Treatment of vitreous floaters using a resonant scanner integrated SLO

Abstract

Certain embodiments disclosed herein provide a system for treating vitreous floaters. Light from a first laser (e.g., a laser diode) is focused onto a plurality of points within the vitreous of a patient's eye using a scanner while measuring reflected light from the plurality of points. The reflected light (e.g., an image) is evaluated to identify a portion of the plurality of points corresponding to one or more vitreous floaters. Second light from a second laser (e.g., a pulsed laser) is focused onto a portion of the plurality of points using a scanner to break down one or more vitreous floaters.

Description

Technical Field

[0001] Cross - Reference to Related Applications This application claims priority to U.S. Provisional Patent Application No. 63 / 388,911, filed on July 13, 2022, the entire content of which is incorporated herein by reference.

Background Art

[0002] Light received by the human eye passes through the transparent cornea covering the iris and pupil of the eye. The light passes through the pupil and is focused by the lens located within a structure called the lens capsule behind the pupil. The light is focused by the lens and the cornea onto the retina, which contains rods and cones that can generate nerve impulses in response to light. The space between the lens and the retina is filled with a transparent gel known as the vitreous body.

Summary of the Invention

Problems to be Solved by the Invention

[0003] For various reasons, there may be floating substances in the vitreous body. The floating substances are typically formed from clumps of cells, collagen fibers, and / or other tissues and are more opaque than the surrounding vitreous body. The floating substances cast shadows on the retina, causing visual impairment in patients, and in some patients, there is a risk of exacerbation.

Means for Solving the Problems

[0004] The present disclosure generally relates to a system for treating vitreous floaters.

[0005] Certain embodiments disclosed herein provide a method and corresponding apparatus, the method including focusing a first light from a first laser onto a plurality of points in the vitreous body of a patient's eye using a scanner system while measuring reflected light from the plurality of points. The method includes determining by a computer system that reflected light from a portion of the plurality of points corresponds to one or more vitreous floaters. In response to the determination that reflected light from a portion of the plurality of points corresponds to one or more vitreous floaters, focusing a second light from a second laser onto the portion of the plurality of points using the scanner system to break down the one or more vitreous floaters.

[0006] The following description and related drawings set forth in detail certain illustrative features of one or more embodiments.

[0007] The accompanying drawings illustrate certain aspects of one or more embodiments and, accordingly, are not to be considered as limiting the scope of the disclosure.

Brief Description of the Drawings

[0008]

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

Figure 6

Figure 7

Figure 8

Figure 9

Best Mode for Carrying Out the Invention

[0009] For clarity, where possible, the same reference numerals are used in multiple drawings to indicate common identical elements. The elements and features of one embodiment are considered to be advantageously incorporated into other embodiments as well, unless otherwise noted.

[0010] Referring to FIG. 1, a human eye 100 includes a cornea 102, which is a curved transparent layer through which light entering the eye 100 passes. The light then passes through each of the anterior chamber 138, pupil 104, and lens 106 of the eye 100. The remaining portion of the globe 108 of the eye 100, known as the posterior chamber or vitreous chamber, is filled with a transparent gel known as the vitreous 110. The light is focused by the cornea 102 and the lens 106 through the vitreous 110 onto the retina 112 at the back of the eye 100.

[0011] Vitreous floaters 114 are clumps of cells, collagen fibers, or other foreign substances. If vitreous floaters 114 are present, they cast a shadow 116 on the retina 112. The shadow 116 may sometimes occupy a large angular range of the field of view of the eye 100. If the floaters 114 are large enough, opaque, and / or numerous, they can significantly reduce the patient's vision.

[0012] FIG. 2 shows an example of a scanning laser ophthalmoscope (SLO) and a therapeutic laser system 200 (hereinafter, "system 200") that can be used to perform the methods described herein. System 200 includes a laser diode LD and a therapeutic laser TL. The laser diode LD is an infrared laser diode suitable for use in an SLO known in the art. The infrared light from the laser diode LD is not visible to the patient. The therapeutic laser TL is a pulsed laser capable of generating pulses at a high repetition rate, such as 1-2 MHz, to decompose the vitreous floaters 114. The therapeutic laser TL can have a higher pulse repetition rate, but can be gated or selectively turned on to achieve this repetition rate. In some implementations, the therapeutic laser TL is a femtosecond therapeutic laser based on a chirped pulse regenerative amplifier (CPA) with a repetition rate of 1 MHz or more. Such a laser can also operate in a "pulse per demand" mode of operation, which means that the pulses can be selected from a pulse train with a repetition rate of MHz up to a similarly high rate. For example, the pulses may be selected to be output at a rate in the range of 1 kHz to 1 MHz suitable for the methods disclosed herein. In some implementations, the pulses are selected using an acousto-optic deflector, a Pockels cell, or other types of pulse picking devices.

