Ophthalmic apparatus

Abstract

To provide an ophthalmologic apparatus capable of obtaining a brighter and clearer examination image.SOLUTION: A slit lamp microscope 100 includes a background illumination system 60, an imaging unit 50, and a control unit 20. The controller 20 includes an examination image generator 21 configured to generate an examination image of the subject's eye E based on the image captured by the imaging unit 50. The examination image generation unit 21 includes an image acquisition unit 24 that acquires, from the imaging unit 50, a plurality of images obtained by imaging the subject's eye E while changing the illumination direction of the illumination light with respect to the subject's eye E, an image extraction unit 25 that extracts a focused portion as a partial image from the plurality of images acquired by the image acquisition unit 24, and an image synthesis unit 26 that synthesizes the plurality of partial images extracted by the image extraction unit 25 to generate an examination image.SELECTED DRAWING: Figure 2

Description

[Technical Field]

[0001] The present disclosure relates to ophthalmic devices. [Background technology]

[0002] Conventionally, there are known ophthalmologic devices that capture an image of a subject's eye illuminated with illumination light using an imaging unit to obtain an examination image of the subject's eye (see, for example, Patent Documents 1 and 2). Patent Document 1 discloses a technique for illuminating the back of the subject's eyelid with infrared light and capturing an image of the meibomian glands present on the back of the eyelid with the imaging unit. Patent Document 2 discloses a technique for generating a high-contrast image by combining or subtracting a surface meibography image of the eyelid obtained when the inner surface of the eyelid is irradiated with infrared light and an IR trans-illumination image obtained when infrared light is trans-illuminated from the outer surface of the patient's eyelid. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] Patent Publication No. 2021-83657 [Patent Document 2] Patent No. 6615748 Summary of the Invention [Problem to be solved by the invention]

[0004] However, because the subject's eye is three-dimensional and the surface of the eyelid, especially when it is everted, is uneven, some parts are out of focus and are blurred, and some parts are dark because of the shadow of the convex parts. Also, bright spots reflected by the illumination light from the subject's eye or surrounding components may appear in the image. For this reason, it is difficult to obtain a clear image of the subject's eye that is bright overall and does not include bright spots or other imperfections.

[0005] The present disclosure has been made in light of the above-mentioned problems, and aims to obtain a brighter and clearer image of the subject's eye. [Means for solving the problem]

[0006] To achieve the above object, the ophthalmologic apparatus of the present disclosure includes an illumination unit that illuminates an eye to be examined with illumination light, an imaging unit that captures images of the eye to be examined, and a control unit that controls the illumination unit and the imaging unit. The control unit includes a test image generation unit that generates a test image of the eye to be examined based on images captured by the imaging unit. The test image generation unit includes an image acquisition unit that acquires, from the imaging unit, multiple images of the eye to be examined while changing the illumination direction of the illumination light relative to the eye to be examined, an image extraction unit that extracts in-focus portions as partial images from the multiple images acquired by the image acquisition unit, and an image synthesis unit that synthesizes the multiple partial images extracted by the image extraction unit to generate the test image. [Effects of the Invention]

[0007] The ophthalmologic apparatus configured in this way extracts in-focus portions of multiple images of the subject's eye that are free of glare such as bright spots, and then synthesizes the extracted partial images to generate a test image, thereby obtaining a brighter and clearer test image. [Brief explanation of the drawings]

[0008] [Figure 1] 1 is a right side view showing the overall configuration of a slit lamp microscope of Example 1, and a perspective view of the vicinity of a power supply unit. FIG. [Figure 2] FIG. 2 is a block diagram showing the configuration of a control system of the slit lamp microscope of the first embodiment. [Figure 3] FIG. 2 is a rear view of the vicinity of the background light switching unit of the slit lamp microscope of Example 1. [Figure 4] 1A and 1B are diagrams showing the background illumination system of the slit lamp microscope of Example 1, in which (a) is a plan view and (b) is a front view. [Figure 5] 10A and 10B are explanatory diagrams for explaining the process of generating an inspection image in an inspection image generating unit. [Figure 6] 4 is a flowchart for explaining an example of the operation of the slit lamp microscope of the first embodiment. [Figure 7]FIG. 10 is a plan view of the background illumination system of the slit lamp microscope of the second embodiment. [Figure 8] FIG. 10 is a right side view showing the overall configuration of the slit lamp microscope of Example 3. [Figure 9] FIG. 10 is a front view of the background illumination system of the slit lamp microscope of the third embodiment. [Figure 10] 10 is a flowchart for explaining an example of the operation of the slit lamp microscope of the third embodiment. [Figure 11] 10A and 10B are diagrams showing the background illumination system of a slit lamp microscope according to a fourth embodiment, in which (a) is a plan view and (b) is a front view. DETAILED DESCRIPTION OF THE INVENTION

[0009] Example 1 A slit lamp microscope 100 according to Example 1, which is an embodiment of an ophthalmic apparatus according to the present disclosure, will be described as follows with reference to Figs. 1 to 6. The slit lamp microscope 100 shown in Fig. 1 is an ophthalmic apparatus that obtains an image of a cross section of the cornea by cutting out an optical slice of the cornea of ​​an eye E to be examined using slit-shaped illumination light, and is also referred to as a "slit lamp microscope." Hereinafter, the slit-shaped illumination light may be referred to as "slit light."

[0010] 1 and 2, the slit lamp microscope 100 of the first embodiment mainly comprises a main body 10 and a control unit 20. The main body 10 is connected to a personal computer (PC) 80 via a communication cable 2.

[0011] In the first embodiment, the control unit 20 is provided in the PC 80 located near the main body unit 10, but the present invention is not limited to this configuration. As a modified example, the control unit 20 may be provided in an external device such as a personal computer connected to the main body unit 10 via a communication network or a cloud server. The control unit 20 may also be provided in the main body unit 10, for example, inside the pedestal 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. This slit lamp microscope 100 is a relatively compact ophthalmic device because the illumination system 30 is arranged below the observation system 40. Note that the slit lamp microscope 100 is not limited to the Zeiss-type. 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 10 is installed on the optical bench 1. The main body 10 mainly comprises an illumination system 30, an observation system 40, an imaging unit 50, a background illumination system 60, and a power supply unit 70. The main body 10 further comprises a base 11 fixed to the upper surface of the optical bench 1, a mount unit 12 provided on the upper surface of the base 11, a movement mechanism 13 that moves the mount unit 12 in the left-right direction, a support unit 14 provided on the upper surface of the mount unit 12, a face support unit 15 supported by the base 11, and a pair of grip units 16 provided on both left-right sides of the base 11.

[0014] The stand unit 12 includes a stand 12a, a dimming knob 12b, an operation lever 12c, and a photographing button 12d provided on the upper surface of the operation lever 12c. The stand unit 12 is movable relative to the base 11 in the front-to-back and left-to-right directions as viewed from the subject's eye E by a movement mechanism 13. The movement mechanism 13 includes a slide rod 13a inserted through the stand 12a and a pair of fixing portions 13b that support both ends of the slide rod 13a so that the slide rod 13a can move in the front-to-back direction. In this specification, the front direction of the front-to-back direction is the direction approaching the subject, and the rear direction is the direction away from the subject and toward the examiner. The left direction of the left-to-right direction is the direction of the subject's left hand, and the right direction is the direction of the subject's right hand.

[0015] The operating lever 12c is a component for issuing instructions for moving the pedestal unit 12, etc. The photographing button 12d is a component for issuing photographing instructions to the imaging unit 50. The operating lever 12c and the photographing button 12d are electrically connected to the control unit 20. An examiner, who is a user of the slit lamp microscope 100, grasps the operating lever 12c and moves it back and forth, left and right, thereby causing the movement mechanism 13 to move the pedestal unit 12 and a section (within the dashed-dotted line area A in FIG. 1 ) arranged above the pedestal unit 12, including the illumination system 30, the observation system 40, the imaging unit 50, and the background illumination system 60, in the back and forth, left and right directions. This movement of the pedestal unit 12 changes the photographing direction and / or photographing position of the subject's eye E by the imaging unit 50 provided on the pedestal unit 12.

[0016] When the examiner tilts the operating lever 12c, the control unit 20 controls the observation system 40 to focus in accordance with the amount and direction of operation. When the examiner rotates the operating lever 12c around its axis, the support unit 14 provided on the upper surface of the pedestal unit 12 moves up and down by an elevating mechanism (not shown) in accordance with the amount and direction of operation. This movement allows the section including the illumination system 30, observation system 40, imaging unit 50, and background illumination system 60 arranged above the pedestal unit 12—more specifically, the area within the dashed-dotted line A in FIG. 1—to move up and down together with the support unit 14. This vertical movement of the imaging unit 50 also changes the imaging direction and / or imaging position of the subject's eye E in the imaging unit 50. When the examiner presses the imaging button 12d, the control unit 20 controls the imaging unit 50 to capture an image of the subject's eye E.

