Head tracking control for ophthalmic surgery.

Abstract

The present disclosure provides a head tracking control system including at least one marker positioned on a surgeon's head. The system further includes an infrared camera including at least two infrared sensors and configured to detect infrared light reflected from the at least one marker, transmit a signal corresponding to the detected light to a processor, and execute instructions on the processor to detect movement of the at least one marker. The system also includes an intelligent tracking system configured to execute instructions on the processor to determine whether the detected movement of the at least one marker corresponds to a defined head movement of the surgeon. The system further includes an ophthalmic surgical microscope including the processor. If the detected movement of the at least one marker corresponds to a defined head movement of the surgeon, the processor executes instructions to control the ophthalmic surgical microscope.

Description

[Technical Field]

[0001] FIELD OF THE DISCLOSURE The present disclosure relates to ophthalmic surgery and surgical equipment, and more particularly to a head tracking control system and related methods for improving visualization for ophthalmic surgery. [Background technology]

[0002] Ophthalmic surgery is surgery performed on the eye or any part of the eye. Ophthalmic surgery protects and improves the vision of tens of thousands of patients each year. However, because vision is sensitive to even slight changes in the eye and the characteristics of many ocular structures are delicate and intricate, ophthalmic surgery can be difficult to perform, and reducing minor or rare surgical errors or even slight improvements in precision of surgical skill can make a noticeable difference in a patient's vision after surgery.

[0003] Vitreoretinal surgery, a type of ophthalmic surgery, involves a variety of delicate procedures involving the interior of the eye, such as the vitreous humor, retina, epiretinal membrane, and internal limiting membrane. Different vitreoretinal surgical procedures, sometimes in conjunction with lasers, are used to improve visual sensation performance in the treatment of many eye diseases, including outer membrane, diabetic retinopathy, vitreous hemorrhage, macular hole, retinal detachment, vitreomacular traction syndrome, macular schizophrenia, and complications of cataract surgery.

[0004] During ophthalmic surgery, such as vitreoretinal surgery, ophthalmologists typically use an optical surgical microscope equipped with an eyepiece to view a magnified image of the eye undergoing surgery. The surgical microscope can provide intraoperative viewing of the optical image of the eye and, optionally, illumination of the eye for the ophthalmic surgery. The patient typically lies supine under the surgical microscope during ophthalmic surgery, and a speculum is used to keep the eye exposed. Depending on the type of optical system used, the surgeon is given a given view of the fundus, which can vary from a narrow field of view to a wide field of view that can extend to the peripheral region of the fundus.

[0005] More recently, ophthalmologists have used eyepiece-less digital imaging systems, such as NGENUITY® (Novartis AG Corp., Switzerland), to aid in visualization during ophthalmic surgery. These systems may include a 3D high-dynamic-range (“HDR”) camera system with a pair of complementary metal-oxide semiconductor (CMOS) sensors that allows the surgeon to view the retina on a display screen using polarized glasses, digital eyepieces, or a head-mounted display. The display screen eliminates the need to observe the surgery using eyepieces and allows others in the operating room to see exactly as the surgeon does. This system also allows for improved images under high magnification and an increased depth of field compared to traditional optical analog surgical microscopes. In addition, ophthalmic surgical microscopes or digital imaging systems may include floor-mounted foot pedals that can provide foot-activated control of various visualization displays during ophthalmic surgery. However, hand-activated, voice-activated, or foot-activated commands for controlling displays or equipment may be undesirable or impractical when performing ophthalmic surgery. Summary of the Invention [Means for solving the problem]

[0006] The present disclosure provides a head tracking control system for improving visualization for ophthalmic surgery. The head tracking control system includes at least one marker positioned on a surgeon's head. The head tracking control system also includes an infrared camera including at least two infrared sensors that detects infrared light reflected from the at least one marker and transmits a signal corresponding to the detected light to a processor. The infrared camera also executes instructions on the processor to detect movement of the at least one marker. The head tracking control system also includes an intelligent tracking system that executes instructions on the processor to determine whether the detected movement of the at least one marker corresponds to a defined head movement of the surgeon. The head tracking control system also includes an ophthalmic surgical microscope that includes a processor. If the detected movement of the at least one marker corresponds to a defined head movement of the surgeon, the processor executes instructions to control the ophthalmic surgical microscope.

[0007] The head tracking control system and method of use may include the following additional features: i) the defined head motion of the surgeon may be a quiet head motion, an intentional head motion, an unusual head motion, or any combination thereof; ii) the intelligent tracking system may include a microphone and a noise detection system that determines whether the detected motion of the at least one marker corresponds to a quiet head motion of the surgeon, a motion thresholding system that determines whether the detected motion of the at least one marker corresponds to an intentional head motion of the surgeon, and a motion recognition system that determines whether the detected motion of the at least one marker corresponds to an unusual head motion of the surgeon; iii) head motions that are not the defined head motions may be ignored by the head tracking control system; and iv) the defined head motions may be: x The displacement may be along an x-axis, a y-axis, a pitch movement, or any combination thereof; v) the system may further include a motorized microscope head support, and the processor may control the ophthalmic surgical microscope by executing instructions to move the motorized microscope head support along an x-axis of microscope movement, a y-axis of microscope movement, or any combination thereof; vi) the system may further include an objective lens, and the processor may control the ophthalmic surgical microscope by executing instructions to move the objective lens; vii) the at least one marker may be an active infrared marker, a passive infrared marker, a fiducial marker, located on the cap, attached with adhesive, marked with a pen, or any combination thereof.

[0008] The present disclosure further provides a head tracking control system including a three-axis gyroscope and a three-axis accelerometer disposed on a surgeon's head to detect head motion of the surgeon and transmit signals corresponding to the detected motion to a processor. The head tracking control system also includes an intelligent tracking system that executes instructions on the processor to determine whether the detected head motion of the surgeon corresponds to a defined head motion of the surgeon. The head tracking control system also includes an ophthalmic surgical microscope that includes the processor. If the detected head motion of the surgeon corresponds to a defined head motion of the surgeon, the processor executes instructions to control the ophthalmic surgical microscope.

[0009] The head tracking control system and method of use may include the following additional features: i) the defined head motion of the surgeon may be a quiet head motion, an intentional head motion, an uncommon head motion, or any combination thereof; ii) the intelligent tracking system may include a microphone and a noise detection system that determines whether the detected head motion of the surgeon corresponds to a quiet head motion, a motion thresholding system that determines whether the detected head motion of the surgeon corresponds to an intentional head motion, and a motion recognition system that determines whether the detected head motion of the surgeon corresponds to an uncommon head motion; iii) head motions that are not defined head motions may be ignored by the head tracking control system; iv) the defined head motion may be a displacement along an x-axis, a displacement along a y-axis, a pitch motion, or any combination thereof; v) the system may further include a motorized microscope head support, and the processor may control the ophthalmic surgical microscope by executing instructions to move the motorized microscope head support along an x-axis of microscope motion, a y-axis of microscope motion, or any combination thereof; and vi) the system may further include an objective lens, and the processor may control the ophthalmic surgical microscope by executing instructions to move the objective lens.

[0010] The present disclosure further provides a head tracking control system including at least one marker positioned on a surgeon's head. The head tracking control system also includes an LED driver that emits near-infrared light. The head tracking control system also includes a digital micromirror device that modulates the near-infrared light emitted by the LED driver and projects the modulated light onto the at least one marker. The head tracking control system also includes a three-dimensional scanning camera that detects distortion of the modulated light reflected from the at least one marker, sends a signal corresponding to the distortion to a processor, and executes instructions on the processor to detect movement of the at least one marker. The head tracking control system also includes an intelligent tracking system that executes instructions on the processor to determine whether movement of the at least one marker corresponds to a defined head movement of the surgeon. The head tracking control system also includes an ophthalmic surgical microscope that includes the processor. If movement of the at least one marker corresponds to a defined head movement of the surgeon, the processor executes instructions to control the ophthalmic surgical microscope.

[0011] The head tracking control system and method of use may include the following additional features: i) the defined head motion of the surgeon may be a quiet head motion, an intentional head motion, an unusual head motion, or any combination thereof; ii) the intelligent tracking system may include a microphone and a noise detection system that determines whether the detected motion of the at least one marker corresponds to a quiet head motion of the surgeon, a motion thresholding system that determines whether the detected motion of the at least one marker corresponds to an intentional head motion of the surgeon, and a motion recognition system that determines whether the detected motion of the at least one marker corresponds to an unusual head motion of the surgeon; iii) head motions that are not the defined head motions may be ignored by the head tracking control system; and iv) the defined head motions may be: x The displacement may be along an x-axis, a y-axis, a pitch movement, or any combination thereof; v) the system may further include a motorized microscope head support, and the processor may control the ophthalmic surgical microscope by executing instructions to move the motorized microscope head support along an x-axis of microscope movement, a y-axis of microscope movement, or any combination thereof; vi) the system may further include an objective lens, and the processor may control the ophthalmic surgical microscope by executing instructions to move the objective lens; vii) the at least one marker may be an active infrared marker, a passive infrared marker, a fiducial marker, located on the cap, attached with adhesive, marked with a pen, or any combination thereof.

