable LCD or DLP projection, microLED projection, use of electro-diffractive optical elements (DOE), hardware predefined patterns, and switching between several such patterns.

[0143] Typically, the lighting device 130 may include motors, tracks, encoders, limit sensors, and any other components for radial and linear movement, and their control may be performed by the motion controller 140. The mechanism may include any combination of any of the six possible degrees of freedom, and any number of degrees of freedom may be motorized. Additionally, the optical projector 132 may include a focusing mechanism; in particular, it may include an autofocus support.

[0144] In embodiments using a laser as the illumination source, the optical projector 132 may include a defocus option to define a specific depth of focus. In such embodiments, the optical projector 132 may also include a distance sensor.

[0145] Additionally, in some embodiments, the relative angle (stereo angle) between cameras can be modified manually or automatically.

[0146] It should be noted that the semi-autonomous system 110 of this disclosure addresses a major problem of distorted images encountered during conventional slit-lamp examinations. In a typical conventional slit-lamp examination, at each moment of the examination, the ophthalmologist can only see clearly and in high quality fragments of a clear image, while other parts are blurry, distorted, out of focus, or even invisible. The ophthalmologist repeatedly aims and focuses on different parts of the eye, gathering all the observed information in order to reconstruct a complete three-dimensional model of the eye being examined in his mind. Due to the very limited DOF of microscopes and the illumination of slit lamps known in the prior art, the ophthalmologist must scan the individual layers of the eye located at different distances from the microscope and the light source in order not to miss any pathological findings. These limitations still exist in the existing technology of "manually controlled remote slit lamps." However, when observing a set of images on a screen, the doctor cannot compensate for all these distortions in his mind, because a bad image remains a bad image.

[0147] In addition to autofocus support, the semi-autonomous system 110 of this disclosure addresses the aforementioned problems by providing an optical system with an extended DOF for the sensors and illumination device 130 of the imaging device 120 (described further below). This provides a clear and sharp slit view of all layers of the eye on the same image. The DOF of the optical projector 132 is wide enough to include multiple anterior segment parts and appendages of the eye in simultaneous focus. As will be described below, in most cases, the short acquisition duration allows all desired images to be captured before any major eye movements.

[0148] The autofocusing operation of both the lighting and imaging devices can utilize standard image system planners well-known in the art. For example, during the automatic operation of the semi-autonomous system 110 of this disclosure, a standard focus measurement function (FMF) can be used to measure relative focus quality, and a standard random search can be applied to detect the global maximum of image sharpness. Alternatively, the lighting autofocus adjustment can utilize the imaging device to adjust the lighting focus using a standard FMF method that examines the projection at the desired point.

[0149] As described above, the illumination device 130 may include an additional illumination unit 142 (or the illumination device 130 may operate in an additional illumination mode) and operate together with the imaging device 120 (e.g., an additional imaging unit 128) to obtain a wide field-of-view image of the eye. This enables the alignment of a foreground image formed from image data fragments associated with a sequence of illumination points with a background image formed from a wide field-of-view image of the eye, as will be described in further detail below.

[0150] Additional lighting 142 may include direct or indirect lighting sources and the intensity and / or color of the lighting may be controlled. Control may be performed by software, triggered by another system component, or manually.

[0151] In some preferred embodiments of this disclosure, the optical projector 132 is configured and controllably operated to automatically project a series of slit-shaped shapes onto a predefined plurality of locations extending across the eye region in a spaced-out relationship during an examination session. In other embodiments, each projected illumination point may have a predetermined pattern suitable for diagnosing different parts of the eye and ocular appendages.

[0152] Furthermore, in some embodiments, each illumination point may have a predetermined pattern suitable for diagnosing most parts of the eye and ocular appendages (which allows for a shorter examination duration).

[0153] Projected patterns can be a single pattern projection, a series of projection patterns of the same type, or a series of shifted patterns of the same type. An aggregation of a series of adjacent shifted patterns can provide coverage of the entire region of interest. A single pattern can have the shape of a vertical line / slit, similar to the shapes / patterns used in conventional slit lamps. Lines can vary in their orientation, i.e., horizontal, diagonal, etc.

[0154] The optical projector 132 can be configured to project slits having a general shape (e.g., concentric, radial, or any other general form). The projected pattern / slits can be projected with various widths (per slit) and heights, have any number of slits / patterns, and have various constant spaces between the slits. The projected pattern can have variable spaces between the slits. Slits with different patterns can partially or completely overlap.

[0155] In some embodiments described in further detail below, the projection of the illumination point sequence includes the projection of a multi-slit shape / pattern (i.e., an array of spaced-apart slit-shaped illumination points). Typically, two or more such multi-slit patterns are projected sequentially onto the eye region. The optical projector 132 is configured and controllably operable during an examination session to automatically project the multi-slit pattern sequence onto the eye region, such that the illumination points are focused at multiple locations extending across the eye region in a spaced-apart relationship.

[0156] Considering the limitations of the focusing slit width and the spatial constraints between the slits, and the desired scanning of the entire eye region with minimal session duration during the examination session, the multi-slit projection pattern is preferably implemented in an interleaved manner. First and second groups of illumination points are projected sequentially (and in a timely manner) onto corresponding spaced-apart positions of the first and second groups / arrays, wherein the first and second positions are arranged in an interleaved manner. The first and second positions may partially overlap.

[0157] It should be noted that interlaced patterns are preferred for retinal imaging. For imaging of the anterior portion of the eye, a so-called "semi-interlaced" pattern can be used, in which all the anterior portion is covered by a series of projected non-overlapping slits / multi-slits (partial overlap between slits / multi-slits can be used to provide a semi-continuous slit scan).

[0158] The camera used by imaging device 120 can be monochrome, color, multicolor, IR, or any other wavelength or combination of several (including simultaneously operable) wavelengths. Instead of moving to different capture positions, multiple cameras located at different locations can be used. In some embodiments, each camera may have different optics. Furthermore, in some embodiments, one or more cameras are integrated to extend the depth of field or to simultaneously capture the front and back of the eye. Similarly, in some embodiments, multiple projectors located at different locations can be used, and these multiple projectors may have different optics.

[0159] In some embodiments, stereo capture from two cameras can be used to acquire focused images of multiple locations illuminated by a lighting point during an examination session. Either pair of cameras can be used to capture stereoscopic images of the eye region for three-dimensional visualization of the eye for an ophthalmologist (similar to a conventional binocular slit-lamp examination).

[0160] In some embodiments, multiple cameras may be used to obtain higher resolution and / or more data and / or more accurate measurements.

[0161] It should be noted that in some embodiments, a multi-lens imaging device can be used to capture the 3D shape of the illuminated point.

[0162] Generally, the techniques disclosed herein can utilize any known 3D imaging technology, and are not limited to stereoscopic vision or multiple vision.

[0163] Each camera in the imaging device 120 may have an extended DOF in the range of 10-14mm and / or may have an autofocus setting.

[0164] It should be noted that the DOF of the optical projector 132 and the DOF of the imaging device 120 are independent and can be controlled independently (e.g., by the controller 151 of the control system 150). However, it should be noted that the DOF enables the projection and imaging to be concentric, and thus enables the expansion of the system's DOF ​​without limiting the movement of the corresponding DOFs of the illumination and imaging devices together.

[0165] More specifically, when using side projection (i.e., projection from an angle relative to the central axis of the eye), high depth of field allows illumination (and corresponding imaging) to be focused at all illumination (capture) locations.

[0166] The extended depth of field enables the projection and capture of the entire slit set without the use of motors or moving parts in an autonomous acquisition session, as it allows for the capture of all / most of the front of the eye in the same view.

[0167] In some embodiments, a triggering mechanism may be used between the illumination source 136 and the camera 122 to ensure any of the following: simultaneous illumination and acquisition by multiple imaging devices, transitions between consecutive patterns in a pattern sequence, and a reduction in the time required for the image acquisition process.