[0017] The light control knob 12b is a member that allows the examiner to turn on and off the slit light of the illumination system 30 and adjust the brightness (light amount). When the examiner rotates the light control knob 12b, the illumination system 30 is turned on or off under the control of the control unit 20, and when the illumination system 30 is turned on, the brightness of the slit light of the illumination system 30 is continuously and freely changed according to the amount and direction of operation from the off position.

[0018] The support unit 14 mainly supports the illumination system 30, the observation system 40, the imaging unit 50, and the background illumination system 60, which serves as an illumination unit. The support unit 14 includes a base 14a, a first support arm 14b, and a second support arm 14c. The base 14a is provided on the upper surface of the mount 12a. The first support arm 14b and the second support arm 14c stand upright from the base 14a. The first support arm 14b and the second support arm 14c are each independently rotatable in the horizontal direction around a coaxial vertical axis (not shown).

[0019] An illumination system housing 31 that houses the optical members of the illumination system 30 is attached to the upper portion of the first support arm 14b, and supports the illumination system 30. A background illumination system 60 is attached to the upper portion of the illumination system 30. The first support arm 14b also supports the background illumination system 60. The first support arm 14b can be rotated manually. Rotation of the first support arm 14b causes the illumination system housing 31 to revolve around the subject's eye. This changes the direction of irradiation of the slit light with respect to the subject's eye. The first support arm 14b may also be rotated up and down, in which case the elevation angle and depression angle of the slit light with respect to the subject's eye are changed.

[0020] An observation system housing 41 that houses the optical members of the observation system 40 is attached to the upper part of the second support arm 14c, and supports the observation system 40. The second support arm 14c also supports the imaging unit 50 that is attached below the observation system 40. The second support arm 14c is manually rotated. By rotating the second support arm 14c, the observation system 40 and the imaging unit 50 revolve around the first support arm 14b. This changes the observation direction of the observation system 40 and the imaging unit 50 relative to the subject's eye E.

[0021] The first support arm 14b and the second support arm 14c house power cables for supplying power to the illumination system 30, the imaging unit 50, the background illumination system 60, and the like.

[0022] The first support arm 14b and the second support arm 14c may be configured to rotate automatically by electricity. In this case, the support unit 14 includes an actuator that generates a driving force to rotate the first support arm 14b and the second support arm 14c, and a transmission mechanism that transmits this driving force. For example, a stepping motor (pulse motor) is used as the actuator. For example, a combination of gears or a rack and pinion is used as the transmission mechanism.

[0023] The face support unit 15 is disposed in front of the observation system 40 and faces the observation system 40. The face support unit 15 includes a chin rest 15a on which the subject's chin is placed, and a forehead rest 15b on which the forehead is placed. In Example 1, the examiner operates the slit lamp microscope 100 to observe the subject's eye, etc., while the subject faces the optical table 1 and places his / her face in contact with the chin rest 15a and forehead rest 15b.

[0024] The face support unit 15 is also provided with a detachable fixation unit 17 used for external fixation. The fixation unit 17 includes a fixation lamp holder 17a made of a flexible arm, and an external fixation lamp 17b (e.g., an LED light source) that is provided at the tip of the fixation lamp holder 17a and emits fixation light. The fixation unit 17 can arbitrarily adjust the position of the external fixation lamp 17b and the emission direction of the fixation light using the fixation lamp holder 17a. The fixation unit 17 can guide the line of sight of the subject's eye E using the external fixation lamp 17b, and adjust the direction of the subject's eye E.

[0025] The pair of gripping parts 16 are members that the subject holds with both hands when undergoing an examination. By gripping these gripping parts 16, the subject can stabilize their body and maintain a stable posture, allowing them to undergo the examination appropriately.

[0026] The illumination system 30 irradiates slit light toward the subject's eye E. The illumination system 30 mainly comprises a slit lamp (e.g., an LED light source) 32 housed in an illumination system housing 31, and a deflection optical system 33. The illumination system 30 may also comprise an exciter filter, a diffuser plate, etc. (not shown) selectively arranged on the optical path of the illumination system 30. The exciter filter, in combination with a barrier filter, enables fluorescent observation of the cornea of ​​the subject's eye E. The diffuser plate diffuses the illumination light emitted from the slit lamp 32, allowing observation of a wider range of the subject's eye E.

[0027] 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 configured with a prism. The deflection optical element 34 deflects the slit light irradiated from the slit lamp 32 toward the subject's eye E. This causes the slit light to be irradiated onto the subject's eye E. Note that the deflection optical element 34 is not limited to a prism, but may be configured with a reflective member such as a reflective mirror, and may deflect the slit light by reflecting it toward the subject's eye E. Furthermore, the slit lamp 32 and the deflection optical system 33 are not limited to the configurations in 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.

[0028] The slit lamp 32 is connected to the control unit 20 via a USB cable (not shown) or the like, and its on / off control is controlled by the control unit 20. The brightness of the slit light emitted from the slit lamp 32 is changed by operating the dimming knob 12b provided on the stand 12a, as described above. The width of the slit light is changed by the examiner operating the slit opening / closing knob 37 provided on the illumination system 30. The slit light is light in which the irradiation area is formed in a band shape by blocking part of the irradiation area, and is slit-shaped illumination light for observing the cornea and fundus of the examinee's eye E.

[0029] The observation system 40 is a so-called microscope used to observe the return light from the subject's eye E. The return light is also called "reflected light." Here, the "return light" includes not only slit light and background light reflected by the subject's eye, but also various types of light, such as scattered light from the subject's eye and its surroundings. In the first embodiment, these various types of light are referred to as "return light." As described above, the observation system 40 is attached to the upper part of the second support arm 14c, and an observation optical system 42 that guides the return light from the subject's eye E is housed in the observation system housing 41. The observation system housing 41 in the first embodiment includes a first observation system housing 41a disposed on the front side of the second support arm 14c, which is the subject's side, and a second observation system housing 41b disposed on the rear side of the second support arm 14c, which is the examiner's side.

[0030] The observation optical system 42 includes one 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 subject's eye E. The pair of left and right eyepieces 45 each include an eyepiece 45a that faces the examiner's left and right eyes e. The pair of left and right relay optical systems 44 each include optical components such as a variable magnification optical system, an aperture, and a prism unit (not shown). The objective lens 43 and part of the relay optical system 44, such as the variable magnification optical system and aperture, are housed in the first observation system housing 41a, while the remainder of the relay optical system 44, such as the prism unit, and the eyepieces 45, are housed in the second observation system housing 41b. Note that the entire relay optical system 44 may be housed in either the first observation system housing 41a or the second observation system housing 41b.

[0031] The examiner can observe the subject's eye E with the naked eye by looking into the pair of eyepieces 45. Furthermore, 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.

[0032] The imaging unit 50 is detachably or fixedly attached to the second support arm 14c of the main body 10. The imaging unit 50 is attached to the rear side of the second support arm 14c, which is the side facing the examiner.

[0033] The imaging unit 50 receives the return light from the subject's eye E and captures an image of the subject's eye E. The imaging unit 50 is composed of, for example, a digital camera. The imaging unit 50 includes an imaging element 52 (see FIG. 2) housed in an imaging unit housing 51. The imaging unit 50 also includes components typically found in digital cameras, such as an imaging optical system that collects a portion of the return light from the subject's eye 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, and a memory for recording images (all of which are not shown). The imaging optical system shares a pair of relay optical systems 44, one on the left and one on the right, with the objective lens 43 of the observation system 40. A portion of the return light that passes through the objective lens 43 is guided to the imaging element 52 by a prism unit of the relay optical system 44. 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.

[0034] The imaging element 52 is a photoelectric conversion element that detects the return light guided by the imaging optical system, converts it into an electric signal (image signal), and outputs it. The imaging element 52 may be, for example, a CCD (Charge Coupled Device) image sensor or a CMOS (Complementary Metal Oxide Semiconductor) image sensor.

[0035] The imaging element 52 is capable of outputting 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 a storage unit 84 within the PC 80. The imaging element 52 also outputs an 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. In other words, the imaging unit 50 is capable of live viewing.

[0036] The imaging unit 50 is electrically connected to the photographing button 12d. When the photographing button 12d is pressed, the imaging unit 50 starts acquiring an image of the subject's eye E using the image sensor 52. The examiner operates the operation lever 12c to move the imaging unit 50 in the front-to-back and left-to-right directions together with the base unit 12 and in the up-to-down direction together with the support unit 14. This movement changes the photographing angle and / or photographing position of the imaging unit 50, and the subject's eye E is photographed at the changed position.