[0012] The present disclosure further provides a visualization system comprising a processor and a head tracking control system including at least one marker positioned on a surgeon's head. The visualization system further includes a surgeon head motion detection device that detects infrared light reflected from the at least one marker, sends a signal corresponding to the detected light to the processor, and executes instructions on the processor to detect movement of the at least one marker. The visualization system further includes an intelligent tracking system that executes instructions on the processor to determine whether the detected movement of the at least one marker corresponds to a defined head movement of the surgeon. The visualization system further includes a surgical camera that operates in six degrees of freedom and is controlled by the processor when movement of the at least one marker corresponds to a defined head movement of the surgeon.

[0013] The visualization system and method of use may include the following additional features: i) the surgical camera may be a component of the NGENUITY® 3D visualization system, ii) the defined head motion of the surgeon may be a quiet head motion, an intentional head motion, an unusual head motion, or any combination thereof, iii) the intelligent tracking system may include a microphone and a noise detection system that determines whether the detected motion of the at least one marker corresponds to a quiet head motion of the surgeon, a motion thresholding system that determines whether the detected motion of the at least one marker corresponds to an intentional head motion of the surgeon, and a motion recognition system that determines whether the detected motion of the at least one marker corresponds to an unusual head motion of the surgeon, iv) head motions that are not the defined head motion may be ignored by the head tracking control system, and the defined head motion may be a displacement along the x-axis, a displacement along the y-axis, a pitch motion, or any combination thereof, and v) the at least one marker may be an active infrared marker, a passive infrared marker, a fiducial marker, located on the cap, attached with an adhesive, marked with a pen, or any combination thereof.

[0014] The present disclosure further provides a method for controlling an ophthalmic surgical microscope by using a head tracking control system to detect a surgeon's head motion, determine if the head motion is a silent head motion, determine if the head motion is an intentional head motion, determine if the head motion is an uncommon head motion, and enable the head tracking control system to control the ophthalmic surgical microscope if the head motion is a silent head motion, an intentional head motion, or an uncommon head motion.

[0015] The present disclosure further provides a method for a surgeon to control a visualization system by performing a defined head motion, detecting the defined head motion using a surgeon head motion detection device, determining a corresponding motion of a surgical camera, and moving the surgical camera in response to the defined head motion. The surgeon's defined head motion may be a silent head motion, a deliberate head motion, an unusual head motion, or any combination thereof. The surgical camera is capable of moving in six degrees of freedom. The surgical camera may be a component of an NGENUITY® 3D visualization system.

[0016] Aspects of the head tracking control system and its methods of use may be combined with one another unless they are clearly mutually exclusive. In addition, additional features of the head tracking control system and its associated methods described above may also be combined with one another unless they are clearly mutually exclusive.

[0017] For a more complete understanding of the present disclosure and its features and advantages, reference is now made to the following description taken in conjunction with the accompanying drawings, which are not to scale and in which like numerals refer to like features, and in which: [Brief explanation of the drawings]

[0018] [Figure 1] FIG. 1 is a schematic diagram of the six degrees of freedom and frame of reference of a surgeon's head gesture. [Figure 2]FIG. 2 is a schematic diagram of a head tracking control system including an ophthalmic surgical microscope, a headband, an infrared camera, an intelligent tracking system, and a motorized microscope head support. [Figure 3] FIG. 3 is a schematic diagram of a process flow for controlling an ophthalmic surgical microscope using a head tracking control system. [Figure 4] FIG. 4 is a schematic diagram of a head tracking control system including an ophthalmic surgical microscope, a headband, a three-axis gyroscope and a three-axis accelerometer, an intelligent tracking system, and a motorized microscope head support. [Figure 5] Figure 5 is a schematic diagram of a head tracking control system, including an ophthalmic surgical microscope, a headband, a 3D scanning camera, a light-emitting diode (LED) driver, a digital light processing controller chip, a digital micromirror device, a lens, an intelligent tracking system, and a motorized microscope head support. [Figure 6] FIG. 6 is a schematic diagram of the head tracking control system as a component of the NGENUITY® 3D visualization system (Novartis AG Corp., Switzerland). [Figure 7] FIG. 7 is a schematic diagram of a computer system including a head tracking control system. [Figure 8A-8B] 8A-8B are schematic diagrams of a medical system including a head tracking control system. [Figure 8C] FIG. 8C is a schematic diagram of a medical system including a head tracking control system. [Figure 9] FIG. 9 is a flow diagram illustrating a method for controlling a visualization system using a head tracking control system. DETAILED DESCRIPTION OF THE INVENTION

[0019] The present disclosure provides a system including head tracking control and related methods for improving visualization for ophthalmic surgery.

[0020] Ophthalmologists face unique challenges when visualizing the eye. During ophthalmic surgery, it may be desirable for the surgeon to control multiple pieces of equipment, visualization systems, and surgical instruments. For example, to perform any of a variety of surgical procedures, the surgeon may desire to control the placement or focus of the visualization system.

[0021] The present disclosure relates to surgeon head-tracking control of a visualization system for ophthalmic surgery. During ophthalmic surgery, surgeons typically operate on a patient using both hands while paying close attention. Therefore, the surgeon's ability to provide continuous user input, for example, to position or focus the visualization system, may be limited. Manual selection controls for the visualization system (such as panel-mounted controls, touchscreen controls, focus rings, or any combination thereof) may be inappropriate or impossible for the surgeon to operate while performing surgery. Voice-activated selection controls for visualization systems may also be inappropriate due to concerns regarding reliability, language customization, and slow voice recognition. Therefore, voice-activated controls may be particularly useful for selecting options with a single command, rather than continuously positioning or focusing the visualization system, which may involve rapid and repetitive user input.

[0022] The visualization system may include an image acquisition arrangement controlled by a foot pedal device. However, foot pedal control may result in the surgeon's inadvertent hand movement, thereby interrupting the delicate surgical procedure. Furthermore, ophthalmic surgical systems typically include a first foot pedal for controlling the ophthalmic surgical system and, optionally, a second foot pedal for controlling the laser. Because surgeons are only two feet tall, it may be difficult to activate a third pedal to further control the visualization system's placement or focus. A head-mounted display with head motion sensing may also be used to control the visualization system. However, this may be undesirable because the head-mounted display may cause nausea, dizziness, spatial disorientation, and fatigue. Furthermore, the use of a head-mounted display may add weight to the surgeon's head, which may cause cervical spine problems. Certain head-tracking control systems for ophthalmic surgery may also be unable to distinguish between head movements intended to control the visualization system and instinctive head movements made by the surgeon, such as those made while talking and not intended to control the visualization system.

[0023] The disclosed head tracking control systems and methods can provide improved control of visualization systems for ophthalmic surgery. In particular, the disclosed head tracking control systems and methods can provide faster, safer, more sterile, and more comfortable surgical procedures compared to certain other control systems. The disclosed head tracking control systems and methods can provide hands-free control of visualization systems for ophthalmic surgery, which can greatly improve ease of use while providing safer and more sterile surgical procedures. The disclosed head tracking control systems and methods can provide improved control of visualization systems compared to certain other control systems by providing improved comfort to the surgeon. In particular, the disclosed head tracking control systems and methods can use a headband, hat, or cap compared to certain other control systems that use heavier head-mounted displays, which can reduce nausea, dizziness, spatial disorientation, fatigue, and head weight for the surgeon during surgery.

[0024] The head tracking control systems and methods disclosed herein may enable improved positioning and focusing of the visualization system compared to certain other control systems. In particular, the head tracking control systems and methods disclosed herein may enable improved control of the visualization system compared to certain other control systems by limiting the types of head motions that may control the visualization system. For example, the disclosed head tracking control systems and methods may allow only defined head motions of the surgeon to control the visualization system. The disclosed head tracking control systems and methods may also improve visualization for ophthalmic surgery compared to certain other control systems by following the horizontal meridian, thereby improving the usability and responsiveness of the head tracking control system. The disclosed head tracking control systems and methods may enable improved control of the visualization system compared to certain other control systems by providing a microphone for monitoring the surgeon's vocal gestures. By doing so, the systems and methods may allow the head tracking control system to ignore the surgeon's head motions while, for example, talking, coughing, or sneezing. The head tracking control systems and methods disclosed herein can enable improved control of the visualization system compared to certain other control systems by ignoring unintentional surgeon head motion, e.g., fast or small head motion. The head tracking control systems and methods disclosed herein can enable improved control of the visualization system compared to certain other control systems by ignoring general head motion, e.g., yaw head motion, which may generally be associated with the surgeon talking to other staff in the operating room.

