Ophthalmological observation device

Abstract

To facilitate ophthalmological surgery.SOLUTION: A moving image generation part of an ophthalmological observation device images an eye to be examined and generates a moving image. An analysis part analyzes a first moving image generated by the moving image generation part before corneal incision in cataract surgery and detects a first image of either a pupillary margin or a cornea ring. A target position determination part determines a target position of the corneal incision at least on the basis of the first image detected by the analysis part. A display control part causes first target position information indicating the target position of the corneal incision determined by the target position determination part to be displayed on a live image generated in real time by the moving image generation part.SELECTED DRAWING: Figure 8A

Description

[Technical field]

[0001] (CROSS REFERENCE TO RELATED APPLICATIONS) This application claims priority to U.S. Provisional Patent Application No. 63 / 106,087, entitled “APPARATUS AND METHOD FOR OPHTHALMIC OBSERVATION,” filed October 27, 2020, which is incorporated by reference in its entirety.

[0002] The present disclosure relates to an ophthalmic observation device. [Background technology]

[0003] An ophthalmic observation device is a device for observing a patient's eye (called an examined eye). Ophthalmic observation is performed in order to grasp the condition of the examined eye in various situations such as examination, surgery, and treatment.

[0004] Conventional ophthalmic observation devices provide users with a magnified image obtained by an objective lens or a variable magnification optical system through an eyepiece, but some recent ophthalmic observation devices are configured to capture the magnified image obtained by the objective lens or the variable magnification optical system with an image sensor and display the captured image (called digital ophthalmic observation devices). Types of digital ophthalmic observation devices include surgical microscopes, slit lamp microscopes, and fundus cameras. In addition, various types of ophthalmic examination devices, such as refractometers, keratometers, tonometers, specular microscopes, wavefront analyzers, and microperimeters, are also provided with the function of a digital ophthalmic observation device.

[0005] Furthermore, some recent ophthalmic observation devices use optical scanning (scanning ophthalmic observation devices). Such ophthalmic devices include scanning laser ophthalmoscopes (SLO) and optical coherence tomography (OCT) devices.

[0006] In general, an ophthalmic observation device provides a moving image of an eye to a user (e.g., a medical professional such as a doctor). A digital ophthalmic observation device is typically configured to perform moving image capture using infrared light and / or visible light as illumination light, and real-time moving image display of the image obtained thereby. On the other hand, a scanning ophthalmic observation device is typically configured to perform data collection by repeated optical scanning, real-time image reconstruction based on data sets collected sequentially, and real-time moving image display of the sequentially reconstructed images. The real-time moving image provided in this manner is called an observation image or a live image.

[0007] Ophthalmic observation devices capable of providing real-time moving images are also used in surgery. There are various types of ophthalmic surgery, but most of them are performed by inserting instruments into the eye. When inserting the instruments, incisions are made in the eye tissue. For example, in cataract surgery, in which the crystalline lens is replaced with an intraocular lens (IOL), corneal incisions (sclerocorneal incisions) and anterior capsular incisions (CCC) are generally made. In refractive surgery, in which an intraocular contact lens (ICL; also called a phakic IOL) is placed in the anterior chamber, corneal incisions are generally made. In minimally invasive glaucoma surgery (MIGS), incisions are made in the trabecular meshwork and stents are inserted into the trabecular meshwork. In vitreoretinal surgery, in which a light guide (illumination) and various instruments are used, conjunctival incisions and scleral incisions are generally made.

[0008] It is necessary to incise such eye tissue at an appropriate position. However, there are few landmarks on the eye, so it is difficult to mark the eye. In addition, the eyeball may move during surgery, so it is difficult to grasp the appropriate incision target position. The same is true for procedures other than incision. [Prior art documents] [Patent documents]

[0009] [Patent Document 1] JP 2019-162336 A Summary of the Invention [Problem to be solved by the invention]

[0010] One object of the present disclosure is to provide new techniques for facilitating ophthalmic surgery. [Means for solving the problem]

[0011] Some exemplary aspects may be an ophthalmic observation device for observing a test eye, including a moving image generation unit that photographs the test eye and generates a moving image, an analysis unit that analyzes still images included in the moving image to detect an image of a specific portion of the test eye, a target position determination unit that determines a target position for a specific treatment based at least on the image of the specific portion detected by the analysis unit, and a display control unit that causes a display device to display the moving image and target position information indicating the target position.

[0012] In some exemplary aspects of the ophthalmic observation device, the target position determination unit may be configured to determine the target position based at least on the image of the specified area detected by the analysis unit and measurement data of the test eye acquired in advance.

[0013] In some exemplary aspects of the ophthalmic observation device, a measurement unit may be further included that acquires measurement data of the subject's eye, and the target position determination unit may be configured to determine the target position based at least on the image of the specified area detected by the analysis unit and the measurement data acquired by the measurement unit.

[0014] In some exemplary aspects of the ophthalmic observation device, the target position determination unit may include an evaluation unit that evaluates the effect of the specified treatment on the subject's eye based on the measurement data acquired by the measurement unit, and the target position determination unit may be configured to determine the target position based at least on the image of the specified area detected by the analysis unit and the result obtained by the evaluation unit.

[0015] In some exemplary aspects of the ophthalmologic observation device, the target position determination unit may be configured to determine, as the target position, a position that is a predetermined distance away from the image of the predetermined part detected by the analysis unit.

[0016] In the ophthalmic observation device according to some exemplary aspects, when a first treatment and a second treatment are applied to the subject's eye, the analysis unit may be configured to perform a first detection to detect an image of a first portion of the subject's eye by analyzing a first still image generated by the moving image generation unit before the first treatment, and a second detection to detect an image of a second portion of the subject's eye by analyzing a second still image generated by the moving image generation unit before the second treatment. Furthermore, the target position determination unit may be configured to perform a first determination to determine a first target position that is a target position of the first treatment based at least on the image of the first portion, and a second determination to determine a second target position that is a target position of the second treatment based at least on the image of the second portion. In addition, the display control unit may be configured to execute a first display control to display the moving image and first target position information indicating the first target position for the first treatment, and a second display control to display the moving image and second target position information indicating the second target position for the second treatment.

[0017] The ophthalmic observation device according to some exemplary embodiments may further include a treatment transition detection unit that detects a transition from the first treatment to the second treatment.

[0018] Some exemplary aspects may be a method for controlling an ophthalmic observation device that includes a processor and generates a moving image of a test eye, the method being configured to cause the processor to analyze still images included in the moving image to detect an image of a specific portion of the test eye, determine a target position for a specific treatment based at least on the detected image of the specific portion, and display the moving image and target position information indicating the target position on a display device.

[0019] Some exemplary aspects may be a program that causes a computer to execute a method according to any of the exemplary aspects.

[0020] Some exemplary aspects may be a computer-readable non-transitory recording medium having a program according to any of the exemplary aspects recorded thereon. Effect of the Invention

[0021] According to an exemplary embodiment, ophthalmic surgery can be facilitated. [Brief description of the drawings]

[0022] [Figure 1] 1 is a schematic diagram showing an example of the configuration of an ophthalmic observation device (ophthalmic surgical microscope) according to an exemplary embodiment. [Diagram 2] FIG. 1 is a schematic diagram showing an example of the configuration of an ophthalmologic observation apparatus according to an exemplary embodiment. [Diagram 3] FIG. 1 is a schematic diagram showing an example of the configuration of an ophthalmologic observation apparatus according to an exemplary embodiment. [Figure 4] FIG. 1 is a schematic diagram showing an example of the configuration of an ophthalmologic observation apparatus according to an exemplary embodiment. [Diagram 5] FIG. 1 is a schematic diagram showing an example of the configuration of an ophthalmologic observation apparatus according to an exemplary embodiment. [Figure 6] FIG. 1 is a schematic diagram showing an example of the configuration of an ophthalmologic observation apparatus according to an exemplary embodiment. [Figure 7] FIG. 1 is a schematic diagram showing an example of the configuration of an ophthalmologic observation apparatus according to an exemplary embodiment. [Figure 8A] 11 is a flowchart illustrating an example of processing executed by an ophthalmologic observation apparatus according to an exemplary embodiment. [Figure 8B] 11 is a flowchart illustrating an example of processing executed by an ophthalmologic observation apparatus according to an exemplary embodiment. [Figure 9A] 1 is a schematic diagram for explaining an example of processing executed by an ophthalmologic observation apparatus according to an exemplary embodiment; [Figure 9B]1 is a schematic diagram for explaining an example of processing executed by an ophthalmologic observation apparatus according to an exemplary embodiment; [Figure 9C] 1 is a schematic diagram for explaining an example of processing executed by an ophthalmologic observation apparatus according to an exemplary embodiment; [Figure 9D] 1 is a schematic diagram for explaining an example of processing executed by an ophthalmologic observation apparatus according to an exemplary embodiment; [Figure 9E] 1 is a schematic diagram for explaining an example of processing executed by an ophthalmologic observation apparatus according to an exemplary embodiment; [Figure 10A] 1 is a schematic diagram for explaining an example of processing executed by an ophthalmologic observation apparatus according to an exemplary embodiment; [Figure 10B] 1 is a schematic diagram for explaining an example of processing executed by an ophthalmologic observation apparatus according to an exemplary embodiment; [Figure 10C] 1 is a schematic diagram for explaining an example of processing executed by an ophthalmologic observation apparatus according to an exemplary embodiment; [Figure 11] 1 is a schematic diagram for explaining an example of processing executed by an ophthalmologic observation apparatus according to an exemplary embodiment; DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0023] Some exemplary aspects of an ophthalmic observation device according to an embodiment, a method for controlling the same, a program, and a recording medium will be described in detail with reference to the drawings. It should be noted that the matters described in the documents cited in this specification and any publicly known technology can be combined with the exemplary aspects.

