Vitreous float treatment using resonant scanner-based SLO

Abstract

Particular embodiments disclosed herein provide a system for treating vitreous floats. Light from a first laser (e.g., a laser diode) is focused on a plurality of points within the vitreous body of a patient's eye using a scanner, while reflected light from the plurality of points is measured. The reflected light (e.g., image) is evaluated to identify a portion of the plurality of points that corresponds to the one or more vitreous floats. Second light from a second laser (e.g., a pulsed laser) is focused at the portion of the plurality of points using the scanner to decompose the one or more vitreous floats.

Description

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS

[0002] This application claims the benefit of U.S. Provisional Patent Application No. 63 / 388,911, filed on July 13, 2022, the entire contents of which are incorporated herein by reference in their entirety. Background Art

[0003] Light enters the human eye through the clear cornea, which covers the iris and pupil of the eye. The light travels through the pupil and is focused by the lens, which is located behind the pupil in a structure called the capsular bag. The light is focused by the lens and cornea onto the retina, which consists of rods and cones, which generate nerve impulses in response to light. The space between the lens and the retina is occupied by a clear gel called the vitreous body.

[0004] Floaters may appear in the vitreous for a variety of reasons. Floaters are usually composed of clumps of cells, collagen fibers, and / or other tissues and are more opaque than the surrounding vitreous. Floaters can cast shadows on the retina, causing visual disturbances that can be severe for some patients. Summary of the invention

[0005] The present disclosure generally relates to a system for treating vitreous floaters.

[0006] Certain embodiments disclosed herein provide a method and corresponding apparatus that includes focusing first light from a first laser at a plurality of points within a vitreous body of an eye of a patient using a scanner system while measuring reflected light from the plurality of points. The method includes determining, by a computer system, that the reflected light from a portion of the plurality of points corresponds to one or more vitreous floaters. In response to determining that the reflected light from the portion of the plurality of points corresponds to the one or more vitreous floaters, focusing second light from a second laser at the portion of the plurality of points using the scanner system to resolve the one or more vitreous floaters.

[0007] The following description and the associated drawings set forth in detail certain illustrative features of the one or more embodiments. BRIEF DESCRIPTION OF THE DRAWINGS

[0008] Certain aspects of one or more embodiments are depicted in the accompanying drawings, and therefore should not be considered to limit the scope of the disclosure.

[0009] Figure 1 is a schematic cross-sectional view of an eye with floaters.

[0010] Figure 2 is a schematic diagram of a scanning laser ophthalmoscope (SLO) and a therapeutic laser system for treating vitreous floaters, according to certain embodiments.

[0011] Figure 3 is an SLO image of vitreous floaters, according to certain embodiments.

[0012] Figure 4 is a diagram illustrating a laser scan path of an SLO according to certain embodiments.

[0013] Figure 5 is a diagram illustrating a boundary containing floating objects according to certain embodiments.

[0014] Figure 6 is a diagram illustrating scanning and activation patterns of a therapeutic laser according to certain embodiments.

[0015] Figure 7 is a diagram illustrating cavitation bubbles generated by therapeutic laser activation, according to certain embodiments.

[0016] Figure 8 An implementation of a scan path implemented by a sinusoidal path is shown in accordance with certain embodiments.

[0017] Fig. 9 An example computing device is shown that at least partially implements one or more functions of an SLO and therapeutic laser system in accordance with certain embodiments.

[0018] To facilitate understanding, identical reference numerals have been used, where possible, to designate identical elements that are common to the figures. It is contemplated that elements and features of one embodiment may be beneficially incorporated in other embodiments without further recitation. DETAILED DESCRIPTION

[0019] refer to Figure 1 , the human eye 100 includes a cornea 102, which is a curved transparent layer through which light enters the eye 100. The light then passes through the anterior chamber 138, pupil 104, and lens 106 of the eye 100, respectively. The remaining volume of the eyeball 108 of the eye 100 (called the posterior chamber or vitreous cavity) is filled with a transparent gel called vitreous 110. The light is focused by the cornea 102 and lens 106, and reaches the retina 112 at the back of the eye 100 through the vitreous 110.

[0020] Vitreous floaters 114 are clumps of cells, collagen fibers, or other contaminants. When vitreous floaters 114 are present, they cast a shadow 116 on the retina 112. The shadow 116 can sometimes occupy a large angular range of the field of view of the eye 100. When the floaters 114 are large enough, opaque, and / or numerous enough, they can severely reduce the patient's vision.