[0168] More specifically, the transition between consecutive patterns in a pattern sequence can be as follows: a pattern is projected; a trigger is sent to the imaging device (camera) to capture the corresponding image; once image acquisition is complete, the projector is triggered to project the second (next) image, and the camera is triggered again when the next pattern is projected, and so on, until all predefined patterns of a specific preset are correctly projected and imaged. The images are kept in storage (e.g., the system may store the images locally, for example, in the camera's memory) until the preset patterns are projected and imaged, i.e., until the required number of image acquisitions are performed for the inspection session; then the images are forwarded (e.g., sent to a backend) for further processing or viewing.

[0169] In some embodiments, the eye / pupil tracking mechanism can be implemented using the imaging device described above, which utilizes the imaging sensor involved in the eye examination (e.g., camera 122), or by using an additional sensor for this purpose, or by implementing other eye-tracking solutions (e.g., using a second dedicated camera, or using IR illumination in combination with another camera (having a VIS cutoff filter, while the examination system uses an IR cutoff filter), etc.). Eye / pupil tracking can be operated automatically by the control system 150 (e.g., controller 151) during the examination session.

[0170] In some embodiments, eye tracking may include iris tracking. Eye tracking, iris tracking, or pupil tracking can be performed using any known suitable techniques (e.g., those known in the fields of image processing and deep learning), utilizing RT segmentation mechanisms, and any known suitable RT eye tracking methods. Such techniques advantageously provide for positioning the system in front of the eye; allowing the system to be automatically centered; and providing image stabilization and slit projection stabilization. Each of these advantageous features improves image quality and / or image set quality, and / or overall clinical examination quality.

[0171] The optics 124 of the imaging device 120 may include one or more of the following: lenses, apertures, polarizers, filters, and other optical elements. Specifically, lenses are used to image the desired region of interest (ROI) of the eye being examined, and the aperture is used to obtain the desired degree of focus (DOF). The desired DOF can be wide enough (10-14 mm) to include all anterior segment and appendages of the eye in focus simultaneously. In addition to the aperture size, the obtained DOF also depends on the specifications of the lens used. The aperture can be a constant size or a variable size (manually variable or electronically variable (controlled by suitable software)). Optics 124 can provide optical magnification capability. This function can be controlled manually or electronically (using pre-programmed software, e.g., in response to activation by a trigger signal from another component).

[0172] Optical device 124 may also include internal moving parts or other mechanisms that allow focusing on various depths / structures / layers of the eye being examined. In particular, the optical design may enable the capture of both anterior and posterior segments of the eye (retina, vitreous body, choroid, and optic disc).

[0173] The motion controller 126 of the imaging device 120 may include some or all of the following components: motors, tracks, encoders, limit sensors, and any other components for radial and linear movement and their control. Any combination of any of the six possible degrees of freedom of movement can be controlled. In particular, the distance between the camera and the eye and / or the angle between the camera's optical axis and the eye's surface may be adjustable, and the mechanical and electronic components controlling these distances / angles may be electrically and / or computer-controlled. The motion controller 126 may also include functions such as autofocus and autofocus (e.g., including a distance sensor). Typically, autofocus is a programmable mechanism that can be implemented using dedicated hardware or a combination of hardware and software.

[0174] As described above, the imaging device 120 of the semi-autonomous system 110 may include a wide field-of-view imaging unit 128 configured to acquire a wide field-of-view image of the eye, as shown with respect to additional illumination 142. In some embodiments, a dedicated wide field-of-view imaging unit 128 may not be required, and a wide field-of-view image of the eye's background may be captured by any of the cameras of sensor 122. Similarly, a dedicated illumination unit 142 may not be used, but the same illumination source 136 may be used in the non-operating state of the projector device. A zoom lens (electronic) may be used for this purpose (wide-range imaging).

[0175] As described above, in some embodiments, the semi-autonomous system 110 includes an eye aiming device 144 (generally referred to as a "focus target"). In some embodiments, a beam splitter / combiner may be used to house the focus target within the imaging axis.

[0176] The fixed-focus target is synchronized and set relative to the current preset and inspection requirements. This can be done automatically, for example, by using voice commands to the user to track it.

[0177] A fixed-focus target is used to align the eye to be examined and / or a second eye to a desired direction or position (i.e., it can replace some motor movement). The fixed-focus target / eye aiming device 144 can be used to stabilize the image of the eye by reducing the frequency and / or amplitude of eye movements, and to return to the desired position after such movements. The eye aiming device 144 can be implemented by a display, LED, laser marker, or any other aiming solution, and can be electric (e.g., in the case of LED aiming). Additionally, the eye aiming device 144 can be automatically controlled and operated by a controller 151, causing the LEDs / pixels / targets on the screen to turn on according to the direction required for the inspection task being performed.

[0178] It should be noted that the lighting and imaging components / parts are configured to move individually, while in some cases or examinations they need to move together. It should also be noted that in embodiments using individual movement of various components belonging to lighting device 130 or imaging device 120, a larger portion of the system, such as all components of lighting device 130 and imaging device 120, can move together (with any linear or angular degrees of freedom) to position the semi-autonomous system in a desired location and angular orientation in front of the eye being examined (and for switching between eyes). This “large-scale” movement of the entire system can be controlled by a master movement controller 146. It should be noted that this movement is typically performed once before the start of the examination session and does not affect rapid image acquisition during the examination session itself.

[0179] As described above, the control system 150 includes a manager utility 155, a controller 151, a processor 152, a memory 153, a communication utility 156, and in some embodiments includes an activation utility 154. The manager utility 155, in response to input data obtained from a local operator's control unit (e.g., a technician's screen 176) or from a remote control station 160 (e.g., a PC / laptop 162), selects a set of one or more presets (predefined examinations) optimized for a selected eye or pathology indicated in the input data and including corresponding operational data. This operational data defines all necessary parameters required to capture all necessary images of each of the one or more presets (predefined examinations).

[0180] The controller 151 is configured to operate the semi-autonomous system 110 based on operational data provided by the manager 155. This includes, but is not limited to, operating the optical projector 132 in a prescribed mode (for a specific examination session), i.e., single-slit and / or multi-slit projection, projection angle, slit size, etc., and operating the imaging device 120 synchronously with the optical projector 132. The operational data defines, on the one hand, optimal examination parameters for a specific examination task, enabling the physician to obtain and analyze the maximum required information in the optimal format, and on the other hand, optimal examination conditions, such that the duration of the examination session can be as short as desired (e.g., shorter than the cycle of large saccadic movements of the eye), thereby minimizing image degradation factors in the image data and minimizing the time the eye is exposed to illumination during the examination session.

[0181] The controller 151 is configured as a computing device and is any of the following: microcontroller, desktop computer, laptop computer, minicomputer or microcomputer, single-board computer, DSP, etc.

[0182] Controller 151 is configured and operable to manage the operation (commands) of all peripheral devices, including lighting equipment 130, imaging equipment 120, alignment mechanisms (including eye aiming device 144 and overall motion control 146). Controller 151 manages the projection of lighting patterns and the acquisition of images or image sequences via control signals or commands, and manages motion control of all degrees of freedom by sending motion control signals (motion commands) to bring corresponding elements (movable parts) to desired positions while monitoring the actual positions reported by the driver cards that directly control the motors. Controller 151 is responsible for performing higher-level tasks such as automatic aiming, automatic focusing, automatic acquisition, testing the validity, grading, quality and approval or rejection of image sequences, managing the acquisition of check sets, and possibly also performing image processing procedures.

[0183] Specifically, as part of the automated operation of the semi-autonomous system disclosed herein, controller 151 is responsible for performing repeated eye captures with different lighting, photography and other system parameters that can be initiated by a remote ophthalmologist or a local operator according to a predetermined examination protocol for each pathology / disease stage / or part of the eye.

