Ophthalmologic examination apparatus, ophthalmologic examination apparatus control method, ophthalmologic examination apparatus control program, medical examination apparatus, medical examination apparatus control method, and medical examination apparatus control program

Abstract

To solve the problem that in the ophthalmology examination apparatus that announces a series of audio assist patterns from inspection start to inspection finish, it was not possible to provide voice guidance that was dynamically set appropriate for the subject, the examination, the status and information of the ophthalmologic examination device, etc.SOLUTION: Provided is an ophthalmologic examination apparatus, including: ophthalmologic examination means for performing an examination of a subject's eye; and control means for controlling the ophthalmologic examination means. The ophthalmologic examination apparatus further includes: voice output control means for controlling voice output means for outputting voice for providing a voice guidance to the subject; and information acquisition means for acquiring information on at least one of the subject, the examination, and the ophthalmologic examination apparatus; wherein the voice output control means controls the voice output means to output voice corresponding to the information acquired by the information acquisition means.SELECTED DRAWING: Figure 3

Description

[Technical field]

[0001] The disclosure of this specification relates to an ophthalmic examination apparatus, a control method for an ophthalmic examination apparatus, a control program for an ophthalmic examination apparatus, a medical examination apparatus, a control method for a medical examination apparatus, and a control program for a medical examination apparatus. [Background technology]

[0002] Known devices for observing a subject's eye include OCT (Optical Coherence Tomography), a fundus camera, a perimeter, etc. Patent Document 1 discloses an ophthalmologic device capable of switching a series of announcement patterns from the start to the end of an examination. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] Patent Publication No. 2020-199226 Summary of the Invention [Problem to be solved by the invention]

[0004] However, in the ophthalmic device of Patent Document 1, although it is possible to switch between a series of announcement patterns from the start of the examination to the end of the examination, the audio output may not be appropriate for the subject, the examination, the status and information of the ophthalmic examination device, etc. [Means for solving the problem]

[0005] An ophthalmic examination apparatus according to one embodiment of the present disclosure includes: An ophthalmic examination apparatus having an ophthalmic examination means for examining an eye to be examined and a control means for controlling the ophthalmic examination means, a voice output means for outputting a voice to provide a voice guidance to a subject; an audio output control means for controlling the audio output means; and an information acquisition means for acquiring information regarding at least one of the subject, the test, and the ophthalmic examination apparatus; The audio output control means controls the audio output means to output audio corresponding to the information acquired by the information acquisition means.

[0006] A method for controlling an ophthalmic examination apparatus according to an embodiment of the present disclosure includes: A control method for an ophthalmic examination apparatus having an ophthalmic examination means for examining an eye to be examined and a control means for controlling the ophthalmic examination means, comprising the steps of: an information acquiring step of acquiring information regarding at least one of a subject having the subject's eye, the examination, and the ophthalmic examination apparatus; a voice output control step of controlling output of a voice to the subject in accordance with the information acquired in the information acquisition step; a sound output step of outputting a sound set under the control of the sound output control step; The present invention relates to a method for controlling an ophthalmic examination apparatus having the above-mentioned features.

[0007] A medical examination apparatus according to an embodiment of the present disclosure includes: A medical testing apparatus having a medical testing means for testing a subject and a control means for controlling the medical testing means, a voice output control means for controlling a voice output means for outputting a voice that provides voice guidance to a subject; and an information acquisition means for acquiring information regarding at least one of the subject, the test, and the medical testing device; The medical examination device is configured so that the audio output control means controls the audio output means to output audio corresponding to the information acquired by the information acquisition means.

[0008] A method for controlling a medical examination apparatus according to an embodiment of the present disclosure includes: A method for controlling a medical testing apparatus having a medical testing means for testing a subject and a control means for controlling the medical testing means, comprising the steps of: an information acquiring step of acquiring information regarding at least one of a subject having the subject, the test, and the medical testing device; a voice output control step of controlling output of a voice to the subject in accordance with the information acquired in the information acquisition step; The present invention relates to a method for controlling a medical examination apparatus, the method comprising the steps of: Effect of the Invention

[0009] In an ophthalmic examination device capable of providing voice guidance, the content of the guidance can be dynamically set (including changed) depending on the subject, the examination, the status and information of the ophthalmic examination device, etc., and voice guidance can be provided to the subject and operator. [Brief description of the drawings]

[0010] [Figure 1] FIG. 1 is a diagram showing an example of an ophthalmic examination apparatus according to a first embodiment. [Diagram 2] 1A is a diagram showing an example of the configuration of an ophthalmic examination apparatus according to Example 1. FIG. 1B is a diagram showing an example of the configuration of an ophthalmic examination apparatus according to Example 1. [Diagram 3] FIG. 4 is a diagram showing an example of a process flow of the ophthalmic examination apparatus according to the first embodiment. [Figure 4] FIG. 2 is a diagram showing an example of a display screen of the ophthalmic examination apparatus according to the first embodiment. [Diagram 5] FIG. 2 is a diagram showing an example of a display screen of the ophthalmic examination apparatus according to the first embodiment. [Figure 6] 1A is a diagram showing an example of a setting screen of the ophthalmic examination apparatus according to Example 1. FIG. 1B is a diagram showing an example of a setting screen of the ophthalmic examination apparatus according to Example 1. [Figure 7] FIG. 11 is a diagram showing an example of a display screen of the ophthalmic examination apparatus according to the second embodiment. [Figure 8] FIG. 11 is a diagram showing an example of the configuration of an ophthalmic examination apparatus according to a third embodiment. [Figure 9] FIG. 11 is a diagram showing an example of a process flow of an ophthalmic examination apparatus according to the third embodiment. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0011] Hereinafter, the embodiments will be described with reference to the drawings. The same or equivalent components, members, and processes shown in each drawing will be given the same reference numerals, and duplicated descriptions will be omitted as appropriate. In addition, some components, members, and processes that are not important for the explanation may be omitted in each drawing.

[0012] <Example 1> FIG. 1 is a diagram showing an example of an ophthalmic examination means according to the first embodiment. The ophthalmic examination means 201 according to the first embodiment includes a head unit 104 movable in the y-axis direction in the figure relative to a base 106, and a stage 105 movable in the x-axis direction and the z-axis direction in the figure. During the examination, the subject places his / her forehead on a forehead rest 101 and places his / her chin on a chin rest 102 that is movable in the up-down direction in the figure. The ophthalmic examination means 201 according to the first embodiment acquires data on the subject's eye via an objective lens 103. In this embodiment, as an example of the ophthalmic examination means, a case will be described in which the ophthalmic examination means itself is a device, and is an ophthalmic examination device capable of taking OCT images of the fundus and taking a front image.

[0013] 2 is a diagram showing an example of the configuration of an ophthalmic examination apparatus according to Example 1. The ophthalmic examination apparatus according to Example 1 has an ophthalmic examination means 201, a control means 209, and a display means 210. In Example 1, since the ophthalmic examination means and the control means are each configured as a device, the ophthalmic examination apparatus of this embodiment can also be called an ophthalmic examination system.

[0014] The ophthalmic examination means 201 acquires a signal indicating a tomographic image of the subject's eye based on a two-dimensional measurement range and measurement depth information specified for, for example, the fundus surface of the subject's eye. The ophthalmic examination means 201 has a measurement optical system for capturing an image of the anterior part Ea of the subject's eye E and a two-dimensional front image and a tomographic image of the fundus Ef of the subject's eye E.

[0015] A first dichroic mirror 202 and a second dichroic mirror 203, which function as an example of an optical path splitting unit, are arranged on the optical axis L1 of the objective lens 103. These dichroic mirrors split the optical path from the objective lens 103 into an optical path of an anterior eye observation system (optical axis L2), an optical path of a fundus photography system (optical axis L3), and an optical path of an OCT optical system (optical axis L5) for each wavelength band. A lens 220, a prism 221, an aperture 222, a lens 223, and an image sensor 224 are arranged on the optical axis L2 in the reflection direction of the second dichroic mirror 203. The image sensor 224 is a monochrome sensor having sensitivity in the infrared range. An anterior eye observation system for observing the anterior eye Ea is configured by these optical members arranged on the optical axis L2. In addition, an anterior eye observation light source 225 is arranged near the objective lens 103. The anterior eye observation light source 225 of this embodiment uses infrared light to illuminate the anterior eye of the subject's eye E. The image sensor 224 is connected to the control means 209.

[0016] The control means 209 can generate an anterior eye observation image based on the signal output by the image sensor 224, and output it to the display means 210 or store it in the storage means 211. A perforated mirror 231, a photographing aperture 232, a focus lens 233, an imaging lens 234, a third dichroic mirror 235, and an image sensor 236 are arranged on an optical axis L3 in the transmission direction of the second dichroic mirror 203. The perforated mirror 231 has an opening in the center. The focus lens 233 can be moved on the optical axis L3 by a driving means such as a motor (not shown) controlled by the control means 209. The control means 209 can adjust the focus of light passing through the optical path of the fundus photography system by controlling the driving means to move the focus lens 233 in the optical axis direction. The optical path on the optical axis L3 is branched by the third dichroic mirror 235 into an optical path leading to the image sensor 236 and an optical path leading to the internal fixation lamp 237 for each wavelength band. The image sensor 236 is arranged in the transmission direction of the third dichroic mirror 235, is sensitive to visible light and infrared light, and is a sensor for obtaining a fundus observation image for observing the fundus Ef of the subject's eye E or a fundus photographing image of the fundus Ef of the subject's eye E.

