JP7768804B2 - ophthalmology equipment - Google Patents

Description

This disclosure relates to an ophthalmic device.

Conventionally, a method for controlling an ophthalmic device is known that uses a tablet computer to wirelessly control both an electric refractor and an optotype presenting device (see, for example, Patent Document 1).

Patent No. 6206430

Incidentally, there is a high need for ophthalmic devices that allow examinations to be performed using a tablet, in order to accommodate social distancing and other requirements. However, in proximity examination mode, in which an examiner sitting near the examinee performs input operations on the ophthalmic device, a device that combines a monitor screen with an operation controller that has a manually operated jog dial or the like is used as the input operation device. For this reason, in remote examination mode, it is difficult to achieve the operational feel of an examiner who is accustomed to manually operating a jog dial or the like using only a tablet. Furthermore, when operating using a tablet, it is difficult to input quantitative information, and blind operation is not possible. Therefore, when performing remote examinations using only a tablet, even if social distancing can be accommodated, there is the issue of increased input operation burden on the examiner.

This disclosure has been made in response to the above-mentioned issues, and aims to provide an ophthalmic device that reduces the input operation burden on the examiner when performing a remote examination via remote operation from an examiner located at a distance from the subject.

In order to achieve the above-mentioned objective, the ophthalmic device disclosed herein comprises a measurement head that performs measurements of examination items on the subject's eye, a control unit that controls the measurement head based on input information, and a remote operating device that transmits the input information to the control unit via wireless communication.
The remote operation device uses a touch operation terminal having a touch panel display screen and a manual operation unit that cooperates with the touch operation terminal.
The manual operation unit has a quantitative content operation means that enables the examiner to input quantitative content by moving his/her hand in a predetermined direction.

By adopting the above-mentioned solution to the problem, the present disclosure can reduce the input operation burden on the examiner when conducting a remote examination via remote operation from an examiner located at a distance from the subject.

1 is a perspective view showing an example of a subjective ophthalmic apparatus according to a first embodiment. 1 is an explanatory diagram for explaining the positional relationship of each part when performing distance vision optometry in a subjective ophthalmic device. FIG. 1 is an explanatory diagram for explaining the positional relationship of each part when near vision examination is performed in a subjective ophthalmic device. FIG. 1 is a diagram illustrating an example of a remote operation device that uses a tablet terminal and a manual operation unit that are detachable from each other in the subjective ophthalmic apparatus of Example 1. FIG. FIG. 10 is a plan view showing a modified example in which a group of peripheral switches is further added to the manual operation unit of the first embodiment. 10 is a perspective view showing a modification of the remote control device of the first embodiment, which is a tilt type that is detachable from the tablet terminal and allows the setting angle of the tablet terminal to be changed. FIG. FIG. 10 is a perspective view showing an example of a subjective/objective ophthalmic device according to a second embodiment. FIG. 10 is a diagram illustrating an example of a remote operation device that uses a tablet terminal and a manual operation unit that are detachable from each other in the subjective/objective ophthalmic device of Example 2. FIG. 11 is a perspective view showing an example of an objective ophthalmologic apparatus according to a third embodiment, as viewed from the examiner's side. FIG. 11 is a side view showing an objective ophthalmic examination state of a subject in the objective ophthalmic apparatus according to the third embodiment. 10A and 10B are diagrams illustrating an example of a remote operation device in which two manual operation units that can be attached to and detached from the left and right peripheral end faces of a single tablet terminal are combined and used together. 10 is a diagram showing an example of a remote operation device in which two manual operation units that can be attached to and detached from the upper and lower peripheral end faces of a single tablet terminal are combined and used together. FIG. 10A to 10F are diagrams showing various other examples (a), (b), (c), (d), (e), and (f) applicable as quantitative content manipulation means. FIG. 10 is a diagram showing an example of operating quantitative contents using two operating levers as quantitative content operating means. FIG. 10 is a diagram showing an example of operating quantitative contents using a motion detection unit that detects gestures by finger movements as a quantitative contents operation means.

Below, as embodiments of the ophthalmic device according to the present disclosure, an example in which a subjective ophthalmic device is used as the ophthalmic examination system (Example 1), an example in which a subjective/objective ophthalmic device is used as the ophthalmic examination system (Example 2), and an example in which an objective ophthalmic device is used as the ophthalmic examination system (Example 3) will be described with reference to the drawings.

The ophthalmic device 10 according to Example 1 is an example of a subjective ophthalmic device that performs a subjective ophthalmic examination of the subject's eye E. In the following, the left-right direction as viewed from the subject S is indicated by arrow X, the up-down direction (vertical direction) is indicated by arrow Y, and the direction perpendicular to the left-right and up-down directions (depth direction) is indicated as the front-to-back direction by arrow Z. Note that an ophthalmic examination in which measurements are carried out while listening to responses from the subject S is referred to as a "subjective ophthalmic examination," and an ophthalmic examination in which measurements are automatically performed by a machine is referred to as an "objective ophthalmic examination."

The ophthalmic device 10 constitutes a subjective ophthalmic device and is used to measure the refractive power of the subject's eye E and to test binocular visual function. The ophthalmic device 10 of Example 1 is a binocular open-eye type that can test and correct the visual function of the subject's eye E while both eyes of the subject S are open, and it is also possible to cover one eye and test each eye at a time. Furthermore, the convergence and divergence forces of the subject S are measured, and the results are used as reference values when correcting the subject's heterophoria.

As shown in FIG. 1, the ophthalmic device 10 includes a refractor head 11 (measurement head), an optotype display device 12, an examination table 14, a power supply unit 19 (control unit), and a remote control device 50. The examination table 14 includes a first table portion 15 that supports the refractor head 11 and on which the subject S's arm rests, and a second table portion 16 on which the optotype display device 12 rests.

The first table unit 15 can be moved up and down by a first lifting mechanism 17 and can be stopped at any position in the vertical direction. As shown in Figures 2 and 3, the second table unit 16 can be moved up and down relative to the first table unit 15 by a second lifting mechanism 18, and can be moved between a position where the optotype display device 12 faces the subject's eye E (see Figure 2) and a position where it is out of the field of view (direction of gaze) of the subject's eye E (see Figure 3).