[0024] An ophthalmic observation device according to an exemplary embodiment is used to grasp the condition of a subject's eye in medical procedures such as surgery, examination, and treatment. Although the ophthalmic observation device according to the exemplary embodiment described below is a surgical microscope system, the ophthalmic observation device is not limited to a surgical microscope system. For example, the ophthalmic observation device may be any of a slit lamp microscope, a fundus camera, a refractometer, a keratometer, a tonometer, a specular microscope, a wavefront analyzer, a microperimeter, an SLO, and an OCT device, or may be a system including any one or more of these. More generally, the ophthalmic observation device may be any ophthalmic device having an observation function.

[0025] The target site of observation using an ophthalmic observation device may be any site of the subject's eye, and may be any site of the anterior eye and / or any site of the posterior eye. Examples of the target sites of observation in the anterior eye include the cornea, iris, anterior chamber, angle, crystalline lens, ciliary body, and Zinn's zonule. Examples of the target sites of observation in the posterior eye include the retina, choroid, sclera, and vitreous body. The target sites of observation are not limited to ocular tissues, and may be any site that is the target of observation in ophthalmology (and / or other departments), such as the eyelids, meibomian glands, and orbit.

[0026] The ophthalmic observation device is used, for example, in surgery for inserting an artificial object into the eye. The artificial object may be any instrument placed in the eye, such as an intraocular lens, an intraocular contact lens, or a MIGS device (stent). The artificial object may also be any medical instrument, such as a light guide, a surgical instrument, an examination instrument, or a treatment instrument.

[0027] At least a portion of the functionality of the elements disclosed herein is implemented using circuitry or processing circuitry. The circuitry or processing circuitry may be a general purpose processor, a special purpose processor, an integrated circuit, a central processing unit (CPU), a graphics processing unit (GPU), an application specific integrated circuit (ASIC), a programmable logic device (e.g., a simple programmable logic device (SPLD), a complex programmable logic device (CPLD), a field programmable gate array (FPGA), or a combination of a programmable logic device (PLC) and a programmable logic device (PGD)), configured and / or programmed to perform at least a portion of the functionality disclosed. The term "circuitry", "unit", "means" or the like includes any of the above-mentioned circuitry, including a transistor and / or other circuitry, a processor, a processor array, a conventional circuitry, and any combination thereof. A processor is considered to be a processing circuitry or circuitry, including transistors and / or other circuitry. In this disclosure, a circuitry, a unit, a means, or the like is hardware that performs at least some of the disclosed functions or is hardware that is programmed to perform at least some of the disclosed functions. The hardware may be hardware disclosed herein or may be known hardware that is programmed and / or configured to perform at least some of the described functions. In the case where the hardware is a processor that can be considered to be a type of circuitry, a circuitry, a unit, a means, or the like is a combination of hardware and software, and the software is used to configure the hardware and / or the processor.

[0028] <Ophthalmological observation device> The configuration of an exemplary embodiment of an ophthalmic observation device is shown in FIG.

[0029] An ophthalmic observation device 1 (surgical microscope system) according to the embodiment includes an operation device 2, a display device 3, and a surgical microscope 10. In some aspects, the surgical microscope 10 may include at least one of the operation device 2 and the display device 3. In some aspects, the display device 3 may not be included in the ophthalmic observation device 1. In other words, the display device 3 may be a peripheral device of the ophthalmic observation device 1.

[0030] <Control device 2> The operation device 2 includes an operation device and / or an input device. For example, the operation device 2 may include a button, a switch, a mouse, a keyboard, a trackball, an operation panel, a dial, and the like. Typically, the operation device 2 includes a foot switch, similar to a general ophthalmic surgical microscope. In addition, the operation device 2 may be configured to perform operations using voice recognition, eye gaze input, and the like.

[0031] <Display device 3> The display device 3 displays an image of the subject's eye acquired by the surgical microscope 10. The display device 3 includes a display device such as a flat panel display. The display device 3 may also include various display devices such as a touch panel. A typical display device 3 includes a large-screen display device. The display device 3 includes one or more display devices. When the display device 3 includes two or more display devices, for example, one may be a relatively large-screen display device and the other may be a relatively small-screen display device. Also, a configuration may be adopted in which one display device is provided with multiple display areas to display multiple pieces of information.

[0032] The operation device 2 and the display device 3 do not need to be separate devices. For example, a device in which an operation function and a display function are integrated, such as a touch panel, may be used as the display device 3. In this case, the operation device 2 includes the touch panel and a computer program. The operation content on the operation device 2 is input to a processor (not shown) as an electric signal. In addition, operations and information input may be performed using a graphical user interface (GUI) displayed on the display device 3 and the operation device 2. In some aspects, the functions of the operation device 2 and the display device 3 may be realized by a touch screen.

[0033] <Surgical microscope 10> The surgical microscope 10 is used to observe the eye (examined eye) of a patient in a supine position. The surgical microscope 10 captures an image of the examined eye to generate digital image data. In particular, the surgical microscope 10 generates a moving image of the examined eye. The moving image (video) generated by the surgical microscope 10 is transmitted to the display device 3 via a wired and / or wireless signal path and displayed. A user (surgeon) can perform surgery while observing the examined eye through the displayed video. Some aspects of the surgical microscope 10 may allow observation through a conventional eyepiece in addition to observation of such a displayed video.

[0034] In some aspects, the surgical microscope 10 includes a communication device for transmitting and receiving an electrical signal to and from the operation device 2. The operation device 2 receives an operation by a user and generates an electrical signal (operation signal) corresponding to the operation. The operation signal is transmitted to the surgical microscope 10 via a wired and / or wireless signal path. The surgical microscope 10 executes a process corresponding to the received operation signal.

[0035] <Optical system of surgical microscope 10> An example of the configuration of the optical system of the surgical microscope 10 will be described below. For convenience of description, the optical axis direction of the objective lens is defined as the z direction (e.g., the vertical direction during surgery, the up-down direction), a predetermined direction perpendicular to the z direction is defined as the x direction (e.g., the horizontal direction during surgery, the left-right direction for the surgeon and patient), and a direction perpendicular to both the z direction and the x direction is defined as the y direction (e.g., the horizontal direction during surgery, the front-back direction for the surgeon, the body axis direction for the patient).

[0036] In the following, the observation optical system will be mainly described as having a pair of left and right optical systems (optical systems capable of binocular observation). However, the observation optical system in other aspects may have an optical system for monocular observation, and those skilled in the art will understand that the configuration described below can be applied to such aspects.

[0037] An example of the configuration of the optical system of the surgical microscope 10 is shown in Fig. 2. Fig. 2 shows a schematic top view of the optical system seen from above and a schematic side view of the optical system seen from the side in association with each other. To simplify the illustration, the illumination optical system 30 disposed above the objective lens 20 is omitted from the top view.

[0038] The surgical microscope 10 includes an objective lens 20, a dichroic mirror DM1, an illumination optical system 30, and an observation optical system 40. The observation optical system 40 includes a zoom expander 50 and an imaging camera 60. In some embodiments, the illumination optical system 30 or the observation optical system 40 includes the dichroic mirror DM1.

[0039] The objective lens 20 is disposed so as to face the eye to be examined. The objective lens 20 is disposed so that its optical axis is along the z direction. The objective lens 20 may include two or more lenses.

[0040] The dichroic mirror DM1 couples the optical path of the illumination optical system 30 and the optical path of the observation optical system 40. The dichroic mirror DM1 is disposed between the illumination optical system 30 and the objective lens 20. The dichroic mirror DM1 transmits illumination light from the illumination optical system 30 and guides it to the subject's eye via the objective lens 20, and also reflects return light from the subject's eye that enters through the objective lens 20 and guides it to the imaging camera 60 of the observation optical system 40.

[0041] The dichroic mirror DM1 coaxially couples the optical path of the illumination optical system 30 and the optical path of the observation optical system 40. That is, the optical axis of the illumination optical system 30 and the optical axis of the observation optical system 40 intersect at the dichroic mirror DM1. When the illumination optical system 30 includes a left-eye illumination optical system (31L) and a right-eye illumination optical system (31R), and the observation optical system 40 includes a left-eye observation optical system 40L and a right-eye observation optical system 40R, the dichroic mirror DM1 coaxially couples the optical path of the left-eye illumination optical system (first illumination optical system 31L) and the optical path of the left-eye observation optical system 40L, and coaxially couples the optical path of the right-eye illumination optical system (first illumination optical system 31R) and the optical path of the right-eye observation optical system 40R.

[0042] The illumination optical system 30 is an optical system for illuminating the subject's eye via the objective lens 20. The illumination optical system 30 may be configured to illuminate the subject's eye with one of two or more illumination lights having different color temperatures. The illumination optical system 30 projects illumination light of a specified color temperature onto the subject's eye under the control of a control unit (200) described later.

[0043] The illumination optical system 30 includes first illumination optical systems 31L and 31R and a second illumination optical system 32.

[0044] The optical axis OL of the first illumination optical system 31L and the optical axis OR of the first illumination optical system 31R are arranged approximately coaxially with the optical axis of the objective lens 20. This makes it possible to realize coaxial illumination and obtain a transillumination image using diffuse reflection at the fundus. In this embodiment, the transillumination image of the subject's eye can be observed with binoculars.

