Ophthalmological practice

Abstract

The present invention relates to an ophthalmological practice with an examination room in which are arranged at least one table, with eye diagnosis devices arranged thereon, and an examination chair that can be rotated and adjusted in height. According to the invention, either the table is round or circular in a plan view, wherein the table is rotatable or has a rotatable table top, at least three of the eye diagnosis devices are arranged, spaced apart from one another, on or at an outer edge region of the table, and the examination chair is fixed releasably at an examination position with respect to the outer edge region of the table; or the table is curved in a plan view, is fixed at a table position in the examination room and arranged around the examination chair; and at least three of the eye diagnosis devices are arranged, spaced apart from one another, on or at an inner edge region of the table, wherein at least one of the eye diagnosis devices has a sensor system connected to a movement controller of the table and / or of the examination chair.

Description

[0001] Ophthalmology practice

[0002] The present invention relates to an ophthalmology practice having an examination room in which at least one table with eye diagnostic devices arranged thereon and a rotatable and height-adjustable examination chair are arranged.

[0003] A shortage of doctors and the associated decline in medical practices, particularly in rural areas, are making medical care increasingly difficult. To ensure basic general medical care in rural areas, mobile medical practices are being used, allowing doctors to travel to patients. Mobile medical practices include vans in which the rear rows of seats have been removed so that, for example, a bed and cabinets can be installed near the windows. A narrow walk-in aisle is located between the bed and the cabinets. Such mobile medical practices are equipped with modern medical equipment, e.g., an ECG and an acute care laboratory. They are wirelessly connected to hospitals, specialists, and general practitioners.The use of mobile medical practices enables the treatment of sick, elderly and less mobile patients and, overall, provides needs-based medical care in rural areas, while relieving existing general practitioners of time-consuming home visits.

[0004] Even when doctor's offices or hospitals have been destroyed or are inaccessible in crisis situations, such as after earthquakes or floods, large caravans are set up in the affected areas in which emergency medical care can be provided. Such caravans are typically equipped like a general practitioner's office, i.e. with a couch, a desk with a computer, a sink, and the like. Since space is limited, the furnishings are arranged along the walls, with a walkable area in between. Such caravans often have two areas separated by a door, providing a reception area and a treatment area. Since the practice area of ​​such caravans is located on top of a chassis, it is relatively difficult to reach via a staircase.

[0005] There are also mobile medical practices based on trucks or buses, including those for ophthalmology. These practices are tied to the vehicle and cannot be operated independently. Furthermore, these practices, like the mobile homes described above, are not wheelchair accessible. A so-called bus ambulance, for example, is known from DE 3523 631 A1.

[0006] In addition, there are medical containers designed for use in expedition base camps or mobile field hospitals for healthcare operations under difficult circumstances and harsh conditions. These functionally equipped, stackable containers, suitable for sea transport, are equipped with leveling blocks, integrated air conditioning, medical gas distribution, and handwashing facilities.

[0007] It is the object of the present invention to provide an ophthalmology practice that can be used both mobile and stationary in confined spaces, in which a large number of eye examinations can be carried out one after the other without major interruptions and with high measurement accuracy.

[0008] The object is achieved by an ophthalmology practice with an examination room in which at least one table with eye diagnostic devices arranged thereon and a rotatable and height-adjustable examination chair are arranged, wherein either the table is round or ring-shaped in a plan view, the table is rotatable or has a rotatable table top, at least three of the eye diagnostic devices are arranged at a distance from one another on or at an outer edge region of the table, and the examination chair is releasably fixed at an examination position relative to the outer edge region of the table; or the table is arc-shaped in a plan view, fixed at a table position in the examination room and arranged around the examination chair; and at least three of the eye diagnostic devices are arranged at a distance from one another on or at an inner edge region of the table.and at least one of the eye diagnostic devices has a sensor system that is connected to a movement control of the table and / or the examination chair;

[0009] Preferably, the ophthalmology practice according to the invention is a mobile ophthalmology practice located in a movable container that can be moved almost anywhere and parked at a suitable location. The container can be placed flat on a surface, so that the examination room has a low floor height and can be entered without obstruction or accessed by wheelchair via a short ramp.

