Ophthalmologic apparatus

Abstract

To provide an ophthalmologic apparatus capable of acquiring brighter and clearer inspection images of the meibomian glands.SOLUTION: A slit lamp microscope 100 includes a background illumination system 60 that illuminates an eye to be examined using visible light or infrared light, an imaging unit 50 that images the eye E to be examined, and a control unit 20 that controls the background illumination system 60 and the imaging unit 50. The control unit 20 includes an inspection image generation part 21 that generates inspection images of the meibomian glands located on the inner side of the eyelid of the eye to be examined. The inspection image generation part 21 includes an eye to be examined determination section 22, an image acquisition section 23, an image extraction section 24, an image synthesis section 25, an infrared light mode determination section 26, a notification section 27, and an AI model setting section 28.SELECTED DRAWING: Figure 2

Description

Technical Field

[0001] The present disclosure relates to an ophthalmic device.

Background Art

[0002] Conventionally, there has been known an ophthalmic device that observes Meibomian glands existing on the back side of the eyelid of an eye to be examined by imaging the eye to be examined illuminated with infrared light using an imaging unit (see, for example, Patent Document 1). Further, Patent Document 2 discloses a technique for generating a high-contrast image by combining or subtracting a meibography image of the inner surface of the eyelid when the inner surface of the eyelid is irradiated with infrared light and an IR transillumination image when infrared light is transilluminated from the outer surface of the patient's eyelid.

Prior Art Documents

Patent Documents

[0003]

Patent Document 1

Patent Document 2

Summary of the Invention

Problems to be Solved by the Invention

[0004] However, since the surface of the eyelid in the turned-back state is uneven and three-dimensional, there are portions that are out of focus and blurry when photographed, or portions that are photographed darkly as a shadow of the protruding portion, making it difficult to obtain a bright and clear image of the entire Meibomian gland.

[0005] The present disclosure has been made paying attention to the above problems, and an object thereof is to obtain a brighter and clearer inspection image of the Meibomian gland.

Means for Solving the Problems

[0006] To achieve the above object, an ophthalmic device according to the present disclosure includes an illumination unit that illuminates an eye to be examined with visible light or infrared light, an imaging unit that images the eye to be examined, and a control unit that controls the illumination unit and the imaging unit. The control unit has an inspection image generation unit that generates an inspection image of the Meibomian glands present on the back side of the eyelid of the eye to be examined. The inspection image generation unit includes an image acquisition unit that acquires a plurality of infrared images obtained by imaging the Meibomian glands while changing the imaging angle and / or the imaging position from the imaging unit that images the eyelid in a turned-over state irradiated with the infrared light, an image extraction unit that extracts a focused portion from the plurality of infrared images acquired by the image acquisition unit as a partial image, and an image synthesis unit that synthesizes the plurality of partial images extracted by the image extraction unit to generate an inspection image of the Meibomian glands.

Advantages of the Invention

[0007] The ophthalmic device configured as described above extracts a focused portion from among a plurality of infrared images, and synthesizes the extracted partial images to generate an inspection image of the Meibomian glands. Therefore, a brighter and clearer inspection image of the Meibomian glands can be obtained.

Brief Description of the Drawings

[0008]

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

Figure 6

Modes for Carrying Out the Invention

[0009] (Example 1) The slit lamp microscope 100 of Example 1, which is an embodiment of the ophthalmic device of the present disclosure, will be described as follows with reference to FIGS. 1 to 4. The slit lamp microscope 100 shown in FIG. 1 is an ophthalmic device that obtains an image of the cross-section of the cornea by cutting a light section of the cornea of the eye to be examined E using slit-shaped illumination light (hereinafter sometimes referred to as "slit light"), and is also referred to as a "slit lamp microscope".

[0010] As shown in FIG. 1 and the like, the slit lamp microscope 100 of Example 1 mainly includes a main body 10 and a control unit 20. The main body 10 is connected to a personal computer (PC) 80 by a communication cable 2.

[0011] In Example 1, the control unit 20 is provided in the PC 80 in the vicinity of the main body 10, but is not limited to this configuration. As a modification, the control unit 20 can also be configured to be provided in an external device such as a personal computer connected to the main body 10 via a communication network or a cloud server, or can be configured to be provided in the main body 10 (for example, inside the gantry 12a, the imaging unit 50, etc.).

[0012] The slit lamp microscope 100 of Example 1 is a so-called Zeiss type (Littman type) slit lamp microscope, and since the illumination system 30 is arranged below the observation system 40, it is a relatively compact ophthalmic device. Note that the slit lamp microscope 100 is not limited to the Zeiss type, and the present disclosure can also be applied to a Haag type (Goldmann type) slit lamp microscope in which the illumination system 30 is arranged above the observation system 40.

[0013] The main body part 10 is installed on the optical bench 1. The main body part 10 mainly includes an illumination system 30, an observation system 40, an imaging part 50, a background illumination system 60 which is an illumination part, and a power supply part 70. The main body part 10 further includes a base part 11 fixed to the upper surface of the optical bench 1, a gantry part 12 provided on the upper surface of the base part 11, a moving mechanism 13 for moving the gantry part 12 in the left - right direction, a support part 14 provided on the upper surface of the gantry part 12, a face support part 15 supported by the base part 11, and a pair of gripping parts 16 provided on both sides of the base part 11 in the left - right direction.

[0014] The gantry part 12 includes a gantry 12a, a dimming knob (dimming operation part) 12b, an operation lever (moving operation part) 12c, and a shooting button 12d provided on the upper surface of the operation lever 12c. The gantry part 12 can be moved in the front - rear direction and the left - right direction as viewed from the eye to be examined E with respect to the base part 11 by the moving mechanism 13. The moving mechanism 13 includes a slide bar 13a inserted through the gantry 12a, and a pair of fixing parts 13b that support both ends of the slide bar 13a so as to be movable in the front - rear direction. In this specification, among the front - rear directions, the front direction is the direction approaching the subject, and the rear direction is the direction moving away from the subject and towards the examiner. Among the left - right directions, the left direction is the left - hand direction of the subject, and the right direction is the right - hand direction of the subject.