[0045] The second illumination optical system 32 is disposed so that its optical axis OS is decentered from the optical axis of the objective lens 20. The first illumination optical systems 31L and 31R and the second illumination optical system 32 are disposed so that the deviation of the optical axis OS from the optical axis of the objective lens 20 is larger than the deviation of the optical axes OL and OR from the optical axis of the objective lens 20. This allows the realization of so-called "angled illumination (oblique illumination)," making it possible to observe the subject's eye with binoculars while preventing the inclusion of ghosts caused by corneal reflection, etc. Furthermore, it also makes it possible to observe the irregularities of the parts and tissues of the subject's eye in detail.

[0046] The first illumination optical system 31L includes a light source 31LA and a condenser lens 31LB. The light source 31LA outputs illumination light with a wavelength in the visible region corresponding to a color temperature of, for example, 3000 K (Kelvin). The illumination light output from the light source 31LA passes through the condenser lens 31LB, transmits through the dichroic mirror DM1, and passes through the objective lens 20 to enter the subject's eye.

[0047] The first illumination optical system 31R includes a light source 31RA and a condenser lens 31RB. The light source 31RA also outputs illumination light with a wavelength in the visible region corresponding to a color temperature of, for example, 3000 K. The illumination light output from the light source 31RA passes through the condenser lens 31RB, transmits through the dichroic mirror DM1, and passes through the objective lens 20 to enter the subject's eye.

[0048] The second illumination optical system 32 includes a light source 32A and a condenser lens 32B. The light source 32A outputs illumination light with a wavelength in the visible region corresponding to a color temperature of, for example, 4000 K to 6000 K. The illumination light output from the light source 32A passes through the condenser lens 32B and passes through the objective lens 20 without passing through the dichroic mirror DM1, and enters the subject's eye.

[0049] That is, the color temperature of the illumination light from the first illumination optical systems 31L and 31R is lower than the color temperature of the illumination light from the second illumination optical system 32. With this configuration, it becomes possible to observe the subject's eye in warm colors using the first illumination optical systems 31L and 31R, and to observe the structure and shape of the subject's eye in detail.

[0050] In some aspects, each of the optical axes OL and OR is movable relative to the optical axis of the objective lens 20. The direction of this relative movement is a direction intersecting the optical axis of the objective lens 20, and this relative movement is expressed by a displacement vector in which at least one of the x component and the y component is not zero. In some aspects, each of the optical axes OL and OR may be movable independently. On the other hand, in some aspects, the optical axes OL and OR may be movable integrally. For example, the surgical microscope 10 includes a moving mechanism (31d) that moves the first illumination optical systems 31L and 31R independently or integrally, and the moving mechanism moves the first illumination optical systems 31L and 31R independently or integrally in a direction intersecting the optical axis of the objective lens 20. This makes it possible to adjust the visibility of the subject's eye. In some aspects, the moving mechanism operates under the control of a control unit (200) described later.

[0051] In some aspects, the optical axis OS is movable relative to the optical axis of the objective lens 20. The direction of this relative movement is a direction intersecting with the optical axis of the objective lens 20, and this relative movement is expressed by a displacement vector in which at least one of the x component and the y component is not zero. For example, the surgical microscope 10 includes a movement mechanism (32d) that moves the second illumination optical system 32, and this movement mechanism moves the second illumination optical system 32 in a direction intersecting with the optical axis of the objective lens 20. This makes it possible to adjust the visibility of unevenness in the part or tissue of the subject's eye. In some aspects, the movement mechanism operates under the control of a control unit (200) described later.

[0052] As described above, in this embodiment, the illumination optical system 30 is disposed directly above the objective lens 20 (in the transmission direction of the dichroic mirror DM1), and the observation optical system 40 is disposed in the reflection direction of the dichroic mirror DM1. For example, the observation optical system 40 may be disposed so that the angle between the optical axis of the observation optical system 40 and the plane (xy plane) perpendicular to the optical axis of the objective lens 20 is ±20 degrees or less.

[0053] According to the configuration of this embodiment, the observation optical system 40, which generally has a longer optical path length than the illumination optical system 30, is arranged approximately parallel to the xy plane, so that the observation optical system is not obstructed from the field of view of the surgeon as in the conventional surgical microscope in which the observation optical system is arranged vertically in front of the surgeon's eyes. Therefore, the surgeon can easily see the screen of the display device 3 installed in front. In other words, the visibility of the displayed information (images and videos of the subject's eye, and various other reference information) during surgery is improved. In addition, since the housing is not arranged in front of the surgeon's eyes, the surgeon does not feel a sense of pressure, and the burden on the surgeon is reduced.

[0054] The observation optical system 40 is an optical system for observing an image formed based on return light of illumination light incident from the subject's eye via the objective lens 20. In this embodiment, the observation optical system 40 provides an image to an imaging element of the imaging camera 60.

[0055] As described above, the observation optical system 40 includes the left-eye observation optical system 40L and the right-eye observation optical system 40R. The configuration of the left-eye observation optical system 40L is similar to the configuration of the right-eye observation optical system 40R. In some aspects, the optical arrangements of the left-eye observation optical system 40L and the right-eye observation optical system 40R may be changeable independently of each other.

[0056] The zoom expander 50 is also called a beam expander, a variable beam expander, etc. The zoom expander 50 includes a left-eye zoom expander 50L and a right-eye zoom expander 50R. The configuration of the left-eye zoom expander 50L is similar to the configuration of the right-eye zoom expander 50R. In some aspects, the left-eye zoom expander 50L and the right-eye zoom expander 50R may be capable of changing the optical arrangements independently of each other.

[0057] The left-eye zoom expander 50L includes a plurality of zoom lenses 51L, 52L, and 53L. At least one of the plurality of zoom lenses 51L, 52L, and 53L is movable in the optical axis direction by a magnification change mechanism (not shown).

[0058] Similarly, the right-eye zoom expander 50R includes a plurality of zoom lenses 51R, 52R, and 53R, and at least one of the plurality of zoom lenses 51R, 52R, and 53R is movable in the optical axis direction by a magnification change mechanism (not shown).

[0059] The magnification change mechanism may be configured to move each zoom lens of the left-eye zoom expander 50L and each zoom lens of the right-eye zoom expander 50R independently or integrally in the optical axis direction. This changes the magnification when photographing the subject's eye. In some aspects, the magnification change mechanism operates under the control of a control unit (200) described later.

[0060] The imaging camera 60 is a device that captures an image formed by the observation optical system 40 to generate digital image data, and is typically a digital camera (digital video camera). The imaging camera 60 includes a left-eye imaging camera 60L and a right-eye imaging camera 60R. The configuration of the left-eye imaging camera 60L is similar to the configuration of the right-eye imaging camera 60R. In some aspects, the optical arrangements of the left-eye imaging camera 60L and the right-eye imaging camera 60R can be changed independently of each other.

[0061] The left-eye imaging camera 60L includes an imaging lens 61L and an imaging element 62L. The imaging lens 61L forms an image based on the return light that has passed through the left-eye zoom expander 50L on the imaging surface of the imaging element 62L. The imaging element 62L is an area sensor, and may typically be a charge-coupled device (CCD) image sensor or a complementary metal-oxide semiconductor (CMOS) image sensor. The imaging element 62L operates under the control of a control unit (200) described below.

[0062] The right-eye imaging camera 60R includes an imaging lens 61R and an imaging element 62R. The imaging lens 61R forms an image based on the return light that has passed through the right-eye zoom expander 50R on the imaging surface of the imaging element 62L. The imaging element 62R is an area sensor, and may typically be a CCD image sensor or a CMOS image sensor. The imaging element 62R operates under the control of a control unit (200) described later.

[0063] <Processing system> The processing system of the ophthalmologic observation device 1 will be described. Examples of the basic configuration of the processing system are shown in Fig. 3 and Fig. 4, and some examples of the specific configuration are shown in Fig. 5, Fig. 6, and Fig. 7. Any two or more of the various configuration examples described below can be at least partially combined. Note that the configuration of the processing system is not limited to these examples.

[0064] The control unit 200 controls each part of the ophthalmic observation device 1. The control unit 200 includes a main control unit 201 and a storage unit 202. The main control unit 201 includes a processor and controls each part of the ophthalmic observation device 1. For example, the processor can read and execute a program stored in the storage unit 202 or another storage device to realize the function according to this embodiment, and can also use (reference, processing, calculation, etc.) data and information stored in the storage unit 202 or another storage device.

[0065] The main control unit 201 can control the light sources 31LA, 31RA, and 32A of the illumination optical system 30, the image pickup elements 62L and 62R of the observation optical system 40, the movement mechanisms 31d and 32d, the magnification change mechanisms 50Ld and 50Rd, the operation device 2, the display device 3, etc.

[0066] The control of the light source 31LA includes turning the light source on and off, adjusting the light amount, adjusting the aperture, etc. The control of the light source 31RA includes turning the light source on and off, adjusting the light amount, adjusting the aperture, etc. The main control unit 201 can control the light sources 31LA and 31RA mutually exclusively. The control of the light source 32A includes turning the light source on and off, adjusting the light amount, adjusting the aperture, etc.

[0067] When the illumination optical system 30 includes a light source capable of changing the color temperature, the main controller 201 can change the color temperature of the output illumination light by controlling this light source.

[0068] The control of the image sensor 62L includes exposure adjustment, gain adjustment, shooting rate adjustment, etc. The control of the image sensor 62R includes exposure adjustment, gain adjustment, shooting rate adjustment, etc. Furthermore, the main control unit 201 can control the image sensors 62L and 62R so that the shooting timings of the image sensors 62L and 62R coincide with each other, or so that the difference between the shooting timings of the two is within a predetermined time. Furthermore, the main control unit 201 can control the reading of the digital data obtained by the image sensors 62L and 62R.