[0184] As described above, controller 151 is responsible for communicating with server / processor unit 158 ​​via communication utility 156, via an internet connection, or via any other interface with other components or devices of system 100. Controller 151 drives one or more of the following: moving parts, motors, controllers, drivers, sliders, gears. Controller 151 can support automatic or semi-automatic movement of the camera subsystem of optical projector 132 and imaging device 120 toward the eye. Controller 151 can also monitor the position of all motors in all degrees of freedom, as well as their homing, switching, optocouplers, optical sensors (e.g., optical sensors reacting as microswitches), and any other hardware constraints.

[0185] Processor 152 may be responsible for running some or all of the image processing algorithms, as well as any other necessary algorithms and software for the operation of the semi-autonomous system 110. In particular, processor 152 may include image processor utility 157, which is configured and operable to analyze image data generated by imaging device 130 and generate data indicating the number of anomalous points in a corresponding number of illumination locations in the eye.

[0186] The server / processor unit 158 ​​at remote station 160 can be configured to perform one or more of the following tasks: image processing, including image reconstruction, examination matching between ophthalmologists and patients, management of patient medical data / files, including historical and previous examinations, and other medical and general tasks as performed in modern systems.

[0187] More specifically, image processing tasks that are typically performed offline and typically executed in the cloud but can typically be performed by the control system 150, or tasks that can be distributed between processors 152 and 158, may include, but are not limited to: (i) Cut slits from a “multi-slit” image and reconstruct the image, for example, by pasting the cut slits onto a background image to generate multiple single-slit images; (ii) Identify different parts of the eye, such as the sclera, appendages, pupil, and iris (this is performed via cloud computing or at physical unit 110 (so as to perform autonomous centering in front of the patient's eye)); (iii) Identify and remove specular back reflections; (iv) Ordering slits from different sets (single slit sets); or ordering frame sequences or videos from the reconstructed image structure; (v) Generate a 3D partial or complete model of the eye for imaging capabilities (this can be an AI-based modeling process).

[0188] As described above and further below, the technology disclosed herein provides optimal data (image data) that enables the use of AI-based data processing, particularly suggestive AI modeling processes, for data analysis, which can also be used to optimize inspection procedures.

[0189] It should be noted that the construction of the ordered sequence of video frames is achieved when utilizing multi-slit imaging. Consider ordering slits from different sets of single slits, which could be a set of wide slits, a set of medium slits, or a set of thin slits. The system is configured and operable to allow a physician to move from a wide slit to a thin slit in the same location (e.g., by scrolling a mouse wheel back and forth). For this purpose, the slits must have a specific order. For example, when using wide slits, using a set of two medium slits and five thin slits in the same location requires data indicating the position of each of these slits within its set. It should be noted that the techniques disclosed herein allow imaging of projected wide and thin slits and rendering of medium-sized slits.

[0190] Regarding the generation of 3D partial or complete models of the eye, it should be noted that the 3D model of the eye can preserve information such as geometric information (due to 3D calibration), and this information can be used as an aid in tasks such as cropping a single slit from a multi-slit image. The 3D model achieves pixel-to-inch / millimeter scale conversion.

[0191] In some embodiments, the server / processor unit 158 ​​may be responsible for storing one or more of the following: images (and metadata of their acquisition parameters), medical data, complete medical files for visual recording, follow-up, sending examination data to a second opinion, etc.

[0192] In some other embodiments, processor unit 158 ​​may be responsible for managing the process of pairing examination units with physician units and / or examination procedures, monitoring system usage, and implementing encryption and data security protocols.

[0193] The technician screen 176, which can be used as a control unit for local operators, may include one or more of the following control accessories and functions: Figure 2 (Not specified): Control accessories, such as keyboard and / or joystick and / or mouse and / or touchscreen; control accessories that allow local technicians to operate the examination equipment; control accessories that assist remote ophthalmologists in performing examinations; user interface that provides options for initiating predefined or manually selected examination sets. The technician's screen / operator's control unit 176 may be a simple screen and / or other display, which may be a touchscreen and / or adjustable, allowing screen rotation for greater convenience. The display may allow the local operator to view the acquired images and decide whether recapture is necessary.

[0194] As described above, in some embodiments, system 100 includes registration component 174, sensing system 170, and security controller 172.

[0195] The registration assembly 174 is used to register the position of a user's face during an examination session and may include a chin rest mechanism or face support for securing the user's face at the registration position during the examination session. The registration assembly 174 may include a support platform carrying the face support, which defines a face support surface for supporting the user's face at the registration position during the examination session, such that the user's eyes are looking toward the eye-aiming target 144. The face support may or may not include a chin rest element.

[0196] Sensing system 170 is configured and operable to monitor the position of a user's face relative to a face support and generate corresponding sensing data. This sensing data is analyzed to selectively generate control signals to enable or disable the operation of system 110 (i.e., a check procedure). Sensing system 170 may include one or more sensors on the face support for monitoring the degree of contact between the user's face and the face support surface. Such one or more sensors on the face support may include at least one pressure sensor, a proximity sensor, or at least one IR sensor. Typically, one or more pressure sensors may be used to monitor the contact between the user's face and the face support surface; alternatively or additionally, imaging devices may be used.

[0197] Safety controller 172 is responsive to sensed data and is configured and operable to analyze the sensed data and generate a control signal to controller 151 when a user's face is identified as being in a safe position. Activation utility 154 of the control system is configured and operable to activate the semi-autonomous system to perform an inspection session in response to the control signal indicating a safe position of the user's face relative to the registration point. When sensed data analysis indicates that the alignment of the semi-autonomous system with respect to the user's face does not meet predetermined requirements and may correspond to a predetermined risk condition, safety controller 172 notifies controller 151, which in turn sends appropriate commands to various system components via activation utility 154, for example, to stop the movement of a specific device.

[0198] Remote control station 160 may include, in particular, a processor unit 158, a PC / laptop computer 162, a display 164, control peripherals 166, 3D visualization peripherals 168, and a security controller 178. PC / laptop computer 162 may be part of system 100 or may be a third-party PC / laptop computer (typically, any device with communication capabilities and a display, such as a laptop computer, PC, tablet, or smartphone, can be used). Typically, PC / laptop computer 162 is used as a tool for ophthalmologists to remotely operate the semi-autonomous system 110, but it may also be used with the local operating system 110. Some additional functions that PC / laptop computer 162 may perform include: allowing ophthalmologists to view raw or reconstructed images by scrolling through single-slit and / or multi-slit images (or any other relevant data in the case of its use as an imaging device); serving as a tool for ophthalmologists to view additional clinical data about the patient; performing diagnoses (e.g., using markers to identify results, write notes, clinical and non-clinical data, scan history, etc.); making decisions about subsequent steps; and serving as a tool for ophthalmologists to “order” additional acquisitions of the patient’s eye with selected parameters.

[0199] The display 164 can be made of, for example, a VR headset or other 3D solution (in... Figure 1 The term "3D visualization peripheral device" (referred to as 3D visualization peripheral device 168) refers to a conventional 2D display or standard 3D display screen, such as holograms, image projection technology, etc.

[0200] In some embodiments, the sensing system 170 is configured and operable to transmit sensing data to a security controller 178 at a remote control station 160, analyze the sensing data at the remote control station 160, and selectively generate control signals and transmit them to a controller 151.

[0201] Figure 2 Additional components of system 100 (not shown) may include one or more of the following: chin and forehead rests, armrests, replaceable optical subunits for different examinations of different eye segments or diseases, and additional optical elements such as folding lenses and prisms. Possible external attachments may include, but are not limited to, Gonio lenses, external reflectors, and contact lenses.

[0202] System 100 may also include means for manually or software-controlled changes to optical system parameters, such as changing the distance between different lenses within the optical system or replacing, adding, or removing some or all of the lenses.

[0203] System 100 can be used as a standalone system or a subsystem of another system.

[0204] As referenced above Figure 1 and Figure 2As described, system 100 can communicate with cloud computing system 105, which performs heavy data processing tasks. Cloud computing can be on an actual cloud service, a remote PC, or even on the local PC of system 100.

