The invention relates to an ophthalmic examination apparatus and a method of forming an alignment between an eye and an ophthalmic examination apparatus.
A typical problem with ophthalmic instruments is how to align the instrument with patient's eye. The problem is particularly difficult with examination instruments which examine optically portions of an eye behind the iris, for example such as fundus cameras, where a wrong alignment may lead to dim and/or vignetted images and/or spurious reflections. Challenges in alignment are caused by a person whose eye is examined, eye movements of the person and from the fact that in many cases there is no precise enough way to know if the ophthalmic instrument is correctly aligned or not with respect to the eye that is examined.
Hence, an improvement to the alignment would be welcome.
The present invention seeks to provide an improvement in the measurements.
The invention is defined by the independent claims. Embodiments are defined in the dependent claims.
Example embodiments of the present invention are described below, by way of example only, with reference to the accompanying drawings, in which
The following embodiments are only examples. Although the specification may refer to “an” embodiment in several locations, this does not necessarily mean that each such reference is to the same embodiment(s), or that the feature only applies to a single embodiment. Single features of different embodiments may also be combined to provide other embodiments. Furthermore, words “comprising” and “including” should be understood as not limiting the described embodiments to consist of only those features that have been mentioned and such embodiments may also contain features/structures that have not been specifically mentioned. All combinations of the embodiments are considered possible if their combination does not lead to structural or logical contradiction.
It should be noted that while Figures illustrate various embodiments, they are simplified diagrams that only show some structures and/or functional entities. The connections shown in the Figures may refer to logical or physical connections. It is apparent to a person skilled in the art that the described apparatus may also comprise other functions and structures than those described in Figures and text. It should be appreciated that details of some functions, structures, and the signalling used for measurement and/or controlling are irrelevant to the actual invention. Therefore, they need not be discussed in more detail here.
In
Eye alignment means that the eye 120 has been oriented and positioned to match certain values or ranges of these coordinates. The targeted alignment accuracy for each dimension depends on the ophthalmic examination apparatus 100 and the use case.
The eye 120 contains a retina and approximately circular iris aperture, whose diameter may vary from a few millimeters up to 10 mm, typically between 3 and 8 mm, a crystalline lens and the cornea 116.
Sufficient horizontal and vertical alignments (yaw and pitch) may be arranged such that the ophthalmic examination apparatus 100 generates a fixation target in the person's field-of-view, and the person is instructed to aim his/her eyes to the fixation target. The fixation target may be arranged such that it guides the eye to a proper yaw and pitch angularly.
Proper rotational alignment (roll) may be achieved by the help of the set-up how the person is positioned in respect to the ophthalmic examination apparatus 100 as a whole. For example, if the person is standing or sitting, the roll-angle of the eye may be known with sufficient accuracy and ophthalmic examination apparatus 100 can be aligned accordingly. For further adjusting the roll-angle, the ophthalmic examination apparatus 100 may also generate a target figure in the person's field-of-view, and the person is instructed to rotate his/her head such that the target figure is in a certain rotation. In many ophthalmic examination apparatuses 100, such as fundus cameras, the accurate alignment of roll is not needed but a rough roll alignment is enough.
For achieving a proper spatial xyz-alignment, the ophthalmic examination apparatus 100 generates at least two beams 104, 104′ which reflect from the cornea. The reflected beams may then be captured by one or more sensors in the ophthalmic examination apparatus 100. The visibility of the beams in those sensors, and the positions of the reflected beams on the detecting surface 114, may be used to compute needed corrective alignment movements.
The calculated alignment instructions can be given to the person whose eye is examined, and he/she can then correct the eye alignment. Or, the instructions may be given to an operator of the ophthalmic examination apparatus 100, who can correct the alignment. Or, an automated alignment mechanism can use the calculated instructions for performing an alignment between the ophthalmic examination apparatus 100 and the eye automatically.
These arrangements are now described in more detail below.
In an embodiment, a cross sectional area of a beam 104, 104′ at or adjacent to the waist W, a normal of the cross section being parallel to propagation of the beam, may be in a range from about 1 mm2 to about 8 mm2, for example (waist W can be seen in
The eye 120 is at an examination location 118 with respect to the imaging unit 110 when the waist W of the envelope 105 is located at least partly inside a pupil 122 of the eye 120 or when the cornea 116 is located within the alignment range AR at about the waist W. In an embodiment, the waist W may be or may be meant to be fully inside the pupil 122 of the eye 120. The ophthalmic examination apparatus 100 naturally has the examination location 118 within the alignment range AR. The examination location 118 can be understood to be a location where the eye examination and/or achieved results of the eye examination lead/leads to an expected resolution, is/are within expected limits and quality can be considered normal and/or at least satisfactory. The examination location 118 has a narrow range which can be considered a tolerance within which the examination of eye 120 can be performed normally and properly.
