JP7141279B2 - Ophthalmic information processing device, ophthalmic device, and ophthalmic information processing method - Google Patents

Description

The present invention relates to an ophthalmic information processing apparatus, an ophthalmic apparatus, and an ophthalmic information processing method.

The adjustment function (accommodative power) is extremely important in vision. The adjustment function is a function of changing the refractive power of the eye according to the distance of the object to bring the object into focus. The lens, zonules and ciliary muscles contribute to changes in the refractive power of the eye. The crystalline lens is a convex lens with variable refractive power. The zonules are tissues that connect the lens and the ciliary muscle. The ciliary muscle is muscle tissue. When looking at near objects, the ciliary muscles contract and the zonules relax, thickening the lens and increasing the refractive power. On the other hand, when looking at a distance, the ciliary muscle relaxes and the zonules become tense, causing the lens to become thinner and the refractive power to decrease.

For example, Patent Literature 1 discloses an ophthalmologic apparatus capable of measuring the refractive power of such an eye. This ophthalmologic apparatus enables subjective examination and objective measurement. A subjective test is one in which results are obtained based on responses from the subject. Objective measurement acquires information about the subject's eye using mainly physical techniques without referring to responses from the subject. In this ophthalmologic apparatus, as objective measurements, it is possible to measure the refractive power of an eye to be inspected, or to perform imaging and measurement using optical coherence tomography (OCT).

For example, Patent Literature 2 discloses a method of generating evaluation information indicating time-series changes in accommodation power by performing OCT on an eye to be inspected in a state in which an accommodation stimulus is given by a target projection optical system. disclosed.

JP 2017-136215 A JP 2016-010445 A

When the subject's eye accompanies accommodative tension, it becomes difficult to properly perform refractive power measurement due to ciliary muscle tension and the like. In this case, even with an ophthalmologic apparatus capable of highly accurate refractive power measurement as disclosed in Patent Document 1, for example, an overcorrected prescription value is obtained. In addition, it is difficult to determine whether or not the measured value is obtained by proper refractive power measurement based on the evaluation information indicating the time-series change in accommodative power disclosed in Patent Document 2, for example.

As described above, the conventional method has a problem that the reliability of the measured value of refractive power decreases due to the accommodation strain of the eye to be examined.

SUMMARY OF THE INVENTION The present invention has been made in view of such circumstances, and its object is to provide a new technique for improving the reliability of the measured value of the refractive power of an eye to be examined.

A first aspect of some embodiments specifies temporal changes in the anterior segment of the eye based on two or more pieces of measurement data obtained by measurements performed at different measurement timings on the anterior segment of the subject's eye. and a calculator for calculating an accommodative strain index indicating the degree of accommodative strain of the eye to be examined based on the temporal change specified by the specifying unit.

In the second aspect of some embodiments, in the first aspect, the specifying unit specifies the shape and position of a predetermined site in the anterior segment, or the temporal change in the intraocular distance in the anterior segment, The calculation unit calculates the adjustment tension index based on an amplitude component of a predetermined frequency component obtained by performing frequency analysis on the temporal change.

A third aspect of some embodiments includes, in the second aspect, a display control section that causes the display means to display information representing the result of the frequency analysis.

A fourth aspect of some embodiments, in the first aspect or the second aspect, includes a display control unit that causes the display means to display the information representing the temporal change.

A fifth aspect of some embodiments is, in the first aspect or the second aspect, a display control unit that causes the display means to display the refractive power measurement information of the eye to be inspected, the display mode of which is changed according to the accommodative tension index. including.

In a sixth aspect of some embodiments, in the fifth aspect, the display control section attaches additional information including the accommodative tension index to the refractive power measurement information and causes the display means to display the information.

In a seventh aspect of some embodiments, in the fifth or sixth aspect, the refractive power measurement information represents a refractive power measurement, a number of refractive power measurements, and a degree of reliability of the refractive power measurement. including at least one reliability index.

An eighth aspect of some embodiments is, in the fifth aspect, a reliability index correction unit that corrects a reliability index indicating the degree of reliability of the refractive power measurement value of the eye to be examined based on the accommodative tension index. The display control section causes the display means to display the refractive power measurement information including the refractive power measurement value and the reliability index corrected by the reliability index correction section.

In a ninth aspect of some embodiments, in any of the first through eighth aspects, the anterior segment comprises at least one of a lens, ciliary muscle, and zonules.

A tenth aspect of some embodiments includes an OCT optical system that performs optical coherence tomography on the anterior segment, and any of the ophthalmologic information processing apparatuses described above, wherein the specifying unit is and an ophthalmologic apparatus that identifies the temporal change based on two or more pieces of measurement data acquired at mutually different measurement timings by the OCT optical system.

An eleventh aspect of some embodiments is a fixation projection system that projects a fixation target onto the eye to be inspected, and a refractive power measurement optical system that irradiates the eye to be inspected with light and detects light returned from the eye to be inspected. an eye refractive power calculation unit that calculates a refractive power measurement value of the eye to be examined based on the detection result of the returned light obtained by the refractive power measurement optical system; An ophthalmologic apparatus includes a reliability index calculator that calculates a reliability index, and the ophthalmologic information processing apparatus described above.

In a twelfth aspect of some embodiments, in the eleventh aspect, the fixation projection system selectively presents a plurality of fixation targets having different visual angles to the eye to be examined, and according to the accommodation tension index, A control unit for controlling the fixation projection system to switch the fixation target to be presented to the subject's eye.

A thirteenth aspect of some embodiments is the eleventh or twelfth aspect, comprising an OCT optical system for performing optical coherence tomography on the anterior segment, wherein the identifying portion is determined by the OCT optical system The change over time is specified based on two or more pieces of measurement data acquired at mutually different measurement timings.

In a fourteenth aspect of some embodiments, in any of the eleventh to thirteenth aspects, the anterior segment comprises at least one of a lens, ciliary muscle, and zonules.

A fifteenth aspect of some embodiments specifies temporal changes in the anterior segment based on two or more pieces of measurement data obtained by measurements performed at different measurement timings on the anterior segment of the subject's eye. and a calculating step of calculating an accommodative tension index representing the degree of accommodative tension of the subject's eye based on the temporal change identified in the identifying step.

In a sixteenth aspect of some embodiments, in the fifteenth aspect, the identifying step identifies the shape and position of a predetermined site in the anterior segment, or the temporal change in intraocular distance in the anterior segment, The calculating step calculates the adjusted tension index based on the amplitude component of a predetermined frequency component obtained by performing frequency analysis on the temporal change.

A seventeenth aspect of some embodiments is, in the fifteenth aspect or the sixteenth aspect, a display control step of displaying, on a display means, the refractive power measurement information of the subject's eye whose display mode has been changed according to the accommodative tension index. including.

In an eighteenth aspect of some embodiments, in any of the fifteenth to seventeenth aspects, the anterior segment comprises at least one of a lens, ciliary muscle, and zonules.

ADVANTAGE OF THE INVENTION According to this invention, it becomes possible to provide the new technique for improving the reliability of the measured value of the refractive power of an eye to be examined.

1 is a schematic diagram showing a configuration example of an ophthalmologic apparatus according to an embodiment; FIG. 1 is a schematic diagram showing a configuration example of an optical system of an ophthalmologic apparatus according to an embodiment; FIG. 1 is a schematic diagram showing a configuration example of an optical system of an ophthalmologic apparatus according to an embodiment; FIG. 1 is a schematic diagram for explaining a processing system of an ophthalmologic apparatus according to an embodiment; FIG. 1 is a schematic diagram for explaining a processing system of an ophthalmologic apparatus according to an embodiment; FIG. It is a schematic diagram for explaining the operation of the ophthalmologic apparatus according to the embodiment. It is a schematic diagram for explaining the operation of the ophthalmologic apparatus according to the embodiment. It is a schematic diagram for explaining the operation of the ophthalmologic apparatus according to the embodiment. It is a schematic diagram for explaining the operation of the ophthalmologic apparatus according to the embodiment. It is a schematic diagram for explaining the operation of the ophthalmologic apparatus according to the embodiment. It is a schematic diagram for explaining the operation of the ophthalmologic apparatus according to the embodiment. 4 is a schematic diagram showing a flow of an operation example of the ophthalmologic apparatus according to the embodiment; FIG. It is a schematic diagram for explaining the operation of the ophthalmologic apparatus according to the embodiment. It is a schematic diagram for explaining the operation of the ophthalmologic apparatus according to the embodiment. It is a schematic diagram showing a flow of an operation example of an ophthalmologic apparatus according to a modification of the embodiment.

Embodiments of an ophthalmic information processing apparatus, an ophthalmic apparatus, and an ophthalmic information processing method according to the present invention will be described in detail with reference to the drawings. It should be noted that the descriptions of the documents cited in this specification and any known techniques can be incorporated into the following embodiments.

An ophthalmologic apparatus according to an embodiment has the function of an ophthalmologic information processing apparatus. The functions of the ophthalmologic information processing apparatus are implemented by a computer that executes processing according to an ophthalmologic information processing program. The ophthalmologic information processing apparatus includes a processor and a storage unit in which an ophthalmologic information processing program is stored in advance. Realize the function.

The ophthalmologic apparatus according to the embodiment can perform refractive power measurement (Ref measurement), and measurement and imaging using Optical Coherence Tomography (OCT).

In the following embodiments, a case where a swept source type OCT method is used in measurement using OCT will be described in detail. However, it is also possible to apply the configuration according to the embodiment to an ophthalmic apparatus using OCT of another type (for example, spectral domain type).

The ophthalmologic apparatus according to some embodiments further includes a subjective test optical system for performing subjective tests and an objective measurement system for performing other objective measurements.

Subjective testing is a measurement technique that uses responses from subjects to obtain information. The subjective examination includes subjective refraction measurement such as distance examination, near examination, contrast examination, glare examination, and visual field examination.

Objective measurement is a measurement technique that obtains information about the subject's eye using mainly physical techniques without referring to responses from the subject. Objective measurement includes measurement for acquiring characteristics of the eye to be inspected and photographing for acquiring an image of the eye to be inspected. Other objective measurements include keratometry, tonometry, fundus photography, and the like.

Hereinafter, the fundus conjugate position is a position that is substantially optically conjugate with the fundus of the subject's eye after alignment is completed, and means a position that is optically conjugate with the fundus of the subject's eye or its vicinity. Similarly, the pupil conjugate position is a position that is approximately optically conjugate with the pupil of the eye to be inspected in a state in which alignment is completed, and means a position that is optically conjugate with the pupil of the eye to be inspected or in the vicinity thereof. .

<Configuration of Ophthalmic Apparatus>
FIG. 1 shows a schematic diagram of a configuration example of an ophthalmologic apparatus 1000 according to an embodiment. The ophthalmologic apparatus 1000 includes an examination optical system 300 and an ophthalmologic information processing apparatus 400 . The inspection optical system 300 is provided with an optical system for optically inspecting the eye to be inspected. In FIG. 1, inspection optics 300 includes refractive power measurement optics 310 and OCT optics 320 .

The refractive power measurement optical system 310 is an optical system for measuring the refractive power of an eye to be examined. Specifically, the refractive power measurement optical system 310 projects light onto the subject's eye and detects the returned light. The OCT optical system 320 is an optical system for performing OCT on the subject's eye. Specifically, the OCT optical system 320 includes an interference optical system, projects measurement light onto the subject's eye, and detects the return light.

The ophthalmologic information processing apparatus 400 includes a function of controlling the inspection optical system 300 and a function of executing predetermined information processing on data obtained by the inspection optical system 300 . The information processing includes processing for calculating a refractive power measurement value based on data obtained by the inspection optical system 300, analysis processing for data obtained by the refractive power measurement optical system 310 or the OCT optical system 320, and processing based on the data. image processing and the like.

In the ophthalmologic apparatus 1000, the refractive power measurement optical system 310 performs refractive power measurement, and the OCT optical system 320 performs multiple OCT measurements on the anterior segment of the subject's eye. A plurality of OCT measurements are performed with the same accommodative stimulus applied during refractive power measurement. For example, in a plurality of OCT measurements, the fixation target used for refractive power measurement is presented to the subject's eye as it is. In some embodiments, multiple OCT measurements are performed while refractive power measurements are taken. The ophthalmologic information processing apparatus 400 calculates the refractive power value (measurement value) of the subject's eye based on the data obtained by the refractive power measurement optical system 310 . In addition, the ophthalmologic information processing apparatus 400 identifies temporal changes in the anterior segment based on the measurement data obtained by the OCT optical system 320, and determines the degree of accommodation tension of the subject's eye based on the identified temporal changes. Identify. The ophthalmologic information processing apparatus 400 provides the examiner or the subject with the calculated refractive power value of the eye to be examined based on the specified degree of accommodative tension, thereby ensuring that the obtained refractive power value is reliable. It is possible to provide the examiner or the like with information on whether or not there is a refractive power value.