[0017] The internal fixation lamp 237 is disposed in the reflection direction of the third dichroic mirror 235, and generates visible light to guide the subject's line of sight. In addition, other optical members such as an aperture (not shown) for cutting the light beam required for fundus photography may be provided in the optical path of the fundus photography system. On the optical axis L4 in the reflection direction of the perforated mirror 231, the corneal baffle 240, the relay lens 241, the focus index unit 242, the lens 243, and the ring slit 244 are disposed in this order. The corneal baffle 240 has a light blocking point at the center. The ring slit 244 has a ring-shaped slit opening. The focus index unit 242 is an optical member that provides an index for focusing using the focus lens 233, and in this embodiment, a split bright line is irradiated as an example of the index. The focus index unit 242 according to this embodiment has a split index member that can move along the optical axis L4 in conjunction with the focus lens 233. The split index member is configured to be inserted and removed from the optical path of the optical axis L4 by a driving means such as a motor (not shown) controlled by the control means 209. The split bright line irradiated by the focus index unit 242 passes through the relay lens 241 and is reflected by the perforated mirror 231 toward the second dichroic mirror 203. The split bright line reflected by the perforated mirror 231 is projected onto the fundus Ef of the subject's eye E via the second dichroic mirror 203, the first dichroic mirror 202, and the objective lens 103. The control means 209 can calculate the amount of focus deviation by detecting the position of the split bright line from the fundus observation image. Also, on the optical axis L4, a crystalline lens baffle 245 as a light-shielding member having a light-shielding point and a dichroic mirror 246 having the property of transmitting infrared light and reflecting visible light are arranged. A condenser lens 247 and a white LED light source 248 are arranged in the reflecting direction of the dichroic mirror 246. The white LED light source 248 is a light source for imaging in which a plurality of white LEDs that emit visible light are arranged. A condenser lens 249 and an infrared LED light source 250 are arranged in the transmitting direction of the dichroic mirror 246. The infrared LED light source 250 is an observation light source in which a plurality of infrared LEDs that emit constant infrared light are arranged.The white LED light source 248 and the infrared LED light source 250 are controlled by the control means 209. The objective lens 103, the dichroic mirror 246, the optical members between them, and the condenser lenses 247 and 249 constitute an illumination optical system for illuminating the fundus Ef. The fundus Ef of the subject's eye E can be illuminated by light from the white LED light source 248 or the infrared LED light source 250 via the illumination optical system. A lens 251, a mirror 252, an OCTX scanner 253-1, an OCTY scanner 253-2, a focus lens 254, and a lens 255 are arranged on the optical axis L5 in the reflection direction of the first dichroic mirror 202. The OCTX scanner 253-1 and the OCTY scanner 253-2 are composed of deflection means such as a galvanometer mirror, and function as a scanning unit that scans the fundus Ef of the subject's eye E with the measurement light. Furthermore, the OCTX scanner 253-1 and the OCTY scanner 253-2 are optically conjugate with the pupil position of the subject's eye E near their central positions.

[0018] In the figure, the optical path between the OCTX scanner 253-1 and the OCTY scanner 253-2 is configured within the plane of the paper, but in reality, it is configured in a direction perpendicular to the plane of the paper. In addition, the scanning means for scanning the measurement light may be configured using a MEMS mirror or the like that can deflect light in a two-dimensional direction with one unit. In this embodiment, the OCTX scanner 253-1 can scan the measurement light in the X direction, and the OCTY scanner 253-2 can scan the measurement light in the Y direction perpendicular to the X direction. In this embodiment, an example of performing 3D scanning with the X direction as the main scanning direction and the Y direction as the sub-scanning direction will be described, but the scanning direction is not limited to this. The main scanning direction and the sub-scanning direction in 3D scanning and raster scanning may be directions that intersect each other, for example, the Y direction may be the main scanning direction and the X direction may be the sub-scanning direction. In addition, the diagonal directions having components in the X direction and the Y direction that intersect each other may be the main scanning direction and the sub-scanning direction.

[0019] In addition, the scan pattern is not limited to 3D scan, and may be, for example, radial scan, cross scan, circle scan, raster scan, etc. The focus lens 254 can be moved on the optical axis L5 by a driving unit such as a motor (not shown) controlled by the control means 209. The control means 209 can adjust the focus of the measurement light passing through the optical path of the OCT interference system by controlling the driving unit to move the focus lens 254 in the optical axis direction. The focus adjustment of the measurement light is performed so that the measurement light emitted from the fiber end of the optical fiber 256-2 acting as a light source is imaged on the fundus Ef. Here, the fiber end of the optical fiber 256-2 has an optical conjugate relationship with the fundus Ef of the subject's eye E. The focus lens 254 functioning as a focus adjustment unit is disposed between the fiber end serving as the light source of the measurement light and the OCTX scanner 253-1 and the OCTY scanner 253-2 functioning as a scanning unit. Therefore, by adjusting the focus using the focus lens 254, an image of the measurement light emitted from the end of the fiber can be formed on the fundus Ef of the test eye E, and the return light from the fundus Ef can be efficiently returned to the optical fiber 256-2.

[0020] Next, the configuration of the optical path from the measurement light source 257, the reference optical system, and the spectroscope 270 will be described. The measurement light source 257 is a light source that emits light to obtain measurement light to be incident on the measurement optical path (optical path of the OCT interference system). In this embodiment, a SLD (Super Luminescent Diode), which is a representative low-coherent light source, is used as the measurement light source 257. The central wavelength of the light emitted from the measurement light source 257 is 880 nm, and the wavelength width is about 60 nm. Here, the wavelength width is an important parameter because it affects the resolution in the optical axis direction of the obtained tomographic image. In addition, although the type of light source is selected as an SLD here, it is sufficient to emit low-coherent light, and ASE (Amplified Spontaneous Emission) or the like can also be used. For example, in consideration of measuring the eye, near-infrared light can be used as the central wavelength of the measurement light. In addition, it is necessary to provide a certain degree of wavelength difference between the wavelengths used in the optical path of the OCT interference system (optical axis L5), the anterior eye observation optical path (optical axis L2), and the optical path of the fundus photography system (optical axis L3). In this embodiment, the above wavelengths are selected as the wavelengths of the SLD from these viewpoints. The light emitted from the measurement light source 257 is guided to the optical coupler 256 via the optical fiber 256-1. The light guided to the optical coupler 256 is split by the optical coupler 256 into measurement light directed toward the optical fiber 256-2 side and reference light directed toward the optical fiber 256-3 side. Here, the optical coupler 256 functions as an example of a splitter that splits the light from the measurement light source 257 into measurement light and reference light. In addition, the optical fibers 256-1 to 256-4 are single-mode optical fibers that are connected to and integrated with the optical coupler 256. In this embodiment, the measurement light in the OCT optical system is emitted from the fiber end of the optical fiber 256-2 as a light source. The measurement light passes through the optical path of the OCT optical system described above, is irradiated onto the fundus Ef of the subject's eye E, which is the subject of imaging, and reaches the optical coupler 256 again through the same optical path due to reflection and scattering by the retina.

[0021] On the other hand, the reference light reaches the reference mirror 260 via the optical fiber 256-3, the lens 258, and the dispersion compensation glass 259 inserted to adjust the dispersion of the measurement light and the reference light, and is reflected. The reference light reflected by the reference mirror 260 returns along the same optical path and reaches the optical coupler 256 again. The reference light and the measurement light (return light) that reach the optical coupler 256 again are multiplexed by the optical coupler 256. Here, when the optical path length of the measurement light and the optical path length of the reference light become almost the same, this multiplexing causes interference between the respective lights. The reference mirror 260 is held so that its position can be adjusted in the optical axis direction of the reference light by a driving unit such as a motor (not shown) controlled by the control means 209. By using such a driving means, it is possible to adjust the optical path length of the reference light to the optical path length of the measurement light that changes depending on the eye E to be examined. The obtained interference light is guided to the spectroscope 270 via the optical fiber 256-4.

[0022] The spectrometer 270 is provided with a lens 271, a diffraction grating 272, a lens 273, and a line sensor 274. The interference light emitted from the optical fiber 256-4 becomes substantially parallel light through the lens 271, is then dispersed by the diffraction grating 272, and is imaged on the line sensor 274 by the lens 273. Each element in the line sensor 274 outputs a signal (interference signal) according to the received light to the control means 209. The measurement light source 257, the optical coupler 256, the optical fibers 256-1 to 256-4, the lens 258, the dispersion compensation glass 259, the reference mirror 260, and the spectrometer 270 form a Michelson interferometer. In this embodiment, a Michelson interferometer is used as the interferometer, but a Mach-Zehnder interferometer may also be used. The driving means 280 for driving the head stage includes three motors (not shown) controlled by the control means 209. The control means 209 can move the optical head unit 104 and the stage 105 in three-dimensional (x, y, z) directions by controlling the driving of the driving means 280. In this way, the control means 209 can align the ophthalmic examination means 201 with the subject's eye E.

[0023] In this embodiment, the configuration for generating an anterior observation image of the subject's eye is called an anterior observation section, the configuration for generating a fundus observation image is called a fundus observation section, and the configuration for generating a fundus photographed image is called a fundus photographing section.