[0010] Alternatively, the ophthalmology practice according to the invention can also be located on a stationary basis, for example in a confined space.

[0011] At least three—for example, three, four, five, or six—eye diagnostic devices are located on or at the table or tabletop. The number of eye diagnostic devices provides a corresponding number of examination options, enabling a comprehensive diagnosis of a patient.

[0012] The height adjustment of the table allows all eye diagnostic devices located on or next to it to be moved vertically together.

[0013] In a first embodiment of the ophthalmology practice according to the invention, the examination chair is arranged at a fixed examination position on an outer edge of the table, and the table or tabletop with the eye diagnostic devices located thereon or thereon can be rotated along the examination chair. Thus, a patient lying on the examination chair can be examined directly one after the other using the respective eye diagnostic devices.

[0014] In a second embodiment of the ophthalmology practice according to the invention, the examination chair is surrounded in an arc by the table and thus by the eye diagnostic devices located on or on it. Due to the arc-shaped design of the table, the eye diagnostic devices located on or on the table are arranged in a circle around the examination chair. For example, the eye diagnostic devices arranged on or on the table are arranged in a star shape around the examination chair. The rotatable and height-adjustable examination chair is located centrally of the eye diagnostic devices arranged on or on the table. Because the examination chair can be rotated, it can be easily aligned with the respective eye diagnostic devices, and a patient lying on the examination chair can be examined directly one after the other using the respective eye diagnostic devices.

[0015] In both embodiments, the present invention offers the possibility of precisely adjusting the relationship between the respective eye diagnostic device and the respective patient. This is possible thanks to the sensors provided on the at least one eye diagnostic device, which can be used to detect, for example, the position and / or posture of the patient's head in relation to the respective eye diagnostic device. The measured values ​​or measurement signals detected by the sensors are transmitted to the motion control system of the table and / or examination chair.If the detected head position and / or posture does not correspond to the respective specifications of the eye diagnostic device for a correct examination, the motion control of the table and / or examination chair specifies a position, rotation, height, and / or orientation of the table and / or examination chair, or the table and / or examination chair is adjusted in its position, rotation, height, and / or orientation until the head position and / or posture corresponds to the respective specifications of the eye diagnostic device for a correct examination. This allows a correct examination to be performed on the eye diagnostic device regardless of the respective initial conditions and the size and / or proportions of the patient.

[0016] Both embodiments of the invention provide particularly compact arrangements that allow for efficient use of space in the examination room. In particular, in both embodiments of the invention, the examination chair does not have to be moved through the ophthalmology practice to access the respective eye diagnostic devices.

[0017] In this way, a large number of important eye examinations can be carried out on the patient one after the other in a very small space without the patient having to leave the examination chair. In the first embodiment of the present invention, and preferably also in the second embodiment of the invention, the examination chair is typically mounted on the floor of the examination room. In order to be able to examine patients who are dependent on a wheelchair without any problems in the ophthalmology practice according to the invention, the examination chair is releasably fixed. This allows the examination chair to be easily removed and the patient to reach the table or an examination area surrounded by the table with their wheelchair. In the second embodiment of the invention, a patient entrance into the examination area is wide enough that a wheelchair can drive through it.In addition, in this embodiment, a preferably circular wheelchair turning area is left free in front of the patient access, which is typically at least 1.5 m in diameter. The examination area also preferably has a circular area with a diameter of 1.5 m.

[0018] In the second embodiment of the invention, the arched design of the table in plan view can, for example, comprise a C- or U-shaped design of the table or a tabletop of the table. The arched design of the table allows an operator to approach the table from outside and make adjustments to the eye diagnostic devices.

[0019] Due to the arched design of the table when viewed from above, it has an opening area through which a patient can easily reach the examination chair, preferably without barriers.

[0020] Since, in the second embodiment of the invention, the examination chair located within the examination area is rotatable, the patient sitting on the examination chair can turn or be rotated toward all eye diagnostic devices located on or at the table. The height adjustability of the patient chair and / or the table allows the respective patient to be placed at a suitable height relative to the respective eye diagnostic device.