[0037] The imaging unit 50 of Example 1 can capture an infrared image of the meibomian glands by capturing an image of the everted eyelid illuminated with infrared light from the background illumination system 60. The meibomian glands are organs located behind the eyelids of the subject's eye E. The imaging unit 50 of Example 1 can also capture visible light images of the anterior segment, fundus, and other components of the subject's eye E by capturing an image of the subject's eye E illuminated with visible light from the background illumination system 60. When the examiner presses the image capture button 12d during this imaging, the imaging unit 50 automatically captures infrared or visible light images continuously for a predetermined imaging time at predetermined time intervals, i.e., captures a series of still images of the infrared or visible light images. The predetermined time interval can be set as appropriate depending on the performance and needs of the imaging unit 50. For example, the time interval can be set to capture 1 to 20 still images per second (frames / second), more preferably 3 to 18 still images. In addition, the images captured by the imaging unit 50 are not limited to still images but may also be moving images, and all frames in the moving image or multiple frames selected from these may be the images input to the control unit 20.

[0038] 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, 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.

[0039] The imaging unit 50 includes a background light switching unit 53. The background light switching unit 53 is a component that allows the examiner to turn on or off the background illumination system 60, switch the background light, and adjust the brightness (light intensity). 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 applied to the subject's eye E and an infrared light mode in which infrared light is applied to the subject's eye E. The background light switching unit 53 is not limited to being provided in the imaging unit 50, but may also be provided in the pedestal 12 or the support 14. The infrared light mode or the visible light mode may be set in advance as a default program or parameter, and the control unit 20 may select or switch between the visible light mode or the infrared light mode based on this setting. A dedicated imaging mode button for capturing images in the infrared light mode or the visible light mode may also be provided on the screen displayed on the display unit of the PC 80.

[0040] The background light switching unit 53 is electrically connected to the background illumination system 60. As shown in FIGS. 1 and 3, the background light switching unit 53 is provided on one surface of the imaging unit housing 51, below the rear side that faces the examiner. The background light switching unit 53 is provided with a marker 53a for indicating the rotation position. The 12 o'clock position above the background light switching unit 53 on one surface of the imaging unit housing 51 is an off position 54a that indicates the off position of the background illumination system 60.

[0041] A predetermined range in the clockwise direction from the off position 54a is the range in which visible light is irradiated from the background illumination system 60 and the brightness thereof can be adjusted. The imaging unit housing 51 has the letters "BG" displayed at a visible light maximum position 54b, where the brightness of the visible light is at its maximum. Furthermore, a predetermined range in the counterclockwise direction from the off position 54a is the range in which infrared light is irradiated from the background illumination system 60 and the brightness thereof can be adjusted. The imaging unit housing 51 has the letters "IR" displayed at an infrared light maximum position 54c, where the brightness of the infrared light is at its maximum.

[0042] As shown in the upper view of Fig. 3, when the marker 53a is at the off position 54a, the background light source unit 62 is turned off. As shown in the right view of Fig. 3, when the examiner rotates the background light switching unit 53 clockwise, visible light of a brightness corresponding to the amount of rotation, i.e., the amount of operation, is emitted from the background light source unit 62. On the other hand, as shown in the left view of Fig. 3, when the examiner rotates the background light switching unit 53 counterclockwise, infrared light of a brightness corresponding to the amount of rotation is emitted from the background light source unit 62.

[0043] The background illumination system 60 illuminates the area surrounding the illumination area of ​​the slit light emitted from the illumination system 30, in other words, the surrounding area or the subject's eye E, with background light. The background illumination system 60 is attached to the front side of the first support arm 14b, which faces the subject, and below the deflection optical element 34. The illumination area by the background illumination system 60 only needs to include at least the surrounding area, and may partially overlap with the illumination area by the illumination system 30. As shown in FIGS. 1 and 4, the background illumination system 60 mainly includes a background illumination housing 61, multiple background light source units 62, and optical components such as a condenser lens (not shown).

[0044] The background illumination system 60 of Example 1 has five background light source units 62, namely, a first background light source unit 62a, a second background light source unit 62b, a third background light source unit 62c, a fourth background light source unit 62d, and a fourth background light source unit 62e. As shown in FIG. 4 , these five background light source units 62 are arranged in an arc shape at intervals of approximately 45° around the subject's eye E, centered on an axis that is substantially coaxial with or parallel to the axis of rotation of the subject's eye E and extends vertically through the point of rotation of the subject's eye E. Therefore, the background illumination system 60 can illuminate the subject's eye E from a direction of approximately 180°. Note that the arrangement angle of the background light source units 62 is not limited to 45° intervals, and they can be arranged at appropriate angles, such as 15° intervals or 30° intervals, depending on the purpose of imaging, the size of the device, and the like. The number of background light source units 62 is also not limited to five, and can be any number depending on the arrangement angle. Alternatively, the arrangement of the background light valve section 62 is not limited to an arc shape, and it can be arranged as appropriate so that the illumination direction is appropriate.

[0045] 4, each background light source unit 62 has a visible light source 621 that emits visible light, which is a type of background light, and a pair of infrared light sources 622 on either side of it that emit infrared light, which is also a type of background light. Turning on, switching, and adjusting the brightness of the visible light and infrared light emitted from each background light source unit 62 are performed by operating the above-mentioned background light switching unit 53. The visible light is used for naked-eye observation and photography of the anterior segment, fundus, etc. of the subject's eye E, and the infrared light is used for observation and photography of the meibomian glands.

[0046] The background light source unit 62 irradiates background light toward the subject's eye E from an irradiation port 63 opened in the background illumination housing 61. The background light irradiated from the background light source unit 62 is collected by a condenser lens and then irradiated toward the subject's eye E. Note that the background light irradiated from the background light source unit 62 is not limited to both visible light and infrared light, and may be only visible light or only infrared light. In addition, in Example 1, the background light source unit 62 is composed of a visible light source 621 and an infrared light source 622, but it may be configured to irradiate visible light and infrared light selectively from a single LED light source. In addition, as a modified example, the background light source unit 62 may include a fluorescent light source, a blue light source, an ultraviolet light source, or the like having an exciter filter, a barrier filter, or the like so as to enable fluorescent observation, blue light observation, ultraviolet light observation, or the like of the cornea of ​​the subject's eye E.

[0047] The power supply unit 70 is a device that supplies power to the slit lamp microscope 100. The power supply unit 70 mainly comprises an AC / DC converter 71 built into the housing 13c of one of the fixed parts 13b of the moving mechanism 13, and a power switch 72 and a confirmation indicator light 73 that are exposed from the housing 13c. Note that the power supply unit 70 is not limited to being provided inside the housing 13c of the fixed part 13b, and may be provided, for example, on the optical table 1, or may be provided in any location as long as a table operator or the like can operate the power switch 72 and see the confirmation indicator light 73.

[0048] The AC / DC converter 71 converts AC voltage into DC voltage. A plug (not shown) that is inserted 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 via the AC / DC converter 71 to the illumination system 30, observation system 40, imaging unit 50, background illumination system 60, etc.

[0049] The confirmation indicator light 73 is a so-called pilot lamp and is made up of, for example, an LED. The confirmation indicator light 73 is used to notify the user of the powered state of the slit lamp microscope 100. The confirmation indicator light 73 lights up when the slit lamp microscope 100 is powered, i.e., activated (power on), and goes out when the slit lamp microscope 100 is not powered, i.e., stopped (power off).

[0050] 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.

[0051] As described above, the control unit 20 is provided in the PC 80. That is, the processor of the PC 80 functions as the control unit 20 of Example 1. The PC 80 also includes a display unit 81, an operation unit 82, a speaker unit 83, a storage unit 84, and a trained AI model 85, as well as a microphone, a communication unit, and other components that the PC 80 typically includes.

[0052] The control unit 20 controls the overall operation of the slit lamp microscope 100. The control unit 20 is connected to the illumination system 30, observation system 40, image capture unit 50, background illumination system 60, and power supply unit 70 via a communication cable 2 and cables housed within the main body 10. The control unit 20 acquires necessary information from these components and controls them by outputting appropriate control commands to them. The operation of the control unit 20 is realized by the cooperation of software such as a control program pre-stored in the memory unit 84 and hardware such as a processor. The control unit 20 may also receive operation input from the examiner via the operation unit 82 and cause the display unit 81 to display images captured by the image capture unit 50, measurement results, etc.

[0053] The control unit 20 controls the imaging unit 50 to capture an image based on an electrical signal from the shooting button 12d. The control unit 20 controls the turning on and off of the slit lamp 32 of the illumination system 30 based on an electrical signal from the dimming knob 12b. The control unit 20 controls the turning on and off of the visible light source 621 and infrared light source 622 of the background light source unit 62 of the background illumination system 60 based on an electrical signal from the background light switching unit 53.