[0024] More specifically, the control means 209 is, for example, a personal computer, and an internal CPU (not shown) reads a program stored in a storage means 211 such as a hard disk and operates as an image processing means, and also performs functions such as processing image data taken from the storage means 211 and generating a screen to be displayed on the display means 210, and also controls the ophthalmic examination means 201.

[0025] The ophthalmic examination apparatus of this embodiment is also provided with an audio output means 290 for outputting audio. In this embodiment, the control means 209 of the ophthalmic examination apparatus is configured to have one audio output means 290, but this is not limiting. For example, the ophthalmic examination means 201 may be configured to have one audio output means 290, or, for example, as in Example 3 described later, the audio output means 290 may be configured to be composed of a plurality of audio output means, and both the ophthalmic examination means 201 and the control means 209 may have audio output means. Alternatively, the audio output control means 2094 may control the audio output means 290 separately and externally installed on the ophthalmic examination means 201 or the control means 209 of the ophthalmic examination apparatus to output audio.

[0026] The display means 210 is, for example, an LCD display connected to a personal computer, and displays various information. Together with the operation means 212, which is a keyboard and a mouse also connected to the personal computer, the display means 210 functions as a user interface that accepts operation instructions from an operator. If the control means 209 is a mobile terminal such as a tablet terminal or a notebook computer having a touch panel unit, the display means 210 also functions as the operation means 212. In this embodiment, the control means 209 and the ophthalmic examination means 201 work together to function as one ophthalmic examination device, and can generate an ophthalmic image diagnosis report (hereinafter, a report) that is composed of an image of the subject's eye captured by the ophthalmic examination means 201 and an image analysis result. The processing means is not limited to a CPU, and may be a GPU or the like. In this embodiment, the control means 209 and the ophthalmic examination means 201 are separate devices, and the ophthalmic examination device is described as an ophthalmic examination system, but is not limited to this. For example, a single device may have a configuration in which the ophthalmic examination means 201 includes the control means 209 .

[0027] 2(b) is a diagram showing a list of main functions of the control means 209. The control means 209 has at least a display control means 2091, an information acquisition means 2092, a report information generation means 2093, a voice output control means 2094, a control means 2095 for an ophthalmic examination means, and a subject eye data acquisition means 2096.

[0028] The control means 209 controls the ophthalmic examination means 201 by the control means 2095 of the ophthalmic examination means included in the control means 209, and acquires an output signal from the line sensor 274 of the ophthalmic examination means 201. For example, based on an operation instruction from the operation means 212, it is possible to set shooting conditions such as a scan pattern and a shooting range in the ophthalmic examination means 201.

[0029] The information acquiring means 2092 acquires information on at least one of the subject, the examination, and the ophthalmic examination apparatus, which is possessed by the control means 209, and the audio output control means 2094 controls the audio output means 290 to output audio corresponding to the information acquired by the information acquiring means 2092. The control of the audio output by the audio output control means 2094 according to the information acquired by the information acquiring means 2092 is, for example, a control to select at least one of the contents, speed, language, pitch, and volume of the audio guidance output by the audio output means 290 according to the information acquired by the information acquiring means. Note that the "selection" described here also includes changing the standard setting of the audio to be output.

[0030] The information on the subject acquired by the information acquiring means 2092 may include, for example, information on the subject, or information on the subject's condition. It may also include both. The information on the subject is, for example, information on at least one of the subject's age and the language used. The information on the subject's condition is, for example, information indicating the subject's condition based on an anterior observation image or a fundus observation image, or information indicating the subject's condition based on the subject's remarks. For example, in this embodiment, when the information acquiring means 2092 acquires information indicating that the subject has been keeping his / her eyelids open for a long time based on the anterior observation image, the voice output control means 2094 controls the voice output means 290 to output "Please blink" and instruct the subject to blink. At this time, the control means 2095 of the ophthalmic examination means may control the ophthalmic examination means 201 to temporarily suspend the acquisition of OCT data.

[0031] The information on the examination acquired by the information acquiring means 2092 includes, for example, information on the progress of the examination, and the information on the progress of the examination is, for example, information indicating that the examination is before the start of the examination, before the start of the OCT data acquisition, or during the OCT data acquisition. The progress of the examination can be acquired, for example, from the operation status by the operator or the current data acquisition status with respect to the schedule. In this embodiment, for example, when the information acquiring means 2092 acquires information indicating that the OCT data acquisition is before the start of the OCT data acquisition in response to the operator opening the imaging screen, the audio output unit 290 outputs, under the control of the audio output control means 2094, a voice indicating the progress of the examination, such as "The examination will start."

[0032] The information on the ophthalmic examination apparatus includes, for example, information on the state of the ophthalmic examination apparatus. The information on the state of the ophthalmic examination apparatus includes, for example, information on the alignment state between the subject's eye and the ophthalmic examination means 201 (for example, whether the alignment state, which is the positional relationship between the ophthalmic examination means 201 and the subject's eye E, is suitable or unsuitable based on information acquired by an anterior eye observation unit or a fundus observation unit). When the information acquisition means 2092 acquires information including information on the alignment state, the control means 209 can control the ophthalmic examination means 201 based on the information on the alignment state acquired by the information acquisition means 2092. When the ophthalmic examination means 201 acquires OCT data, it is desirable that the ophthalmic examination means 201 is in a position suitable for acquiring OCT data with respect to the subject's eye E. Therefore, for example, the information acquiring means 2092 acquires information on the alignment state based on the anterior eye observation image acquired by the anterior eye observation unit, and the control means 209 performs alignment processing to move the chin rest 102, the head unit 104, or the stage 105 to a position suitable for acquiring OCT data or a fundus photographed image with respect to the subject's eye E based on the acquired information on the alignment state, and starts acquiring the OCT data or the fundus photographed image. The alignment processing, for example, detects a pupil region from the anterior eye observation image, and moves the head unit 104 or the stage 105 so that the pupil region is observed at a substantially central position of the anterior eye observation image. Alternatively, when the alignment state is poor, an artifact with high brightness (hereinafter, flare) may occur especially in the peripheral portion of the fundus observation image. The alignment processing may move the head unit 104 or the stage 105 to a position where no flare occurs or where the flare is minimized. At this time, the focus state may be detected based on the fundus observation image, and the position of the focus lens 233 may be controlled. Furthermore, while acquiring OCT data, the information acquisition means 2092 acquires information on the alignment state regarding the positional relationship between the ophthalmic examination means 201 and the subject's eye E based on the anterior eye observation image or the fundus observation image, and performs tracking processing to continuously control so as to maintain the alignment state based on the acquired information.Since it is difficult to keep the gaze direction constant for a long period of time, it is necessary to take into account the movement of the subject's eye during data acquisition, particularly in cases such as OCTA (OCT Angiography), where the same area of ​​the subject's eye is scanned repeatedly to acquire data. For this reason, it is desirable to perform tracking processing.

[0033] Another example of the information on the state of the ophthalmic examination apparatus is information on the state of the processing load of the ophthalmic examination apparatus. The state of the processing load can be detected, for example, from the memory usage of the control means 209 and the processing time required for acquiring OCT data. In this embodiment, when the information acquiring means 2092 acquires information indicating that the processing load of the ophthalmic examination apparatus is temporarily high, the state is not suitable for the examination, so that the audio output control means 2094 controls the audio output means 290 to output "Please wait a moment."

[0034] The subject's eye data acquiring means 2096 acquires an output signal from the line sensor 274. The control means 209 acquires the signal output from the line sensor 274, samples it at a predetermined timing, and performs predetermined signal processing to generate a tomographic image. Note that a method for generating a tomographic image can be realized by a known method, and therefore a detailed description will be omitted. Note that a configuration may be adopted in which the tomographic image is stored in the storage means 211. The subject's eye data acquiring means 2096 may acquire OCT data stored in the storage means 211.

[0035] The report information generating means 2093 can display the acquired images and analysis results as a report on the display means 210, or output them to a printing device (not shown).

[0036] Next, the operation of the control means 209 according to the first embodiment will be described with reference to Fig. 3 and Fig. 4. Fig. 4 is an example of an imaging screen which is a screen for performing an examination.

[0037] The ophthalmic examination apparatus of this embodiment can set a plurality of shooting modes for specifying the shooting method. During the examination, the operator selects the shooting mode, and the ophthalmic examination means 201 acquires data according to the shooting mode. The shooting mode of this embodiment is defined by the shooting method such as a scan pattern and the shooting position, and includes, for example, a macular area shooting mode for mainly shooting the macular area by cross scanning, a wide-angle shooting mode for shooting the optic disc and the macular area at once by raster scanning, and a fundus shooting mode for shooting the fundus Ef of the subject's eye with a fundus camera. In addition, by setting a plurality of shooting modes as a protocol, the shooting modes set in the protocol can be performed continuously. In this embodiment, it is assumed that a protocol is selected in which data acquisition by the wide-angle shooting mode and the fundus shooting mode is performed continuously for the left and right eyes. At this time, the ophthalmic examination apparatus of this embodiment has an instruction receiving means (not shown), and when the instruction receiving means receives an instruction from the operator to start the examination, it automatically operates to perform wide-angle photography and fundus photography of the right eye, and then move the head 104 and stage 105 to successively perform wide-angle photography and fundus photography of the left eye.