[0205] It should be noted that the techniques of this disclosure can be operated in conjunction with AI-based processing of image data to identify suspicious areas / parts and observations for detecting ocular abnormalities / pathologies. In fact, because the systems of this disclosure utilize autonomous or semi-autonomous ophthalmic examination systems configured as described above, the image data collected by such systems includes high-quality images of various ocular regions from various patients collected by the same system (under the same operating conditions), and furthermore, such image data is less affected or even less affected by errors caused by different operators. This provides optimized data for machine learning processing, particularly suggestive AI-based processing. In particular, suggestive AI-based techniques can be further used to automatically optimize operational data based on updated findings.

[0206] Typically, AI-based functions can be installed in remote control systems. Figure 1 and Figure 2 In system 105, the remote control system is a server system (a computerized system including input and output utilities, memory, processor, etc.) that can be connected via a communication network to a subscriber eye examination system of the type performing a semi-autonomous eye examination procedure. Each subscriber system has its unique ID appropriately assigned to it in its subscription program. The subscriber system sends image data obtained by the system and associated with preset data and / or examination task data used to obtain corresponding image data to the server, and may also send other relevant patient-related data. Patient-related data may include the patient's IP address, and the server can access (at the server or at the physician-related station, as appropriate) other patient-related data, such as historical data of the patient's previous eye examination results. The server system is configured and operable to perform model-based processing (AI-based processing) of the input data received from each subscriber system and generate output data. Such output data may include data indicating suspicious portions and observations in the examined eye region to enable the detection of abnormalities and / or pathologies; and / or data indicating abnormalities and / or pathologies detected in one or more portions of the examined eye region; and / or the quality level of image data provided by the subscriber system; and / or data indicating recommended preset data for an examination session for eye examination to be performed by a specific subscriber system.

[0207] Such recommended preset data may include optimized operating parameters for the system, such as patterns optimized for specific parts of the eye and / or specific abnormalities to be detected and / or specific patients. For example, AI-based processing can identify inadequate image quality and generate recommended data (e.g., optimized preset data) that instructs optimized operating data to improve image quality. System 100 (its manager utility) can respond to such optimized / updated preset data to initiate the automatic execution of additional examination sessions using the optimized operating data. Alternatively or additionally, AI-based processing at server 105 can generate optimized preset data for a specific examination session for a specific patient based on analysis of historical data from previous eye examinations of a specific patient, and transmit the corresponding data to examination system 100.

[0208] In some embodiments, specifically, the AI ​​subsystem is capable of performing one or more of the following functions: detecting poor-quality images and notifying the user (via the user interface of system 100 and possibly also at the doctor's system, as appropriate) about the problem; recapturing the poor-quality images (because the acquisition and projection parameters are retained within the system); detecting suspicious areas / parts, observations, or pathologies and labeling them for the user; autonomously providing or performing additional acquisition sets suitable for further investigation using existing presets or AI-generated presets; and potentially summarizing its findings (if any). The ability for the user or operator to manually override AI decisions is optional.

[0209] Figure 3 An eye examination system 200 of this disclosure is illustrated, comprising a semi-autonomous system 250 (presenting a non-limiting example of system 110 described above) and a control system / computer 212 (which may constitute control system 150 or control system 160). In this non-limiting example, the semi-autonomous system 250 includes two digital cameras 204A, 204B for stereoscopic acquisition of multiple positions of the eye 220 illuminated by an optical projector 202 during an examination session. The use of a pair of cameras allows for three-dimensional visualization for ophthalmologists (similar to conventional binocular slit-lamp examination). However, it should be understood that the technology of this invention utilizes autonomous or semi-autonomous examination systems that can be configured for monocular or stereoscopic vision, and the principles of the technology of this disclosure are not limited to the use of 3D imaging.

[0210] Furthermore, in this non-limiting example, a beam splitter / combiner mechanism is used to achieve 3D imaging. However, it should be noted that the implementation of the technology disclosed herein is not limited to this configuration. For example, two direct imaging axes (without using a beam splitter) can be used with, for example, microlens technology.

[0211] The optical projector 202 includes an illumination source, an illumination projection device (e.g., a scanning mirror), and various optical components.

[0212] An illumination IL is coupled / incidentally directed onto the eye 220 at a predetermined angle using a reflector / prism 206. Light RL reflected from the eye 220 is collected (typically in the normal direction relative to the patient's face). The reflected light RL is split into two propagation paths by a beam splitter 208 and directed to two digital cameras 204A and 204B. The digital cameras include corresponding lens modules 210A and 210B, which may include several lenses and an autofocus mechanism to obtain a focused image with an extended DOF.

[0213] It should be noted that the optical axis of the eye 220 can have various orientations relative to, for example, the optical axis of the digital camera 204B, which can be determined by... Figure 2 Eye-aiming device 144 is limited and in Figure 3 Not shown in the image.

[0214] The operation of system 200 is managed and controlled by control system 212, which is configured and operable as described above regarding control system 150 of system 110. Control system 212 is responsible for sending trigger signals TR to optical projector 202 and two digital cameras 204A and 204B, causing the projection of the illumination point and the acquisition of the corresponding image sequence to be performed synchronously, and is preferably configured to be fast enough to eliminate image blurring caused by eye movements (such as saccades, blinking, eye movements (e.g., due to patient eye fatigue)). See above reference... Figure 2 In detail, the control system 212 controls the operation of the optical projector 202, digital cameras 204A and 204B, and is configured and operable to select pre-stored operating data for the semi-autonomous system 250 using data indicating the examination task. The operating data defines the operating parameters of the eye examination session.

[0215] Figures 4A to 4C An example of a single-slit image obtained using the eye examination system of this disclosure is shown. Figure 4A It shows the use of white lighting; Figure 4B Illumination with a high-intensity blue channel is shown; Figure 4C This demonstrates the need to examine different parts / areas of the eye under varying lighting intensities. It should be noted that... Figure 4A and Figure 4B In the image (using this different lighting), the two small planes (front and back) of the eye's lens can be observed. Figure 4C This shows that although the illumination intensity is sufficient to properly observe the slits on the cornea and iris, if the sclera is also to be examined, there is saturation above and below the iris (on the sclera), requiring a lower illumination intensity.

[0216] It can be seen that a clear image of the slit can be obtained simultaneously from reflections from the cornea, iris, and posterior capsule of the lens, which confirms that an eye examination system of this disclosure can achieve a DOF of approximately 12 mm.

[0217] Figure 5A An example image of a single slit with obvious pathological results is shown. In a healthy eye, the projection on the iris is expected to be relatively uniform. However, as can be seen in this example, the projection of the slit on the iris is distorted in shape, width, and color. As mentioned above, the distortion of the slit may be related to a pathology or condition in the eye's structure.

[0218] Figure 5B and Figure 5C An example of a single-slit image capable of extracting pathologically relevant data is shown. Figure 5B The example shows a traumatic eye with corneal scarring. The width of the slit projected onto the cornea shows varying thickness and the point of tear in the inner layer (Descemet's membrane) (the location indicated by the arrow). Figure 5C It shows another location of the same eye, with arrows pointing to areas of the cornea with varying thickness.

[0219] Figure 6 This is an example of multiple slit projections on a real eye. The images of the slits can be seen in the lens behind the cornea, iris, and pupil.

[0220] In embodiments that project a multi-slit pattern onto the eye, image reconstruction is utilized. This technique employs so-called "image slicing," which involves image reconstruction in which a portion of the acquired image is extracted and pasted onto another image.

[0221] Figure 7 An example of such image reconstruction is shown, in which multiple multi-slit images are acquired, possibly with predetermined offsets in the relative positions of the slits in adjacent (temporally) projected multi-slit patterns. Wide-field images of the eye are also acquired during the examination session. During the image processing step, slits are extracted from each multi-slit image, and each extracted slit is pasted onto the wide-field image used as a background image. Thus, multiple reconstructed single-slit images are generated from a smaller set of acquired images illuminated by multi-slit projections and the “background” image (ROI illumination). The single slit / multiple single slits pasted on top of the background image of the eye simulate a single slit scan (or a scan with several slits simultaneously), similar to a scan performed by an ophthalmologist using a conventional system.

