JP7423379B2 - ophthalmology equipment - Google Patents

Description

The present invention relates to an ophthalmological apparatus for observing the fundus of a patient's eye.

2. Description of the Related Art Surgical microscopes are known, which are used for surgeries on patients' eyes, such as cataract surgeries. As described in Patent Documents 1 and 2, for example, this surgical microscope uses an illumination optical system to illuminate the cornea or fundus of a patient's eye with illumination light, and also uses an illumination optical system to illuminate the cornea or fundus of a patient's eye, and to detect the return light of the illumination light from the cornea or fundus. is guided to a camera (imaging device) or eyepiece through an observation optical system. This allows the operator to observe an observation image of the cornea or fundus taken by the camera through the monitor, or to observe the cornea or fundus through the eyepiece.

Japanese Patent Application Publication No. 2012-152454 Japanese Patent Application Publication No. 2013-27536

By the way, when observing the fundus using a surgical microscope, there is a problem in that it is difficult for the operator to observe the observed image of the fundus because ghosts and flares occur due to reflection of illumination light on the cornea and the like. For this reason, conventionally, the fundus of the eye has been illuminated by puncturing the patient's eye with the distal ends of a plurality of optical fiber cables, but this has the problem of increasing the effort of the operator and the burden on the patient.

The present invention has been made in view of the above circumstances, and it is an object of the present invention to provide an ophthalmological apparatus that can obtain a good observation image of the fundus while reducing the time and effort of the operator and the burden on the patient.

An ophthalmological apparatus for achieving the object of the present invention includes an objective lens, an illumination optical system that emits illumination light from a light source toward the fundus of a patient's eye via the objective lens, and a link between the objective lens and the light source. a pattern generation element that is provided on the optical path of the illumination light and generates pattern light from the illumination light, and a light scanning unit that scans the pattern light emitted toward the fundus in a direction perpendicular to the optical axis of the objective lens. and an observation optical system that guides the return light of the pattern light from the fundus that has entered through the objective lens to at least one of an image sensor and an eyepiece.

According to this ophthalmologic apparatus, reflection of light on the cornea and the like during observation of the fundus of the eye can be significantly suppressed.

In the ophthalmological apparatus according to another aspect of the present invention, the optical axis of the illumination optical system is decentered with respect to the optical axis of the objective lens, and the illumination optical system emits pattern light in an oblique direction with respect to the fundus through the objective lens. Inject it into the This makes it possible to observe the fundus while avoiding the effects of ghosts and flares caused by reflections from the cornea and the like.

In the ophthalmological apparatus according to another aspect of the present invention, the observation optical system guides the returned light to the image sensor, and the camera includes the image sensor, and while the light scanning section is scanning the pattern light, It includes a camera that repeatedly performs imaging of returned light by an image sensor and output of an observed image of a part of the fundus based on the returned light. As a result, a good observation image in which ghost and flare are suppressed can be obtained.

In the ophthalmological apparatus according to another aspect of the present invention, a composite observation image generation unit generates a composite observation image of the fundus based on the observation image for one scan each time the observation image for one scan of pattern light is output from the camera. and a display control unit that outputs the composite observation image to the monitor every time the composite observation image generation unit generates the composite observation image. As a result, a good composite observation image in which the occurrence of ghosts and flares is suppressed can be obtained.

An ophthalmologic apparatus according to another aspect of the present invention includes a display control section that repeatedly outputs an observation image output from the camera to a monitor while the light scanning section scans the pattern light. Thereby, an image of the scanning area scanned by the pattern light in the fundus of the eye can be configured on the monitor.

In an ophthalmological apparatus according to another aspect of the present invention, a pattern generation element generates slit light as pattern light from illumination light. This narrows the range of light irradiated onto the patient's eye, thereby suppressing light reflection on the cornea and the like.

In the ophthalmologic apparatus according to another aspect of the present invention, the light scanning section vertically scans the patterned light by displacing the pattern generation element in the vertical direction.

In an ophthalmological apparatus according to another aspect of the invention, a pattern generating element is provided within the illumination optical system.

In the ophthalmological apparatus according to another aspect of the present invention, the optical axis of the observation optical system is perpendicular to the optical axis of the objective lens, and is provided at the intersection of the optical axis of the objective lens and the optical axis of the observation optical system. The present invention includes a deflection optical element that deflects the return light incident from the objective lens toward the observation optical system. This eliminates the need for the observation optical system to be placed in front of the operator. Furthermore, the casing placed in front of the operator does not give the operator a feeling of pressure, and the burden on the operator can be reduced.

According to the present invention, a good observation image of the fundus can be obtained while reducing the labor of the operator and the burden on the patient.

It is a top view of the surgical microscope of a 1st embodiment. FIG. 1 is a side view of the surgical microscope of the first embodiment. FIG. 3 is an explanatory diagram of a pattern generation element and a light scanning section. FIG. 3 is an explanatory diagram of an observation image captured and output by an image sensor of a camera in an oblique illumination mode. It is a functional block diagram of a control device. FIG. 3 is an explanatory diagram for explaining generation of a composite observation image by a composite observation image generation unit. 2 is a flowchart showing the operation of the surgical microscope according to the first embodiment, particularly the flow of observation processing of the fundus of a patient's eye in the oblique illumination mode. It is a flowchart which shows the operation|movement of the surgical microscope of 2nd Embodiment, especially the flow of the observation process of the fundus Ef of the patient's eye E in the oblique illumination mode. It is a top view of the surgical microscope of 3rd Embodiment. It is a side enlarged view of a part of microscope main body of the surgical microscope of 4th embodiment. It is an explanatory view of a modification of a pattern generation element. It is an explanatory view of a modification of a pattern generation element.