[0038] In step S301, the operator prepares for the examination. In this embodiment, the operator presses a tab 401 for opening a screen for imaging, and the display control means 2091 displays a screen for imaging 400 on the display means 210. At this time, it is assumed that a protocol for performing wide-angle imaging and fundus imaging successively for the left and right eyes is selected in the initial state.

[0039] In step S302, when the information acquiring means 2092 acquires information indicating that preparation for the examination is complete, the audio output control means 2094 controls the audio output control means 2094 to output audio for notifying the subject of the start of the examination. For example, the audio output means 290 can output audio including a notification of the start of the examination and instructions for the subject, such as "Please rest your chin and forehead on the screen." At this time, audio may also be output to notify the subject of the contents of the examination. For example, the audio output means 290 can output "We will take two images of each of the left and right eyes."

[0040] In step S303, the operator confirms that the subject places the chin on the chin rest 102 and places the forehead on the forehead rest 101, and then presses the button 402, which is an instruction to start the examination, and the instruction receiving means receives the instruction and starts the examination. When the examination starts, the ophthalmic examination means 201 of this embodiment starts observing the anterior part of the subject's eye by the anterior eye observation unit and the fundus observation unit, displays an anterior part image acquired by the anterior eye observation unit in an area 403 of the shooting screen 400, and a fundus observation image acquired by the fundus observation unit in an area 404, and turns on or blinks the internal fixation light 237. In addition, the information acquiring means 2092 starts acquiring information about the ophthalmic examination apparatus.

[0041] In this embodiment, the subject places his / her chin on the chin rest 102, and the control means 2095 of the ophthalmic examination means controls to move the chin rest 102, the head 104, or the stage 105. The information acquiring means 2092 acquires information indicating that the anterior part of the subject's eye can be observed based on the anterior eye observation unit, and the process proceeds to step S304. Alternatively, if the anterior part of the subject's eye cannot be observed with the anterior eye observation unit, the operator performs an operation to move the chin rest 102, the head 104, and the stage 105 to a position where the anterior part of the subject's eye can be observed with the anterior eye observation unit. The operator can move the chin rest 102 by operating, for example, the button 410 for moving the chin rest. Also, the operator can move the stage 105 to a desired position by operating the button 411 for moving the stage 105 or an operating member not shown. After the operator performs the alignment adjustment operation, when the information acquiring means 2092 acquires information indicating that the anterior part of the eye can be observed, the process proceeds to step S304. In this embodiment, the chin rest 102 and other components are moved by operating the operating section displayed on the imaging screen using the operating means, but an operating member such as a joystick connected to the ophthalmic examination means 201 may also be used.

[0042] In step S304, the audio output control means outputs audio from the audio output means 290 to guide the subject's gaze direction, such as "Look at the internal fixation light," and starts alignment processing (so-called tracking) under automatic control of the control means 209.

[0043] In step S305, the alignment process is performed, and the information acquiring means 2092 periodically acquires information on the alignment state (note that, although "alignment and state detection" is described in S305 of FIG. 3, this indicates the above alignment process). At this time, the coherence gate position may be adjusted so that the reference optical path length is suitable for acquiring OCT data. Also, the focusing state may be detected based on the fundus observation image, and the position of the focus lens 233 may be adjusted. Also, the emitted light amount of the infrared LED light source 250 may be adjusted so that the fundus observation image has a brightness suitable for observation during the examination. When the information acquiring means 2092 acquires information indicating the alignment state between the ophthalmic examination means 201 and the subject's eye E, that is, the positional relationship between the ophthalmic examination means 201 and the subject's eye E has become suitable for the examination, the process proceeds to step S306.

[0044] In step S306, under the control of the audio output control means 2094, the audio output means 920 outputs audio to notify the subject of the start of acquisition of OCT data. For example, it is possible to output "Please open your eyes wide. Imaging will begin."

[0045] In step S307, OCT data of the right eye of the subject is acquired in wide-angle shooting mode. Tracking processing may be performed during acquisition of the OCT data. When the information acquisition unit 2092 acquires information indicating that acquisition of the OCT data is completed, the process proceeds to step S308.

[0046] In step S308, the fundus photographing unit of the ophthalmic examination means is controlled to photograph the fundus. At this time, similar to step S305, the focusing state may be detected based on the fundus observation image, and the position of the focus lens 233 may be adjusted again. Also, the amount of light emitted by the white LED light source 248 may be adjusted so that the brightness of the fundus photographed image becomes appropriate.

[0047] In step S309, the information acquiring means 2092 acquires information indicating that acquisition of data for the right eye has been completed, and under the control of the audio output control means 2094, the audio output means 290 outputs audio to notify the subject that acquisition of data for the right eye has been completed and that acquisition of data for the left eye is about to begin. For example, it can output a message such as "Right eye examination is complete. The device will be moved. Please blink."

[0048] In step S310, the stage 105 is moved to a position suitable for acquiring data for the left eye.

[0049] After moving the stage 105 in step S310, the process proceeds to step S304, and the same processes as those in steps S305 to S308 described above are performed to obtain data on the left eye of the subject. When fundus photography of the left eye of the subject is completed in step S308, the process proceeds to step S311.

[0050] In step S311, the information acquiring means 2092 acquires information indicating that acquisition of predetermined data has been completed, and under the control of the audio output control means 2094, the audio output means 920 outputs audio to notify the subject that a series of examinations has been completed. For example, it is possible to output a message such as "imaging has ended. Please wait until further instructions are given." In addition, for example, a screen 500 shown in FIG. 5 for the operator to check the results is displayed on the display means 210.

[0051] If the operator checks the acquired data and determines that re-imaging is necessary, the operator can operate the operation unit 501 (also called the operation area) provided for each acquired data by the operation means 212 to perform re-imaging in the same imaging mode. The operation unit in this embodiment functions as a check box, and the operator can start re-imaging by pressing the operation unit 502 with the operation unit 501 provided for the data to be re-imaging checked. At this time, a sound may be output to notify the subject that re-imaging will be performed. For example, a sound saying "We will perform re-imaging. Please place your chin on the device and your forehead on the device. We will perform one image of your right eye." may be output. At this time, the information acquisition means 2092 may acquire information indicating that the operator has operated the operation unit 502 to perform re-imaging, and output the above sound.

[0052] In the ophthalmic examination apparatus of this embodiment, the voice output contents can be set in advance. FIG. 6 is an example of a screen for setting the voice output contents. By the operation of the operator, the display control means 2091 displays an editing screen 600 for editing the voice output contents on the display means 210, and the operator can edit the voice contents to be output according to the state of the examination (which can also be called the progress of the examination). More specifically, when the operator presses an editing button 610 corresponding to each state of the examination, the control means 209 displays a screen 620 for editing the voice contents to be output in each state of the examination. The operator inputs the voice contents to be output in an area 621, and when the input is completed, presses a button 622 or a button 623, which is an operation unit. In addition, by leaving the voice output contents for the state of the examination uninputted, it is possible to prevent the voice output in each of the above steps. When the input for all the states of the examination is completed, the operator presses a button 611 or a button 612 to close the editing screen 600.

[0053] In this embodiment, the voice output contents can be directly edited and changed on the editing screen, but the present invention is not limited to this. For example, the voice output contents may be selected from predetermined voice output contents and set. Alternatively, the voice output contents may be changed based on a setting file such as an XML, CSV, or text file in which the voice output contents are described. Alternatively, the voice output contents may be edited on the editing screen after the setting file is read. In this case, it is desirable that the initial state when the operator opens the editing screen 600 be displayed with the contents read from the setting file.

[0054] In this embodiment, data acquisition using the wide-angle photography mode and the fundus photography mode is performed consecutively for the left and right eyes, but this is not limited to the above. For example, data acquisition using multiple photography modes may be performed for only one eye, data acquisition using only one photography mode may be performed consecutively for the left and right eyes, or data may be acquired while the operator appropriately selects the required photography mode.

[0055] According to the above method, the voice output means 290 outputs a voice guidance voice having contents corresponding to information on at least one of the subject, the examination, and the ophthalmic examination device acquired by the information acquisition means 2092. This allows the subject to grasp the timing of blinking or the progress of the examination, for example, in cases where the examination time is long due to unstable fixation, frequent blinking, etc., or when the examination time is long, such as when motion contrast data is generated based on OCT data obtained by photographing the same position of the same subject eye multiple times to obtain vascular information of the subject eye.

[0056] [Variations] The ophthalmic examination apparatus of this embodiment can further change the voice output contents based on information about the subject. When using the ophthalmic examination apparatus, the operator often knows information about the subject, such as the age, sex, and language, in advance. In the control means 209 of this modified example, the information acquisition means 2092 acquires information including information about the subject input by the operator, and based on the acquisition result, the voice output control means performs control to set at least one of the contents, speed, language, pitch, and volume of the voice guidance output by the voice output means 290 (including changing from the standard setting).

[0057] For example, the contents of the voice may be set based on the age of the subject included in the information about the subject acquired by the information acquiring means 2092. More specifically, if the age of the subject is young (for example, below a certain age or younger), a voice guidance voice in simple language with contents substantially the same as the set contents is output. For example, in step S304, "Look at the green light" or the like is output.