[0021] Figure 2An example scanning laser ophthalmoscope (SLO) and therapeutic laser system 200 (hereinafter referred to as "system 200") that can be used to implement the methods described herein is shown. System 200 includes a laser diode LD and a therapeutic laser TL. The laser diode LD is an infrared laser diode known in the art for use in SLO. The infrared light emitted by the laser diode LD is invisible to the patient. The therapeutic laser TL is a pulsed laser that can generate pulses with a high repetition rate (such as between 1 and 2 MHz) for decomposing vitreous floaters 114. The therapeutic laser TL may have a higher pulse repetition rate, but requires gating or selective switching to achieve this repetition rate. In some embodiments, the therapeutic laser TL is a femtosecond therapeutic laser based on a chirped pulse regenerative amplifier (CPA) with a repetition rate on the order of one or more MHz. Such a laser can also be operated in a "pulse on demand" operating mode, which means that pulses up to the same high rate can be selected from a MHz repetition rate pulse train. For example, pulses can be selected to be output at a rate between 1 kHz and 1 MHz, which is suitable for the methods disclosed herein. In some embodiments, the pulses are selected using an acousto-optic deflector, a Pockels cell, or other type of pulse selection device.

[0022] Lens L4 is used to make the light beam from the laser diode LD substantially (e.g., within 1 degree) parallel. The light beam from the laser diode LD is incident on a scanning mirror SM that rotates around at least two rotation directions. For example, the scanning mirror SM can rotate along rotation directions RX and RY, which can be defined as rotations around the X-axis and the Y-axis, respectively. In some embodiments, the scanning mirror SM is implemented by a first reflector ("RX mirror") that rotates around the rotation direction RX and a second reflector ("RY mirror") that rotates around the direction RY. For example, the RX mirror can be implemented as a resonant scanner, and the RY mirror can be implemented as a relatively slow galvanometer.

[0023] The light reflected from the scanning mirror SM is directed through one or more lenses L1, L2. One or both of the lenses L1, L2 can be mounted on a lens actuator LA. The lens actuator LA actuates the position of one or both of the lenses L1, L2 along the optical axis OA of the lenses L1, L2 to change the position PZ of the focus of the laser diode LD and the treatment laser TL along the Z axis. The Z axis can be substantially (e.g., within 0.1 degrees) parallel to the optical axis OA. Adjustment of the position PZ can be accompanied by using the scanning mirror SM to change the position PXY of the focus in the XY plane so as to target any three-dimensional coordinate within the vitreous body of the eye. In some embodiments, the lenses L1 and L2 and the lens actuator LA can be replaced with one or more electronically controlled optofluidic lenses that can achieve the same degree of adjustment without the use of a mechanical actuator. In some embodiments, an electrically adjustable lens L5 can be added between the beam splitter BS2 and the scanning mirror SM. Activation of the lens L5 can move the focus PXY to the desired depth PZ. For example, to understand the order of magnitude, for an average emmetropic eye, an increase of 0.36 diopters results in a shift of the focal depth PZ about 1 mm away from the retina. To obtain adequate optical resolution, L1 and L2 can each be a single lens or a compound lens system.

[0024] A portion of the light from the focal point PXY of the laser diode LD is reflected from the glass body, passes through lenses L2 and L1, and is reversely scanned by the scanning mirror SM to the beam splitter BS1. The beam splitter BS1 guides at least a portion of the reversely scanned light to the photodiode PD. Figure 2 It can be seen that the light emitted from the laser diode LD is incident on the beam splitter BS1 , and a part of the light passes through the beam splitter and reaches the glass body 110 .

[0025] In some embodiments, to reduce the detection of light reflected from the cornea, lens, or other structures located somewhere other than the focal point of the laser diode LD, a lens L3 is disposed between the beam splitter BS1 and the photodiode PD. A pinhole PH is located between the lens L3 and the photodiode PD and is aligned with the focal point FP of the reverse scanned light to implement a confocal pinhole filter PH. The focal point FP is the focal point of the optical path from the focal point of the laser diode in the vitreous body 110 (position PXY, PZ), which includes the effects of lenses L1, L2, and L3. Therefore, light reflected from any position other than position PXY, PZ will not be focused when it reaches the pinhole PH and will be substantially blocked by the pinhole PH. The diameter of the pinhole PH can be selected to block unwanted reflections while still allowing enough light to pass through to be detected by the photodiode PD. To effectively select the depth, the diameter of the pinhole PH should be approximately the diffraction-limited spot diameter of the lens L3 (e.g., within 10% of it). The focal depth PZ and the pinhole PH are optically conjugated, and the pinhole PH acts as a confocal filter, suppressing any light that does not come from the focal points PXY, PZ of the system 200. The lens L3 can be implemented as a single lens or a compound lens system. Thus, the system 200 can measure the reflectivity of the retina in 2D or the reflectivity of floaters in 3D.