[0021] In a preferred embodiment of the ophthalmology practice according to the invention, the sensor system is a head position and / or head posture sensor system. Such a head position and / or head posture sensor system offers the possibility of precisely adjusting the relationship between the respective eye diagnostic device and the respective patient. The head position and / or head posture sensor system detects the position and / or posture of the respective patient's head in relation to the respective eye diagnostic device. The measured values ​​or measurement signals detected by the sensors are transmitted to the motion control of the table and / or examination chair, and the position of the table and / or examination chair is adjusted based on the detected measured values ​​or measurement signals.

[0022] In an advantageous embodiment of the present invention, the head position and / or head posture sensor system comprises at least one pressure and / or force sensor which is arranged on or in a chin rest and / or a forehead contact surface of the respective eye diagnostic device.

[0023] Preferably, the at least one pressure and / or force sensor is integrated into a support that adheres to the chin rest and / or the forehead contact surface.

[0024] Particularly preferably, the table is vibration-damped or decoupled from the floor of the examination room. This protects the usually sensitive eye diagnostic devices arranged on or near the table from shocks and / or vibrations, which occur particularly during container transport. Appropriate vibration-damping or decoupling mechanisms can be integrated, for example, into the table legs.

[0025] In the ophthalmology practice according to the invention, standard eye examinations can be performed without the need for a physician on-site. The evaluation of the completed eye examinations can, for example, be done online. The movement control of the table and examination chair can also be monitored and / or influenced online.

[0026] Preferably, each of the eye diagnostic devices arranged on or at the table can be individually aligned horizontally and vertically to a patient seated on the examination chair. This, in combination with the adjustable position of the examination chair and / or table, allows for an optimal examination of each patient.

[0027] In a particularly advantageous embodiment of the invention, the table has at least one pull-out unit coupled to the motion control system, on which at least one of the eye diagnostic devices is mounted. In this embodiment, the eye diagnostic device attached to or mounted on the pull-out unit is pushed by means of the pull-out unit to the patient lying on the examination chair. The pull-out unit enables simplified cable routing. Furthermore, the pull-out unit can be designed as a modular device platform, allowing for easy interchangeability of the eye diagnostic device. This allows for comprehensive equipment and flexible usage options for the ophthalmology practice according to the invention.

[0028] By coupling at least one extension unit with the motion control system, the position of the eye diagnostic device mounted on or attached to the extension unit can be optimally adjusted to the position and / or posture of the patient's head based on the measured values ​​or signals acquired by the sensors. For this purpose, the position of the extension unit is changed by the motion control system.

[0029] Preferably, all eye diagnostic devices of the ophthalmology practice according to the invention are arranged on or at a pull-out.

[0030] Preferably, the at least one extension can be locked to the table. If the ophthalmology practice according to the invention is installed, for example, in a mobile container, this prevents accidental displacement of the eye diagnostic devices, particularly during transport of the container.

[0031] Particularly preferably, the table is configured with a plurality of pull-out sections that can be moved independently of one another. This can prevent the pull-out sections from colliding. If, for example, one of the pull-out sections is extended into an examination area surrounded by the table, the movement of the other pull-out sections or at least adjacent pull-out sections is blocked. It is particularly advantageous if all of the eye diagnostic devices arranged on or at the table deliver examination results in digital form. This allows their examination results to be automatically recorded and subsequently evaluated without the need for direct intervention by a medical professional, so that they can then be transmitted to a doctor easily, quickly and reliably. Furthermore, such eye diagnostic devices can be easily adjusted automatically.

[0032] It is particularly advantageous if, in the ophthalmology practice according to the invention, at least three of the eye diagnostic devices and the motion control of the table and / or examination chair are linked wirelessly or via the internet to an external ophthalmology practice. This means that an ophthalmologist does not need to be on-site in the ophthalmology practice according to the invention. The ophthalmologist can still view all examination results immediately or later and make diagnoses and / or issue instructions. The ophthalmologist can also remotely adjust the position of the table and / or examination chair by linking it to the motion control, thus adapting the patient's position to the eye diagnostic devices.