[0058] It is also known that as a person ages, the audible frequency band narrows, making it difficult to hear voices in the high frequency band in particular. For this reason, the speed, pitch, and volume of the voice to be output may be set based on the age of the subject included in the information on the subject acquired by the information acquiring means 2092. More specifically, when the age of the subject is high (for example, above a certain age or older), the speed, pitch, volume, etc. of the voice are controlled by outputting the set content in a lower-pitched voice, outputting at a slower output speed, outputting at a louder volume, etc. Alternatively, a configuration may be provided in which the frequency band of the voice to be output according to age can be edited separately.

[0059] Alternatively, the contents and language of the voice guidance may be changed based on the language used by the subject included in the information about the subject acquired by the information acquiring means 2092. In this case, the voice output contents may be set for each language on the editing screen 600, or the voice output contents in a specific language edited and determined by the operator on the editing screen 600 may be translated and output according to the language used by the subject. In this way, the voice output means 290 outputs voices with contents according to the state of the examination in a language and contents according to the information about the subject, so that the subject can grasp the progress of the examination.

[0060] <Example 2> In the first embodiment, a configuration for outputting voice guidance according to the alignment state or the state of the examination, such as the start of the examination or photographing, is described. In this embodiment, a configuration for notifying the subject of the progress of the examination is described. Note that, in this embodiment, as in the first embodiment, data acquisition in the wide-angle photographing mode and the fundus photographing mode is performed consecutively for the left and right eyes. In this embodiment, only steps different from the first embodiment are described, and the rest are the same as the first embodiment.

[0061] Since a tomographic image contains noise components, a method is known in which the noise components are reduced by using multiple tomographic images obtained by photographing the same part of the subject's eye multiple times. While the noise components of the tomographic image are reduced by using multiple tomographic images, the time required for the examination increases. In addition, in recent years, OCTA has come to be used as an angiography method that does not use a contrast agent. In OCTA, a two-dimensional image depicting blood vessels is obtained by generating an En-Face image, which is a two-dimensional image projected onto a plane based on two arbitrary reference planes in the depth direction, from a three-dimensional motion contrast image obtained by the ophthalmic examination means 201. Here, the motion contrast image is generated by photographing the same part of the subject's eye multiple times by the ophthalmic examination means 201 and detecting the temporal change of the measurement target between the photographs. For example, the temporal change of the phase, vector, or intensity of the complex OCT signal can be calculated from the difference, ratio, or correlation. In this case, the time required for the examination is also increased because the temporal change of the same part is obtained. However, because of known eye movements such as saccades and drifts, it is difficult to keep the gaze direction in the same position for a certain period of time. For this reason, rescanning may be required to obtain OCT data for the same area again, assuming that the subject's eye moves during OCT data acquisition. As a result, it is difficult for the subject to grasp the remaining time of the examination or what kind of examination will be performed next.

[0062] The control means 209 of this embodiment notifies the subject of the progress of the examination by voice as appropriate. For example, instead of the voice output in step S306, a voice that also notifies the progress, such as "Please open your eyes wide. Shooting will start. Shooting will take about 30 seconds," is output. At this time, if the information acquisition means 2092 acquires information indicating that the subject's eyelids are not open enough, it may output "Please open your eyes a little wider." Also, while acquiring OCT data in step S307, a voice is periodically output to notify the subject of the progress of the examination, such as "10 seconds left" or "About a quarter left." Alternatively, for example, when there are many rescans and the examination time is long, a voice including a progress notification such as "Almost there" or "It's okay to blink" and an instruction to the subject, such as a blink instruction, is output.

[0063] In addition, in fundus photography, it is desirable to be able to photograph the subject's eye with the eyelids open as much as possible. For this reason, when the information acquiring means 2092 acquires information indicating that acquisition of OCT data is completed in step S307, before the start of fundus photography in step S308, a sound such as "The fundus will be photographed in 3 seconds. It may be a little dazzling, but please open your eyes wide" is output. In addition, when the information acquiring means 2092 detects that data acquisition of the right eye is completed based on the information acquired in step S309, a sound such as "The examination of the right eye is completed. The device will be moved. Please blink. There are two shots remaining." is output.

[0064] As in the first embodiment, the combination of the imaging modes is not limited. For example, three or more imaging modes may be performed consecutively for the left and right eyes. At this time, a sound may be output to notify the subject of the progress of the examination each time the completion of data acquisition in one imaging mode is detected based on information acquired by the information acquiring means 2092, such as "Two imaging sessions of the left eye have been completed. One session remains" or "Two sessions of imaging of the right eye remain." Alternatively, only one imaging mode may be performed for one eye.

[0065] The above method allows the subject to appropriately grasp the progress of the examination.

[0066] [Variations] The ophthalmic examination apparatus of this embodiment can further suspend and resume the examination depending on the state of the examination. When the operator instructs the ophthalmic examination apparatus of this embodiment to start the examination, the ophthalmic examination apparatus displays, for example, a screen 700 showing the progress of the examination as shown in Fig. 7 on the display means 210. This allows the operator to grasp the progress of the examination.

[0067] If the operator determines that there are many rescans during OCT data acquisition, he or she presses the operation unit 701 to temporarily halt the progress of the examination. When the information acquiring means 2092 acquires information indicating that the examination has been temporarily halted, it is possible to output a voice message such as "Examination will be temporarily halted. Please blink. It will resume in 5 seconds." The operator can resume the examination by pressing the button 701 again. This allows the subject to appropriately grasp the progress of the examination.

[0068] <Example 3> In the first and second embodiments, a configuration for outputting a voice guide including the progress of the examination according to the state of the examination is described. In the present embodiment, a configuration for outputting information including the progress of the examination according to the statement from the subject as the state of the subject is described with reference to Figs. 8 and 9.

[0069] In recent years, remote examinations have become common, in which an operator performs an examination while being located away from an ophthalmic examination device (or an ophthalmic examination means). The ophthalmic examination device of this embodiment can start or stop the examination at the discretion of the subject, and can input voices uttered by the operator or the subject.

[0070] In the ophthalmic examination apparatus of this embodiment, the audio output means 290 has the audio output means 290-1 and the audio output means 290-2 in FIG. 8. The control means 209 has the audio output means 290-1, the ophthalmic examination means 201 has the audio output means 290-2, and further has an operation means 801 operated by the subject to instruct the start and stop of the examination, and an audio input means 802. Note that, although FIG. 8 shows a configuration in which the operation means 801 (for example, a physical button) for operating the ophthalmic examination means 201 is present, it may be an operation unit displayed on a monitor such as a touch panel separately provided for the subject. Note that the control means 209 and the ophthalmic examination means 201 may be connected by a wire such as a USB cable, or the control means 209 may be a mobile terminal such as a tablet terminal or a notebook computer having a touch panel unit, and the control means 209 and the ophthalmic examination means 201 may be connected wirelessly such as Bluetooth. Similarly, the voice input means 802 and the voice output means 290 may be connected to the control means 209 and the ophthalmic examination means 201 by wire or wirelessly.

[0071] In step S901, the operator prepares for the examination. In this embodiment, the operator guides the subject to the ophthalmic examination means 201, and presses the tab 401 for opening the image capture screen, and the display control means 2091 displays the image capture screen 400 on the display means 210. The operator instructs the subject to press the button of the operation means 801 as soon as the preparation for the examination is completed. In addition, the operator explains that if the voice output content is unclear, the subject can ask again as appropriate. Alternatively, the voice output means 290-2 may be configured to output the same content as the above explanation content. Subsequently, under the control of the voice output control means 2094, the voice output means 290-2 outputs a voice for notifying the subject of the start of the examination. For example, when the information acquisition means 2092 acquires information indicating that the preparation for the examination is completed, the voice output means 290-2 can output a voice such as "Put your chin on it and put your forehead on it" as a voice for notifying the subject of the start of the examination.

[0072] In step S902, the subject presses a button on the operation means 801 at any timing to start the examination.

[0073] In step S903, the control means 209 prepares for data acquisition. Specifically, the control means 2095 of the ophthalmic examination means controls the movement of the chin rest 102, the head 104, and the stage 105 to positions where the anterior eye of the subject can be observed by the anterior eye observation unit, and controls the internal fixation light 237 to light up or blink. In addition, the control means 2095 of the ophthalmic examination means starts observation of the anterior eye of the subject by the anterior eye observation unit and observation of the fundus of the subject by the fundus observation unit so that the operator can check the condition of the subject, and the display control means 2091 displays an anterior eye image and a fundus observation image on the display means 210.

[0074] Then, for example, the information acquisition means 2092 acquires information indicating that it is now possible to observe the anterior segment of the subject's eye based on the anterior eye observation section, and under the control of the audio output control means 2094, the audio output means 290-2 outputs audio to guide the subject's gaze direction, such as, for example, "Look at the internal fixation light. If you cannot see it, please let us know," and starts the alignment process.

[0075] At this time, when the subject makes a sound, the sound is input to the ophthalmic examination means 201 by the sound input means 802 and transmitted to the control means 209 as a sound signal. The sound signal is recognized by the sound recognition means 2097 possessed by the information acquisition means 2092, and based on the recognition result, the sound output control means controls the sound output.