In some embodiments, the temporal change in the anterior segment is a temporal change in the morphology, position, or intraocular distance of a predetermined site in the anterior segment. The predetermined site of the anterior segment includes, for example, the lens, the ciliary muscle, the zonules, or at least one of these. The intraocular distance in the anterior segment includes lens thickness, anterior chamber depth, distance between the anterior corneal surface and the posterior surface of the lens, and the like.

In some embodiments, display means (not shown) displays information (such as a graph) representing temporal changes in the identified anterior segment along with the refractive power value of the subject's eye. In some embodiments, an accommodative tone index representing the degree of accommodative tone of the subject's eye is calculated based on the identified temporal change. In some embodiments, the display mode of the refractive power value of the subject's eye is changed based on the calculated accommodative tone index. In some embodiments, the reliability index representing the degree of reliability of the refractive power value of the eye to be examined is corrected based on the calculated accommodative tension index.

In some embodiments, the ophthalmic device 1000 has only the functions of the ophthalmic information processing device 400 and acquires data obtained by refractive power measurement and data obtained by OCT from an external device. In some embodiments, the ophthalmic apparatus 1000 includes only one of the refractive power measurement optical system 310 and the OCT optical system 320, and receives data obtained by refractive power measurement or data obtained by OCT measurement from an external device. get.

<Configuration of optical system>
FIG. 2 shows a configuration example of the optical system of the ophthalmologic apparatus 1000 shown in FIG. The function of the refractive power measurement optical system 310 in FIG. 1 is realized by the ref measurement projection system 6 and the ref measurement light receiving system 7 in FIG. The function of the OCT optical system 320 in FIG. 1 is implemented by the OCT optical system 8 in FIG. The functions of the ophthalmologic information processing apparatus 400 in FIG. 1 are implemented by the processing unit 9 in FIG.

The ophthalmologic apparatus 1000 includes an optical system for observing an eye to be examined E, an optical system for examining the eye to be examined E, and a dichroic mirror for wavelength-separating the optical paths of these optical systems. An anterior segment observation system 5 is provided as an optical system for observing the eye E to be examined. An OCT optical system and a reflector measurement optical system (refractive power measurement optical system) are provided as an optical system for examining the eye E to be examined.

The ophthalmologic apparatus 1000 includes a Z alignment system 1, an XY alignment system 2, a keratometric measurement system 3, a fixation projection system 4, an anterior segment observation system 5, a reflector measurement projection system 6, a reflector measurement light receiving system 7, and an OCT optical system 8. including. In the following description, for example, the anterior ocular segment observation system 5 uses light of 940 nm to 1000 nm, the reflector measurement optical system (ref measurement projection system 6, reflector measurement light receiving system 7) uses light of 830 nm to 880 nm, and the fixation projection system 4 uses light of 400 nm to 700 nm, and the OCT optical system 8 uses light of 1000 nm to 1100 nm.

(Anterior segment observation system 5)
The anterior segment observation system 5 captures a moving image of the anterior segment of the eye E to be examined. In the optical system passing through the anterior segment observation system 5, the imaging surface of the imaging element 59 is arranged at the pupil conjugate position. The anterior segment illumination light source 50 irradiates the anterior segment of the eye E to be examined with illumination light (for example, infrared light). The light reflected by the anterior segment of the subject's eye E passes through the objective lens 51, passes through the dichroic mirror 52, passes through a hole formed in the diaphragm (telecentric diaphragm) 53, and passes through the half mirror 23. , the relay lenses 55 and 56 and the dichroic mirror 76 . The dichroic mirror 52 synthesizes (separates) the optical path of the reflex measurement optical system and the optical path of the anterior eye observation system 5 . The dichroic mirror 52 is arranged such that the optical path synthesizing surface for synthesizing these optical paths is inclined with respect to the optical axis of the objective lens 51 . The light transmitted through the dichroic mirror 76 is imaged on the imaging surface of the imaging element 59 (area sensor) by the imaging lens 58 . The imaging element 59 performs imaging and signal output at a predetermined rate. The output (video signal) of the imaging device 59 is input to the processing section 9 which will be described later. The processing unit 9 displays an anterior segment image E' based on this video signal on a display screen 10a of the display unit 10, which will be described later. The anterior segment image E' is, for example, an infrared moving image.

(Z alignment system 1)
The Z alignment system 1 projects light (infrared light) onto the subject's eye E for alignment in the optical axis direction (front-rear direction, Z direction) of the anterior segment observation system 5 . The light output from the Z alignment light source 11 is projected onto the cornea Cr of the eye E to be examined, reflected by the cornea Cr, and imaged on the sensor surface of the line sensor 13 by the imaging lens 12 . When the position of the corneal vertex changes in the optical axis direction of the anterior segment observation system 5, the light projection position on the sensor surface of the line sensor 13 changes. The processing unit 9 obtains the position of the corneal vertex of the subject's eye E based on the light projection position on the sensor surface of the line sensor 13, and based on this, controls the mechanism for moving the optical system to perform Z alignment.

(XY alignment system 2)
The XY alignment system 2 applies light (infrared light) to the eye to be examined E for alignment in directions perpendicular to the optical axis of the anterior eye observation system 5 (horizontal direction (X direction) and vertical direction (Y direction)). to irradiate. The XY alignment system 2 includes an XY alignment light source 21 and a collimator lens 22 provided in an optical path branched from the optical path of the anterior eye observation system 5 by a half mirror 23 . Light output from the XY alignment light source 21 passes through the collimator lens 22 , is reflected by the half mirror 23 , and is projected onto the subject's eye E through the anterior eye observation system 5 . Reflected light from the cornea Cr of the eye E to be inspected is guided to the imaging device 59 through the anterior segment observation system 5 .

The image (bright point image) Br based on this reflected light is included in the anterior segment image E'. The processing unit 9 causes the display screen of the display unit to display the anterior segment image E′ including the bright spot image Br and the alignment mark AL. When manually performing the XY alignment, the user moves the optical system so as to guide the bright spot image Br into the alignment mark AL. When the alignment is performed automatically, the processing unit 9 controls the mechanism for moving the optical system so that the displacement of the bright spot image Br with respect to the alignment mark AL is cancelled.

(Kerato measurement system 3)
The keratometry system 3 projects a ring-shaped light beam (infrared light) for measuring the shape of the cornea Cr of the eye E to be examined onto the cornea Cr. The keratoplate 31 is arranged between the objective lens 51 and the eye E to be examined. A kerato ring light source 32 is provided on the back side of the kerato plate 31 (on the objective lens 51 side). By illuminating the kerat plate 31 with light from the keratizing light source 32, a ring-shaped light flux (arc-shaped or circumferential measurement pattern) is projected onto the cornea Cr of the eye E to be examined. Reflected light (keratling image) from the cornea Cr of the subject's eye E is detected by the imaging element 59 together with the anterior segment image E'. The processing unit 9 calculates corneal shape parameters representing the shape of the cornea Cr by performing known calculations based on this keratling image.

(ref measurement projection system 6, ref measurement light receiving system 7)
The ref measurement optical system includes a ref measurement projection system 6 and a ref measurement light receiving system 7 used for refractive power measurement. The ref measurement projection system 6 projects a refractive power measurement light beam (for example, a ring-shaped light beam) (infrared light) onto the fundus oculi Ef. The ref measurement light-receiving system 7 receives the return light from the subject's eye E of this luminous flux. The reflector measurement projection system 6 is provided on an optical path branched by a perforated prism 65 provided in the optical path of the reflector measurement light receiving system 7 . The aperture formed in the apertured prism 65 is arranged at the pupil conjugate position. In the optical system passing through the ref measurement light-receiving system 7, the imaging surface of the imaging device 59 is arranged at the fundus conjugate position.

In some embodiments, the ref measurement light source 61 is an SLD (Superluminescent Diode) light source, which is a high luminance light source. The ref measurement light source 61 is movable in the optical axis direction. A reflex measurement light source 61 is arranged at a fundus conjugate position. The light output from the ref measurement light source 61 passes through the relay lens 62 and enters the conical surface of the conical prism 63 . Light incident on the conical surface is deflected and emitted from the bottom surface of the conical prism 63 . Light emitted from the bottom surface of the conical prism 63 passes through a ring-shaped transparent portion of the ring aperture 64 . The light (ring-shaped luminous flux) that has passed through the transparent portion of the ring diaphragm 64 is reflected by the reflecting surface formed around the hole of the apertured prism 65, passes through the rotary prism 66, and is reflected by the dichroic mirror 67. be. The light reflected by the dichroic mirror 67 is reflected by the dichroic mirror 52, passes through the objective lens 51, and is projected onto the eye E to be examined. The rotary prism 66 is used for averaging the light quantity distribution of the ring-shaped light flux for blood vessels and diseased areas of the fundus oculi Ef and for reducing speckle noise caused by the light source.

The return light of the ring-shaped luminous flux projected onto the fundus oculi Ef passes through the objective lens 51 and is reflected by the dichroic mirrors 52 and 67 . The return light reflected by the dichroic mirror 67 passes through the rotary prism 66, passes through the aperture of the perforated prism 65, passes through the relay lens 71, is reflected by the reflecting mirror 72, and passes through the relay lens 73 and the focusing lens. Pass 74. The focusing lens 74 is movable along the optical axis of the ref measurement light receiving system 7 . The light that has passed through the focusing lens 74 is reflected by the reflecting mirror 75 , reflected by the dichroic mirror 76 , and imaged on the imaging surface of the imaging element 59 by the imaging lens 58 . The processing unit 9 calculates the refractive power value of the subject's eye E by performing a known calculation based on the output from the imaging device 59 . For example, power values include spherical power, cylinder power and cylinder axis angle, or equivalent spherical power.

(Fixation projection system 4)
An OCT optical system 8, which will be described later, is provided in an optical path separated by a dichroic mirror 67 from the optical path of the reflective measurement optical system. A fixation projection system 4 is provided on an optical path branched from the optical path of the OCT optical system 8 by a dichroic mirror 83 .

A fixation projection system 4 presents a fixation target to the eye E to be examined. A fixation unit 40 is arranged in the optical path of the fixation projection system 4 . The fixation unit 40 can move along the optical path of the fixation projection system 4 under the control of the processing section 9 which will be described later. The fixation unit 40 includes a liquid crystal panel 41 .

The liquid crystal panel 41 controlled by the processing unit 9 displays a pattern representing the fixation target. The liquid crystal panel 41 displays a first fixation target pattern representing a fixation target for reflex measurement (eg, landscape chart) and a fixation target for OCT measurement (eg, dot target (bright point), cross target). It is possible to selectively display a second fixation target pattern representing . The first fixation target pattern is a pattern with a larger visual angle than the second fixation target pattern. The liquid crystal panel 41 can display the second fixation target pattern superimposed on the first fixation target pattern.

In some embodiments, the fixation target for reflex measurement includes two or more fixation targets with different visual angles. In this case, the liquid crystal panel 41 displays a pattern representing any one of the two or more fixation targets so that two or more fixation targets with different visual angles are selectively presented to the eye E to be examined. For example, if the refractive power value obtained by the refractive power measurement is determined to be unreliable due to accommodation tension, the liquid crystal panel 41 switches to a fixation target with a larger visual angle and presents it to the eye E to be examined. controlled by Any of the two or more fixation targets with different visual angles has a larger visual angle than the fixation target for OCT measurement.

The fixation projection system 4 uses the above-described fixation target for reflex measurement when performing OCT measurement for the purpose of specifying temporal changes in the anterior segment (or the posterior segment) of the eye to be examined E, as will be described later. It is possible to present it to the eye E to be examined.

By changing the display position of the pattern on the screen of the liquid crystal panel 41, the fixation position of the subject's eye E can be changed. The fixation position of the subject's eye E includes a position for acquiring an image centered on the macula of the fundus oculi Ef, a position for acquiring an image centered on the optic papilla, and a position between the macula and the optic papilla. There is a position for acquiring an image centered on the center of the fundus in between. It is possible to arbitrarily change the display position of the pattern representing the fixation target.

Light from the liquid crystal panel 41 passes through the relay lens 42 , dichroic mirror 83 , relay lens 82 , reflection mirror 81 , dichroic mirror 67 , and dichroic mirror 52 . . The light reflected by the dichroic mirror 52 passes through the objective lens 51 and is projected onto the fundus oculi Ef. In some embodiments, each of the liquid crystal panel 41 and the relay lens 42 is independently movable in the optical axis direction.