As shown in FIG. 1, the refractor head 11 has a pair of optometry units 21 and a support mechanism 22. The pair of optometry units 21 are attached to the first table portion 15 of the optometry table 14 by the support mechanism 22. The support mechanism 22 has a support post 22a, a support arm 22b, and a support member 22c. The support post 22a extends vertically from above the first table portion 15 and is extendable and retractable in the vertical direction and rotatable in the circumferential direction, as indicated by the arrows. The support arm 22b extends horizontally (diagonally upward) from the support post 22a. A support member 22c is provided at the tip of this support arm 22b, and the refractor head 11 is suspended from this support member 22c. By rotating the support column 22a in the circumferential direction, the support mechanism 22 can position the refractor head 11 between the subject's eye E and the optotype display device 12 (see Figure 2), and can also retract the refractor head 11 from there (see Figure 1).

The eye examination units 21 are provided with a forehead rest against which the forehead of the subject S rests, and are provided in pairs on the left and right to correspond to the left and right eyes E of the subject S positioned there, with individual eye examination optical systems for the left and right eyes. Below, when referring to each unit individually, the eye examination unit for the left eye will be referred to as eye examination unit 21L and the eye examination unit for the right eye as eye examination unit 21R. Each eye examination unit 21 is attached to the support member 22c of the support mechanism 22 by a known sliding mechanism so that it can slide left and right (X direction), allowing them to be moved closer to each other and for communication to be possible.

Each eye examination unit 21 is provided with an eye examination window 23L, 23R. Each eye examination window 23L, 23R forms an optical path from the test eye E side of the corresponding eye examination unit 21 to the optotype display device 12 side, allowing for the selective placement of optical elements (not shown) used for eye examination. The optical elements are a collection of various lenses, polarizing elements, etc. used to correct the visual function of the test eye E, and include, for example, polarizing filters, spherical lenses, cylindrical lenses, and prisms.

The refractor head 11 is provided with a near point rod 27 extending vertically on the optotype display device 12 side of each of the eye examination units 21. A near point rod 27 has an optotype display unit 28 for near vision examination suspended from its tip. The near point rod 27 is foldable, and when in use, the optotype display unit 28 is positioned at the near vision examination distance (e.g., 300-400 mm) (see Figure 3), and when not in use, the near point rod 27 and optotype display unit 28 are stored vertically (see Figures 1 and 2). The optotype display unit 28 displays an optotype for near vision examination. The refractor head 11 is also provided with a subject microphone 31 for acquiring audio and an internal speaker 32 for outputting audio.

As shown in FIG. 1, the optotype display device 12 is placed on the second table 16 and positioned in front of the subject's eye E, sandwiching the refractor head 11 on the first table 15. The optotype display device 12 has a rectangular parallelepiped housing 41, which houses an optotype presentation optical system and an optotype control unit (not shown). The housing 41 has a partially open upper front surface (facing the subject's eye E), providing a window 41a through which the subject S can view the optotype. In addition, a subject imaging unit 47 for imaging the subject S is provided below the window 41a.

The power supply unit 19 is a unit that houses a personal computer that is responsible for the overall control of the operation of each part of the ophthalmic device 10. The refractor head 11 and optotype display device 12 are connected to the power supply unit 19 via a LAN cable. When using an input operation device (e.g., a wired controller) not shown in the figure in the proximity test mode, the input operation device is connected to the power supply unit 19 via a LAN cable.

An example of the operation of performing distance and near vision eye examinations during subjective eye examinations using the ophthalmic device 10 shown in Figure 1 will be described with reference to Figures 2 and 3.

First, a distance eye examination is performed using the optotype display device 12. At this time, as shown in FIG. 2, the support 22a of the ophthalmic apparatus 10 is rotated as appropriate to position the refractor head 11 in front of the window 41a of the optotype display device 12. The subject S, standing or seated in a chair, faces the optotype display device 12 (window 41a) on the second table 16 across the refractor head 11 on the first table 15, places their forehead against the forehead rest, and rests their elbows and arms on the first table 15. The ophthalmic apparatus 10 then moves the first table 15 up and down as appropriate, along with the second table 16, to match the height of the subject's eye E in a natural posture, depending on the subject S's condition, such as their posture (standing or sitting), height, seated height, and the height of the subject's eye E from the floor. As a result, the vertical height of the refractor head 11 and optotype display device 12 of the ophthalmic device 10 is adjusted, and the support column 22a is extended or retracted to fine-tune the height of the eye examination unit 21 to fit the subject's eye E.

The ophthalmic device 10 then displays an optotype for distance vision examination tailored to the purpose on the optotype display device 12, and presents the optotype image at the distance vision examination distance using the optotype presentation optical system 42. The ophthalmic device 10 performs distance vision examination of the subject's eye E by having the subject S gaze at the optotype image through the examination windows 23L, 23R of the left and right examination units 21L, 21R. The ophthalmic device 10 then changes the power of the refractive lenses and prisms in the examination windows 23L, 23R in the refractor head 11 depending on how the optotype image appears in this distance vision state, thereby correcting refractive errors, heterophoria, etc. in the distance vision state.

Next, the ophthalmic device 10 performs a near vision examination using the optotype display device 12. At this time, as shown in Figure 3, the ophthalmic device 10 lowers the second table unit 16 and places the optotype display unit 28, which is lowered from the tilted near point rod 27, in the space above it.

The ophthalmic device 10 then performs a near vision eye examination of the subject's eye E by having the subject S gaze at the near vision eye test target on the target display unit 28 through the eye test windows 23L and 23R of the left and right eye test units 21L and 21R, depending on the purpose. The ophthalmic device 10 then changes the power of the refractive lenses and prisms placed in the eye test windows 23L and 23R in the refractor head 11 depending on how the target appears in this near vision state, thereby correcting refractive errors, heterophoria, and the like in the near vision state. This allows the ophthalmic device 10 to examine changes in the accommodation power of the subject's eye E due to aging, etc.

Next, the detailed configuration of the remote control device 50 will be described with reference to Figure 4.