[0013] The beam from the laser diode LD travels substantially parallel (e.g., within 1 degree) using the lens L4. The beam from the laser diode LD is incident on a scanning mirror SM that rotates in at least two rotational directions. For example, the scanning mirror SM can rotate in rotational directions RX, RY that may be defined as rotations about the X-axis and Y-axis, respectively. In some implementations, the scanning mirror SM is implemented by a first mirror that rotates about the RX direction ("RX mirror") and a second mirror that rotates in the RY direction ("RY mirror"). For example, the RX mirror is implemented as a resonant scanner, while the RY mirror is implemented as a relatively slow galvanometer mirror.

[0014] The light reflected from the scanning mirror SM is guided through one or more lenses L1, L2. One or both of the lenses L1, L2 may be mounted on the lens actuator LA. The lens actuator LA moves the position of one or both of the lenses L1, L2 along the optical axis OA of the lenses L1, L2 to change the focal position PZ of the laser diode LD and the therapeutic laser TL along the Z-axis. The Z-axis may be substantially parallel (e.g., within 0.1 degrees) to the optical axis OA. Adjustment of the position PZ may involve changing the focal position PXY in the XY plane using the scanning mirror SM to target any three-dimensional coordinates within the vitreous body of the eye. In some implementation examples, the lenses L1, L2 and the lens actuator LA may be replaced by one or more electronically controlled liquid lenses that can achieve a similar degree of adjustment without using a mechanical actuator. In some embodiments, an electrically adjustable lens L5 can be added between the beam splitter BS2 and the scanning mirror SM. By activating the lens L5, the focal point PXY can be moved to the required depth PZ. As an example, to make the order of magnitude easier to understand, in an average emmetropic eye, an additional 0.36 diopters causes the focal depth PZ to move approximately 1 mm away from the retina. To obtain an appropriate optical resolution, L1, L2 may each be either a single lens or a compound lens system.

[0015] A portion of the light from the focal point PXY of the laser diode LD reflected from the vitreous body passes back through the lenses L2, L1 and is descanned by the scanning mirror SM to the beam splitter BS1. The beam splitter BS1 guides at least a portion of the descanned light to the photodiode PD. As shown explicitly in FIG. 2, the light from the laser diode LD is incident on the beam splitter BS1, and a portion of it passes through and reaches the vitreous body 110.

[0016] In some implementation examples, in order to reduce the detection of light reflected from other structures located outside the focus of the cornea, lens, or laser diode LD, the lens L3 is disposed between the beam splitter BS1 and the photodiode PD. The pinhole PH is disposed between the lens L3 and the photodiode PD and is aligned with the focal point FP of the descanned light to implement the confocal pinhole filter PH. The focal point FP is the focal point of the optical path from the focal point (positions PXY, PZ) of the laser diode in the vitreous body 110 and includes the influence of the lenses L1, L2, and L3. Therefore, light reflected from positions other than PXY and PZ does not reach the pinhole PH in focus and is substantially blocked by the pinhole PH. The diameter of the pinhole PH may be selected to block unwanted reflections while allowing sufficient light to pass through for detection by the photodiode PD. For efficient depth selection, the diameter of the pinhole PH should be close to the diffraction-limited spot diameter of the lens L3 (e.g., the difference in diameters is within 10%). The depth of focus PZ and the pinhole PH are optically conjugate, and the pinhole PH functions as a confocal filter that suppresses light not emitted from the focal points PXY, PZ of the system 200. The lens L3 may be implemented as a single lens or a compound lens system. Therefore, the system 200 can measure the reflectivity of the retina in two dimensions or the reflectivity of floating objects in three dimensions.