In some embodiments, instead of the liquid crystal panel 41, a transmissive or reflective optotype chart, an illumination light source for illuminating the optotype chart, and a point light source are provided. A first fixation target pattern representing a fixation target for reflex measurement is printed on the optotype chart. A fixation target for reflex measurement is presented to the subject's eye E by illuminating the optotype chart with an illumination light source. Two or more optotype charts printed with fixation target patterns with different visual angles are selectively illuminated by an illumination light source so as to selectively present two or more fixation targets with different visual angles to the eye E to be examined. It may be configured as A fixation target for OCT measurement is presented to the subject's eye E by lighting the point light source. A second fixation target pattern representing a fixation target for OCT measurement may be printed on the optotype chart.

(OCT optical system 8)
The OCT optical system 8 is an optical system for performing OCT measurement. The position of the focusing lens 87 is adjusted so that the end surface of the optical fiber f1 is conjugated to the imaging site (fundus oculi Ef or anterior segment) and the optical system based on the results of the reflex measurement performed prior to the OCT measurement. .

The OCT optical system 8 is provided in an optical path separated by a dichroic mirror 67 from the optical path of the ref measurement optical system. The optical path of the fixation projection system 4 is coupled to the optical path of the OCT optical system 8 by a dichroic mirror 83 . Thereby, the respective optical axes of the OCT optical system 8 and the fixation projection system 4 can be coaxially coupled.

OCT optical system 8 includes an OCT unit 100 . As shown in FIG. 3, in the OCT unit 100, the OCT light source 101 is a wavelength sweeping (wavelength scanning) light source capable of sweeping (scanning) the wavelength of emitted light, like a general swept source type OCT apparatus. Consists of A swept-wavelength light source includes a laser light source including a resonator. The OCT light source 101 temporally changes the output wavelength in the near-infrared wavelength band invisible to the human eye.

As illustrated in FIG. 3, the OCT unit 100 is provided with an optical system for performing swept-source OCT. This optical system includes an interference optical system. This interference optical system has a function of dividing light from a wavelength tunable light source (wavelength swept light source) into measurement light and reference light, return light of the measurement light from the subject's eye E, and reference light passing through the reference light path. and a function of generating interference light and a function of detecting this interference light. A detection result (detection signal) of the interference light obtained by the interference optical system is a signal indicating the spectrum of the interference light, and is sent to the processing unit 9 .

The OCT light source 101 includes, for example, a near-infrared tunable laser that changes the wavelength of emitted light (wavelength range of 1000 nm to 1100 nm) at high speed. The light L0 output from the OCT light source 101 is guided to the polarization controller 103 by the optical fiber 102, and its polarization state is adjusted. The light L0 whose polarization state has been adjusted is guided by the optical fiber 104 to the fiber coupler 105 and split into the measurement light LS and the reference light LR.

The reference light LR is guided by the optical fiber 110 to the collimator 111 and converted into a parallel beam, and guided to the corner cube 114 via the optical path length correction member 112 and the dispersion compensation member 113 . The optical path length correction member 112 acts to match the optical path length of the reference light LR and the optical path length of the measurement light LS. The dispersion compensation member 113 acts to match the dispersion characteristics between the reference light LR and the measurement light LS. The corner cube 114 is movable in the incident direction of the reference light LR, thereby changing the optical path length of the reference light LR.

The reference light LR that has passed through the corner cube 114 passes through the dispersion compensating member 113 and the optical path length correcting member 112 , is converted by the collimator 116 from a parallel beam to a converged beam, and enters the optical fiber 117 . The reference light LR incident on the optical fiber 117 is guided to the polarization controller 118 to adjust its polarization state, guided to the attenuator 120 by the optical fiber 119 to adjust the light amount, and guided to the fiber coupler 122 by the optical fiber 121.

On the other hand, the measurement light LS generated by the fiber coupler 105 is guided by the optical fiber f1, converted into a parallel light beam by the collimator lens unit 89, and passes through the light scanner 88, the focusing lens 87, the relay lens 85, and the reflecting mirror 84. , and is reflected by the dichroic mirror 83 .

The light scanner 88 deflects the measurement light LS one-dimensionally or two-dimensionally. Optical scanner 88 includes, for example, a first galvanometer mirror and a second galvanometer mirror. The first galvanomirror deflects the measurement light LS so as to scan the imaging region (fundus oculi Ef or anterior segment) in the horizontal direction perpendicular to the optical axis of the OCT optical system 8 . The second galvanomirror deflects the measurement light LS deflected by the first galvanomirror so as to scan the imaging region in the vertical direction perpendicular to the optical axis of the OCT optical system 8 . Scanning modes of the measurement light LS by the light scanner 88 include, for example, horizontal scanning, vertical scanning, cross scanning, radial scanning, circular scanning, concentric scanning, and spiral scanning.

The measurement light LS reflected by the dichroic mirror 83 passes through the relay lens 82, is reflected by the reflecting mirror 81, passes through the dichroic mirror 67, is reflected by the dichroic mirror 52, is refracted by the objective lens 51, and reaches the subject's eye E incident on The measurement light LS is scattered and reflected at various depth positions of the eye E to be examined. The return light of the measurement light LS from the subject's eye E travels in the opposite direction along the same path as the forward path, is guided to the fiber coupler 105 , and reaches the fiber coupler 122 via the optical fiber 128 .

The fiber coupler 122 combines (interferences) the measurement light LS that has entered via the optical fiber 128 and the reference light LR that has entered via the optical fiber 121 to generate interference light. The fiber coupler 122 generates a pair of interference lights LC by splitting the interference lights at a predetermined splitting ratio (for example, 1:1). A pair of interference beams LC are guided to detector 125 through optical fibers 123 and 124, respectively.

Detector 125 is, for example, a balanced photodiode. A balanced photodiode includes a pair of photodetectors that respectively detect a pair of interference lights LC, and outputs a difference between a pair of detection results obtained by these photodetectors. The detector 125 sends this output (detection signal) to a DAQ (Data Acquisition System) 130 .

A clock KC is supplied from the OCT light source 101 to the DAQ 130 . The clock KC is generated in the OCT light source 101 in synchronization with the output timing of each wavelength swept within a predetermined wavelength range by the wavelength tunable light source. The OCT light source 101, for example, optically delays one of the two branched lights obtained by branching the light L0 of each output wavelength, and then outputs the clock KC based on the result of detecting these combined lights. Generate. The DAQ 130 samples the detection signal input from the detector 125 based on the clock KC. The DAQ 130 sends the sampling result of the detection signal from the detector 125 to the arithmetic processing section 220 of the processing section 9 . For example, for each series of wavelength scans (for each A line), the arithmetic processing unit 220 forms a reflection intensity profile for each A line by applying Fourier transform or the like to the spectral distribution based on the sampling data. Furthermore, the arithmetic processing unit 220 forms image data by imaging the reflection intensity profile of each A line.

In this example, a corner cube 114 is provided for changing the length of the optical path (reference optical path, reference arm) of the reference light LR. It is also possible to change the difference between

Note that the ophthalmologic apparatus 1000 may include a detachable front lens between the subject's eye E and the objective lens 51 . For example, when performing OCT measurement on the anterior segment, the front lens is arranged between the subject's eye E and the objective lens 51, and when performing OCT measurement on the fundus, the front lens is placed between the subject's eye E and the objective lens 51. It is retracted from between it and the objective lens 51 .

The processing unit 9 calculates a refractive power value from the measurement result obtained using the reflector measurement optical system, and based on the calculated refractive power value, the fundus oculi Ef, the reflector measurement light source 61, and the image sensor 59 are conjugated. The ref measurement light source 61 and the focusing lens 74 are moved in the optical axis direction to the respective positions. In some embodiments, the processing unit 9 moves the focusing lens 87 of the OCT optical system 8 along its optical axis in conjunction with the movement of the focusing lens 74 . In some embodiments, the processing section 9 moves the liquid crystal panel 41 (fixation unit 40) along its optical axis in conjunction with the movement of the ref measurement light source 61 and the focusing lens 74. FIG.

<Configuration of processing system>
The configuration of the processing system of the ophthalmologic apparatus 1000 will be described. An example of the functional configuration of the processing system of the ophthalmologic apparatus 1000 is shown in FIGS. 4 and 5. FIG. FIG. 4 shows an example of a functional block diagram of the processing system of the ophthalmologic apparatus 1000. As shown in FIG. FIG. 5 shows an example of a functional block diagram of the data processing unit 223. As shown in FIG.

The processing unit 9 controls each unit of the ophthalmologic apparatus 1000 . In addition, the processing unit 9 can execute various arithmetic processing. The processing unit 9 includes a processor.プロセッサの機能は、例えば、ＣＰＵ（Ｃｅｎｔｒａｌ Ｐｒｏｃｅｓｓｉｎｇ Ｕｎｉｔ）、ＧＰＵ（Ｇｒａｐｈｉｃｓ Ｐｒｏｃｅｓｓｉｎｇ Ｕｎｉｔ）、ＡＳＩＣ（Ａｐｐｌｉｃａｔｉｏｎ Ｓｐｅｃｉｆｉｃ Ｉｎｔｅｇｒａｔｅｄ Ｃｉｒｃｕｉｔ）、プログラマブル論理デバイス（例えば、ＳＰＬＤ（Ｓｉｍｐｌｅ Ｐｒｏｇｒａｍｍａｂｌｅ Ｌｏｇｉｃ Ｄｅｖｉｃｅ）、ＣＰＬＤ（Ｃｏｍｐｌｅｘ Ｐｒｏｇｒａｍｍａｂｌｅ Ｌｏｇｉｃ Ｄｅｖｉｃｅ） , FPGA (Field Programmable Gate Array)). The processing unit 9 implements the functions according to the embodiment by, for example, reading and executing a program stored in a storage circuit or storage device.

The processing unit 9 is an example of an "ophthalmic information processing apparatus" according to the embodiment. That is, the program for realizing the function of the processing unit 9 is an example of the "ophthalmic information processing program" according to the embodiment.

Processing unit 9 includes control unit 210 and arithmetic processing unit 220 . The ophthalmologic apparatus 1000 also includes a moving mechanism 200 , a display section 270 , an operation section 280 and a communication section 290 .

The moving mechanism 200 includes a Z alignment system 1, an XY alignment system 2, a keratometric measurement system 3, a fixation projection system 4, an anterior segment observation system 5, a reflector measurement projection system 6, a reflector measurement light receiving system 7, an OCT optical system 8, and the like. This is a mechanism for moving the head section in which the optical system is housed in the front, rear, left, and right directions. For example, the moving mechanism 200 is provided with an actuator that generates driving force for moving the head section and a transmission mechanism that transmits this driving force. The actuator is composed of, for example, a pulse motor. The transmission mechanism is configured by, for example, a combination of gears, a rack and pinion, or the like. The control unit 210 (main control unit 211) controls the movement mechanism 200 by sending control signals to the actuators.

(control unit 210)
The control unit 210 includes a processor and controls each unit of the ophthalmologic apparatus. Control unit 210 includes a main control unit 211 and a storage unit 212 . A computer program for controlling the ophthalmologic apparatus is stored in advance in the storage unit 212 . The computer programs include a light source control program, a detector control program, an optical scanner control program, an optical system control program, an arithmetic processing program, a user interface program, and the like. The main control unit 211 operates according to such a computer program, so that the control unit 210 executes control processing.

A main control unit 211 performs various controls of the ophthalmologic apparatus as a measurement control unit. Control of the Z alignment system 1 includes control of the Z alignment light source 11, control of the line sensor 13, and the like. The control of the Z alignment light source 11 includes turning on/off the light source, adjusting the amount of light, and adjusting the aperture. Control of the line sensor 13 includes exposure adjustment, gain adjustment, and detection rate adjustment of the detection element. As a result, the Z alignment light source 11 is switched between lighting and non-lighting, or the amount of light is changed. The main control unit 211 captures the signal detected by the line sensor 13 and identifies the projection position of the light on the line sensor 13 based on the captured signal. The main control unit 211 obtains the position of the corneal vertex of the subject's eye E based on the specified projection position, and based on this, controls the movement mechanism 200 to move the head unit in the front-rear direction (Z alignment).

Control of the XY alignment system 2 includes control of the XY alignment light source 21 and the like. The control of the XY alignment light source 21 includes turning on/off the light source, adjusting the amount of light, and adjusting the aperture. Thereby, lighting and non-lighting of the XY alignment light source 21 are switched, or the amount of light is changed. The main control unit 211 captures the signal detected by the imaging element 59 and identifies the position of the bright spot image based on the return light from the XY alignment light source 21 based on the captured signal. The main control unit 211 controls the moving mechanism 200 so as to cancel the displacement of the position of the bright point image Br with respect to a predetermined target position (for example, the center position of the alignment mark AL), and moves the head unit in left, right, up and down directions. Move (XY alignment).

Control of the keratometry system 3 includes control of the keratometry light source 32 and the like. The control of the keratling light source 32 includes turning on/off the light source, adjusting the amount of light, and adjusting the aperture. Thereby, lighting and non-lighting of the keratling light source 32 are switched, or the amount of light is changed. The main control unit 211 causes the arithmetic processing unit 220 to perform a known arithmetic operation on the keratling image detected by the imaging device 59 . Thereby, the corneal shape parameter of the eye E to be examined is obtained.