[0222] In the simplest embodiment, a series of multi-slit patterns can be displayed, i.e., the initially acquired images, and scrolling between such image sequences to cover all regions of interest may be sufficient to locate any anomalies within those regions.

[0223] In some embodiments, the system captures a set of multiple slits and a set of single slits, and when pointing to a slit in the multiple slit image, a single slit (from the other acquired sequences) is presented to the observer. To detect the correct location of the slit pattern matching method, eye segmentation and mapping or multiple-to-single slit operations described below can be used.

[0224] To separate slits in a multi-slit image (used as single slits), the techniques disclosed herein can utilize image processing techniques known in the art, such as image binarization, foreground and background separation, or semantic segmentation (using DNN) or combinations thereof. After foreground / background separation and slit segmentation, slits are cropped from the multi-slit image and pasted onto a “background image,” and then the slits are sorted / arranged into a sequence of individual slits according to their positional order.

[0225] In posterior and anterior slit projection and imaging, the inventors have discovered that better image quality of the reconstructed single-slit image can be obtained if the optical projector is operable to sequentially project a first and second set of illumination points of a multi-slit shape onto the corresponding first and second set of positions, wherein the first and second positions are arranged in an alternating manner. This alternating method of arranging the first and second positions is referred to herein as the "even / odd method" and is used for retinal multi-slit imaging or full frontal imaging (without tilt angle) based on multi-slit projection.

[0226] Figure 8A and Figure 8B A method for acquiring this image is illustrated, comprising capturing two multi-slit pattern projections, namely "even" and "odd," wherein the "odd" projection includes illumination opposite to that of the "even" projection; that is, areas bright in the "even" group are dark in the "odd" group, and vice versa. White dashed lines drawn on the two interleaved multi-slit images of "even" and "odd" groups help to understand the interleaving principle.

[0227] An additional third "background" image can also be captured. Interlaced multi-slit projections can include non-overlapping slits, where two projections ("even" and "odd") may or may not overlap; that is, the sum of alternating projections can produce continuous coverage when needed, or intentionally leave gaps. Slits in an "even" and "odd" pattern can cover the entire field of view, such that if both projections are illuminated simultaneously, it is equivalent to illuminating the entire field of view with full illumination. The projection angles can be correlated with the slit widths and the space between the slits to create a series of multi-slits. Typically, interlaced (i.e., "even" and "odd") images are subtracted from each other to obtain better contrast.

[0228] Methods for slit separation during image processing may include one or more of the following image processing methods: adaptive image binarization, foreground binarization using, for example, the Otsu method, and foreground cropping. Alternatively, semantic segmentation methods known in the art, such as deep neural network (DNN) methods, may be used. Labeling may be performed using standard image processing methods, such as watershed methods and enhanced watershed image processing methods known in the art. A depth-first search (DFS) algorithm may be applied to collect slits in the order of their projection.

[0229] During reconstruction, single or multiple separate slits can be pasted on top of the wide field-of-view background image of the eye.

[0230] In embodiments requiring conventional slit scan simulation, the generated image is reconstructed by pasting each of the slits from each of the "even" and "odd" multi-slit images onto a background image. This method provides complete coverage of the ROI and allows single-slit scan simulation by displaying an image with the slits at the current scan location when selected during an inspection session. In this method, due to the even-odd nature, only three images (even, odd, and background) can be used to cover all regions of interest. This can result in a very short acquisition process, less than a saccade motion, i.e., when capturing the posterior aspect of the eye, leading to very accurate imaging.

[0231] This reconstruction method can also be used when images are acquired simultaneously by two cameras, allowing for stereoscopic slit scanning, similar to the traditional slit-lamp method. This stereoscopic slit scanning results in a video-like slit scan of the area of ​​the eye being examined, analogous to scans obtained via conventional slit-lamp equipment. The scan can be stopped / repeated / played back from end to start, thus changing the direction of the scan and altering the playback speed, just as in captured video.

[0232] Figure 9 This shows a stereoscopic single-slit view of the eye being examined, displayed to a remote ophthalmologist. Each slit is photographed from its own angle (as if the doctor were viewing it through the eyepiece of a slit lamp). These two images are interpreted by the ophthalmologist as stereoscopic single-slit images, similar to an examination performed using a conventional binocular slit lamp device.

[0233] In some embodiments, the physician can observe multiple slits captured simultaneously (from the right and left cameras) and view the multiple slits in a stereoscopic view.

[0234] In some embodiments, the method of obtaining multiple reconstructed single-slit images from a smaller set of multi-slit images can also be applied to non-frontal slits in any part of the eye, including anterior segments of the slit that can be observed at multiple layers, surfaces, and depths of the translucent layer. In these embodiments, multiple slit pattern projections are captured, with constant and / or varying spaces between the slits. The patterns may not overlap or may partially overlap between slits of different patterns (e.g., to obtain a smoother and more continuous scan by the physician during the slit scanning phase later in the examination procedure). In some embodiments, the slits may cover the entire field of view or some regions of interest (ROI) of the current examination. During the rapid acquisition of the multi-slit image sequence, when all slits acquired from all projection patterns are in the same / similar positions, their overall aggregation will cover the entire ROI, such that almost every location of the ROI will be covered by the slits. As described above, reconstruction may include pasting one or more separate slits on top of a background image.

[0235] In traditional slit scan simulation use cases, the generated image is reconstructed by pasting each slit from each multi-slit image onto a background image, thus providing complete ROI coverage. When, for example, a physician requests a single-slit scan simulation, a reconstructed image with the slits can be displayed at the current scan location.

[0236] It should be noted that, for example, the projection pattern of illumination points with slit shapes should provide sufficient space between their successive points / slits on the captured image of the eye. The space between points / slits can be defined based on other system parameters of the acquired examination, such as slit width, projection angle, and specific ophthalmic conditions. In anterior segment examinations, each slit projection on the cornea should not overlap with successive slit projections on the iris.

[0237] This non-overlapping condition also applies to the cornea / iris projected onto the lens, as well as the cornea or iris of a continuous slit (potentially under large-angle illumination). For example, capturing an image of the eye using illumination oriented / propagating along an axis forming an angle of approximately 60 degrees relative to the eye's optical axis from the right side results in a projection on the right cornea appearing on the left side of the iris reflection.

[0238] In some embodiments, single-slit images can be used as part of an acquisition sequence, for example, to overcome the challenging separation of slit images that are difficult for machines to decipher. This can occur in situations such as saturation, blindness, iris boundaries, etc. Multiple slits can be used instead of projecting a single slit individually onto a single-slit image. Multiple-slit images can be decomposed into individual single-slit images and added to single-slit images for a continuous series of problematic locations. In this case, a sequence of multiple-slit images and a sequence of single-slit images are acquired (at the same FOV), and the single-slit images are used to separate the single slits from the multiple-slit images. In some embodiments, a combination of multiple-slit and single-slit sets can be used during the same acquisition or in continuous acquisition.

[0239] In these embodiments, more images may be required than in the standard sequence of multi-slit projection, and the image analysis is similar to the “even / odd” method described above.

[0240] In the example above, the doctor is viewing the image in 3D. This disclosure also provides an alternative method using 3D reconstruction, namely, creating a solid mesh of the eye using slits, much like structured light, while preserving and rendering the slits as textures on that solid. Thus, a 3D single-slit image rendering method for the anterior or posterior segment of the eye can be used. This method is capable of reconstructing the 3D structure of the examined portion of the eye obtained through multi-slit sequence pattern projection, followed by rendering the desired slits and background. The slits can be generated sequentially, allowing for simulation of dynamic scanning of the object / eye.