[0054] The control unit 20 turns on the visible light sources 621 or infrared light sources 622 of the first background light source unit 62a, the second background light source unit 62b, the third background light source unit 62c, the fourth background light source unit 62d, and the fifth background light source unit 62e in a predetermined order. While the control unit 20 turns on any one background light source unit 62, the control unit 20 turns off the other four background light source units 62. The lighting time of each background light source unit 62 and the timing of switching to the next background light source unit 62 may be synchronized with the timing of image capture by the image capture unit 50, may be synchronized with the timing of receiving an instruction to turn on from the examiner, or may be synchronized with the timing of a predetermined time. For example, when synchronized with the timing of image capture, the control unit 20 turns on the first background light source unit 62a while the image capture unit 50 acquires a predetermined number of images. The control unit 20 turns off the first background light source unit 62a and turns on the second background light source unit 62b while the image capture unit 50 acquires the next predetermined number of images. In this way, the control unit 20 turns on and off the five background light source units 62 in turn each time the imaging unit 50 acquires a predetermined number of images. This allows the slit lamp microscope 100 to cause the imaging unit 50 to acquire multiple images of the subject's eye E while changing the illumination direction of the background illumination light from the background illumination system 60 toward the subject's eye E.

[0055] The control unit 20 also functions as an examination image generation unit 21 that generates an examination image of the meibomian glands present behind the eyelids of the subject's eye E, an examination image of the anterior segment of the eye, an examination image of the fundus of the eye, etc., by executing an examination image generation program stored in advance in the storage unit 84. The examination image generation unit 21 has an examination eye determination unit 22, an illumination direction setting unit 23, an image acquisition unit 24, an image extraction unit 25, an image synthesis unit 26, a mode determination unit 27, a notification unit 28, and an AI model setting unit 29.

[0056] The subject's eye assessment unit 22 acquires real-time image signals input from the imaging unit 50 and performs image analysis on the images based on the image signals to assess the eyelid state, i.e., determine whether the eyelid state of the subject's eye E is appropriate. In infrared light mode, the subject's eye assessment unit 22 performs image analysis on infrared images based on image signals from the imaging unit 50 to determine whether the eyelids of the subject's eye E are everted. In visible light mode, the subject's eye assessment unit 22 performs image analysis on visible light images based on image signals from the imaging unit 50 to determine whether the eyelids of the subject's eye E are appropriately open. The eyelid open state refers to the degree to which the eyelids are open. When the eyelids are raised and the entire iris can be seen, the eyelids are appropriately open. When the eyelids are drooping due to blinking, ptosis, or other diseases, and part of the iris is hidden by the eyelids, the eyelids are not appropriately open. In the first embodiment, when the mode determination unit 27 determines that the illumination mode is the infrared light mode or the visible light mode, the subject's eye determination unit 22 automatically starts eyelid state determination according to the illumination mode, but is not limited to this. As a modified example, the subject's eye determination unit 22 can also be configured to start eyelid state determination when the examiner presses the photographing button 12d after determining that the illumination mode is the infrared light mode or the visible light mode.

[0057] The subject's eye judgment unit 22 in Example 1 judges the eyelid state by artificial intelligence (AI) using a trained AI model 85. More specifically, when the subject's eye judgment unit 22 inputs an infrared image to the trained AI model 85, the trained AI model 85 outputs an image recognition result to the subject's eye judgment unit 22. Based on this image recognition result, the subject's eye judgment unit 22 judges whether the eyelid is everted or drooping. This judgment result is used to determine whether to start automatic capture of an infrared image by the imaging unit 50.

[0058] The eyelid state determination by the subject's eye determination unit 22 is not limited to a configuration using artificial intelligence, but may be a configuration using a known image recognition program.

[0059] The illumination direction setting unit 23 sets the illumination direction of background illumination for the subject's eye E. More specifically, the illumination direction setting unit 23 sets the illumination direction by sequentially selecting an object to be turned on from five background light source units 62 arranged at a predetermined angle with respect to the subject's eye E. The control unit 20 changes the illumination direction by turning on the visible light source 621 or the infrared light source 622 of the background light source unit 62 selected by the illumination direction setting unit 23.

[0060] The image acquisition unit 24 acquires multiple images from the imaging unit 50. In the infrared light mode, the image acquisition unit 24 acquires multiple infrared images G (see FIG. 5 ) from the imaging unit 50, which captures images of the everted eyelid irradiated with infrared light. As shown in FIG. 5( a), these multiple infrared images G are images of the meibomian glands M captured by the imaging unit 50 while the background light source unit 62 is turned on in sequence and the illumination direction of the background illumination light relative to the subject's eye E is changed. When the subject's eye evaluation unit 22 determines that the eyelid is everted, the image acquisition unit 24 starts acquiring the infrared images G from the imaging unit 50. The image acquisition unit 24 also acquires live view images captured with infrared light from the imaging unit 50. On the other hand, in the visible light mode, when the subject's eye judgment unit 22 judges that the eyelid opening state is appropriate, the image acquisition unit 24 starts acquiring images from the imaging unit 50 and acquires multiple visible light images of the anterior segment of the subject's eye E irradiated with visible light.

[0061] The image extraction unit 25 extracts in-focus portions without luminance anomalies from the multiple images acquired by the image acquisition unit 24. In the example shown in FIG. 5(b), the image extraction unit 25 extracts in-focus portions from multiple infrared images G of the meibomian glands M. Hereinafter, the extracted images are referred to as "partial images g." More preferably, the image extraction unit 25 of the first embodiment extracts partial images g from the multiple infrared images G, excluding out-of-focus portions, luminance anomalies, bright spots, and surrounding reflections. An out-of-focus portion refers to a portion that is out of focus and blurred when photographed. An luminance anomaly portion refers to a portion with inappropriate luminance, such as a blown-out portion, a darkened portion due to shadows, or uneven luminance. A bright spot refers to a small spot of light reflected by the subject's eye E from the illumination light. W shown in FIG. 5(c) indicates a bright spot. Surrounding reflection refers to the situation where surrounding objects, such as a part of the slit lamp microscope 100 or the scenery, are reflected by the subject's eye E, and these surrounding objects appear in the image together with the subject's eye E.

[0062] The image synthesis unit 26 generates a single test image by synthesizing the multiple partial images g extracted by the image extraction unit 25 using a known image synthesis method. In the example shown in Figure 5(c), the image synthesis unit 26 generates a test image GA for testing the meibomian glands M.

[0063] The mode determination unit 27 determines whether the illumination mode of the background illumination system 60 is the infrared light mode or the visible light mode. More specifically, if the background light switching unit 53 is rotated from the off position 54a toward the visible light maximum position 54b, the mode determination unit 27 determines the mode as the "visible light mode," and if the background light switching unit 53 is rotated from the off position 54a toward the infrared light maximum position 54c, the mode determination unit 27 determines the mode as the "infrared light mode."

[0064] When the subject's eye evaluation unit 22 determines that the eyelid condition is inappropriate, the notification unit 28 notifies the examiner that the eyelid condition is inappropriate. More specifically, the notification unit 28 controls the speaker unit 83 to output a warning message by voice. The warning message is not particularly limited, but examples of warning messages include, for example, a message such as "Your eyelids are not fully everted. Please try again" when the eyelids are not everted properly. When the eyelids are drooping due to ptosis or blinking and are not properly open, examples of warning messages include, "Your eyes are not fully open. Please lift your eyelids." The notification unit 28 is not limited to a configuration that notifies by voice from the speaker unit 83. Instead of or in addition to the notification from the speaker unit 83, the notification unit 28 may be configured to display a warning message in text or a warning image on the display unit 81.

[0065] The AI ​​model setting unit 29 sets (generates) a trained AI model 85. The AI ​​model setting unit 29 sets the trained AI model 85 in a storage device incorporated in the PC 80 (for example, this can be part of the storage unit 84 or a storage device separate from the storage unit 84). That is, in the artificial intelligence system of Example 1, the PC 80 (edge ​​device) connected to the main body 10 of the slit lamp microscope 100 is responsible for data analysis, and this is what is known as "edge AI." This "edge AI" has the advantage of being able to perform real-time eyelid state determination.

[0066] The artificial intelligence system used in the ophthalmologic apparatus of the present disclosure is not limited to edge AI. As a modified example, the artificial intelligence system may be a "cloud AI" in which the trained AI model 85 is incorporated into a cloud server connected to the PC 80 via a communication network, and data analysis is performed in the cloud. In the case of cloud AI, the control unit 20 may be configured without the AI ​​model setting unit 29, or the AI ​​model setting unit 29 may be provided on the cloud server.