[0015] The operation lever 12c is a member for giving an instruction for moving the gantry part 12 and the like. The shooting button 12d is a member for giving a shooting instruction to the imaging part 50. The operation lever 12c and the shooting button 12d are electrically connected to the control part 20. An examiner who is a user using the slit - lamp microscope 100 can move the part including the illumination system 30, the observation system 40, the imaging part 50, and the background illumination system 60 (inside the dashed - dotted line part A in Fig. 1) arranged above the gantry part 12 in the front - rear and left - right directions together with the gantry part 12 by the action of the moving mechanism 13 by moving the operation lever 12c grasped in the front - rear, left - and - right directions. By moving the gantry part 12, the shooting direction and / or the shooting position of the eye to be examined E by the imaging part 50 provided on the gantry part 12 is changed.

[0016] Further, when the examiner tilts the operation lever 12c, the control unit 20 controls the observation system 40 according to the operation amount and operation direction, causing focusing to be performed. When the examiner rotates the operation lever 12c around the axis, the support portion 14 provided on the upper surface of the gantry portion 12 moves vertically by a lifting mechanism (not shown) according to the operation amount and operation direction. Due to this movement, the portion including the illumination system 30, the observation system 40, the imaging unit 50, and the background illumination system 60 disposed above the gantry portion 12 (inside the one-dot chain line portion A in FIG. 1) can also move vertically together with the support portion 14. Also, due to the vertical movement of the imaging unit 50 in this manner, the imaging direction and / or imaging position of the eye E to be examined by the imaging unit 50 is changed. When the examiner presses down the imaging button 12d, the control unit 20 controls the imaging unit 50 to capture an image of the eye E to be examined.

[0017] The dimming knob 12b is a member for the examiner to perform the lighting and extinguishing operations of the slit light of the illumination system 30 and the adjustment operation of the brightness (light amount). When the examiner rotates the dimming knob 12b, under the control of the control unit 20, the illumination system 30 is turned on or off, and when it is turned on, the brightness of the illumination light of the illumination system 30 is continuously and freely changed according to the operation amount and operation direction from the extinguished position.

[0018] The support portion 14 mainly supports the illumination system 30, the observation system 40, the imaging unit 50, and the background illumination system 60. The support portion 14 includes a pedestal 14a, a first support arm 14b, and a second support arm 14c. The pedestal 14a is provided on the upper surface of the gantry 12a. The first support arm 14b and the second support arm 14c stand up from the pedestal 14a. The first support arm 14b and the second support arm 14c can each independently rotate around a coaxial vertical axis 14d.

[0019] Further, the support portion 14 includes a test rod 14e that is detachably attached to a rotation shaft hole (not shown) provided on the vertical axis 14d. This test rod 14e is a member for confirming the state of the slit light irradiated from the illumination system 30, and is removed when irradiating and observing the eye E to be examined with the slit light.

[0020] The first support arm 14b supports the illumination system 30 with an illumination system housing 31 that houses the optical members of the illumination system 30 attached to the upper part thereof. The first support arm 14b can be manually rotated. When the first support arm 14b rotates, the illumination system housing 31 pivots around the eye to be examined. As a result, the irradiation direction of the slit light with respect to the eye to be examined is changed. Note that the first support arm 14b may also rotate in the vertical direction, and in this case, the elevation angle and depression angle of the slit light with respect to the eye to be examined are changed.

[0021] The second support arm 14c supports the observation system 40 with an observation system housing 41 that houses the optical members of the observation system 40 attached to the upper part thereof. Also, an imaging unit 50 is attached below the observation system 40 to the second support arm 14c, and the second support arm 14c supports the imaging unit 50. The second support arm 14c can be manually rotated. When the second support arm 14c rotates, the observation system 40 and the imaging unit 50 pivot around the first support arm 14b. As a result, the observation direction of the observation system 40 and the imaging unit 50 with respect to the eye to be examined E is changed.

[0022] The second support arm 14c houses a power cable for supplying power to the illumination system 30, the imaging unit 50, the background illumination system 60, etc. The second support arm 14c is provided with a background illumination system 60 on the side facing the subject and below the objective lens 43 of the observation system 40. The background illumination system 60 may be fixedly attached to the second support arm 14c in a non-detachable manner, or may be detachably attached.

[0023] Note that the first support arm 14b and the second support arm 14c may be configured to rotate automatically by electric power. In this case, the support part 14 includes an actuator that generates a driving force for rotating the first support arm 14b and the second support arm 14c, and a transmission mechanism that transmits this driving force. As the actuator, for example, a stepping motor (pulse motor) is used. Also, as the transmission mechanism, for example, a combination of gears or a rack and pinion is used.

[0024] The face support portion 15 is disposed opposite to the observation system 40 in front of the observation system 40. The face support portion 15 includes a jaw receiving portion 15a on which the jaw of the subject is placed and a forehead abutting portion 15b that abuts against the forehead. In the first embodiment, with the subject facing the optical bench 1 and the face in contact with the jaw receiving portion 15a and the forehead abutting portion 15b, the examiner operates the slit lamp microscope 100 to observe the subject eye and the like.

[0025] Further, the face support portion 15 is provided with a fixation portion 17 for external fixation detachably. The fixation portion 17 includes a fixation lamp holding portion 17a made of a flexible arm and an external fixation lamp 17b (for example, an LED light source) provided at the tip of the fixation lamp holding portion 17a that emits fixation light. The fixation portion 17 can arbitrarily adjust the position of the external fixation lamp 17b and the emission direction of the fixation light by the fixation lamp holding portion 17a. The fixation portion 17 can guide the line of sight of the subject eye E by the external fixation lamp 17b and adjust the orientation of the subject eye E.

[0026] The pair of gripping portions 16 are members that the subject grips with both hands when receiving an examination. By gripping the gripping portion 16, the subject can fix the body, maintain a stable posture, and appropriately receive the examination.

[0027] The illumination system 30 irradiates slit light toward the subject eye E. The illumination system 30 mainly includes a slit lamp (for example, an LED light source) 32 housed in an illumination system housing 31 and a deflection optical system 33. Further, the illumination system 30 may include an exciter filter, a diffusion plate, etc. (not shown) selectively arranged on its optical path. The exciter filter enables fluorescence observation of the cornea of the subject eye E in combination with a barrier filter described later. The diffusion plate diffuses the illumination light irradiated from the slit lamp 32, enabling observation of a wider range of the subject eye E.