The remote operation device 50 is a device that transmits input information to the power supply unit 19 via wireless communication, and is used in remote examination mode in which the ophthalmic device 10 is operated by an examiner located at least a social distance away from the subject S.

The remote control device 50 combines a tablet terminal 51 (touch operation terminal) with a touch panel display screen 51a and a manual operation unit 52 that works in conjunction with the tablet terminal 51. The remote control device 50 can be used by placing it on a table or by holding it in your hand. When used on a table, for example, as shown in FIG. 6, the manual operation unit 52 is provided with a tiltable tilt connection mechanism 53, and the tablet terminal 51 is inserted into the tablet terminal storage section 53a of the tilt connection mechanism 53 to connect it. In this case, the screen tilt angle of the tablet terminal 51 can be adjusted to an appropriate angle within a specified tilt angle range relative to the manual operation unit 52.

The tablet terminal 51 is network-connected to the power supply unit 19 via cable-free wireless LAN communication. In remote inspection mode, the touch-panel display screen 51a displays multiple input operation selection information that can be selected primarily by touch operation, as shown in Figure 4.

The manual operation unit 52 is detachably attached to the lower peripheral edge surface of the tablet terminal 51 and can be in an attached state or a detached proximity state. Here, the attached state includes both a state in which it is attached to the tablet terminal 51 by plugging it in, and a state in which it is connected to the tablet terminal 51 via a cable. Furthermore, the detached proximity state refers to a state in which they are arranged so that they can communicate information with each other via short-range wireless communication. Therefore, the tablet terminal 51 and manual operation unit 52 of the remote control device 50 can cooperate not only in the attached state, but also in the detached proximity state.

The manual operation unit 52 includes a unit power supply 52a, a microswitch 52b (mounting status detection means) that detects the mounting status of the tablet terminal 51, and a short-range communicator 52c for the tablet terminal 51. The unit power supply 52a is turned on and off by a power switch 503. The proximity status is also detected by determining the communication status using the short-range communicator 52c.

When the microswitch 52b detects that the tablet terminal 51 and the manual operation unit 52 are attached, or when it detects that they are detached and in close proximity, a predetermined reaction action is set.

Predetermined reaction actions include, for example, disabling tablet operation, prioritizing tablet operation, both tablet operation and manual operation, power mode (power saving mode), active (data exchange), termination judgment, etc.

The manual operation unit 52 has a jog dial 500 (quantitative content operation means) that allows the examiner to input quantitative content by moving their hand in a predetermined direction. The jog dial 500 is used when changing the numerical values of the lens refractive power or astigmatism axis, etc. Turning it to the right changes it to the negative side, and turning it to the left changes it to the positive side. Here, the "jog dial" is a rotary selector that operates with the simple action of "turning and pressing" the dial. For example, quantitative content can be input in detail by using a jog operation that changes the amount little by little in steps, with a predetermined amount of change being set as a step unit. In other words, while the touch-operated tablet terminal 51 is not good at inputting quantitative content, the jog dial 500 is an operation means that is good at inputting quantitative content.

The jog dial 500 can be used in combination with touch operations on the display screen 51a of the tablet terminal 51. Screen touch operations that can be combined with the input of quantitative content to the jog dial 500 include spherical power/addition power operation, astigmatism power operation, astigmatism axis operation, horizontal/vertical prism operation, and PD operation. Note that "PD" refers to the interpupillary distance between the centers of the left and right pupils (irises) of the subject's eye E. Furthermore, while the shift switch 515 (described below) is pressed, the change step for each operation becomes the default value.

The manual operation unit 52 includes a first peripheral switch group 501 arranged around the periphery of the jog dial 500.

As shown in FIG. 4, the first peripheral switch group 501 includes a forward switch 510, a first switch 511, a second switch 512, a plus switch 513, a minus switch 514, and a shift switch 515.

The forward switch 510 advances the course program one step, and pressing it while pressing the shift switch 515 moves the course program back one step. In monocular mode, the first switch 511 sets a green-framed cross cylinder lens on the eye being tested and starts the test. In binocular mode, the test automatically starts in right eye test mode. In monocular mode, the second switch 512 sets a red-framed cross cylinder lens on the eye being tested and starts the test. In binocular mode, the test automatically starts in right eye test mode. The plus switch 513 is green, and the value changes to the plus side each time it is pressed. The minus switch 514 is red, and the value changes to the minus side each time it is pressed. The shift switch 515 is used in combination with the forward switch 510, etc.

Here, the plus switch 513 and minus switch 514 can be used in combination with screen touch operations on the display screen 51a of the tablet terminal 51. Screen touch operations that can be combined with operations on the plus switch 513 and minus switch 514 include operations during spherical power/addition power operation, astigmatism power operation, astigmatism axis operation, horizontal/vertical prism operation, and PD operation. Note that while the shift switch 515 is pressed, the change step for each operation becomes the default value.

Here, the peripheral switch group may include, as shown in FIG. 5, a first peripheral switch group 501, 501' arranged around the jog dial 500, and a second peripheral switch group 502 arranged at a position farther away from the jog dial 500 than the first peripheral switch group 501, 501'.

As described above, the first peripheral switch group 501 includes the forward switch 510, the first switch 511, the second switch 512, the plus switch 513, the minus switch 514, and the shift switch 515.

The first peripheral switch group 501' includes a right eye switch 516, a left eye switch 517, a binocular switch 518, and occlusion switches 519 and 520. The right eye switch 516 specifies the right eye as the eye to be tested. The left eye switch 517 specifies the left eye as the eye to be tested. The binocular switch 518 sets the device to binocular measurement mode. The occlusion switches 519 and 520 set the occlusion for the right or left eye. Pressing them again removes the occlusion. Pressing them while pressing the shift switch 515 allows you to change the type of occlusion.

The second peripheral switch group 502 includes a movement switch 521 and a visual acuity switch 522. The movement switch 521 is used to move the mask or list selection items, and includes an upward movement switch section 521a, a downward movement switch section 521b, a leftward movement switch section 521c, and a rightward movement switch section 521d. The visual acuity switch 522 is located in the center of each switch section 521a, 521b, 521c, and 521d, and is used to input measured visual acuity values. A jog dial may be located in the center of the second peripheral switch group 502, and the jog dial and the second peripheral switch group 502 may be combined.