[0025] The systems and methods disclosed herein can improve visualization for ophthalmic surgery by providing a head tracking control system that tracks the surgeon's head position using optical tracking, at least one 3-axis gyroscope sensor and at least one 3-axis accelerometer sensor, optical 3D scanning, or any combination thereof. The systems and methods disclosed herein can include a headband, hat, or cap, or any combination thereof, placed on the surgeon's head, which can result in a reduction in the surgeon's head weight during surgery. The headband, hat, or cap can include at least one marker. Movement of the at least one marker can be detected by the head tracking control system and can be executed to control the visualization system in response to a command for movement.

[0026] Referring now to FIG. 1 , the head gestures used by the surgeon 101 to control the visualization system may include six degrees of freedom on separate axes. Rotational degrees of freedom may include pitch 110, yaw 120, and roll 130. Translational degrees of freedom may include x 140, z 150, and y 160. If the surgeon is facing straight ahead with his or her head horizontal, pitch 110, yaw 120, and roll 130 may all be zero. Pitch 110 may be a rotational motion about the lateral x-axis 111. Pitch 110 may be positive when the surgeon 101 is pointing his or her head up and negative when the surgeon 101 is pointing his or her head down. Yaw 120 may be a rotational motion about the vertical z-axis 121. Yaw 120 may be positive when the surgeon 101 is pointing his or her head to his or her right and negative when the surgeon 101 is pointing his or her head to his or her left. Roll 130 may be a rotational motion about a longitudinal y-axis 131. Roll 130 may be positive when the surgeon 101 tilts his / her head to the right and negative when the surgeon 101 turns his / her head to the left.

[0027] If the surgeon has his / her head in a neutral, non-extended position, the translations x 140, z 150, and y 160 may be zero. The translation x 140 may be a displacement along the x-axis 111. The translation x 140 may be positive when the surgeon 101 is displacing his / her head to the left and may be negative when the surgeon 101 is displacing his / her head to the right. The translation z 150 may be a displacement along the z-axis 121. The translation z 150 may be positive when the surgeon 101 is displacing his / her head upward and may be negative when the surgeon 101 is displacing his / her head downward. The translation y 160 may be a displacement along the y-axis 131. The translation y 160 may be positive when the surgeon 101 is displacing his / her head forward and may be negative when the surgeon 101 is displacing his / her head backward.

[0028] 2, the head tracking control system 200 may include an ophthalmic surgical microscope 201, a headband 230, an infrared camera 250, and a motorized microscope head support 265. The ophthalmic surgical microscope 201 may include a microscope body 205, binoculars 210, and an objective lens 220. The objective lens 220 may be positioned in an optical path 225 (dotted line) and may represent a selectable objective lens to provide a desired magnification or field of view of the fundus of the eye 10. The objective lens 220 may be moved closer to or farther away from the eye 10 to change the focus of the ophthalmic surgical microscope 201. The ophthalmic surgical microscope 201 may include an illumination source 226. The illumination source 226 may be an internal illuminator (not shown). Alternatively, illumination source 226 may be provided by an ophthalmic surgical microscope, such as ophthalmic surgical microscope 201, or another ophthalmic visualization system, such as the NGENUITY® 3D visualization system (Novartis AG Corp., Switzerland).

[0029] The binoculars 210 can be used in combination with the microscope body 205 and can be positioned in an optical path 225. The optical path 225 can extend through the binoculars 210 to the eye of the surgeon 101. Portions of the eye 10 suitable for observation using the ophthalmic surgical microscope 201 can include the retina, macula (e.g., the fovea, retinal fovea centralis, parafovea, and perifovea), cornea, iris, lens, lens capsule, optic nerve head (e.g., the optic cup), or one or more layers of the retina, vitreous body, vitreous body, retinal pigment epithelium, choroid, or any portion where surgical instruments are also observed.

[0030] The ophthalmic surgical microscope 201 may further include various other electronic and mechanical components in different embodiments. Thus, while the particular optical design discussed with reference to Figure 2 is specific to an ophthalmic visualization system that includes the ophthalmic surgical microscope 201, one skilled in the art will understand that alternative optical arrangements to support other ophthalmic visualization systems are within the scope of this disclosure.

[0031] During surgery, the surgeon 101 can use the ophthalmic surgical microscope 201 to observe at least a portion of the eye 10. The eye 10 can be illuminated by an illumination source 226. The ophthalmic surgical microscope 201 can have an exemplary field of view that includes an XY plane 266. The XY plane 266 can be formed by an x-axis of microscope movement 211 and a y-axis of microscope movement 231. The XY plane 266 can be a horizontal plane that is approximately parallel to the operating room floor. The XY plane 266 can be a plane that is approximately horizontal above the eye 10 during surgery. The objective lens 220 can be moved toward or away from the eye 10 along a focus z-axis 221 to change the focus of the ophthalmic surgical microscope 201. In another example, the focus of the ophthalmic surgical microscope 201 can be changed optomechanically by operating an optical element called a cell or by moving the entire microscope toward or away from the eye 10.

[0032] The head tracking control system 200 can track the head position of the surgeon 101 using optical tracking. In particular, the head tracking control system 200 can track the head position of the surgeon 101 using an infrared camera 250 and a headband 230. The infrared camera 250 can be a camera that detects infrared light, which can be light having a wavelength in the range of 0.7 to 1000 microns. The headband 230 can be placed on the head of the surgeon 101. Alternatively, the headband 230 can be a hat or cap. The headband 230 can include at least one marker 235. During surgery, the position of the at least one marker 235 can be tracked using the infrared camera 250.

[0033] The marker 235 may be an active infrared marker. The active infrared marker may include an infrared light emitting element and may include at least one light emitting diode (LED). In one example, the marker 235 may include six active beacons. Including six active beacons may allow the marker 235 to be tracked as a rigid body with six degrees of freedom. In another example, the marker 235 may include six LEDs. The LEDs may blink in a time-synchronized control sequence. In another example, the marker 235 may include at least one passive infrared marker and at least one passive reflective marker. The marker 235 may include six passive infrared markers. Including six passive markers may allow the marker 235 to be tracked as a rigid body with six degrees of freedom. The marker 235 may function as a fiducial. The marker 235 may function as a fiducial in a captured image, in real space, or a combination thereof. The markers 235 may be placed within the cap, attached with adhesive, marked with a pen, marked by other means, or any combination thereof. The markers 235 may be placed in any orientation required so that their position can be tracked in six degrees of freedom.

[0034] The infrared camera 250 may be mounted on top of the ophthalmic surgical microscope 201. Alternatively, the infrared camera 250 may be positioned in any suitable location for tracking the at least one marker 235. For example, the infrared camera 250 may be positioned within a range of approximately 2 feet to approximately 6 feet from the marker 235. The infrared camera 250 may detect reflected infrared light, emitted infrared light, or a combination thereof. The infrared camera 250 may have a field of view wide enough to include the at least one marker 235. The infrared camera 250 may include at least infrared sensors 252 and 253. The infrared sensors 252 and 253 may be photodetectors that detect infrared light. The infrared sensors 252 and 253 may be two pairs of area array infrared sensors. The infrared sensors 252 and 253 may be active infrared imaging sensors, time-of-flight area sensors, infrared-sensitive CMOS sensors, infrared-sensitive CCD sensors, or any combination thereof. In another example, the infrared camera 250 may be used in place of three line-scan infrared cameras. The infrared camera 250 can use infrared sensors 252 and 253 to detect infrared light reflected from the at least one marker 235. Alternatively, the infrared camera 250 can use infrared sensors 252 and 253 to detect infrared light emitted by the at least one marker 235. The infrared camera 250 can include an active infrared illuminator 256 that can emit infrared light in the thermal portion of the infrared spectrum. The infrared camera 250 can use infrared sensors 252 and 253 to detect infrared light emitted by the active infrared illuminator 256 and reflected from the at least one marker 235.

[0035] The head tracking control system 200 may include an image processing system 270. The digital images captured by the infrared sensors 252 and 253 may be processed by the image processing system 270. The image processing system 270 may include a processor 280. The infrared sensors 252 and 253 may detect infrared light reflected from the at least one marker 235 and send a signal corresponding to the detected light to the processor 280.

[0036] Processor 280 may include, for example, a field programmable gate array (FPGA), a microprocessor, a microcontroller, a digital signal processor (DSP), a graphics processing unit (GPU), an application specific integrated circuit (ASIC), or any other digital or analog circuit configured to interpret and / or execute program instructions and / or process data.