[0028] The slit lamp 32 irradiates slit light toward the deflection optical system 33. The deflection optical system 33 is provided above the slit lamp 32. The deflection optical system 33 includes a deflection optical element 34. In the first embodiment, the deflection optical element 34 is composed of a prism. The deflection optical element 34 deflects the slit light irradiated from the slit lamp 32 toward the eye E to be examined. As a result, the eye E to be examined is irradiated with the slit light. Note that the deflection optical element 34 is not limited to a prism and may be composed of a mirror (reflecting mirror) or the like and deflect by reflecting the slit light toward the eye E to be examined. Further, the slit lamp 32 and the deflection optical system 33 are not limited to the configuration of the first embodiment, and their shape, structure, and arrangement are not particularly limited as long as they are used in a Zeiss type slit lamp microscope.

[0029] The slit lamp 32 is connected to the control unit 20 via a USB cable or the like (not shown), and the lighting and extinguishing are controlled by the control unit 20. The brightness of the slit light irradiated from the slit lamp 32 is changed by operating the dimming knob 12b provided on the gantry 12a as described above. The width of the slit light is changed by the examiner operating the slit opening / closing knob (slit opening / closing operation unit) 37 provided in the illumination system 30. The slit light is light in which the irradiation region is formed in a strip shape by blocking a part of the irradiation region, and is illumination light for observing the cornea and fundus of the eye E to be examined.

[0030] The observation system 40 is used to observe the return light (also referred to as "reflected light") from the eye to be examined, and is a so-called microscope. Here, the "return light" includes not only the slit light and background light reflected by the eye to be examined, but also various types of light such as scattered light from the eye to be examined and its surroundings. In the first embodiment, the one including these various types of light is called "return light". The observation system 40 is attached to the upper part of the second support arm 14c as described above, and an observation optical system 42 for guiding the return light from the eye E to be examined is housed in the observation system housing 41. The observation system housing 41 of the first embodiment includes a first observation system housing 41a arranged on the subject side (front side) of the second support arm 14c and a second observation system housing 41b arranged on the examiner side (rear side) of the second support arm 14c.

[0031] The observation optical system 42 includes an objective lens 43, a pair of left and right relay optical systems 44, and a pair of left and right eyepieces 45. The objective lens 43 is a lens that faces the eye to be examined E. The pair of left and right eyepieces 45 each include an eyepiece lens 45a that faces the left and right examiner's eyes e of the examiner. The pair of left and right relay optical systems 44 each include optical members such as a zoom optical system (not shown), a diaphragm, and a prism unit. A part of the objective lens 43 and the relay optical system 44 (for example, the zoom optical system and the diaphragm, etc.) is housed in the first observation system housing 41a, and the rest of the relay optical system 44 (for example, the prism unit, etc.) and the eyepiece 45 are housed in the second observation system housing 41b. Note that the relay optical system 44 may be entirely housed in the first observation system housing 41a or the second observation system housing 41b.

[0032] The examiner can observe the eye to be examined E with the naked eye by looking into the pair of eyepieces 45 with both eyes. In addition, observation magnification adjustment handles 46 for changing the observation magnification are provided on the left and right side surfaces of the observation system housing 41.

[0033] The imaging unit 50 is detachably or fixedly attached to the second support arm 14c of the main body unit 10. The imaging unit 50 is attached to the side (rear side) of the second support arm 14c facing the examiner.

[0034] The imaging unit 50 receives the return light from the eye to be examined E and captures an image of the eye to be examined E. The imaging unit 50 is composed of, for example, a digital camera. The imaging unit 50 houses an imaging element 52 (see FIG. 2) in an imaging unit housing 51. The imaging unit 50 also includes an imaging optical system that collects a part of the return light from the eye to be examined E and guides it to the imaging element 52, a control board that controls the imaging unit 50 under the control of the control unit 20, a memory in which an image is recorded (not shown above), and members that a normal digital camera has. The imaging unit housing 51 is attached to the second support arm 14c so as to be sandwiched between the second observation system housing 41b and the second support arm 14c.

[0035] The imaging element 52 is a photoelectric conversion element that detects the return light guided by the imaging optical system, converts it into an electrical signal (image signal), and outputs it. As the imaging element 52, for example, a CCD (Charge Coupled Device) image sensor or a CMOS (Complementary Metal Oxide Semiconductor) image sensor is used.

[0036] The imaging element 52 can output an image signal to the PC 80 via the communication cable 2. The image signal is input to the control unit 20 of the PC 80, and an image based on the image signal is stored in the storage unit 84 in the PC 80. Further, the imaging element 52 outputs the image signal acquired in real time to the control unit 20. The control unit 20 displays the image signal input from the imaging element 52 on the display unit 81 in real time. That is, the imaging unit 50 enables live view.

[0037] The imaging unit 50 is electrically connected to the shooting button 12d. When the shooting button 12d is pressed down, the imaging unit 50 starts acquiring an image of the eye E to be examined by the imaging element 52. The imaging unit 50 moves in the front-back, left-right, and up-down directions together with the gantry unit 12 and the support unit 14 by operating the operation lever 12c of the examiner. By this movement, the imaging unit 50 changes the shooting angle and / or shooting position while shooting an image of the eye E to be examined.

[0038] The imaging unit 50 of the first embodiment can capture an infrared image of the meibomian gland by capturing an image of the eyelid in an inverted state irradiated with infrared light from the background illumination system 60. The meibomian gland is an organ present behind the eyelid of the subject's eye E. When the examiner presses down the capture button 12d during this capture, the imaging unit 50 automatically captures infrared images continuously for a predetermined capture time at a predetermined time interval, that is, captures still images of the infrared images continuously. The predetermined time interval can be an appropriate time interval depending on the performance and necessity of the imaging unit 50, and can be, for example, a time interval that allows 1 to 20 infrared images (frames / second) to be captured per second, more preferably 3 to 18 infrared images. The infrared image captured by the imaging unit 50 is not limited to a still image, but may be a moving image, and all frames in the moving image or a plurality of frames selected from these may be input to the control unit 20 as the infrared image.

[0039] The predetermined photographing time can be, for example, several seconds to several tens of seconds after the examiner presses down the photographing button 12d, and more specifically, can be 3 to 10 seconds. Alternatively, the predetermined time interval can be from the time the examiner presses down the photographing button 12d to the time the examiner presses down the photographing button 12d again, or from the time the examiner presses down the photographing button 12d to the time the examiner presses up the photographing button 12d again, that is, until the examiner releases his / her finger from the photographing button 12d.