The control of the fixation projection system 4 includes control of the liquid crystal panel 41, movement control of the fixation unit 40, and the like. The control of the liquid crystal panel 41 includes turning on/off the display of the pattern representing the fixation target, switching the pattern representing the fixation target, switching the display position of the pattern representing the fixation target, and the like. As described above, switching of the pattern representing the fixation target includes switching between the pattern representing the fixation target for reflex measurement and the pattern representing the fixation target for OCT measurement, and switching between the pattern representing the fixation target for reflex measurement and the fixation target with a small visual angle for reflex measurement. and a pattern representing a fixation target with a large viewing angle for reflex measurement.

For example, the fixation projection system 4 is provided with a moving mechanism that moves the liquid crystal panel 41 (or the fixation unit 40) in the optical axis direction. Similar to the moving mechanism 200, this moving mechanism is provided with an actuator that generates a driving force for moving the moving mechanism and a transmission mechanism that transmits this driving force. The main control unit 211 controls the movement mechanism by sending control signals to the actuators, and moves at least the liquid crystal panel 41 in the optical axis direction. Thereby, the position of the liquid crystal panel 41 is adjusted so that the liquid crystal panel 41 and the fundus oculi Ef are optically conjugated.

The control of the anterior segment observation system 5 includes control of the anterior segment illumination light source 50, control of the imaging element 59, and the like. The control of the anterior ocular segment illumination light source 50 includes turning on/off the light source, light amount adjustment, aperture adjustment, and the like. As a result, the lighting and non-lighting of the anterior segment illumination light source 50 is switched, or the amount of light is changed. Control of the imaging element 59 includes exposure adjustment, gain adjustment, detection rate adjustment, and the like of the imaging element 59 . The main control unit 211 captures the signals detected by the imaging device 59 and causes the arithmetic processing unit 220 to execute processing such as formation of an image based on the captured signals.

The control of the ref measurement projection system 6 includes control of the ref measurement light source 61, control of the rotary prism 66, and the like. The control of the ref measurement light source 61 includes turning on and off the light source, adjusting the amount of light, adjusting the aperture, and the like. As a result, lighting and non-lighting of the ref measurement light source 61 are switched, or the amount of light is changed. For example, the reflector measurement projection system 6 includes a moving mechanism that moves the reflector measurement light source 61 in the optical axis direction. Similar to the moving mechanism 200, this moving mechanism is provided with an actuator that generates a driving force for moving the moving mechanism and a transmission mechanism that transmits this driving force. The main control unit 211 controls the movement mechanism by sending a control signal to the actuator to move the ref measurement light source 61 in the optical axis direction. The control of the rotary prism 66 includes rotation control of the rotary prism 66 and the like. For example, a rotating mechanism for rotating the rotary prism 66 is provided, and the main controller 211 rotates the rotary prism 66 by controlling this rotating mechanism.

Control of the ref measurement light-receiving system 7 includes control of the focusing lens 74 and the like. Control of the focusing lens 74 includes movement control of the focusing lens 74 in the optical axis direction. For example, the ref measurement light-receiving system 7 includes a moving mechanism that moves the focusing lens 74 in the optical axis direction. Similar to the moving mechanism 200, this moving mechanism is provided with an actuator that generates a driving force for moving the moving mechanism and a transmission mechanism that transmits this driving force. The main control unit 211 controls the moving mechanism by sending a control signal to the actuator to move the focusing lens 74 in the optical axis direction. The main control unit 211 controls the refractometer measurement light source 61 and the focusing lens 74 according to the refractive power of the subject's eye E, for example, so that the refractometer light source 61, the fundus oculi Ef, and the imaging device 59 are optically conjugate. Axial movement is possible.

Control of the OCT optical system 8 includes control of the OCT light source 101, control of the optical scanner 88, control of the focusing lens 87, control of the corner cube 114, control of the detector 125, control of the DAQ 130, and the like. The control of the OCT light source 101 includes turning on and off the light source, adjusting the amount of light, adjusting the aperture, and the like. Control of the optical scanner 88 includes control of the scanning position, scanning range, and scanning speed by the first galvanomirror, and control of the scanning position, scanning range, and scanning speed by the second galvanomirror.

The control of the focusing lens 87 includes movement control of the focusing lens 87 in the optical axis direction, movement control of the focusing lens 87 to the focus reference position corresponding to the imaging part, movement range (focusing) corresponding to the imaging part. movement control within the focal range). For example, the OCT optical system 8 includes a moving mechanism that moves the focusing lens 87 in the optical axis direction. Similar to the moving mechanism 200, this moving mechanism is provided with an actuator that generates a driving force for moving the moving mechanism and a transmission mechanism that transmits this driving force. The main control unit 211 controls the moving mechanism by sending a control signal to the actuator to move the focusing lens 87 in the optical axis direction. In some embodiments, the ophthalmic device is provided with a retaining member that retains the focusing lenses 74 and 87 and a drive that drives the retaining member. The main control section 211 performs movement control of the focusing lenses 74 and 87 by controlling the driving section. For example, the main control unit 211 may move only the focusing lens 87 based on the intensity of the interference signal after moving the focusing lens 87 in conjunction with the movement of the focusing lens 74 .

The control of the corner cube 114 includes movement control of the corner cube 114 along the optical path. For example, the OCT optical system 8 includes a moving mechanism that moves the corner cube 114 along the optical path. Similar to the moving mechanism 200, this moving mechanism is provided with an actuator that generates a driving force for moving the moving mechanism and a transmission mechanism that transmits this driving force. The main control unit 211 controls the moving mechanism by sending control signals to the actuators to move the corner cube 114 along the optical path. Control of the detector 125 includes exposure adjustment, gain adjustment, and detection rate adjustment of the detection element. The main control unit 211 samples the signal detected by the detector 125 by the DAQ 130, and causes the arithmetic processing unit 220 (image forming unit 222) to perform processing such as formation of an image based on the sampled signal.

The main control unit 211 also functions as a display control unit to provide an image of the subject's eye E (anterior segment image, fundus image) obtained by the imaging device 59, and a graphical user interface for realizing the functions of the operation unit 280 by means of a touch panel. , and information corresponding to the processing result of the arithmetic processing unit 220 can be displayed on the display unit 270 . The processing results of the arithmetic processing unit 220 include the refractive power value of the subject's eye E calculated by the eye refractive power calculation unit 221, the image formed by the image forming unit 222, the processing results of the data processing unit 223, and the like. The processing results of the data processing unit 223 include analysis results by the analysis unit 224, calculation results by the index calculation unit 225, and the like.

Furthermore, the main control unit 211 performs processing of writing data to the storage unit 212 and processing of reading data from the storage unit 212 .

(storage unit 212)
The storage unit 212 stores various data. The data stored in the storage unit 212 includes, for example, objective measurement results, OCT measurement results, tomographic image data, fundus image data, eye information, subject information, standard data, and the like. be. The eye information to be inspected includes information related to the eye to be inspected, such as left eye/right eye identification information. The subject information includes information about the subject such as patient ID, name, age, sex, height and weight of the subject. In some embodiments, subject information is information obtained from an electronic medical record. In some embodiments, eye information to be examined and subject information are information input by the examiner or the subject using the operation unit 280 . The standard data is statistically derived from a large number of measurement data of normal eyes and the information of the subject of the measurement data, and is called normal eye data (normative data) or the like. The storage unit 212 also stores various programs and data for operating the ophthalmologic apparatus.

(Arithmetic processing unit 220)
Arithmetic processing unit 220 includes an image forming unit 222 and a data processing unit 223 .

(Image forming unit 222)
The image forming unit 222 forms image data of a tomographic image of the fundus oculi Ef based on the signal detected by the detector 125 . That is, the image forming unit 222 forms image data of the subject's eye E based on the detection result of the interference light LC by the interference optical system. This processing includes processing such as filter processing and FFT (Fast Fourier Transform), as in conventional spectral domain type OCT. The image data acquired in this manner is a data set containing a group of image data formed by imaging reflection intensity profiles in a plurality of A-lines (paths of each measuring light LS in the eye E to be examined). be.

To improve image quality, multiple data sets collected by scanning the same pattern multiple times can be superimposed (averaged).

(Data processing unit 223)
The data processing unit 223 performs various data processing (image processing) and analysis processing on the tomogram formed by the image forming unit 222 . For example, the data processing unit 223 executes correction processing such as image luminance correction and dispersion correction. In addition, the data processing unit 223 performs various image processing and analysis processing on the image (anterior segment image, etc.) obtained using the anterior segment observation system 5 .

The data processing unit 223 can form volume data (voxel data) of the subject's eye E by executing known image processing such as interpolation processing for interpolating pixels between tomographic images. When displaying an image based on volume data, the data processing unit 223 performs rendering processing on this volume data to form a pseudo-three-dimensional image when viewed from a specific line-of-sight direction.

The data processing unit 223 performs various renderings on the acquired volume data (three-dimensional data set, stack data, etc.) to obtain B-mode images (longitudinal cross-sectional images, axial cross-sectional images) at arbitrary cross-sections, C-mode images (cross-sectional images, horizontal cross-sectional images), projection images, shadowgrams, etc. can be formed. An arbitrary cross-sectional image, such as a B-mode image or a C-mode image, is formed by selecting pixels (pixels, voxels) on a specified cross-section from a three-dimensional data set. A projection image is formed by projecting a three-dimensional data set in a predetermined direction (Z direction, depth direction, axial direction). A shadowgram is formed by projecting a portion of the three-dimensional data set (for example, partial data corresponding to a specific layer) in a predetermined direction. An image such as a C-mode image, a projection image, or a shadowgram whose viewpoint is the front side of the subject's eye is called an en-face image.

The data processing unit 223 also generates a B-mode image or a front image (vessel-enhanced image, angiographic image, etc.) in which retinal vessels and choroidal vessels are emphasized based on data (for example, B-scan image data) collected in time series by OCT. gram) can be constructed. For example, time-series OCT data can be collected by repeatedly scanning substantially the same portion of the eye E to be examined.

In some embodiments, the data processing unit 223 compares time-series B-scan images obtained by B-scans of approximately the same site, and converts the pixel values of the portions where the signal intensity changes to the pixel values corresponding to the changes. An enhanced image in which the changed portion is emphasized is constructed by the conversion. Further, the data processing unit 223 extracts information for a predetermined thickness in a desired region from the constructed multiple enhanced images and constructs an en-face image to form an OCT angiogram.

As shown in FIG. 5 , data processing section 223 includes analysis section 224 and index calculation section 225 .

(analysis unit 224)
The analysis unit 224 performs predetermined analysis processing on the data obtained by the ref measurement light receiving system 7 or the OCT optical system 8 . The analysis unit 224 includes an intraocular parameter identification unit 2241 , a change information identification unit 2242 , a received light image analysis unit 2243 , and an eye refractive power calculation unit 2244 .

(Intraocular parameter specifying unit 2241)
The intraocular parameter specifying unit 2241 specifies one or more intraocular parameters of the eye E to be examined based on the detection result of the interference light LC obtained by the OCT optical system 8 . The intraocular parameters include the position of the predetermined site, the intraocular distance, the shape of the predetermined site, and the like. For example, the intraocular parameter specifying unit 2241 obtains the position of the predetermined part in the subject's eye E, the intraocular distance, and the form of the predetermined part by the method disclosed in Japanese Patent Application Laid-Open No. 2016-010445.

FIG. 6A shows an explanatory diagram of the operation of the intraocular parameter specifying unit 2241. As shown in FIG. FIG. 6A shows an example of the reflection intensity profile obtained when the measurement light LS projected onto the subject's eye E passes through the pupil.

A reflection intensity profile P is acquired based on the detection result of the interference light LC. The intraocular parameter specifying unit 2241 determines the characteristic values (maximum value, minimum value, maximum value, local minimum value, etc.) of the reflection intensity profile P, the shape of the reflection intensity profile P, the anatomical data of the eye, and the clinical data (for example, , general or individual relationship between tissue and depth position (z coordinate value)), etc.

For example, the intraocular parameter identifying unit 2241 identifies z0, which is the minimum z-coordinate value at which the reflected light amount L is non-zero, as the position of the corneal surface (corneal front surface) at the measurement position (A line). Alternatively, the intraocular parameter specifying unit 2241 specifies z0, which is the z-coordinate value at which the reflected light amount L takes the maximum value, as the position of the corneal surface on the A line. Alternatively, the intraocular parameter specifying unit 2241 specifies z0, which is the z coordinate value of the first peak from the shallow side (−z side) to the deep side (+z side), as the position of the corneal surface on the A line. do. Similarly, the intraocular parameter specifying unit 2241 sets z1, z2, and z3, which are the z-coordinate values of the second, third, and fourth peaks, to the positions of the posterior corneal surface and the anterior surface of the lens on the A-line, respectively. Identify the position and the position of the posterior surface of the lens.