[0076] For example, suppose that the subject utters a voice indicating that he or she has a problem with hearing, such as "I can't hear well," and the voice input means 802 inputs the voice to the ophthalmic examination means 201 in sub-step S9031 in step S903. A voice signal, which is information regarding the subject's condition and is generated based on the input voice, is transmitted to the control means 209, received by a signal receiving means (not shown) of the control means 209, and the voice signal acquired by the information acquisition means 2092 is recognized by the voice recognition means 2097. Depending on the recognition result, the voice output control means 2094 controls the volume of the voice to be output to be louder than the volume output previously in sub-step S9032 in step S903, and the voice output means 290-2 outputs again, "Please look at the internal fixation light."

[0077] Alternatively, for example, suppose that the subject utters a voice saying "I can't see the internal fixation light," and the voice input means 802 inputs the voice to the ophthalmic examination means 201. At this time, as in the above, a voice signal generated based on the input voice is transmitted to the control means 209, the information acquisition means 2092 acquires the voice signal received by the control means 209, and in sub-step S9031, the voice output control means 2094 selects the output content "Look at the green light," and outputs it from the voice output means 290-2 according to the voice recognition result of the voice recognition means 2097. The control means 209 detects that the voice recognition means 2097 recognizes that the subject uttered the voice saying "I saw it," or that the subject saw the internal fixation light, and proceeds to step S904. To detect that the subject saw the internal fixation light, for example, a known gaze direction detection method can be used. Alternatively, if the subject's gaze direction remains stable even after re-output, or if the voice recognition means 2097 recognizes that the subject has again uttered the voice "I don't understand," in step S9031, the voice output control means 2094 may output "Look straight ahead" via the voice output means 290-2 and turn off the internal fixation light 237, or the internal fixation light 237 may be turned on in a position that matches the detected gaze direction of the subject.

[0078] In step S904, data of the subject's eye is acquired in the same manner as in the first embodiment. The voice input means 802 accepts voice input from the subject at any time even during data acquisition. For example, if the examination time is long, the subject may feel fatigued. At this time, if the voice recognition means 2097 recognizes that the subject has said something like "My eyes are tired," or if the information acquisition means 2092 acquires information indicating that the anterior eye observation unit has lowered the eyelids, the voice output means 290-2 outputs a voice including an instruction to the subject to take a break, such as "The examination will be temporarily stopped. Please take your chin off and relax. After the break, please place your chin on the chin rest 102 again and rest your forehead on the chin rest." or "Please blink," under the control of the voice output control means 2094, and controls to temporarily stop the examination. The subject places his chin on the chin rest 102 again, and the information acquisition means 2092 acquires information indicating that the anterior eye observation unit can observe the subject's anterior eye, so that the examination can be resumed.

[0079] In this embodiment, the information acquiring means 2092 acquires information indicating that the subject has placed his / her chin on the chin rest 102 and resumes the examination, but the present invention is not limited to this. For example, the examination may be paused and resumed in response to an operation on the operating means 801. In this case, when the voice recognition means 2097 recognizes that the subject has uttered a voice such as "My eyes are tired," the voice output control means 2094 may control the voice output means 290-2 to output "The examination will be paused. Please operate the operating unit to pause the examination. When the break is over, please place your chin on the chin again and press the operating unit." In addition, when the voice recognition means 2097 recognizes that the subject has uttered a statement intended to ask "How much time is left," the voice output control means 2094 causes the voice output means 290-2 to output a voice such as "30 seconds left" or "One more shot will be taken" to notify the subject of the progress of the examination.

[0080] In recent years, research into AI using machine learning has been actively conducted. Generative AI, which is a type of AI, is different from AI that produces highly accurate output from existing data in a specific field, and is trained to be able to dynamically generate text, pictures, etc. in response to input from a user. For this reason, it may be possible to have a conversation that is comparable to that of a real person. The content to be output in response to the voice from the subject may be determined according to a predetermined setting as in Example 1, or a generative AI or the like may be used.

[0081] In this embodiment, the ophthalmic examination means 201 is located at a remote location from the operator, and the subject controls the start and stop of the examination, but the present invention is not limited to this. For example, the same configuration as in the first embodiment may be used, in a state where the ophthalmic examination means 201 and the operator are in the same examination room, and the control means 209 is a tablet terminal and is wirelessly connected to the ophthalmic examination means 201. At this time, if the subject cannot recognize the internal fixation light in step S903, the audio output means 290-1 can output "Please use the external fixation light for the examination" to the operator, and the audio output means 290-2 can output "Please release your chin and relax" to the subject. Alternatively, the audio output means 290-1 can output "Do you want to use the external fixation light for the examination?" to the operator, and the output content to the subject can be changed depending on the result. Alternatively, in step 903, when the information acquiring means 2092 acquires information indicating that the subject's eyelids are not sufficiently open, the voice output unit 290-2 may output to the subject, "Can you open your eyes a little more?" For example, when the voice input unit 802 inputs a voice such as "I can't open my eyes any more" uttered by the subject to the ophthalmic examination means 201 and transmits the voice signal to the control means 209, and the voice recognition means 2097 recognizes it, the voice output control means 2094 can control the voice output means 290-1 to output "Please help the subject open his / her eyelids" to the operator, and the voice output means 290-2 to output "Please wait a moment. It's okay to blink" to the subject. Alternatively, in step S904, if the voice recognition means 2097 recognizes that the subject has said something such as "My eyes are tired" while data of the test eye is being acquired, the voice output control means 2094 controls the voice output means 290-1 to output "Do you want to pause the examination?" to the operator, and in response to the selection to pause the examination, the voice output means 290-2 may output "The examination will be paused. Please relax your chin for a moment" or the like to the subject.Alternatively, in step S904, when the information acquiring means 2092 acquires information indicating that the alignment state is not suitable (or in other words, inappropriate) for a certain period of time, the audio output means 290-2 may output to the operator, "Do you want to stop the tracking process and switch to manual alignment?" under the control of the audio output control means 2094. When the operator selects manual alignment, the audio output means 290-2 outputs to the subject, "We will adjust the device again. Please open your eyes wide and look at the internal fixation light.", and the control means 2095 of the ophthalmic examination means suspends the tracking process and data acquisition. Alternatively, when the information acquiring means acquires information indicating that acquisition of data of the subject's eye has been completed, the audio output means 290-1 outputs to the operator, "Do you want to end the examination?" under the control of the audio output control means 2094. When the operator selects to end the examination, the information acquisition means acquires information indicating that the examination status is complete, and the voice output means 290-2 outputs "This completes the examination. Thank you for your hard work" under the control of the voice output control means 2094. On the other hand, similarly to the first embodiment, when the operator who has checked the acquired data of the subject's eye determines that re-imaging is necessary and selects re-imaging, the voice output means 290-2 can output "We will re-imaging" to the subject.

[0082] The operator may select to pause or end the examination, or to retake an image by using an operating member (not shown), or by providing a voice input unit (not shown) for the operator and having the voice recognition means 2097 recognize a voice signal generated based on the voice input from the voice input means.

[0083] By providing audio output means for the operator (audio output means 290-1) and the subject (audio output means 290-2), it becomes easier for both the operator and the subject to recognize the audio output contents. In this case, the audio output from the audio output means 290-1 and the audio output from the audio output means 290-2 may have different sound quality. For example, a low-pitched audio may be output from the audio output means 290-1, and a high-pitched audio may be output from the audio output means 290-2. Alternatively, the audio output means 290-1 and 290-2 may each be an audio output means having directionality. This makes it easier for both the operator and the subject to separate and hear the audio intended for each, even when audio is output from multiple audio output means at the same time.

[0084] In this embodiment, the ophthalmic examination means 201 is configured to have the voice input means 802 for inputting the voice of the subject, but is not limited to this. For example, the control means 209 may be configured to have the voice input means. At this time, the operator utters a voice of "start examination" (voice related to the examination including an examination instruction), and the voice input means (not shown) of the control means 209 inputs the voice to the control means 209, and the voice recognition means 2097 recognizes the voice signal, and accordingly, the process of step S903 can be started. Similarly, when the operator utters "pause" or "end examination", the corresponding process can be performed. Alternatively, the voice input means 802 connected to the ophthalmic examination means 201 may be used to accept the instructions of "start examination", "pause", and "end examination" from the operator in the same manner. In this case, the voice recognition means 2097 may be configured to recognize the characteristics of the operator's voice in advance and perform the process by extracting the characteristics of the operator's voice in advance. Note that various known methods can be used for voice recognition, and therefore, the description of this embodiment will be omitted.

[0085] According to the above method, the subject can hear the voice output according to his / her own condition, and can appropriately grasp the progress of the examination.

[0086] In the above-mentioned embodiment, one control means is provided for one ophthalmic examination means, but the configuration may be such that an operator controls multiple ophthalmic examination means with one control means, and different subjects are examined for each ophthalmic examination means. In that case, for example, when outputting sounds indicating the completion of the examination or the need for reexamination so that the operator can easily understand these, a lamp on the ophthalmic examination means may be turned on (for example, a lamp of a different color or light intensity may be used to indicate the completion of the examination and the need for reexamination), the display form (color, etc.) of the display screen may be changed, or the volume may be increased when outputting these sounds, and the output or display may be performed in a manner different from that when other sounds are output.

[0087] <Example 4> In the first and second embodiments, the configuration for outputting the progress of the examination by voice in accordance with the state of the examination is described. In the present embodiment, the configuration for outputting the information including the progress of the examination by voice in accordance with the alignment state as the state of the ophthalmic examination apparatus is described.