[0241] This 3D reconstruction can be used for one or more of the following: (1) It can help with the separation of slits in multiple slits, especially slit projection on the cornea, because the 3D position of the cornea is on a higher surface than the iris or the lens of the eye (closer to the camera). (2) 3D reconstruction provides 3D information about the slits. (3) Since a calibration process is performed in any case of 3D reconstruction, 3D reconstruction actually provides a physical measurement of the results (because pixels are converted to inches / millimeters as part of the calibration). (4) 3D reconstruction provides a simulated view of the eye without the need for virtual reality (VR) or a 3D screen.

[0242] This disclosure provides a method for measuring elements (e.g., distances (two-dimensional and three-dimensional)) in an eye by using eye structure extracted from image data provided by at least one camera. The three-dimensional structure can be analyzed using methods known in the art. For example, even when using only a single camera with a slit projection, the three-dimensional structure of the eye can be obtained from structured light projection. When the imaging device includes at least two cameras and / or when three-dimensional structured light is combined with stereo vision for higher accuracy, structural analysis can utilize three-dimensional stereo vision.

[0243] In addition, the 3D reconstruction of the acquired image data can be used to obtain measurements in pixels per mm, which can be used as part of the 3D calibration process during the analysis of the eye structure extracted from the acquired image data.

[0244] The techniques disclosed herein allow for the single acquisition of sequences of multi-slit patterns, or through the use of other structured light or any other method. Even at a later date, three-dimensional image / eye reconstruction can be performed on image data generated from any possible slit scans and using any examination parameters. In some embodiments, slit separation is performed using the three-dimensional shape of the captured slits.

[0245] In some other embodiments, a point cloud of the slits is constructed using methods known in the art, such as structured light (if using a single camera) or stereo vision (if using more than one camera), or a combination of both. Slit analysis and rendering are performed using a depth map derived from the point cloud using methods known in the art. The depth of any part of the eye (such as the sclera, iris, cornea, or retina) is determined by the depth map from the point cloud. Note that the slit order during projection is determined relative to the projection direction of the eye.

[0246] Generating multiple reconstructed single-slit images from a small set of acquired images illuminated by multi-slit projection and a "background" image can utilize semantic segmentation using DNNs (deep neural networks) known in the art, such as SegNet, UNet, etc. These techniques are considered methods for analyzing image data and producing a final 3D map.

[0247] Image quality can typically be measured using convolutional neural networks (CNNs) for classification or other methods known in the art.

[0248] Figure 10A This is a flowchart illustrating an asynchronous examination procedure 800 using the eye examination system of this disclosure, which includes rapid projection of a multi-slit pattern (and corresponding image acquisition). It should be noted that the procedure illustrated in this figure can also be used for single-slit set acquisition, or combinations of those methods as described above.

[0249] The procedure begins (step 810) with the local operator assisting the patient in preparing for the examination, for example, by positioning his / her head on a chin rest. Next (step 812), the local technician initiates the examination procedure.

[0250] As described above, one or more presets (predefined checks) can be selected via a user interface (e.g., a technician screen 176 communicating with the manager utility 155). Typically, a set of predefined checks to be performed by default (referred to herein as "presets") is stored in memory 153 or dynamically retrieved from a server of the control system 150, and can be initiated by a local operator. Examples of presets selected / instructed by a physician may include, but are not limited to, cornea, fluorescein, contact lens wearing, anterior chamber, iris and posterior chamber, retrograde illumination, lens / IOL (intraocular lens), adnexa, eye movements, and pupillary light response.

[0251] The stored presets can be specific to each clinical examination (e.g., designed to detect / analyze specific pathologies). Each preset can include, but is not limited to, predefined values ​​for illumination angle, imaging angle, slit shape, and intensity. Furthermore, the semi-autonomous system 110 of this disclosure can focus on an optimal point in the eye as needed for a specific examination. To this end, the system utilizes a novel focusing mechanism based on an understanding of binocular anatomy, clinical examination requirements, and system adjustments. For example, if the examination targets the cornea (which is a transparent object), the preset can command initial focusing on the blood vessels on the iris or cornea (which provide high contrast), and then move the system's focus backward from the focal point of the iris toward the requested focal point on the cornea, which can be easily estimated based on the average size of the human eye (e.g., approximately 6 mm backward).

[0252] In some embodiments, the preset may include specific lighting patterns and colors that can help detect contact lenses and markings on them.

[0253] Specifically, preset parameters may include, but are not limited to, one or more of the following: desired eye (left / right / both eyes); initial hardware position (for all / some degrees of freedom) - possibly including chin height; fixed-focus target (eye aiming / gazing at the target) - which may be variable during acquisition (for each frame); background illumination - possibly multispectral parameters, which may be variable during acquisition (for each frame); region of interest; optical / digital zoom; aperture control of the camera and illumination source lenses; autofocus target (including final offset fixation); lens selection (in the case of several interchangeable lenses); lens parameters (in the case where zoom and / or focus can be internally controlled); number of acquisitions (a set with the same presets); image quality threshold (minimum required level); point shape, including the outline of each pattern to be projected / binary image of each pattern; security hardware constraint parameters.

[0254] When using slit / multi-slit sequences, this parameter may include one or more of the following: slit parameters (e.g., exposure duration; width; height; offset of the leftmost slit in the pattern); number of slits in the pattern / single-to-multi-slit selection; spatial arrangement (between consecutive slits in the case of multi-slits); rotation angle; tilt; acquisition (projector) illumination – which may be a multispectral parameter (additional illumination) and can be variable during acquisition (for each frame / pattern); illumination duty cycle (%) of the slit segments on each part of the eye (e.g., cornea = 100%, sclera = 45% (this will address saturation issues on the sclera – see...). Figure 4C Examples); camera parameters, which can be adjusted for each frame, and include exposure duration; gamma; gain (for each (color) channel and main gain); one or more of the black levels.

[0255] It should be noted that the manager utility 155 of the semi-autonomous system 110 disclosed herein enables the system to function autonomously, for example, during an asynchronous check 800, where a local operator can simply press a button to initiate a series of tests (preset), the results of which will be sent for analysis by a physician.

[0256] The examination plan guides the technician to aim the eye to be examined in the desired direction (step 814) and sets the illumination parameters for the aiming phase (step 816). In step 818, automatic aiming and centering of the camera and illumination of the eye are performed (manual aiming can also be assisted). The correct positions of the capture / imaging unit and the illumination unit are specified by the examination plan. In step 820, automatic focusing of the camera and illumination of the desired portion of the eye are performed. These steps (818 and 820) can be performed manually, automatically, or in combination. IR / “soft” or ambient lighting can be used to perform positioning and other operations (described below) to improve patient comfort. Automatic operations prior to image capture, such as steps 818 and 820, can be applied iteratively; that is, if automatic aiming and autofocusing are unsuccessful (step 822), steps 818 and 820 can be repeated. The control software can independently control the DOF of both illumination and image capture and can be parameterized as needed.

[0257] Therefore, prior to image capture, the automatic operation of the semi-autonomous system may include one or more of the following: automatic aiming of the gaze direction of the examined / second eye, automatic centering of the examined eye, initial autofocus, automatic illumination, and final autofocus. Once the image sequence is successfully acquired (checked in step 824 by estimation by a local operator, remote OD, or using an image quality method (e.g., CNN or image processing method), in step 826, the acquired (one or more) images are stored (e.g., in memory 153) and sent to a server (step 828) for generating / reconstructing (not limited to) multiple single-slit images (step 830).

[0258] Steps 814 through 828 are performed for each desired examination indicated in the predefined set of examinations obtained by the local technician in step 812. The acquired / generated / reconstructed single-slit images are stored (locally or remotely, for example, in a cloud server, which, as described above, can be implemented in a physical cloud or even on a local or remote computer) and sent to the ophthalmologist's PC for evaluation (step 832). The ophthalmologist performs an asynchronous "slit scan" of the patient's eye by scrolling between the generated single-slit images (step 834) and reports the findings of the examination session (step 836). The ophthalmologist may choose to display the results as multi-slit images (if using the multi-slit image acquisition mode as shown in optional step 830) or single-slit (after algorithmic separation) images. The ophthalmologist's display may include any of the following: two-dimensional and / or three-dimensional displays, such as virtual reality, depth reality viewers, three-dimensional screens, three-dimensional modeling of images (three-dimensional meshes with textures), or image reconstructions acquired from different angles.