[0040] The imaging unit 50 also includes a background light switching unit 53. The background light switching unit 53 is a member that allows the examiner to turn on or off the background illumination system 60, switch the background light, and adjust the brightness (amount of light). The background light switching unit 53 functions as an illumination switch that switches the illumination mode of the background illumination system 60 between a visible light mode in which visible light is illuminated onto the subject's eye E, and an infrared light mode in which infrared light is illuminated onto the subject's eye E.

[0041] The background light switching unit 53 is electrically connected to the background lighting system 60. As shown in FIGS. 1 and 3, the background light switching unit 53 is provided below one surface of the imaging unit housing 51 on the side (rear side) facing the examiner. The background light switching unit 53 is provided with a marker 53a for indicating the rotational position. On one surface of the imaging unit housing 51, above the background light switching unit 54, the position at 12 o'clock is the light-off position 54a indicating the light-off position of the background lighting system 60.

[0042] A predetermined range in the clockwise direction with reference to the light-off position 54a is a range where visible light is irradiated from the background lighting system 60 and its brightness is adjustable. On the imaging unit housing 51, the characters "BG" are displayed at the position (visible light maximum position 54b) where the brightness of the visible light is maximum. Also, a predetermined range in the counterclockwise direction with reference to the light-off position 54a is a range where infrared light is irradiated from the background lighting system 60 and its brightness is adjustable. On the imaging unit housing 51, the characters "IR" are displayed at the position (infrared light maximum position 54c) where the brightness of the infrared light is maximum.

[0043] As shown in the top view of FIG. 3, when the marker 53a is at the light-off position 54a, the background light source 62 is turned off. As shown in the right view of FIG. 3 on the paper, when the examiner rotates the background light switching unit 53 clockwise, visible light with a brightness corresponding to the operation amount (rotation amount) is emitted from the background light source 62. On the other hand, as shown in the left view of FIG. 3 on the paper, when the examiner rotates the background light switching unit 53 counterclockwise, infrared light with a brightness corresponding to the operation amount (rotation amount) is emitted from the background light source 62.

[0044] The background illumination system (illumination unit) 60 illuminates the area around the irradiation area of the slit light irradiated from the illumination system 30 (surrounding area) or the eye to be examined E with background light. The background illumination system 60 is attached to the side facing the subject of the second support arm 14c (front) and below the objective lens 43 of the observation system 40. The irradiation area by the background illumination system 60 only needs to include at least the surrounding area, and may partially overlap with the irradiation area by the illumination system 30. The background illumination system 60 mainly includes a background illumination housing 61, a background light source 62, and optical members such as a condenser lens (not shown).

[0045] The background light source 62 has a visible light source 62a that irradiates visible light (background light: BG), and a pair of infrared light sources 62b that irradiate infrared light (IR light: IR) on both sides thereof. The lighting, switching, and brightness adjustment of the visible light and infrared light irradiated from the background light source 62 are performed by operating the background light switching unit 54 arranged on the examiner side as described above. The visible light is used for naked-eye observation and photography, and the infrared light is used for observing and photographing the meibomian gland. The background light source 62 irradiates the eye to be examined E with background light from the irradiation port 63 opened in the background illumination housing 61. The background light irradiated from the background light source 62 is collected by a condenser lens and then irradiated toward the eye to be examined E. Note that the background light irradiated from the background light source 62 is not limited to both visible light and infrared light, and may be only infrared light. Also, in the first embodiment, the background light source 62 is composed of the visible light source 62a and the infrared light source 62b, but it can be configured to alternately irradiate visible light and infrared light from one LED light source.

[0046] The power supply unit 70 is a device that supplies power to the slit lamp microscope 100. The power supply unit 70 mainly includes an AC / DC converter 71 built in the housing 13c of one fixed part 13b of the moving mechanism 13, and a power switch 72 and a confirmation display lamp 73 exposed from the housing 13c. Note that the power supply unit 70 is not limited to the configuration provided in the housing 13c of the fixed part 13b. For example, it may be provided on the optical table 1, and may be provided at any location as long as the table operator or the like can operate the power switch 72 and visually recognize the confirmation display lamp 73.

[0047] The AC / DC converter 71 converts an AC voltage into a DC voltage. An insertion plug (not shown) that is plugged into an outlet is connected to the AC / DC converter 71. The power switch 72 is a switch for starting up the slit lamp microscope 100. When the operator turns on the power switch 72, the power supply unit 70 supplies power to the illumination system 30, the observation system 40, the imaging unit 50, the background illumination system 60, etc. via the AC / DC converter 71.

[0048] The confirmation indicator lamp 73 is a so-called pilot lamp and is composed of, for example, an LED. The confirmation indicator lamp 73 is for notifying the user of the energized state of the slit lamp microscope 100. The confirmation indicator lamp 73 lights up when the slit lamp microscope 100 is in the energized state, that is, the startup state (power on), and goes out when it is in the non-energized state, that is, the stop state (power off).

[0049] The PC 80 includes a motherboard (main board) having a processor such as a CPU (Central Processing Unit) and storage devices such as a ROM (Read Only Memory), a RAM (Random Access Memory), and a hard disk drive.

[0050] The control unit 20 is provided in the PC 80 as described above. That is, the processor of the PC 80 functions as the control unit 20 of the first embodiment. The PC 80 also includes a display unit 81, an operation unit 82, a speaker unit 83, a storage unit 84, and a learned AI model 85, and further includes a microphone, a communication unit, and other members that the PC 80 usually has.

[0051] The control unit 20 controls the operation of the entire slit lamp microscope 100. The control unit 20 is connected to the illumination system 30, the observation system 40, the imaging unit 50, the background illumination system 60, and the power supply unit 70 by means of a communication cable 2 and cables housed in the main body unit 10. The control unit 20 acquires necessary information from these components, outputs appropriate control commands thereto, and controls them. The operation of the control unit 20 is realized by the cooperation of software such as a control program pre-stored in the storage unit 84 and hardware such as a processor. Further, the control unit 20 may receive an operation input from the operation unit 82 by the examiner and cause the display unit 81 to display an image captured by the imaging unit 50, a measurement result, and the like.