[0037] The processor 280 may include any physical device capable of storing and / or executing instructions. The processor 280 may execute processor instructions to implement at least a portion of one or more systems, one or more flowcharts, one or more processes, and / or one or more methods described herein. For example, the processor 280 may execute instructions to track the head position of the surgeon 101. The processor 280 may be configured to receive instructions from a memory medium 281. In one example, the processor 280 may include the memory medium 281. In another example, the memory medium 281 may be external to the processor 280. The memory medium 281 may store instructions. The instructions stored by the memory medium 281 may be executable by the processor 280 and may consist of, code, and / or encode instructions according to at least a portion of one or more systems, one or more flowcharts, one or more methods, and / or one or more processes described herein.

[0038] The FPGA may be configured, coded, and / or encoded to implement at least a portion of one or more systems, one or more flowcharts, one or more processes, and / or one or more methods described herein. For example, the FPGA may be configured, coded, and / or encoded to track the head position of the surgeon 101. The ASIC may be configured to implement at least a portion of one or more systems, one or more flowcharts, one or more processes, and / or one or more methods described herein. For example, the ASIC may be configured, coded, and / or encoded to track the head position of the surgeon 101. The DSP may be configured, coded, and / or encoded to implement at least a portion of one or more systems, one or more flowcharts, one or more processes, and / or one or more methods described herein. For example, the DSP may be configured, coded, and / or encoded to track the head position of the surgeon 101.

[0039] A single device may include processor 280 and image processing system 270, or processor 280 may be separate from image processing system 270. In one example, a single computer system may include processor 280 and image processing system 270. In another example, a device may include an integrated circuit that may include processor 280 and image processing system 270. Alternatively, processor 280 and image processing system 270 may be incorporated into a surgical console.

[0040] Processor 280 can interpret and / or execute program instructions and / or process data stored in memory medium 281. Memory medium 281 can be configured, in part or in whole, as application memory, system memory, or both. Memory medium 281 can include any system, device, or apparatus configured to hold and / or accommodate one or more memory devices. Each memory device can include any system, module, or apparatus (e.g., computer-readable medium) configured to retain program instructions and / or data for a period of time. One or more of the described servers, electronic devices, or other machines can include one or more similar processors or memories capable of storing and executing program instructions to perform the functions of the associated machine.

[0041] Infrared sensors 252 and 253 can detect infrared light reflected from at least one marker 235 at detection points 254 and 255, respectively, and transmit signals corresponding to detection points 254 and 255 to processor 280. The relative positions of detection points 254 and 255 on each of infrared sensors 252 and 253, respectively, can define a three-dimensional position of at least one marker 235. Infrared sensors 252 and 253 can be positioned in any relative orientation suitable for defining the three-dimensional position of at least one marker 235.

[0042] The position of the marker 235 can be tracked in real time using the infrared camera 250. As used herein, "real time" may refer to updating information at the same rate as the data is received. In the context of the head tracking control systems and methods of the present disclosure, "real time" may mean that image data is acquired, processed, and transmitted from the photosensor at a high enough data rate and low enough latency that when the data is displayed, the objects appear smoother without judder or delay that the user may notice. For example, this may occur when the combined processing of the signals has a latency of less than about 1 / 30 of a second, with new images acquired, processed, and transmitted at a rate of at least 30 frames per second and displayed at about 60 frames per second.

[0043] The infrared camera 250 can detect infrared light reflected from the at least one marker 235 using infrared sensors 252 and 253 and transmit a signal corresponding to the detected light to the processor 280. The infrared camera 250 can further execute instructions on the processor 280 to detect movement of the at least one marker 235. The movement of the at least one marker 235 can be analyzed by the intelligent tracking system 271. The movement of the marker 235 detected by the infrared camera 250 can correspond to head movement of the surgeon 101, which can be pitch 110, yaw 120, roll 130, x 140, z 150, y 160, or any combination thereof. The head movement of the surgeon 101 can be described by Cartesian coordinates corresponding to the x-axis 111, z-axis 121, and y-axis 131.

[0044] The intelligent tracking system 271 can execute instructions on the processor 280 to determine whether a movement of the at least one marker 235 corresponds to a defined head movement of the surgeon 101. The intelligent tracking system 271 can include a noise detection system 272, a movement thresholding system 273, and a movement recognition system 274. The intelligent tracking system 271 can enable the head tracking control system 200 to control the ophthalmic surgical microscope 201 when the surgeon 101 makes a defined head movement. The defined head movement can include a silent head movement, an intentional head movement, an unusual head movement, or any combination thereof. The defined head movement can correspond to a characteristic movement of the marker 235 detected by the infrared camera 250.

[0045] Quiet head movements may include head movements that are not accompanied by noise from the surgeon 101. The noise may include talking, sneezing, coughing, sighing, or any combination thereof. The conversation by the surgeon may include communication with others in the operating room. Quiet head movements may be detected by the noise detection system 272. The noise detection system 272 may be communicatively coupled to the microphone 260. The microphone 260 may be worn by the surgeon 101. The microphone 260 may be a wireless microphone. The microphone 260 may be a head-mounted microphone. If little or no signal is detected from the microphone 260 at approximately the same time that movement of the marker 235 is detected by the infrared camera 250, the head movement may be quiet head movements. The noise detection system 272 may determine whether the head movement is quiet head movements and send a signal corresponding to the determination to the processor 280. The processor 280 may execute instructions for controlling the ophthalmic surgical microscope 201 in response to the quiet head movements.

[0046] Intentional head movements may include head movements intentionally performed by the surgeon 101, for example, head movements that are not instinctive. Intentional head movements may include head movements that are slower than instinctive head movements, head movements with a larger magnitude than instinctive head movements, head movements that are smoother than instinctive head movements, or any combination thereof. Intentional head movements may be head movements slower than head movements occurring at 2 Hz. Alternatively, intentional head movements may be head movements slower than head movements occurring at 4 Hz. Intentional head movements may be head movements with a larger magnitude than 1 mm when measured by moving a specific point on the surgeon's head in three-dimensional space. Alternatively, intentional head movements may be head movements in the range of approximately 1 mm to approximately 16 mm when measured by moving a specific point on the surgeon's head in three-dimensional space. Intentional head movements may be head movements with a magnitude of 1 m / s. 2 A deliberate head movement can be a smoother movement than a head movement that accelerates the head faster than 2 m / s. 2 A head movement may be a smooth head movement rather than a head movement that accelerates the head faster than the intended head movement. Intentional head movements can be detected by the motion thresholding system 273. If the movement of the marker 235 detected by the infrared camera 250 is slow, large in magnitude, smooth, or any combination thereof, the head movement may be an intended head movement. Alternatively, if the movement of the marker 235 detected by the infrared camera 250 is slow, large in magnitude, and smooth, the head movement may be an intended head movement. The motion thresholding system 273 can determine whether the head movement is an intended head movement and send a signal corresponding to the determination to the processor 280. The processor 280 can execute instructions for controlling the ophthalmic surgical microscope 201 in response to the intended head movement.

[0047] Unusual head movements may include head movements that surgeons do not typically perform during surgery. For example, unusual head movements may include translation x 140 or y 160. Common surgeon movements that frequently occur during surgery may include yaw 120, for example, to accommodate other staff in the operating room. Unusual head movements may be detected by the motion recognition system 274. If the movement of the marker 235 detected by the infrared camera 250 corresponds to a head movement that surgeons do not typically perform during surgery, the head movement may be an unusual head movement. The motion recognition system 274 may determine whether the head movement is an unusual head movement and send a signal corresponding to the determination to the processor 280. The processor 280 may execute instructions for controlling the ophthalmic surgical microscope 201 in response to the unusual head movement.

[0048] The intelligent tracking system 271 may enable the head tracking control system 200 to control the ophthalmic surgical microscope 201 when the surgeon 101 performs defined head movements that are silent, intentional, and uncommon. Alternatively, the intelligent tracking system 271 may enable the head tracking control system 200 to control the ophthalmic surgical microscope 201 when the surgeon 101 performs defined head movements that are silent, intentional, uncommon, or any combination thereof. Surgeon's head movements that are not defined head movements may be ignored by the head tracking control system 200.

[0049] The ophthalmic surgical microscope 201 can execute instructions on the processor 280 in response to defined head movements of the surgeon 101. For example, the processor 280 can execute instructions to move the motorized microscope head support 265 in response to defined head movements of the surgeon 101. The movement of the motorized microscope head support 265 can be described by a two-dimensional Cartesian coordinate system of an x-axis of microscope movement 211 and a y-axis of microscope movement 231.