[0017] Various elements may include a coupling optical system that routes the light from the therapeutic laser TL to be exactly parallel (e.g., within 0.001 degrees) and collinear (e.g., within 0.01 μm) with the light from the laser diode LD. For example, using the second beam splitter BS2, a portion of the light from the therapeutic laser TL may be redirected to be parallel and collinear with the light from the laser diode LD passing through the second beam splitter BS2. In the illustrated implementation example, the beam splitter BS2 is disposed between the beam splitter BS1 and the scanning mirror SM.

[0018] In the illustrated system 200, there is an advantage that light from the therapeutic laser TL and light from the laser diode LD are accurately focused (with an error within 0.01 μm) at the same positions PXY and PZ regardless of the refraction by the cornea 102 and lens 106 of the patient's eye. Thus, if light is scattered by a point on the float 114 in a predetermined state of the lenses L1, L2, and the scanning mirror SM, the light from the therapeutic laser can pass through the system 200 in the same state as the lenses L1, L2, and the scanning mirror SM to destroy the said point on the float 114. Therefore, if an image of the float is detected by the system 200 and perhaps displayed on the operator's screen, the therapeutic laser is automatically focused on the float. Simultaneous calibration of the focus of the laser diode LD beam and the focus of the therapeutic laser TL beam is not required. The lenses L1, L2, and L5 (when applicable) are selected such that the light diverges greatly after passing through the positions PXY and PZ to reduce the intensity of the light incident on the retina 112. The numerical apertures of the therapeutic laser TL beam and the laser diode LD beam are limited only by the pupil diameter.

[0019] The system 200 may be coupled to a computer system such as a computer system having some or all of the attributes of the computing system 900 described below. The computer system can continuously receive information regarding the output of the photodiode PD and the angular directions of the mirrors from the encoders of the RX and RY mirrors. The position of the depth of focus PZ is given by the encoder of the lens actuator LA. By combining these data, the computing system 900 (see FIG. 9) can continuously create a three-dimensional map of the vitreous body and the float 114. The computer can also display a 2D or 3D image of the front of the float in video format.

[0020] FIG. 3 shows an example of the floating object 114 obtained using the system 200. The illustrated image may include a two-dimensional array of intensity values measured using the photodiode PD for a single depth PZ of the floating object 114 embedded in the vitreous body 110, i.e., the front X / Y image. The image of FIG. 3 is thus an image of a cross-section of the floating object 114 at a given depth PZ. In conventional ophthalmology, SLO is typically used for imaging the retina 112. In such a case, the focal points PXY, PZ are on the retina, i.e., PZ = 0, and SLO measures the reflectance of the laser diode light from the retina. When the floating object 114 is present, the shadow 116 cast by the floating object appears as a dark patch on the image of the retina 112. Conventional SLO can acquire an image of the retina including the shadow 116 cast by the floating object 114 on the retina. However, the system 200 may be inserted into the vitreous body so that the focal plane is away from the retina 112 to enable direct detection of the light reflected from the floating object 114. The front image of the floating object 114 shown in FIG. 3 is one frame of a video captured at 4 frames per second. The video is of a patient dissatisfied with the floating object. The angular size of the scan was 30°×30°, corresponding to a retinal size of 8 mm×8 mm.

[0021] Referring now to FIGS. 4 and 8, the horizontal line in FIG. 4 shows the scanning pattern of the beam of the laser diode LD scanned by the RX and RY scanning mirrors SM. The RX mirror is rotated by a resonant scanner. The angular deflection of the LD laser beam in the X direction is a sine function of time, as shown in FIG. 8. To form the image example of FIG. 3, intervals such as AB, CD, and EF are used to scan the laser spot of the laser diode LD along the X direction from left to right in the range of -4 mm to +4 mm shown in FIG. 8. Intervals such as AB, CD, and EF are approximately 1 / 4 of the full oscillation period of the resonant scanner. In each of these intervals, the deflection speed of the beam can be regarded as approximately constant. Intervals BC, DE, etc. were used to move the beam in the Y direction in steps of 30 μm. The spatial resolution of the suspended matter 114 is extremely good due to the Y-direction step being 30 μm. To form one front X / Y image, 8 mm / 30 μm = 266 horizontal scanning traces were used. Only 54 horizontal scans are shown so that the figure does not become too complicated. The output of the signal of the photodiode PD is ignored by the computing system 900 during periods such as BC and DE. The frame rate of the video was 4 frames per second. Therefore, the oscillation period of the resonant scanner of the RX mirror is 0.25 s / 266. The scanning time of the OD interval (FIG. 8) is approximately 0.25 s / (266 * 8), and the scanning distance is 4 mm. Therefore, the scanning speed is 4 mm * 266 * 8 / 0.25 s = 34 m / s. The resonant scanner of the RX mirror is very likely to be able to achieve this scanning speed. The distances, angles, speeds, and other values in the above examples are merely illustrative. Other values can also be achieved. In particular, the resonant scanner of the RX mirror and the galvo of the RY mirror can operate at speeds slower or faster than those described above.