[0069] The moving mechanism 31d moves the light sources 31LA and 31RA independently or integrally in a direction intersecting the optical axis of the objective lens 20. The main controller 201 can move the optical axes OL and OR independently or integrally with respect to the optical axis of the objective lens 20 by controlling the moving mechanism 31d.

[0070] The moving mechanism 32d moves the light source 32A in a direction intersecting the optical axis of the objective lens 20. The main controller 201 can move the optical axis OS relative to the optical axis of the objective lens 20 by controlling the moving mechanism 32d.

[0071] The moving mechanism 70 moves the surgical microscope 10. For example, the moving mechanism 70 is configured to integrally move at least a part of the illumination optical system 30 and the observation optical system 40. This allows the relative positions of at least a part of the illumination optical system 30 and the observation optical system 40 to be changed with respect to the subject's eye while maintaining the relative positional relationship between at least a part of the illumination optical system 30 and the observation optical system 40. In some aspects, the moving mechanism 70 is configured to integrally move the first illumination optical systems 31L and 31R and the observation optical system 40. This allows the relative positions of the first illumination optical systems 31L and 31R and the observation optical system 40 to be changed with respect to the subject's eye while maintaining the state of coaxial illumination. In some aspects, the moving mechanism 70 is configured to integrally move the second illumination optical system 32 and the observation optical system 40. This allows the relative positions of the second illumination optical system 32 and the observation optical system 40 to be changed with respect to the subject's eye while maintaining the illumination angle of oblique illumination. In some aspects, the movement mechanism 70 is configured to integrally move the first illumination optical systems 31L and 31R and the second illumination optical system 32 and the observation optical system 40. This makes it possible to change the relative positions of the illumination optical system 30 and the observation optical system 40 with respect to the subject's eye while maintaining both the coaxial illumination state and the illumination angle of the oblique illumination. The movement mechanism 70 operates under the control of the control unit 200.

[0072] In some aspects, the main controller 201 can control at least two of the moving mechanisms 31d, 32d, and 70 in a coordinated manner.

[0073] The magnification change mechanism 50Ld moves at least one of the multiple zoom lenses 51L to 53L of the left-eye zoom expander 50L in the optical axis direction. The main controller 201 can change the magnification of the left-eye observation optical system 40L by controlling the magnification change mechanism 50Ld.

[0074] Similarly, the magnification change mechanism 50Rd moves at least one of the multiple zoom lenses 51R to 53R of the right-eye zoom expander 50R in the optical axis direction. The main controller 201 can change the magnification of the right-eye observation optical system 40R by controlling the magnification change mechanism 50Rd.

[0075] The control over the operation device 2 includes operation permission control, operation prohibition control, and transmission control and / or reception control of an operation signal from the operation device 2. The main control unit 201 receives an operation signal generated by the operation device 2, and executes control corresponding to the received signal.

[0076] The control of the display device 3 includes information display control. The main control unit 201, as a display control unit, causes the display device 3 to display various information. For example, the main control unit 201 can cause the display device 3 to display an image based on the digital image data generated by the imaging elements 62L and 62R. Typically, the main control unit 201 can cause the display device 3 to display a moving image (image) based on the digital image data (video signal) generated by the imaging elements 62L and 62R, and can also cause the display device 3 to display a still image (frame) included in the moving image. Furthermore, the main control unit 201 can cause the display device 3 to display an image (moving image, still image, etc.) obtained by processing the digital image data generated by the imaging elements 62L and 62R. In addition, the main control unit 201 can cause the display device 3 to display any information generated by the ophthalmic observation device 1 or any information acquired by the ophthalmic observation device 1 from the outside.

[0077] Further, the main control unit 201 can create a left eye image from the digital image data generated by the imaging element 62L and a right eye image from the digital image data generated by the imaging element 62R, and can display the created left eye image and right eye image on the display device 3 in a manner that allows stereoscopic viewing. For example, the main control unit 201 can create a pair of left and right parallax images from the left eye image and the right eye image, and can display the pair of parallax images on the display device 3. A user (such as a surgeon) can recognize the pair of parallax images as a stereoscopic image by using a known stereoscopic viewing method. Any stereoscopic viewing method can be applied to this embodiment, and can be, for example, a stereoscopic viewing method with the naked eye, a stereoscopic viewing method using an auxiliary device (such as polarized glasses), a stereoscopic viewing method using image processing (such as image synthesis and rendering) on ​​the left eye image and the right eye image, a stereoscopic viewing method that simultaneously displays a pair of parallax images, a stereoscopic viewing method that switches between and displays a pair of parallax images, or a stereoscopic viewing method that combines two or more of these.

[0078] The data processing unit 210 executes various types of data processing. Some examples of processing that the data processing unit 210 can execute are described below. The data processing unit 210 (each of its elements) includes a processor that operates according to a specific software (program), and is realized by the cooperation of hardware and software.

[0079] Some examples of processes that can be executed by the data processing unit 210 will be described together with related elements. Fig. 4 shows an example of a basic configuration of the data processing unit 210. The data processing unit 210 in this example includes an analysis unit 211 and a target position determination unit 212.

[0080] The surgical microscope 10 captures an image of the subject's eye to generate a moving image (live image). The control unit 200 captures frames (still images) of the moving image and inputs them to the analysis unit 211. For example, the control unit 200 captures frames from the moving image in response to a manual or automatic trigger.

[0081] The analysis unit 211 analyzes frames captured from the moving image to detect an image of a predetermined part of the subject's eye (i.e., an image area corresponding to the predetermined part of the subject's eye). The image area detected from the frame by the analysis unit 211 may be, for example, an image area specified as an image of the part, or an image area obtained by processing the image of the part (and its vicinity) (for example, an approximate figure such as an approximate ellipse or an approximate circle).

[0082] The predetermined part of the subject's eye detected by the analysis unit 211 may be any part. When the observation target of the ophthalmic observation device 1 is the anterior eye, the analysis unit 211 may be configured to detect, for example, any of the pupil (whole or characteristic parts such as the pupil edge, pupil center, and pupil centroid), the cornea (whole or characteristic parts such as the corneal limbus, corneal limbus, corneal center, and corneal apex), the iris (whole or characteristic parts such as the iris inner edge, iris outer edge, and iris pattern), the anterior chamber (whole or characteristic parts such as the anterior boundary and posterior boundary), the angle (whole or peripheral part), the lens (whole or characteristic parts such as the lens capsule, anterior capsule, posterior capsule, and lens nucleus), the ciliary body, the zonucleus of Zinn, blood vessels, and diseased parts. When the observation target by the ophthalmic observation device 1 is the posterior segment, the analysis unit 211 may be configured to detect, for example, any of the optic disc, macula, blood vessels, retina (whole, surface, or one or more sub-tissues), choroid (whole, anterior surface, posterior surface, or one or more sub-tissues), sclera (whole, anterior surface, posterior surface, or one or more sub-tissues), vitreous body (whole, opacity, floaters, detached tissue, etc.), and a diseased area. When the observation target by the ophthalmic observation device 1 is not an ocular tissue, the analysis unit 211 may be configured to detect any part (tissue) such as the eyelid, meibomian gland, or orbit. The part detected by the analysis unit 211 may be determined according to the illumination method, the surgical site, the surgical method, etc.

[0083] The analysis unit 211 can detect an image of a predetermined part of the test eye from a still image using any region extraction method. For example, when detecting an image of a part having a characteristic brightness, the analysis unit 211 may be configured to detect an image of the predetermined part of the test eye from a still image using a brightness threshold process such as binarization. When detecting an image of a part having a characteristic shape, the analysis unit 211 may be configured to detect an image of the predetermined part of the test eye from a still image using a shape analysis process such as pattern matching. When detecting an image of a part having a characteristic color tone, the analysis unit 211 may be configured to detect an image of the predetermined part of the test eye from a still image using a color analysis process such as feature color extraction. In addition, the analysis unit 211 may be configured to detect an image of the predetermined part of the test eye by applying segmentation for identifying the image of the predetermined part of the test eye to the still image. In general, segmentation is a process for identifying a partial region in an image. Segmentation may include any known image processing technique, for example segmentation using image processing such as edge detection and / or segmentation using machine learning (e.g., deep learning).

[0084] An image of a predetermined part of the subject's eye detected by the analysis part 211 (information indicating its position, range, etc.) is input to the target position determination part 212. The target position determination part 212 determines a target position for a predetermined treatment based at least on the image of the predetermined part detected by the analysis part 211.

[0085] The predetermined procedure may be any medical procedure, such as a surgical procedure or a therapeutic procedure. In some examples, the predetermined procedure may be any one or more of incision creation (corneal incision, sclerocorneal incision), viscoelastic injection, anterior capsulotomy (CCC), phacoemulsification, IOL insertion, viscoelastic removal, and wound closure in cataract surgery. In some examples, the predetermined procedure may be any refractive surgery procedure, any minimally invasive glaucoma surgery (MIGS) procedure, any vitreoretinal surgery procedure, and any other ophthalmic surgery procedure.

[0086] Several examples of the target position determination process will be described. In the first example, a preliminary measurement of the subject's eye is performed. Measurement data obtained from the subject's eye by the preliminary measurement is stored in the storage unit 202 of the ophthalmic observation device 1, or in a storage device accessible by the ophthalmic observation device 1. The configuration example shown in FIG. 5 may be applied to the first example. The data processing unit 210A is an example of the data processing unit 210 in FIG. 4, and the target position determination unit 212A is an example of the target position determination unit 212.