[Overall configuration of surgical microscope of first embodiment]
FIG. 1 is a top view of a surgical microscope 10 (surgical microscope system) according to the first embodiment. FIG. 2 is a side view of the surgical microscope 10 of the first embodiment. Note that the X direction in the figure is the left-right direction (pupillary width direction of the patient's eye E) with respect to the patient (also referred to as the subject or the operated person), and the Z direction is the optical axis OA of the objective lens 20, which will be described later. The working distance direction is parallel to (for example, the vertical direction in this embodiment), and the Y direction is a direction perpendicular to the XZ direction.

As shown in FIGS. 1 and 2, a surgical microscope 10 corresponds to the ophthalmological apparatus of the present invention, and is used in various surgeries on the patient's eye E of a patient in a supine position. This surgical microscope 10 has a fundus observation mode in which an enlarged image of the fundus Ef of the patient's eye E is observed as an observation mode in which the patient's eye E is observed. This fundus observation mode includes a 0 degree illumination mode in which the fundus Ef is observed with "0 degree illumination" and an oblique illumination mode in which the fundus Ef is observed with "oblique illumination". The surgical microscope 10 also has a corneal observation mode in which an enlarged image of the cornea Ec of the patient's eye E is observed, but a detailed explanation thereof will be omitted here.

The surgical microscope 10 includes a microscope main body 10a, an operating section 12, a monitor 14, and a control device 16.

In the 0-degree illumination mode, the microscope main body 10a shoots a moving image of an enlarged image of the fundus Ef while stereo coaxially illuminating the fundus Ef, and outputs an observation image D (image data). Further, in the oblique illumination mode, the microscope main body 10a performs oblique illumination and scanning of the fundus Ef with a slit light LP, which will be described later, while photographing a moving image of an enlarged image of the fundus Ef and outputting an observation image D.

The operation unit 12 is connected to the control device 16 by wire or wirelessly. This operation unit 12 is a surgical microscope that includes an operation for adjusting the position and posture of the microscope body 10a (manual alignment operation), an operation for switching the observation mode of the patient's eye E, and an operation for changing the zoom magnification of the microscope body 10a. Accepts input for 10 various operations. The operation unit 12 includes various operation devices such as hardware keys (switches, buttons) provided on the microscope main body 10a, an operation lever, a mouse, a keyboard, and an operation panel (including the display surface of the monitor 14).

As the monitor 14, a display device such as a flat panel display such as an LCD (Liquid Crystal Display) is used. The monitor 14 is connected to the control device 16 by wire or wirelessly, and under the control of the control device 16 displays an observation image D of the fundus Ef taken as a moving image by the microscope main body 10a.

The control device 16 is an arithmetic device such as a computer provided within the housing of the surgical microscope 10. The control device 16 comprehensively controls the operation of each part of the microscope main body 10a and the display of the observation image D and the like on the monitor 14 in accordance with input operations on the operation section 12. Note that the control device 16 may be provided outside the housing of the surgical microscope 10.

[Microscope body]
The microscope main body 10a includes an objective lens 20, a fundus observation lens 21 (also referred to as a front lens), a reflection mirror RM, a dichroic mirror DM, first illumination optical systems 31L and 31R, and a second illumination optical system 32. , observation optical systems 40L, 40R, and cameras 60L, 60R.

The objective lens 20 has an optical axis OA parallel to the Z direction, and is provided at a position facing the patient's eye E. The reflecting mirror RM is positioned above the objective lens 20 in the Z direction and reflects light from observation optical systems 40L and 40R, which will be described later, and extends in the direction (here, the Y direction) perpendicular to the optical axis OA. It is provided at the intersection with the axis OB. A dichroic mirror DM, observation optical systems 40L and 40R, and cameras 60L and 60R are arranged along the optical axis OB (Y direction) from the reflection mirror RM. The first illumination optical systems 31L and 31R are provided at positions above the dichroic mirror DM in the Z direction. The second illumination optical system 32 is provided above the objective lens 20 in the Z direction and at a position shifted in the Y direction with respect to the reflection mirror RM.

<Objective lens>
In the 0-degree illumination mode, the objective lens 20 irradiates the fundus Ef with illumination light L1 emitted from first illumination optical systems 31L and 31R, which will be described later, through the fundus observation lens 21, and also provides illumination from the fundus Ef. The return light LA of the light L1 is transmitted and emitted toward the reflection mirror RM. Further, in the oblique illumination mode, the objective lens 20 irradiates the fundus Ef with the slit light LP emitted from the second illumination optical system 32 via the fundus observation lens 21, and also irradiates the slit light LP from the fundus Ef. The return light LB is transmitted and emitted toward the reflection mirror RM.

The fundus observation lens 21 is shared by the first illumination optical systems 31L, 31R and the second illumination optical system 32. The fundus observation lens 21 is provided between the objective lens 20 and the patient's eye E so that it can be inserted into and removed from the optical path of the illumination light L1 and the optical path of the slit light LP. The fundus observation lens 21 focuses the light incident from the objective lens 20 onto the fundus Ef. The fundus observation lens 21 is inserted into each optical path of the illumination light L1 and the slit light LP in the 0-degree illumination mode and the tilted illumination mode. Insertion and removal of the fundus observation lens 21 into each optical path is performed by a lens insertion and removal mechanism (not shown). Note that when the objective lens 20 is focused on the fundus Ef, the fundus observation lens 21 is omitted.

<Reflection mirror>
The reflecting mirror RM corresponds to the deflection optical element of the present invention, and is shared by the first illumination optical systems 31L, 31R and the observation optical systems 40L, 40R. This reflecting mirror RM reflects the light incident from one of the objective lens 20 and the dichroic mirror DM to the other, and reflects the light incident from the other to one.