[0026] The various elements may include combined optical elements for routing the light from the treatment laser TL to be precisely (e.g., within 0.001 degrees) parallel and co-linear (e.g., within 0.01 μm) with the light from the laser diode LD. For example, a second beam splitter BS2 may be used to redirect a portion of the light from the treatment laser TL to be parallel and co-linear with the light from the laser diode LD that passes through the second beam splitter BS2. In the illustrated embodiment, the beam splitter BS2 is located between the beam splitter BS1 and the scanning mirror SM.

[0027] An advantage of the system 200 shown is that the light from the treatment laser TL and the light from the laser diode LD are focused precisely (e.g., within 0.01 μm) to the same position PXY, PZ, regardless of the refraction caused by the cornea 102 and lens 106 of the patient's eye. Therefore, if for a given state of the lenses L1, L2 and scanning mirror SM, the light is scattered by a point on the floater 114, the light from the treatment laser can be transmitted through the system 200 with the same state of the lenses L1, L2 and scanning mirror SM to destroy that point of the floater 114. Therefore, if the system 200 detects the image of the floater and may display it on the operator's screen, the treatment laser is automatically focused on the floater. There is no need to calibrate the focus of the laser diode LD beam and the focus of the treatment laser TL beam together. The lenses L1, L2 and L5 (if applicable) are selected so that the light diverges significantly after passing through the position PXY, PZ to reduce the light intensity incident on the retina 112. The numerical aperture of the therapy laser TL beam and the laser diode LD beam is limited only by the pupil diameter.

[0028] System 200 may be coupled to a computer system, such as a computer system having some or all of the attributes of computing system 900 described below. The computer system may continuously receive the output of photodiode PD and information about the angular orientation of the mirrors from encoders of the RX and RY mirrors. The depth PZ position of the focal point is provided by the encoder of the lens actuator LA. In conjunction with these data, computing system 900 (see Fig. 9 ) can continuously create a three-dimensional map of the vitreous body and floaters 114. The computer can also display a frontal 2D or 3D image of the floaters in video form.

[0029] Figure 3 An example image of a floater 114 that may be obtained using the system 200 is shown. The image shown may include a two-dimensional array of intensity values ​​measured using a photodiode PD for a single depth PZ (ie, a frontal X / Y image) of a floater 114 embedded in the vitreous body 110. Thus, Figure 3 The image is a cross-sectional image of a floater 114 at a given depth PZ. In conventional ophthalmic practice, the retina 112 is typically imaged using an SLO. In this case, the focus PXY, PZ is located on the retina, i.e., PZ=0, and the SLO measures the reflectivity of the laser diode light from the retina. If a floater 114 is present, the shadow 116 cast by the floater will appear as a darker spot on the image of the retina 112. A conventional SLO is able to capture an image of the retina, including the shadow 116 cast onto the retina by the floater 114. However, the system 200 can move the focal plane into the vitreous and away from the retina 112 so that light reflected from the floater 114 can be directly detected. Figure 3The frontal image of the floater 114 shown is a frame of a video taken at 4 frames per second. The subject of the video was a patient complaining of floaters. The scan angle size was 30°×30°, corresponding to a retinal size of 8 mm×8 mm.