[0022] Since the slope of the sine wave within the OD interval is not completely constant, it causes distortion of the image along the X direction. By using the characteristics of the sine function, the above-mentioned distortion can be corrected before displaying the front X / Y image. However, the accuracy of laser treatment using the therapeutic laser TL is not affected by the distortion because the imaging and the therapeutic laser beam are scanned by the same system 200.

[0023] The above scanning can be regarded as the design phase of the treatment procedure. In this phase, the x / y position, x / y size and shape of the floating object 114 are determined for all PZ depths using image analysis software known in the art. A plurality of front cross-sectional images of the 3D image of the floating object can be combined and displayed in video format if necessary. In this example (Figs. 4, 5), the x / y size of the orthogonal treatment box is defined to be 2.3 mm × 2.3 mm and the depth is 3 mm. This treatment box BX is a closed surface that completely surrounds the floating object 114. In this example, the treatment box has a rectangular shape, but the shape may be any closed 3D shape corresponding to the actual 3D shape of the floating object.

[0024] Fig. 5 shows an example of the scanning pattern used during the treatment of the floating object 114 by the treatment laser TL. Since the treatment laser TL beam and the laser diode LD beam are scanned by the same scanner, the movement of the treatment laser spot is the same as the movement of the LD laser spot. During treatment, the resonance frequency and the X scanning speed of 34 m / s do not change, but the Y line separation is increased from 30 μm to 300 μm. Thus, the number of horizontal X scanning lines is 27 instead of 266, and the frame rate is increased from 4 frames per second to 40 frames per second. These values are merely exemplary and may change according to the changes in the values used for imaging as described above with reference to Fig. 4.

[0025] For the treatment of the floaters 114, a vertical line pitch of 300 μm was selected for the following reasons. In the experiments conducted by the inventors, it was shown that the floaters can be decomposed by a plurality of 15 μJ laser pulses. The experiments also showed that a 15 μJ laser pulse generates a transient cavitation bubble with a diameter of 370 μm. Thus, by filling the treatment box BX with laser pulses focused on a 300 μm × 300 μm × 300 μm matrix, the floaters 114 can be completely decomposed. To achieve a 300 μm laser spot separation along the X direction, the repetition rate of the treatment laser TL can be made substantially (within 1 Hz) equal to the value obtained by dividing the scanning speed by the laser spot separation, i.e., (34 m / s) / 300 μm = 113 kHz. The typical repetition rate of a CPA laser is about 2 MHz. However, by using an optical deflector or a Pockels cell, pulses can be selected to transmit into the vitreous 110 at the required repetition rate. To separate the 300 um laser spots in the Z direction, it is necessary to activate the depth focusing lens actuator LA between two layers as described above. In the experiments using the system 200, a 300 um Z step was realized by increasing the focusing power of the treatment laser TL beam by about 0.8 diopter. In some embodiments, the laser treatment of the floaters starts from the deepest (closest to the retina 112) Z layer and the treatment is moved stepwise in the forward direction (towards the cornea 102). In this case, the long-lived cavitation bubbles do not prevent the passage of the treatment laser TL beam from reaching the deeper trough portion of the floaters 114. Another advantage of starting from the deepest Z layer is that the longer-lived bubbles partially protect the retina from exposure to the treatment laser TL beam.

[0026] During treatment of the floaters 114, a portion of the TL energy of the treatment laser reaches the retina 112. To avoid retinal damage, the exposure should be kept below the so-called American National Standards Institute (ANSI) maximum permissible exposure (MPE) limit as described in ANSI Z136.1-2014, the full text of which is incorporated by reference. The ANSI-MPE limit depends on laser pulse energy, laser repetition rate, numerical aperture of the focused laser beam, number of laser pulses used, distance in the PZ direction from the retina 112, laser wavelength, laser pulse duration, scanning pattern, and other parameters.