<Dichroic mirror>
The dichroic mirror DM is shared by the first illumination optical systems 31L, 31R and the observation optical systems 40L, 40R, and is connected to the optical path of the illumination light L1 emitted from the first illumination optical systems 31L, 31R, and to the observation optical system. The optical paths of 40L and 40R are combined. The dichroic mirror DM reflects the illumination light L1 emitted from the first illumination optical systems 31L and 31R toward the reflection mirror RM, and conversely transmits the return light LA or return light LB incident from the reflection mirror RM for observation. The light is emitted toward optical systems 40L and 40R.

<First illumination optical system and second illumination optical system>
The first illumination optical systems 31L, 31R and the second illumination optical system 32 are optical systems for illuminating the patient's eye E via the objective lens 20 and the like.

(First illumination optical system)
The first illumination optical systems 31L and 31R perform stereo coaxial illumination with the illumination light L1 on the fundus Ef in the 0 degree illumination mode. The optical axes OL and OR of the first illumination optical systems 31L and 31R are coupled to the optical axis OA of the objective lens 20 via the dichroic mirror DM and the reflection mirror RM. That is, the optical axes OL and OR and the optical axis OA substantially coincide. Thereby, the first illumination optical systems 31L and 31R illuminate the fundus Ef with so-called "0-degree illumination" using the illumination light L1. Thereby, the illumination light L1 is diffusely reflected on the fundus Ef, so that a transillumination image (red reflex) of the fundus Ef can be stereoscopically photographed (observed).

The first illumination optical systems 31L and 31R include a light source 31a and a condenser lens 31b. The light source 31a is a semiconductor light source, for example, and outputs illumination light L1 having a wavelength in the visible region. The illumination light L1 passes through the condenser lens 31b, is reflected by the dichroic mirror DM and the reflection mirror RM, passes through the objective lens 20 and the fundus observation lens 21, and is irradiated onto the fundus Ef. As a result, the return light LA of the illumination light L1 that has been diffusely reflected on the fundus Ef passes through the objective lens 20, etc., is reflected on the reflection mirror RM, and then passes through the dichroic mirror DM to the observation optical system 40L, Inject into 40R.

(Second illumination optical system)
The second illumination optical system 32 corresponds to the illumination optical system of the present invention. The second illumination optical system 32 is a so-called Koehler illumination system, and can illuminate the patient's eye E with no unevenness in the light source. The second illumination optical system 32 irradiates (projects) the slit light LP onto the fundus Ef in the oblique illumination mode, and scans the slit light LP in a direction perpendicular to the optical axis OA. Here, the optical axis OS of the second illumination optical system 32 is eccentric in a direction (here, the Y direction) perpendicular to the optical axis OA of the objective lens 20. Therefore, the second illumination optical system 32 can illuminate the fundus Ef by so-called oblique illumination without using the reflection mirror RM, and in the oblique illumination mode, irradiates the fundus Ef with the slit light LP from an oblique direction. Thereby, the fundus Ef can be stereoscopically photographed (observed) while avoiding the effects of ghost and flare caused by reflections from the cornea Ec and the like.

The second illumination optical system 32 includes a light source 32a, a condenser lens 32b, a pattern generation element 35, and a light scanning section 36.

For example, a semiconductor light source is used as the light source 32a, and outputs illumination light L2 having a wavelength in the visible region. Illumination light L2 output from the light source 32a is converted into slit light LP by a pattern generation element 35, which will be described later, and then enters the condenser lens 32b. The slit light LP transmitted through the condenser lens 32b passes through the objective lens 20 and the fundus observation lens 21 without passing through the reflection mirror RM, and is irradiated obliquely onto the fundus Ef. Further, the slit light LP irradiated onto the fundus Ef is scanned by a light scanning section 36, which will be described later. Thereby, the return light LB of the slit light LP from the fundus Ef passes through the objective lens 20, is reflected by the reflection mirror RM, and then passes through the dichroic mirror DM and enters the observation optical systems 40L and 40R.

<Observation optical system>
The observation optical system 40L is an optical system that guides the return light LA or return light LB incident from the dichroic mirror DM to the camera 60L. Furthermore, the observation optical system 40R is an optical system that guides the return light LA or return light LB incident from the dichroic mirror DM to the camera 60R.

In this embodiment, the observation optical systems 40L, 40R and their optical axes OB extend in the Y direction perpendicular to the optical axis OA (for example, including substantially perpendicular within a range of ±20°). Note that the direction is not limited to the Y direction as long as it is perpendicular to the optical axis OA, and the observation optical systems 40L, 40R and their optical axes OB may extend, for example, in the X direction. Thereby, the observation optical systems 40L and 40R having long optical path lengths are arranged in a direction substantially parallel to the XY plane. Therefore, without the observation optical systems 40L and 40R being placed in front of the operator, the operator can easily view the screen of the monitor 14 in front of him (or the situation in front of him). Further, the casing placed in front of the operator does not give the operator a feeling of pressure, and the burden on the operator can be reduced.

The observation optical system 40L includes a zoom expander 50L. The zoom expander 50L includes a plurality of zoom lenses 51, 52, and 53 that are movable in the optical axis OB direction by a variable power mechanism (not shown). Thereby, the zoom magnification of the observed image D can be changed.

The observation optical system 40R has the same configuration as the observation optical system 40L, and includes a zoom expander 50R that includes a plurality of zoom lenses 51, 52, 53, and has a zoom mechanism (not shown) that allows the observation optical system 40R to have the same configuration as the observation optical system 40L. By moving 53, the zoom magnification of the observation image D is changed. Here, the observation optical system 40L and the observation optical system 40R can have different zoom magnifications for the observation image D.

<Camera>
The cameras 60L and 60R image the return light LA or the return light LB incident from the observation optical systems 40L and 40R, and output an observation image D.

