Ophthalmological device

Abstract

Provided is an ophthalmological device capable of obtaining a brighter and clearer inspection image.　A slit lamp microscope (100) comprises: a background illumination system (60); an imaging unit (50); and a control unit (20). The control unit (20) comprises an inspection image generation unit (21) that generates an inspection image of an inspected eye, on the basis of images captured by the imaging unit (50). The inspection image generation unit (21) has: an image acquisition unit (24) that acquires, from the imaging unit (50), a plurality of images captured through imaging an inspected eye while changing the illumination direction of illumination light with respect to the inspected eye; an image extraction unit (25) that extracts, as a partial image, a portion at which focus is achieved from the plurality of images acquired by the image acquisition unit (24); and an image combination unit (26) that combines a plurality of the partial images extracted by the image extraction unit (25) together to generate an inspection image.

Description

ophthalmology equipment

[0001] The present disclosure relates to ophthalmic devices.

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

[0003] JP 2021-83657 A Patent No. 6615748 A

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

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

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

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

[0008] FIG. 1 is a right side view showing the overall configuration of a slit lamp microscope of Example 1, and a perspective view of the vicinity of a power supply unit. FIG. 2 is a block diagram showing the configuration of a control system of the slit lamp microscope of Example 1. FIG. 3 is a back view of the vicinity of a background light switching unit of the slit lamp microscope of Example 1. FIG. 4 is a plan view of a background illumination system of the slit lamp microscope of Example 1. FIG. 5 is a front view of the background illumination system of the slit lamp microscope of Example 1. FIG. 6 is an explanatory diagram for explaining the process of generating an examination image in the examination image generating unit. FIG. 7 is a flowchart for explaining an example of the operation of the slit lamp microscope of Example 1. FIG. 8 is a plan view of a background illumination system of a slit lamp microscope of Example 2. FIG. 9 is a right side view showing the overall configuration of a slit lamp microscope of Example 3. FIG. 10 is a front view of the background illumination system of the slit lamp microscope of Example 3. FIG. 11 is a flowchart for explaining an example of the operation of the slit lamp microscope of Example 3. FIG. 12 is a plan view of a background illumination system of a slit lamp microscope of Example 4. FIG. 13 is a front view of the background illumination system of the slit lamp microscope of Example 4.

[0009] Example 1 A slit lamp microscope 100 according to Example 1, which is an embodiment of an ophthalmic apparatus according to the present disclosure, will be described below with reference to FIGS. 1 to 6. The slit lamp microscope 100 shown in FIG. 1 is an ophthalmic apparatus that uses slit-shaped illumination light to cut out an optical slice of the cornea of ​​an eye E to obtain an image of a cross section of the cornea. The slit lamp microscope 100 is also referred to as a "slit lamp microscope." Hereinafter, the slit-shaped illumination light may be referred to as "slit light."

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

[0011] In the first embodiment, the control unit 20 is provided in the PC 80 located near the main body 10, but the present invention is not limited to this configuration. As a modified example, the control unit 20 may be provided in an external device such as a personal computer connected to the main body 10 via a communication network or a cloud server. The control unit 20 may also be provided in the main body 10, for example, inside the pedestal 12a, the imaging unit 50, etc.

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

[0013] The main body 10 is installed on the optical bench 1. The main body 10 mainly includes an illumination system 30, an observation system 40, an imaging unit 50, a background illumination system 60, and a power supply unit 70. The main body 10 also includes a base 11 fixed to the top surface of the optical bench 1, a mount unit 12 provided on the top surface of the base 11, a movement mechanism 13 that moves the mount unit 12 in the left-right direction, a support unit 14 provided on the top surface of the mount unit 12, a face support unit 15 supported by the base 11, and a pair of grip units 16 provided on both left-right sides of the base 11.

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

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

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

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

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

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

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

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

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

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

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

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

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

[0027] The slit lamp 32 irradiates slit light toward the deflection optical system 33. The deflection optical system 33 is provided above the slit lamp 32. The deflection optical system 33 includes a deflection optical element 34. In Example 1, the deflection optical element 34 has a prism. The deflection optical element 34 deflects the slit light irradiated from the slit lamp 32 toward the subject's eye E. This causes the slit light to be irradiated onto the subject's eye E. Note that the deflection optical element 34 is not limited to having a prism, and may have a reflecting member such as a reflecting mirror and deflect the slit light by reflecting it toward the subject's eye E. Furthermore, the slit lamp 32 and the deflection optical system 33 are not limited to the configurations in Example 1, and their shapes, structures, and arrangements are not particularly limited as long as they are used in a Zeiss-type slit lamp microscope.