[0259] Figure 10B This is a flowchart illustrating a simultaneous examination procedure 850 using the eye examination system of this disclosure, which includes rapid projection (and corresponding image acquisition) of a multi-slit pattern. Procedure 850 is similar in all respects to... Figure 10A The procedure is 800, but the difference is that it allows ophthalmologists to decide in real time whether to re-examine using the same or different examination parameters.

[0260] For example, an ophthalmologist may decide that additional examinations are needed (step 852). In this case, several non-limiting actions can be taken: (i) the ophthalmologist may use predefined or manually selected parameters to select the desired set of examinations (854); (ii) the ophthalmologist may use the remote control capabilities of the semi-autonomous system disclosed herein to center and aim the illumination, camera, and the eye being examined (856); the ophthalmologist may control the slit position and other parameters in real time to gain a sense of the examination to be acquired (858). Non-limiting examples of controlled examination parameters include: slit width, slit height, RGB (wavelength), illumination intensity, illumination angle, photographic angle, focus shift, eye rotation, and background illumination.

[0261] The eye examination system disclosed herein may further include various human-machine interface features (HMIs) not shown in the figures, such as a touchscreen for controlling various system components, a joystick or keyboard, visual commands (e.g., for aiming at the eye being examined or a second eye), and voice commands (for initiating examinations by a doctor, recording procedures / findings, etc., and automated commands from the system to the patient). Additionally, the eye examination system of this disclosure may include means for remotely / locally defining the area to be examined and for remotely / locally requesting zooming and focusing on the desired area.

[0262] It should be noted that the flowchart above illustrates a specific, but not limiting, example of the technology disclosed herein.

[0263] It should also be noted that in some embodiments, appropriate AI-based data analysis may be used, which may be used to point to suspicious areas or discoveries, identify and alert on pathology, mark suspicious areas, color doctor discoveries, automatically measure pathology (radius, variation, etc.) marked by doctors, automatically center and aim on discovery and / or capture with specifications related to these discoveries, etc.

[0264] The examination procedure can utilize different illumination intensities relative to the area / location of the eye being imaged: for example, a lower illumination intensity for imaging the scleral area and a higher illumination intensity for imaging the corneal area on the same slit or projection. In another example, the illumination is appropriately adjustable. For example, the illumination can be adjusted based on the color of the iris or modified according to the characteristics of the area being examined (e.g., a mole, which may be darker than the surrounding area). It should be noted that illumination adjustment can be performed automatically and as part of an autonomous process.

Claims

1. A system for eye examination, comprising: A semi-autonomous system configured and operable to perform an eye examination session, the semi-autonomous system comprising: -- An illumination device comprising at least one optical projector, each of the at least one optical projector being configured and controllably operable to automatically project a sequence of illumination points of a predetermined shape onto a plurality of locations extending across the eye region in a spaced-apart relationship during the eye examination session; and -- At least one imaging device, each of which is configured and operable to acquire images of the eye including locations illuminated by the illumination point during the examination session, and to generate image data associated with the plurality of locations, the image data indicating anomalies with respect to each of the locations within the eye region, and The control system includes a manager utility and a controller, wherein the manager utility is configured and operable to define operational data of the semi-autonomous system controlled by the controller in response to input data including preset data indicating an examination task, the operational data defining operational parameters of the examination session of the eye, and the controller is configured to operate each of the at least one imaging device in synchronization with a corresponding at least one optical projector, thereby minimizing image degradation factors in the image data and minimizing the time the eye is exposed to illumination during the examination session.

2. The system according to claim 1, wherein, The preset data input includes at least one of the following: pre-stored data indicating the examination task; and input dynamically provided by the doctor from the remote doctor's station, including data indicating the examination task.

3. The system according to claim 1, wherein, The preset data input includes a list of records associated with a specific pathological type of a specific part of the eye region and at least one record in the examination, the records including multiple data records associated with various types of operational data to be used in the examination session.

4. The system according to claim 1, wherein, The input data includes data received from the doctor's remote station during the doctor's review of image data provided by the control system, thereby enabling the doctor to preview the expected image acquisition during the examination session and to provide various examination parameters.

5. The system according to claim 1, wherein, The preset data includes data indicating two or more examination tasks across different areas of the eye. The control system is configured to operate the semi-autonomous system in a fully automatic mode, which enables the automatic execution of sequences of two or more examination tasks, thereby providing data indicating a broad overview of the eye's condition.

6. The system according to claim 1, wherein, The preset data input includes identification data of multiple patients associated with the prescribed operational data.

7. The system according to claim 1, wherein, The input data includes at least one of the following: The input preset data includes a list of records associated with at least one of a specific pathological type, function, and examination of a specific part of the eye region, the records including multiple data records associated with various types of operational data to be used in the examination session; The input data includes data received from the doctor's remote station, which is based on the doctor's review of initial image data provided by the control system, indicating doctor preview data for expected image acquisition during the examination session, the doctor preview data including data indicating one or more examination parameters; The preset data includes data indicating two or more examination tasks across different areas of the eye. The control system is configured to operate the semi-autonomous system in a fully automatic mode, which enables the automatic execution of sequences of two or more examination tasks, thereby providing data indicating a broad overview of the eye's condition.

8. The system according to claim 1, wherein, The control system is configured and operable to generate an activation signal to the semi-autonomous system to initiate the inspection session, while preventing any movement of any physical components of the semi-autonomous system after the activation signal is generated.

9. The system according to claim 1, wherein, The semi-autonomous system is configured and operable to perform an electronic scan of the eye region during the examination session using illumination points projected onto the eye region in the form of different or varying patterns, while keeping the semi-autonomous system physically stationary during the examination session.

10. The system according to claim 1, wherein, The lighting equipment includes N (N≥1) optical projectors and M (M≥1) imaging devices, wherein the number N and M may be the same or different.

11. The system of claim 10, wherein the illumination device comprises at least one pair of optical projectors, each of the at least one pair of optical projectors being associated with one or two imaging devices for performing at least one of: (i) simultaneously examining the patient’s eyes, or (ii) performing stereoscopic imaging of the eyes.

12. The system of claim 10, wherein the illumination device comprises two or more of the optical projectors, the two or more optical projectors being configured to operate with different operating parameters to simultaneously or sequentially perform examinations of different portions of the eye region.

13. The system according to claim 1, wherein, The at least one optical projector and the at least one imaging device are configured with extended depth of field, such that the illumination points automatically projected onto the plurality of locations are focused at the respective plurality of locations, and the image data indicates the corresponding focused image at the location.

14. The system according to claim 1, wherein, The at least one optical projector and the at least one imaging device are configured with an extended depth of field that is independently controlled by the controller.

15. The system of claim 14, wherein the extended depth of field is selected to include multiple anterior segment portions and appendages of the eye being simultaneously focused.

16. The system according to claim 1, wherein, The semi-autonomous system includes a focusing mechanism configured and operable to initially focus at least one of the optical projector and the imaging device on a relatively high-contrast portion of the eye, and then move the focus forward or backward toward the portion to be examined based on a known distance between the relatively high-contrast portion and the area of ​​the eye to be examined.

17. The system of claim 1, wherein the semi-autonomous system includes an autofocus mechanism that is automatically operated by the controller according to the operating parameters of the eye examination session.

18. The system according to claim 17, wherein, At least one of the optical projector and the imaging device includes the autofocus mechanism.

19. The system according to claim 1, wherein, The predetermined shape of the illumination point is a slit shape.

20. The system of claim 19, wherein the at least one optical projector is configured and controllably operated to automatically project the sequence of slit-shaped illumination points in a single-slit continuous manner, the image data comprising corresponding continuous image data segments, each image data segment comprising a single-slit image.