In the manual operation unit 52 of the first embodiment, the following parameter input operations are performed by manually operating the jog dial 500.
(P1) The test distance between the subject's eye E and the test target is set.
(P2) Set the optotype switching, auxiliary lens switching, mask switching, and data switching.
(P3) The adjustment amount of the convergence amount and the divergence amount is set.
(P4) Change the subject explanation display, select menu items, input numerical values such as the patient number, and set the fixation light intensity, target XY position, spherical refraction value [S], cylindrical refraction value [C], axial angle [A], and prism [P].

Here, "amount of convergence/divergence" refers to the eye movement that occurs when the subject S moves their gaze to an object at a different distance (depth) from them, with both eyes moving in different directions. "Convergence" refers to the eyes coming together when looking at something close, and "divergence" refers to the eyes moving apart when looking at something far away.

Next, we will explain how to input parameters in remote examination mode. There is a high demand for ophthalmic devices that allow examinations via tablet operation to accommodate social distancing, and this has been proposed in the above-mentioned prior art document (Patent Publication No. 6206430) and elsewhere.

However, in proximity testing mode, where an examiner sitting near the subject performs input operations on the ophthalmic device, the input operation device typically uses a monitor screen and an operation controller with a manually operated jog dial, control lever, etc.

For this reason, in remote examination mode, it is difficult for examiners who are accustomed to manually operating jog dials, control levers, etc. to achieve the same operational feel as in close-proximity examination mode using only tablet operation. Furthermore, while tablet operation is convenient for selecting from multiple options, it makes it difficult to input quantitative information and blind operation is not possible. Therefore, when remote examinations are conducted using only tablet operation to accommodate social distancing, the burden of input operations on examiners increases.

In contrast, the remote operation device 50 used in remote examination mode combines a tablet terminal 51 with a touch panel display screen 51a and a manual operation unit 52 that works in conjunction with the tablet terminal 51. The manual operation unit 52 is configured with a jog dial 500 as a quantitative content operation means that allows the examiner to input quantitative content by moving their hand in a specified direction.

Therefore, in remote examination mode, the tablet terminal 51's advantage of being convenient for selecting from multiple options is utilized, while the jog dial 500 compensates for the difficulties of the tablet terminal 51 in inputting quantitative information and blind operation. Furthermore, the operating feel of an examiner who is accustomed to manually operating a jog dial, etc. in close examination mode is realized in remote examination mode. Therefore, when a remote examination is performed by an examiner who is distant from the subject S and operates the remote operation, the examiner's input operation burden is reduced.

The ophthalmic device 10 of Example 1 has the following advantages:

(1) The device comprises a measurement head (refractor head 11) that measures the test items on the subject's eye E, a control unit (power supply unit 19) that controls the measurement head based on input information, and a remote operation device 50 that transmits the input information to the control unit via wireless communication. The remote operation device 50 uses a touch operation terminal (tablet terminal 51) with a touch panel display screen in combination with a manual operation unit 52 that interfaces with the touch operation terminal. The manual operation unit 52 has a quantitative content operation means (jog dial 500) that allows the examiner to input quantitative content by moving their hand in a predetermined direction. Therefore, when a remote examination is performed by an examiner remotely operating the device from a distance from the subject S, the burden of input operations on the examiner can be reduced.

(2) The manual operation unit 52 includes a group of peripheral switches (first group of peripheral switches 501, 501', etc.) arranged around the quantitative content operation means (jog dial 500). Therefore, in addition to the combined operation of the quantitative content operation means (jog dial 500) and the touch operation terminal (tablet terminal 51), it is also possible to combine the quantitative content operation means (jog dial 500) and the group of peripheral switches (first group of peripheral switches 501, 501', etc.). This further reduces the examiner's input operation burden when performing remote testing.

(3) The peripheral switch group includes a first peripheral switch group 501, 501' and a second peripheral switch group 502 arranged around the jog dial 500 (quantitative content operation means). Therefore, by configuring the first peripheral switch group 501, 501' and the second peripheral switch group 502 to be switch groups that allow intuitive and smart operation, operability can be improved when performing remote testing.

(4) The manual operation unit 52 is configured so that it can be attached to the touch operation terminal (tablet terminal 51) or detached and placed in close proximity. The manual operation unit 52 is equipped with a unit power supply 52a, an attachment state detection means (microswitch 52b) that detects the attachment state with the touch operation terminal, and a short-range communication device 52c for the touch operation terminal. Therefore, even when the manual operation unit 52 is detached from the remote operation terminal (tablet terminal 51) and placed in close proximity, it is possible to maintain communication between the remote operation terminal (tablet terminal 51) and the manual operation unit 52.

(5) When the attachment state detection means (microswitch 52b) detects that the touch operation terminal (tablet terminal 51) and the manual operation unit 52 are attached to each other, or when a detached proximity state is detected, a predetermined reaction action is set. Therefore, the detection signal from the attachment state detection means (microswitch 52b) can be used to set the reaction action.

(6) The ophthalmic device 10 is a subjective ophthalmic device equipped with a measurement head (refractor head 11) that measures subjective examination items for the subject's eye E, and the manual operation unit 52 uses a jog dial 500 as a quantitative content operation means. Therefore, when performing a remote examination using a subjective ophthalmic examination system, the examiner's input operation burden can be reduced by using parameter input operations on the jog dial 500.

(7) The manual operation unit 52 performs parameter input operations to set the test distance between the subject's eye E and the test target using the jog dial 500. Therefore, when performing a remote test using the subjective eye examination system, the test distance between the subject's eye E and the test target can be set by inputting parameters into the jog dial 500.

(8) The manual operation unit 52 performs parameter input operations to set optotype switching, auxiliary lens switching, mask switching, and data switching using the jog dial 500. Therefore, when performing a remote examination using the subjective optometry system, optotype switching, auxiliary lens switching, mask switching, and data switching can be set by inputting parameters into the jog dial 500.

(9) The manual operation unit 52 performs parameter input operations to set the amount of convergence and divergence adjustment using the jog dial 500. Therefore, when performing a remote examination using the subjective eye examination system, the amount of convergence and divergence adjustment can be set by inputting parameters into the jog dial 500.