[0087] In some embodiments where the predetermined procedure is an incision in the eye (corneal incision, sclerocorneal incision, conjunctival incision, scleral incision, etc.), the preliminary measurement may be, for example, any of aberration measurement of the test eye using a wavefront sensor, corneal shape measurement of the test eye using a corneal topographer, and corneal shape measurement of the test eye using an anterior segment OCT device. Wavefront sensors and corneal topographers are described, for example, in WO 2003 / 022138. Anterior segment OCT is described, for example, in WO 2017 / 154348.

[0088] 5 is an example of data obtained from the subject's eye in a preliminary measurement. The measurement data 203 includes, for example, aberration data (corneal aberration data) of the subject's eye obtained using a wavefront sensor, corneal shape data of the subject's eye obtained using a corneal topographer, and corneal shape data of the subject's eye obtained using an anterior segment OCT device.

[0089] The target position determination unit 212A of the first example is configured to determine a target position of a predetermined treatment based at least on an image of a predetermined part of the subject's eye detected by the analysis unit 211 and the measurement data 203. When the predetermined treatment is an incision of the eyeball (corneal incision, scleral corneal incision, etc.), the target position determination unit 212A can determine a position that can most effectively reduce corneal astigmatism that may be caused by the incision.

[0090] For example, the target position determination unit 212A can determine a position where the incision has a small effect on the corneal astigmatism based on the measurement data 203 (corneal shape data, corneal aberration data, etc.). Typically, the cornea is incised at the position of the dominant meridian in order to correct the corneal astigmatism before the incision by the incision-induced astigmatism (dominant meridian incision). In this case, the measurement data 203 may include data indicating the position of the dominant meridian of the cornea of ​​the subject's eye (data indicating the angular direction of the dominant meridian). More generally, the measurement data 203 may include data indicating a rough target position used to determine a specific target position in the subject's eye.

[0091] For example, the target position determination unit 212A can identify a position corresponding to the direction of the dominance meridian in the limbus of the test eye (or a closed curve a predetermined distance outside the limbus, etc.) based on the dominance meridian data contained in the measurement data 203 or the dominance meridian data calculated from the measurement data 203 and the image of the limbus detected by the analysis unit 211, and set this position as the target incision position of the test eye.

[0092] More generally, the target position determination unit 212A can identify a position corresponding to the approximate target position in a specified part of the test eye (or a location that satisfies specified conditions for the specified part) based on the approximate target position included in the measurement data 203 or the approximate target position determined from the measurement data 203 and the image of the specified part detected by the analysis unit 211, and set this position as the target application position of a specified treatment to the test eye.

[0093] The number of target positions to be determined is arbitrary. When the predetermined procedure is an incision of the eye, for example, the position of a main port (main incision, main incision) and the positions of one or more side ports (side incision, side incision) may be determined. The number and positions of the target positions can be set based on various conditions, such as the type of predetermined procedure, the type and degree of disease, the type of instrument used, and the doctor's preference.

[0094] In the second example of the target position determination process, the measurement of the subject's eye is performed by the ophthalmologic observation device 1 (or a system including it). That is, in the second example, it is not necessary to perform a preliminary measurement as in the first example. Therefore, the second example is also applicable to cases where measurement data is not prepared.

[0095] In addition, the second example may optionally refer to the measurement data obtained in the preliminary measurement. For example, some aspects may be configured to obtain third measurement data from both the first measurement data obtained in the preliminary measurement and the second measurement data obtained by the ophthalmic observation device 1, and perform the target position determination process by referring to the third measurement data. The process of obtaining the third measurement data from the first and second measurement data may include any statistical process. Also, some aspects may be configured to select one of the first measurement data obtained in the preliminary measurement and the second measurement data obtained by the ophthalmic observation device 1, and perform the target position determination process by referring to the selected measurement data.

[0096] The measurement data obtained from the subject's eye by the ophthalmic observation device 1 is stored in the storage unit 202 of the ophthalmic observation device 1, or in a storage device accessible by the ophthalmic observation device 1. The configuration example shown in Fig. 6 may be applied to the second example. The data processing unit 210B is an example of the data processing unit 210 in Fig. 4, and the target position determination unit 212B is an example of the target position determination unit 212.

[0097] The ophthalmic observation device 1 of the embodiment shown in Fig. 6 further includes a measurement unit 220. The measurement unit 220 has any ophthalmic measurement function for acquiring measurement data of the subject's eye. As with the ophthalmic measurement device to which the preliminary measurement of the first example is also applied, when the predetermined treatment is an incision of the eye, the measurement unit 220 may include any of a wavefront sensor, a corneal topographer, and an anterior segment OCT device.

[0098] The measurement data 203 shown in FIG. 6 is an example of data obtained from the test eye by the measurement unit 220, and may include, for example, any of aberration data (corneal aberration data) of the test eye obtained using a wavefront sensor, corneal shape data of the test eye obtained using a corneal topographer, and corneal shape data of the test eye obtained using an anterior segment OCT device.

[0099] The target position determination unit 212B of the second example is configured to determine a target position for a specified treatment based at least on an image of a specified part of the test eye detected by the analysis unit 211 and the measurement data 203 acquired by the measurement unit 220.

[0100] Similar to the target position determination unit 212A in the first example, when the predetermined treatment is an incision of the eye, the target position determination unit 212B can determine a position that can most effectively reduce corneal astigmatism that may be caused by the incision. The attributes of the target position and the contents of the target position determination process in the second example may be similar to those in the first example.

[0101] When determining a target position by taking into consideration the effect of a predetermined treatment on the subject's eye, such as when taking into consideration corneal astigmatism that may occur due to eye incision, the configuration example shown in Fig. 7 may be applied. Data processing unit 210C is an example of data processing unit 210B in Fig. 6, and target position determination unit 212C is an example of target position determination unit 212B.

[0102] The target position determination unit 212C includes an evaluation unit 213. The evaluation unit 213 is configured to evaluate the influence of a predetermined treatment on the subject's eye based on the measurement data of the subject's eye acquired by the measurement unit 220. For example, the evaluation unit 213 evaluates the influence of an eye incision (corneal incision, scleral incision, etc.) on the corneal astigmatism of the subject's eye. In some aspects, the evaluation process may include, for example, a process of determining the direction of the strongest meridian from corneal shape data and corneal aberration data, a process of determining the refractive power in the strongest meridian direction, a process of determining the direction of the weakest meridian, a process of determining the refractive power in the weakest meridian direction, and a process of determining the distribution of refractive power.

[0103] Furthermore, the evaluation process of some aspects can simulate the state of the cornea after the incision of the eye based at least on the state of the cornea before the incision of the eye (corneal shape data, corneal aberration data, the direction of the strongest meridian, the refractive power in the direction of the strongest meridian, the direction of the weakest meridian, the refractive power distribution, etc.). The simulation of some examples may be a rule-based process according to a predetermined simulation program. Furthermore, the simulation of some examples may be performed using a machine learning system (neural network, inference model) constructed by supervised learning using training data including the state of the cornea before the incision of the eye, attributes of the incision of the eye (incision position, incision shape, incision size, etc.), and the state of the cornea after the incision of the eye. Simulations that can be performed by the evaluation unit 213 are not limited to these, and may include simulations using other methods such as unsupervised learning, or may include simulations that at least partially combine two or more methods.

[0104] 7 is configured to determine a target position of a predetermined process for the subject's eye based at least on the image of the predetermined part detected by the analysis unit 211 and the result obtained by the evaluation unit 213. For example, the target position determination unit 212C can determine a position that is estimated to minimize corneal astigmatism that may be caused by eye incision as the target position of the predetermined process for the subject's eye.

[0105] In a third example of the target position determination process, a target position of a predetermined treatment for the subject's eye is determined without referring to the measurement data of the subject's eye as in the first and second examples. The configuration example shown in FIG. 4 (or any of FIGS. 5 to 7) may be applied to the third example. The target position determination unit 212 in the third example is configured to determine a position a predetermined distance away from the image of the predetermined part of the subject's eye detected by the analysis unit 211 as the target position of the predetermined treatment for the subject's eye. The predetermined distance is defined, for example, as an actual distance (millimeters, micrometers, etc.) or an image distance (number of pixels, etc.).

[0106] For example, in anterior capsulotomy (CCC) of cataract surgery, the analysis unit 211 can obtain characteristics of the anterior part of the subject's eye (image of the limbus, its dimensions, image of the pupil margin, its dimensions, etc.). The target position determination unit 212 can obtain a figure of a predetermined shape and predetermined dimensions based on the characteristics of the anterior part obtained by the analysis unit 211. This figure is, for example, a circle with a diameter of 6 mm. This circle may be, for example, any one of a circle with a radius of 3 mm based on the center of an approximation circle (approximation ellipse) of the limbus, a circle with a radius of 3 mm based on the center of an approximation circle (approximation ellipse) of the pupil margin, a circle with a diameter of 6 mm obtained by isotropically enlarging (reducing) the approximation circle of the limbus, and a circle with a diameter of 6 mm obtained by isotropically enlarging (reducing) the approximation circle of the limbus. The shape and dimensions of the figure may be arbitrarily changed by the user.

[0107] In addition, in vitreoretinal surgery, the analysis unit 211 can detect an image of the corneal limbus of the examinee's eye. The target position determination unit 212 can set a target position for inserting a surgical instrument at a position that is a predetermined distance (e.g., 3 to 4 mm) away from the detected image of the corneal limbus to the outside. The shape and dimensions of the figure may be arbitrarily changeable by the user.