[0088] As described above, the ophthalmic examination apparatus of this embodiment performs alignment processing before data acquisition, and then starts acquiring data of the subject's eye, such as OCT data and fundus photographed images, and performs tracking processing to maintain the alignment state during acquisition of the examination data, and changes the output contents from the audio output means 290 (FIG. 2(a)) according to the alignment state. For example, when the information acquisition means 2092 acquires information indicating that the alignment state is maintained favorably from before the start of the examination until acquisition of the examination data, audio is sequentially output, for example, as in the first embodiment. On the other hand, when the information acquisition means 2092 acquires information indicating that the alignment state is not favorable for a certain period of time or more during acquisition of the OCT data, the examination is temporarily stopped, and the audio output control means 2094 controls the audio output control means 2094 to output contents to allow the subject to rest, such as "Please release your chin. Please place your chin again after a while" or "Please blink."

[0089] In addition, when the subject places his / her chin on the chin rest 102 again and the information acquiring means 2092 acquires information indicating that the anterior eye observation unit can observe the anterior eye of the subject, the alignment process is performed and the audio output control means 2094 outputs audio from the audio output means 290 to notify the subject of the resumption of the examination, such as "Alignment is being performed. Please wait a moment" or "Please look at the internal fixation light." In addition, when the information acquiring means 2092 acquires information indicating that the subject blinked while acquiring data of the subject's eye, the acquisition of data of the subject's eye and audio output may be suspended in the same manner. For example, when the pupil area cannot be detected for a certain period of time from the anterior eye observation image or when the information acquiring means 2092 acquires information indicating that the luminance change in the time direction of the anterior eye observation image is large, it may be detected that the subject blinked. Note that, similarly to the third embodiment, when the information acquiring means 2092 acquires information indicating that the alignment is not suitable even after a predetermined number of repetitions, the control to change the audio content to be output may be performed. For example, when starting or resuming an examination, the voice output "Please look at the internal fixation light" may be changed to voice guidance such as "Please look straight ahead" or "The external fixation light will be turned on. Please follow the operator's instructions to direct your gaze."

[0090] In this embodiment, the voice output according to the information on the alignment state, which is the information on the ophthalmic examination means 201, has been described, but the information on the ophthalmic examination means is not limited to this. For example, when multiple examinations are performed at once, it may take time to store, analyze, and display the acquired data. If the next examination is started in this state, the load on the ophthalmic examination apparatus may be high. For this reason, the examination may not be started until a certain amount of processing such as storing, analyzing, and displaying the acquired data is completed. In this way, when the information acquisition means 2092 acquires information indicating that the control means 209 is under load, the voice output control means 2094 may control the voice output means 290 to output a voice to inform the subject of how much time is left until the examination starts, such as "Please wait a while until the examination starts. The examination will start in about 10 seconds." In addition, after that, in response to the information acquisition means 2092 acquiring information indicating that the ophthalmic examination apparatus is ready for the examination, the voice output control means 2094 may control the voice output means 209 to output "The examination is ready. Please place your chin on the ophthalmic examination apparatus and rest your forehead on the ophthalmic examination apparatus."

[0091] According to the above method, the subject can hear the audio output corresponding to the state of the ophthalmic examination apparatus, and can appropriately grasp the progress of the examination.

[0092] In the first to fourth embodiments, the information acquired by the information acquiring means 2092 indicates information such as the subject, the examination, and the state of the ophthalmic examination apparatus, and a configuration is described in which sound corresponding to that information is output. However, a configuration in which such information is obtained by processing the information acquired by the information acquiring means 2092, and sound corresponding to that information is output, is also naturally included in the concept of "the sound output means outputs sound corresponding to the information acquired by the information acquiring means."

[0093] <Other embodiments> Although the embodiment has been described above in detail, the disclosed technology can be embodied as, for example, a system, an apparatus, a method, a control program for an examination apparatus, or a recording medium (storage medium). Specifically, the technology may be applied to a system composed of a plurality of devices (for example, a host computer, an interface device, an imaging device, a web application, etc.), or may be applied to an apparatus composed of a single device. In addition, an example in which the progress of the examination is output by voice has been described as one of the embodiment examples, but, for example, a display means for the examinee is provided in the ophthalmic examination apparatus 201, and the progress of the examination can be displayed on the display means for the examinee. This configuration also allows the examinee to grasp the progress of the examination. At this time, the focus state of the examinee's eye relative to the display unit for the examinee may be adjusted using the focus state detected based on the fundus observation image. In addition, the technology has been described in detail using an ophthalmic examination apparatus as an example, but is not limited to this as long as it is a medical examination apparatus that performs an examination of a subject using voice guidance. For example, the technology may be applied to a configuration in which the examinee answers predetermined questions such as a medical interview.

[0094] The present disclosure can also be realized by supplying a recording medium (or storage medium) on which a software program code (computer program) that realizes one or more functions of the above-mentioned embodiments is recorded to a system or device, and then a computer (or a CPU or MPU) of the system or device reads and executes the program code stored in the recording medium. Needless to say, such a storage medium is a computer-readable storage medium. In this case, the program code itself read from the recording medium realizes the functions of the above-mentioned embodiments, and the recording medium on which the program code is recorded is included in the present disclosure.

[0095] The configuration of the measurement optical system in the ophthalmologic apparatus according to the above-described embodiment is merely an example, and may be changed arbitrarily according to a desired configuration.

[0096] It should be noted that the above-described embodiments of the present disclosure are merely illustrative examples of the implementation of the present disclosure, and the technical scope of the present disclosure should not be interpreted as being limited by these. In other words, the present disclosure can be implemented in various forms without departing from its technical concept or main features.

[0097] Here, the disclosure of the embodiments of the present disclosure includes the following configurations, methods, and programs.

[0098] [Configuration 1] An ophthalmic examination apparatus having an ophthalmic examination means for examining an eye to be examined and a control means for controlling the ophthalmic examination means, a voice output control means for controlling a voice output means for outputting a voice that provides voice guidance to a subject; and an information acquisition means for acquiring information regarding at least one of the subject, the test, and the ophthalmic examination apparatus; The audio output control means controls the audio output means to output audio corresponding to the information acquired by the information acquisition means.

[0099] [Configuration 2] An ophthalmic examination device as described in configuration 1, wherein the control by the audio output means to output audio corresponding to the information acquired by the information acquisition means is control to set at least one of the content, speed, language, pitch, and volume of the audio guidance corresponding to the information acquired by the information acquisition means.

[0100] [Configuration 3] The information acquiring means acquires information about the subject, The information about the subject includes information about at least one of the subject's age and language; 3. The ophthalmic examination apparatus according to configuration 1 or 2, wherein the audio output control means performs the setting based on information regarding at least one of the subject's age and the language used.

[0101] [Configuration 4] 4. The ophthalmic examination apparatus of claim 2 or 3, wherein the setting is a change from a standard setting.

[0102] [Configuration 5] 5. The ophthalmic examination apparatus according to any one of configurations 1 to 4, wherein the information about the subject includes information about the condition of the subject.

[0103] [Configuration 6] 6. The ophthalmic examination apparatus according to any one of configurations 1 to 5, wherein the information relating to the ophthalmic examination apparatus includes information relating to a state of the ophthalmic examination apparatus.

[0104] [Configuration 7] The information acquisition means acquires information regarding the examination, The information relating to the test includes information relating to a progress status of the test, An ophthalmic examination device according to any one of configurations 1 to 6, wherein the audio output control means controls the audio output means to output audio guidance notifying the user of the progress of the examination in accordance with information regarding the progress of the examination.

[0105] [Configuration 8] The information acquisition means acquires information regarding the examination, The information relating to the test includes information relating to a progress status of the test, An ophthalmic examination device according to any one of configurations 1 to 7, wherein the audio output control means controls the audio output means to output audio including instructions for the subject in accordance with information regarding the progress of the examination.

[0106] [Configuration 9] the information acquisition means acquires information about the ophthalmic examination apparatus, the information on the state of the ophthalmic examination apparatus includes information on an alignment state between the subject's eye and the ophthalmic examination means, An ophthalmic examination device described in any one of configurations 1 to 8, wherein the audio output control means controls the audio output means to output audio including instructions for the subject to improve the alignment state in accordance with information regarding the alignment state between the test eye and the ophthalmic examination means.

[0107] [Configuration 10] 10. The ophthalmic examination apparatus according to any one of configurations 1 to 9, wherein the control means has a voice recognition means for performing voice recognition based on a voice uttered by the subject.

[0108] [Configuration 11] An ophthalmic examination device as described in configuration 10, wherein when the voice recognition result by the voice recognition means indicates that the subject is having problems hearing, the voice output control means controls the voice output means to re-output the same content as that output by the voice output means.

[0109] [Configuration 12] 12. The ophthalmic examination apparatus according to configuration 11, wherein the audio output control means controls the audio output means to output again the same content as that output by the audio output means at a volume louder than the volume of the previous output.

[0110] [Configuration 13] 11. The ophthalmic examination apparatus according to configuration 10, wherein the control means stops the examination when a voice recognition result by the voice recognition means indicates that the subject is feeling fatigued.

[0111] [Configuration 14] 14. The ophthalmic examination apparatus according to any one of configurations 1 to 13, wherein the ophthalmic examination apparatus has the audio output means.

[0112] [Configuration 15] the ophthalmic examination means has the audio output means, 15. The ophthalmic examination apparatus according to configuration 14, wherein the control means comprises the audio output control means and the information acquisition means.