The camera 60L includes an imaging lens 61 and an image sensor 62 arranged along the optical axis OB. The imaging lens 61 forms an image of the return light LA or the return light LB incident from the observation optical system 40L on the imaging surface of the image sensor 62. The image sensor 62 images the return light LA or LB formed by the imaging lens 61 and outputs an observation image D to the control device 16 . As a result, in the 0-degree illumination mode, a normal observation image D (transillumination image) of the fundus Ef based on the return light LA is obtained, and in the oblique illumination mode, a part of the fundus Ef (transillumination image) based on the return light LB (slit light LP) is obtained. Observation image D of the irradiated area) is obtained.

The camera 60R has the same configuration as the camera 60L, and includes an imaging lens 61 and an image sensor 62. As a result, the return light LA or return light LB incident from the observation optical system 40R is imaged by the imaging lens 61 on the imaging surface of the image sensor 62, and the return light LA or return light LB is imaged by the image sensor 62. Observation image D is output to the control device 16. As a result, the above-mentioned observation image D is obtained depending on the type of fundus observation mode. Note that in the cameras 60L and 60R, the optical arrangement of the imaging lens 61 and the image sensor 62 can be changed independently from each other, that is, the focus can be changed on the left and right sides.

<Pattern generation element and optical scanning section>
FIG. 3 is an explanatory diagram of the pattern generation element 35 and the optical scanning section 36. As shown by reference numeral 3A in FIG. 3, the pattern generation element 35 includes a reticle, a light-shielding plate, and a light-shielding plate on which a slit-shaped light transmitting pattern 35a (slit holes may also be used) extending perpendicularly to the optical axis OA is formed. These include a filter, aperture, focus plate, or mask. Thereby, the pattern generation element 35 generates the slit light LP from the illumination light L2 emitted from the light source 32a. In other words, the pattern generation element 35 converts the illumination light L2 into the slit light LP.

The slit light LP is an optical pattern extending in a direction perpendicular to the optical axis OA, and corresponds to the pattern light of the present invention. In this embodiment, the slit light LP is parallel to the X-axis direction, but there is no particular limitation as long as it is perpendicular to the optical axis OA. For example, the slit light LP may be parallel to the Y-axis direction.

As the pattern generation element 35 generates the slit light LP from the illumination light L2, as shown by reference numeral 3B in FIG. The slit light LP is irradiated (projected) onto a part of the image from an oblique direction. As a result, an observation image D of a portion of the fundus Ef irradiated with the slit light LP by the cameras 60L, 60R can be obtained via the objective lens 20, the observation optical systems 40L, 40R, and the like.

The pattern generation element 35 can be inserted into and removed from the optical path of the illumination light L2 emitted from the light source 32a by an insertion/removal mechanism (not shown). Thereby, when irradiating the fundus Ef with the slit light LP, the pattern generation element 35 is inserted into the optical path of the illumination light L2. Furthermore, by retracting the pattern generation element 35 from the optical path of the illumination light L2, the patient's eye E (cornea Ec, fundus Ef) can be irradiated with the illumination light L2 from an oblique direction.

The optical scanning unit 36 is an actuator that reciprocates (displaces) the pattern generating element 35 continuously or intermittently along the scanning directions A1 and A2 in the tilt illumination mode. The scanning directions A1 and A2 are directions perpendicular to the optical axis OA and parallel to the transverse direction of the slit light LP (light transmission pattern 35a). For example, scanning directions A1 and A2 are one side and the other side of the Y-axis direction when the slit light LP is parallel to the X-axis direction, and when the slit light LP is parallel to the Y-axis direction, are one side and the other side in the X-axis direction. Thereby, the fundus Ef can be scanned along the scanning directions A1 and A2 by the slit light LP.

FIG. 4 is an explanatory diagram of an observation image D captured and output by the image pickup devices 62 of the cameras 60L and 60R during the oblique illumination mode. In addition, in FIG. 4, the area irradiated with the slit light LP in the image of the fundus Ef in the observation image D is simply shown in white, and the area not irradiated with the slit light LP is shown in dots. It is shown in a simplified manner (the same applies to FIG. 6, which will be described later).

As shown in FIG. 4, in the oblique illumination mode, the cameras 60L and 60R capture images of the returned light LB and observation images for each scanning position of the slit light LP that scans the fundus Ef along the scanning directions A1 and A2. The output of D is repeatedly executed. As a result, in the oblique illumination mode, an observation image D is obtained in which the fundus Ef is divided into a plurality of regions along the scanning directions A1 and A2. That is, in the oblique illumination mode, divisional imaging of the fundus Ef is performed. Each observation image D includes a divided area image 80 corresponding to the above-mentioned divided area (the area irradiated with the slit light LP).

<Control device>
FIG. 5 is a functional block diagram of the control device 16. As shown in FIG. 5, the control device 16 includes an arithmetic circuit including various processors, memories, and the like. Various processors include CPU (Central Processing Unit), GPU (Graphics Processing Unit), ASIC (Application Specific Integrated Circuit), and programmable logic devices [for example, SPLD (Simple Programmable Logic Devices), CPLD (Complex Programmable Logic Device), and FPGA (Field Programmable Gate Arrays)]. Note that the various functions of the control device 16 may be realized by one processor, or may be realized by a plurality of processors of the same type or different types.

The control device 16 includes, in addition to the aforementioned operation section 12, monitor 14, first illumination optical systems 31L, 31R, second illumination optical system 32, observation optical systems 40L, 40R, cameras 60L, 60R, a storage section 18. is connected. Although not shown in the drawings, the storage unit 18 stores a control program for the surgical microscope 10 and the like.