[0108] An example of target position determination processing (including distance calculation processing) applicable to the third example (or other examples) will be described. In the following, a case will be described in which the predetermined part of the subject's eye detected by the analysis unit 211 is the corneal limbus (outer edge of the iris), but similar processing can also be performed when another part (for example, the pupil edge) is targeted.

[0109] As a preliminary preparation, prior to surgery, an image of the anterior segment of the subject's eye is taken, the distance (working distance (WD)) between the subject's eye and the imaging device at the time of imaging is recorded, the corneal limbus is detected from the image obtained by the above-mentioned imaging, the dimensions (e.g., diameter) of the detected corneal limbus are measured, and the obtained measurement values ​​of the dimensions are recorded. Note that any method may be used to obtain the dimensions of the corneal limbus in advance, and for example, the dimensions may be measured from an OCT image (e.g., a cross-sectional image or a three-dimensional image) of the anterior segment, or the dimensions of the corneal limbus may be measured directly without using an image.

[0110] With the above preparations, during surgery, the ophthalmic observation device 1 is used to photograph the subject's eye and obtain an observation image (surgical microscope 10), the working distance at the time of photographing is recorded (control unit 200), the corneal limbus is detected from the observation image obtained by the above photographing (analysis unit 211), the dimensions of the detected corneal limbus are measured (data processing unit 210), and the obtained measurement values ​​of the dimensions are recorded (control unit 200).

[0111] Furthermore, the target position determination unit 212 obtains a relationship between the scale of the above-mentioned preoperative photographed image (e.g., actual distance per pixel) and the scale of the above-mentioned intraoperative observation image (e.g., ratio of the scales of the two images) based on a relationship between the working distance in preoperative photographing and the working distance in intraoperative photographing (e.g., ratio of the two working distances). Furthermore, the target position determination unit 212 specifies a location that is a predetermined distance (e.g., 3 to 4 millimeters) outward from the image of the corneal limbus detected from the intraoperative image based on the obtained relationship between the scale of the preoperative image and the scale of the intraoperative image. In this example, the control unit 200 (main control unit 201) can display an observation image (live image) of the subject's eye on the display device 3, and can display target position information indicating the specified location (target position) on the observation image. The form of the target position information is arbitrary, and may be, for example, a circular, elliptical, or arc-shaped indicator.

[0112] Several modified examples will be described. In preoperative photography, photography may be performed with a ruler placed on the subject's eye (anterior segment), and the actual distance may be calculated based on the ruler that appears in the obtained photographed image. Similarly, in intraoperative photography, photography may be performed with a ruler placed on the subject's eye (anterior segment), and the actual distance may be calculated based on the ruler that appears in the obtained photographed image. The distance from the corneal limbus to the target position is 3 to 4 mm in the above example, but may be any distance. For example, the distance from the corneal limbus to the target position can be set based on the surgeon's preference, corneal shape (for example, corneal curvature or corneal curvature distribution), etc.

[0113] When any of the configuration examples of Figures 4 to 7 is applied, or when other configuration examples are applied, the control unit 200 receives a live image of the test eye from the surgical microscope 10 and displays it on the display device 3, while also displaying target position information indicating the target position determined by the analysis unit 211 and the target position determination unit 212 on the display device 3.

[0114] According to the ophthalmologic observation device 1 configured in this way, the target position of a predetermined treatment applied to the subject's eye can be provided together with a live image, so that the user can grasp the position to apply the predetermined treatment in real time. This makes it possible to facilitate surgery (or treatment, etc.), shorten the time of surgery (or treatment, etc.), reduce or prevent treatment errors, and reduce the burden on the patient.

[0115] The ophthalmic observation device 1 can update the target position information displayed together with the live image generated by the surgical microscope 10 in real time. To this end, the analysis unit 211 sequentially detects images of a predetermined part of the subject's eye from frames (still images) sequentially generated by the surgical microscope 10 in parallel with the generation of a moving image by the surgical microscope 10. In parallel with the generation of the moving image and the image detection, the target position determination unit 212 sequentially determines the target position of a predetermined treatment based at least on the images of the predetermined part sequentially detected by the analysis unit 211. In parallel with the generation of the moving image, the image detection, and the target position determination, the control unit 200 executes the display of the live image (sequential updating of frames) and the update (sequential switching) of the target position information based on the target position sequentially determined by the target position determination unit 212. According to this configuration, the user can grasp the change in the target position of the predetermined treatment in real time while observing the live image of the subject's eye. The change in the target position is caused by the movement of the subject's eye, etc.

[0116] When two or more procedures are performed sequentially or in parallel, the ophthalmologic observation device 1 can execute different processing contents for each procedure. For example, in cataract surgery, procedures such as incision creation (corneal incision, sclerocorneal incision), viscoelastic agent injection, anterior capsular incision (CCC), phacoemulsification and aspiration, IOL insertion, viscoelastic agent removal, and wound closure are executed.

[0117] Generally, when first to Nth treatments are applied to a test eye, the analysis unit 211 can detect an image of the nth portion of the test eye by analyzing the nth still image generated by the surgical microscope 10 before the nth treatment.

[0118] Here, N is an integer of 2 or more, and n is any integer of 1 or more and N or less. Any two integers n of 1 or more and N or less 1 , n 2 About (n 1 ≠ n 2 ), nth 1 Treatment and nth 2 The treatment may be the same or different, and may be the nth 1 and the nth part 2The site may be the same site or a different site.

[0119] Furthermore, the target position determining unit 212 can determine an nth target position, which is a target position for the nth treatment, based at least on the image of the nth part detected from the nth still image.

[0120] In addition, the control unit 200 can display a live image acquired by the surgical microscope 10 and nth target position information indicating the nth target position for the nth procedure (nth display control).

[0121] When two or more treatments are performed sequentially, the ophthalmic observation device 1 may be configured to automatically detect the transition of the treatment. For example, the data processing unit 210 is configured to detect the transition from the first treatment to the second treatment (treatment transition detection unit). Note that the ophthalmic observation device 1 may be configured to detect the transition of the treatment by a user's instruction (operation input, voice input, etc.).

[0122] Most surgeries and treatments are performed according to a predetermined procedure, such as in cataract surgery, which involves sequentially creating an incision, injecting a viscoelastic agent, incising the anterior lens capsule, phacoemulsification and aspiration, inserting an IOL, removing a viscoelastic agent, and closing the wound. Therefore, the processing contents (image detection, target position determination, display of target position information, etc.) in each procedure of the surgery can be preset as an operation mode corresponding to a certain surgery (or a certain treatment).

[0123] By referring to the preset information in this manner, the ophthalmologic observation device 1 can automatically detect that a new procedure (new treatment) has been started, and can further execute an operation mode that has been previously associated with this new procedure.

[0124] Automatic detection of treatment transitions may be achieved, for example, by analyzing live images to detect the condition of specific areas of the test eye, and / or by analyzing live images to detect images of instruments or intraocular devices.

[0125] For example, automatic detection of transition to anterior capsulotomy (CCC) in cataract surgery can be achieved by a combination of detection that a corneal incision has already been made and detection that no treatment has been performed on the anterior capsule. Alternatively, automatic detection of transition to anterior capsulotomy (CCC) can be achieved by a combination of detection that a corneal incision has already been made and detection of an image of a CCC instrument.

[0126] The procedure to be automatically detected is not limited to anterior capsulotomy (CCC), but may be other procedures (other procedures) in cataract surgery, any procedure in any other surgery, or any procedure in any medical practice (treatment, diagnosis, etc.). A specific method for automatically detecting a transition to a procedure other than anterior capsulotomy (CCC) can be performed in the same manner as the above example regarding anterior capsulotomy (CCC).

[0127] <Operation / Usage form> The operation and usage of the ophthalmic observation device 1 will be described. Examples of the operation and usage of the ophthalmic observation device 1 are shown in Figs. 8A and 8B. In this example, application to the corneal incision phase and anterior capsulotomy (CCC) phase in cataract surgery will be described, but the operation and usage can be substantially the same as in this example in application to other phases of cataract surgery or application to other medical procedures (surgery, treatment, diagnosis, etc.).

[0128] (S1: Start generating and displaying live images) First, the user performs a predetermined operation using the operation device 2 to start the generation and display of a live image of the subject's eye (anterior eye) by the ophthalmic observation device 1. Specifically, the surgical microscope 10 generates digital image data (video) of the subject's eye by the imaging elements 62L and 62R while illuminating the subject's eye by the illumination optical system 30. The generated video (live image 301) is displayed in real time on the display device 3 (see FIG. 9A). That is, a moving image acquired by the surgical microscope 10 is displayed on the display device 3 as a live image (observation image). The user can perform surgery while observing this live image.

[0129] (S2: Select cataract surgery mode) The ophthalmologic observation device 1 displays a screen for selecting an operation mode on the display device 3 in response to, for example, an instruction from a user. The operation mode options may include, for example, a cataract surgery mode, a vitreous retinal surgery mode, and the like. The user selects a predetermined operation mode using the operation device 2. In this example, the cataract surgery mode is selected.

[0130] (S3: Transition to corneal incision phase) Cataract surgery begins and the procedure phase moves to corneal incision.

[0131] (S4: Detecting an image of a specific area from a live image) Next, the analysis unit 211 detects an image of a predetermined part of the subject's eye from the live image (the frame) whose generation has started in step S1. The part to be detected for corneal incision may be, for example, the pupil margin or the limbus.

[0132] In some aspects, to detect an image of a predetermined portion, the analysis unit 211 first applies binarization, edge detection, or segmentation to a frame of the live image 301. In the example shown in FIG 9B, an image 302 of the pupil edge is detected from the live image 301.