[0113] [Configuration 16] 15. The ophthalmic examination apparatus according to configuration 14, wherein the audio output means is composed of a plurality of audio output means, and the ophthalmic examination means and the control means each have the audio output means.

[0114] [Configuration 17] the information acquiring means acquires information about the subject, When the information regarding the condition of the subject includes information indicating that the subject blinked while the ophthalmic examination means was acquiring data of the subject's eye, 6. The ophthalmic examination apparatus according to configuration 5, wherein the control means controls the ophthalmic examination means to stop acquiring data of the subject's eye.

[0115] [Configuration 18] the information acquiring means acquires information regarding the ophthalmic examination apparatus; When the information on the state of the ophthalmic examination apparatus indicates that the state of the ophthalmic examination apparatus is unsuitable for examination, the audio output control means controls the audio output means to output an audio signal indicating that the examination is to be temporarily stopped; An ophthalmic examination apparatus as described in configuration 6, wherein, when information regarding the status of the ophthalmic examination apparatus includes information indicating that the status of the ophthalmic examination apparatus is suitable for examination, the audio output control means controls the audio output means to output audio indicating that the examination will be started or resumed.

[0116] [Configuration 19] The control means has an instruction receiving means, When the instruction receiving means receives an instruction to start an examination from the operator, 19. The ophthalmic examination apparatus according to any one of configurations 1 to 18, wherein the ophthalmic examination apparatus automatically performs the examination.

[0117] [Method 1] A control method for an ophthalmic examination apparatus having an ophthalmic examination means for examining an eye to be examined and a control means for controlling the ophthalmic examination means, comprising the steps of: an information acquiring step of acquiring information regarding at least one of a subject having the subject's eye, the examination, and the ophthalmic examination apparatus; a voice output control step of controlling output of a voice to the subject in accordance with the information acquired in the information acquisition step; A method for controlling an ophthalmic examination apparatus having the above-mentioned features.

[0118] [Program 1] A control program for an ophthalmic examination apparatus that causes a computer to execute the control method for an ophthalmic examination apparatus according to Method 1.

[0119] [Configuration 20] A medical testing apparatus having a medical testing means for testing a subject and a control means for controlling the medical testing means, a voice output control means for controlling a voice output means for outputting a voice that provides voice guidance to a subject; and an information acquisition means for acquiring information regarding at least one of the subject, the test, and the medical testing device; The medical examination device, wherein the audio output control means controls the audio output means to output audio corresponding to the information acquired by the information acquisition means.

[0120] [Method 2] A method for controlling a medical testing apparatus having a medical testing means for testing a subject and a control means for controlling the medical testing means, comprising the steps of: an information acquiring step of acquiring information regarding at least one of a subject having the subject, the test, and the medical testing device; a voice output control step of controlling output of a voice to the subject in accordance with the information acquired in the information acquisition step; 13. A method for controlling a medical examination apparatus comprising:

[0121] [Program 2] A control program for a medical testing apparatus that causes a computer to execute the method for controlling a medical testing apparatus according to method 2. [Explanation of symbols]

[0122] 201 Ophthalmic Examination Methods 209 Control Means 210 Display means 211 Memory means 212 Operating means 290 Audio output means

Claims

1. An ophthalmic examination apparatus having an ophthalmic examination means for examining an eye to be examined and a control means for controlling the ophthalmic examination means, a voice output control means for controlling a voice output means for outputting a voice that provides voice guidance to a subject; and an information acquisition means for acquiring information regarding at least one of the subject, the test, and the ophthalmic examination apparatus; An ophthalmic examination apparatus, wherein the audio output control means controls the audio output means to output audio corresponding to the information acquired by the information acquisition means.

2. The ophthalmic examination device according to claim 1, characterized in that the control by the voice output means to output voice corresponding to the information acquired by the information acquisition means is control to set at least one of the content, speed, language, pitch, and volume of the voice guidance corresponding to the information acquired by the information acquisition means.

3. The information acquiring means acquires information about the subject, The information about the subject includes information about at least one of the subject's age and language; 3. The ophthalmic examination apparatus according to claim 2, wherein the voice output control means performs the setting based on information on at least one of the subject's age and the language used.

4. 4. The ophthalmic examination apparatus according to claim 3, wherein the settings are changes from standard settings.

5. 2. The ophthalmic examination apparatus according to claim 1, wherein the information about the subject includes information about a condition of the subject.

6. 2. The ophthalmic examination apparatus according to claim 1, wherein the information relating to the ophthalmic examination apparatus includes information relating to a state of the ophthalmic examination apparatus.

7. The information acquisition means acquires information regarding the examination, The information relating to the test includes information relating to a progress status of the test, The ophthalmic examination device according to claim 1, characterized in that the voice output control means controls the voice output means to output voice guidance notifying the progress of the examination in accordance with information regarding the progress of the examination.

8. The information acquisition means acquires information regarding the examination, The information relating to the test includes information relating to a progress status of the test, 2. The ophthalmic examination apparatus according to claim 1, wherein the voice output control means controls the voice output means to output a voice including instructions for the subject in accordance with information relating to a progress status of the examination.

9. the information acquisition means acquires information about the ophthalmic examination apparatus, the information on the state of the ophthalmic examination apparatus includes information on an alignment state between the subject's eye and the ophthalmic examination means, The ophthalmic examination apparatus according to claim 1, characterized in that the audio output control means controls the audio output means to output audio including instructions to the subject for optimizing the alignment state, in accordance with information regarding the alignment state between the subject's eye and the ophthalmic examination means.

10. 2. An ophthalmic examination apparatus according to claim 1, wherein the control means comprises a voice recognition means for performing voice recognition based on a voice uttered by the subject.

11. The ophthalmic examination apparatus according to claim 10, characterized in that, when the voice recognition result by the voice recognition means indicates that the subject is having problems hearing, the voice output control means controls the voice output means to output again the same content as that output by the voice output means.

12. 12. The ophthalmic examination apparatus according to claim 11, wherein the audio output control means controls the audio output means to output the same content as that output by the audio output means again at a volume louder than the volume of the previous output.

13. 11. The ophthalmic examination apparatus according to claim 10, wherein the control means performs control to stop the examination when a voice recognition result by the voice recognition means indicates that the subject is feeling fatigued.

14. 2. The ophthalmic examination apparatus according to claim 1, further comprising the audio output means.

15. the ophthalmic examination means has the audio output means, 15. The ophthalmic examination apparatus according to claim 14, wherein the control means comprises the audio output control means and the information acquisition means.

16. 15. An ophthalmic examination apparatus according to claim 14, wherein said audio output means is composed of a plurality of audio output means, and each of said ophthalmic examination means and said control means has said audio output means.

17. the information acquiring means acquires information about the subject, When the information regarding the condition of the subject includes information indicating that the subject blinked while the ophthalmic examination means was acquiring data of the subject's eye, 6. The ophthalmic examination apparatus according to claim 5, wherein the control means controls the ophthalmic examination means to stop acquiring data of the subject's eye.

18. the information acquiring means acquires information regarding the ophthalmic examination apparatus; When the information on the state of the ophthalmic examination apparatus includes information indicating that the state of the ophthalmic examination apparatus is unsuitable for the examination, the audio output control means controls the audio output means to output an audio indicating that the examination is to be temporarily stopped; The ophthalmic examination apparatus according to claim 6, characterized in that, when the information regarding the status of the ophthalmic examination apparatus includes information indicating that the status of the ophthalmic examination apparatus is suitable for examination, the audio output control means controls the audio output means to output an audio indicating that the examination will be started or resumed.

19. The control means has an instruction receiving means, When the instruction receiving means receives an instruction to start an examination from the operator, 19. The ophthalmic examination apparatus according to claim 1, wherein the ophthalmic examination apparatus automatically performs the examination.

20. A control method for an ophthalmic examination apparatus having an ophthalmic examination means for examining an eye to be examined and a control means for controlling the ophthalmic examination means, comprising the steps of: an information acquiring step of acquiring information regarding at least one of a subject having the subject's eye, the examination, and the ophthalmic examination apparatus; a voice output control step of controlling output of a voice to the subject in accordance with the information acquired in the information acquisition step; 13. A method for controlling an ophthalmic examination apparatus comprising:

21. A control program for an ophthalmic examination apparatus that causes a computer to execute the control method for an ophthalmic examination apparatus according to claim 19.

22. A medical testing apparatus having a medical testing means for testing a subject and a control means for controlling the medical testing means, a voice output control means for controlling a voice output means for outputting a voice that provides voice guidance to a subject; and an information acquisition means for acquiring information regarding at least one of the subject, the test, and the medical testing device; The medical examination apparatus according to claim 1, wherein the audio output control means controls the audio output means to output audio corresponding to the information acquired by the information acquisition means.

23. A method for controlling a medical testing apparatus having a medical testing means for testing a subject and a control means for controlling the medical testing means, comprising the steps of: an information acquiring step of acquiring information regarding at least one of a subject having the subject, the test, and the medical testing device; a voice output control step of controlling output of a voice to the subject in accordance with the information acquired in the information acquisition step; 13. A method for controlling a medical examination apparatus comprising:

24. A control program for a medical examination apparatus that causes a computer to execute the control method for a medical examination apparatus according to claim 23.

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