(10) The manual operation unit 52 uses the jog dial 500 to change the patient instruction display, select menu items, input numerical values such as the patient number, and input parameters to set the fixation light intensity, target XY position, spherical refraction value [S], cylindrical refraction value [C], axial angle [A], and prism [P]. Therefore, when performing a remote examination using the subjective optometry system, various parameters other than (7) to (9) can be set by inputting parameters to the jog dial 500.

The ophthalmic device 110 according to Example 2 is an example of a subjective/objective ophthalmic device that performs both subjective and objective eye examinations of the subject's eye E. In the following, the left-right direction as viewed from the subject S is indicated by arrow X, the up-down direction (vertical direction) is indicated by arrow Y, and the direction perpendicular to the left-right and up-down directions (depth direction) is indicated as the front-back direction by arrow Z.

A distinctive feature of the ophthalmic device 110 is that it can perform autorefraction and keratomileusis measurements under binocular vision and subjective refraction tests with a single device. Furthermore, because the autorefractor, phoropter, and visual acuity chart are integrated, the hassle of moving between tests and the space required for equipment installation are eliminated, allowing the two tests to be performed in a smaller space than previously required for visual acuity tests. Furthermore, as with Example 1, it also supports remote operation, allowing visual acuity tests to be performed while maintaining social distancing. The configuration of the ophthalmic device 110 according to Example 2 will now be described with reference to Figures 7 and 8.

As shown in FIG. 7, the ophthalmologic apparatus 110 of Example 2 includes a base 111 installed on the floor, an eye examination table 112, a support 113, an arm 114, and a measurement head 120. The subject faces the eye examination table 112 and places their forehead in contact with a forehead support 115 provided on the measurement head 120, during which the ocular characteristics of the subject's eye are measured.

The optometry table 112 is supported by a base 111, and its height is adjustable. A support 113 stands upright in the Y direction from the rear end of the optometry table 112, and an arm 114 is attached to its upper part. The arm 114 supports the measurement head 120 by suspending it above the optometry table 112, and extends from the support 113 in the Z direction. The arm 114 is attached to the support 113 so that it can move up and down.

Below the optometry table 112 is attached a power supply unit 130 (controller), which is a unit incorporating a personal computer that performs the overall control of the operation of each part of the ophthalmic device 110. Power is supplied to the power supply unit 130 from a commercial power source (not shown) via a power cable 130b.

The measurement head 120 is controlled by the power supply unit 130 and simultaneously measures the ocular characteristics of the subject eye, including the anterior-posterior dimension information of the subject eye, the corneal shape of the subject eye, and the refractive characteristics of the subject eye, for both the left and right eyes. The measurement head 120 may also be used to perform any subjective test or any objective measurement other than those described above.

The measurement head 120 includes a left drive mechanism 121L and a right drive mechanism 121R mounted on an attachment base (not shown), a left eye measurement head 122L supported by the left drive mechanism 121L, and a right eye measurement head 122R supported by the right drive mechanism 121R.

The left eye measurement head 122L and right eye measurement head 122R are provided in pairs to correspond individually to the left and right eyes to be examined, and are configured to be plane-symmetrical with respect to a vertical plane located midway between them in the X direction. Furthermore, the configuration of each drive unit of the left drive mechanism 121L that supports the left eye measurement head 122L and the configuration of each drive unit of the right drive mechanism 121R that supports the right eye measurement head 122R are configured to be plane-symmetrical with respect to a vertical plane located midway between them in the X direction.

The ophthalmic device 110 of Example 2, with the above-described configuration, measures the spherical refractive power, astigmatic refractive power, and astigmatic axis direction of the eyeball, as well as the radius of curvature of the corneal surface. In addition, various subjective refractive visual acuity tests are performed. The ophthalmic device 110 is characterized by its ability to simultaneously measure the refractive power, corneal shape, and subjective measurements of both eyes of the subject, and by its ability to perform measurements using simultaneous auto-alignment of both eyes, enabling subjective measurements while maintaining binocular vision.

The remote operation device 50 of Example 2 is a device that transmits input information to the power supply unit 19 via wireless communication, and is used in a remote examination mode in which the ophthalmic device 110 is operated by an examiner located at a distance of at least the social distance from the subject S.

As shown in FIG. 8, the remote control device 50, like in Example 1, uses a tablet terminal 51 (touch operation terminal) having a touch panel display screen 51a and a manual operation unit 52 that works in conjunction with the tablet terminal 51.

The tablet terminal 51 is network-connected to the power supply unit 130 via cable-free wireless LAN communication. In remote inspection mode, the touch-panel display screen 51a displays multiple input operation selection information that can be selected primarily by touch operation.

The manual operation unit 52 is detachably attached to the tablet terminal 51 and can be attached or detached and placed in close proximity. Similarly to Example 1, the manual operation unit 52 has a jog dial 500 (quantitative content operation means) that allows the examiner to input quantitative content by moving their hand in a predetermined direction. The detailed configuration of the manual operation unit 52 is the same as in Example 1, so illustrations and explanations are omitted.

In the manual operation unit 52 of the second embodiment, the following parameter input operations are performed by manually operating the jog dial 500.
(P1) The test distance between the eye E to be examined and the test target is set.
(P2) Set the optotype switching, auxiliary lens switching, mask switching, and data switching.
(P3) The adjustment amount of the convergence amount and the divergence amount is set.
(P4) Change the subject explanation display, select menu items, input numerical values such as the patient number, and set the fixation light intensity, target XY position, spherical refraction value [S], cylindrical refraction value [C], axial angle [A], and prism [P].
(P5) Fine-tune the XYZ position of the measurement part relative to the subject's eye during objective measurement, and set the adjustment amount for the amount of fogging during objective measurement.

Here, in (P5), the Z position may be the VD value (vertex distance). The X value may be the PD value (pupillary distance) or half PD value. Also, in (P5), "fogging" refers to intentionally creating a state of myopia and preventing the examinee's ability to accommodate. "Amount of fogging" refers to the amount (strength) of fogging applied to the examinee's eye, and is expressed as the presentation position (presentation distance) of the fixation target. To adjust the amount of fogging, if the amount of fogging is increased, the presentation position of the fixation target is moved toward distance viewing (positive side), and if the amount of fogging is decreased, the fixation target is moved toward near viewing (negative side). Tests using fogging are particularly used in hyperopic refraction tests and when examining the eyes of young examinees with significant accommodation.