[0052] Also, the control unit 20 functions as an inspection image generation unit 21 that generates an inspection image of the Meibomian glands existing on the back side of the eyelid of the eye to be examined E by executing an inspection image generation program pre-stored in the storage unit 84. This inspection image generation unit 21 includes an eye to be examined determination unit 22, an image acquisition unit 23, an image extraction unit 24, an image synthesis unit 25, an infrared light mode determination unit 26, a notification unit 27, and an AI model setting unit 28.

[0053] The eye to be examined determination unit 22 acquires a real-time image signal of the infrared image input from the imaging unit 50, and determines whether or not the eyelid of the eye to be examined E is in an inverted state by analyzing the infrared image based on the image signal (hereinafter, sometimes simply referred to as "eyelid state determination"). In the first embodiment, when the illumination mode is determined to be the infrared light mode by the infrared light mode determination unit 26, the eye to be examined determination unit 22 automatically starts the eyelid state determination, but is not limited thereto. As a modification, the eye to be examined determination unit 22 may be configured to start the eyelid state determination when the imaging button 12d is pressed by the examiner after it is determined that the infrared light mode is on.

[0054] The eye to be examined determination unit 22 in Example 1 performs eyelid state determination by artificial intelligence (AI; Artificial Intelligence) using a learned AI model 85. More specifically, when the eye to be examined determination unit 22 inputs an infrared image into the learned AI model 85, the learned AI model 85 outputs an image recognition result to the eye to be examined determination unit 22. The eye to be examined determination unit 22 determines whether the eyelid is turned inside out based on this image recognition result. This determination result is used to determine whether to start automatic shooting of an infrared image by the imaging unit 50.

[0055] Note that the eyelid state determination by the eye to be examined determination unit 22 is not limited to a configuration using artificial intelligence, and may also be a configuration using a known image recognition program.

[0056] The image acquisition unit 23 acquires a plurality of infrared images G (see FIG. 5) from the imaging unit 50 that captures the turned - inside - out eyelid irradiated with infrared light. As shown in FIG. 5(a), these plurality of infrared images G are images obtained by the imaging unit 50 while changing the shooting angle and / or shooting position to capture the meibomian gland M. When the eye to be examined determination unit 22 determines that the eyelid is in the turned - inside - out state, the image acquisition unit 23 starts acquiring the infrared image G from the imaging unit 50. Also, the image acquisition unit 23 acquires a live - view image captured with infrared light from the imaging unit 50.

[0057] As shown in FIG. 5(b), the image extraction unit 24 cuts out the in - focus part from the plurality of infrared images G that capture the meibomian gland M acquired by the image acquisition unit 23. Hereinafter, the image of this cut - out part is referred to as a "partial image g". More preferably, the image extraction unit 24 in Example 1 cuts out a partial image g excluding the out - of - focus part and the luminance - abnormal part from the plurality of infrared images G.

[0058] As shown in FIG. 5(c), the image synthesis unit 25 synthesizes the plurality of partial images g extracted by the image extraction unit 24 by a known image synthesis method to generate an inspection image GA for inspecting the meibomian gland M.

[0059] The infrared light mode determination unit 26 determines whether the illumination mode of the background illumination system 60 has been switched and selected to the infrared light mode. More specifically, if the background light switching unit 54 has been rotated to the side of the maximum visible light position 54b rather than the extinguished position 54a, the infrared light mode determination unit 26 determines that it is in the "visible light mode", and if the background light switching unit 54 has been rotated to the side of the maximum infrared light position 54c rather than the extinguished position 54a, it determines that it is in the "infrared light mode".

[0060] When the eyelid determination unit 22 determines that the eyelid is not in the turned-back state, the notification unit 27 notifies the examiner that the eyelid is not turned back. More specifically, the notification unit 27 controls the speaker unit 83 to output a warning message by voice. The warning message is not particularly limited, and examples include "The eyelid is not turned back enough. Please try again." etc. Note that the notification unit 27 is not limited to the configuration of notifying by voice from the speaker unit 83, and instead of or in addition to the notification from the speaker unit 83, it can also be configured to display the characters of the warning message or a warning image on the display unit 81.

[0061] The AI model setting unit 28 sets (generates) the learned AI model 85. The AI model setting unit 28 sets the learned AI model 85 in a storage device incorporated in the PC 80 (for example, it can be a part of the storage unit 84 or a storage device separate from the storage unit 84). That is, in the artificial intelligence system of the first embodiment, the place responsible for data analysis is the PC 80 (edge device) connected to the main body 10 of the slit lamp microscope 100, which is a so-called "edge AI". This "edge AI" has the advantage that the eyelid state can be determined in real time.

[0062] Note that the artificial intelligence system used in the ophthalmic device of the present disclosure is not limited to edge AI. As a modification, the artificial intelligence system may be "cloud AI" in which the learned AI model 85 is incorporated into a cloud server connected to the PC 80 via a communication network, and the place responsible for data analysis is the cloud. In the case of cloud AI, the control unit 20 may be configured not to have the AI model setting unit 28, or the AI model setting unit 28 may be provided on the cloud server.

[0063] As shown in FIG. 2, the AI model setting unit 28 includes a data collection unit 281, a teacher data creation unit 282, and a machine learning unit 283. The data collection unit 281 collects a large number of infrared images of the inner side of the upper eyelid and infrared images of the inner side of the lower eyelid that have been photographed in advance from an external device or the like. The infrared images of the inner side of the upper eyelid and the infrared images of the inner side of the lower eyelid are preferably a large number of infrared images of the inner side of the eyelids of various people according to age, gender, race, etc. In addition, it is also desirable that these a large number of infrared images include not only appropriately turned-back eyelid infrared images but also inappropriately turned-back eyelid infrared images. Furthermore, it is desirable that the large number of infrared images include not only infrared images of normal meibomian glands but also infrared images of meibomian glands that are not normal due to diseases or the like, and more preferably, infrared images of various types of abnormal meibomian glands according to symptoms. By using infrared images of meibomian glands in various states as teacher data in this way, machine learning can be performed more appropriately, and the accuracy of data analysis by the learned AI model 85 can be further improved.

[0064] The teacher data creation unit 282 processes (annotates) a large number of infrared images collected by the data collection unit 281 to create teacher data with an "upper eyelid inner side image tag" indicating that it is data of an infrared image of the inner side of the upper eyelid and teacher data with a "lower eyelid inner side image tag" indicating that it is data of an infrared image of the inner side of the lower eyelid. The machine learning unit 283 gives the teacher data created by the teacher data creation unit 282 to a selected machine learning algorithm for image recognition to execute machine learning and generate a learned AI model 85.