[0050] For example, movement of at least one marker 235 corresponding to a defined head movement of x140 by the surgeon 101 may be detected by the infrared camera 250, and a signal corresponding to the detected movement may be transmitted to the processor 280. The processor 280 may execute instructions to move the motorized microscope head support along the x-axis 211 of microscope movement, thereby changing the field of view that includes the XY plane 266 observed by the surgeon 101 along the x-axis 211 of microscope movement. Similarly, movement of at least one marker 235 corresponding to a defined head movement of y160 by the surgeon 101 may be detected by the infrared camera 250, and a signal corresponding to the detected movement may be transmitted to the processor 280. The processor 280 may execute instructions to move the motorized microscope head support along the y-axis 231 of microscope movement, thereby changing the field of view that includes the XY plane 266 observed by the surgeon 101 along the y-axis 231 of microscope movement.

[0051] Alternatively, the processor 280 can execute other instructions to control the ophthalmic surgical microscope 201 in response to defined head movements of the surgeon 101. For example, movement of the at least one marker 235 corresponding to defined head movements by the surgeon 101, including z 150 and pitch 110, can be detected, and a signal corresponding to the detected movement can be sent to the processor 280. The processor 280 can execute instructions to change the focus of the ophthalmic surgical microscope 201 by moving the objective lens 220. The objective lens 220 can be moved along a focus z-axis 221. If z 150 and pitch 110 are positive, the processor 280 can execute instructions to move the objective lens 220 away from the eye 10 along the focus z-axis 221 in the surgical microscope 201. If z 150 and pitch 110 are negative, the processor 280 can execute instructions to move the objective lens 220 closer to the eye 10 along the focus z-axis 221. The processor 280 can execute instructions for controlling the ophthalmic surgical microscope 201 in any manner useful for ophthalmic surgery in response to well-defined head movements of the surgeon 101. Such instructions can be unique and programmable to accommodate the preferences of individual ophthalmologists.

[0052] The instructions executed by the processor 280 to control the ophthalmic surgical microscope 210 may be motion instructions. The motion commands may have a speed parameter, which may be measured in units such as mm / sec or μm / sec. The speed of the motion commands may be fixed or variable. The speed of the motion command may vary depending on the position of the corresponding motion. For example, the speed of a motion command to move the motorized microscope head support 265 in response to a defined head movement of the surgeon 101 may vary depending on the position of the motorized microscope head support 265. Movement of the at least one marker 235 corresponding to the defined head movement in y 160 by the surgeon 101 may be detected by the infrared camera 250, and a signal corresponding to the detected movement may be transmitted to the processor 280. The processor 280 may execute the motion commands to move the motorized microscope head support along the y-axis 231 of microscope movement. The motorized microscope head support 265 may move from a start point 261 to an end point 262. As the motorized microscope head support 265 moves away from the starting point 261, the speed of the motion command may increase as the distance from the starting point 261 increases. This increase may continue until the motorized microscope head support 265 reaches a point equidistant between the starting point 261 and the ending point 262. The speed of the motion command may then decrease as the distance of the motorized microscope head support 265 to the ending point 262 decreases. Thus, the motion commands may be configured to provide a gradual increase and decrease in the motion speed of the motorized microscope head support 265. The motion commands may also be configured to provide any motion speed of the components of the ophthalmic surgical microscope 210 that improves visualization for the ophthalmic surgery.

[0053] The head tracking control system 200 may include a control device 282. The control device 282 may adjust, for example, the settings of the intelligent tracking system 271, the sensitivity of the microphone 260, the speed of the movement commands executed by the processor 280, other surgeon-specific settings of the head tracking control system 200, or any combination thereof.

[0054] FIG. 3 shows a process flow 300 for controlling an ophthalmic surgical microscope using a head tracking control system. Process flow 300 may include detecting a surgeon's head motion in step 301. The head motion may be detected by an infrared camera, such as infrared camera 250. Process flow 300 may further include determining whether the head motion is a quiet head motion in step 310. A noise detection system, such as noise detection system 272, may detect whether the head motion is a quiet head motion. If the head motion is not a quiet head motion, then in step 340, the head tracking control system, such as head tracking control system 200, may not control the ophthalmic surgical microscope, such as ophthalmic surgical microscope 201. If the head motion is a quiet head motion, process flow 300 may include determining whether the head motion is an intentional head motion in step 320. A motion thresholding system, such as motion thresholding system 273, may detect whether the head motion is an intentional head motion. If the head motion is not an intentional head motion, the head tracking control system may not control the ophthalmic surgical microscope in step 340. If the head motion is an intentional head motion, process flow 300 may include determining whether the head motion is an unusual head motion in step 330. A motion recognition system, such as motion recognition system 274, can detect whether the head motion is an unusual head motion. If the head motion is not an unusual head motion, the head tracking control system may not control the ophthalmic surgical microscope in step 340. If the head motion is an unusual head motion, process flow 300 may include enabling a head tracking control system, such as head tracking control system 200, to control the ophthalmic surgical microscope.

[0055] In process flow 300, the surgeon's head movements may be silent, deliberate, and infrequent head movements, allowing the head tracking control system to control the ophthalmic surgical microscope. Alternatively, the surgeon's head movements may be silent, deliberate, infrequent, or any combination thereof, allowing the head tracking control system to control the ophthalmic surgical microscope.

[0056] Referring now to FIG. 4, the head tracking control system 400 may include the ophthalmic surgical microscope 201, a headband 430, a three-axis gyroscope 457, a three-axis accelerometer 458, and a motorized microscope head support 265.

[0057] The head tracking control system 400 can track head motion of the surgeon 101 using at least one gyroscope sensor and at least one accelerometer sensor. For example, the head tracking control system 400 can include a three-axis gyroscope 457 and a three-axis accelerometer 458 attached to a headband 430. The headband 430 can be placed on the head of the surgeon 101. The three-axis gyroscope 457 and the three-axis accelerometer 458 can be wirelessly communicatively coupled to the processor 480. In another example, the head tracking control system 400 can include a vibrating structure gyroscope sensor. The head tracking control system 400 can include a gyroscope sensor included on a single chip. The head tracking control system 400 can include an accelerometer sensor included on a single chip. Alternatively, the headband 430 can be a hat or cap.

[0058] The three-axis gyroscope 457 may be a three-axis gyroscope sensor capable of detecting the angular velocity of the head of the surgeon 101 wearing the headband 430. The three-axis gyroscope 457 may also detect the rotational movement pitch 110, yaw 120, and roll 130 of the head of the surgeon 101. The three-axis accelerometer 458 may be a three-axis accelerometer sensor capable of detecting the acceleration of the head of the surgeon 101 wearing the headband 430. The three-axis accelerometer 458 may also detect the x 140, z 150, and y 160 movement of the head of the surgeon 101.

[0059] During surgery, the three-axis gyroscope 457 and the three-axis accelerometer 458 can detect head movements of the surgeon 101 and send signals corresponding to the detected movements to the processor 480. The head movements of the surgeon 101 can be analyzed by the intelligent tracking system 271. The head movements of the surgeon 101 detected by the three-axis gyroscope 457 and the three-axis accelerometer 458 can correspond to head movements that are pitch 110, yaw 120, roll 130, x 140, z 150, y 160, or any combination thereof. The head movements of the surgeon 101 can be described by Cartesian coordinates corresponding to the x-axis 111, z-axis 121, and y-axis 131. The head movements of the surgeon 101 can be tracked in real time using the three-axis gyroscope 457 and the three-axis accelerometer 458.

[0060] The intelligent tracking system 271 can execute instructions on the processor 480 to determine whether a head movement of the surgeon 101 corresponds to a defined head movement. The intelligent tracking system 271 can include a noise detection system 272, a movement thresholding system 273, and a movement recognition system 274. The intelligent tracking system 271 can enable the head tracking control system 400 to control the ophthalmic surgical microscope 201 when the surgeon 101 makes a defined head movement. The defined head movement can include a silent head movement, an intentional head movement, an unusual head movement, or any combination thereof. The defined head movement can correspond to a characteristic head movement of the surgeon 101 detected by the three-axis gyroscope 457 and the three-axis accelerometer 458.

[0061] The intelligent tracking system 271 may enable the head tracking control system 400 to control the ophthalmic surgical microscope 201 when the surgeon 101 performs defined head movements that are silent, intentional, and uncommon. Alternatively, the intelligent tracking system 271 may enable the head tracking control system 400 to control the ophthalmic surgical microscope 201 when the surgeon 101 performs defined head movements that are silent, intentional, uncommon, or any combination thereof. Thus, the surgeon's head movements that are not defined head movements may be ignored by the head tracking control system 400.

[0062] The ophthalmic surgical microscope 201 can execute instructions on the processor 480 in response to defined head movements of the surgeon 101. For example, the processor 480 can execute instructions to move the motorized microscope head support 265 in response to defined head movements of the surgeon 101. The movement of the motorized microscope head support 265 can be described by a two-dimensional Cartesian coordinate system corresponding to an x-axis of microscope movement 211 and a y-axis of microscope movement 231. Alternatively, the processor 480 can execute other instructions to control the ophthalmic surgical microscope 201 in response to defined head movements of the surgeon 101.