The ophthalmic device 110 of Example 2 has the following advantages in addition to the advantages (1) to (5) and (7) to (10) of Example 1.

(11) The ophthalmic device 110 is a subjective/objective ophthalmic device that measures subjective and objective test items on the subject's eye. The manual operation unit 52 uses a jog dial 500 as a quantitative content operation means, and the jog dial 500 is used to perform parameter input operations that fine-tune the XYZ position of the measurement unit relative to the subject's eye during objective measurement and set the amount of adjustment for the amount of fogging during objective measurement. Therefore, when performing a remote examination using the subjective/objective ophthalmic examination system, parameter input operations on the jog dial 500 can be used to fine-tune the XYZ position of the measurement unit relative to the subject's eye during objective measurement and set the amount of adjustment for the amount of fogging during objective measurement.

The ophthalmic device 210 according to Example 3 is called an "autokeratorefractotonometer" and is an example of an objective ophthalmic device that performs an objective eye examination of the subject's eye E. In the following, as viewed from the subject S, the left-right direction is indicated by arrow X, the up-down direction (vertical direction) is indicated by arrow Y, and the direction perpendicular to the left-right and up-down directions (depth direction) is indicated by arrow Z as the front-to-back direction.

A distinctive feature of the ophthalmic device 210 is that it is equipped with two measurement heads, and combines measurements using two measurement items (REF, KRT) in the R/K measurement mode and two measurement items (TONO, PACHY) in the T/P measurement mode into a single unit.

Here, "REF (abbreviation for Refractometer)" refers to REF measurements of spherical refractive power, astigmatic refractive power, and astigmatic axis direction. "KRT (abbreviation for Keratometer)" refers to keratometry measurements of corneal radius of curvature, corneal principal meridian direction, and corneal refractive power. "TONO (abbreviation for Tonometer)" refers to tonometry of intraocular pressure. "PACHY (abbreviation for Pachymeter)" refers to pachymetry of corneal thickness. The configuration of the ophthalmic device 210 according to Example 3 will be described below with reference to Figures 9 and 10.

The ophthalmic device 210 includes a face support unit 220 and a monitor unit 240. The overall system for ophthalmic measurements also includes an optical table 230 on which the ophthalmic device 210 is placed and a chair 250 on which the subject S sits.

The ophthalmic device 210 is placed on the top plate 231 of the optical table 230 and includes a base portion 211, a composite measurement head 212 (measurement head), and a cover member 213.

An XYZ drive mechanism and drive circuit 216 (drive mechanism) is provided inside the base portion 211 and between it and the composite measuring head 212. A control lever 2111, a USB input terminal 2114, and a LAN output terminal 2115 are provided on the outside of the base portion 211.

The XYZ drive mechanism/drive circuit 216 uses, for example, a stepping motor as a drive actuator, and drives the combined measurement head 212 in the XYZ directions (up and down, left and right, front and back) relative to the subject's eye E. The control lever 2111 is an operating lever used when manually driving the combined measurement head 212 in the XYZ directions relative to the subject's eye E during alignment adjustment, etc.

As shown in FIG. 10, the combined measurement head 212 is positioned within a cover member 213 facing the subject's eye E, and performs measurements of multiple measurement items while observing an anterior eye image via an optical system. The combined measurement head 212 has a T/P measurement head 212a and an R/K measurement head 212b. The T/P measurement head 212a is composed of an optical system with an imaging element for the anterior eye image, and performs tonoscopic and pachyscopic measurements for each of the left and right eyes of the subject S. The R/K measurement head 212b is positioned below the T/P measurement head 212a, is composed of an optical system with an imaging element for the anterior eye image, and performs reflex and keratoscopic measurements for each of the left and right eyes of the subject S. Switching between T/P measurement mode and R/K measurement mode is performed by moving the combined measurement head 212 in the Y-axis direction, and switching between the left and right eyes is performed by moving the combined measurement head 212 in the X-axis direction.

The cover member 213 covers the combined measurement head 212. When the subject S side of the ophthalmic device 110 is the front side, a T/P measurement window 2131 is located on the upper side of the front, and an R/K measurement window 2132 is located below the T/P measurement window 2131. A wide-angle camera 214 is located between the T/P measurement window 2131 and the R/K measurement window 2132. A printer cover 2133 and a printer cover open button 2134 are provided on the back side of the cover member 213. Furthermore, a measurement window height mark 2135 for the R/K measurement window 2132 is set on the side of the cover member 213 facing the subject S.

The face support unit 220 is connected and fixed to the front (front face) of the base unit 211 of the ophthalmic device 110, and shares the function of supporting the face of the subject S. The face support unit 220 comprises a base 221, a chin rest 222, a pair of supports 223, a forehead rest 224, a drive mechanism 225, and a chin rest paper stopper pin 228. A height mark 227 for the subject's eye E is set on the side of the support 223.

As shown in FIG. 10, the optical table 230 includes a top plate 231, a lifting mechanism 232, a table control unit 233, a power button 234, a lifting lever 235, and a caster base 236.

The monitor unit 240 is attached to the top of the rear side of the cover member 213 and has a touch panel display screen 241. The monitor unit 240 includes the display screen 241, a monitor cover member 242, and a monitor support portion 243.

The remote operating device 50 of Example 3 is a device that transmits input information via wireless communication to the power supply unit 217 built into the base unit 211, and is used in a remote examination mode in which the ophthalmic device 210 is operated by an examiner located at least a social distance away from the subject S.

The remote control device 50 uses a tablet terminal 51 (touch operation terminal) with a touch panel display screen 51a and a manual operation unit 52 that works in conjunction with the tablet terminal 51.

The tablet terminal 51 is network-connected to the power supply unit 217 via cable-free wireless LAN communication. When in remote examination mode and fine alignment adjustment is being performed, the touch-panel display screen 51a displays a face image centered on the eyes of the subject S, which is displayed on the display screen 241 of the monitor unit 240.