The imaging unit 110 receives reflections of the beams 104, 104′ of light from a cornea 116 of the eye 120, when the eye 120 is within the alignment range AR. The measures and design of the ophthalmic examination apparatus 100 are based on a principle that the eye 120 is assumed to be at least to a certain extent similar to a standard eye within standard tolerances of the standard eye.
The standard eye may be based on an Emsley model, Emsley-Gullstrand model, or Liou and Brennan schematic eye model, for example. The eye model may be similar to an anatomical and optical eye. It may have a power of about 60.4 D and an axial length of about 24 mm for example. The eye model may estimate aberrations in a visible range of light. In an embodiment, the eye model may have variation depending on a size of a person 160 that is examined, sex and age especially when it is a question of a child, for example. That is, the eye model may be selected based on anatomical and/or optical information on the person 160 to be examined.
A user interface 128 of the ophthalmic examination apparatus 100 presents, directly or indirectly, a person 160, whose eye 120 is examined, and/or an operator guidance information on a location of the eye 120 with respect to the examination location 118 based on locations of the reflections of the beams 104, 104′ of light on a detecting surface 114 of the imaging unit 110. The guidance information may be an image how spots of light are distributed on a detecting surface 114 of the imaging unit 110 (see
A processing unit 126 of the ophthalmic examination apparatus 100 may provide, directly or indirectly, the person 160, whose eye 120 is examined, and/or the operator with the guidance information on a location of the eye 120 with respect to the examination location 118 based on locations of the reflections of the beams 104, 104′ of light on the detecting surface 114 of the imaging unit 110. This information may be more processed than mere information in the form of an image of the spots 400 on the detecting surface 114 and may include symbols of a writing system such as alphabets, kanji-signs and/or numbers. The operator may be a human being or a machine. The machine may be an artificial intelligence machine, for example. The information may include arrows, colors, lines, dots, circles, any combination of these, or the like, for example.
In an embodiment, the processing unit 126 forms the guidance information based on the locations of the reflections of the beams 104, 104′ with respect to each other. In an embodiment, the processing unit 126 forms the guidance information based on a distance between the locations of the reflections of the beams 104, 104′. In an embodiment, a first reflection of one of the beams 104, 104′ is detected with a first detecting surface element and a second reflection of the another of the beams 104, 104′ is detected with a second detecting surface element, a distance between the first detecting surface element and the second detecting surface element being known and/or determined, and the processing unit 126 forms the guidance information based on the locations of the reflections of the beams 104, 104′ on the first and second detecting surface elements and the distance between the first and second detecting surface elements.
In general, the alignment light generator 102 comprises at least one light source 102′. The at least one light source 102′ may output near-infrared light such that the wavelength range distracts the person whose eye 102 is examined less than if the light contained mostly visible light. In an embodiment, a dominating wavelength band may be from about 700 to about 1100 nm, for example. In an embodiment, a dominating wavelength band may be from about 750 to about 970 nm, for example. The at least one light source 102′ may comprise one or more light emitting diodes (LED), organic light emitting diodes (OLED), one or more incandescent light sources, and/or one or more lasers, and/or any kind of light source capable of emitting light at least partially in the desired wavelength range. The at least one light source 102′ may comprise a filter for band-pass filtering a desired wavelength band.
After the beam splitter 106 in a direction of propagation from the alignment light generator 102 toward the eye 120, the beams 104, 104′ of light may be pass through at least one objective lens 310. The at least one objective lens 310 may be common to the alignment light generator 102 and the imaging unit 110 like in the example of
The at least one objective lens 310 may cause an envelope 105 of the beams 104, 104′ of light to converge to and diverge from the waist W. In this manner, the beams 104, 104′ of light approach each other and the optical axis OA. However, the beams 104, 104′ of light do not necessarily intersect each other. In an embodiment, at least two of the beams 104, 104′ of light intersect each other and/or the optical axis OA. This convergence can be caused together with the at least one initial lens 150 and the objective lens 310 in this example. Alternatively particularly in an embodiment when the alignment light generator 102 and the imaging unit 110 may have separate objective lenses, the convergence may be caused alone by the at least initial lens 150, at least one image forming optical component 300 or by a light manipulation arrangement 254, which is not image forming (see
The at least one image forming optical component 300 may comprise one of more optically refractive and/or reflective components which may form a real image or a virtual image. The one of more optically refractive and/or reflective components may comprise at least one lens and/or mirror, which has a curved surface.
Any of the at least one objective lens 310 may be an image forming lens, for example. Alternatively or additionally to the at least one objective lens 310, the alignment light generator 102 may comprise at least one mirror. Any of the at least one mirror may be an image forming mirror, for example.