[0063] Referring now to FIG. 5, the head tracking control system 500 may include an ophthalmic surgical microscope 201, a headband 530, a 3D scanning camera 550, an LED driver 556, a digital light processing controller chip 557, a digital micromirror device 558, a lens 559, and a motorized microscope head support 265.

[0064] The head tracking control system 500 can track the head movements of the surgeon 101 using optical 3D scanning to provide a digitized 3D scan of the surgeon's 101 head. The 3D scanning can be performed using structured light, which can be provided by a digital micromirror device 558. 3D scanning using structured light is an optical method in which a series of patterns can be projected onto the head of the surgeon 101. The 3D scanning camera 550 can detect distortions in the structured light pattern reflected from the head of the surgeon 101. Image processing and triangulation algorithms, which can be performed by the image processing system 270, can convert these distortions into a 3D point cloud. The point cloud can be used to determine the head movements of the surgeon 101.

[0065] Digital light processing controller chip 557 can control an array of reflective aluminum mirrors disposed on digital micromirror device 558. LED driver 556 can emit near-infrared light (e.g., wavelengths in the range of 700 nm to 2500 nm). In another configuration, LED driver 556 can be used in place of a lamp or laser. Digital micromirror device 558 can modulate the amplitude, direction, phase, or any combination thereof, of the incident light emitted by LED driver 556. The light emitted by LED driver 556 and modulated by digital micromirror device 558 can pass through lens 559.

[0066] The head tracking control system 500 may include a headband 530. The headband 530 may be placed on the head of the surgeon 101. Alternatively, the headband 530 may be a hat or cap. The headband 530 may include at least one marker 535. The marker 535 may include six passive infrared markers. The inclusion of six passive markers may allow the marker 535 to be tracked as a rigid body with six degrees of freedom. During surgery, the position of the at least one marker 535 may be tracked using a 3D scanning camera 550 using optical 3D scanning. The marker 535 may function as a fiducial. The marker 535 may serve as a fiducial for captured images. The marker 535 may also serve as a fiducial in real space. The marker 535 may be placed in a cap, attached with adhesive, marked with a pen, marked by other means, or any combination thereof. The marker 535 can be placed in any orientation required so that its position can be tracked in six degrees of freedom.

[0067] The 3D scanning camera 550 can detect structured light reflected from the at least one marker 535 and transmit a signal corresponding to the detected light to the processor 580. The 3D scanning camera 550 can further execute instructions on the processor 280 to detect movement of the at least one marker 535. The movement of the at least one marker 535 can be analyzed by the intelligent tracking system 271. The movement of the markers 535 detected by the 3D scanning camera 550 can correspond to head movement of the surgeon 101, which can be pitch 110, yaw 120, roll 130, x 140, z 150, y 160, or any combination thereof. The head movement of the surgeon 101 can be described by Cartesian coordinates corresponding to the x-axis 111, z-axis 121, and y-axis 131. The head movement of the surgeon 101 can be tracked in real time using the 3D scanning camera 550. In another example, the 3D scanning camera 550 may be a LIPSedge™ AE400 stereo camera (LIPS Corp., Taiwan).

[0068] The intelligent tracking system 271 can execute instructions on the processor 580 to determine whether movement of at least one marker 535 corresponds to a defined head movement of the surgeon 101. The intelligent tracking system 271 can include a noise detection system 272, a movement thresholding system 273, and a movement recognition system 274. The intelligent tracking system 271 can enable the head tracking control system 500 to control the ophthalmic surgical microscope 201 when the surgeon 101 makes a defined head movement. The defined head movement can include a silent head movement, a deliberate head movement, an unusual head movement, or any combination thereof. The defined head movement can correspond to a characteristic movement of the marker 535 detected by the 3D scanning camera 550.

[0069] The intelligent tracking system 271 may enable the head tracking control system 500 to control the ophthalmic surgical microscope 201 when the surgeon 101 performs defined head movements that are silent, intentional, and uncommon. Alternatively, the intelligent tracking system 271 may enable the head tracking control system 500 to control the ophthalmic surgical microscope 201 when the surgeon 101 performs defined head movements that are silent, intentional, uncommon, or any combination thereof. Thus, the surgeon's head movements that are not defined head movements may be ignored by the head tracking control system 500.

[0070] The ophthalmic surgical microscope 201 can execute instructions on the processor 580 in response to defined head movements of the surgeon 101. For example, the processor 580 can execute instructions to move the motorized microscope head support 265 in response to defined head movements of the surgeon 101. The movement of the motorized microscope head support 265 can be described by a two-dimensional Cartesian coordinate system corresponding to an x-axis of microscope movement 211 and a y-axis of microscope movement 231. Alternatively, the processor 580 can execute other instructions to control the ophthalmic surgical microscope 201 in response to defined head movements of the surgeon 101.

[0071] 6 , head tracking control system 200, head tracking control system 400, or head tracking control system 500 may be used, at least in part, as a component of the NGENUITY® 3D visualization system (Novartis AG Corp., Switzerland) in visualization system 600. Visualization system 600 may include a headband 630, a surgeon head motion detection device 650, an intelligent tracking system 271, a surgical camera 660, a patient table 665, a surgical camera system 685, and a display 690. Surgeon head motion detection device 650 may be a device such as an infrared camera 250, a three-axis gyroscope 457 and a three-axis accelerometer 458, a three-dimensional scanning camera 550, or any combination thereof.

[0072] The headband 630 may be placed on the head of the surgeon 101. Alternatively, the headband 630 may be a hat or cap. The headband 630 may include at least one marker 635. During surgery, the position of the at least one marker 635 may be tracked using the surgeon head motion detection device 650. The marker 635 may be an active infrared marker. The active infrared marker may include an infrared light emitting element and may include at least one light emitting diode (LED). In one example, the marker 635 may include six active beacons. The inclusion of six active beacons may allow the marker 635 to be tracked as a rigid body with six degrees of freedom. In another example, the marker 635 may include six LEDs. The LEDs may flash in a time-synchronized control sequence.

[0073] The markers 635 may be passive markers. The markers 635 may include six passive infrared markers. Including six passive markers may allow the markers 635 to be tracked as rigid bodies with six degrees of freedom. The markers 635 may function as references. The markers 635 may function as references for captured images. The markers 635 may also function as references in real space. If at least a portion of the head tracking control system 400 is included as a component of the visualization system 600, the headband 630 may include a three-axis gyroscope and a three-axis accelerometer, such as a three-axis gyroscope 457 and a three-axis accelerometer 458 (not shown), instead of the markers 635.

[0074] The surgical camera 660 may be positioned above a patient table 665. The surgical camera 660 may be a digital camera, an HDR camera, a 3D camera, a surgical camera, or any combination thereof. The surgical camera 660 may be capable of movement with six degrees of freedom. The surgical camera 660 may also utilize an optomechanical focus system 661, a zoom system 662, and a variable working distance system 663. The surgical camera 660 may be communicatively coupled to a surgical camera system 685 and a display 690. The surgical camera system 685 may include an image processing system 670, a processor 680, and a memory medium 681.

[0075] The display 690 may be a head-up display mounted on a support member 698 and a mount base 699. The support member 698 and the mount base 699 may be adjustable to change the distance between the display 690 and the surgeon. The display 690 may also be ceiling-mounted. The display 690 may be communicatively coupled to the surgical camera system 685. The display 690 may be a picture-in-picture display. In another example, the surgical camera 660 may be a 3D HDR camera and the display 690 may be a 3D 4K OLED surgical display. The display 690 may display 3D surgical images of the eye. The processor 680 may be an ultra-fast 3D image processor that may optimize the 3D HDR image in real time.

[0076] The surgical camera 660 may be communicatively coupled to a surgical camera system 685 and a display 690. The display 690 may receive information from the surgical camera 660 via the surgical camera system 685. The display 690 may display a digital image of the eye captured by the surgical camera 660.

[0077] The surgeon head motion detection device 650 can detect head motion of the surgeon 101 and send a signal corresponding to the detected head motion to the processor 680. The head motion of the surgeon 101 can be analyzed by the intelligent tracking system 271. The head motion of the surgeon 101 can be pitch 110, yaw 120, roll 130, x 140, z 150, y 160, or any combination thereof. The head motion of the surgeon 101 can be described by Cartesian coordinates corresponding to the x-axis 111, z-axis 121, and y-axis 131.