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

[0029] The observation system 40 is a so-called microscope used to observe the return light from the subject's eye E. The return light is also called "reflected light." Here, "return light" includes not only slit light and background light reflected by the subject's eye E, but also various types of light, such as scattered light from the subject's eye E and its surroundings. In Example 1, these various types of light are referred to as "return light." As described above, the observation system 40 is attached to the upper part of the second support arm 14c. The observation system housing 41 houses an observation optical system 42 that guides the return light from the subject's eye E. The observation system housing 41 in Example 1 includes a first observation system housing 41a and a second observation system housing 41b. The first observation system housing 41a is located on the front side of the second support arm 14c, which is the subject's side. The second observation system housing 41b is located on the rear side of the second support arm 14c, which is the examiner's side.

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

[0031] The examiner can observe the subject's eye E with the naked eye by looking into the pair of eyepieces 45. Furthermore, observation magnification adjustment handles 46 for changing the observation magnification are provided on the left and right side surfaces of the observation system housing 41.

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

[0033] The imaging unit 50 receives return light from the subject's eye E and captures an image of the subject's eye E. The imaging unit 50 is, for example, a digital camera. The imaging unit 50 includes an imaging element 52 (see FIG. 2 ) housed within an imaging unit housing 51. The imaging unit 50 also includes components typically found in digital cameras, such as an imaging optical system that collects a portion of the return light from the subject's eye E and directs it to the imaging element 52, a control board that controls the imaging unit 50 under the control of the control unit 20, and a memory for recording images (all of which are not shown). The imaging optical system shares a pair of relay optical systems 44, one on the left and one on the right, with the objective lens 43 of the observation system 40. A portion of the return light that passes through the objective lens 43 is directed to the imaging element 52 by a prism unit of the relay optical system 44. The imaging unit housing 51 is attached to the second support arm 14c so as to be sandwiched between the second observation system housing 41b and the second support arm 14c.

[0034] The imaging element 52 is a photoelectric conversion element that detects the return light guided by the imaging optical system, converts the returned light into an electrical signal (image signal), and outputs the electrical signal. The imaging element 52 may be, for example, a charge coupled device (CCD) image sensor or a complementary metal oxide semiconductor (CMOS) image sensor.

[0035] The imaging element 52 is capable of outputting an image signal to the PC 80 via the communication cable 2. The image signal is input to the control unit 20 of the PC 80, and an image based on the image signal is stored in a storage unit 84 within the PC 80. The imaging element 52 also outputs an image signal acquired in real time to the control unit 20. The control unit 20 displays the image signal input from the imaging element 52 on the display unit 81 in real time. In other words, the imaging unit 50 is capable of live viewing.

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

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

[0038] Furthermore, the predetermined photographing time can be, for example, several seconds to several tens of seconds after the examiner presses the photographing button 12d, and more specifically, can be 3 to 10 seconds. Alternatively, the predetermined time interval can be from the time the examiner presses the photographing button 12d to the time the examiner presses the photographing button 12d again. The predetermined time interval can also be from the time the examiner presses the photographing button 12d to the time the examiner presses the photographing button 12d again, that is, until the examiner releases his / her finger from the photographing button 12d.

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

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

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

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

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

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

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

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

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

[0048] The AC / DC converter 71 converts AC voltage into DC voltage. A plug (not shown) that is inserted into an outlet is connected to the AC / DC converter 71. The power switch 72 is a switch for starting up the slit lamp microscope 100. The operator turns on the power switch 72. This causes the power supply unit 70 to supply power to the illumination system 30, observation system 40, imaging unit 50, background illumination system 60, etc. via the AC / DC converter 71.

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

[0050] The PC 80 includes a motherboard (main board) having a processor such as a CPU (Central Processing Unit), and storage devices such as a ROM (Read Only Memory), a RAM (Random Access Memory), and a hard disk drive.