[0030] Reference now Figure 4 and Figure 8 , Figure 4 The horizontal lines in the figure show the scanning pattern of the beam of the laser diode LD as scanned by the RX and RY scanning mirrors SM. The RX mirror is rotated by the resonant scanner. The angular deflection of the LD laser beam in the X direction is a sinusoidal function of time, as Figure 8 In order to form Figure 3 The example images in Figure 8 Segments AB, CD, EF, etc. within the segment shown from -4mm to +4m scan the laser diode LD laser spot from left to right along the X direction. Segments AB, CD, EF, etc. account for approximately 1 / 4 of the total oscillation period of the resonant scanner. In each segment, the speed of the beam deflection can be considered to be virtually constant. Segments BC, DE, etc. are used to move the beam in steps of 30um along the Y direction. The step size of 30μm in the Y direction gives the float 114 very good spatial resolution. In order to establish a frontal X / Y image, 8mm / 30μm=266 horizontal scanning trajectories are used. In order to avoid graphic crowding, only 54 horizontal scans are shown. During the BC, DE, etc. periods, the computing system 900 ignores the signal output of the photodiode PD. The frame rate of the video is 4 frames per second. Therefore, the oscillation period of the RX mirror resonant scanner is 0.25s / 266. The OD segment ( Figure 8 ) has a scanning time of about 0.25s / (266*8), and a scanning distance of 4mm. Therefore, the scanning speed is 4mm*266*8 / 0.25s=34m / s. The resonant scanner of the RX mirror is fully capable of achieving this scanning speed. The distances, angles, speeds and other values ​​in the above examples are only exemplary. Other values ​​may also be achieved. Specifically, the resonant scanner of the RX mirror and the galvanometer of the RY mirror may operate slower or faster than the speeds described above.

[0031] The slope of the sinusoid in the OD segment may not be completely constant, which can cause some image distortion in the X direction. Using the properties of the sine function, this distortion can be corrected before displaying the frontal X / Y image. However, since the imaging and treatment laser beams are scanned using the same system 200, the accuracy of laser treatment using the treatment laser TL is not affected by any distortion.

[0032] The scans discussed above can be viewed as the planning phase of the treatment process. At this stage, the x / y position and x / y size and shape of the floater 114 are determined for each PZ depth using image analysis software known in the art. By combining multiple frontal cross-sectional images, a 3D image of the floater can be constructed and displayed in the form of a video if desired. In this example ( Figure 4 and Figure 5 ), an orthogonal treatment box is defined with x / y dimensions of 2.3 mm×2.3 mm and a depth of 3 mm. The treatment box BX is a closed surface that completely surrounds the floating object 114. In this example, the treatment box has a rectangular shape, but the shape can have any closed 3D geometric shape corresponding to the actual 3D shape of the floating object.

[0033] Figure 5 An example scanning pattern used during treatment of a floater 114 using a treatment laser TL is shown. The treatment laser TL beam and the laser diode LD beam are scanned using the same scanner, so the movement of the treatment laser spot is the same as the movement of the LD laser spot. During treatment, the resonant frequency and the X-scan speed of 34 m / s remain unchanged, but the Y line spacing is increased from 30 μm to 300 μm. In this way, the horizontal X-scan lines are no longer 266, but only 27, and the frame rate is also increased from 4 frames per second to 40 frames per second. These values ​​are only exemplary and can be based on the above description of Figure 4 The values ​​described for imaging vary.

[0034] For the treatment of the floaters 114, a vertical line spacing of 300 μm was selected for the following reasons. Experiments conducted by the inventors showed that the floaters could be decomposed using multiple 15 μJ laser pulses. The experiments also showed that a 15 μJ laser pulse could generate transient cavitation bubbles with a diameter of 370 μm. In this way, the floaters 114 can be completely decomposed by filling the treatment frame BX with laser pulses focused into a 300 μm×300 μm×300 μm matrix. To achieve a 300 μm laser spot spacing along the X direction, the repetition rate of the treatment laser TL can be substantially (e.g., within 1 Hz) equal to the scanning speed divided by the laser spot spacing, that is, (34 m / s) / 300 μm=113 kHz. Typical repetition rates for CPA lasers are up to about 2 MHz. However, using an acousto-optic deflector or a Pockels cell, pulses can be selected for delivery into the vitreous body 110 at a desired repetition rate. To achieve a laser spot spacing of 300um in the Z direction, the deep focus lens actuator LA should be activated between the two layers, as described above. In experiments using the system 200, a Z step size of 300um was achieved by increasing the focusing power of the treatment laser TL beam by about 0.8 diopters. In some embodiments, laser treatment of floaters begins with the deepest Z layer (closest to the retina 112) and moves the treatment stepwise in the anterior direction (towards the cornea 102). In this case, the longer-lived cavitation bubbles do not block the treatment laser TL beam from reaching the deeper parts of the floaters 114. Another advantage of starting with the deepest Z layer is that the longer-lived bubbles can partially protect the retina from being exposed to the treatment laser TL beam.