The control device 16 functions as a microscope main body control section 100, an image acquisition section 102, a composite observation image generation section 104, and a display control section 106 by reading and executing the control program in the storage section 18. Hereinafter, what will be described as the "~ section" of the control device 16 may also be "~ circuit," "~ device," or "~ device." That is, what is described as "unit" may be composed of firmware, software, hardware, or a combination thereof.

The microscope main body control unit 100 controls the operation of the first illumination optical systems 31L, 31R, the second illumination optical system 32, the observation optical systems 40L, 40R, and the cameras 60L, 60R, and also controls the insertion and removal of the fundus observation lens 21. and controls insertion and removal of the pattern generation element 35.

When switching to the 0 degree illumination mode is performed using the operation unit 12, the microscope main body control unit 100 turns on the light source 31a and places the fundus observation lens 21 in the optical path of the illumination light L1 and slit light LP. Let it be inserted. Further, the microscope main body control unit 100 causes the imaging elements 62 of the cameras 60L and 60R to capture the returned light LA and output the observation image D. As a result, in the 0-degree illumination mode, a wide observation image D (transillumination image) of the fundus Ef is continuously output from the image sensor 62.

When switching to the tilted illumination mode is performed using the operation unit 12, the microscope main body control unit 100 turns on the light source 32a, inserts the pattern generation element 35 into the optical path of the illumination light L2, and inserts the pattern generation element 35 into the optical path of the illumination light L1. Then, the fundus observation lens 21 is inserted into the optical path of the slit light LP. Further, the microscope main body control section 100 drives the optical scanning section 36 to cause the pattern generation element 35 to continuously reciprocate along the scanning directions A1 and A2. Further, the microscope main body control unit 100 controls the imaging of the cameras 60L and 60R every time the position of the pattern generation element 35 is displaced, that is, every time the scanning position of the slit light LP as shown in FIG. The element 62 is caused to take an image of the returned light LB and output an observation image D. As a result, in the tilt illumination mode, the observation image D is continuously outputted from the image sensor 62 at each scanning position of the slit light LP, as shown in FIG. 4 described above.

The image acquisition unit 102 acquires an observation image D from the image pickup devices 62 of the cameras 60L and 60R via an interface (not shown) in the 0-degree illumination mode and the tilt illumination mode. Then, the image acquisition unit 102 sequentially outputs the acquired observation image D to the display control unit 106 in the 0 degree illumination mode. Furthermore, the image acquisition unit 102 sequentially outputs the acquired observation images D to the composite observation image generation unit 104 in the oblique illumination mode.

FIG. 6 is an explanatory diagram for explaining generation of the composite observation image SD by the composite observation image generation unit 104. As shown in FIG. 6 and FIG. 5 described above, the composite observation image generation unit 104 operates in the oblique illumination mode. The composite observation image generation unit 104 generates an observation image D for one scan in the scanning direction A2 of the slit light LP every time it acquires the observation image D for one scan in the scanning direction A1 of the slit light LP from the image acquisition unit 102. Each time it is acquired, a composite observation image SD of the fundus Ef is generated based on the observation image D for one scan.

Specifically, when the composite observation image generation unit 104 acquires observation images D for one scan in the scanning direction A1 of the slit light LP, it detects the divided area images 80 from each of the observation images D for one scan. . For example, the composite observation image generation unit 104 compares the brightness values of each pixel in each observation image D, and detects an area where the brightness value is equal to or greater than a predetermined threshold value as the divided area image 80. Then, the composite observation image generation unit 104 generates a composite observation image by combining the divided area images 80 in each observation image D along the scanning direction A1 based on the detection results of the divided area images 80 in each observation image D. Generate SD. The composite observation image SD corresponds to a photographed image of a scanning area (scanning range) scanned by the slit light LP in the fundus Ef.

Further, the composite observation image generation unit 104 similarly generates the composite observation image SD when the observation image D for one scan in the scanning direction A2 of the slit light LP is acquired. Then, the composite observation image generation unit 104 outputs the composite observation image SD to the display control unit 106 every time the composite observation image SD is generated. Note that the composite observation image generation unit 104 may generate the composite observation image SD based on the observation image D for one reciprocating scan in the scanning directions A1 and A2, as the observation image D for one scan described above.

Returning to FIG. 5, the display control unit 106 controls the display of the monitor 14. The display control unit 106 sequentially displays observation images D sequentially input from the image acquisition unit 102 on the monitor 14 in the 0-degree illumination mode, and displays composite observation images sequentially input from the composite observation image generation unit 104 in the tilt illumination mode. The SD is sequentially displayed on the monitor 14. This allows the operator to observe the fundus Ef through the monitor 14.

[Operation of the first embodiment]
FIG. 7 is a flowchart showing the operation of the surgical microscope 10 of the first embodiment having the above configuration, particularly the flow of observation processing of the fundus Ef of the patient's eye E in the oblique illumination mode.

As shown in FIG. 7, after manual alignment of the microscope main body 10a with respect to the patient's eye E is performed, the operator inputs an operation to switch to the oblique illumination mode on the operation unit 12 (step S1). In response to this switching operation, the microscope main body control unit 100 turns on the light source 32a, so that the illumination light L2 is emitted from the light source 32a (step S2). At the same time, the microscope main body control unit 100 inserts the pattern generation element 35 into the optical path of the illumination light L2, inserts the fundus observation lens 21 into the optical path of the illumination light L1 and the slit light LP, and captures images with the cameras 60L and 60R. Activate element 62.