When the measurement light LS is incident on the iris of the eye to be examined E, the first and second peaks similarly correspond to the anterior and posterior surfaces of the cornea, and the third peak corresponds to the anterior surface of the iris. Equivalent to. Also, for example, the posterior surface of the iris is detected as the fourth peak, the anterior surface of the lens is detected as the fifth peak, and the posterior surface of the lens is detected as the sixth peak. For example, based on the position of the scanning point (A line) in the scan pattern and the position of the pupil (or iris) specified by analyzing the anterior eye image obtained by the anterior eye observation system 5, the measurement light LS can be determined whether passes through the pupil or enters the iris.

As described above, the intraocular parameter specifying unit 2241 analyzes the detection result of the interference light LC obtained by the OCT optical system 8, and obtains the detection result (interference signal) of the interference light corresponding to the predetermined site in the eye. A peak position can be identified, and a position corresponding to a predetermined site in the subject's eye E can be identified based on the identified peak position. The intraocular parameter identification unit 2241 can obtain a predetermined intraocular distance in the subject's eye E from the plurality of identified positions. In addition, the intraocular parameter specifying unit 2241 can specify the form (shape) of the predetermined part in the subject's eye E from the specified positions. In this case, the intraocular parameter identification unit 2241 can identify the morphology of the predetermined region by referring to anatomical data of the eye, clinical data, or data of the eye model.

In the above example, the case of specifying the position of the predetermined site in the anterior segment has been described. It is possible to specify the position, intraocular distance, morphology, etc. of a predetermined site in the .

FIG. 6B shows another operation explanatory diagram of the intraocular parameter specifying unit 2241. As shown in FIG. FIG. 6B shows an example of a tomographic image of the eye E to be examined.

For example, the tomographic image G is formed by arranging in the x-direction a plurality of A-scan data (A-scan images) formed based on the LC detection result of the interference light. Each A-scan data is image data obtained by assigning a luminance value to a light amount value of the reflection intensity profile. The A-scan data Ak arranged at the x-coordinate value xk in the tomogram G corresponds to the reflection intensity profile P in FIG. 6A. The image area H0 is an image area corresponding to the anterior surface of the cornea, the image area H1 is an image area corresponding to the posterior surface of the cornea, the image area H2 is an image area corresponding to the anterior surface of the lens, and the image area H3 is an image area corresponding to the posterior surface of the lens. image area.

The intraocular parameter specifying unit 2241 determines the depth of a predetermined region of the eye E to be examined based on the pixel value (brightness value) of the tomographic image G, the form of the object being drawn (the size, shape, position, etc. of the tissue), and the like. position. For example, the intraocular parameter identifying unit 2241 identifies an image region H0 corresponding to the anterior surface of the cornea by executing a known segmentation process, and identifies its depth position. The depth position of the image region H0 may be one or more values (for example, maximum value, minimum value, maximum value, minimum value, etc.) among a plurality of positions corresponding to a plurality of pixels forming the image region H0. , may be one or more values (for example, statistical values such as average, median, and mode) obtained by performing arithmetic processing on these multiple positions.

The intraocular parameter specifying unit 2241 acquires the z-position of the image region in the B-section by executing the process shown in FIG. 6B for each B-scan data (B-scan image), and based on the acquired z-position A position corresponding to the predetermined site in the eye E to be examined can be identified. The intraocular parameter identification unit 2241 can obtain a predetermined intraocular distance in the subject's eye E from the plurality of identified z-positions. In addition, the intraocular parameter specifying unit 2241 can specify the form (shape) of the predetermined region in the subject's eye E from the plurality of specified z-positions. In this case, the intraocular parameter identification unit 2241 can identify the morphology of the predetermined region by referring to anatomical data of the eye, clinical data, or data of the eye model.

The intraocular parameter specifying unit 2241 according to some embodiments includes the positions of the anterior and posterior surfaces of the cornea, the positions of the anterior and posterior surfaces of the lens, the axial length, the corneal thickness, the anterior chamber depth, the lens thickness, the vitreous cavity length, the retinal thickness, Obtain the choroidal thickness, etc. The intraocular parameter identifier 2241 according to some embodiments further identifies the position or morphology of the ciliary muscle and the position or morphology of the zonules.

(Change information identification unit 2242)
The change information identifying unit 2242 identifies temporal changes in the anterior segment (or posterior segment). Specifically, the change information identifying section 2242 identifies temporal changes in the position, intraocular distance, or morphology of the predetermined site identified by the intraocular parameter identifying section 2241 .

For example, the OCT measurement is repeatedly performed on the anterior segment of the subject's eye E to which the accommodation stimulus is applied by presenting the fixation target. The intraocular parameter specifying unit 2241 specifies intraocular parameters such as the position of the predetermined site in the anterior segment as described above, based on the detection results of the interference light obtained by each OCT measurement. The change information identifying unit 2242 can identify temporal changes in intraocular parameters by obtaining differences between a plurality of intraocular parameters obtained by a plurality of OCT measurements performed at different timings. The change information specifying unit 2242 according to some embodiments obtains frequency spectrum information obtained by performing frequency analysis on the intraocular parameter difference as the temporal change of the intraocular parameter.

The change in the intraocular parameter when the subject's eye E accompanies the accommodation strain is greater than the change in the intraocular parameter when it is determined that the subject's eye E does not accompany the accommodation strain. When the subject's eye E accompanies accommodative tension, the amplitude component of the predetermined frequency component in the intraocular parameter change increases.

7A to 7D schematically show changes in intraocular parameters. FIG. 7A schematically shows changes in lens thickness as an intraocular parameter when it is determined that the subject's eye E is not accompanied by accommodative tension, and frequency components of the changes. The frequency components shown in FIG. 7A are obtained by Fourier transforming the change in lens thickness. FIG. 7B schematically shows changes in lens thickness and frequency components of the changes when the subject's eye E is subjected to accommodative strain. FIG. 7C schematically shows changes in the depth of the anterior chamber of the eye E to be examined. FIG. 7D schematically shows changes in the intraocular distance between the anterior corneal surface and the posterior surface of the lens of the eye E to be examined.

When it is determined that the subject's eye E does not accompany accommodation tension, the lens thickness changes as shown in FIG. 7A. On the other hand, when the subject's eye E accompanies accommodative tension, the lens thickness changes more greatly as shown in FIG. 7B. A frequency component (1.0 Hz to 2.3 Hz) that is considered to be caused by the trembling of the ciliary muscle can be extracted by frequency analysis of changes in lens thickness. In this frequency component range, when it is determined that the eye E to be examined is not accompanied by accommodation tension, the change C1 in the appearance frequency (amplitude component) shown in FIG. 7A is shown in FIG. 7B shows the change C2 in frequency of occurrence.

For changes in the depth of the anterior chamber shown in FIG. 7C and changes in the intraocular distance between the anterior corneal surface and the posterior surface of the lens shown in FIG. It is possible. Although not shown, frequency components may be extracted from changes in the distance between the posterior surface of the lens and the retina.

Therefore, by frequency analysis of the temporal change in the intraocular parameter specified by the change information specifying unit 2242, the frequency component considered to be caused by the tremor of the ciliary muscle is extracted, and based on the amplitude component of the extracted frequency component , the degree of accommodation tension in the eye E to be examined. The degree of accommodation tension in the eye E to be examined includes information as to whether or not the eye E to be examined is accompanied by accommodation tension. In some embodiments, the examiner or subject is informed of the determined degree of accommodation tone. The notification includes display output of information by the display unit 270, light output or sound output by other output means, and the like. In this embodiment, by changing the display mode of the refractive power value obtained by the refractive power measurement, the examiner or the subject is notified of the specified result of the degree of accommodation tension in the eye E to be examined. do.

In some embodiments, the main controller 211 causes the display 270 to display information representing temporal changes in intraocular parameters. As an example of information representing temporal changes in intraocular parameters, there are graphs in which the horizontal axis represents time and the vertical axis represents intraocular parameters, as shown in FIGS. 7A to 7D.

In some embodiments, the main control unit 211 causes the display unit 270 to display information representing the results of frequency analysis of temporal changes in intraocular parameters. As an example of information representing the result of frequency analysis, there is a graph in which the horizontal axis represents frequency and the vertical axis represents frequency of appearance, as shown in FIGS. 7A and 7B.

(Received image analysis unit 2243)
The received light image analysis unit 2243 analyzes a ring image (pattern image) obtained by the imaging element 59 receiving the return light of the ring-shaped light flux (ring-shaped measurement pattern) projected onto the fundus oculi Ef by the reflector measurement projection system 6. to parse For example, the received light image analysis unit 2243 obtains the barycentric position of the ring image from the luminance distribution in the obtained image in which the ring image is rendered, and the luminance distribution along a plurality of scanning (longitudinal) directions radially extending from this barycentric position. is obtained, and the ring image is specified from this luminance distribution.

The ring image specified by the received light image analysis unit 2243 is used for calculation processing of the refractive power value of the eye E to be examined and calculation processing of the reliability index of the calculated refractive power value.

(Eye refractive power calculator 2244)
The eye refractive power calculation unit 2244 obtains an approximate ellipse of the ring image specified by the received light image analysis unit 2243, and substitutes the major axis and minor axis of the approximate ellipse into a known formula to calculate the spherical power, the cylindrical power, and the cylindrical axis. Find the angle (refracting power value). Alternatively, the eye refractive power calculation unit 2244 can obtain eye refractive power parameters based on the deformation and displacement of the ring image with respect to the reference pattern.

The eye refractive power calculator 2244 also calculates the corneal refractive power, the corneal astigmatism degree, and the corneal astigmatism axis angle based on the keratling image acquired by the anterior eye observation system 5 . For example, the eye refractive power calculator 221 calculates the corneal curvature radii of the strong and weak principal meridians of the corneal front surface by analyzing the keratling image, and calculates the above parameters based on the corneal curvature radii.

(Index calculator 225)
The index calculation unit 225 calculates a reliability index representing the degree of reliability of the refractive power value and an adjustment tension based on the data obtained by the refractometer light receiving system 7 or the OCT optical system 8 or the analysis result by the analysis unit 224. A regulated tone index representing the degree is calculated. The index calculator 225 can also perform correction processing on the calculated index. The index calculator 225 includes an adjustable tension index calculator 2251 , a reliability index calculator 2252 , and an index corrector 2253 .

(Adjustment tension index calculator 2251)
The accommodative strain index calculator 2251 calculates accommodative strain index representing the degree of accommodative strain of the subject's eye E based on the temporal change in the intraocular parameter specified by the change information specifying unit 2242 . Specifically, the accommodative tension index calculator 2251 performs frequency analysis on the temporal change in the intraocular parameter identified by the change information identifying unit 2242 to determine that the tremor is caused by the ciliary muscle tremor. A frequency component is extracted, and an accommodation tension index is obtained based on the amplitude component of the extracted frequency component. For example, the regulatory tension index calculator 2251 obtains one of the indices "1" to "10" corresponding to the difference of the amplitude component of the frequency component with respect to a predetermined reference value as the regulatory tension index.

In some embodiments, the adjusted strain index calculator 2251 calculates the adjusted strain index such that the greater the difference, the larger the value. In some embodiments, the accommodative strain index calculation unit 2251 calculates the accommodative strain index so that it is determined that the subject's eye E is accompanies accommodative strain when the accommodative strain index is equal to or greater than a predetermined value (eg, "5"). Ask for

In some embodiments, the adjusted strain index calculator 2251 obtains the adjusted strain index such that the greater the difference, the smaller the value. In some embodiments, the accommodative strain index calculator 2251 calculates the accommodative strain index so that it is determined that the subject's eye E is accompanies accommodative strain when the accommodative strain index is less than a predetermined value (eg, "5"). Ask for

In some embodiments, the main control unit 211 causes the display unit 270 to display the refractive power measurement information whose display mode is changed according to the calculated accommodative tension index. The refractive power measurement information includes the refractive power value calculated by the eye refractive power calculator 2244, the number of refractive power measurements, a reliability index described later, and the like. In some embodiments, the number of refractive power measurements indicates the number of measurements in question out of the total number of measurements. Changes in the display mode include the addition of additional information indicating that the subject's eye is accompanies accommodative strain to the refractive power measurement information, the change of the refractive power measurement information, and the like. Changes to the refractive power measurement information include changes to the display to a corrected reliability index.