[0065] The display unit 81 is composed of a liquid crystal display monitor or the like, and displays an operation screen, an image of the eye E to be examined that has been photographed, etc. under the control of the control unit 20. The operation unit 82 is composed of a touch panel, a keyboard, a mouse, etc. provided on the display unit 81, receives the operator's operation input, and outputs this operation input signal to the control unit 20. The speaker unit 83 outputs the voice of a warning message to the outside under the control of the notification unit 27. Although the speaker unit 83 is provided in the PC 80 in the first embodiment, it is not limited to this configuration and can also be separately provided in the main body unit 10, and the warning message can be output more clearly from a location closer to the examiner or the examinee.

[0066] The storage unit 84 is composed of storage devices such as the RAM, ROM, and hard disk drive provided in the PC 80. The storage unit 84 stores various programs such as a control program and an inspection image generation program, and various parameters used in ophthalmic examinations. Further, the storage unit 84 stores an image of the eye E to be examined photographed by the imaging unit 50, for example, an image photographed with visible light, an infrared image photographed with infrared light, an inspection image generated based on the infrared image, etc.

[0067] As described above, the learned AI model 85 is a learned AI model based on the infrared image on the inner side of the upper eyelid and the infrared image on the inner side of the lower eyelid, which is set by the AI model setting unit 28.

[0068] An example of the operation performed by the slit lamp microscope 100 of the first embodiment configured as described above will be described as follows based on the flowchart shown in FIG. 6. The flowchart shown in FIG. 6 is mainly an operation performed by the control unit 20. Observation and photographing of the eye E to be examined using slit light and background light in the observation system 40 and the imaging unit 50 of the slit lamp microscope 100 are the same as the observation and photographing of the eye E to be examined performed by known procedures, so detailed description is omitted, and mainly the process for generating an inspection image (inspection image generation method) will be described below.

[0069] When generating an inspection image, it is assumed that the power supplies of the main body 10 including the imaging unit 50 and the PC 80 of the slit lamp microscope 100 are turned on and each is normally activated. When the power of the imaging unit 50 is turned on, it captures a live view image and outputs it to the control unit 20. The examiner seats the subject on a chair or the like, faces the slit lamp microscope 100, places the chin on the chin support portion 15a, and places the forehead against the forehead rest portion 15b. The examiner can observe the test eye E and capture an image using the slit lamp microscope 100.

[0070] Then, in order for the examiner to capture an infrared image of the meibomian gland of the test eye E, the examiner rotates the background light switching unit 53 to switch the illumination mode of the background illumination system 60 to the infrared light mode. This switching of the illumination mode is transmitted to the control unit 20 (test eye determination unit 22) by an electrical signal output from the background light switching unit 53, and the operation of the flowchart shown in FIG. 6 is started. The examiner turns the eyelid of the subject inside out with a finger so that the meibomian gland M existing on the back side of the eyelid can be seen.

[0071] In step S01, the inspection image generation unit 21 of the control unit 20 determines whether the power of the imaging unit 50 (main body 10) is turned on and the illumination mode is switched to the infrared light mode. If this determination is YES, the program proceeds to step S02. If the determination is NO, the program proceeds to END and the image generation process ends.

[0072] In the next step S02, the image acquisition unit 23 acquires a live view image of the infrared image from the imaging unit 50 and outputs it to the test eye determination unit 22. In step S03, the test eye determination unit 22 inputs the infrared image of the live view image to the learned AI model 85 and determines (eyelid state determination) whether the eyelid is turned back sufficiently based on the output image recognition result.

[0073] In step S03, when the test eye determination unit 22 determines that the eyelid is in a state where it is turned back sufficiently (YES), the program proceeds to step S05. On the other hand, when it is determined that the eyelid is not turned back sufficiently (NO), the program proceeds to step S04.

[0074] In step S04, the notification unit 27 controls the speaker unit 83 to output a warning message. As a result, the examiner can clearly recognize that the eyelids of the subject are not fully turned inside out, and can repeat the operation of turning the eyelids inside out so that the eyelids are properly turned inside out. After the execution of step S04, the program returns to step S02, and the live view image is acquired again.

[0075] The steps of S02 to S04 are continued until it is determined that the eyelids are fully turned inside out. However, the number of determinations can be counted, and when the number reaches a plurality of times (threshold value), the program can be configured to proceed to END and end the image generation process. Alternatively, the elapsed time since the switch to the infrared light mode can be measured, and when the measured time reaches a predetermined time (threshold value), the program can be configured to proceed to process END and end the image generation process.

[0076] When the eyelids are fully turned inside out, in the next step S05, the inspection image generation unit 21 controls the imaging unit 50 to automatically and continuously acquire infrared images of the meibomian glands M. At the time of this imaging, the examiner moves the operation lever 12c back and forth, left and right, or rotates it while holding it, so that the entire apparatus (more specifically, the illumination system 30, the observation system 40, the imaging unit 50, and the background illumination system 60 within the one-dot chain line portion A in FIG. 1) moves in the front-rear, up-down, left-right directions together with the gantry portion 12 and / or the support portion 14 by the action of the moving mechanism 13 and the elevating mechanism.

[0077] As a result, the imaging unit 50 captures the turned-inside-out eyelids at a predetermined shooting time at predetermined time intervals while the shooting direction and / or shooting position of the subject eye E is changed, and can acquire a plurality of infrared images G with different shooting directions and / or shooting positions. The imaging unit 50 outputs the acquired infrared images G to the sequential image acquisition unit 23. The image acquisition unit 23 acquires a plurality of infrared images G captured corresponding to the movement of the entire apparatus in the front-rear, up-down, left-right directions from the imaging unit 50.

[0078] In the next step S06, as shown in FIG. 5(b), the image extraction unit 24 cuts out, from each infrared image G obtained in step S05, a properly focused portion as a partial image g, excluding the out-of-focus portion and the luminance abnormal portion. In the next step S07, as shown in FIG. 5(c), the image synthesis unit 25 synthesizes the plurality of partial images g extracted in step S06 by a known image synthesis method to generate an inspection image GA of the meibomian gland M. As described above, a bright and clear inspection image GA of the meibomian gland M can be obtained. By displaying this inspection image GA on the display unit 81, the examiner can more appropriately confirm the state of the meibomian gland M.