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

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

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

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

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

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

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

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

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

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

[0061] The image extraction unit 25 extracts in-focus portions without luminance abnormalities from the multiple images acquired by the image acquisition unit 24. In the example shown in FIG. 5B, the image extraction unit 25 extracts in-focus portions from multiple infrared images G of the meibomian glands M. Hereinafter, the extracted images are referred to as "partial images g." More preferably, the image extraction unit 25 of Example 1 extracts partial images g from the multiple infrared images G, excluding out-of-focus portions, luminance abnormalities, bright spots, and surrounding reflections. The out-of-focus portions refer to portions that are out of focus and blurred when photographed. The luminance abnormalities refer to portions with inappropriate luminance, such as blown-out highlights, darkened areas due to shadows, and uneven luminance. The bright spots refer to small points of light reflected by the subject's eye E from the illumination light. W shown in FIG. 5C indicates a bright spot. Surrounding reflection refers to the situation where surrounding objects, such as a part of the slit lamp microscope 100 or the scenery, are reflected by the subject's eye E, and these surrounding objects appear in the image together with the subject's eye E.

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

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

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

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

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

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

[0068] The teacher data creation unit 292 annotates the numerous infrared images collected by the data collection unit 291 to create teacher data with an "upper eyelid backside image tag" indicating that the data is infrared image data of the back side of the upper eyelid, and teacher data with a "lower eyelid backside image tag" indicating that the data is infrared image data of the back side of the lower eyelid. The teacher data creation unit 292 processes the numerous visible light images collected by the data collection unit 291 to create teacher data with an "open eyelid state image tag" indicating that the data is visible light image data of the subject's eye E in an open eyelid state. The machine learning unit 293 provides the teacher data created by the teacher data creation unit 292 to a selected machine learning algorithm for image recognition, performs machine learning, and generates a trained AI model 85.

[0069] The display unit 81 is a monitor such as a liquid crystal display monitor. Under the control of the control unit 20, the display unit 81 displays an operation screen and an infrared image or a visible light image of the subject's eye E being photographed. The operation unit 82 has an input interface such as a touch panel, a keyboard, or a mouse provided on the display unit 81. The operation unit 82 accepts operation inputs from the examiner and outputs the operation input signals to the control unit 20. The speaker unit 83 outputs a sound of a warning message to the outside under the control of the notification unit 28. In the first embodiment, the speaker unit 83 is provided in the PC 80, but is not limited to this configuration. The speaker unit 83 can also be provided separately in the main body unit 10, allowing the warning message to be output more clearly from a location closer to the examiner or subject.

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

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

[0072] An example of the operation performed by the slit lamp microscope 100 of Example 1 will be described below based on the flowchart shown in Fig. 6. The flowchart shown in Fig. 6 mainly shows the operation performed by the control unit 20. The observation system 40 and imaging unit 50 of the slit lamp microscope 100 observe and photograph the subject's eye E using slit light and background light in the same manner as the observation and photography of the subject's eye E performed using known procedures, so a detailed description will be omitted. The following mainly describes a test image generation method including a step for generating a test image using the background light source unit 62.

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

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

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

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

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

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

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

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

[0081] The process of steps S03 to S05 continues until it is determined that the eyelid state is appropriate, that is, until it is determined that the eyelid is fully everted. The control unit 20 can count the number of determinations, and when the number reaches a predetermined number, the program can proceed to END and end the image generation process. Alternatively, the control unit 20 can measure the elapsed time since switching to infrared light mode, and when the measured time reaches a predetermined time, the program can proceed to END and end the image generation process.

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

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

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

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

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

[0087] Step S10 is executed when image capturing in all lighting directions is completed. In step S10, the image extracting unit 25 removes out-of-focus areas, areas with abnormal brightness, bright spots, and surrounding reflections from all infrared images G acquired by the image acquiring unit 24, as shown in Fig. 5B. The image extracting unit 25 cuts out in-focus areas as partial images g.

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

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

[0090] Furthermore, in Example 1, the examiner, upon recognizing that the illumination direction has been changed, presses the capture button 12d, causing the image capture unit 50 to capture an image. However, this configuration is not limiting. In a modified example of the slit lamp microscope 100, all steps in the flowchart of FIG. 6 may be automatically performed, for example, when the examiner switches the illumination mode and then presses the capture button 12d. The control unit 20 then sets the illumination direction in steps S06 and S07, turns on the corresponding background light source unit 62, and then proceeds to step S08. The control unit 20 is configured to automatically control the image capture unit 50 to capture an image without waiting for instructions from the examiner. This configuration allows the illumination direction to be changed and the image to be captured more quickly, reducing the burden on the examinee.