[0035] During treatment of floaters 114, a portion of the treatment laser TL energy reaches the retina 112. To avoid retinal damage, the exposure should be kept below the so-called American National Standards Institute (ANSI) Maximum Permissible Exposure (MPE) limits, such as those described in ANSI Z136.1-2014, which is hereby incorporated by reference in its entirety. The ANSI MPE limits depend on the laser pulse energy, the laser repetition rate, the numerical aperture of the focused laser beam, the number of laser pulses used, the distance from the retina 112 in the PZ direction, the laser wavelength, the laser pulse duration, the scanning pattern, and other parameters.

[0036] The system 200 can even be used to image floaters during a treatment procedure. However, in the above example, the image spatial resolution in the vertical (i.e., Y) direction is reduced from 30 μm to a vertical pitch size of 300 μm. A vertical resolution of 300 μm is sufficient to track possible slow movement of the floaters 114 during treatment and to aid in re-aiming the floaters using the treatment laser.

[0037] In the following description, a closed "treatment box BX" is used to identify the boundary, but it should be understood that other boundaries can also be used in a similar manner. For example, the boundary can be more precisely defined in the form of an oriented box, having a rectangular shape, but the sides are not necessarily parallel to the X and Y axes. The boundary can also be a non-rectangular shape, tracking the estimated boundary of the portion of the image corresponding to the floating object 114. For example, the perimeter of a block of pixels with an intensity above a threshold in each X / Y image can be used as a boundary.

[0038] After determining the position, shape and size of the treatment frame BX, the vitreous body 110 can be scanned and treated using a focused beam of the treatment laser TL. As described above, in some embodiments, the vertical scanning pitch of the treatment laser TL in the Y direction can be greater than the scanning pitch of the laser diode LD during the imaging phase. For example, the scanning pitch can be 5 to 15 times, such as 10 times, the scanning pitch of the laser diode LD. For example, in the example shown, the vertical scanning pitch is 300 μm. When scanning with the treatment laser TL, it can be achieved by scanning in cycles (BC, DE, etc.) Figure 8 ) to achieve an increased vertical scan pitch, for example, by a factor of 10 to increase the vertical scan pitch from 30 μm to 300 μm. As described above, the vertical scan pitch may be selected based on the diameter of the cavitation bubbles.

[0039] refer to Figure 6 During treatment, the treatment laser TL scans the vitreous body 110 in three dimensions. For each depth position PZ, the treatment laser TL is turned off for all positions PXY outside the treatment box BX obtained from the X / Y image of the current depth position PZ. For the positions PXY within the bounding box BX, the treatment laser TL is turned on and pulses of the treatment laser TL are selectively allowed to reach the vitreous body 110 to destroy the floaters 114. Figure 6 Arrows are used to indicate the switching points of laser “on” and laser “off”.

[0040] When multiple floaters 114 are detected during the imaging phase, multiple treatment boxes BX can be defined. Multiple floaters 114 can be treated one by one or all at once starting with the deepest floaters. In this way, longer lived cavitation bubbles will not cast shadows on the deeper floaters.

[0041] refer to Figure 7, the pulses from the treatment laser TL incident on the points PXY, PZ in the vitreous body will generate transient cavitation bubbles, which will decompose a portion of the floating objects located near the points PXY, PZ. As described above, the horizontal pulse spacing that allows the pulses to reach the vitreous body 110 can be selected based on the estimated diameter of the cavitation bubbles. The vertical scanning spacing along the Y direction and the depth scanning spacing along the Z direction can also be selected based on the estimated cavitation bubble diameter. For example, the horizontal pulse spacing, the vertical scanning spacing, and the depth scanning spacing can be selected to be between 0.5 and 1.5 times, between 0.7 and 1.3 times, or between 0.9 and 1.1 times the estimated cavitation bubble diameter. For example, the horizontal pulse spacing can be selected to be between 0.1 and 0.4 mm. The previous paragraph describes an algorithm for selecting treatment parameters. These parameters depend on the volume and shape of the floating objects 114 and the energy of the laser pulses to be used, which determines the size of the cavitation bubbles.

[0042] A certain degree of synchronization is required between the scanning of the scanning mirror SM and the activation and pulse selection of the treatment laser TL. Assuming a 2 MHz regenerative amplifier, the spatial accuracy of the treatment laser TL is (34 m / s) / (2 MHz) = 17 μm. This spatial accuracy is completely satisfactory, because the spatial accuracy of 17 μm is only 4.6% of the cavitation bubble diameter size (370 μm).

