The present invention relates to a tonometer, and in particular to a non contact eyeball vibration type tonometer.
As disclosed in, for example, U.S. Pat. No. 3,585,849, in a prior art device for measuring intraocular pressure, a method is employed of blowing air against the subject eyeball, and detecting the resulting concavity of the subject eyeball optically.
Furthermore, in U.S. Pat. No. 5,148,807 and in publication WO03/082087, tonometers are disclosed that do not blow air against the subject eyeball, but instead vibrate it with sound.
With the method of blowing air against the subject eyeball disclosed in U.S. Pat. No. 3,585,849, there are adverse effects due to this blowing of air, such as discomfort, blinking, possible infection, and so on. And with the method disclosed in U.S. Pat. No. 5,148,807, while there is no requirement for blowing of air against the eyeball, a loud sound is required for vibrating the subject eyeball. And with the method disclosed in WO03/082087, although a cup is used for enhancing the sound pressure, some background sound diffuses out to the surroundings; and furthermore this can hardly be termed a non-contact type method.
In consideration of the circumstances described above, the object of the present invention is to provide a tonometer that can measure the intraocular pressure in a non-contact manner, without blowing air against the subject eyeball, and without generating audio at a volume so great as to cause discomfort to the subject and also to surrounding persons.
As a result of extensive study by the present inventors, the present invention has been formulated as follows:
According to the present invention, it is possible to generate sufficient sound pressure for measurement in the vicinity of the front surface of the subject eye; and moreover, since the volume of any sound reaching the subject or surrounding persons is extremely small, accordingly it is possible to vibrate the subject eye without imparting any feeling of discomfort. In concrete terms, since, according to the present invention, the eyeball is caused to vibrate by this eyeball vibration type tonometer, the characteristic frequency of the eyeball is obtained, and from this characteristic frequency the intraocular pressure, which is the pressure internal to the eyeball, is detected, accordingly it is possible to perform measurement of the intraocular pressure at high accuracy and in a less invasive and less disturbing manner, and prior art risks that were attendant upon blowing air at the eyeball are eliminated, such as discomfort to the subject, splashing around of tears (such splashing can cause hospital-acquired infection), poor eyelid opening in elderly persons (which can reduce data reliability), and so on. Furthermore, since vibration is applied only in the immediate vicinity of the subject eye and almost no vibration is applied around the eye, accordingly there is the advantageous aspect that the influence of vibration in the surroundings of the eye is very small, so that it is possible to detect the vibration of the subject eye with good accuracy.
The present invention will now be explained while referring to the drawings as appropriate. However, the present invention is not limited to the mode of implementation shown in these figures. The reference symbols in the drawings have the following meanings:
10: spherical surface
11: center
20: ultrasound generating element
21, 31, 41: subject eyes
30, 40: parametric speakers
32: ultrasound sensor
33, 44: ultrasound waves
34: vibration data
42: light source
43: light detector
45, 46: light beams
The non contact eyeball vibration type tonometer (hereinafter sometimes simply termed a “tonometer”) of the present invention employs a parametric speaker. A parametric speaker is a speaker that generates low frequency sound pressure by amplitude modulating a signal that drives one or more ultrasound generating elements at low frequency, due to non-linearity generated by the ultrasound. It is possible to obtain very sharp directivity with the use of ultrasound. For the details of the concrete structures and modes of operation of parametric speakers themselves, reference may be made to appropriate prior art documentation in the speaker field.
Typically, a parametric speaker is built from a plurality of ultrasound generating elements arranged in a predetermined configuration. Desirably, these ultrasound generating elements are made to be capable of generating ultrasound signals of 30 to 100 kHz modulated at a frequency of 5 to 100 Hz. The modulation described above is more desirably in the range of 10 to 100 Hz, and yet more desirably is in any appropriate range within the range of 10 to 100 Hz, providing that the characteristic frequency of the subject eyeball is covered by this range. The ultrasound signal is desirably in the range of from 30 to 50 kHz, and more desirably is in any appropriate range within the range of 30 to 100 kHz. Yet more desirably, the ultrasound generating elements are adapted so that the above frequency of modulation can be swept over time. According to the theory of parametric speakers, each of the ultrasound generating elements is driven at an ultrasound frequency such as that described above by way of example, and modulation is performed upon its driving wave at a frequency such as that described above by way of example. With regard to the generation of audible sound (i.e. audible sound waves) for the present invention by a parametric speaker, it should be understood that such audible sound could be generated by beat sound due to a frequency difference. In more concrete terms, in order to generate low frequency sound pressure, the group of generating elements may be divided into two subgroups, and a frequency difference may be set up between the drive frequency for one subgroup and the drive frequency for the other subgroup, so that sound pressure at low frequency is generated by the beats generated by this frequency difference. Or it would also be possible to generate low frequency sound (i.e. sound waves) by exploiting the non-linearity that occurs when vibrations become sound.
Desirably, the plurality of ultrasound generating elements are arranged upon a spherical surface that is focused upon the front surface of the subject eye.
While, in the preferred embodiment described above, the ultrasound generating elements 20 are arranged upon a spherical surface, as another preferred embodiment, it may also be suggested to dispose the ultrasound generating elements upon a plane, and to increase the sound pressure in the vicinity of the subject eyeball by adjusting the phases of the driving waveforms for the various generating elements by phase shifting these driving waveforms according to the distances of the elements from the center element.
With the tonometer of the present invention, due to the use of a parametric speaker, when the signals that drive the ultrasound generating elements are amplitude modulated at low frequency, due to the non-linearity generated by the sound, sound pressure is generated at low frequency (i.e. sound waves), but the sound pressure near the focus is further increased due to this low frequency sound pressure. And, by arranging the ultrasound generating elements in an appropriate configuration as described above, it is possible further to increase the directivity of the sound emitted, and thus to increase the sound pressure just in the neighborhood of the front surface of the subject eye. When vibrating the subject eye with this low frequency sound pressure, it is possible to generate sound waves only at the front surface of the subject eye, and neither the subject nor the people around the subject can hear this sound, so that it is possible to vibrate the subject eye without causing any feeling of discomfort to anybody. The subject eye has a characteristic frequency based upon causes such as its intraocular pressure and so on, and experiences vibration in response to the sound wave signal that it receives. Accordingly, a detection device that detects vibration data related to the subject eye is incorporated in the tonometer of the present invention as an essential structural element.
As described above, the method of detecting the vibration data for the subject eye is not particularly limited; an ultrasonic detection technique or an optical detection technique or the like may be employed, as appropriate.
The intraocular pressure of the subject eye is calculated from the vibration data for the subject eye that has been detected as described above. The tonometer of the present invention includes a processing device that calculates the intraocular pressure of the subject eye from the detected vibration data for the subject eye. Fundamentally, this calculation of the intraocular pressure is processing that obtains the characteristic frequency of the eyeball of the subject eye from the vibration data that has been obtained as described above, and that derives the intraocular pressure, which is the internal pressure of the eyeball, from this characteristic frequency.
For correction of individual differences, it would also be possible to build the tonometer of the present invention so that it becomes possible to make data linkage with OCT, pachymeter, and/or ocular axis length measurement.
According to the present invention, it is possible to perform measurement in a perfectly non-contact manner without worrying about the noise being heard by the subject or the person doing the measurement or the like; the influence of vibration in the vicinity of the subject eye is minimized; it is possible to detect data relating to vibration of the subject eye at high accuracy; and accordingly it may be anticipated that intraocular pressure measurement can become simpler and more efficient.