Household amblyopia afterimage therapeutic instrument

Abstract

The application is a kind of home amblyopia afterimage therapeutic instrument, belonging to the field of eye optometry amblyopia treatment. The application provides an economic home amblyopia afterimage therapeutic instrument and its operation method with good stability, high accuracy of macular fovea covering protection, low requirement of cooperation of the operator and the patient and applicability to wide-angle para-central fixation amblyopia patients by the integration design of multiple systems, especially the use of three-dimensional translation table to adjust the light source position and present the fundus image on the display screen, and the operation guidance by the voice prompting system, and the use of topological light source for saturated illumination. The application is mainly applied to the home treatment of para-central fixation amblyopia patients, and can also be applied to the hospital treatment, reducing the work burden of doctors and nurses.

Description

TECHNICAL FIELD

[0001] The present application relates to a multi-system integrated design of a home amblyopia afterimage therapy instrument, which is mainly applied to the treatment of patients with paracentral fixation amblyopia. BACKGROUND

[0002] For paracentral fixation amblyopia, afterimage vision enhancement is an effective auxiliary treatment scheme, especially suitable for patients with large-angle paracentral fixation amblyopia and difficult amblyopia.

[0003] In 1936, W. Comberg of Germany first proposed the idea of "using stimulation of the fovea of the amblyopic eye to achieve central fixation", and thereafter, Bangerter and Cüppers introduced various instruments based on this principle, among which Bangerter manufactured the first afterimage therapy instrument in the current sense.

[0004] The basic operation steps of modern afterimage therapy are as follows: a professional person (trained doctor or nurse) holds an ophthalmoscope with a small black screen, i.e. an afterimage mirror, to irradiate the fundus of the child, the strong light emitted by the afterimage mirror forms a ring on the retina, and during the irradiation process, the operator manually controls the position of the afterimage mirror to ensure that the small black screen image is aligned with the macular fovea region, and the strong light outside the small black screen image bleaches the retina outside the fovea region. After the irradiation is completed, the child holds a small stick for knocking training to further consolidate the central fixation.

[0005] The effect of a single afterimage treatment depends on whether the small black screen image can accurately cover the macular fovea region, which involves the stability of the instrument, the focusing position of the light source, the specific adjustment of the black screen size, and the cooperation of the patient; complete afterimage treatment, i.e. achieving stable central fixation, requires repeated training, and the treatment period may last for several years. Long-term hospital treatment leads to a rapid increase in time and economic costs for patient parents, reduces treatment motivation, and many patients, especially children, miss the golden treatment opportunity. The above treatment method requires a professional person to operate on site in the hospital, and cannot be directly used at home. Therefore, there is an urgent need to develop a home amblyopia afterimage therapy instrument that can be operated by non-professionals.

[0006] To solve this problem, previous people integrated various elements to allow patients to use them at home, and the following are related patents or research introductions.

[0007] The afterimage color light magnifier proposed by Qian Yu (CN87202100U) and the afterimage instrument for children's amblyopia proposed by Zhang Jiading (CN209827479U) both belong to subjective treatment method or self-illuminated afterimage method, that is, the patient gazes at the fixation target in the center of the cover sheet to protect the fovea centralis. In this method, the cover sheet may protect the eccentric fixation point, not necessarily the fovea centralis, and improper operation may further inhibit central fixation. Clinicians generally have a negative attitude towards its treatment effect.

[0008] The lan light afterimage red light flicker amblyopia treatment instrument proposed by Du Liping (CN1033363C) belongs to objective treatment method or vision enhancement method. The treatment instrument has a double barrel (including a treatment barrel and an examination barrel), and the operator can observe the fundus through the examination barrel and adjust the afterimage mirror to the appropriate position. This method can align the small black screen image with the fovea centralis, and the entire instrument is located on the desktop, without the need for the operator to hold the entire instrument, reducing the workload of doctors and nurses. However, it is not convenient for parents without professional knowledge to operate by observing the fundus through the barrel, and secondly, it is difficult to fix the eyes of children of several years old at the treatment barrel and keep them still.