[0043] The above parameters and calculations are only exemplary. These parameters depend on the size and shape of the floater 114, as well as the laser pulse energy, the resonant frequency of the scanner, etc. The following are possible parameter ranges for the treatment laser TL and the laser diode LD: the pulse duration of the treatment laser TL can be 10ps to 50fs; the repetition rate of the treatment laser can be between 1kHz and 2MHz; the treatment laser wavelength TL can be 650nm to 2μm; the energy of the treatment laser TL pulse on the target can be 1 to 50μJ, 5 to 25μJ, or 10 to 20μJ; the spatial spacing of the laser treatment spot along the X scanning direction can be 10μm to 1mm; the vertical scanning pitch during imaging using the laser diode LD can be 5μm to 200μm; the vertical scanning pitch of the treatment laser TL can be 30μm to 1mm; the depth scanning pitch of the treatment laser TL can be 30μm to 1mm; and the frame rate during laser diode LD imaging can be 0.5 to 25 frames / second.

[0044] Various modifications may be implemented to increase the accuracy of the above method. The floater may be mobile and will move in response to saccadic motions of the eye 100. Therefore, the patient may be instructed to stare at a fixation target for at least two seconds before and during imaging and treatment to reduce changes in the position of the floater 114 between imaging and treatment and during treatment.

[0045] As the name "floater" indicates, the floater 114 can move in space. When staring, this movement is quite slow, about 0.02° per second to 0.1° per second. Keeping in mind that the system 200 is able to image the floater 114 even during laser treatment, the system 200 can be programmed to always track this movement and reposition the treatment box BX according to the tracked movement during treatment.

[0046] As the floater 114 breaks down, the expansion of the cavitation bubbles may push the floater 114. Likewise, the buoyancy of the cavitation bubbles may displace the floater 114. The system 200 may be programmed to track these movements during treatment and properly reposition the treatment frame BX in response to the movement during treatment.

[0047] When staring, the eyeball will make small, rapid and spatially random movements, called micro-saccades. The purpose of micro-saccades is to prevent the image from disappearing. The amplitude of micro-saccades is about 0.8°, the duration is about 0.012 seconds, the frequency is about 0.9 times / second, and the angular velocity can reach 40° per second. It is technically very challenging to track these rapid and short movements with an eye tracker and move the treatment frame BX. Therefore, the treatment frame BX can be approximately 0.5 mm larger than the actual size of the floater 114 in all directions of X, Y, and Z.

[0048] In order to increase the speed of removing floating objects, beam multiplexing technology can be used. Beam multiplexing refers to the optical modification of a single beam of a treatment laser TL so that it has not only one focused laser spot, but also multiple focused laser spots at the same time. Multiplexing can be achieved in the X / Y plane or the Z direction or by a combination of both. Multiplexing can be achieved by incorporating optical elements into the system 200, such as diffractive optical elements, spatial phase modulators, birefringent optical components, or different types of interferometers. These optical elements can be located between the scanning mirror SM and the lens actuator LA. For example, each beam emitted by these elements can be focused by a different lens group and a corresponding lens actuator.

[0049] Fig. 9 Demonstrates at least partial implementation of the invention Figures 1 to 8 An example computing system 900 that implements one or more of the functions described herein. Computing system 900 may be integrated with an imaging device such as system 200, or may be a separate computing device that receives an image of a patient's eye from the imaging device.

[0050] As shown, the computing system 900 includes a central processing unit (CPU) 902, one or more I / O device interfaces 904 that can allow various I / O devices 914 (e.g., keyboard, display, mouse device, pen input, etc.) to be connected to the computing system 900, a network interface 906 through which the computing system 900 is connected to a network 990, a memory 908, a storage device 910, and an interconnect 912.

[0051] Where computing system 900 is an imaging system, such as system 200, computing system 900 may further include one or more optical components for obtaining ophthalmic images of a patient's eye, as well as any other components known to one of ordinary skill in the art.

[0052] CPU 902 may retrieve and execute programming instructions stored in memory 908. Similarly, CPU 902 may retrieve and store application data residing in memory 908. Interconnect 912 transfers programming instructions and application data between CPU 902, I / O device interface 904, network interface 906, memory 908, and storage device 910. CPU 902 is included to represent a single CPU, multiple CPUs, a single CPU with multiple processing cores, etc.