[0079] As described above, the slit lamp microscope 100 of the first embodiment and the modified example includes an illumination unit (background illumination system 60) that illuminates the eye to be examined with visible light or infrared light, an imaging unit 50 that images the eye to be examined E, and a control unit 20 that controls the background illumination system 60 and the imaging unit 50. The control unit 20 has an inspection image generation unit 21 that generates an inspection image GA of the meibomian gland M existing on the back side of the eyelid of the eye to be examined E. The inspection image generation unit 21 includes an image acquisition unit 23 that acquires a plurality of infrared images G obtained by imaging the meibomian gland M while changing the imaging angle and / or the imaging position from the imaging unit 50 that images the turned-back eyelid irradiated with infrared light, an image extraction unit 24 that extracts a properly focused portion from the plurality of infrared images G acquired by the image acquisition unit 23 as a partial image g, and an image synthesis unit 25 that synthesizes the plurality of partial images g extracted by the image extraction unit 24 to generate an inspection image GA of the meibomian gland M. With this configuration, the slit lamp microscope 100 of the first embodiment can obtain a brighter and clearer inspection image of the meibomian gland.

[0080] The image extraction unit 24 of the first embodiment is configured to cut out, from a plurality of infrared images G, a portion excluding the out-of-focus portion and the luminance abnormal portion as a partial image g. By using such partial images g, the image synthesis unit 25 can synthesize a more properly focused inspection image GA.

[0081] The inspection image generation unit 21 of Example 1 includes an eye being examined determination unit 22 that determines whether or not the eyelid of the eye being examined E is turned inside out. When the eye being examined determination unit 22 determines that the eyelid is in the state of being turned inside out, the image acquisition unit 23 is configured to acquire a plurality of infrared images G from an imaging unit 50 that continuously and automatically captures infrared images G at a predetermined time interval. With this configuration, the examiner does not need to operate the shooting button 12d, and the image acquisition unit 23 can acquire a plurality of infrared images G that are automatically and continuously captured by the imaging unit 50.

[0082] The slit lamp microscope 100 of Example 1 includes an illumination changeover switch (background light changeover unit 53) that switches the illumination mode of the background illumination system 60 between a visible light mode in which visible light illuminates the eye being examined E and an infrared light mode in which infrared light illuminates the eye being examined E. The inspection image generation unit 21 has an infrared light mode determination unit 26 that determines whether or not the infrared light mode is selected for switching. When the eye being examined determination unit 22 determines, based on the determination by the infrared light mode determination unit 26, that the illumination mode is the infrared light mode, the eye being examined determination unit 22 determines whether or not the eyelid of the eye being examined E is in the state of being turned inside out. With this configuration, the eye being examined determination unit 22 can automatically determine whether or not the eyelid is in the state of being turned inside out without depending on an instruction from the examiner.

[0083] The inspection image generation unit 21 of Example 1 has an AI model setting unit 28 that constructs a learned AI model by giving the teacher data of the infrared image G on the inner side of the upper eyelid of the eye being examined E and the teacher data of the infrared image G on the inner side of the lower eyelid of the eye being examined E to a machine learning algorithm, and sets the constructed learned AI model. When determining the state where the eyelid is turned inside out, the eye being examined determination unit 22 inputs the infrared image G acquired from the imaging unit 50 into the learned AI model 85, and determines whether or not the eyelid is in the state of being turned inside out based on the image recognition result output from the learned AI model 85. With this configuration, the eye being examined determination unit 22 can determine whether or not the eyelid is in the state of being turned inside out at a higher speed and with higher accuracy.

[0084] When the examination image generation unit 21 of Example 1 is determined by the eye lid inversion determination unit 22 not to be in a state where the eyelid is turned inside out, it has a notification unit 27 that notifies the examiner that the eyelid is not turned inside out. By the notification by this notification unit 27, the examiner can clearly recognize that the eyelid is not sufficiently turned inside out, and can redo the operation of turning the eyelid so that the eyelid is properly turned inside out.

[0085] As described above, the ophthalmic apparatus of the present disclosure has been described based on Example 1 and Example 2. However, regarding the specific configuration, it is not limited to these examples, and design changes, additions, etc. are allowed as long as they do not deviate from the gist of the invention according to each claim of the claims.

[0086] The ophthalmic apparatuses of the above examples and modified examples are slit lamp microscopes, but the ophthalmic apparatuses to which the present disclosure is applied are not limited to slit lamp microscopes. For example, the ophthalmic apparatus may be a microscope for surgical operations. Also, in addition to these, the present disclosure can be applied to ophthalmic apparatuses that observe and photograph the eye to be examined using specific light different from the illumination light. In this case, the specific light irradiation system is not limited to a configuration that irradiates background light, and may be a configuration that irradiates a second illumination light having a different wavelength and illumination range from the illumination light for observation. Further, the illumination unit of the present disclosure is not limited to the background illumination system 60, and any one can be used as long as it can illuminate the eye to be examined E with visible light or infrared light and cause the imaging unit 50 to photograph the meibomian gland M.

[0087] Also, in the slit lamp microscope 100 of the above embodiments and modified examples, although the imaging unit 50 automatically captures a plurality of infrared images G when the eyelid is turned inside out, the present invention is not limited to this configuration. As a modified example, an examiner moves the gantry unit 12 back and forth, left and right, or rotates it to move the imaging unit 50 in the front-rear, up-down, left-right directions, and while changing the shooting angle and shooting position, by pressing the shooting button 12d, the imaging unit 50 can be configured to acquire an infrared image, enabling shooting according to the examiner's intention. Further, the slit lamp microscope 100 may be provided with a sensor that detects the posture or movement state of the imaging unit 50, such as the angle and position of the imaging unit 50, and when the sensor detects a change or movement in the posture of the imaging unit 50, the imaging unit 50 may be configured to acquire an infrared image. Also, in the above embodiments and modified examples, although the imaging unit 50 is moved in the front-rear, up-down, left-right directions so that the shooting direction and / or shooting position of the eye to be examined E by the imaging unit 50 is changed, the present invention is not limited to this, and the imaging unit 50 may be moved in at least any one of the front-rear direction, up-down direction, and left-right direction.