[0027] System 200 may be used for imaging the floaters even during a treatment procedure. However, in the example above, the spatial resolution of the images in the vertical (i.e., Y) direction has decreased from 30 μm to 300 μm. The 300-μm vertical resolution is sufficient to track the slow movement of the floaters 114 during treatment and enable re-aiming of the treatment laser at the floaters.

[0028] In the following description, while understanding that other boundaries may be used similarly, a closed "treatment box BX" is used to identify the boundary. For example, the boundary can be more precisely defined in the form of an oriented box of a rectangle having sides that are not necessarily parallel to the X and Y axes. The boundary may also be a non-rectangular shape that traces the estimated boundary of the portion of the image corresponding to the floaters 114. For example, the perimeter of the blob of pixels within each X / Y image having an intensity exceeding a threshold may be used as the boundary.

[0029] After determining the position, shape, and dimensions of the treatment box BX, the focused therapeutic laser TL beam may be used to scan and treat the vitreous body 110. As already described above, in some embodiments, the vertical scanning pitch of the therapeutic laser TL in the Y direction may be greater than the scanning pitch of the laser diode LD during the imaging phase. For example, the scanning pitch may be 5 to 15 times, e.g., 10 times, greater than the scanning pitch of the laser diode LD. For example, in the illustrated example, the vertical scanning pitch is 300 μm. When scanning with the therapeutic laser TL, the vertical scanning pitch can be increased by, for example, increasing the scanning steps by 10 times during periods such as BC and DE in the Y direction (FIG. 8) to increase the vertical scanning pitch from 30 μm to 300 μm. As described above, the vertical scanning pitch may be selected based on the diameter of the cavitation bubbles.

[0030] Referring to FIG. 6, during treatment, the vitreous body 110 is scanned transversely in three dimensions with the therapeutic laser TL. At each depth position PZ, the therapeutic laser TL is turned off at all positions PXY outside the treatment box BX obtained from the X / Y image at the current depth position PZ. At the PXY positions within the boundary box BX, the therapeutic laser TL is turned on and pulses from the therapeutic laser TL selectively reach the vitreous body 110 to destroy the floating objects 114. The laser "on" and laser "off" transition points are indicated by arrows in FIG. 6.

[0031] If a plurality of floating objects 114 are detected during the imaging phase, a plurality of treatment boxes BX can be defined. The plurality of floating objects 114 can be treated one by one starting from the deepest floating object or all at once. In this way, long-lived cavitation bubbles do not cast a shadow on the floating objects at deep positions.

[0032] Referring to FIG. 7, pulses from the treatment laser TL incident on points PXY and PZ in the vitreous body generate momentary cavitation bubbles that decompose a part of the floating matter located near points PXY and PZ. As described above, the horizontal pulse pitch at which the pulses can reach the vitreous body 110 may be selected based on the estimated diameter of the cavitation bubbles. Similarly, the vertical scanning pitch in the Y direction and the depth scanning pitch in the Z direction may also be selected based on the estimated diameter of the cavitation bubbles. For example, the horizontal pulse pitch, the vertical scanning pitch, and the depth scanning pitch may be selected to be 0.5 to 1.5 times, 0.7 to 1.3 times, or 0.9 to 1.1 times the estimated cavitation bubble diameter. For example, the horizontal pulse pitch may be selected between 0.1 and 0.4 mm. The previous paragraph describes an algorithm for selecting treatment parameters. These parameters depend on the volume and shape of the floating matter 114 and the energy of the laser pulses used, which determines the size of the cavitation bubbles.

[0033] Some synchronization is required between the scanning by the scanning mirror SM and the activation and pulse selection of the treatment laser TL. Assuming a 2 MHz regenerative amplifier, the spatial accuracy of the treatment laser TL is (34 m / s) / (2 MHz) = 17 μm. Since this spatial accuracy is only 4.6% of the diameter of the cavitation bubbles (370 μm), it is completely satisfactory.