[0067] As shown in FIG. 2, the AI ​​model setting unit 29 includes a data collection unit 291, a teacher data creation unit 292, and a machine learning unit 293. The data collection unit 291 collects a large number of images captured in advance from an external device or the like. These images include, for example, infrared images of the underside of the upper eyelid and the underside of the lower eyelid, and visible light images of the subject's eye E with an appropriate eyelid opening state and a visible light image of the subject's eye E with an inappropriate eyelid opening state. The infrared images of the underside of the upper eyelid and the underside of the lower eyelid are preferably a large number of infrared images captured of the undersides of the eyelids of various people according to age, gender, race, etc. Furthermore, it is also desirable that these large number of infrared images include not only infrared images in which the eyelids are properly everted, but also infrared images in which the eyelids are improperly everted. Furthermore, it is desirable that the multiple infrared images include not only infrared images of normal meibomian glands but also infrared images of abnormal meibomian glands due to disease or the like, and more desirably, infrared images of various types of abnormal meibomian glands according to symptoms. It is also desirable that the visible light images of the subject's eye E include visible light images of various people with appropriate eyelid opening states and visible light images of their eyelids not being appropriately open, depending on their age, gender, race, etc. In this way, using infrared images of meibomian glands in various states and visible light images of the subject's eye E as training data allows for more appropriate machine learning and further improves the accuracy of data analysis by the trained AI model 85.

[0068] The teacher data creation unit 292 annotates the numerous infrared images collected by the data collection unit 281 to create teacher data with an "upper eyelid inside-side image tag" indicating that the data is infrared image data of the inside of the upper eyelid, and teacher data with a "lower eyelid inside-side image tag" indicating that the data is infrared image data of the inside of the lower eyelid. The teacher data creation unit 282 processes the numerous visible light images collected by the data collection unit 281 to create teacher data with an "open eyelid state image tag" indicating that the data is visible light image data of the subject's eye E in an open eyelid state. The machine learning unit 293 provides the teacher data created by the teacher data creation unit 292 to a selected machine learning algorithm for image recognition, performs machine learning, and generates a trained AI model 85.

[0069] The display unit 81 is composed of a liquid crystal display monitor or the like, and displays an operation screen and a captured infrared image or visible light image of the subject's eye E 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, and receives operation inputs from the examiner and outputs this operation input signal to the control unit 20. The speaker unit 83 outputs a sound of a warning message to the outside under the control of the notification unit 28. In the first embodiment, the speaker unit 83 is provided in the PC 80, but is not limited to this configuration and can also be provided separately in the main body unit 10, allowing the warning message to be output more clearly from a location closer to the examiner or subject.

[0070] The storage unit 84 is composed of storage devices such as RAM, ROM, and a hard disk drive provided in the PC 80. The storage unit 84 stores various programs such as a control program and a test image generation program, various parameters used in ophthalmic examinations, etc. The storage unit 84 also stores images of the subject's eye E captured by the imaging unit 50, such as visible light images captured with visible light, infrared images captured with infrared light, and test images generated based on the visible light images or infrared images.

[0071] As described above, the trained AI model 85 is a trained AI model set by the AI ​​model setting unit 29 based on an infrared image of the inside of the upper eyelid and an infrared image of the inside of the lower eyelid.

[0072] An example of the operation performed by the slit lamp microscope 100 of the first embodiment will be described below based on the flowchart shown in Fig. 6. The flowchart shown in Fig. 6 mainly shows the operation performed by the control unit 20. Since the observation and photography of the subject's eye E using slit light and background light in the observation system 40 and imaging unit 50 of the slit lamp microscope 100 is similar to the observation and photography of the subject's eye E performed using known procedures, a detailed description will be omitted, and the following mainly describes a test image generation method including a step for generating a test image using the background light source unit 62.

[0073] When generating an examination image, the slit lamp microscope 100 assumes that the main body 10 including the image capture unit 50 and the PC 80 are powered on and have started up normally. When the image capture unit 50 is powered on, it captures a live view image and outputs it to the control unit 20. The examiner has the subject sit in a chair or the like facing the slit lamp microscope 100, with the subject's chin resting on the chin rest 15a and the forehead resting on the forehead rest 15b. The examiner can use the slit lamp microscope 100 to observe the subject's eye E and take images.

[0074] When an infrared image of the meibomian glands of the subject's eye E is captured using the background illumination system 60, 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. On the other hand, when a visible light image of the anterior segment of the subject's eye E is captured, the examiner rotates the background light switching unit 53 to switch the illumination mode of the background illumination system 60 to the visible light mode. This switching of the illumination mode is transmitted to the subject's eye evaluation unit 22 of the control unit 20 by an electrical signal output from the background light switching unit 53, and the operation of the flowchart shown in Fig. 6 is started.

[0075] An example of the operation of the control unit 20 in the infrared light mode will be described below with reference to FIG. 6. The operation of the control unit 20 in the visible light mode will be omitted because it will be described in the same way by replacing infrared light with visible light. The examiner operates the operating lever 12c and positions the imaging unit 50 using the movement mechanism 13. For example, the examiner positions the imaging unit 50 so that it faces directly in front of the subject's eye E. Next, the examiner turns over the subject's eyelid with his or her fingers so that the meibomian glands M present on the back side of the eyelid can be seen.

[0076] In step S01, the inspection image generating unit 21 of the control unit 20 determines whether the illumination mode has been switched to the infrared light mode or the visible light mode. If the determination is YES, the program proceeds to step S02, and if the determination is NO, the program proceeds to END, where the image generation process ends. Here, it is assumed that the infrared light mode has been selected.

[0077] In step S02, in order to capture a live view image, the control unit 20 turns on the background light source unit 62 in the initial position. The background light source unit 62 in the initial position may be, for example, the first background light source unit 62a on the right end and the third background light source unit 62c in the center.

[0078] In step S03, the image acquisition unit 24 acquires a live view image of an infrared image from the imaging unit 50 and outputs it to the eye-to-be-examined evaluation unit 22. In step S04, the eye-to-be-examined evaluation unit 22 inputs the live view image to the trained AI model 85 and, based on the output image recognition result, determines whether the eyelid state is appropriate, more specifically, whether the eyelid is sufficiently everted.

[0079] If the answer to step S04 is YES, that is, if the subject's eye evaluation unit 22 determines that the eyelid is sufficiently everted, the program proceeds to step S06. On the other hand, if the answer to step S04 is NO, that is, if the answer to step S04 is NO, that is, if the eyelid is not sufficiently everted, the program proceeds to step S05.

[0080] In step S05, the notification unit 28 controls the speaker unit 83 to output a warning message. This allows the examiner to clearly recognize that the subject's eyelids are not fully everted, and allows the examiner to redo the eyelid eversion operation so that the eyelids are everted properly. After step S05 is executed, the program returns to step S03, and a live view image is acquired again.

[0081] The process of steps S03 to S05 continues until it is determined that the eyelid is sufficiently everted. The control unit 20 counts the number of determinations, and when the number reaches a predetermined number, the program proceeds to END, ending the image generation process. Alternatively, the control unit 20 may measure the elapsed time since switching to infrared light mode, and when the measured time reaches a predetermined time, the program proceeds to END, ending the image generation process.

[0082] When the eyelids are sufficiently turned back, in step S06, the lighting direction setting unit 23 selects the background light source units 62 to be turned on in order to set the lighting direction. Here, the lighting direction setting unit 23 selects the first, second, third, fourth, and fifth background light source units 62a, 62b, 62c, 62d, and 62e in this order.

[0083] In step S07, the control unit 20 changes the illumination direction of the background light source unit 62 by turning on the infrared light source 622 of the background light source unit 62 selected by the illumination direction setting unit 23. At this time, if any of the other background light source units 62 are turned on, the control unit 20 turns them off.

[0084] After confirming that the background light source unit 62 is lit, i.e., that the lighting direction has been changed, the examiner presses the photographing button 12d to issue a command to start photographing to the imaging unit 50. In response to this photographing command, in step S08, the control unit 20 controls the imaging unit 50 to photograph a predetermined number of images of the meibomian glands M. The image acquisition unit 24 acquires image signals from the imaging unit 50 and, based on the acquired image signals, acquires a predetermined number of images, in this case, infrared images G.

[0085] In step S09, the lighting direction setting unit 23 determines whether shooting has been completed in all lighting directions, so that the imaging unit 50 can take images with the lighting direction changed. If the determination is YES, that is, if shooting has been completed in all lighting directions, the program proceeds to step S10. If the determination is NO, that is, if there is a lighting direction that needs to be changed, the program returns to step S06.

[0086] When the program returns to step S06, the illumination direction setting unit 23 selects the next background light source unit 62 to be turned on in order to change the illumination direction. In step S07, the control unit 20 turns on the infrared light source 622 of the selected background light source unit 62 and turns off the infrared light sources 622 of the other background light source units 62. After the examiner confirms the change in illumination direction and presses the photographing button 12d, in step S08 the control unit 20 controls the image capturing unit 50 to capture images of the meibomian glands M in the changed illumination direction. The image acquiring unit 24 acquires a predetermined number of infrared images G from the image capturing unit 50. The program then proceeds to the determination in step S09, and steps S06 to S09 are repeated until photographing in all illumination directions is completed, that is, until all background light source units 62 are turned on and photographing by the image capturing unit 50 is completed.