The manual operation unit 52 is detachably attached to the tablet terminal 51 and can be either attached or detached and placed in close proximity. The manual operation unit 52 has a control lever 530 (quantitative content operation means) that allows the examiner to input quantitative content by moving their hand in a specified direction.

In the manual operation unit 52 of the third embodiment, the following parameter input operations are performed by manually operating the control lever 530 (the tilt direction and tilt time of the lever).
(P6) Fine adjustment of the XYZ positions of the T/P measurement window 2131 and the R/K measurement window 2132 relative to the eye E is performed.

As described above, when performing a remote examination, the manual operation unit 52 manually operates the control lever 530 to fine-tune the XYZ position of the measurement unit relative to the subject's eye. At this time, just as when performing an examination in the close-up examination mode, the touch-panel display screen 51a displays a face screen that is the same as the face screen centered on the eyes of the subject S that is displayed on the display screen 241 of the monitor unit 240. Therefore, the operating feel of the examiner who is accustomed to manually operating the control lever 2111 in the close-up examination mode can be realized in the remote examination mode.

The ophthalmic device 210 of Example 3 has the following advantages in addition to the advantages (1), (4), and (5) of Example 1.

(12) The ophthalmic device 210 is equipped with a measurement head (combined measurement head 212) that measures objective system test items for the subject's eye E. The manual operation unit 52 uses a control lever 530 as a quantitative content operation means, and the control lever 530 is used to input parameters for fine-tuning the XYZ position of the measurement unit relative to the subject's eye E. Therefore, when performing a remote examination using the objective ophthalmology system, the XYZ position of the measurement unit relative to the subject's eye E can be fine-tuned by inputting parameters into the control lever 530. In addition, when performing fine alignment adjustment operations in remote examination mode, the control lever 530 can be operated with the same operating feel as in close-up examination mode.

The ophthalmic device of the present invention has been described above based on Examples 1 to 3. However, the specific configuration is not limited to these examples. Design changes and additions are permitted as long as they do not deviate from the gist of the invention as defined in each claim.

In Examples 1 to 3, an example was shown in which a single manual operation unit 52 is detachably attached to a tablet terminal 51 having a touch panel display screen 51a as the remote operation device 50. However, the specific configuration of the remote operation device 50 is not limited to the examples in Examples 1 to 3.

For example, as shown in FIG. 11, the remote control device 50 may be configured as a three-component system with two detachable manual operation units 52, 52 arranged side-by-side on the left and right peripheral edges of a tablet terminal 51 having a touch-panel display screen 51a. In this case, an examiner skilled in using both hands can improve operational efficiency compared to a device with a single manual operation unit. The manual operation unit 52 may include, for example, a jog dial 500, a first peripheral switch group 501, a power switch 503, and switches 504.

For example, as shown in FIG. 12, the remote control device 50 may be configured as a three-component vertical arrangement with two manual operation units 52, 52' detachably attached to the top and bottom peripheral edges of a tablet terminal 51 having a touch-panel display screen 51a. The manual operation unit 52 includes, for example, a jog dial 500, a first peripheral switch group 501, and a power switch 503. The manual operation unit 52' includes, for example, switches 504.

In Examples 1 and 2, an example was shown in which a jog dial 500 was used as the quantitative content manipulation means, and in Example 3, an example was shown in which a control lever 530 was used as the quantitative content manipulation means. However, the quantitative content manipulation means is not limited to examples using a jog dial or control lever. In short, any quantitative content manipulation means that allows the examiner to input quantitative content by moving their hand in a predetermined direction will suffice.

For example, a jog lever 531 as shown in Figure 13(a) may be used. A scroll button 532 as shown in Figure 13(b) may be used. A trackball 533 as shown in Figure 13(c) may be used. A control lever 534 as shown in Figure 13(d) may be used. A jog dial 535 in the shape of a flat ring as shown in Figure 13(e) may be used. A jog dial 536 that also functions as a cross key may be used as shown in Figure 13(f).

In Examples 1 to 3, an example was shown in which one means (jog dial 500, control lever 530) was used as the quantitative content operation means. However, as shown in FIG. 14, two means, a first operation lever 537 and a second operation lever 538, may also be used as the quantitative content operation means. The arrows shown in FIG. 14 indicate the input operation directions of the first operation lever 537 and the second operation lever 538. Here, the two X-axis rotation arrows of the first operation lever 537 indicate the input operation directions of the two rotational rotations of the measurement unit relative to the subject's eye.

In an example of a quantitative content manipulation means using two levers, a first manipulation lever 537 and a second manipulation lever 538, as shown in FIG. 14, up and down inputs (Y-axis direction inputs) may be input by rotating the second manipulation lever 538 to the right and left. Also, as shown in FIG. 14, a dial knob 539 may be provided on the top surface of the cylindrical base of the first manipulation lever 537, and the up and down inputs (Y-axis direction inputs) may be input by rotating the dial knob 539 to the right and left. Furthermore, as shown in FIG. 15, the quantitative content manipulation means may be a motion detection unit 540 that executes input processing of predetermined quantitative content associated with a detected motion (finger gesture) based on the motion (see, for example, JP 2020-141828 A).

In Examples 1, 2, and 3, an example of a configuration in which the tablet terminal 51 and the manual operation unit 52 are detachably attached as the remote operation device 50 is shown. However, the remote operation device may be configured such that the tablet terminal and the manual operation unit remain separate and link together via near-field communication. Also, the remote operation device may be configured such that the tablet terminal and the manual operation unit are foldably connected together, as shown in FIG. 6, for example. Furthermore, the tablet terminal and the manual operation unit may be configured such that they remain separate and are connected to each other via a USB cable to link input and output.

In Examples 1, 2, and 3, an example of a tablet terminal 51 prepared independently of the ophthalmologic device was shown as the touch operation terminal of the remote operation device 50. However, as an example of the touch operation terminal of the remote operation device, for example, the monitor unit 240 in Example 3 shown in FIG. 9 may be provided detachably from the device main body, and the monitor unit 240 detached from the device main body may serve as the touch operation terminal. In this case, the tablet terminal can be omitted.