[0034] The above parameters and calculations are merely exemplary. The parameters depend on the size and shape of the floaters 114, as well as the laser pulse energy, the resonant frequency of the scanner, etc. The following shows the range of parameters that can be used for the therapeutic laser TL and the laser diode LD. The pulse duration of the therapeutic laser TL may be from 10 ps to 50 fs, the repetition rate of the therapeutic laser may be between 1 kHz and 2 MHz, the wavelength of the therapeutic laser TL may be from 650 nm to 2 μm, the pulse energy of the therapeutic laser TL for the target may be 1 to 50 μJ, 5 to 25 μJ, or 10 to 20 μJ. The spatial separation of the laser treatment spots along the X scanning direction is from 10 μm to 1 mm. The vertical scanning pitch during imaging using the laser diode LD is from 5 μm to 200 μm, the vertical scanning pitch of the therapeutic laser TL is from 30 μm to 1 mm, the depth scanning pitch of the therapeutic laser TL is from 30 μm to 1 mm, and the frame rate during imaging by the laser diode LD may be from 0.5 to 25 frames / second.

[0035] Various improvements may be made to improve the accuracy of the approach described above. The floaters may be motile and would move in response to the impulsive movements of the eye 100. Thus, the patient may be instructed to fixate on a stationary target for at least 2 seconds before and during imaging and treatment so that the position of the floaters 114 does not change during imaging and treatment.

[0036] As the name "floaters" suggests, the floaters 114 can move within the space. If the line of sight is fixed, this movement becomes quite slow, such as from 0.02° per second to 0.1° per second. With the system 200 being able to image the floaters 114 even during laser treatment in mind, the system 200 can constantly track this movement and be programmed to change the position of the treatment box BX during treatment according to the tracked movement.

[0037] As the debris 114 is decomposed, the debris 114 may move due to the expansion of the cavitation bubbles. Similarly, the debris 114 may shift due to the buoyancy of the cavitation bubbles. The system 200 can be programmed to track these movements during treatment and appropriately change the position of the treatment box BX in response to this movement during treatment.

[0038] If the line of sight is fixed, there occur minute, high-speed, and spatially disordered eye movements called microtremors. The purpose of microtremors is to avoid image attenuation. The amplitude of microtremors can reach about 0.8°, the duration can be about 0.012 seconds, the frequency can be about 0.9 per second, and the angular velocity can reach 40° per second. Tracking these fast and short movements with an eye tracker to move the treatment box BX can be extremely difficult technically. Therefore, the treatment box BX may be made about 0.5 mm larger than the actual size of the debris 114 in all of the X, Y, and Z directions.

[0039] Beam multiplexing can be used to increase the removal rate of debris. Beam multiplexing means optically modifying a single beam of the treatment laser TL beam to provide not only one but also a plurality of focused laser spots simultaneously. Multiplexing can be achieved in the X / Y plane, in the Z direction, or a combination of these. Multiplexing can be realized by optical elements incorporated in the system 200, such as diffractive optical elements, spatial phase modulators, birefringent optical components, or different types of interferometers. These optical elements may be arranged between the scanning mirror SM and the lens actuator LA. For example, each beam emitted from these elements may be focused by a different set of lenses and corresponding lens actuators.

[0040] FIG. 9 shows an exemplary computing system 900 that at least partially implements one or more of the functions described herein with respect to FIGS. 1 - 8. The computing system 900 may be integrated with an imaging device such as the system 200 or may be a separate computing device that receives an image of a patient's eye from the imaging device.

[0041] As shown, computing system 900 includes a central processing unit (CPU) 902, one or more I / O device interfaces 904 that can connect various I / O devices 914 (e.g., keyboard, display, mouse device, pen input, etc.) to computing system 900, and a network interface 906 for connecting computing system 900 to network 990, memory 908, storage 910, and interconnect 912.

[0042] When computing system 900 is an imaging system such as system 200, computing system 900 may further include one or more optical elements for performing ophthalmic imaging of a patient's eye, and any other elements known to those skilled in the art.

[0043] CPU 902 can retrieve and execute programming instructions stored in memory 908. Similarly, CPU 902 can retrieve and store application data within memory 908. Interconnect 912 transfers programming instructions and application data between CPU 902, I / O device interface 904, network interface 906, memory 908, and storage 910. CPU 902 is included to represent a single CPU, multiple CPUs, or a single CPU having multiple processing cores.

[0044] Memory 908 represents volatile memory such as random access memory and / or non-volatile memory such as non-volatile random access memory, phase change random access memory. As shown, memory 908 can store a scanning module 916 configured to image the vitreous body 110 of a patient's eye in system 200 as described above. Memory 908 can further store a treatment module 918 configured to control system 200 to destroy floaters as described above.