[0133] (S5: Determine the target position for corneal incision) Next, the target position determination unit 212 determines a corneal incision target position in the live image based at least on the image of the predetermined portion (pupil margin) detected in step S4. The target position determination unit 212 executes, for example, any of the processing examples described above.

[0134] In the example shown in Fig. 9C, the target position determination unit 212 first identifies a point 303 that is a predetermined distance outward from the image 302 of the pupil margin detected in step S4. Next, the target position determination unit 212 obtains the inferential meridian 304 of the cornea of ​​the subject's eye from the measurement data 203 (corneal shape data, corneal aberration data, etc.) acquired in advance (see Fig. 9D). The target position determination unit 212 determines the position where the point 303 that is a predetermined distance outward from the image 302 of the pupil margin intersects with the inferential meridian 304 as the corneal incision target position. In the example shown in Fig. 9D, two corneal incision target positions 305a and 305b are set.

[0135] (S6: Display the target position information for corneal incision on the live image) Next, the control unit 200 displays target position information indicating the corneal incision target position determined in step S5 on a live image of the subject's eye.

[0136] In the example shown in FIG. 9E, two pieces of target position information 306a and 306b, which indicate two corneal incision target positions 305a and 305b determined in the example shown in FIG. 9D, are displayed on the live image 301. The target position information 306a and 306b indicate the positions to be incised in the cornea incision, and each of them is an arc-shaped index image. The aspect of the arc-shaped index image (length, radius of curvature, thickness, etc.) may be set in advance, or may be arbitrarily adjustable by the user. This allows the user to easily grasp the position of the cornea to be incised. In addition, in this example, it is possible to facilitate the incision along the major meridian for the purpose of reducing postoperative corneal astigmatism.

[0137] (S7: Should we proceed to anterior capsulotomy?) Steps S4 to S6 are repeated at least until the corneal incision is completed. Typically, steps S4 to S6 are repeated until the injection of an ocular viscoelastic agent is started or until the anterior capsulotomy (CCC) is started. Steps S4 to S6 are sequentially applied to frames sequentially acquired as the live image 301. For example, steps S4 to S6 can be applied to all frames acquired as the live image 301 (time-series images), or steps S4 to S6 can be applied to frames selected from all frames acquired as the live image 301. The selection of frames may be, for example, a thinning process in which selection is performed at intervals of a predetermined number of frames. By repeating such a process, even if the target position of the corneal incision changes due to the movement of the subject's eye, the user can easily grasp the location of the cornea to be incised in real time.

[0138] Corneal incision target position information (for example, an arc-shaped index image) can be displayed at any stage after corneal incision. For example, corneal incision target position information can be displayed in response to a user's operation. This allows the user to check the target position for corneal incision at a desired timing. For example, since the side port is small, there is a risk of losing sight of it during surgery, but according to this example, it is possible to check the position of the side port at any time. When the location indicated by the corneal incision target position information is actually incised, the control unit 200 can store the coordinate information of the location indicated by the corneal incision target position information in the storage unit 202 or the like. On the other hand, when a location different from the location indicated by the corneal incision target position information is actually incised, the control unit 200 can store the coordinate information of the location actually incised in the storage unit 202 or the like. At this time, the coordinate information of the location indicated by the corneal incision target position information may further be stored in the storage unit 202 or the like.

[0139] (S8: Detecting an image of a specific area from a live image) When the process proceeds to the anterior capsulotomy (CCC) phase, the analysis unit 211 detects an image of a predetermined part of the subject's eye from the live image (the frame) whose generation has started in step S1. The part to be detected for the anterior capsulotomy may be, for example, the pupil margin or the limbus.

[0140] In some aspects, to detect an image of a predetermined region, the analysis unit 211 first applies binarization, edge detection, or segmentation to a frame of the live image 301. In the example shown in Fig. 10A, an image 311 of the pupil edge is detected from the live image 301, similar to the corneal incision phase.

[0141] (S9: Determine the target position for anterior capsulotomy) Next, the target position determination unit 212 determines a target position for anterior capsulotomy in the live image based at least on the image of the predetermined portion (pupil margin) detected in step S8. The target position determination unit 212 executes, for example, any of the processing examples described above.

[0142] In the example shown in Figure 10B, the target position determination unit 212 identifies a location a predetermined distance inward from the pupil edge image 311 detected in step S8, and sets the identified location as the anterior capsule incision target position 312.

[0143] (S10: Display the target position information for the anterior capsulotomy on the live image) Next, the control unit 200 displays target position information indicating the corneal incision target position determined in step S9 on the live image of the subject's eye. In the example shown in FIG. 10C, target position information 313 indicating the anterior lens capsule incision target position 312 determined in the example shown in FIG. 10B is displayed on the live image 301. The target position information 313 is a circular index image (or may be an arc-shaped index image), and encourages the anterior lens capsule incision to be performed along a part of this index image. The shape of the circular index image may be preset, or may be arbitrarily adjustable by the user. This allows the user to easily grasp the location of the anterior lens capsule to be incised.

[0144] (S11: Should we move on to the next step?) Steps S8 to S10 are repeated at least until the anterior capsular incision is completed. Typically, steps S8 to S10 are repeated until phacoemulsification is started. Steps S8 to S10 are sequentially applied to frames sequentially acquired as the live images 301. For example, steps S8 to S10 can be applied to all frames acquired as the live images 301 (time-series images), or steps S8 to S10 can be applied to frames selected from all frames acquired as the live images 301. Frame selection may be, for example, a thinning process in which selection is performed at intervals of a predetermined number of frames. By repeating such a process, even if the target position for corneal incision changes due to the movement of the subject's eye, the user can easily grasp the location of the cornea to be incised in real time.

[0145] The anterior lens capsule incision target position information (e.g., a circular index image) can be displayed at any stage after the anterior lens capsule incision. For example, the anterior lens capsule incision target position information can be displayed in response to a user's operation. This allows the user to check the target position for the anterior lens capsule incision at a desired timing. When the location indicated by the anterior lens capsule incision target position information is actually incised, the control unit 200 can store the coordinate information of the location indicated by the anterior lens capsule incision target position information in the storage unit 202 or the like. On the other hand, when a location different from the location indicated by the anterior lens capsule incision target position information is actually incised, the control unit 200 can store the coordinate information of the location actually incised in the storage unit 202 or the like. At this time, the coordinate information of the location indicated by the anterior lens capsule incision target position information may further be stored in the storage unit 202 or the like.

[0146] (S12: Perform other procedures) Once the anterior capsulotomy is complete, the user performs subsequent procedures (phacoemulsification, IOL insertion, viscoelastic agent removal, wound closure, etc.) in sequence, completing the cataract surgery (end).

[0147] Other aspects will be briefly described below. In vitreoretinal surgery, for example, the analysis unit 211 applies image processing (such as binarization) to the observed image to detect an image of the corneal limbus, the target position determination unit 212 specifies a location a predetermined distance (for example, 3 to 4 mm) outward from the image of the corneal limbus as the target position, and the control unit 200 displays an index (for example, circular) at this target position.

[0148] An example of information displayed for vitreoretinal surgery is shown in FIG. 11. In this example, a circular index image 403 indicating a location a predetermined distance (e.g., 3 to 4 mm) away from an image 402 of the corneal limbus on the outside is displayed together with a live image 401 acquired by the surgical microscope 10. The user can make a port by performing a scleral incision (conjunctival incision) in vitreoretinal surgery while referring to the index image 403. The port provides a path for inserting a light guide (illumination) and various instruments into the eye. In FIG. 11, three ports 404a, 404b, and 404c formed on the index image 403 are presented. The ophthalmic observation device 1 can record the coordinate information of each formed port, and can further display an index image indicating the position of the port on the live image in response to, for example, a user's request.

[0149] As described above, ophthalmic surgery is generally performed by inserting an instrument into the eye. The present disclosure can display, for example, optimal treatment locations (for example, instrument insertion locations, incision locations, perforation locations, etc.) on live images. For example, by displaying an indicator (for example, an image) indicating a treatment target location during surgery, the treatment target location is marked within the user's field of view, thereby facilitating surgery.

[0150] Furthermore, the present disclosure is capable of tracking the treatment target position by sequentially processing multiple frames sequentially acquired as live images, and after the actual treatment, the treatment site can be presented on the live image.

[0151] Although the present disclosure describes applications to cataract surgery (such as corneal incision and anterior lens capsule incision) and vitreous retinal surgery, those skilled in the art will understand that the applications of the present disclosure are not limited to these.

[0152] In some embodiments, when incising the cornea in cataract surgery, a figure (e.g., an arc-shaped line) that will be the incision target can be displayed based on the characteristics of the anterior segment (such as the limbus, pupil, and their dimensions) and the measurement data of the subject's eye. The dimensions and shape of this figure may be variable. Before or during surgery, corneal data can be obtained using a wavefront sensor, corneal topographer, or anterior segment OCT, a location that has little effect on corneal astigmatism can be identified, and characteristic positions (e.g., pupil edge, pupil center) can be obtained from a live image, thereby making markings for corneal incision.

[0153] In some embodiments, when incising the anterior capsuloscope in cataract surgery, a figure (e.g., a circle with a diameter of 6 mm) determined from features of the anterior eye (such as the limbus, pupil, and their dimensions) can be displayed as an incision target. The dimensions and shape of this figure may be variable. Note that, before or during surgery, predetermined data (e.g., limbus diameter, pupil diameter) can be acquired, the dimensions of the target image (figure) to be displayed can be determined, features (e.g., limbus, pupil edge) can be detected from a live image, and a target image of the determined dimensions can be displayed, thereby performing marking for incising the anterior capsuloscope.