[0078] The intelligent tracking system 271 can execute instructions on the processor 680 to determine whether a head movement of the surgeon 101 corresponds to a defined head movement. The intelligent tracking system 271 can include a noise detection system 272, a movement thresholding system 273, and a movement recognition system 274. The intelligent tracking system 271 can enable the head tracking control system to control the surgical camera 660 when the surgeon 101 makes a defined head movement. The defined head movement can include a silent head movement, an intentional head movement, an unusual head movement, or any combination thereof. The defined head movement can correspond to a characteristic movement of the marker 635 detected by the surgeon head movement detection device 650.

[0079] The processor 680 can execute instructions to operate the surgical camera 660 in response to defined head movements of the surgeon 101. The movement of the surgical camera 660 can be described by Cartesian coordinates corresponding to an x-axis 611, a z-axis 621, and a y-axis 631. The visualization system 600 can maintain the relative orientation between the surgeon's 101's head (x-axis 111, z-axis 121, and y-axis 131) and the surgical camera 660 (x-axis 611, z-axis 621, and y-axis 631) in six degrees of freedom (x, y, z, pitch, yaw, and roll). In this manner, the surgical camera 660 can function as if it were attached to the surgeon's 101's head when the head tracking control system is activated. The surgical camera 660 can be at a distance 666 from the surgeon's 101's head. The distance 666 can range from approximately 175 mm to approximately 300 mm. When the head tracking control system is activated, the surgeon 101 can move his or her head as if it were the surgical camera 660. The head tracking control system can be activated, for example, by a foot pedal.

[0080] The intelligent tracking system 271 may enable the head tracking control system to control the surgical camera 660 when the surgeon 101 performs defined head movements that are silent, intentional, and uncommon. Alternatively, the intelligent tracking system 271 may enable the head tracking control system to control the surgical camera 660 when the surgeon 101 performs defined head movements that are silent, intentional, uncommon, or any combination thereof. Thus, surgeon head movements that are not defined head movements may be ignored by the head tracking control system in the visualization system 600. The defined head movements when controlling the surgical camera 660 may be different from the defined head movements when controlling the ophthalmic surgical microscope 201.

[0081] In another example, the processor 680 may execute instructions in response to defined head movements of the surgeon 101 to enable navigation on the display 690. The display 690 may show a virtual display of a surgical procedure. The surgeon's 101 head movements, be it pitch 110 or yaw 120, may be used to navigate around the virtual display. Alternatively, the surgeon's 101 head movements, be it pitch 110 or yaw 120, may be used to execute "yes" and "no" commands to navigate on the display 690, respectively.

[0082] 7, head tracking control system 200, head tracking control system 400, or head tracking control system 500 may be used in combination with computer system 700. Computer system 700 may include a processor 710, a volatile memory medium 720, a non-volatile memory medium 730, and input / output (I / O) devices 740. Volatile memory medium 720, non-volatile memory medium 730, and I / O devices 740 may be communicatively coupled to processor 710.

[0083] The term “memory medium” may refer to “memory,” “storage device,” “memory device,” “computer-readable medium,” and / or “tangible computer-readable storage medium.” For example, memory medium may include, without limitation, storage media such as direct access storage devices including hard disk drives, sequential access storage devices such as tape disk drives, compact discs (CDs), random access memory (RAM), read-only memory (ROM), CD-ROMs, digital versatile discs (DVDs), electrically erasable programmable read-only memory (EEPROM), flash memory, non-transitory media, or any combination thereof. As shown in FIG. 7 , non-volatile memory medium 730 may include processor instructions 732. Processor instructions 732 may be executed by processor 710. In one example, one or more portions of processor instructions 732 may be executed via non-volatile memory medium 730. In another example, one or more portions of processor instructions 732 may be executed via volatile memory medium 720. One or more portions of processor instructions 732 may be transferred to volatile memory medium 720.

[0084] The processor 710 may execute the processor instructions 732 in performing at least a portion of one or more systems, one or more flow diagrams, one or more processes, and / or one or more methods described herein. For example, the processor instructions 732 may comprise, code, and / or encode a plurality of instructions in accordance with at least a portion of one or more systems, one or more flow diagrams, one or more methods, and / or one or more processes described herein. While the processor 710 is shown as a single processor, the processor 710 may be or include multiple processors. One or more of the storage medium and memory medium may be a software product, a program product, and / or an article of manufacture. For example, the software product, the program product, and / or the article of manufacture may be comprised of, coded, and / or encoded with processor-executable instructions in accordance with at least a portion of one or more systems, one or more flow diagrams, one or more methods, and / or one or more processes described herein.

[0085] Processor 710 may include any suitable system, device, or apparatus operable to interpret and execute program instructions, process data, or both stored on a memory medium and / or received over a network. Processor 710 may also include one or more microprocessors, microcontrollers, FPGAs, DSPs, ASICs, or other circuitry configured to interpret and execute program instructions, process data, or both.

[0086] I / O devices 740 may include any one or more devices that permit, authorize, and / or enable a user to interact with computer system 700 and related elements by enabling input from and output to a user. Enabling input from a user allows the user to operate and / or control computer system 700, and enabling output to a user allows computer system 700 to display the effects of the user's operations and / or controls. For example, I / O devices 740 may enable a user to input data, instructions, or both into computer system 700 and otherwise operate and / or control computer system 700 and related elements. I / O devices may include user interface devices such as a keyboard, mouse, touchscreen, joystick, handheld lens, tool tracking device, coordinate input device, or any other I / O suitable for use with the system.

[0087] The I / O devices 740 may include, among other things, one or more buses, one or more serial devices, and / or one or more network interfaces that may facilitate and / or allow the processor 710 to implement at least a portion of one or more systems, processes, and / or methods described herein. In one example, the I / O devices 740 may include a storage device interface that may facilitate and / or allow the processor 710 to communicate with external storage devices. The storage device interface may include, among other things, one or more of a Universal Serial Bus (USB) interface, a Serial ATA (SATA) interface, an Ethernet, a Parallel ATA (PATA) interface, and a Small Computer System Interface (SCSI). In a second example, the I / O devices 740 may include a network interface that may facilitate and / or allow the processor 710 to communicate with a network. The I / O devices 740 may include one or more of a wireless network interface and a wired network interface. In a third example, the I / O device 740 may include one or more of a Peripheral Component Interconnect (PCI) interface, a PCI Express (PCIe) interface, a Serial Peripheral Interconnect (SPI) interface, and an Inter-Integrated Circuit (I2C) interface, among others. In a fourth example, the I / O device 740 may include circuitry that may allow the processor 710 to communicate data with one or more sensors. In a fifth example, the I / O device 740 may facilitate and / or allow the processor 710 to communicate data with one or more of the display 750 and the head tracking control system 200, among others. As shown in FIG. 7, the I / O device 740 may be coupled to a network 770. For example, the I / O device 740 may include a network interface.

[0088] Network 770 may include a wired network, a wireless network, an optical network, or any combination thereof. Network 770 may include and / or be coupled to various types of communication networks. For example, network 770 may include and / or be coupled to a local area network (LAN), a wide area network (WAN), the Internet, a public switched telephone network (PSTN), a cellular telephone network, a satellite telephone network, or any combination thereof. A WAN may include a private WAN, a corporate WAN, a public WAN, or any combination thereof.

[0089] 7 shows computer system 700 as external to head tracking control system 200, head tracking control system 200 may include computer system 700. For example, processor 710 may be or include processor 280.

[0090] 8A-8C show an example of a medical system 800. As shown in FIG. 8A, the medical system 800 may include the head tracking control system 200. Alternatively, the medical system 800 may include the head tracking control system 400 or the head tracking control system 500. As shown in FIG. 8B, the medical system 800 may include the head tracking control system 200 and a computer system 700. The head tracking control system 200 may be communicatively coupled to the computer system 700. As shown in FIG. 8C, the medical system 800 may include the head tracking control system 200, which may include the computer system 700.

[0091] FIG. 9 illustrates a flow diagram of a method for controlling a visualization system using a head tracking control system. In step 900, the surgeon performs a defined head motion, which may be a silent head motion, an intentional head motion, or an uncommon head motion. In step 910, the defined head motion may be detected by a surgeon head motion detection device, such as surgeon head motion detection device 650. The defined head motion may be pitch 110, yaw 120, roll 130, x 140, z 150, y 160, or any combination thereof. In step 920, a corresponding motion of a surgical camera, such as surgical camera 660, may be determined. The corresponding motion of the surgical camera may have six degrees of freedom. Alternatively, the corresponding motion of the surgical camera may have fewer than six degrees of freedom. For example, head tracking control system 200 may detect the surgeon's defined head motion with six degrees of freedom, but control an ophthalmic surgical microscope 201 with three degrees of freedom. In step 930, the surgical camera may operate in response to the surgeon's defined head motion.