[0033] Advantageous embodiments of the present invention, their structure, function and advantages are explained in more detail below with reference to figures, in which

[0034] Figure 1 schematically shows an examination area of ​​a first embodiment of an ophthalmology practice according to the invention in a perspective view;

[0035] Figure 2 shows schematically the examination area of ​​the ophthalmology practice from Figure 1 in a plan view;

[0036] Figure 3 schematically shows an examination area of ​​a second embodiment of an ophthalmology practice according to the invention in a perspective view; and Figure 4 schematically shows a table and an examination chair of the examination area shown in Figure 3 in a perspective view.

[0037] Figures 1 and 2 show an examination area of ​​an examination room of a first embodiment of an ophthalmology practice according to the invention. The examination room of the ophthalmology practice can, for example, be located in a container (not shown). In addition to the examination room, the container can also contain at least one additional room, such as an entrance or patient reception area and / or a restroom and / or a preferably soundproof consultation room, which is separated from the examination room, for example, by a wall with a door.

[0038] The container is a mobile container. This means that although it typically doesn't have its own chassis, it can be moved by means of a vehicle. The container can be, for example, a semi-trailer or a transportable swap body.

[0039] The examination room has a floor, a ceiling and side walls.

[0040] The examination room includes an examination area comprising a table 3 and an examination chair 4. In the example shown, table 3 is circular in plan view. Five eye diagnostic devices 5 are arranged in a circle on table 3. The eye diagnostic devices 5 are located on an outer edge of table 3.

[0041] The examination chair 4, on which a patient to be examined can sit, is arranged on the table 3.

[0042] In the illustrated embodiment, both the table 3 and the examination chair 4 are stationary, i.e., fixed to the floor of the examination room. To ensure that each of the eye diagnostic devices 5 can be optimally aligned with a patient sitting on the examination chair 4 without the patient having to get up from the examination chair 4, a tabletop 33 of the table 3 is rotatable, with the table 3 or the tabletop 33 being adjustable in height. For ideal alignment of the eye diagnostic devices 5 with the patient, the examination chair 4 is also height-adjustable and rotatable at least within a certain angle.

[0043] Examination chair 4 is detachably connected to the floor of the examination room. This allows even patients who rely on wheelchairs to be examined without any problems. Once the examination chair 4 is detachable, it can simply be pushed aside, allowing the patient to access the examination area in their wheelchair.

[0044] The round design of the table 3 with the eye diagnostic devices 5 arranged in a circle on it makes it possible to carry out a large number of important eye examinations on a patient one after the other in a very small space, without the patient having to leave the examination chair 4.

[0045] In the embodiment shown in Figure 1, the eye diagnostic devices 5 are arranged in a circle on the table 3 and can be individually aligned horizontally and vertically to an examination area.

[0046] The eye diagnostic devices 5 have a sensor system 2, specifically a head position and / or head posture sensor system, which is connected to a motion control system 1 of the table 3 and the examination chair 4. The head position and / or head posture sensor system enables precise adjustment of the relationship between the respective eye diagnostic device 5 and the respective patient.

[0047] In Figure 1, the coupling of the sensor system 2 to the motion controller is illustrated by a dashed line between the motion controller 1 and one of the eye diagnostic devices 5. This coupling can be established, for example, via at least one cable, radio, or WLAN. Of course, more than one eye diagnostic device 5 or all eye diagnostic devices 5 can be connected to the motion controller.

[0048] The head position and / or head posture sensors detect the position and / or posture of the respective patient's head in relation to the respective eye diagnostic device 5. The measured values ​​or measurement signals detected by the head position and / or head posture sensors are transmitted to a motion controller 1 of the table 3 and / or the examination chair 4.If the detected position and / or posture of the head does not correspond to the respective specifications of the eye diagnostic device 5 for a correct examination, a position, rotation, height, and / or orientation of the table 3 and / or the examination chair 4 is specified by a motion control 1 of the table 3 and / or the examination chair 4, or the position, rotation, height, and / or orientation of the table 3 and / or the examination chair 4 is changed until the position and / or posture of the head corresponds to the respective specifications of the eye diagnostic device 5 for a correct examination. Thus, a correct examination can be performed on the respective eye diagnostic device 5, regardless of the respective initial conditions and the size of the patient and / or the proportions of the patient.