[0045] Storage 910 may be a non-volatile memory such as a disk drive, a solid state drive, or a group of storage devices distributed across multiple storage systems. Storage 910 can optionally store the X / Y image 920 obtained using system 200 for subsequent processing to identify the boundaries of the floating matter as described above.

[0046] Additional Considerations The above description has been provided so that those skilled in the art can implement the various embodiments described herein. Various changes to these embodiments will be readily apparent to those skilled in the art, and the general principles defined herein can be applied to other embodiments. For example, changes may be made to the functions and arrangements of the elements discussed without departing from the scope of the present disclosure. In various examples, various procedures or elements may be omitted, substituted, or added as necessary. The features described with respect to some examples may be combined in some other examples. For example, an apparatus may be implemented or a method may be executed using any number of the aspects described herein. Also, the scope of the present disclosure is intended to cover, in addition to the various aspects of the disclosure described herein, or in lieu thereof, similar apparatuses or methods implemented using structures, functions, or a combination of structures and functions. It should be understood that any aspect of the disclosure disclosed herein may be implemented by one or more of the elements recited in the claims.

[0047] As used herein, the phrase referring to a list of items "at least one of" refers to any combination of those items including a single member. By way of example, "at least one of a, b, or c" is intended to cover not only a, b, c, a-b, a-c, b-c, and a-b-c, but also any combination with multiple identical elements (e.g., a-a, a-a-a, a-a-b, a-a-c, a-b-b, a-c-c, b-b, b-b-b, b-b-c, c-c, and c-c-c or any other arbitrary order of a, b, and c).

[0048] As used herein, the term "determining" encompasses a wide range of operations. For example, "determining" may include calculating, computing, processing, deriving, investigating, querying (e.g., querying a table, database, or other data structure), validating, etc. Further, "determining" may also include receiving (e.g., receiving information), accessing (e.g., accessing data in a memory), etc. Still further, "determining" may also include resolving, selecting, choosing, establishing, etc.

[0049] The methods disclosed herein include one or more steps or operations for implementing the methods. The method steps and / or operations may be interchangeable with each other without departing from the claims. In other words, the order and / or use of specific steps and / or operations may be changed without departing from the claims, unless a specific order of the steps or operations is specified. Further, the various operations of the methods described above may be performed by any suitable means capable of performing the corresponding functions. These means may include, but are not limited to, circuits, application specific integrated circuits (ASICs), or processors, and may include various hardware and / or software elements (groups) and / or modules (groups). Generally, where there are operations shown in the drawings, those operations may include corresponding means-plus-function elements with similar numbers.

[0050] Various illustrative logical blocks, modules, and circuits described in connection with the present disclosure may be implemented or executed by a general purpose processor, a digital signal processor (DSP), an application specific integrated circuit (ASIC), a field programmable gate array (FPGA) or other programmable logic element (PLD), discrete gate or transistor logic, discrete hardware elements, or any combination thereof designed to perform the functions described herein. The general purpose processor may be a microprocessor, but in the alternative, the processor may be any commercially available processor, controller, microcontroller, or state machine. The processor may also be implemented as a combination of computing devices, such as a combination of a DSP and a microprocessor, a plurality of microprocessors, one or more microprocessors working in conjunction with a DSP core, or any other such configuration.

[0051] The processing system may be implemented in a bus architecture. The bus may include any number of interconnecting buses and bridges depending on the specific application of the processing system and the overall design constraints. The bus may, in particular, interconnect various circuits including a processor, a machine-readable medium, and an input / output device. A user interface (e.g., keypad, display, mouse, joystick, etc.) may also be connected to the bus. The bus may also connect various other circuits known in the art and thus not described further herein, such as a timing source, peripherals, voltage regulators, power management circuits, etc. The processor may be implemented with one or more general purpose and / or dedicated processors. By way of example, microprocessors, microcontrollers, DSP processors, and other circuits capable of executing software are included. Those of skill in the art will recognize how best to implement the described functions of the processing system depending on the particular application and the overall design constraints imposed on the overall system.