[0009] The afterimage amblyopia treatment instrument guided by the Haidinge light brush proposed by Chen Jie et al. (CN2757776Y and CN102697625B) uses the combination of light brush plate and cover sheet to achieve more accurate covering of the fovea centralis with low operation professional requirement. However, it is difficult to command small children to drag the light brush image and maintain it at a certain fixation target, so it is not a completely objective treatment method; more importantly, children with severe peripheral fixation amblyopia (such as peripheral fixation point outside the 3rd ring) cannot find the Haidinge light brush image at the early stage of treatment, resulting in complete failure of the treatment plan.

[0010] The amblyopia afterimage vision enhancement system designed by Liu Hang based on fundus camera principle belongs to objective treatment method. After the image is collected by CMOS detector, the computer identifies the position and size of the fovea centralis in the image, and generates a conjugate image on the DMD chip with light switching function through digital light processing technology. Then the DMD reflects the light beam back to the fundus, realizing strong light stimulation outside the macular area of the affected eye (Liu Hang. Amblyopia afterimage vision enhancement optical system design based on fundus camera [D]. Changchun University of Science and Technology, 2020.). This vision enhancement system replaces the role of professional doctors with computers, which can liberate manpower, but the difficulty in production limits the rapid production of the system, and the single production cost makes it difficult for ordinary families to afford.

[0011] In summary, existing technologies suffer from a series of problems, including low accuracy in protecting the fovea, high requirements for operator expertise and patient cooperation, unsuitability for patients with severe eccentric fixation amblyopia, and high production costs, making them unsuitable for home treatment of amblyopia patients. Summary of the Invention

[0012] This invention belongs to the field of optometric amblyopia treatment. Addressing the shortcomings of existing technologies in this field, this invention provides an economical home-use amblyopia afterimage therapy device and its operating method, which offers good stability, high accuracy in foveal occlusion protection, low requirements for operator expertise and patient cooperation, and is suitable for patients with large-angle eccentric fixation amblyopia.

[0013] The home-use amblyopia afterimage therapy device provided by this invention consists of six parts: a structural frame, a voice prompt system, an imaging illumination and display system, a saturated illumination system, a three-dimensional translation stage, and an operation panel and an operation joystick.

[0014] To achieve the objectives of this invention, the following technical solution is adopted:

[0015] The structural frame is designed to maintain the stability of the child's head and the instrument. The material used to make the structural frame should be non-deformable, such as metal or resin. The structural frame should include four large bases, a support structure and a panel, and devices to maintain the stability of the child's head, such as a height-adjustable boat-shaped support for the child's chin, handles for the child to grip with both hands, and a teacup-shaped rubber frame to fix the child's eyes.

[0016] The voice prompt system plays voice and music when the device is turned on, and provides voice prompts or clear instructions for each step of the operation process after powering on, making it convenient for parents and patients to operate.

[0017] The imaging illumination and display system comprises an illumination source, an optical path, an image receiver, and a display screen. The light source has a low intensity (requiring no noticeable afterimage to the fundus; the specific intensity value is set according to illumination needs or as prescribed by the doctor). It can be a conventional light source or a topological light source, such as vortex light or topological vector light. The light source is guided into the optical path after being coupled via an optical fiber bundle. The optical path consists of two parts: a Kohler illumination optical path and an imaging optical path. A mirror ensures that these two optical paths are parallel to each other. The objective lens in the Kohler illumination optical path can move back and forth. The objective lens and imaging lens in the optical path can be ordinary spherical lenses or planar lenses with micro / nano structures, such as Fresnel lenses or metalenses. The optical path also includes other necessary optical components, such as neutral density (ND) filters, condenser lenses, polarizers, beam splitters, and fiber arrays. The image receiver includes devices such as CCDs, CMOS sensors, and cameras. The display screen allows parents to observe the child's fundus images.