After the pattern generation element 35 generates the slit light LP from the illumination light L2 emitted from the light source 32a, this slit light LP passes through the condenser lens 32b, the objective lens 20, and the fundus observation lens 21, and is obliquely directed to the fundus Ef. It is irradiated in the direction (step S3). By irradiating the patient's eye E with the slit light LP in this manner, the range of light irradiation onto the patient's eye E is narrowed, so that reflection of light on the cornea Ec and the like is suppressed. Further, by performing oblique illumination on the fundus Ef, reflection of light on the cornea Ec and the like can be suppressed. As a result, by performing oblique illumination of the fundus Ef with the slit light LP, reflection of light on the cornea Ec and the like can be significantly suppressed.

Then, the return light LB of the slit light LP from the fundus Ef passes through the objective lens 20, the reflection mirror RM, the dichroic mirror DM, and the observation optical systems 40L and 40R, and enters the imaging plane of the imaging device 62 of the cameras 60L and 60R. .

Next, the microscope main body control unit 100 drives the optical scanning unit 36 to start reciprocating movement of the pattern generation element 35 in the scanning directions A1 and A2, thereby causing the slit light LP to scan the fundus Ef in the scanning directions A1 and A2. (Step S4).

Then, the imaging elements 62 of the cameras 60L and 60R image the returned light LB and output the observation image D including the divided area image 80 to the image acquisition unit 102 (step S5). As described above, since the reflection of light on the cornea Ec and the like is significantly suppressed, the occurrence of ghosts and flares within the divided area image 80 is suppressed. The image acquisition unit 102 acquires the observation image D from the image sensor 62 and outputs it to the composite observation image generation unit 104 (step S6).

As the scanning position of the slit light LP moves in the scanning direction A1 or the scanning direction A2 on the fundus Ef, the imaging device 62 captures an image of the return light LB and the image acquisition unit 102 performs imaging for each scanning position of the slit light LP. The acquisition of the observation image D and the output to the composite observation image generation unit 104 are repeatedly executed (NO in step S7, steps S8, S5, S6). As a result, the fundus Ef is photographed in sections.

When the composite observation image generation unit 104 acquires the observation image D for one scan in the scanning direction A1 or the scanning direction A2 of the slit light LP, the composite observation image generation unit 104 is activated (YES in step S7). As shown in FIG. 6 described above, the composite observation image generation unit 104 detects divided area images 80 from each observation image D for one scan, and converts the divided area images 80 in each observation image D into scanning directions A1. Alternatively, a composite observation image SD is generated by combining along the scanning direction A2 (step S9). As described above, since the occurrence of ghosts and flares within each divided area image 80 is suppressed, the occurrence of ghosts and flares within the composite observation image SD is also suppressed. Then, the composite observation image generation unit 104 outputs the composite observation image SD to the display control unit 106.

The display control unit 106 that has acquired the composite observation image SD from the composite observation image generation unit 104 displays this composite observation image SD on the monitor 14 (step S10).

Similarly, until the oblique illumination mode ends, that is, while the scanning of the slit light LP in the scanning directions A1 and A2 continues, the processes from step S5 to step S10 described above are repeatedly executed (step S11 ). Thereby, the operator can observe the fundus Ef through the monitor 14.

Note that the scanning speed of the slit light LP and the frame rate of the image sensor 62 are sufficiently high, and the generation of the composite observation image SD can also be made faster due to recent improvements in the processing power of CPUs and the like. Therefore, the display delay of the image of the fundus Ef (synthetic observation image SD) displayed on the monitor 14 can also be reduced to such an extent that the operator does not feel any discomfort.

[Effects of the first embodiment]
As described above, in the first embodiment, by scanning the slit light LP along the scanning directions A1 and A2 while irradiating the fundus Ef with the slit light LP in an oblique direction, the cornea Ec during observation of the fundus Ef is Reflection of light on surfaces such as surfaces is greatly reduced. Therefore, the occurrence of ghosts and flares in the observation images D taken by the cameras 60L and 60R at each scanning position of the slit light LP and in the composite observation image SD generated based on each observation image D is significantly reduced. be able to. This eliminates the need to puncture the patient's eye E with an optical fiber cell for fundus illumination as in the past, or the number of punctures can be reduced. As a result, a good composite observation image SD of the fundus Ef can be obtained while reducing the operator's effort and the patient's burden.

[Second embodiment]
Next, a surgical microscope 10 according to a second embodiment will be explained. In the first embodiment, a composite observation image SD is generated based on the observation images D taken by the cameras 60L and 60R at each scanning position of the slit light LP, and this composite observation image SD is displayed on the monitor 14. On the other hand, in the surgical microscope 10 of the second embodiment, the observation image D taken at each scanning position of the slit light LP is displayed on the monitor 14.

The surgical microscope 10 of the second embodiment is similar to the first embodiment except that the control device 16 does not function as the composite observation image generation section 104 and the functions of the image acquisition section 102 and display control section 106 are partially different. It has basically the same configuration as the surgical microscope 10 of the embodiment. For this reason, the same reference numerals are given to the same elements in function or configuration as those in the first embodiment, and the explanation thereof will be omitted.

FIG. 8 is a flowchart showing the operation of the surgical microscope 10 of the second embodiment, particularly the flow of observation processing of the fundus Ef of the patient's eye E in the oblique illumination mode. Incidentally, steps S1 to S5 are basically the same as those in the first embodiment shown in FIG. 7 described above, and therefore the description thereof will be omitted.

As shown in FIG. 8, the image acquisition unit 102 of the second embodiment sequentially outputs the observation image D acquired from the image sensor 62 in the oblique illumination mode to the display control unit 106 (step S6A). Then, the display control unit 106 of the second embodiment causes the monitor 14 to sequentially display the composite observation image SD that is sequentially input from the image acquisition unit 102 in the oblique illumination mode (step S7A). As a result, until the oblique illumination mode ends, that is, while the scanning of the slit light LP in the scanning directions A1 and A2 continues, the observation at each scanning position of the slit light LP shown in FIG. Images D are sequentially and repeatedly displayed (steps S8A, S9A).