[0154] In some embodiments, during vitreoretinal surgery, a figure (e.g., a circular image) that serves as a target for inserting an instrument (a perforation target, a port formation target) can be displayed at a position that is a predetermined distance (e.g., 3 to 4 mm) away from the corneal limbus. The size and shape of this figure may be variable.

[0155] In other surgeries, treatments, examinations, and the like, target position information indicating the position where a specific treatment should be applied can also be displayed together with a live image.

[0156] This will make it possible to simplify procedures, shorten times, reduce errors, and ease the burden on patients during surgery, treatment, examinations, and other procedures.

[0157] <Method for controlling an ophthalmic observation device> An exemplary embodiment (for example, the above-mentioned ophthalmic observation device 1) provides a method for controlling the ophthalmic observation device. Any feature related to the ophthalmic observation device 1 of the above-mentioned embodiment can be combined with the exemplary method described below.

[0158] An ophthalmic observation device controlled by the method of the exemplary embodiment includes a processor (e.g., a control unit 200 and a data processing unit 210) and generates a moving image of the subject's eye (surgical microscope 10). The method of the exemplary embodiment first causes the processor to analyze a still image included in the moving image to detect an image of a predetermined part of the subject's eye. Furthermore, the method of the exemplary embodiment causes the processor to determine a target position for a predetermined treatment based at least on the image of the predetermined part detected from the still image. In addition, the method of the exemplary embodiment causes the processor to display the moving image on a display device and to display target position information indicating the determined target position on the display device.

[0159] According to the method of such an exemplary aspect, it is possible to achieve the same actions and effects as those of the ophthalmic observation device 1 of the above embodiment. Moreover, by combining the matters related to the ophthalmic observation device 1 of the above embodiment with the method of the exemplary aspect, the method obtained as a result can achieve the actions and effects corresponding to the combined matters.

[0160] <Program> The exemplary embodiment provides a program for causing a computer to execute the method of the exemplary aspect described above. It is possible to combine the features related to the ophthalmologic observation device 1 of the above embodiment with such a program.

[0161] According to such a program, it is possible to achieve the same actions and effects as those of the ophthalmic observation device 1 of the above embodiment. Moreover, by combining the items related to the ophthalmic observation device 1 of the above embodiment with a program, the resulting program can achieve the actions and effects corresponding to the combined items.

[0162] <Recording Media> The exemplary embodiment provides a computer-readable non-transitory recording medium having the above-mentioned program recorded therein. It is possible to combine the features related to the ophthalmic observation device 1 of the above-mentioned embodiment with such a recording medium. The non-transitory recording medium may be in any form, and examples thereof include a magnetic disk, an optical disk, a magneto-optical disk, and a semiconductor memory.

[0163] According to such a recording medium, it is possible to achieve the same actions and effects as those of the ophthalmic observation device 1 of the above embodiment. Moreover, by combining the items related to the ophthalmic observation device 1 of the above embodiment with a recording medium, the resulting recording medium can achieve the actions and effects corresponding to the combined items.

[0164] The present disclosure is merely an example of an embodiment, and any modifications, omissions, additions, substitutions, and the like can be made within the scope of the present disclosure and its equivalents. [Explanation of symbols]

[0165] 1 Ophthalmic observation device 2 Control device 3 Display device 10 Surgical microscope 30 Illumination optical system 40 Observation Optical System 200 Control section 203 Measurement Data 210, 210A, 210B, 210C Data processing unit 211 Analysis Department 212, 212A, 212B, 212C Target position determination unit 213 Evaluation Department 220 Measuring section

Claims

1. An ophthalmologic observation device for observing a subject's eye in cataract surgery, comprising: a moving image generating unit that captures an image of the subject's eye and generates a moving image; An analysis unit that analyzes the moving image; A target position determination unit that determines a target position of a predetermined treatment in the cataract surgery based at least on a result of the analysis by the analysis unit; a display control unit that causes a display device to display the moving image and target position information indicating the target position; Including, the analysis unit analyzes a first moving image generated by the moving image generation unit before a corneal incision in the cataract surgery to detect a first image which is an image of either a pupil edge or a corneal limbus; the target position determiner determines a target position of the corneal incision based at least on the first image; the display control unit causes first target position information indicating the target position of the corneal incision to be displayed on a live image generated in real time by the moving image generating unit; Ophthalmic observation equipment.

2. the target position determination unit determines a target position of a main port and a target position of a side port for the corneal incision; the display control unit causes the first target position information indicating the target position of the main port and the target position of the side port to be displayed on the live image.

2. An ophthalmologic observation device according to claim 1.

3. the target position determination unit determines a target position of the corneal incision based at least on the first image detected by the analysis unit and measurement data including any one of corneal aberration data and corneal shape data of the subject's eye acquired in advance.

2. An ophthalmologic observation device according to claim 1.

4. a measurement unit that performs corneal aberration measurement and corneal shape measurement to obtain the measurement data of the subject's eye, 4. An ophthalmologic observation device according to claim 3.

5. the target position determination unit determines, based on at least the first image and the measurement data, a location where the corneal incision has a small effect on corneal astigmatism as the target position of the corneal incision.

4. An ophthalmologic observation device according to claim 3.

6. the measurement data includes data indicating a position of the principal meridian of the subject's eye, the target position determination unit determines a position of the principal meridian as a target position of the corneal incision based at least on the first image and the measurement data; 6. An ophthalmologic observation device according to claim 5.

7. The target position determination unit an evaluation unit that performs an evaluation process for evaluating an effect of the corneal incision on corneal astigmatism based on the measurement data; determining a target location for the corneal incision based at least on the first image and results of the evaluation process; 4. An ophthalmologic observation device according to claim 3.

8. the evaluation unit executes a simulation of a state of the cornea of ​​the subject's eye after the corneal incision based at least on the measurement data in the evaluation process.

8. An ophthalmologic observation device according to claim 7.

9. The evaluation unit executes the simulation using an inference model constructed by supervised learning using training data including a state of the cornea before corneal incision, attributes of the corneal incision, and a state of the cornea after the corneal incision.

9. An ophthalmologic observation device according to claim 8.

10. the target position determination unit estimates a position at which corneal astigmatism that may be caused by the corneal incision is minimized based on at least the first image and a result of the evaluation process, and determines the estimated position as a target position for the corneal incision.

8. An ophthalmologic observation device according to claim 7.

11. the analysis unit analyzes the second moving image generated by the moving image generation unit before anterior capsular incision in the cataract surgery to detect a second image that is an image of one of a pupil edge and a corneal limbus; the target position determiner determines a target position of the anterior capsulotomy based at least on the second image; the display control unit displays second target position information indicating the target position of the anterior capsular incision on the live image.

2. An ophthalmologic observation device according to claim 1.

12. the target position determination unit determines a position a predetermined distance away from the second image as the target position of the anterior capsulotomy; 12. An ophthalmologic observation device according to claim 11.

13. the target position determination unit determines the position at the predetermined distance from the second image based on a dimension of an image of the one part measured based on an image obtained by a pre-photographing of the subject's eye, a working distance in the pre-photographing, a dimension of the second image detected by the analysis unit, and a working distance when the second moving image is generated.

13. An ophthalmologic observation device according to claim 12.

14. The cataract surgery system further includes a treatment transition detection unit that detects a transition of a treatment phase in the cataract surgery, When the transition from the corneal incision phase to the anterior capsulotomy phase is detected by the treatment transition detection unit, the analysis unit starts detecting the second image, the target position determination unit starts determining a target position of the anterior capsulotomy, and the display control unit starts displaying information about the second target position.

12. An ophthalmologic observation device according to claim 11.

15. In parallel with the generation of the first moving image by the moving image generator, the analyzer sequentially detects the first image from frames sequentially generated as the first moving image; In parallel with the generation of the first moving image by the moving image generation unit and the detection of the first image by the analysis unit, the target position determination unit sequentially determines a target position of the corneal incision based at least on the first image sequentially detected by the analysis unit; the display control unit updates the first target position information to be displayed on the live image in parallel with the generation of the first moving image by the moving image generation unit, the detection of the first image by the analysis unit, and the determination of the target position by the target position determination unit.

2. An ophthalmologic observation device according to claim 1.

16. In parallel with the generation of the second moving image by the moving image generator, the analyzer sequentially detects the second image from frames sequentially generated as the second moving image; In parallel with the generation of the second moving image by the moving image generation unit and the detection of the second image by the analysis unit, the target position determination unit sequentially determines a target position of the anterior capsulotomy based at least on the second images sequentially detected by the analysis unit; the display control unit updates the second target position information to be displayed on the live image in parallel with the generation of the second moving image by the moving image generation unit, the detection of the second image by the analysis unit, and the determination of the target position by the target position determination unit.

12. An ophthalmologic observation device according to claim 11.

17. An ophthalmologic observation device for observing a subject's eye in cataract surgery, comprising: a moving image generating unit that captures an image of the subject's eye and generates a moving image; An analysis unit that analyzes the moving image; A target position determination unit that determines a target position of a predetermined treatment in the cataract surgery based at least on a result of the analysis by the analysis unit; a display control unit that causes a display device to display the moving image and target position information indicating the target position; Including, the analysis unit analyzes a second moving image generated by the moving image generation unit before anterior capsular incision in the cataract surgery to detect a second image that is an image of either a pupil edge or a corneal limbus; the target position determiner determines a target position of the anterior capsulotomy based at least on the second image; the display control unit causes second target position information indicating the target position of the anterior capsular incision to be displayed on a live image generated in real time by the moving image generating unit. Ophthalmic observation equipment.

Images