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

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

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

[0094] An example of the operation performed by the slit lamp microscope 100 of Example 2 is basically the same as the operation of the slit lamp microscope 100 of Example 1 using the flowchart shown in Figure 6. In Example 2, the processing contents in steps S02 and S06 to S07 are replaced with the following processing contents.

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

[0096] Therefore, the slit lamp microscope 100 of Example 2 can change the illumination direction while capturing images of the subject's eye E using the imaging unit 50. The slit lamp microscope 100 can capture brighter and clearer examination images based on the multiple captured images.

[0097] In addition, when the background light source unit 62 is continuously rotated at a constant angular velocity, the control unit 20 may control the image capture unit 50 to capture images of the subject's eye E at regular intervals or continuously while the background light source unit 62 is being rotated. The control unit 20 automatically controls the image capture by the image capture unit 50 in accordance with the rotational movement of the background light source unit 62, thereby enabling faster and more accurate acquisition of infrared images G. Furthermore, by limiting the time from start to finish of image capture to within a few seconds, the image capture time can be shortened, reducing the burden on the subject and preventing image capture errors due to blinking, etc. Alternatively, as a modified example, the illumination movement unit 64 may have a rotation axis but no actuator, and the examiner may manually rotate the background light source unit 62.

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

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

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

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

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

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

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

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

[0106] In step S22, the control unit 20 turns on the visible light source 621 of the background light source unit 62 to capture a live view image. At this time, the control unit 20 drives and controls the illumination moving unit 64 and the image capturing moving unit 55 to position the background light source unit 62 and the image capturing unit 50 at a position facing the front of the subject's eye E, for example, at the center position in FIG. 9 .

[0107] In step S23, the image acquisition unit 24 acquires a live view image of a visible light image from the imaging unit 50 and outputs it to the eye-to-be-tested judgment unit 22. In step S24, the eye-to-be-tested judgment unit 22 inputs the live view image to the trained AI model 85. Based on the image recognition result output from the trained AI model 85, the eye-to-be-tested judgment unit 22 judges whether the eyelid state is appropriate, more specifically, whether the eyelid of the eye to be tested E is in an appropriate open state.

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

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

[0110] The processes of steps S23 to S25 are continued until it is determined that the eyelid open state is appropriate. The control unit 20 can count the number of determinations, and when the number reaches a predetermined number, the program can proceed to END and end the image generation process. Alternatively, the control unit 20 can measure the elapsed time since switching to infrared light mode, and when the measured time reaches a predetermined time, the program can proceed to END and end the image generation process.

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

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

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

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

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

[0116] In step S30, the image extraction unit 25 removes out-of-focus areas, areas with abnormal brightness, bright spots, and surrounding reflections from all images (here, visible light images) acquired by the image acquisition unit 24. The image extraction unit 25 cuts out in-focus areas as partial images.

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

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

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

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

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

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

[0123] An example of the operation performed by the slit lamp microscope 100 of Example 4 is basically the same as the operation of the slit lamp microscope 100 of Example 3 using the flowchart shown in Figure 10. In Example 4, the processing contents in steps S22 and S26 to S27 are replaced with the following processing contents.