(Reliability index calculator 2252)
The reliability index calculator 2252 calculates a reliability index representing the degree of reliability of the refractive power value calculated by the eye refractive power calculator 2244 . Specifically, the reliability index calculator 2252 calculates the reliability index based on the analysis result of the ring image specified by the received light image analyzer 2243 . For example, the reliability index calculator 2252 calculates the reliability index based on the image quality of the specified ring image and the degree of lack of the ring image.

In some embodiments, the reliability index calculation unit 2252 calculates the degree of brightness unevenness of the identified ring image, the clarity of the ring image, the degree of reflected light amount of the ring image, and the degree of chipping of the ring image. Calculate the reliability index based on In some embodiments, the reliability index is calculated such that the reliability increases as the degree of unevenness in brightness of the ring image decreases. In some embodiments, a reliability index is calculated such that the higher the sharpness of the ring image, the higher the reliability. In some embodiments, the reliability index is calculated such that the greater the amount of reflected light of the ring image, the higher the reliability. In some embodiments, the reliability index is calculated such that the smaller the degree of chipping of the ring image, the higher the reliability.

In some embodiments, the degree of brightness unevenness of the ring image in a plurality of scanning directions radially extending from the center of gravity of the ring image, the clarity of the ring image, the degree of reflected light amount of the ring image, and lack of ring image A reliability index is calculated based on the degree of In some embodiments, the reliability index calculation unit 2252 obtains any of the indices “1” to “10” as the reliability index so that the higher the reliability, the larger the value.

By attaching the calculated reliability index as additional information to the refractive power value calculated by the eye refractive power calculator 2244, the examiner or subject can recognize the degree of reliability of the refractive power value. .

In some embodiments, the main control unit 211 causes the display unit 270 to display at least one of the refractive power value whose display mode is changed according to the calculated reliability index and the number of refractive power measurements.

(Exponent correction unit 2253)
The index corrector 2253 corrects the reliability index calculated by the reliability index calculator 2252 . In some embodiments, correction processing by the exponent correction unit 2253 does not need to be executed. In this case, the exponent calculator 225 has a configuration in which the exponent corrector 2253 is omitted. For example, when presenting (displaying) both the adjusted tension index and the reliability index to the examiner or subject, the index correction unit 2253 does not perform correction processing.

When executing the reliability index correction process, the index correction unit 2253 corrects the reliability index based on the adjusted strain index calculated by the adjusted strain index calculation unit 2251 . For example, the index correction unit 2253 corrects the reliability index so that the reliability decreases as the degree of adjustment tension increases. Also, for example, the index correction unit 2253 corrects the reliability index so that the reliability decreases as the degree of adjustment strain decreases.

In some embodiments, the index correction unit 2253 adjusts the degree of unevenness in the brightness of the ring image, the degree of sharpness of the ring image, the degree of the amount of reflected light of the ring image, and the degree of the ring image based on the accommodative tension index. Correct at least one degree of chipping. In this case, the reliability index calculator 2252 calculates the reliability index based on the degree of brightness unevenness corrected by the index corrector 2253 .

(Display unit 270, operation unit 280)
Display unit 270 displays information as a user interface unit under the control of control unit 210 . Display unit 270 includes display unit 10 shown in FIG. 2 and the like.

The operation unit 280 is used as a user interface unit to operate the ophthalmologic apparatus. The operation unit 280 includes various hardware keys (joystick, button, switch, etc.) provided in the ophthalmologic apparatus. The operation unit 280 may also include various software keys (buttons, icons, menus, etc.) displayed on the touch panel display screen 10a.

At least part of the display unit 270 and the operation unit 280 may be configured integrally. A typical example is a touch panel display screen 10a.

(Communication unit 290)
The communication unit 290 has a function for communicating with an external device (not shown). The communication unit 290 has a communication interface according to a connection form with an external device. An example of an external device is a spectacle lens measuring device for measuring the optical properties of lenses. The spectacle lens measuring device measures the dioptric power of the spectacle lens worn by the subject, and inputs this measurement data to the ophthalmologic device 1000 . Also, the external device may be any ophthalmologic device, a device (reader) that reads information from a recording medium, or a device (writer) that writes information to a recording medium. Furthermore, the external device may be a hospital information system (HIS) server, a DICOM (Digital Imaging and Communication in Medicine) server, a doctor terminal, a mobile terminal, a personal terminal, a cloud server, or the like. The communication unit 290 may be provided in the processing unit 9, for example.

The processing unit 9 (ophthalmic information processing apparatus 400) is an example of the "ophthalmic information processing apparatus" according to the embodiment. The change information specifying unit 2242 is an example of a "specifying unit" according to the embodiment. The adjusted tension index calculator 2251 is an example of a “calculator” according to the embodiment. The control unit 210 or the main control unit 211 is an example of the "display control unit" according to the embodiment. The display unit 270 is an example of "display means" according to the embodiment. The index correction unit 2253 is an example of the "reliability index correction unit" according to the embodiment. The refractometer optical system (refractive power measuring optical system 310, refractor measuring projection system 6, and refractor measuring light receiving system 7) is an example of the "eye refractive power measuring optical system" according to the embodiment.

<Operation example>
The operation of the ophthalmologic apparatus 1000 according to the embodiment will be described.

FIG. 8 shows an example of the operation of the ophthalmologic apparatus 1000. As shown in FIG. FIG. 8 depicts a flow diagram of an example operation of the ophthalmic device 1000 . A computer program for realizing the processing shown in FIG. 8 is stored in the storage unit 212 . The main control unit 211 executes the processing shown in FIG. 8 by operating according to this computer program.

FIG. 8 illustrates a case where the accommodative tension index is calculated based on the temporal change in the lens thickness of the eye E to be examined. The same applies to the calculation of .

(S1: start presenting fixation target)
When the examiner performs a predetermined operation on the operation unit 280 with the subject's face fixed to a face receiving unit (not shown), the ophthalmologic apparatus 1000 performs a reflex measurement on the subject's eye E. Start presenting the fixation target.

Specifically, the main control unit 211 controls the fixation projection system 4 to display a fixation target pattern representing a predetermined fixation target such as a landscape chart on the liquid crystal panel 41 .

(S2: Alignment)
The ophthalmologic apparatus 1000 performs alignment when the examiner performs a predetermined operation on the operation unit 280 while the subject's face is fixed to a face receiving unit (not shown).

Specifically, the main controller 211 turns on the Z alignment light source 11 and the XY alignment light source 21 . Further, the main controller 211 turns on the anterior segment illumination light source 50 . The processing unit 9 acquires the imaging signal of the anterior segment image on the imaging surface of the imaging element 59 and causes the display unit 270 to display the anterior segment image. After that, the optical system shown in FIG. 2 is moved to the examination position of the eye E to be examined. The inspection position is a position at which the eye to be inspected E can be inspected with sufficient accuracy. The subject's eye E is placed at the inspection position through the above-described alignment (alignment by the Z alignment system 1, the XY alignment system 2, and the anterior segment observation system 5). Movement of the optical system is executed by the control unit 210 according to an operation or instruction by the user or an instruction by the control unit 210 . That is, the movement of the optical system to the inspection position of the subject's eye E and the preparation for objective measurement are performed.

Further, the main control unit 211 moves the ref measurement light source 61, the focusing lens 74, and the fixation unit 40 (liquid crystal panel 41) to their origin positions (for example, positions corresponding to 0D) along their respective optical axes. move.

Note that the keratometry may be performed after the alignment in step S2 is completed. In this case, the main controller 211 causes the liquid crystal panel 41 to display a pattern indicating a fixation target at a display position corresponding to a desired fixation position. Thereby, the subject's eye E is gazed at the desired fixation position. After that, the main controller 211 turns on the keratling light source 32 . When light is emitted from the keratizing light source 32, a ring-shaped light beam for corneal shape measurement is projected onto the cornea Cr of the eye E to be examined. The eye refractive power calculation unit 2244 calculates the corneal curvature radius by performing arithmetic processing on the image specified by the received light image analysis unit 2243, and calculates the corneal refractive power, the corneal astigmatism, and the Calculate the corneal astigmatism axis angle. In the control unit 210 , the calculated corneal refractive power and the like are stored in the storage unit 212 .

In response to an instruction from the main control unit 211 or a user's operation or instruction to the operation unit 280, the operation of the ophthalmologic apparatus 1000 proceeds to step S3.

(S3: refractive power measurement)
In the refractive power measurement, the main controller 211 projects the ring-shaped measurement pattern light beam for the refractive power measurement onto the eye E to be examined as described above. A ring image is formed on the imaging surface of the imaging device 59 based on the return light of the measurement pattern light flux from the eye E to be inspected. The main control unit 211 determines whether or not the ring image based on the return light from the fundus oculi Ef detected by the imaging element 59 has been acquired. For example, the main control unit 211 detects the position (pixel) of the edge of the image based on the return light detected by the imaging device 59, and determines whether the width of the image (difference between the outer diameter and the inner diameter) is equal to or greater than a predetermined value. determine whether or not Alternatively, the main control unit 211 determines whether a ring image can be obtained by determining whether a ring can be formed based on points (images) having a predetermined height (ring diameter) or more. good too.

When it is determined that the ring image has been acquired, the eye refractive power calculation unit 2244 analyzes the ring image based on the return light of the measurement pattern light flux projected onto the subject's eye E by a known method, and calculates the temporary spherical power S and A temporary astigmatism power C is obtained. Based on the obtained temporary spherical power S and cylindrical power C, the main control unit 211 adjusts the ref measurement light source 61, the focusing lens 74, and the fixation unit 40 (liquid crystal panel 41) to the equivalent spherical power (S+C/2). position (position corresponding to the temporary far point).

(S4: clouds)
The main controller 211 further moves the fixation unit 40 (liquid crystal panel 41) from the position of the equivalent spherical power (S+C/2) specified in step S3 to the fog position.

(S5: refractive power measurement)
After step S4, the main control unit 211 controls the ref measurement projection system 6 and the ref measurement light receiving system 7 to acquire the ring image again as the main measurement. The main control unit 211 causes the eye refractive power calculation unit 2244 to calculate the spherical power, the cylindrical power, and the cylindrical axis angle from the analysis result of the ring image obtained in the same manner as described above and the movement amount of the focusing lens 74 .

Further, the eye refractive power calculator 2244 obtains the position corresponding to the far point of the subject's eye E (the position corresponding to the far point obtained by this measurement) from the obtained spherical power and cylindrical power. The main control unit 211 moves the liquid crystal panel 41 to the position corresponding to the far point obtained. In the control unit 210 , the position of the focusing lens 74 and the calculated spherical power are stored in the storage unit 212 . The operation of the ophthalmologic apparatus 1000 proceeds to step S6 in response to an instruction from the main control unit 211 or a user's operation or instruction to the operation unit 280 .

When it is determined that the ring image cannot be acquired, the main control unit 211 considers the possibility of the eye being a highly ametropic eye, and moves the ref measurement light source 61 and the focusing lens 74 to the minus power side (for example, -10D), and move it to the plus power side (for example, +10D). The main control unit 211 controls the ref measurement light-receiving system 7 to detect the ring image at each position. If it is still determined that the ring image cannot be acquired, the main control unit 211 executes predetermined measurement error processing. At this time, the operation of the ophthalmologic apparatus 1000 may proceed to step S6. In the control unit 210, information indicating that the result of the ref measurement was not obtained is stored in the storage unit 212. FIG.

(S6: OCT measurement)
Subsequently, the main control unit 211 starts executing repetitive OCT measurement on the subject's eye E in a state where the same fixation target as in the refractive power measurement in step S5 is presented.

Specifically, the main controller 211 turns on the OCT light source 101 and controls the optical scanner 88 to scan the anterior ocular segment (at least including the crystalline lens) of the subject's eye E with the measurement light LS. Measurement data acquired by scanning with the measurement light LS is sent to the image forming unit 222 and the data processing unit 223 each time.

The image forming unit 222 forms a tomographic image of the anterior segment of the subject's eye E based on the acquired measurement data. The main control unit 211 causes the display unit 270 to display a tomographic image formed each time based on measurement data obtained by repeated OCT measurement.

The data processing unit 223 uses the intraocular parameter specifying unit 2241 to specify the lens thickness as described above based on the acquired measurement data. The main control unit 211 causes the intraocular parameter specifying unit 2241 to specify the lens thickness each time based on measurement data obtained by repeated OCT measurements.

(S7: Identify variation in lens thickness)
The main controller 211 controls the change information identifying unit 2242 to identify temporal changes in the lens thickness sequentially identified in step S6.

(S8: Calculate index)
Subsequently, the main controller 211 causes the accommodative tension index calculator 2251 to calculate the accommodative tension index based on the temporal change in the lens thickness specified in step S7. Similarly, the main control unit 211 causes the received light image analysis unit 2243 to analyze the ring image acquired in step S5, and causes the reliability index calculation unit 2252 to calculate the reliability index. Note that the calculation of the reliability index may be performed in step S5.