[0087] Step S10 is a step that is executed when image capturing in all lighting directions is completed. In step S10, the image extracting unit 25 extracts in-focus portions as partial images g from all infrared images G acquired by the image acquiring unit 24, excluding out-of-focus portions, portions with abnormal brightness, bright spots, and surrounding reflections, as shown in (b) of Fig. 5.

[0088] In the final step S11, as shown in FIG. 5(c), the image synthesis unit 26 synthesizes the multiple partial images g extracted in step S10 using a known image synthesis method to generate a test image GA of the meibomian glands M. As a result, a test image GA is obtained in which the meibomian glands M are bright and clear. This test image GA is displayed on the display unit 81, allowing the examiner to more appropriately check the condition of the meibomian glands M.

[0089] As described above, after the imaging unit 50 has been positioned, the slit lamp microscope 100 of Example 1 causes the imaging unit 50 to acquire an image while changing the illumination direction of the background illumination system 60, more specifically while turning on the five background light source units 62 in sequence. Thereafter, the slit lamp microscope 100 can also cause the imaging unit 50 to acquire an image while changing the illumination direction of the background illumination system 60, with the imaging unit 50 moved and positioned at a different position.

[0090] Furthermore, in the first embodiment, the examiner, upon recognizing that the illumination direction has been changed, presses the capture button 12d, causing the image capture unit 50 to capture an image. However, this configuration is not limiting. In a modified slit lamp microscope 100, all steps in the flowchart of FIG. 6 may be automatically performed, for example, when the examiner switches the illumination mode and then presses the capture button 12d. The control unit 20 then sets the illumination direction in steps S06 and S07, turns on the corresponding background light source unit 62, and then proceeds to step S08. The control unit 20 automatically controls the image capture unit 50 to capture an image without waiting for instructions from the examiner. This configuration allows the illumination direction to be changed and the image capture to be performed more quickly, reducing the burden on the examinee.

[0091] Example 2 The slit lamp microscope 100 according to Example 2 has the same basic configuration as the slit lamp microscope 100 of Example 1 shown in Figure 1 etc., except that it is equipped with a background illumination system 60A shown in Figure 7 instead of the background illumination system 60, and further equipped with an illumination movement unit 64 shown by dashed lines in Figures 1 and 2. In Example 2 and other examples described below, configurations and functions that differ from Example 1 will mainly be described.

[0092] The background illumination system 60A includes a background illumination housing 61, one background light source unit 62 as a light source, and an illumination moving unit 64. This one background light source unit 62 has one visible light source 621 and two infrared light sources 622. The illumination moving unit 64 includes an actuator such as a stepping motor and is built into the first support arm 14b. A rotation axis 64a of the illumination moving unit 64 is approximately coaxial with or parallel to the axis of rotation of the subject's eye E and is connected and fixed to the background illumination housing 61. The illumination moving unit 64 rotates the background light source unit 62 together with the background illumination housing 61 in the left-right direction along the subject's eye E around the rotation axis 64a.

[0093] The illumination moving unit 64 is driven and controlled by the control unit 20. The control unit 20 drives and controls the illumination moving unit 64 to rotate and move the background light source unit 62 within a range of 90° left and right relative to the eye E, that is, within a range of 180° left and right. Note that the range of movement is not limited to 180°, and may be a narrower or wider angular range. The control unit 20 drives and controls the illumination moving unit 64 to rotate and move the background light source unit 62 intermittently at a predetermined angular speed, for example, 15°, 30°, or 45°, from 0° to 180°, or may rotate and move the background light source unit 62 continuously at a constant angular speed.

[0094] An example of the operation performed by the slit lamp microscope 100 of the second embodiment is basically the same as the operation of the slit lamp microscope 100 of the first embodiment using the flowchart shown in Fig. 6. In the second embodiment, the processing contents in steps S02, S06 to S07 are replaced with the following processing contents.

[0095] In step S02, in order to capture a live view image, control unit 20 drives and controls illumination moving unit 64 to place background light source unit 62 at an initial position and turns on visible light source 621 or infrared light source 622. In step S06, illumination direction setting unit 23 sets an angle by which background light source unit 62 is rotated as the illumination direction. In step S07, control unit 20 drives and controls illumination moving unit 64 to rotate background light source unit 62 by an angle corresponding to the set illumination direction.

[0096] Therefore, the slit lamp microscope 100 of the second embodiment can capture images of the subject's eye E using the imaging unit 50 while changing the illumination direction. The slit lamp microscope 100 can capture brighter and clearer examination images based on the multiple captured images.

[0097] In addition, when the background light source unit 62 is continuously rotated at a constant angular velocity, the control unit 20 may control the image capture unit 50 to capture images of the subject's eye E at regular intervals or continuously while the background light source unit 62 is being rotated. The control unit 20 automatically controls the image capture by the image capture unit 50 in accordance with the rotational movement of the background light source unit 62, thereby enabling the infrared image G to be acquired more quickly and appropriately. Furthermore, by setting the time from the start to the end of image capture to within a few seconds, the image capture time can be shortened, reducing the burden on the subject and preventing image capture errors due to blinking, etc. In addition, as a modified example, the illumination movement unit 64 may be composed of only a rotation axis, and the examiner may manually rotate the background light source unit 62.

[0098] Example 3 Figure 8 is a right side view showing the overall configuration of a slit lamp microscope 100 of Example 3. The overall configuration of the slit lamp microscope 100 of Example 3 has the same basic configuration as the slit lamp microscope 100 of Example 1 shown in Figure 1 etc., except that it is equipped with a background illumination system 60B shown in Figures 8 and 9 instead of the background illumination system 60, and further equipped with an illumination moving unit 64 and an imaging moving unit 55 shown by dashed lines in Figures 2 and 8.

[0099] In the slit lamp microscopes 100 according to Examples 1 and 2, after the image capturing unit 50 is positioned, the image capturing unit 50 does not move, and only the illumination direction of the background illumination system 60 is changed while the subject's eye E is photographed. In contrast, in the slit lamp microscope 100 according to Example 3, the position of the image capturing unit 50 is changed in synchronization with the change in the illumination direction while the subject's eye E is photographed.

[0100] The background illumination system 60B is suspended from the forehead rest 15b. The background illumination system 60B includes a background illumination housing 61, a background light source unit 62 as a light source, and an illumination moving unit 64. One end of the background illumination housing 61 is attached to the forehead rest 15b and protrudes from the forehead rest 15b in an L-shape in a side view. The background light source unit 62 is provided at the other end of the background illumination housing 61. The illumination moving unit 64 includes an actuator such as a stepping motor and is provided on the forehead rest 15b. A rotation axis 64a of the illumination moving unit 64 is approximately coaxial with or parallel to the axis of rotation of the subject's eye E and is connected and fixed to the background illumination housing 61. The illumination moving unit 64 rotates the background illumination housing 61 and the background light source unit 62 left and right along the subject's eye E around the rotation axis 64a.

[0101] The background illumination system 60B of Example 3 and the background illumination system 60C of Example 4 described below are not limited to being suspended from the forehead rest 15b, but may be provided in any part of the face support part 15 including the chin rest 15c, the base 11 of the main body part 10, any part of the main body part 10 including the stand part 12, or the optical bench 1.

[0102] The imaging moving unit 55 rotates and moves the imaging unit 50 to change the imaging angle and / or imaging position of the imaging unit 50. The imaging moving unit 55 includes an actuator and is built into the base 14a. A second rotation axis 55a, which is the rotation axis of the imaging moving unit 55, is connected to the second support arm 14c. The imaging unit 50 is attached to the second support arm 14c. The imaging moving unit 55 rotates and moves the imaging unit 50 by rotating and moving the second support arm 14c about the second rotation axis 55a, thereby changing the imaging angle and / or imaging position of the imaging unit 50.

[0103] The illumination moving unit 64 and the imaging moving unit 55 are driven and controlled by the control unit 20. The control unit 20 drives and controls the illumination moving unit 64 and the imaging moving unit 55 to automatically and synchronously rotate the background light source unit 62 and the imaging unit 50 within a range of 180° or within a different range along the subject's eye E. This rotation may be intermittent rotation in increments of 15°, 30°, or 45°, or may be continuous rotation at a constant angular velocity.

[0104] An example of the operation performed by the slit lamp microscope 100 of the third embodiment will be described below with reference to the flowchart shown in Fig. 10. Hereinafter, an example of the operation when a visible light image of the anterior segment of the subject's eye E is obtained using visible light will be described.