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

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

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

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

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

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

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

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

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

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

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

[0135] In addition, with respect to the above descriptions of Examples 1 to 4 and modified examples, the following is further disclosed. (1) An ophthalmic apparatus comprising: an illumination unit that illuminates an eye to be examined with illumination light; an imaging unit that images the eye to be examined; and a control unit that controls the illumination unit and the imaging unit, wherein the control unit comprises a test image generation unit that generates a test image of the eye to be examined based on an image captured by the imaging unit, and the test image generation unit comprises: an image acquisition unit that acquires, from the imaging unit, a plurality of images of the eye to be examined while changing the illumination direction of the illumination light with respect to the eye to be examined; an image extraction unit that extracts in-focus portions as partial images from the plurality of images acquired by the image acquisition unit; and an image synthesis unit that synthesizes the plurality of partial images extracted by the image extraction unit to generate the test image. (2) The ophthalmic apparatus according to (1), wherein the illumination unit comprises at least one of a visible light source that emits visible light and an infrared light source that emits infrared light. (3) The ophthalmologic apparatus according to (1) or (2), wherein the illumination unit includes a plurality of light sources provided at different positions with respect to the subject's eye, and the control unit controls the illumination of the plurality of light sources in sequence in response to an input of an instruction to turn them on or automatically, thereby changing the illumination direction of the illumination light. (4) The ophthalmologic apparatus according to any of (1) to (3), wherein the illumination unit includes an illumination moving unit that moves the illumination unit, and the illumination unit is moved by the illumination moving unit to change the illumination direction with respect to the subject's eye. (5) The ophthalmologic apparatus according to (4), wherein the illumination moving unit includes an actuator driven and controlled by the control unit, and the control unit drives and controls the illumination moving unit to move the illumination unit around the subject's eye at a predetermined angular velocity to change the illumination direction, and controls the imaging unit to acquire an image of the subject's eye at a timing when the illumination direction of the illumination unit is changed. (6) The ophthalmologic apparatus according to any one of (1) to (5), further comprising an imaging moving unit that moves the imaging unit, wherein the imaging unit is moved in synchronization with the movement of the illumination direction of the illumination unit.(7) An ophthalmologic device according to any one of (1) to (6), characterized in that the image extraction unit cuts out the partial image from the plurality of images, excluding out-of-focus areas, areas with abnormal brightness, bright spots, and surrounding reflection areas. CROSS-REFERENCE TO RELATED APPLICATIONS

[0136] This application claims priority based on Japanese Patent Application No. 2024-130203, filed with the Japan Patent Office on August 6, 2024, the entire disclosure of which is incorporated herein by reference in its entirety.

[0137] 24: Image acquisition section 25: Image extraction section 26: Image synthesis section 50: Imaging section 55: Imaging movement section 60: Background illumination system (illumination section) 62: Background light source section (illumination section) 62a: First background light source section (illumination section) 62b: Second background light source section (illumination section) 62c: Third background light source section (illumination section) 62d: Fourth background light source section (illumination section) 62e: Fifth background light source section (illumination section) 64: Illumination movement section 621: Visible light source 622: Infrared light source E: Eye to be examined GA: Test image g: Partial image

Claims

1. An ophthalmic device comprising: an illumination unit that illuminates an eye to be examined with illumination light; an imaging unit that photographs the eye to be examined; and a control unit that controls the illumination unit and the imaging unit, wherein the control unit comprises an examination image generation unit that generates an examination image of the eye to be examined based on an image photographed by the imaging unit, and the examination image generation unit comprises: an image acquisition unit that acquires from the imaging unit a plurality of images of the eye to be examined while changing the illumination direction of the illumination light relative to the eye to be examined; an image extraction unit that extracts in-focus portions as partial images from the plurality of images acquired by the image acquisition unit; and an image synthesis unit that generates the examination image by synthesizing the plurality of partial images extracted by the image extraction unit.

2. The ophthalmologic apparatus according to claim 1, characterized in that the illumination unit comprises at least one of a visible light source that emits visible light and an infrared light source that emits infrared light.

3. The ophthalmic device of claim 1, wherein the illumination unit comprises a plurality of light sources arranged at different positions relative to the subject's eye, and the control unit controls the lighting of the plurality of light sources in sequence in response to an input instruction to turn them on or automatically, thereby changing the lighting direction of the illumination light.

4. An ophthalmic apparatus according to claim 1, further comprising an illumination moving unit that moves the illumination unit, and the illumination unit is moved by the illumination moving unit to change the illumination direction relative to the subject's eye.

5. The ophthalmic device according to claim 4, characterized in that the illumination moving unit includes an actuator that is driven and controlled by the control unit, and the control unit drives and controls the illumination moving unit to move the illumination unit around the subject's eye at a predetermined angular velocity to change the illumination direction, and controls the imaging unit to acquire an image of the subject's eye at the timing when the illumination direction of the illumination unit is changed.

6. The ophthalmologic apparatus according to claim 1, further comprising an imaging moving unit that moves the imaging unit, wherein the imaging unit is moved in synchronization with the movement of the illumination direction of the illumination unit.

7. The ophthalmologic device of claim 1, characterized in that the image extraction unit cuts out portions of the multiple images excluding out-of-focus areas, areas with abnormal brightness, bright spots, and surrounding reflections as the partial images.

Images