[0049] In the embodiment of the invention shown in Figures 1 and 2, the head position and / or head posture sensor system comprises a pressure and / or force sensor which is arranged on or in a chin rest (8) and / or a forehead contact surface (9) of the respective eye diagnostic device 5.

[0050] In the embodiment shown, the eye diagnostic devices 5 are mounted on pull-outs 32, by means of which they can be pushed toward a patient located on the examination chair 4. The pull-outs 32 are designed as platforms. In a respective transport position, the pull-outs 32 can be locked to the table 3.

[0051] In the embodiment shown, the drawers 32 can be moved independently of one another.

[0052] The extensions 32 are coupled to the movement control 1 so that the eye diagnostic devices 5 mounted on the extensions 32 can be adapted to the position of the respective patient by moving the extensions 32.

[0053] In the embodiment shown in Figures 1 and 2, table 3 is vibration-damped or decoupled from the floor of the examination room. For this purpose, in the embodiment shown in Figures 1 and 2, damping elements are integrated into table columns 34 of table 3. Outside the examination area, a vision test chart or vision test monitor 6 is arranged at a distance from table 3. The vision test chart or vision test monitor 6 is located at a height and is arranged relative to the examination area such that a patient sitting on examination chair 4 can completely view the vision test chart or vision test monitor 6. As can be seen in Figures 1 and 2, the vision test chart or vision test monitor 6 can be viewed through a free space F formed between two of the eye diagnostic devices 5.

[0054] For example, a ceiling-mounted phoropter (not shown in the figures) can protrude from the ceiling of the examination room into the examination area. In other embodiments of the present invention not shown, the phoropter can also be wireless, i.e., a mobile phoropter operated by remote control, and can be worn by the patient similar to glasses.

[0055] In the embodiment shown in Figure 1, all eye diagnostic devices 5 of the mobile ophthalmology practice are linked wirelessly or via the internet to an external, stationary ophthalmology practice. Thus, eye findings determined using the eye diagnostic devices 5 and the phoropter can be transmitted in real time to an ophthalmologist who does not need to be on-site.

[0056] Furthermore, the motion controller 1 of the ophthalmology practice according to the invention shown in Figures 1 and 2 is also linked wirelessly or via the internet to an external, stationary ophthalmology practice, so that the attending physician can, under certain circumstances, change the position of the table 3, the treatment chair 4, and / or the extensions 32 based on measured values ​​and / or measurement signals measured by the head position and / or head posture sensors. For this purpose, the motion controller 1 is also coupled to the respective table 3 and / or examination chair 4.

[0057] Figures 3 and 4 show a perspective view of an examination area of ​​an examination room of a second embodiment of an ophthalmology practice according to the invention, wherein the same reference numerals as used in Figures 1 and 2 denote the same components. In the examination room, there is a table 3' that is curved in plan view. Specifically, the table 3' is C-shaped in plan view. Alternatively, the table 3' can also have a U-shape. In any case, the table 3' has an opening area that forms a patient access 31 to the examination area 2.

[0058] The table 3' is arranged around an examination chair 4'. The examination chair 4' is thus at least partially enclosed by the table 3'.

[0059] In the embodiment shown in Figures 3 and 4, the examination chair 4' is designed to be movable. In the embodiment shown, the examination chair 4' has casters 41, allowing it to be rolled toward and away from the table 3'. The examination chair 4' is also rotatable and height-adjustable. The rotatability of the examination chair 4' is at least such that the examination chair 4' can perform a certain angular rotation in order to be aligned to specific positions relative to the table 3'.

[0060] In the example of Figures 3 and 4, the table 3' is fixed and not rotatable, but its height is adjustable.

[0061] On the table 3', eye diagnostic devices 5 are arranged at a distance from one another. The eye diagnostic devices 5 are arranged on an inner edge area of ​​the table 3'.