[0105] In step S21, the inspection image generating unit 21 of the control unit 20 determines whether the illumination mode has been switched to the infrared light mode or the visible light mode. If the determination is YES, the program proceeds to step S22, and if the determination is NO, the program proceeds to END, where the image generation process ends. Here, it is assumed that the visible light mode has been selected.

[0106] In step S22, the control unit 20 turns on the visible light source 621 of the background light source unit 62 to capture a live view image. At this time, the control unit 20 drives and controls the illumination moving unit 64 and the imaging moving unit 55 to position the background light source unit 62 and the imaging unit 50 at positions facing the front of the subject's eye E, for example, at the center positions in FIG.

[0107] In step S23, the image acquisition unit 24 acquires a live view image of the visible light image from the imaging unit 50 and outputs it to the subject's eye evaluation unit 22. In step S24, the subject's eye evaluation unit 22 inputs the live view image to the trained AI model 85 and, based on the output image recognition result, determines whether the eyelid state is appropriate, more specifically, whether the subject's eye E has an appropriate eyelid open state.

[0108] If the answer to step S24 is YES, that is, if the subject's eye determination unit 22 determines that the eyelid is appropriately open, the program proceeds to step S26. On the other hand, if the answer to step S24 is NO, that is, if the eyelid is not appropriately open, the program proceeds to step S25.

[0109] In step S25, the notification unit 28 controls the speaker unit 83 to output a warning message. This allows the examiner to clearly recognize that the subject's eyelids are not properly open, and the examiner can push up the eyelids with their fingers or warn the subject not to blink. After step S25 is executed, the program returns to step S23, and a live view image is acquired again.

[0110] The process of steps S23 to S25 continues until it is determined that the eyelid open state is appropriate. The control unit 20 counts the number of determinations, and when the number reaches a predetermined number, the program proceeds to END, ending the image generation process. Alternatively, the control unit 20 may measure the elapsed time since switching to infrared light mode, and when the measured time reaches a predetermined time, the program proceeds to END, ending the image generation process.

[0111] When the eyelid opening state becomes appropriate, in step S26, the lighting direction setting unit 23 sets the lighting direction. For example, as shown in Fig. 9, when the right direction from the subject's perspective is set as 0°, the lighting direction setting unit 23 sets the lighting direction in increments of a predetermined angle, for example, 45°, counterclockwise from 0°.

[0112] In step S27, the control unit 20 drives and controls the lighting movement unit 64 and the imaging movement unit 55 to rotate the background light source unit 62 to a position corresponding to the lighting direction set by the lighting direction setting unit 23, and rotates the imaging unit 50 in synchronization with the rotation of the background light source unit 62.

[0113] In step S28, the control unit 20 controls the imaging unit 50 to capture a predetermined number of images of the anterior segment of the subject's eye E. The image acquisition unit 24 acquires image signals from the imaging unit 50, and acquires a predetermined number of visible light images based on the acquired image signals.

[0114] In step S29, the illumination direction setting unit 23 determines whether imaging has been completed in all illumination directions so that the eye E can be illuminated from the next illumination direction and the imaging unit 50 can take an image. If the determination is YES, that is, the eye E has been illuminated in all illumination directions, the program proceeds to step S30. If the determination is NO, that is, there is a next illumination direction, the program returns to step S26.

[0115] When the program returns to step S26, the illumination direction setting unit 23 sets the illumination direction to be illuminated next. In step S27, the control unit 20 drives and controls the illumination moving unit 64 and the imaging moving unit 55 to rotate and move the background light source unit 62 and the imaging moving unit 55 to positions corresponding to the illumination direction set by the illumination direction setting unit 23, thereby changing the illumination direction and the imaging direction. In step S28, the control unit 20 controls the imaging unit 50 to photograph the anterior segment, and the image acquisition unit 24 acquires a predetermined number of visible light images from the imaging unit 50. Then, the program proceeds to the determination in step S29, and steps S26 to S29 are repeated until imaging in all illumination directions is completed.

[0116] In step S30, the image extraction unit 25 extracts in-focus parts as partial images from all images acquired by the image acquisition unit 24, in this case visible light images, excluding out-of-focus parts, parts with abnormal brightness, bright spots, and surrounding reflection parts.

[0117] In the final step S31, the image synthesis unit 26 synthesizes the multiple partial images extracted in step S30 using a known image synthesis method to generate an examination image of the anterior segment. As a result, a bright and clear examination image is obtained. This examination image is displayed on the display unit 81, allowing the examiner to more appropriately check the condition of the anterior segment of the subject's eye E.

[0118] As described above, the slit lamp microscope 100 of Example 3 can acquire images of the subject's eye E from various directions by synchronously changing the illumination direction of the background illumination system 60 and the imaging direction of the imaging unit 50 at the same angular velocity from initial positions at the same angle. Note that the illumination direction and imaging direction are not limited to being changed from initial positions at the same angle, and the angles of the initial positions of the illumination direction and imaging direction may be different. For example, the illumination direction may be changed in predetermined angle increments from the initial position of 0°, and the imaging direction may be changed in predetermined angle increments from the initial position of 30°.

[0119] As a modified example, the background illumination system 60 and the imaging unit 50 can be configured to be manually rotated by the examiner, or can be configured so that the examiner issues an instruction to capture an image by pressing the imaging button 12d when the illumination direction is changed, thereby enabling imaging according to the examiner's intention. On the other hand, as in Example 3, the background illumination system 60 and the imaging unit 50 are automatically rotated and captured by the illumination moving unit 64 and the imaging moving unit 55 under the control of the control unit 20, thereby enabling these rotational movements and imaging of the subject's eye E to be performed more quickly and with higher accuracy, and reducing the burden on the subject.

[0120] Example 4 The slit lamp microscope 100 of Example 4 has the same basic configuration as the slit lamp microscope 100 of Example 3 shown in Figure 8, etc., except that it has a background illumination system 60C shown in Figure 11 instead of the background illumination system 60B and does not have an illumination movement unit 64.

[0121] The background illumination system 60C has five background light source units 62, namely, a first background light source unit 62a, a second background light source unit 62b, a third background light source unit 62c, a fourth background light source unit 62d, and a fifth background light source unit 62e. These five background light source units 62 are arranged in an arc shape around the subject's eye E at intervals of approximately 45° around an axis that is approximately coaxial with or parallel to the axis of rotation extending in the vertical direction of the subject's eye E. Therefore, the background illumination system 60C can illuminate the subject's eye E from a direction of approximately 180°. The angular intervals at which the background light source units 62 are arranged are not limited to 45° intervals, but can be any appropriate angle, such as 15° intervals or 30° intervals, depending on the purpose of imaging, the size of the device, and the like.

[0122] The driving of background illumination system 60C is controlled by control unit 20. Control unit 20 controls first to fifth background light source units 62a to 62e to turn them on and off in order.

[0123] An example of the operation performed by the slit lamp microscope 100 of the fourth embodiment is basically the same as the operation of the slit lamp microscope 100 of the third embodiment using the flowchart shown in Fig. 10. In the fourth embodiment, the processing contents in steps S22, S26 to S27 are replaced with the following processing contents.

[0124] In step S22, the control unit 20 turns on the visible light source 621 or infrared light source 622 of the background light source unit 62 at the initial position in order to capture a live view image. In step S26, the illumination direction setting unit 23 selects the background light source unit 62 to be turned on in order to set the illumination direction. In step S27, the control unit 20 turns on the visible light source 621 or infrared light source 622 of the selected background light source unit 62. In synchronization with this lighting control, the control unit 20 drives and controls the imaging movement unit 55 to rotate and move the imaging unit 50 to a position corresponding to the turned-on background light source unit 62.

[0125] Therefore, the slit lamp microscope 100 of Example 4 can change the illumination direction and capture an image of the subject's eye E using the imaging unit 50 at a position according to the illumination direction. The slit lamp microscope 100 can capture a brighter and clearer image of the subject's eye E based on the multiple captured images.

[0126] As described above, the slit lamp microscope 100 of each embodiment and modified example includes a background illumination system 60, more specifically a background light source unit 62, which is an illumination unit that illuminates the subject's eye E with illumination light; an imaging unit 50 that captures an image of the subject's eye E; and a control unit 20 that controls the background illumination system 60 and the imaging unit 50. The control unit 20 also includes a test image generation unit 21 that generates a test image of the subject's eye E based on an image captured by the imaging unit 50. The test image generation unit 21 includes an image acquisition unit 24 that acquires multiple images of the subject's eye E from the imaging unit 50 while changing the illumination direction of the illumination light relative to the subject's eye E; an image extraction unit 25 that extracts in-focus portions from the multiple images acquired by the image acquisition unit 24 as partial images; and an image synthesis unit 26 that synthesizes the multiple partial images extracted by the image extraction unit 25 to generate a test image. This configuration enables the slit lamp microscope 100 of each embodiment and modified example to obtain brighter and clearer test images.