In Examples 1, 2, and 3, the above parameters (P1) to (P6) are input by an input operation using the quantitative content manipulation means. However, the parameters input by an input operation using the quantitative content manipulation means are not limited to parameters (P1) to (P6).

For example, this includes adjusting the amount of vertical rotation in the ophthalmic apparatus 110 of Example 2 and adjusting the XYZ position of the robot arm. Here, "adjusting the amount of vertical rotation" refers to adjusting the amount of upward or downward rotation around the X axis in an ophthalmic apparatus having an X-axis rotation drive unit that rotates the measurement head around the axis of rotation (X axis) that extends horizontally through the center of rotation of the subject's eye (see JP 2019-166037 A, etc.). In the ophthalmic apparatus of Example 2, the robot arm refers to a configuration consisting of multiple arms from the frame unit to the measurement head and a rotation support mechanism provided at the joint position connecting the arms. Furthermore, adjusting the XYZ position of the robot arm refers to adjusting the XYZ position of the measurement head by driving the rotation support mechanism (see JP 2021-019975 A, etc.).

In Example 1, ophthalmic device 10 is shown as an example of a subjective ophthalmic device. However, other subjective ophthalmic devices can be used as long as they are equipped with a measurement head that measures subjective test items on the subject's eye. In Example 2, ophthalmic device 110 is shown as an example of a subjective/objective ophthalmic device. However, other subjective/objective ophthalmic devices can be used as long as they are equipped with a measurement head that measures subjective test items and objective test items on the subject's eye. In Example 3, ophthalmic device 210 is shown as an example of an objective ophthalmic device. However, other objective ophthalmic devices can be used as long as they are equipped with a measurement head that measures objective test items on the subject's eye.

10. Ophthalmic device (subjective ophthalmic device)
11 Refractor head (measuring head)
19 Power supply unit (control unit)
50 Remote operation device 51 Tablet terminal (touch operation terminal)
52 Manual operation unit 500 Jog dial (quantitative content operation means)
110 Ophthalmic device (subjective/objective ophthalmic device)
120 Measuring head 130 Power supply unit (control unit)
210 Ophthalmological equipment (objective ophthalmological equipment)
212 Composite measuring head (measuring head)
217 Power supply unit (control unit)
52' Manual operation unit 530 Control lever (quantitative content operation means)

Claims (12)

An ophthalmologic apparatus comprising: a measurement head that performs measurement of an examination item on an eye to be examined; a control unit that controls the measurement head based on input information; and a remote operation device that transmits the input information to the control unit via wireless communication,
the remote operation device uses a touch operation terminal having a touch panel display screen and a manual operation unit linked to the touch operation terminal;
The ophthalmologic apparatus according to claim 1, wherein the manual operation unit has a quantitative content operation means that enables an examiner to input quantitative content by moving his/her hand in a predetermined direction. 2. The ophthalmic apparatus according to claim 1,
The ophthalmologic apparatus according to claim 1, wherein the manual operation unit includes a group of peripheral switches arranged at peripheral positions of the quantitative content operation means. 3. The ophthalmic apparatus according to claim 2,
The ophthalmologic apparatus according to claim 1, wherein the peripheral switch group includes a first peripheral switch group and a second peripheral switch group arranged around the quantitative content operation means. The ophthalmic apparatus according to any one of claims 1 to 3,
the manual operation unit is provided so as to be capable of being attached to the touch operation terminal and being detached and close to the touch operation terminal,
an ophthalmologic apparatus, wherein the manual operation unit includes a unit power supply, an attachment state detection means for detecting an attachment state of the manual operation unit relative to the touch operation terminal, and a short-range communication device for communicating with the touch operation terminal; 5. The ophthalmic apparatus according to claim 4,
an ophthalmologic apparatus, characterized in that when the attachment state detection means detects that the touch operation terminal and the manual operation unit are attached to each other, or when the attachment state detection means detects a detached proximity state between the touch operation terminal and the manual operation unit, a predetermined reaction action is set. 6. The ophthalmic apparatus according to claim 1,
the ophthalmologic apparatus is a subjective ophthalmologic apparatus including the measurement head for measuring subjective examination items for the subject's eye,
The ophthalmologic apparatus according to claim 1, wherein the manual operation unit uses a jog dial as the quantitative content operation means. 7. The ophthalmic apparatus according to claim 6,
The ophthalmologic apparatus according to claim 1, wherein the manual operation unit performs a parameter input operation to set an examination distance between the subject's eye and an examination target using the jog dial. 8. The ophthalmic apparatus according to claim 6 or 7,
The ophthalmologic apparatus according to claim 1, wherein the manual operation unit performs parameter input operations for setting optotype switching, auxiliary lens switching, mask switching, and data switching using the jog dial. 9. The ophthalmic apparatus according to claim 6,
The ophthalmologic apparatus according to claim 1, wherein the manual operation unit performs a parameter input operation for setting an adjustment amount of convergence/divergence using the jog dial. 10. The ophthalmic apparatus according to claim 6,
The manual operation unit is configured to use the jog dial to change the explanation display for the patient, select a menu item, input numerical values such as a patient number, and input parameters to set the fixation light intensity, the XY position of the target, the spherical refraction value, the cylindrical refraction value, the axial angle, and the amount of prism. 6. The ophthalmic apparatus according to claim 1,
the ophthalmic apparatus is a subjective/objective ophthalmic apparatus that measures subjective examination items and objective examination items for a subject's eye,
The ophthalmologic apparatus is characterized in that the manual operation unit uses a jog dial as the quantitative content operation means, and the jog dial is used to fine-tune the XYZ position of the measurement unit with respect to the subject's eye during objective measurement, and to input parameters that set the adjustment amount of the amount of fogging during objective measurement. 6. The ophthalmic apparatus according to claim 1,
the ophthalmologic apparatus is an objective ophthalmologic apparatus including the measurement head for measuring objective examination items for the subject's eye,
The ophthalmologic apparatus according to claim 1, wherein the manual operation unit uses a control lever as the quantitative content operation means, and the control lever is used to input parameters for fine adjustment of the XYZ position of the measurement unit relative to the subject's eye.