Here, the area other than the divided area image 80 of each observation image D, that is, the image of the area in the fundus Ef that is not irradiated with the slit light LP becomes a dark image (black or gray image), and conversely, each observation image D The inner divided area image 80 becomes a bright image. Further, as described above, the scanning speed of the slit light LP and the frame rate of the image sensor 62 can be increased. Therefore, by displaying the observation image D (divided area image 80) for each scanning position of the slit light LP on the monitor 14 at a high frame rate, the monitor 14 can be displayed using a similar display method such as a known non-interlaced method or a progressive method. A divided area image 80 is displayed (scanned) within the screen. As a result, an image of the scanning area scanned by the slit light LP in the fundus Ef (that is, a composite observation image SD) can be formed on the screen of the monitor 14. In this case, the higher the frame rate of the observation image D is, the closer the image to the composite observation image SD can be displayed on the monitor 14.

As described above, in the second embodiment, generation of the composite observation image SD can be omitted by sequentially and repeatedly displaying the observation images D for each scanning position of the slit light LP on the monitor 14. Therefore, the amount of calculation processing by the control device 16 can be reduced. Furthermore, the second embodiment is the same as the first embodiment except that generation and display of the composite observation image SD are omitted, so that the same effects as the first embodiment can be obtained.

[Third embodiment]
FIG. 9 is a top view of the surgical microscope 10 of the third embodiment. In each of the above embodiments, the observation optical systems 40L and 40R guide the return light LB (the same goes for the return light LA) to the image pickup elements 62 of the cameras 60L and 60R, but in the third embodiment, the observation optical systems 40L and 40R The light LB is also guided to the eyepieces 65 of the eyepiece systems 63L and 63R.

As shown in FIG. 9, in the surgical microscope 10 of the third embodiment, the microscope body 10a is provided with eyepiece systems 63L and 63R, and the observation optical system 40L includes a beam splitter BSL, and the observation optical system 40R includes a beam splitter BSL. It has basically the same configuration as the surgical microscope 10 of each of the embodiments described above, except that it includes a beam splitter BSR. For this reason, the same reference numerals are given to the same elements in terms of function or configuration as in each of the above embodiments, and the explanation thereof will be omitted.

Beam splitter BSL is arranged between zoom expander 50L and camera 60L. This beam splitter BSL transmits a portion of the return lights LA and LB that have entered from the zoom expander 50L and outputs them to the camera 60L, and reflects the remainder of the return light LB toward the eyepiece lens system 63L.

Beam splitter BSR is arranged between zoom expander 50R and camera 60R. This beam splitter BSR transmits a portion of the return lights LA and LB that have entered from the zoom expander 50R and outputs them to the camera 60R, and reflects the remainder of the return light LB toward the eyepiece system 63R.

The eyepiece systems 63L and 63R include an imaging lens 64 and an eyepiece 65. The imaging lens 64 of the eyepiece system 63L guides the return light LB incident from the beam splitter BSL to the eyepiece 65. Further, the imaging lens 64 of the eyepiece lens system 63R guides the return light LB incident from the beam splitter BSR to the eyepiece lens 65. Thereby, the operator can observe the fundus Ef through the eyepiece 65 as in the second embodiment.

The surgical microscope 10 of the third embodiment includes both cameras 60L and 60R (imaging device 62) and eyepiece systems 63L and 63R, but the cameras 60L and 60R are omitted and the eyepiece systems 63L and 63R are provided. 63R may be provided.

[Fourth embodiment]
FIG. 10 is an enlarged side view of a part of the microscope main body 10a of the surgical microscope 10 of the fourth embodiment. The surgical microscope 10 of the fourth embodiment is the same as the surgical microscope of each of the above embodiments except that the arrangement of the second illumination optical system 32 is different and a dichroic mirror DM1 is provided instead of the reflecting mirror RM. It has basically the same configuration as 10. For this reason, the same reference numerals are given to the same elements in terms of function or configuration as in each of the above embodiments, and the explanation thereof will be omitted.

In each of the above embodiments, the optical axis OS of the second illumination optical system 32 is decentered in the direction perpendicular to the optical axis OA of the objective lens 20, but as shown in FIG. The optical axis OS may coincide with the optical axis OA of the objective lens 20, that is, be coaxial.

The dichroic mirror DM1 (corresponding to the deflection optical element of the present invention) transmits the slit light LP emitted from the second illumination optical system 32 and emits it toward the objective lens 20, and also transmits the return light incident from the objective lens 20. The LB is reflected toward observation optical systems 40L and 40R. Thereby, it is possible to irradiate the fundus Ef with the slit light LP from the second illumination optical system 32 via the dichroic mirror DM1 with "0 degree illumination". Also in this case, by irradiating the patient's eye E with the slit light LP, the range of light irradiated onto the patient's eye E is narrowed, so that reflection of light on the cornea Ec and the like is suppressed. Therefore, the same effects as in each of the above embodiments can be obtained.

Note that instead of providing the second illumination optical system 32 above the dichroic mirror DM1 in the Z direction, the second illumination optical system 32 may be provided above the dichroic mirror DM in the above embodiments in the Z direction.

[Modified example of pattern generation element]
11 and 12 are explanatory diagrams of modified examples of the pattern generation element 35. In each of the above embodiments, the slit-shaped light transmission pattern 35a is formed on the pattern generation element 35, but the shape of the light transmission pattern 35a formed on the pattern generation element 35 is not particularly limited and may be changed as appropriate. Good too.