[0018] The saturation illumination system comprises a light source, a saturation illumination optical path, and a timer. The light source has a high intensity (enough to produce a clear afterimage in the fundus; the specific intensity value should be set according to the doctor's instructions). The saturation illumination optical path is based on the optical path of the aforementioned imaging illumination and display system, with the addition of several optical components, including elements that transform ordinary light sources into topological light sources, such as spiral phase plates and spatial light modulators, as well as a light shield. The topological light source has a central dark area with topological protection, so when this light source shines into the patient's fundus through the light shield, it provides double protection for the fovea region of the macula. The timer limits the duration of the saturation illumination (e.g., 7 seconds), which can be manually set according to treatment progress and the doctor's requirements. The intense light automatically turns off after the timer expires.

[0019] The three-dimensional translation stage allows parents (or other operators) to manually adjust the position of the small black screen image. The operator adjusts the front-to-back distance of the objective lens to obtain a clear image of the macula on the display screen. When adjusting the base shared by the light shield and spiral phase plate (up, down, left, and right), the dark area of ​​the topological light source image can be aligned with the fovea centralis by combining the image on the display screen.

[0020] The control panel and joystick include control buttons for all the aforementioned systems and the joystick for the 3D translation stage. It also features an emergency stop button, which parents can press to cut off the light source if they notice strong light mistakenly shining on the fovea of ​​the macula on the monitor. This section can be implemented in two ways: one is to separate the display screen and control panel, with the display screen specifically showing the fundus image and the control panel equipped with mechanical buttons and switches for operation; the other is to replace the control panel with a touchscreen, a soft control panel that simultaneously displays the fundus image.

[0021] The technical advantages of this invention are as follows:

[0022] 1. High stability. Compared with handheld devices, the structural frame of the amblyopia afterimage therapy device of this invention not only ensures the stability of the instrument, but also restricts the range of motion of the child's head to a certain extent; and for the same child, the instrument can maintain the calibrated position for a longer period of time after adjustment, avoiding frequent large-scale adjustments.

[0023] 2. Ease of operation. Stability reduces the need for operator expertise; the instrument itself is calibrated, and the joystick and real-time display, similar to those in computer games, help operators easily focus images on the child's fundus, achieving highly accurate occlusion of the fovea; the voice prompt system allows non-professional parents to smoothly operate the entire treatment process.

[0024] 3. Easy to cooperate. The child only needs to hold the handles with both hands, place his / her chin on the boat-shaped support, align his / her eye socket with the cup-shaped rubber frame, and hold the position for a few seconds to complete the process of saturated illumination to form an afterimage. The requirement for the child's cooperation is low, which avoids the problem of reduced treatment effect caused by the child's lack of cooperation.

[0025] 4. Miniaturization and ease of maintenance. Using reflectors to make the illumination and imaging optical paths parallel optimizes space utilization and facilitates the connection between external and internal components of the therapeutic instrument. Furthermore, the use of lenses with micro-nano structures in the optical path further promotes the miniaturization of the entire instrument. The light source box is attached separately to the outside of the therapeutic instrument, and the light source is coupled into the internal optical path of the therapeutic instrument using an optical fiber bundle. A dedicated heat dissipation device is added to the light source box, thereby reducing the heat dissipation requirements of the therapeutic instrument and simplifying the replacement of consumables such as bulbs.

[0026] 5. Better protection for the fovea. The topological light source used in the saturated illumination system has a topologically protected central dark area. Therefore, as long as the small black screen is aligned with the fovea region of the macula, neither geometric bright spots nor diffraction bright spots (such as Airy disks) will be generated in the fovea region during focusing. In addition, taking vortex light as an example, by placing a spiral phase plate that generates vortex light with different topological charges inside the instrument and selecting it using a switching device, the size of the small black screen image can be changed, avoiding operations that would compromise the stability of the instrument, such as directly replacing small black screens of different sizes or moving the position of the small black screen.