[0062] For optimal alignment of the eye diagnostic devices 5 arranged on the table 3' to a patient sitting on the examination chair 4', despite the rigid design of the table 3', the eye diagnostic devices 5 are arranged on extensions 32. As shown in Figure 4, one of the eye diagnostic devices 5 can be brought close to the patient via the extension 32 on which the respective eye diagnostic device 5 is located, without the patient having to move the examination chair 4' any distance.

[0063] As shown in Figure 3, a vision chart or vision monitor 6 arranged outside the examination area is visible through a free space F formed between two eye diagnostic devices 5 arranged on the table 3'. In other embodiments of the present invention, the patient access 31 can also be arranged opposite the vision chart or vision monitor 6, so that the respective patient can view the vision chart or vision monitor 6 through the patient access 31.

[0064] In the exemplary embodiments shown, the eye diagnostic devices 5 arranged on the table 3, 3' can, for example, comprise at least one device for measuring intraocular pressure, a refractometer, an OCT device (optical coherence tomography device), a slit lamp, an ultra-wide-angle fundus camera, an ophthalmoscope and / or a pentacam.

[0065] In the embodiments shown, the respective eye diagnostic devices 5 each have a head position and / or head posture sensor system. The respective head position and / or head posture sensor system can, for example, be integrated into a chin rest and / or a forehead support surface of the respective eye diagnostic device 5 or into a support, such as a removable pad, that adheres to the chin rest and / or forehead support surface.

[0066] The head position and / or head posture sensor system is connected to a motion control system for the table 3, 3' and the examination chair 4, 4'. The motion control system can, for example, change the height and / or rotation of the respective table 3, 3' or the respective table top 65 and the respective examination chair 4, 4'. It is also possible for the motion control system to output at least one signal with which the height and / or rotation of the table 3, 3' or the table top 33 and the examination chair 4, 4' can be changed.

Claims

Patent claims 1. An ophthalmology practice with an examination room in which at least one table (3, 3') with eye diagnostic devices (5) arranged thereon and a rotatable and height-adjustable examination chair (4, 4') are arranged, characterized in that - either the table (3) is round or ring-shaped in a plan view, wherein the table (3) is rotatable or has a rotatable table top (33), at least three of the eye diagnostic devices (5) are arranged at a distance from one another on or at an outer edge region of the table (3), and the examination chair (4) is releasably fixed at an examination position relative to the outer edge region of the table (3); - or the table (3') is arcuate in plan view, fixed at a table position in the examination room and arranged around the examination chair (4'); and at least three of the eye diagnostic devices (5) are arranged spaced apart from one another on or at an inner edge region of the table (3'), wherein at least one of the eye diagnostic devices (5) has a sensor system (2) which is connected to a movement control system (1) of the table (3, 3') and / or the examination chair (4, 4').

2. Ophthalmology practice according to claim 1, characterized in that the sensor system (2) is a head position and / or head posture sensor system.

3. Ophthalmology practice according to claim 2, characterized in that the head position and / or head posture sensor system comprises at least one pressure and / or force sensor which is arranged on or in a chin rest (8) and / or a forehead contact surface (9) of the respective eye diagnostic device (5).

4. Ophthalmology practice according to claim 3, characterized in that the at least one pressure and / or force sensor is integrated into a support adhering to the chin rest and / or the forehead contact surface.

5. Ophthalmology practice according to one of the preceding claims, characterized in that the table (3, 3') is vibration-damped or decoupled from a floor of the examination room.

6. Ophthalmology practice according to one of the preceding claims, characterized in that the table (3, 3') has at least one pull-out (32) coupled to the movement control, on which at least one of the eye diagnostic devices (5) is mounted.

7. Ophthalmology practice according to claim 6, characterized in that the at least one extension (32) can be locked on the table (3, 3').

8. Ophthalmology practice according to claim 6 or 7, characterized in that several of the pull-outs (32) are formed on the table (3, 3'), which can be moved dependently on one another.

9. Ophthalmology practice according to one of the preceding claims, characterized in that at least three of the eye diagnostic devices (5) and the movement control of the table (3, 3') and / or the examination chair (4, 4') are coupled by radio or via the Internet to an external, stationary ophthalmology practice.

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