[0127] The background illumination system 60 in each of the embodiments and modified examples includes at least one of a visible light source 621 that emits visible light and an infrared light source 622 that emits infrared light. With this configuration, the slit lamp microscope 100 in each of the embodiments and modified examples can obtain brighter and clearer examination images of the anterior segment, fundus, etc. of the subject's eye E using visible light, or can obtain brighter and clearer examination images of the meibomian glands using infrared light.

[0128] The background illumination system 60 in Examples 1 and 4 includes a plurality of background light source units 62 provided at different positions with respect to the subject's eye E, and the control unit 20 controls the lighting of the plurality of background light source units 62 in order in response to an input of a lighting instruction or automatically, thereby changing the lighting direction of the background illumination system 60. With this configuration, the lighting direction can be changed more easily and more accurately without moving the background light source units 62.

[0129] The slit lamp microscopes 100 of Examples 2 and 3 include an illumination moving unit 64 that moves the background illumination system 60, and the illumination direction of the background illumination system 60 relative to the subject's eye E is changed by being moved by the illumination moving unit 64. With this configuration, even if there is only one background light source unit 62, the illumination direction can be appropriately changed.

[0130] Furthermore, the illumination moving unit 64 in Examples 2 and 3 includes an actuator that is driven and controlled by the control unit 20. The control unit 20 drives and controls the illumination moving unit 64 to move the background light source unit 62 at a predetermined angular velocity around the subject's eye E to change the illumination direction, and controls the image capturing unit 50 to capture an image of the subject's eye at the timing when the illumination direction of the background light source unit 62 is changed. With this configuration, the change in the illumination direction and the image capturing by the image capturing unit 50 are synchronized, allowing for more appropriate image capture.

[0131] The slit lamp microscopes 100 of Examples 2 and 3 are equipped with an imaging movement unit 55 that moves the imaging unit 50, and the imaging unit 50 is moved in synchronization with the movement of the illumination direction of the background illumination system 60. With this configuration, the slit lamp microscopes 100 of Examples 2 and 4 can position the illumination direction and imaging direction with greater precision, allowing for more appropriate image acquisition.

[0132] In each of the above-described embodiments and modifications, the image extraction unit 25 extracts from a plurality of images, as partial images g, portions excluding out-of-focus portions, portions with abnormal brightness, bright spots, and surrounding reflection portions. By using such partial images g, the image synthesis unit 26 can synthesize a more focused inspection image GA.

[0133] The ophthalmic device of the present disclosure has been described above based on Examples 1 and 2, but the specific configuration is not limited to these Examples, and design changes and additions are permitted as long as they do not deviate from the gist of the invention according to each claim in the scope of the claims.

[0134] Although the ophthalmic apparatuses in the above-described embodiments and modified examples are slit lamp microscopes, the ophthalmic apparatus to which the present disclosure is applicable is not limited to slit lamp microscopes. For example, the ophthalmic apparatus may be a surgical microscope, or any other ophthalmic apparatus that illuminates the subject's eye E and acquires images of the subject's eye E. Furthermore, the present disclosure may also be applied to ophthalmic apparatuses that observe and photograph the subject's eye 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, but may be a configuration that irradiates second illumination light having a wavelength, illumination range, etc. different from the observation illumination light. Furthermore, in the above-described third embodiment, the background illumination system 60 and the image capture unit 50 are moved to change the illumination direction and image capture direction relative to the subject's eye E. However, the present disclosure is not limited to this. Alternatively, the background illumination system 60 may be immobile, and only the image capture unit 50 may be moved. With this configuration, the illumination direction of the illumination light relative to the image capture unit 50 is changed, allowing the image capture unit 50 to acquire multiple images of the subject's eye E illuminated from various illumination directions.

[0135] The following will be further disclosed regarding the above description of the first embodiment and the modified examples. (1) an illumination unit that illuminates the subject's eye with illumination light; an imaging unit that captures an image of the subject's eye; a control unit that controls the illumination unit and the imaging unit, the control unit includes an examination image generation unit that generates an examination image of the subject's eye based on an image captured by the imaging unit, The inspection image generation unit an image acquisition unit that acquires, from the imaging unit, a plurality of images of the subject's eye captured while changing the illumination direction of the illumination light with respect to the subject's eye; an image extraction unit that extracts in-focus portions as partial images from the plurality of images acquired by the image acquisition unit; an image synthesis unit that synthesizes the plurality of partial images extracted by the image extraction unit to generate the inspection image; An ophthalmic device characterized by: (2) The illumination unit includes at least one of a visible light source that emits visible light and an infrared light source that emits infrared light. The ophthalmic apparatus according to (1) above, (3) The illumination unit includes a plurality of light sources provided at different positions with respect to the subject's eye, The control unit controls the lighting of the plurality of light sources in turn, either automatically or in response to a lighting instruction input, thereby changing the lighting direction of the illumination light. The ophthalmic apparatus according to (1) or (2) above, (4) An illumination moving unit that moves the illumination unit is provided, and the illumination direction of the illumination unit relative to the subject's eye is changed by being moved by the illumination moving unit. The ophthalmologic apparatus according to any one of (1) to (3) above, characterized in that: (5) The lighting moving unit includes an actuator that is driven and controlled by the control unit, The control unit drives and controls the illumination moving unit to move the illumination unit around the subject's eye at a predetermined angular velocity to change the illumination direction, and controls the imaging unit to acquire an image of the subject's eye at a timing when the illumination direction of the illumination unit is changed. The ophthalmologic apparatus according to (4) above, (6) An imaging moving unit that moves the imaging unit, The imaging unit is moved in synchronization with the movement of the illumination direction of the illumination unit. The ophthalmologic apparatus according to any one of (1) to (5) above, characterized in that: (7) The image extraction unit extracts, from the plurality of images, portions excluding out-of-focus portions, portions with abnormal brightness, bright spots, and surrounding reflection portions, as the partial images. The ophthalmologic apparatus according to any one of (1) to (6) above, characterized in that: [Explanation of symbols]

[0136] 24: Image acquisition unit 25: Image extraction unit 26: Image synthesis unit 50: Imaging unit 55: Imaging moving unit 60: Background lighting system (lighting unit) 62: Background light source section (lighting section) 62a: First background light source section (lighting section) 62b: Second background light source section (lighting section) 62c: Third background light source section (lighting section) 62d: 4th background light source section (illumination section) 62e: 5th background light source section (illumination section) 64: Lighting moving part 621: Visible light source 622: Infrared light source E: Subject's eye GA: Inspection image g: Partial image

Claims

1. an illumination unit that illuminates the subject's eye with illumination light; an imaging unit that captures an image of the subject's eye; a control unit that controls the illumination unit and the imaging unit, the control unit includes an examination image generation unit that generates an examination image of the subject's eye based on an image captured by the imaging unit, The inspection image generation unit an image acquisition unit that acquires, from the imaging unit, a plurality of images of the subject's eye captured while changing the illumination direction of the illumination light with respect to the subject's eye; an image extraction unit that extracts in-focus portions as partial images from the plurality of images acquired by the image acquisition unit; an image synthesis unit that synthesizes the plurality of partial images extracted by the image extraction unit to generate the inspection image; An ophthalmic device characterized by:

2. The illumination unit includes at least one of a visible light source that emits visible light and an infrared light source that emits infrared light.

2. An ophthalmic apparatus according to claim 1.

3. the illumination unit includes a plurality of light sources provided at different positions with respect to the eye to be examined, The control unit controls the lighting of the plurality of light sources in turn, either automatically or in response to a lighting instruction input, thereby changing the lighting direction of the illumination light.

2. An ophthalmic apparatus according to claim 1.

4. The illumination unit includes an illumination moving unit that moves the illumination unit, and the illumination direction with respect to the subject's eye is changed by the illumination unit being moved by the illumination moving unit.

2. An ophthalmic apparatus according to claim 1.

5. the illumination moving unit includes an actuator that is driven and controlled by the control unit, The control unit drives and controls the illumination moving unit to move the illumination unit around the subject's eye at a predetermined angular velocity to change the illumination direction, and controls the imaging unit to acquire an image of the subject's eye at a timing when the illumination direction of the illumination unit is changed.

5. An ophthalmic apparatus according to claim 4.

6. an imaging moving unit that moves the imaging unit; The imaging unit is moved in synchronization with the movement of the illumination direction of the illumination unit.

2. An ophthalmic apparatus according to claim 1.

7. The image extraction unit extracts, from the plurality of images, portions excluding out-of-focus portions, portions with abnormal brightness, bright spots, and surrounding reflection portions, as the partial images.

2. An ophthalmic apparatus according to claim 1.

Images