[0027] 6. Objectivity. This invention is a completely objective treatment method. During saturated illumination, the dark area of ​​the light source is aligned with the foveal region of the macula in the affected eye, thereby effectively stimulating the visual function of the foveal region.

[0028] In summary, the home-use amblyopia afterimage therapy device provided by this invention has good stability, high accuracy in foveal occlusion, and low requirements for operator expertise and child cooperation, allowing children to undergo effective eccentric fixation amblyopia afterimage therapy at home. Of course, this invention can also replace the handheld therapy devices commonly used in hospitals, reducing the workload of nurses and other operators. Attached Figure Description

[0029] Appendix Figure 1 Light path diagram for illumination and imaging

[0030] Appendix Figure 2 State switching logic diagram for ND filter

[0031] Appendix Figure 3 A three-dimensional view of the afterimage therapy device.

[0032] Appendix Figure 4 A stereoscopic view of the afterimage therapy device from another perspective. Detailed Implementation

[0033] The embodiments of the present invention will be described in further detail below with reference to the accompanying drawings. However, these embodiments do not limit the present invention. Any similar structures and variations thereof that adopt the present invention should be included in the protection scope of the present invention.

[0034] Figure 1 A schematic diagram of the lighting and imaging optical path inside the afterimage therapy device is shown. The light source 1 is placed in a separate box and attached to the outside of the therapeutic instrument to reduce the heat dissipation requirements inside the instrument. The light source 1 is introduced into the therapeutic instrument via fiber optic cable coupling. A controllable neutral density (ND) filter and its rotating frame 2 are placed in front of the fiber optic cable and connected to a countdown shutter 3, so that the light source automatically switches between three states: weak light, strong light, and no light according to a set program. Using Kohler illumination, after the beam passes through the condenser lens 4 and the variable aperture 5, the light source image formed at the variable aperture 6 is very small and can be approximated as a new point light source. This light source image becomes parallel light after passing through the condenser lens 7 and generates vortex light with a topological dark area for saturation illumination through the spiral phase plate 9. The light shield 10 further generates a ring light source when used for saturation illumination, and images it onto the fundus through a subsequent optical path, providing dual protection for the fovea of ​​the macula together with the spiral phase plate 9. The spiral phase plate 9 and the light shield 10 are placed on a flip-up frame so that the light intensity switches from uniform illumination to hollow illumination. The center of the spiral phase plate 9 and the light shield 10 are... The centers of the 10 lenses are aligned and share a common base, which can move in the XY direction to adjust the position of the small black screen image on the retina, aligning the image with the fovea of ​​the macula. The objective lens 12 can move in the Z direction to adjust the focus, which can be adjusted manually or by using a feedback loop and a stepper motor to control the objective lens 12 for automatic focusing. The light reflected from the retina of the affected eye 13 enters the imaging optical path after passing through the beam splitter 11. The reflector 14 makes the illumination optical path and the imaging optical path parallel to each other. After passing through the imaging lens 16, the light beam is clearly imaged on the image receiver 17 and transferred to the display screen to present the fundus image. The polarizer 8 and analyzer 15 eliminate the light directly reflected from the objective lens 12 and the cornea of ​​the affected eye 13, preventing such reflected light from affecting the image quality. Another method to eliminate such reflected light is to place a black circular screen on the conjugate surface of the rear surface of the objective lens 12 and the outer surface of the cornea to filter the reflected light. All inner wall surfaces of the treatment device are covered with black velvet 18 to prevent light reflected from the inner wall from affecting the image quality.