In some embodiments, the main controller 211 causes the index corrector 2253 to correct the reliability index based on the adjusted tension index.

(S9: display)
The main control unit 211 causes the display unit 270 to display refractive power measurement information. Specifically, the main control unit 211 outputs the refractive power measurement information including the refractive power value acquired in step S5, the number of refractive power measurements, and the reliability index calculated in step S8 (or step S5). Displayed on the display unit 270 . At this time, the main control unit 211 changes the display mode of the refractive power measurement information according to the accommodative strain index calculated in step S8.

In addition, the main control unit 211 causes the display unit 270 to display information representing temporal changes in intraocular parameters such as the graphs shown in FIGS. 7A to 7D together with the refractive power measurement information. In some embodiments, the main control unit 211 further causes the display unit 270 to display information representing results of frequency analysis with respect to temporal changes in intraocular parameters, such as graphs shown in FIGS. 7A and 7B.

The main control unit 211 displays the refractive power measurement information so that the examiner can determine whether the refractive power value acquired in step S5 is reliable. For example, the main controller 211 corrects the reliability index based on the accommodative tension index, and if it is determined that the refractive power value is unreliable based on the corrected reliability index, the refractive power value or the refractive power Change the display mode of the number of measurements. For example, it can be determined that the optical power value is unreliable when the corrected reliability index is less than a predetermined threshold.

FIG. 9A shows a display example of refractive power measurement information. FIG. 9A shows the refractive power value (spherical power S , astigmatism power C, and astigmatism axis angle A).

In the first example of FIG. 9A, when it is determined that the refractive power value is unreliable based on the reliability index corrected by the index correction unit 2253, the main control unit 211 controls the spherical power shown in parentheses. S, the degree of astigmatism C, and the astigmatism axis angle A are displayed on the display unit 270 (FIG. 9A(1)).

In the second example of FIG. 9A, when it is determined that the refractive power value is unreliable based on the reliability index corrected by the index correction unit 2253, the main control unit 211 controls the refractive power The number of measurements is displayed on the display unit 270 ((2) in FIG. 9A).

In the third example of FIG. 9A, when it is determined that the refractive power value is unreliable based on the reliability index corrected by the index correction unit 2253, the main control unit 211 adjusts the spherical power S, the cylindrical power C, And the incidental information w is added to the astigmatic axis angle A and displayed on the display unit 270 ((3) in FIG. 9A). The incidental information w includes the reliability index corrected by the index correction unit 2253 .

In the fourth example of FIG. 9A, when it is determined that the refractive power value is unreliable based on the reliability index corrected by the index correction unit 2253, the main control unit 211 adds additional information w is displayed on the display unit 270 ((4) in FIG. 9A). As in the third example, the incidental information w includes the reliability index corrected by the index correction unit 2253 .

In the first to fourth examples of FIG. 9A, even if the refractive power value is determined to be reliable based on the reliability index corrected by the index correction unit 2253, the refractive power value or The number of refractive power measurements may be indicated, or supplementary information may be attached.

In some embodiments, the main controller 211 causes the accommodative tension index to be displayed separately from the refractive power value obtained in step S5.

FIG. 9B shows another display example of refractive power measurement information. Similar to FIG. 9A, FIG. 9B shows that the eye to be examined E is the right eye of the subject, and the refractive index when the measurement is the third measurement out of three total measurements. A display example of force values (sphere power S, cylinder power C, cylinder axis angle A) is shown.

In the first example of FIG. 9B, when it is determined that the refractive power value is unreliable based on the reliability index calculated by the reliability index calculation unit 2252, the main control unit 211 outputs Supplementary information w is attached to the spherical power S, the cylinder power C, and the cylinder axis angle A, and displayed on the display unit 270 (FIG. 9B(1)). The incidental information w includes the adjusted strain index calculated by the adjusted strain index calculator 2251 .

In the second example of FIG. 9B, when it is determined that the refractive power value is unreliable based on the reliability index calculated by the reliability index calculator 2252, the main controller 211 outputs The incidental information w is added to the number of refractive power measurements and displayed on the display unit 270 ((2) in FIG. 9B). As in the second example, the incidental information w includes the adjusted strain index calculated by the adjusted strain index calculator 2251 .

In the third example of FIG. 9B, when it is determined that the refractive power value is unreliable based on the reliability index calculated by the reliability index calculation unit 2252, the main control unit 211 calculates the spherical power S, the cylindrical power Supplementary information u and w are added to C and the astigmatic axis angle A and displayed on the display unit 270 ((3) in FIG. 9B). The additional information u includes the reliability index calculated by the reliability index calculator 2252 . The incidental information w includes the adjusted strain index calculated by the adjusted strain index calculator 2251 .

In the fourth example of FIG. 9B, when it is determined that the refractive power value is unreliable based on the reliability index calculated by the reliability index calculator 2252, the main controller 211 adds The information u and w are attached and displayed on the display unit 270 ((4) in FIG. 9B). As in the third example, the additional information u includes the reliability index calculated by the reliability index calculator 2252 . As in the third example, the incidental information w includes the adjusted strain index calculated by the adjusted strain index calculator 2251 .

In addition, in the first to fourth examples of FIG. 9B, even if the refractive power value is determined to be reliable based on the reliability index, the refractive power value or the number of times of refractive power measurement is indicated in parentheses. , additional information may be added.

With this, the operation of the ophthalmologic apparatus 1000 ends (end).

[Modification]
In the above embodiment, a case has been described in which the reliability of the refractive power value is notified based on the calculated accommodative tension index, but the configuration of the ophthalmologic apparatus according to the embodiment is not limited to this. In a modification of the embodiment, the visual angle of the fixation target presented to the subject's eye E is changed based on the calculated accommodative tension index, and the refractive power is remeasured. An ophthalmologic apparatus according to a modification of the embodiment will be described below, focusing on differences from the embodiment.

The configuration of the ophthalmologic apparatus according to the modification of the embodiment is the same as the configuration of the ophthalmologic apparatus 1000 according to the embodiment, and thus the description thereof is omitted.

FIG. 10 shows an example of the operation of the ophthalmologic apparatus according to the modified example of the embodiment. FIG. 10 represents a flow diagram of an operation example of an ophthalmologic apparatus according to a modification of the embodiment. A computer program for realizing the processing shown in FIG. 10 is stored in the storage unit 212 . The main control unit 211 executes the processing shown in FIG. 10 by operating according to this computer program.

10, similar to FIG. 8, the case of calculating the accommodative tension index based on the temporal change in the lens thickness of the eye E to be examined will be described. The same is true when calculating the adjusted tension index based on.

(S11: start presenting fixation target)
When the examiner performs a predetermined operation on the operation unit 280 with the subject's face fixed to the face receiving unit (not shown), the ophthalmologic apparatus moves the subject's eye E, as in step S1. to start presenting a fixation target for reflex measurement.

(S12: Alignment)
When the examiner performs a predetermined operation on the operation unit 280 while the subject's face is fixed to the face receiving unit (not shown), the ophthalmologic apparatus performs alignment in the same manner as in step S2.

(S13: refractive power measurement)
Subsequently, the main control unit 211 performs refractive power measurement in the same manner as in step S3, obtains the temporary spherical power S and the temporary cylindrical power C, and based on the obtained temporary spherical power S and the cylindrical power C, The ref measurement light source 61, the focusing lens 74, and the fixation unit 40 are moved to the equivalent spherical power position.

(S14: clouds)
As in step S4, the main control section 211 further moves the fixation unit 40 to the fog position from the position of the equivalent spherical power specified in step S13.

(S15: refractive power measurement)
As in step S5, the main control unit 211 executes refractive power measurement as the main measurement, and causes the eye refractive power calculation unit 2244 to calculate the spherical power, the cylinder power, and the cylinder axis angle.

(S16: OCT measurement)
Subsequently, similarly to step S6, the main control unit 211 starts executing repetitive OCT measurement on the subject's eye E in a state in which the same fixation target as in the refractive power measurement in step S15 is presented. .

(S17: Identify variation in lens thickness)
The main control unit 211 specifies temporal changes in the lens thickness sequentially specified in step S6 by controlling the change information specifying unit 2242 in the same manner as in step S7.

(S18: Calculate index)
Subsequently, the main controller 211 causes the accommodative tension index calculator 2251 to calculate the accommodative tension index based on the temporal change in the lens thickness identified in step S17, as in step S8. Similarly, the main control unit 211 causes the received light image analysis unit 2243 to analyze the ring image acquired in step S15, and causes the reliability index calculation unit 2252 to calculate the reliability index.

(S19: Overcorrection?)
Next, the main control unit 211 determines whether or not the prescription value generated based on the refractive power value acquired in step S15 is an overcorrection prescription value. For example, the main control unit 211 determines whether or not the prescription value is an overcorrection prescription value based on the adjustment tension index calculated in step S18. Specifically, when it is determined that the subject's eye E has accommodative tension based on the accommodative tension index, the main control unit 211 determines that the prescription value generated based on the refractive power value acquired in step S15 is excessive. It is judged to be a prescription value for correction. For example, when the accommodative strain index is equal to or greater than a predetermined threshold, it can be determined that the subject's eye E is accompanies accommodative strain.

When it is determined that the prescription value generated based on the refractive power value acquired in step S15 is an overcorrection prescription value (S19: Y), the operation of the ophthalmologic apparatus proceeds to step S20. When it is determined that the prescription value generated based on the refractive power value acquired in step S15 is not an overcorrection prescription value (S19: N), the operation of the ophthalmologic apparatus ends (end).

In some embodiments, when it is determined that the prescription value generated based on the refractive power value acquired in step S15 is not an overcorrection prescription value (S19: N), the main control unit 211 performs step The refractive power value acquired in S15 or the prescription value generated based on the refractive power value is displayed on the display unit 270 .

(S20: Visual angle expansion)
In step S19, when it is determined that the prescription value generated based on the acquired refractive power value is an overcorrection prescription value (S19: Y), the main control unit 211 controls the fixation target with a larger visual angle. is displayed on the liquid crystal panel 41, and the visual angle of the fixation target presented to the eye E to be examined is enlarged.

(S21: clouds)
As in step S14, the main controller 211 further moves the fixation unit 40 from the position of the equivalent spherical power specified in step S13 to the fog position.

(S22: refractive power measurement)
As in step S15, the main control unit 211 re-executes the refractive power measurement as the main measurement, and causes the eye refractive power calculation unit 2244 to calculate the spherical power, the cylinder power, and the cylinder axis angle. With the above, the operation of the ophthalmologic apparatus is completed (end).

In some embodiments, step S20 is followed by step S14. As a result, remeasurement of refractive power can be repeated until it is determined that the prescription value generated based on the acquired refractive power value is not an overcorrected prescription value. Note that the operation of the ophthalmologic apparatus may be terminated when the number of times the prescription value is determined to be an overcorrection prescription value is equal to or greater than a predetermined number of times.

[Action/effect]
The actions and effects of the ophthalmologic information processing apparatus, the ophthalmologic apparatus, and the ophthalmologic apparatus control method according to the embodiments will be described.

An ophthalmologic information processing apparatus (400, processing unit 9) according to some embodiments includes an identification unit (change information identification unit 2242) and a calculation unit (accommodative tension index calculation unit 2251). The identifying unit identifies temporal changes in the anterior segment of the eye (E) based on two or more pieces of measurement data obtained by measurements performed at different measurement timings. The calculator calculates an accommodative tension index representing the degree of accommodative tension of the subject's eye based on the temporal change identified by the identification unit.

According to such a configuration, the degree of accommodation tension of the subject's eye can be quantitatively evaluated from the temporal change in the anterior segment. It becomes possible to easily assess the reliability of the refractive power measurements.

In some embodiments, the identifying unit identifies the shape and position of the predetermined site in the anterior segment, or the temporal change in the intraocular distance in the anterior segment, and the calculating unit performs frequency analysis on the temporal change. is calculated based on the amplitude component of the predetermined frequency component obtained by performing the above.

According to such a configuration, it becomes possible to quantitatively evaluate the degree of accommodative tension caused by the tremor of the ciliary muscle, so that the reliability of the measured value of the refractive power of the subject's eye can be improved with higher accuracy. can be evaluated.

The ophthalmologic information processing apparatus according to some embodiments includes a display control unit (control unit 210, main control unit 211) that causes display means (display unit 270) to display information representing the result of frequency analysis.

According to such a configuration, the information representing the result of frequency analysis with respect to temporal change is displayed on the display means, so that the degree of accommodation tension can be visualized and the reliability of the refractive power value of the subject's eye can be judged. be able to assist.

The ophthalmologic information processing apparatus according to some embodiments includes a display control unit (control unit 210, main control unit 211) that causes display means (display unit 270) to display information representing temporal changes.

According to such a configuration, since the display means displays the information representing the temporal change, it is possible to visualize the degree of accommodation tension and assist in determining the reliability of the refractive power value of the subject's eye. become.