[0092] Head tracking control system 200, head tracking control system 400, head tracking control system 500, visualization system 600, computer system 700, medical system 800, and their components may be combined with other elements of the visualization tools and systems described herein, unless clearly mutually exclusive. For example, infrared cameras and active infrared illuminators may be used with other visualization systems described herein.

[0093] The above disclosed subject matter should be considered illustrative and not limiting, and the appended claims are intended to cover all such modifications, enhancements, and other embodiments that fall within the true spirit and scope of the present disclosure. For example, while head tracking control systems are most commonly required to improve control of visualization systems for ophthalmic surgery, the systems and methods described herein may be used where useful in other procedures, such as purely diagnostic procedures, that are not otherwise considered surgical. According to aspect (1), there is provided a head tracking control system, at least one marker operable to be placed on the head of a surgeon; at least two infrared sensors; and Detecting infrared light reflected from at least one of the markers and transmitting a signal corresponding to the detected light to a processor; Executing instructions on the processor to detect movement of at least one of the markers. an infrared camera operable to an intelligent tracking system operable to execute instructions on the processor to determine whether the detected movement of at least one of the markers corresponds to a defined head movement of the surgeon; an ophthalmic surgical microscope including the processor; Equipped with the processor is operable to execute instructions for controlling the ophthalmic surgical microscope if the detected movement of at least one of the markers corresponds to the defined head movement of the surgeon. It is a head tracking control system. According to aspect (2), the defined head movements of the surgeon are silent head movements, deliberate head movements, unusual head movements, or any combination thereof. According to aspect (3), the intelligent tracking system comprises: a noise detection system including a microphone and operable to determine whether the detected movement of at least one of the markers corresponds to a quiet head movement of the surgeon; a motion thresholding system operable to determine whether the detected motion of at least one of the markers corresponds to an intentional head motion of the surgeon; a motion recognition system operable to determine whether the detected motion of at least one of the markers corresponds to an unusual head motion of the surgeon; Equipped with. According to aspect (4), head movements that are not within the defined head movements are ignored by the head tracking control system. According to aspect (5), the defined head motion is a displacement along the x-axis, a displacement along the y-axis, a pitch motion, or any combination thereof. According to aspect (6), the microscope further includes a motorized microscope head support, The processor is operable to control the ophthalmic surgical microscope by executing instructions to move the motorized microscope head support along an x-axis of microscope motion, a y-axis of microscope motion, or any combination thereof. According to aspect (7), the imaging device further includes an objective lens, The processor is operable to control the ophthalmic surgical microscope by executing instructions for operating the objective lens. According to aspect (8), at least one of the markers is an active infrared marker, a passive infrared marker, a reference marker, placed on the cap, attached with adhesive, marked with a pen, or any combination thereof. According to aspect (9), there is provided a head tracking control system, a three-axis gyroscope and a three-axis accelerometer operable to be positioned on a surgeon's head and operable to detect head movement of the surgeon and transmit signals corresponding to the detected movement to a processor; an intelligent tracking system operable to execute instructions on the processor to determine whether the detected head movements of the surgeon correspond to defined head movements of the surgeon; an ophthalmic surgical microscope including the processor; Equipped with the processor is operable to execute instructions for controlling the ophthalmic surgical microscope if the detected head movement of the surgeon corresponds to the defined head movement of the surgeon. It is a head tracking control system. According to aspect (10), the defined head movements of the surgeon are silent head movements, deliberate head movements, unusual head movements, or any combination thereof. According to aspect (11), the intelligent tracking system comprises: a noise detection system including a microphone and operable to determine whether the detected head movement of the surgeon corresponds to a quiet head movement; a motion thresholding system operable to determine whether the detected head motion of the surgeon corresponds to an intentional head motion; a motion recognition system operable to determine whether the detected head motion of the surgeon corresponds to an unusual head motion; Equipped with. According to aspect (12), head movements that are not within the defined head movements are ignored by the head tracking control system. According to aspect (13), the defined head motion is a displacement along the x-axis, a displacement along the y-axis, a pitch motion, or any combination thereof. According to aspect (14), the microscope further includes a motorized microscope head support, The processor is operable to control the ophthalmic surgical microscope by executing instructions to move the motorized microscope head support along an x-axis of microscope motion, a y-axis of microscope motion, or any combination thereof. According to aspect (15), the imaging device further includes an objective lens, 10. The head tracking control system of claim 9, wherein the processor is operable to control the ophthalmic surgical microscope by executing instructions for operating the objective lens.

Claims

1. 1. A head tracking and control system comprising: at least one operable marker positioned on the head of the surgeon; at least two infrared sensors; and Detecting infrared light reflected from at least one of the markers and transmitting a signal corresponding to the detected infrared light to a processor; Executing instructions on the processor to detect movement of at least one of the markers. an infrared camera operable to an intelligent tracking system operable to execute instructions on the processor to determine whether the detected movement of at least one of the markers corresponds to a defined head movement of the surgeon; an ophthalmic surgical microscope including the processor; Equipped with the processor is operable to execute instructions for controlling the ophthalmic surgical microscope if the detected movement of at least one of the markers corresponds to the defined head movement of the surgeon; the intelligent tracking system, a noise detection system including a microphone and operable to determine whether the detected movement of at least one of the markers corresponds to quiet head movement of the surgeon, wherein the microphone detects noise including the surgeon talking, sneezing, coughing, sighing, or any combination thereof, and determines that the detected movement is quiet head movement of the surgeon if little or no noise is detected from the microphone at approximately the same time that movement of the marker is detected by the infrared camera; a motion thresholding system operable to determine whether the detected motion of at least one of the markers corresponds to an intentional head motion of the surgeon; a motion recognition system operable to determine whether the detected motion of at least one of the markers corresponds to an unusual head motion of the surgeon; A head tracking control system comprising:

2. The head tracking control system of claim 1 , wherein the defined head movements of the surgeon are silent head movements, deliberate head movements, unusual head movements, or any combination thereof.

3. The head tracking control system of claim 1 , wherein head movements that are not the defined head movements are ignored by the head tracking control system.

4. The head tracking control system of claim 1 , wherein the defined head motion is a displacement along an x-axis, a displacement along a y-axis, a pitch motion, or any combination thereof.

5. a motorized microscope head support; 10. The head tracking control system of claim 1, wherein the processor is operable to control the ophthalmic surgical microscope by executing instructions to move the motorized microscope head support along an x-axis of microscope motion, a y-axis of microscope motion, or any combination thereof.

6. further comprising an objective lens; 2. The head tracking control system of claim 1, wherein the processor is operable to control the ophthalmic surgical microscope by executing instructions for operating the objective lens.

7. 2. The head tracking control system of claim 1, wherein at least one said marker is an active infrared marker, a passive infrared marker, a fiducial marker, located on a cap, attached with adhesive, marked with a pen, or any combination thereof.

8. 1. A head tracking and control system comprising: a three-axis gyroscope and a three-axis accelerometer positioned on the surgeon's head and operable to detect head movement of the surgeon and transmit signals corresponding to the detected head movement to a processor; an intelligent tracking system operable to execute instructions on the processor to determine whether the detected head movements of the surgeon correspond to defined head movements of the surgeon; an ophthalmic surgical microscope including the processor; Equipped with the processor is operable to execute instructions for controlling the ophthalmic surgical microscope if the detected head movement of the surgeon corresponds to the defined head movement of the surgeon; the intelligent tracking system, a noise detection system including a microphone and operable to determine whether the detected head movement of the surgeon corresponds to a quiet head movement, wherein the microphone detects noises including the surgeon talking, sneezing, coughing, sighing, or any combination thereof, and determines that the surgeon's head movement is a quiet head movement if little or no signal is detected from the microphone at approximately the same time that the surgeon's head movement is detected; a motion thresholding system operable to determine whether the detected head motion of the surgeon corresponds to an intentional head motion; a motion recognition system operable to determine whether the detected head motion of the surgeon corresponds to an unusual head motion; A head tracking control system comprising:

9. The head tracking control system of claim 8 , wherein the defined head movements of the surgeon are silent head movements, deliberate head movements, unusual head movements, or any combination thereof.

10. The head tracking control system of claim 8 , wherein head movements that are not the defined head movements are ignored by the head tracking control system.

11. The head tracking control system of claim 8 , wherein the defined head motion is a displacement along an x-axis, a displacement along a y-axis, a pitch motion, or any combination thereof.

12. a motorized microscope head support; 9. The head tracking control system of claim 8, wherein the processor is operable to control the ophthalmic surgical microscope by executing instructions to move the motorized microscope head support along an x-axis of microscope motion, a y-axis of microscope motion, or any combination thereof.

13. further comprising an objective lens; 9. A head tracking control system according to claim 8, wherein the processor is operable to control the ophthalmic surgical microscope by executing instructions for operating the objective lens.

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