For example, a rectangular light transmitting pattern 35b may be formed on the pattern generating element 35 as shown in FIG. 11, or a circular light transmitting pattern 35c may be formed on the pattern generating element 35 as shown in FIG. good. Thereby, the pattern generation element 35 can generate pattern light of various shapes such as a rectangular shape or a circular shape from the illumination light L2, and the fundus Ef can be scanned with this pattern light. Note that the scanning direction of the pattern light (including the slit light LP) is not particularly limited as long as it is perpendicular to the optical axis OA, and may be scanned in the XY axis direction, for example.

[others]
In each of the above embodiments, the pattern generation element 35 is provided in the second illumination optical system 32, but this is not particularly limited as long as it is on the optical path of the illumination light L2 between the light source 32a and the objective lens 20. It may be provided outside the second illumination optical system 32.

In each of the above embodiments, a reticle or the like has been described as an example of the pattern generation element 35, but the type of the pattern generation element 35 is not particularly limited as long as it can generate the slit light LP from the illumination light L2. A transmissive display device such as a liquid crystal panel or a light modulation element such as a digital macro mirror device may also be used. Note that when a transmissive display device and a light modulation element are used as the pattern generation element 35, the scanning of the slit light LP can be performed by controlling the transmissive display device and the light modulation element without displacing the pattern generation element 35. It can be carried out. In this case, the pattern generating element 35 also functions as the optical scanning section of the present invention.

In each of the above embodiments, the slit light LP is scanned in the direction perpendicular to the optical axis OA by displacing the pattern generating element 35 such as a reticle in the direction perpendicular to the optical axis OA. As long as scanning is possible in this vertical direction, there are no particular limitations on the shape of the pattern generating element 35 and its displacement method (including rotation, rocking, etc.). For example, the pattern generation element 35 is formed in a columnar shape extending in the vertical direction, and by rotating or swinging the pattern generation element 35 about its central axis, the slit light LP can be scanned in the vertical direction. good.

In each of the above embodiments, the surgical microscope 10 is equipped with the monitor 14, but the present invention is also applicable to a surgical microscope 10 that is not equipped with the monitor 14 and uses an external monitor.

In each of the above embodiments, the observation optical systems 40L, 40R and their optical axes OB extend in a direction perpendicular to the optical axis OA, but for example, they may extend parallel (including substantially parallel) to the optical axis OA. Generally, the orientations of the observation optical systems 40L, 40R and their optical axes OB are not particularly limited.

In each of the embodiments described above, the surgical microscope 10 includes the binocular first illumination optical systems 31L, 31R, the observation optical systems 40L, 40R, and the cameras 60L, 60R, but it may be a monocular type.

In each of the above embodiments, the surgical microscope 10 used for surgery on the patient's eye E has been described as an example, but the present invention can also be applied to various ophthalmological apparatuses for observing the fundus Ef of the patient's eye E.

10 Surgical microscope 10a Microscope body 12 Operation section 14 Monitor 16 Control device 18 Storage section 20 Objective lens 21 Fundus observation lenses 31L, 31R First illumination optical system 31a Light source 31b Condenser lens 32 Second illumination optical system 32a Light source 32b Condenser lens 35 Pattern generation elements 35a, 35b, 35c Light transmission pattern 36 Light scanning units 40L, 40R Observation optical systems 50L, 50R Zoom expanders 51, 52, 53 Zoom lenses 60L, 60R Camera 61 Imaging lens 62 Image pickup elements 63L, 63R Eyepiece Lens system 64 Imaging lens 65 Eyepiece 80 Divided area image 100 Microscope main body control section 102 Image acquisition section 104 Composite observation image generation section 106 Display control sections A1, A2 Scanning direction BSL, BSR Beam splitter D Observation image DM, DM1 Dichroic mirror E Patient's eye Ec Cornea Ef Fundus L1, L2 Illumination light LA, LB Return light LP Slit light OA, OB, OL, OR, OS Optical axis RM Reflection mirror SD Synthetic observation image

Claims (6)

objective lens;
an illumination optical system that emits illumination light from a light source toward the fundus of the patient's eye via the objective lens;
a pattern generation element that is provided on the optical path of the illumination light between the objective lens and the light source and generates pattern light from the illumination light;
a light scanning unit that scans the pattern light emitted toward the fundus in a direction perpendicular to the optical axis of the objective lens;
an observation optical system that guides the return light of the pattern light from the fundus that has entered through the objective lens to an imaging device;
The camera includes the image sensor, and while the light scanning unit is scanning the pattern light, the image sensor captures an image of the return light and images the part of the fundus based on the return light. A camera that repeatedly outputs observation images;
a display control unit that repeatedly outputs the observation image output from the camera to a monitor while the light scanning unit scans the pattern light;
A control unit that controls the scanning speed of the patterned light by the optical scanning unit and the frame rate of the image pickup device to form an entire image of the scanning area scanned by the patterned light in the fundus on the screen of the monitor. and,
An ophthalmological device comprising: The optical axis of the illumination optical system is decentered with respect to the optical axis of the objective lens,
The ophthalmologic apparatus according to claim 1, wherein the illumination optical system causes the pattern light to enter the fundus in an oblique direction through the objective lens. The ophthalmologic apparatus according to claim 1 or 2 , wherein the pattern generation element generates slit light as the pattern light from the illumination light. The ophthalmologic apparatus according to any one of claims 1 to 3 , wherein the light scanning unit scans the pattern light in the vertical direction by displacing the pattern generation element in the vertical direction. The ophthalmologic apparatus according to any one of claims 1 to 4 , wherein the pattern generation element is provided within the illumination optical system. The optical axis of the observation optical system is perpendicular to the optical axis of the objective lens,
a deflection optical element provided at the intersection of the optical axis of the objective lens and the optical axis of the observation optical system, the deflection optical element deflecting the return light incident from the objective lens toward the observation optical system; The ophthalmologic apparatus according to any one of claims 1 to 5 , comprising an element.

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