The ophthalmologic information processing apparatus according to some embodiments includes a display control unit (control unit 210 , main control unit 211).

According to such a configuration, the display mode of the refractive power measurement information of the subject's eye is changed according to the accommodative strain index and displayed on the display means. Recognize the reliability of force measurements.

In the ophthalmologic information processing apparatus according to some embodiments, the display control unit causes the display means to display the incidental information including the accommodative strain index to the refractive power measurement information.

According to such a configuration, the refractive power measurement information of the eye to be examined is accompanied by the accommodative tension index. will be able to recognize

In the ophthalmologic information processing apparatus according to some embodiments, the refractive power measurement information includes at least one of a refractive power measurement value, the number of refractive power measurements, and a reliability index representing the degree of reliability of the refractive power measurement value. .

According to such a configuration, it is possible to recognize the reliability of the measured value or the reliability index of the refractive power of the subject's eye due to the presence or absence of accommodation tension and the degree of accommodation tension.

The ophthalmologic information processing apparatus according to some embodiments includes a reliability index correction unit (index correction unit 2253) that corrects a reliability index indicating the degree of reliability of the refractive power measurement value of the eye to be examined based on the accommodative tension index. and the display control section causes the display means to display refractive power measurement information including the refractive power measurement value and the reliability index corrected by the reliability index correction section.

According to this configuration, the reliability index is corrected based on the accommodation tension index, and the refractive power measurement information including the corrected reliability index is displayed on the display unit together with the refractive power measurement value. It is possible to easily recognize the reliability of the measured value of the refractive power of the subject's eye due to the presence or absence of tension and the degree of accommodation tension.

In the ophthalmic information processing apparatus according to some embodiments, the anterior segment includes at least one of the lens, the ciliary muscle, and the zonules.

According to such a configuration, it is possible to specify the degree of accommodation tension with high accuracy, and the reliability of the measured value of the refractive power of the eye to be examined due to the presence or absence of accommodation tension and the degree of accommodation tension is increased. Accuracy can be improved.

An ophthalmic device (1000) according to some embodiments comprises an OCT optical system (8, OCT optical system 320) for performing optical coherence tomography on an anterior eye segment, and an ophthalmic information processing system according to any of the above. and a device, wherein the specifying unit specifies the temporal change based on two or more pieces of measurement data acquired at mutually different measurement timings by the OCT optical system.

According to such a configuration, since it is possible to specify the temporal change of the anterior segment with high accuracy by OCT measurement, it is possible to determine the refractive power of the subject's eye due to the presence or absence of accommodation tension and the degree of accommodation tension. It becomes possible to improve the reliability of the measured value with much higher accuracy.

An ophthalmologic apparatus according to some embodiments includes a fixation projection system (4) that projects a fixation target onto an eye to be inspected, and a refractive power measurement optical system that irradiates the eye to be inspected with light and detects light returned from the eye to be inspected. system (reflex measurement projection system 6 and reflex measurement light receiving system 7), and an eye refractive power calculator (2244 ), a reliability index calculation unit (2252) that calculates a reliability index based on the detection result of the return light, and the ophthalmologic information processing apparatus described above.

According to such a configuration, it is possible to improve the reliability of the refractive power measurement value obtained by the refractive power measurement optical system based on the degree of accommodation tension specified based on the temporal change of the anterior segment. It becomes possible to provide an ophthalmic apparatus capable of

In the ophthalmologic apparatus according to some embodiments, the fixation projection system selectively presents a plurality of fixation targets having mutually different visual angles to the subject's eye, and presents the fixation targets to the subject's eye according to the accommodative tension index. and a control unit (210, main control unit 211) for controlling the fixation projection system to switch between .

According to such a configuration, it becomes easy to acquire a refractive power measurement value in a state in which it is determined that the eye to be inspected is not accompanies with accommodative strain. becomes easier.

An ophthalmologic apparatus according to some embodiments includes an OCT optical system (8, OCT optical system 320) that performs optical coherence tomography on an anterior eye segment, and the identifying unit uses the OCT optical system to perform different measurement timings. A temporal change is identified based on the two or more pieces of measurement data acquired in .

According to such a configuration, the refractive power measurement optical system and the OCT optical system are provided, and the refractive power obtained by the refractive power measurement optical system is based on the degree of accommodation tension specified using the OCT optical system. It is possible to provide an ophthalmologic apparatus capable of improving the reliability of measured values.

In some embodiments of the ophthalmic device, the anterior segment includes at least one of the lens, the ciliary muscle, and the zonules.

According to such a configuration, it is possible to specify the degree of accommodation tension with high accuracy, and the reliability of the measured value of the refractive power of the eye to be examined due to the presence or absence of accommodation tension and the degree of accommodation tension is increased. Accuracy can be improved.

An ophthalmologic information processing method according to some embodiments calculates the time of the anterior segment of an eye (E) based on two or more pieces of measurement data obtained by measurements performed at different measurement timings. and a calculating step of calculating an accommodative tension index representing the degree of accommodative tension of the subject's eye based on the temporal change identified in the identifying step.

According to this method, the degree of accommodation tension in the subject's eye can be quantitatively evaluated from temporal changes in the anterior segment. It becomes possible to easily assess the reliability of the refractive power measurements.

In the ophthalmologic information processing method according to some embodiments, the identifying step identifies the shape and position of the predetermined site in the anterior segment, or the temporal change in the intraocular distance in the anterior segment, and the calculating step temporally The accommodation tension index is calculated based on the amplitude component of the predetermined frequency component obtained by performing frequency analysis on the change.

According to such a method, it becomes possible to quantitatively evaluate the degree of accommodative tone caused by the tremor of the ciliary muscle, so that the reliability of the measured value of the refractive power of the subject's eye can be improved with higher accuracy. can be evaluated.

An ophthalmologic information processing method according to some embodiments includes a display control step of displaying, on display means (display unit 270), refractive power measurement information of an eye to be examined whose display mode has been changed according to the accommodative strain index.

According to this method, the display mode of the refractive power measurement information of the subject's eye is changed according to the accommodative strain index and displayed on the display means. Recognize the reliability of force measurements.

In the ophthalmic information processing method according to some embodiments, the anterior segment includes at least one of the lens, the ciliary muscle, and the zonules.

According to such a method, it is possible to specify the degree of accommodation strain with high accuracy, and the reliability of the measured value of the refractive power of the eye to be examined due to the presence or absence of accommodation strain and the degree of accommodation strain can be increased. Accuracy can be improved.

<Others>
The embodiment shown above is merely an example for carrying out the present invention. A person who intends to implement this invention can make arbitrary modifications, omissions, additions, etc. within the scope of the gist of this invention.

In the above embodiments, the case of specifying temporal changes in the anterior segment using measurement results obtained by OCT measurement has been described. is not limited to this. In some embodiments, an MRI (Magnet Resonance Imaging) method, an ultrasonic method, a slit lamp microscope, or an ophthalmologic apparatus equipped with an optical system that applies the Scheimpflug principle is used to measure temporal changes in the anterior segment of the eye. identified.

In some embodiments, temporal changes in the posterior segment of the subject's eye E (eg, temporal changes in axial length) are used to improve the reliability of the refractive power measurements as needed.

In some embodiments, OCT measurements and refractive power measurements are performed simultaneously. For example, refractive power measurement information obtained by refractive power measurement and information based on temporal changes in the anterior segment obtained by OCT measurement performed simultaneously with the refractive power measurement (accommodative tension index, graph, etc.) It is displayed on the display unit 270 at the same time. In some embodiments, information based on temporal changes in the refractive power information (such as a graph representing temporal changes in the refractive power information) is combined with the refractive power information and the anterior ocular time obtained from the OCT measurement. It is displayed on the display unit 270 together with at least one of the information (accommodative tension index, graph, etc.) based on the target change.

1 Z alignment system 2 XY alignment system 3 Keratometry system 4 Fixation projection system 5 Anterior eye observation system 6 Reflector measurement projection system 7 Reflector measurement light receiving system 8, 320 OCT optical system 9 Processing unit 210 Control unit 211 Main control unit 223 Data processing unit 224 Analysis unit 2241 Intraocular parameter identification unit 2242 Change information identification unit 2243 Received image analysis unit 2244 Eye refractive power calculation unit 225 Index calculation unit 2251 Accommodative tension index calculation unit 2252 Reliability index calculation unit 2253 Index correction unit 300 Examination Optical system 310 Refractive power measurement optical system 400 Ophthalmic information processing apparatus 1000 Ophthalmic apparatus

Claims (16)

an identifying unit that identifies temporal changes in the anterior segment of the subject's eye based on two or more pieces of measurement data obtained by measurements performed at different measurement timings;
a calculator that calculates an accommodative tension index representing the degree of accommodative tension of the subject eye based on the temporal change identified by the identification unit;
a display control unit for displaying, on a display means, the refractive power measurement information of the eye to be inspected, the display mode of which is changed according to the accommodative strain index;
an ophthalmic information processing apparatus including; The identifying unit identifies the shape and position of a predetermined site in the anterior segment, or the temporal change in the intraocular distance in the anterior segment,
The ophthalmology according to claim 1, wherein the calculation unit calculates the accommodative tension index based on an amplitude component of a predetermined frequency component obtained by performing frequency analysis on the temporal change. Information processing equipment. 3. The ophthalmologic information processing apparatus according to claim 2, further comprising a display control unit that causes a display unit to display information representing the result of the frequency analysis. 3. The ophthalmologic information processing apparatus according to claim 1, further comprising a display control unit that causes a display unit to display information representing the temporal change. 5. The display control unit according to any one of claims 1 to 4 , wherein the refractive power measurement information is attached with incidental information including the accommodative tension index and displayed on the display means. Ophthalmic information processing device. The refractive power measurement information includes at least one of a refractive power measurement value, the number of refractive power measurements, and a reliability index representing a degree of reliability of the refractive power measurement value. 6. The ophthalmologic information processing apparatus according to any one of 5 . a reliability index correction unit that corrects a reliability index indicating the degree of reliability of the refractive power measurement value of the subject eye based on the accommodative tension index;
The display control section causes the display means to display the refractive power measurement information including the refractive power measurement value and the reliability index corrected by the reliability index correction section. 7. The ophthalmologic information processing apparatus according to any one of items 6 . The ophthalmologic information processing apparatus according to any one of claims 1 to 7, wherein the anterior segment includes at least one of a lens, a ciliary muscle, and a zonules. an OCT optical system for performing optical coherence tomography on the anterior segment;
The ophthalmologic information processing apparatus according to any one of claims 1 to 8 ,
including
The ophthalmologic apparatus, wherein the specifying unit specifies the temporal change based on two or more pieces of measurement data acquired at mutually different measurement timings by the OCT optical system. a fixation projection system that projects a fixation target onto the eye to be examined;
a refractive power measurement optical system for irradiating the eye to be inspected with light and detecting light returned from the eye to be inspected;
an eye refractive power calculation unit that calculates a refractive power measurement value of the eye to be examined based on the detection result of the returned light obtained by the refractive power measurement optical system;
a reliability index calculator that calculates the reliability index based on the detection result of the returned light;
an ophthalmologic information processing apparatus according to claim 6 or claim 7 ;
An ophthalmic device comprising: The fixation projection system selectively presents a plurality of fixation targets having different visual angles to the subject's eye,
11. The ophthalmologic apparatus according to claim 10, further comprising a control unit that controls the fixation projection system so as to switch the fixation target presented to the eye according to the accommodation tension index. OCT optics for performing optical coherence tomography on the anterior segment;
The ophthalmology according to claim 10 or 11, wherein the specifying unit specifies the temporal change based on two or more pieces of measurement data acquired at mutually different measurement timings by the OCT optical system. Device. The ophthalmic apparatus according to any one of claims 10 to 12, wherein the anterior segment includes at least one of a crystalline lens, a ciliary muscle, and a zonules. a specifying step of specifying a temporal change in the anterior segment of the subject's eye based on two or more pieces of measurement data obtained by measurements performed at different measurement timings;
a calculating step of calculating an accommodative tension index representing the degree of accommodative tension of the subject eye based on the temporal change identified in the identifying step;
a display control step of displaying, on a display means, the refractive power measurement information of the eye to be inspected, the display mode of which has been changed according to the accommodative strain index;
ophthalmic information processing method comprising: The identifying step identifies the shape and position of a predetermined site in the anterior segment, or the temporal change in the intraocular distance in the anterior segment,
15. The ophthalmologist according to claim 14, wherein the calculating step calculates the accommodative tension index based on an amplitude component of a predetermined frequency component obtained by performing frequency analysis on the temporal change. Information processing methods. The ophthalmologic information processing method according to claim 14 or 15, wherein the anterior segment includes at least one of a crystalline lens, ciliary muscle, and zonules.

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