[0035] Figure 2The diagram shows the switching logic for the three states of the ND filter. In the default mode, the ND filter is in a slightly transparent state (i.e., obtaining weak light) for illuminating and displaying the fundus. When saturation illumination is triggered, the ND filter switches to a fully transparent state (i.e., obtaining strong light), and the countdown shutter connected to the ND filter starts timing. After the countdown ends, the ND filter automatically switches to a completely dark state, ending the saturation illumination.

[0036] Figure 3 and Figure 4 Two perspective views of the afterimage therapy device from different embodiments are shown. The patient holds two handles 20, aligns their eyes with the cup-shaped rubber frame 19, and rests their chin on the boat-shaped support 21, the height of which is adjustable. A speaker 22 plays voice prompts guiding the operation. The Z-direction translation stage 23 connects to the objective lens 12 for focusing the fundus, while the X and Y-direction translations connect to a base shared by the light-shielding plate 10 and the spiral phase plate 9, used to position the small black screen image to the fovea of ​​the macula. The three-dimensional translation stage is operated using an ergonomically designed joystick. The display screen 24 shows the patient's fundus image. After pressing the power button on the operation panel 25, subsequent steps can be performed according to the voice prompts. The display screen 24 and operation panel 25 have two configuration options; one is as follows... Figure 3 The display screen 24 and the operation panel 25 are separate. The display screen 24 is specifically for displaying fundus images. The operation panel 25 is equipped with mechanical buttons and switches for operation. Alternatively, a touch screen can be used instead of the operation panel, which is a soft operation and displays fundus images on the touch screen. The light source box 26 is used to house the light source. The light source box 26 has a separate heat dissipation device and the box is detachable. The power socket 27 is used to supply power to the light source and the circuit. The heat dissipation hole 28 is used for heat dissipation inside the treatment device. The cross-shaped flashing light source 31, the switch 30 of the cross-shaped flashing light source, and the place 29 for the tapping stick are used for the patient to perform tapping consolidation training after afterimage illumination.

[0037] The procedure for afterimage treatment using this instrument for children is as follows:

[0038] Operator presses Figure 3After pressing the power button on the control panel 25, the instrument emits a voice prompt: "Power-on successful. Please keep your child's eyes open throughout the process. If any operational error occurs, please press the 'Emergency' button. After about 10 seconds, power on again." A 3-5 second startup music plays after the voice prompt. After the music ends, the voice prompts: "Please place your child's chin on the boat-shaped support, and then please press the 'Dimmed Light' button." After the operator presses the "Dimmed Light" button, the voice prompts: "A faint light is now shining into your child's eyes. Please keep your posture still." At this time, the instrument emits a dim light to illuminate the patient's fundus, and the fundus image is displayed on the screen 24. The voice prompts: "Please operate the Z-axis lever on the 3D translation stage until the macula on the retina can be clearly identified on the screen 24. After adjustment, please press the 'Switch' button." The operator presses the "Switch" button. Afterwards, the voice prompt says, "Please keep your current posture and don't move. Pay attention to the black dot in front of you." At this time, the spiral phase plate 9 and the light shield 10 flip up, switching the ordinary light source to vortex light. In the default mode, the dark area of ​​the vortex light is the largest. The voice prompt says, "Please adjust the operating levers along the X and Y directions so that the dark area is aligned with the center of the macula. After adjustment, please press the 'Continue' button." After the operator presses the "Continue" button, the voice prompt says, "Please rotate the 'Dark Area' knob to adjust the size of the dark area so that it just covers the macula. After adjustment, please press the 'High Light' button." After the operator presses the "High Light" button, the voice prompt says, "Please keep your current posture." At this time, the high light begins to produce an afterimage. The display screen 24 shows a countdown. After the high light has been irradiated for the preset time, the light source automatically turns off. The voice prompt says, "Please go to the tapping training area for training now." The operator turns on the switch 30 of the cross flashing light source, and the child takes the tapping stick from the tapping stick placement 29 and taps the cross flashing light source 31, performing tapping training at 60-80 times per minute for 3-5 minutes.