[0088] Regarding the descriptions of the above Embodiment 1 and modified examples, the following is further disclosed. (1) An illumination unit that illuminates the eye to be examined with visible light or infrared light, An imaging unit that captures the eye to be examined, An ophthalmic device comprising a control unit that controls the illumination unit and the imaging unit, The control unit has an inspection image generation unit that generates an inspection image of the Meibomian glands present on the back side of the eyelid of the eye to be examined, The inspection image generation unit, An image acquisition unit that acquires a plurality of infrared images of the Meibomian glands by photographing the turned-inside-out eyelid irradiated with the infrared light from the imaging unit while changing the shooting angle and / or shooting position, An image extraction unit that extracts in-focus portions from the plurality of infrared images acquired by the image acquisition unit as partial images, An image synthesis unit that synthesizes the plurality of partial images extracted by the image extraction unit to generate an inspection image of the Meibomian glands, An ophthalmic device characterized by the above. (2) The image extraction unit cuts out, as the partial image, a portion obtained by excluding the out-of-focus portion and the luminance anomaly portion from the plurality of infrared images. The ophthalmic apparatus according to (1) above, characterized in that. (3) The inspection image generation unit has an eye to be examined determination unit that determines whether or not the eyelid of the eye to be examined is turned inside out, when the eye to be examined determination unit determines that the eyelid is in the state of being turned inside out, the image acquisition unit acquires a plurality of the infrared images from the imaging unit that continuously and automatically captures the infrared images at a predetermined time interval. The ophthalmic apparatus according to (1) or (2) above, characterized in that. (4) The ophthalmic apparatus includes an illumination changeover switch that switches the illumination mode of the illumination unit between a visible light mode in which the visible light illuminates the eye to be examined and an infrared light mode in which the infrared light illuminates the eye to be examined, the inspection image generation unit has an infrared light mode determination unit that determines whether or not the infrared light mode is selected for switching, when the infrared light mode determination unit determines that the illumination mode is the infrared light mode, the eye to be examined determination unit determines whether or not the eyelid of the eye to be examined is in the state of being turned inside out. The ophthalmic apparatus according to (3) above, characterized in that. (5) The inspection image generation unit has an AI model setting unit that constructs a learned AI model by machine learning that gives teacher data of an infrared image on the inner side of the upper eyelid of the eye to be examined and teacher data of an infrared image on the inner side of the lower eyelid to a machine learning algorithm, and sets the constructed learned AI model, when determining the state in which the eyelid is turned inside out, the eye to be examined determination unit inputs the infrared image acquired from the imaging unit into the learned AI model, and determines whether or not the eyelid is in the state of being turned inside out based on the image recognition result output from the learned AI model. The ophthalmic apparatus according to (3) above, characterized in that. (6) When the eye to be examined determination unit determines that the eyelid is not in the state of being turned inside out, the inspection image generation unit has a notification unit that notifies the examiner that the eyelid is not turned inside out. The ophthalmic device according to the above (3), characterized in that...

Explanation of Signs

[0089] 20: Control unit 21: Inspection image generation unit 22: Test eye determination unit 23: Image acquisition unit 24: Image extraction unit 25: Image synthesis unit 26: Infrared light mode determination unit 27: Notification unit 28: AI model setting unit 50: Imaging unit 53: Background light switching unit (lighting switch) 60: Background lighting system (lighting unit) 85: Trained AI model 100: Slit lamp microscope (ophthalmic device) E: Test eye G: Infrared image GA: Inspection image M: Meibomian gland g: Partial image

Claims

1. An ophthalmic apparatus comprising: an illumination unit that illuminates an eye to be examined with visible light or infrared light; an imaging unit that images the eye to be examined; and a control unit that controls the illumination unit and the imaging unit, wherein the control unit has an inspection image generation unit that generates an inspection image of the Meibomian glands present on the back side of the eyelid of the eye to be examined, the inspection image generation unit includes an image acquisition unit that acquires a plurality of infrared images of the Meibomian glands by imaging the Meibomian glands while changing the imaging angle and / or imaging position from the imaging unit that images the eyelid in the turned-back state irradiated with the infrared light; an image extraction unit that extracts in-focus portions from the plurality of infrared images acquired by the image acquisition unit as partial images; and an image synthesis unit that synthesizes the plurality of partial images extracted by the image extraction unit to generate an inspection image of the Meibomian glands. An ophthalmic apparatus characterized by the above.

2. The image extraction unit cuts out, as the partial image, a portion excluding the out-of-focus portion and the luminance abnormal portion from the plurality of infrared images. The ophthalmic apparatus according to claim 1, characterized by the above.

3. The inspection image generation unit has an eye to be examined determination unit that determines whether or not the eyelid of the eye to be examined is in a turned-back state, and when the eye to be examined determination unit determines that the eyelid is in a turned-back state, the image acquisition unit acquires a plurality of the infrared images from the imaging unit that continuously and automatically images the infrared images at a predetermined time interval. The ophthalmic apparatus according to claim 1, characterized by the above.

4. The ophthalmic apparatus includes an illumination changeover switch that switches the illumination mode of the illumination unit between a visible light mode in which the visible light illuminates the eye to be examined and an infrared light mode in which the infrared light illuminates the eye to be examined, the inspection image generation unit has an infrared light mode determination unit that determines whether or not the infrared light mode is switched and selected, and when the infrared light mode determination unit determines that the illumination mode is the infrared light mode, the eye to be examined determination unit determines whether or not the eyelid of the eye to be examined is in a turned-back state. The ophthalmic apparatus according to claim 3, characterized by the above.

5. The inspection image generation unit has an AI model setting unit that constructs a learned AI model by machine learning that gives teacher data of an infrared image on the inner side of the upper eyelid of the eye to be examined and teacher data of an infrared image on the inner side of the lower eyelid of the eye to be examined to a machine learning algorithm, and sets the constructed learned AI model. When determining the state where the eyelid is turned inside out, the eye examination determination unit inputs the infrared image acquired from the imaging unit into the learned AI model, and determines whether the eyelid is in the state of being turned inside out based on the image recognition result output from the learned AI model. The ophthalmic apparatus according to claim 3, characterized in that.

6. When the examination image generation unit is determined by the eye examination determination unit not to be in the state where the eyelid is turned inside out, it has a notification unit that notifies the examiner that the eyelid is not turned inside out. The ophthalmic apparatus according to claim 3, characterized in that.

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