[0053] The memory 908 represents a volatile memory such as a random access memory and / or a non-volatile memory such as a non-volatile random access memory, a phase change random access memory, etc. As shown, the memory 908 can store a scanning module 916 configured to cause the system 200 to image the vitreous body 110 of the patient's eye, as described above. The memory 908 can also store a processing module 918 configured to control the system 200 to destroy floaters, as described above.

[0054] Storage device 910 may be a non-volatile memory such as a disk drive, a solid state drive, or a collection of storage devices distributed across multiple storage systems. Storage device 910 may optionally store X / Y images 920 captured using system 200 for subsequent processing to identify boundaries of floating objects, as described above.

[0055] Additional considerations

[0056] The foregoing description is provided to enable any person skilled in the art to practice the various embodiments described herein. Various modifications to these embodiments are clear to those skilled in the art, and the general principles defined herein may be applied to other embodiments. For example, without departing from the scope of the present disclosure, the functions and arrangements of the elements discussed may be changed. Various examples may appropriately omit, replace or add various programs or components. In addition, the features described with respect to some examples may be combined in some other examples. For example, any number of aspects set forth herein may be used to implement a device or practice method. In addition, the scope of the present disclosure is intended to cover devices or methods practiced using other structures, functions, or structures and functions in addition to or different from the various aspects of the present disclosure set forth herein. It should be understood that any aspect of the present disclosure disclosed herein may be embodied by one or more elements of the claims.

[0057] As used herein, the phrase "at least one of" a list of items refers to any combination of those items, including single members. For example, "at least one of a, b, or c" is intended to cover any combination of a, b, c, ab, ac, bc, and abc, as well as multiples of the same element (e.g., aa, aaa, aab, aac, abb, acc, bb, bbb, bbc, cc, and ccc or any other order of a, b, and c).

[0058] As used herein, the term "determining" encompasses a wide variety of actions. For example, "determining" may include calculating, computing, processing, deriving, investigating, searching (e.g., searching in a table, database, or other data structure), ascertaining, etc. Also, "determining" may include receiving (e.g., receiving information), accessing (e.g., accessing data in a memory), etc. Also, "determining" may include resolving, selecting, choosing, establishing, etc.

[0059] The method disclosed herein includes one or more steps or actions for implementing the method. Without departing from the scope of the claims, the method steps and / or actions can be interchangeable with each other. In other words, unless a specific step or action sequence is specified, the order and / or use of specific steps and / or actions can be modified without departing from the scope of the claims. Further, the various operations of the above-mentioned method can be performed by any suitable device capable of performing the corresponding function. These devices may include various hardware and / or software components and / or modules, including but not limited to circuits, application specific integrated circuits (ASICs) or processors. Typically, where operations are shown in the figure, those operations may have corresponding corresponding devices with similar numbers plus functional components.

[0060] The various illustrative logical blocks, modules, and circuits described in conjunction with the present disclosure may be implemented or executed with a general purpose processor, a digital signal processor (DSP), an application specific integrated circuit (ASIC), a field programmable gate array (FPGA) or other programmable logic device (PLD), discrete gate or transistor logic, discrete hardware components, or any combination thereof designed to perform the functions described herein. A general purpose processor may be a microprocessor, but in an alternative, the processor may be any commercially available processor, controller, microcontroller, or state machine. The processor may also be implemented as a combination of computing devices, for example, a combination of a DSP and a microprocessor, a plurality of microprocessors, one or more microprocessors in conjunction with a DSP core, or any other such configuration.

[0061] The processing system can be implemented with a bus architecture. Depending on the specific application and overall design constraints of the processing system, the bus may include any number of interconnecting buses and bridges. The bus may link together various circuits including a processor, a machine-readable medium, and an input / output device. A user interface (e.g., a keyboard, a display, a mouse, a joystick, etc.) may also be connected to the bus. The bus may also link various other circuits such as timing sources, peripherals, voltage regulators, power management circuits, etc., which are well known in the art and therefore will not be described further. The processor may be implemented with one or more general and / or special processors. Examples include microprocessors, microcontrollers, DSP processors, and other circuit systems that can execute software. Those skilled in the art will recognize how to best implement the described functions of the processing system according to the specific application and the overall design constraints imposed on the entire system.