[0039] After one tapping training session, one round of afterimage therapy is completed. Generally, 5-10 rounds of therapy are performed every half day, with the exact number determined by the doctor's instructions. When restarting the afterimage therapy device, parents can directly press the "Continue" button. If the dark area on display 24 is located in the fovea centralis, the subsequent steps can be performed under voice prompts (i.e., rotating the "Dark Area" knob to adjust the size of the dark area, pressing the "Strong Light" button to perform strong light irradiation to generate the afterimage, and performing tapping training). If the macular area is off-center from the dark area, after the child places their chin on the boat-shaped support 21, press the "Weak Light" button and follow the voice prompts to perform the subsequent steps.

Claims

1. A home-use amblyopia afterimage therapy device, characterized in that: The therapeutic device is integrated with a structural frame, voice prompt system, imaging illumination and display system, saturated illumination system, three-dimensional translation stage, and operation panel and joystick. The imaging illumination and display system includes a light source, a first optical path, an image receiver, and a display screen. The light source is introduced into the treatment device via fiber optic bundle coupling. A controllable neutral density filter and a rotating frame are placed in front of the fiber optic bundle and connected to a countdown shutter, so that the light source automatically switches between three states: weak light, strong light, and no light according to a set program. The first optical path includes two parts: a Kohler illumination optical path and an imaging optical path. When illuminating and displaying the fundus, the light source is in a weak light state with low intensity, and it is required that no obvious afterimage is produced in the fundus. The saturated illumination system includes the light source, a timer, and a second optical path. The second optical path is formed by adding an element to the first optical path that transforms the light source into a topological light source with a central dark area and a light shield with a central small black screen. The topological light source element and the light shield are placed on a flip-up frame, which is placed on a base that can move in four directions (up, down, left, and right) to achieve coaxiality. During saturated illumination, the light source is in a strong light state with high intensity, which is required to produce a clear afterimage in the fundus. The Z-direction translation slider of the three-dimensional translation stage is connected to the objective lens, and the X-direction translation slider and the Y-direction knob are connected to the base shared by the light shield and the topological light source components. The base can move in the X and Y directions, thereby adjusting the position of the small black screen image on the retina so that the small black screen image is aligned with the fovea of ​​the macula. The Kohler illumination optical path includes the objective lens and the beam splitter, and the imaging optical path includes the reflector, the imaging lens, and the image receiver. The objective lens can be moved in the Z direction to adjust the focus. The light reflected from the retina of the affected eye enters the imaging optical path after passing through the beam splitter. The reflector makes the Kohler illumination optical path and the imaging optical path parallel to each other. After passing through the imaging lens, the light beam is clearly imaged on the image receiver.

2. The home-use amblyopia afterimage therapy device according to claim 1, characterized in that: The structural frame includes four stable bases, support structures and panels, and three devices for stabilizing the child's head. The three devices for stabilizing the child's head include a height-adjustable boat-shaped support for the child's chin, a handle for the child's hands to grip, and a teacup-shaped rubber frame to fix the child's eyes.

3. The home-use amblyopia afterimage therapy device according to claim 1, characterized in that: The light source is placed in a separate box and attached to the outside of the treatment device.

4. The home-use amblyopia afterimage therapy device according to claim 1, characterized in that: The objective lens in the Kohler illumination optical path can be moved in two ways: one is by manual adjustment, and the other is by using a feedback loop and a stepper motor to control the objective lens and achieve automatic focusing.

5. The home-use amblyopia afterimage therapy device according to claim 1, characterized in that: The operation panel can be implemented in two ways. In one way, the display screen and the operation panel are separated. The display screen is dedicated to displaying fundus images, and the operation panel is equipped with mechanical buttons and switches for operation. In the other way, a touch screen is used to replace the operation panel for touch operation, and the fundus images are displayed on the touch screen.

Images