21. The system according to claim 19, wherein, The at least one optical projector is configured and controllably operated to automatically and simultaneously project at least a first array of spaced-apart slit-shaped illumination points in at least a first multi-slit manner; the image data includes at least one first image, each first image being an image of the at least first array at spaced-apart locations.

22. The system according to claim 21, wherein, The optical projector is operable to sequentially project a first array of illumination points in the shape of slits in the first multi-slit configuration and a second array of illumination points in the shape of slits in the second multi-slit configuration onto corresponding first and second arrays at the location, wherein the first and second arrays at the location are arranged in an alternating manner; the image data includes a first image and a second image of the first and second arrays at the location, respectively.

23. The system of claim 22, wherein the first position and the second position partially overlap.

24. The system according to claim 1, wherein, The at least one optical projector is configured and operable to automatically change the projection spherical angle of the illumination point relative to the eye, and the image data includes image data segments at corresponding positions associated with data indicating the projection spherical angle.

25. The system of claim 1, further comprising an imaging unit configured and operable to obtain a wide field-of-view image of the eye, thereby enabling alignment of a foreground image formed from the image data with a background image formed from the wide field-of-view image of the eye.

26. The system of claim 1, further comprising a registration component for registering the position of a user's face during the inspection session.

27. The system according to claim 26, wherein, The control system also includes an activation utility configured and operable to activate the semi-autonomous system to perform the inspection session in response to a control signal indicating a safe state in which the user's face is in registration position.

28. The system of claim 26, further comprising a sensing system configured and operable to monitor the user's facial position and generate corresponding sensing data to be analyzed in order to determine the user's facial position relative to the registration position, so as to selectively generate the control signal.

29. The system according to claim 28, wherein, The sensing system is configured and operable to transmit the sensing data to a safety controller at a remote control station, where the sensing data is analyzed and the control signals are selectively generated and transmitted to the controller.

30. The system of claim 28, further comprising a security controller that is responsive to the sensing data and is configured and operable to analyze the sensing data and generate the control signal to the controller when recognizing the registration location of a user's face.

31. The system of claim 1, wherein the lighting device includes a flash illuminator.

32. The system of claim 1, wherein the semi-autonomous system includes an eye-aiming device that is automatically operated by the controller according to the operating parameters of the eye examination session.

33. The system of claim 1, wherein the semi-autonomous system includes an eye-tracking mechanism that is automatically operated by the controller during the inspection session.

34. The system according to claim 1, wherein, The semi-autonomous system includes one or more movement mechanisms for enabling controllable movement of one or more components of the system; and includes a safety controller configured and operable to control the one or more movement mechanisms.

35. The system according to claim 1, wherein, The at least one imaging device is configured and capable of operating to capture 3D images.

36. The system of claim 1, wherein the at least one imaging device comprises a color or monochrome sensor.

37. The system of claim 1, wherein the at least one imaging device comprises a monocular and / or multispectral sensor.

38. The system according to claim 1, wherein, The control system also includes an image processor utility configured and operable to analyze the image data and generate data indicating the number of anomalies in a corresponding number of locations.

39. The system according to claim 1, wherein, The control system is configured and operable to transmit data indicating the image data to a remote control station for further processing to identify and analyze abnormalities in the eye.

40. The system according to claim 20, wherein, The control system also includes an image processor utility configured and operated to: extract the single slit image from each of the consecutive image data segments at the corresponding locations, crop the extracted single slit image, and paste the cropped extracted single slit image onto a background image serving as a wide field-of-view image of the eye.

41. The system according to claim 21, wherein, The control system also includes an image processor utility configured and operable to segment the at least first multi-slit image into a set of corresponding single-slit images.

42. The system according to claim 41, wherein, The image processor utility is also configured and operable to paste each of the single slit images extracted from the at least first multi-slit image onto a background image serving as a wide field-of-view image of the eye.

43. The system according to claim 41, wherein, The image processor utility is configured and operable to generate data indicating the dynamic movement of the single slit image above the eye, thereby enabling the human to pause the data presented for a particular slit view.

44. The system according to claim 38, wherein, The image processor is configured and operable to use the image data to generate a 3D reconstruction of the acquired data in the acquired image.

45. The system of claim 21, wherein the semi-autonomous system is configured and operable to perform stereoscopic imaging of the eye and provide stereoscopic image data of the eye region, and wherein the image processor is configured and operable to: generate a 3D reconstructed image from two multi-slit images using the stereoscopic image data; identify at least one 3D single-slit image in the 3D reconstructed image; project the at least one 3D single-slit image onto a 2D image to obtain a 2D projected image including the at least one single-slit image; extract the at least one single-slit image from the 2D projected image; crop the extracted single-slit image; and paste the cropped extracted single-slit image onto a background image serving as a wide field-of-view image of the eye.

46. ​​The system according to claim 45, wherein, The lighting device includes at least one pair of optical projectors, each pair of optical projectors being associated with one or two imaging devices for performing stereoscopic imaging of the eye.

47. The system of claim 38, wherein the image processing utility is configured and operable to analyze the image data by applying algorithmic techniques, the algorithmic techniques including one or more of artificial intelligence, image enhancement, image recognition, image sharpening and image restoration, and encoding.

48. The system of claim 38, wherein the image processing utility is integrated with at least one of the optical projector and the imaging device.

49. The system according to claim 1, wherein, The manager utility is configured to communicate with the image processor at a remote control station.

50. The system of claim 49, wherein the data communication includes data transmission using encrypted secure communication.

51. The system according to claim 49, wherein, The manager utility is configured and operable to generate a compressed representation of the image data and transmit the compressed representation to the image processor at the remote control station.

52. The system of claim 1, wherein the control system is configured and operable to independently control the automatic variation of one or more of the following operating parameters: the size of the illumination point, the illumination wavelength, the illumination intensity, the illumination angle, the imaging angle, the focus shift of the illumination and / or imaging device, the eye turn, and the background illumination.

53. The system according to claim 1, wherein, The control system responds to input data of updated preset data from a suggested AI-based processor and is configured to optimize the operational data of the semi-autonomous system using the updated preset data.

54. A control system for managing and controlling eye examinations via a semi-autonomous examination system, the control system comprising at least one optical projector and at least one imaging device, the optical projector being operable to automatically project a sequence of illumination points of a predetermined shape onto a plurality of locations extending across an eye region at intervals during an eye examination session, the imaging device being operable to acquire images of the plurality of locations and generate image data associated with the plurality of locations during the examination session; the control system being configured as a computerized system having data input and output utilities, memory, and image processor utilities, wherein the control system includes: A manager utility, configured and operable in response to input data including preset data indicating an inspection task, to define operational data for the semi-autonomous system, the operational data defining operational parameters for the eye's inspection session, and... A controller is configured to operate the at least one imaging device using the operational data and in synchronization with the optical projector, thereby minimizing image degradation factors in the image data and minimizing the time the eyes are exposed to illumination during the examination session.

55. The control system of claim 54, configured as an electronic unit to be installed in the semi-autonomous inspection system.

56. The control system of claim 54, configured and operable to communicate with a remote control station, the manager utility responding to instructions from the remote control station to update at least one of the preset data and the operational data.

57. A control system comprising a computerized system capable of being connected via a communication network to a subscriber eye examination system of the type performing a semi-autonomous eye examination procedure, the control system being configured and operable to receive input image data from each subscriber eye examination system, apply model-based processing to the received input image data, and generate output data including at least one of: (i) data indicating suspicious portions and observations in the examined eye region to enable the detection of abnormalities and / or pathologies; (ii) data indicating abnormalities and / or pathologies in one or more portions of the eye region examined by the respective subscriber eye examination system; (iii) data indicating the quality level of the received image data provided by the respective subscriber eye examination system; and (iv) data indicating recommended preset data defining operational data for an examination session to be performed by the respective subscriber eye examination system.

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