[0062] If implemented in software, the function may be stored as one or more instructions or codes on a computer-readable medium or transmitted via a computer-readable medium. Software should be broadly interpreted as instructions, data, or any combination thereof, whether referred to as software, firmware, middleware, microcode, hardware description language, or other. Computer-readable media include both computer storage media and communication media (such as any medium that facilitates the transfer of computer programs from one place to another). The processor may be responsible for managing the bus and general processing, including the execution of software modules stored on a computer-readable storage medium. A computer-readable storage medium may be coupled to a processor so that the processor can read information from the storage medium and write information to the storage medium. In an alternative, the storage medium may be integrated with the processor. For example, a computer-readable medium may include a transmission line, a carrier modulated by data, and / or a computer-readable storage medium on which instructions separated from a wireless node are stored, all of which may be accessed by a processor via a bus interface. Alternatively or in addition, a computer-readable medium or any portion thereof may be integrated into a processor, such as a cache and / or a general register file. For example, examples of machine-readable storage media may include RAM (random access memory), flash memory, ROM (read-only memory), PROM (programmable read-only memory), EPROM (erasable programmable read-only memory), EEPROM (electrically erasable programmable read-only memory), registers, magnetic disks, optical disks, hard drives, or any other suitable storage media, or any combination thereof. Machine-readable media may be embodied in a computer program product.

[0063] A software module may include a single instruction or multiple instructions, and may be distributed over several different code segments, between different programs, and across multiple storage media. A computer-readable medium may include multiple software modules. A software module includes instructions that, when executed by a device such as a processor, cause a processing system to perform various functions. A software module may include a transmission module and a reception module. Each software module may exist in a single storage device, or may be distributed across multiple storage devices. For example, when a triggering event occurs, a software module may be loaded from a hard drive into a RAM. During the execution of a software module, a processor may load some instructions into a cache to increase access speed. Then, one or more cache lines may be loaded into a general register file for execution by the processor. When referring to the function of a software module, it should be understood that such function is implemented by the processor when executing instructions from the software module.

[0064] The following claims are not intended to be limited to the embodiments shown herein, but are given the full scope consistent with the language of the claims. In the claims, unless otherwise specified, reference to a singular element is not intended to mean "one and only one", but "one or more". Unless otherwise specifically stated, the term "some" refers to one or more. According to 35 U.S.C. § 112 (f), the elements of any claim will not be interpreted unless the phrase "device for..." is used to expressly describe these elements, or in the case of a method claim, the phrase "step for..." is used to describe these elements. All structural and functional equivalents of the elements of the various aspects described throughout this disclosure that are known or will be known to those of ordinary skill in the art are expressly incorporated herein by reference and are intended to be covered by the claims. In addition, whether or not such disclosure is explicitly described in the claims, the content disclosed herein is not intended to be committed to the public.

Claims

1. A system comprising: 3D scanner; a first laser for imaging vitreous floaters; a second laser configured to emit pulses sufficient to decompose the vitreous floaters; as well as One or more combining optical devices are configured to direct the first light from the first laser and the second light from the second laser into the three-dimensional scanner, and the one or more combining optical devices are configured to place the second focal point of the second laser within 0.01 μm of the second focal point of the second laser.

2. The system of claim 1, wherein: The three-dimensional scanner includes a mirror driven by a resonant scanner.

3. The system of claim 2, wherein: The three-dimensional scanner includes one or more adjustable lenses.

4. The system of claim 3, wherein: The one or more tunable lenses include one or more lenses mounted to an actuator.

5. The system of claim 3, wherein: The one or more tunable lenses include an electrically tunable optical fluid lens.

6. The system of claim 2, wherein: The one or more combining optics include one or more beam splitters positioned to receive the first light from the first laser and the second light from the second laser.

7. The system of claim 6, wherein: The one or more beam splitters include: The first beam splitter is configured to pass a first portion of the first light and guide a second portion of the second light to be parallel to the first portion.

8. The system of claim 7, wherein: The one or more beam splitters include: A second beam splitter is positioned between the first beam splitter and the first laser, the second beam splitter being configured to direct a third portion of the first light reflected from the vitreous floater onto a photodiode.

9. The system of claim 8, further comprising a confocal pinhole filter located between the second beam splitter and the photodiode.

10. The system of claim 9, further comprising a lens located between the second beam splitter and the confocal pinhole filter such that a focus of the third portion of the first light is located at the confocal pinhole filter.

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