[0052] When implemented in software, the above-described functions may be stored or transmitted as one or more instructions or codes on a computer-readable medium. Software is to be construed broadly to mean instructions, data, or any combination thereof, regardless of how it is called, such as software, firmware, middleware, microcode, a hardware description language, or the like. The computer-readable medium includes both computer storage media and communication media, such as any medium that facilitates transfer of a computer program from one place to another. The processor may play a role in managing buses and general processing, including execution of software modules stored on a computer-readable storage medium. The computer-readable storage medium may be coupled to the processor such that the processor can read information from, and write information to, the storage medium. Alternatively, the storage medium may be integrated into the processor. As an example, the computer-readable medium may include a transmission line, a carrier wave modulated by data, and / or a computer-readable storage medium in which instructions are stored separately from a wireless node, all of which may be accessed from the processor via a bus interface. Alternatively or additionally, the computer-readable medium, or any portion thereof, may be integrated into the processor, as in the case of a cache and / or a general-purpose register file. Examples of machine-readable storage media include, for example, RAM (Random Access Memory), flash memory, ROM (Read Only Memory), PROM (Programmable Read Only Memory), EPROM (Erasable Programmable Read Only Memory), EEPROM (Electrically Erasable Programmable Read Only Memory), registers, magnetic disks, optical disks, hard drives, or any other suitable storage medium or any combination thereof. The machine-readable medium may be implemented in a computer program product.

[0053] A software module may contain a single instruction or multiple instructions, and may be distributed across several different code segments, across different programs, and across multiple storage media. A computer-readable medium may contain a number of software modules. A software module, when executed by an apparatus such as a processor, contains instructions that cause a processing system to perform various functions. A software module may contain a transmission module and a reception module. Each software module may reside in a single storage device or may be distributed across multiple storage devices. For example, when a trigger event occurs, a software module may be loaded from a hard drive into RAM. During the execution of a software module, the processor may load a portion of the instructions into a cache to increase the access speed. Then one or more cache lines may be loaded into the general-purpose register file for execution by the processor. When referring to the functions of a software module, it should be understood that such functions are realized by the processor when executing the instructions from the software module.

[0054] The following claims are not limited to the embodiments shown in this specification, but shall follow the full scope consistent with the language of the claims. In the claims, when an element is referred to in the singular, it does not mean "only one" unless specifically stated otherwise, but means "one or more". Unless specifically stated otherwise, the term "some" refers to one or more. No element of any claim shall be construed under the provisions of 35 U.S.C. § 112(f) unless the element is expressly recited using the phrase "means for" or, in the case of a method claim, the element is recited using the phrase "step of". All structural and functional equivalents of the elements of the various aspects described throughout this disclosure, known or later to be known to those skilled in the art, are hereby expressly incorporated by reference into this specification and are intended to be included in the claims. Further, the disclosure of this specification is not intended to be dedicated to the public whether or not such disclosure is expressly recited in the claims.

Claims

1. A three-dimensional scanner, a first laser for imaging vitreous floaters, a second laser configured to emit pulses sufficient to decompose the vitreous floaters, and one or more coupling optical systems configured to guide first light from the first laser and second light from the second laser to the three-dimensional scanner, wherein the one or more coupling optical systems are configured to place a second focus of the second laser within 0.01 μm of the second focus of the second laser.

2. The system according to claim 1, wherein the three-dimensional scanner includes a mirror driven by a resonant scanner.

3. The system according to claim 2, wherein the three-dimensional scanner includes one or more adjustable lenses.

4. The system according to claim 3, wherein the one or more adjustable lenses include one or more lenses mounted on an actuator.

5. The system according to claim 3, wherein the one or more adjustable lenses include electro-optically adjustable fluidic lenses.

6. The system according to claim 2, wherein the one or more coupling optical systems include one or more beam splitters arranged to receive the first light from the first laser and the second light from the second laser.

7. The one or more beam splitters, include a first beam splitter configured to pass a first portion of the first light and direct a second portion of the second light parallel to the first portion. The system according to claim 6.

8. The one or more beam splitters, include a second beam splitter arranged between the first beam splitter and the first laser, the second beam splitter being configured to direct a third portion of the first light reflected from the vitreous floaters to a photodiode. The system according to claim 7.

9. The system according to claim 8, further including a confocal pinhole filter arranged between the second beam splitter and the photodiode.

10. The system according to claim 9, further including a lens arranged between the second beam splitter and the confocal pinhole filter, the focus of the third portion of the first light being arranged at the confocal pinhole filter.

Images