The imaging unit 110 may comprise one of more optically refractive and/or reflective components which may form a real image or a virtual image. The one of more optically refractive and/or reflective components may comprise at least one lens and/or mirror, which has a curved surface.
When the distance between the eye 120 and the ophthalmic examination apparatus 100 is too short for a proper examination, the beam 104 and its reflection 104RN (Reflection Near) from the cornea 116 are almost parallel in this example.
When the distance between the eye 120 and the ophthalmic examination apparatus 100 is correct for a proper examination, the reflection 104RC (Reflection Correct) of the beam 104 from the cornea 116 is almost parallel to the optical axis OA in this example.
When the distance between the eye 120 and the ophthalmic examination apparatus 100 is too long for a proper examination, the reflection 104RC (Reflection Far) of the beam 104 from the cornea 116 deviates strongly from the beam 104 and the optical axis OA.
It can also be seen in
When the reflections of the beams 104, 104′ of light seem to propagate through the image 112 of the aperture stop 108 of the imaging unit 110, the reflected beams also may pass the aperture stop 1080 of the imaging unit 110.
When the reflection of the beam 104 is directed in different directions as a function of a distance between the eye 120 and the ophthalmic examination apparatus 100 or at least the imaging unit 110, the different directions translate into different positions on the detecting surface 114 which is illustrated in
When the eye 120 is too near the ophthalmic examination apparatus 100 at the location Z0=−2.8 mm, the reflections 104RN, 104′RN of the beams 104, 104′ are close to the optical axis OA.
When the eye 120 is too far from the ophthalmic examination apparatus 100 at the location Z2=+3.2 mm, the reflections 104RF, 104′RF of the beams 104, 104′ are close to the extremes of the field-of-view FOV and hit close to the edges of the detecting surface 114.
Now referring to
All of these conditions apply simultaneously.
In
Note that the depicted arrangement may also have the following properties:
The ophthalmic examination apparatus 100 can thus guide the eye 120 toward the examination location when the eye 120 is far too far (Z4=+12 mm) from the ophthalmic examination apparatus 100 at first as illustrated in
In an embodiment, the alignment light generator 102 may generate two sets of the beams 104, 104′ which are configured to operate in different alignment range AR. The first set of the beams 104, 104′ may be configured as described in
In an embodiment the alignment light generator 102 may generate the beams 104, 104′ which are used to obtain eye alignment information, and in addition to that, the examination apparatus 100 comprises a camera which is used to capture video from the iris of the eye 120 during the alignment. The video may then be used to give additional eye alignment information. The camera system may be configured to give a rough position of the eye 120 in larger alignment range AR than the beams 104, 104′, whereas the beams 104, 104′ may be used to obtain more accurate eye positioning information closer to the examination location 118.
In an embodiment, an example of which is shown in
In an embodiment, the alignment light generator 102 may direct the beams 104, 104′ of light, which are parallel in a second plane a normal of which is perpendicular to an optical axis OA of the imaging unit 110 to the cornea 116 so that the lines along the beams reflected from the cornea 116 pass through the image 112 of the aperture stop 108 of the imaging unit 110 when the eye 120 is located in the alignment range AR, the normal of the first plane and the normal of the second plane being non-parallel.
In an embodiment, the alignment light generator 102 may direct the beams 104, 104′ of light, which are parallel in a first plane, a normal of which is perpendicular to an optical axis of the eye 120, which is aligned in the examination location 118, to the cornea 116 so that the lines that are virtual continuations of the beams reflected from the cornea 116 pass through an image 112 of the aperture stop 108 of the imaging unit 110 when the eye 120 is located in the alignment range AR.
In an embodiment an example of which is illustrated in
In an embodiment, the imaging unit 110 may cause at least one change of the direction of the reflections of the beams 104, 104′ of light on the detecting surface 114 (see
In an embodiment, the imaging unit 110 may cause the at least one change of the locations of the reflections of the beams 104, 104′ of light on the detecting surface 114 in response to the movement of the eye 120 between opposite limits of the alignment range AR in a direction parallel to the optical axis OA of the imaging unit 110.
In an embodiment, the alignment light generator 102 may output at least two beams 104, 104′ of light and direct the at least two beams 104, 104′ in a non-symmetrical manner, and the processing unit 126 of the ophthalmic examination apparatus 100 may compute a position of the eye 120 three-dimensionally with respect to the examination location 118 and a curvature of the cornea 116 of the eye 120.
In an embodiment, the ophthalmic examination apparatus 100 comprises three or more beams 104, 104′ for computing a position of the eye 120 and the curvature of the cornea 116 of the eye 120. The three or more beams 104, 104′ may be used to compute a gradient of a surface of the cornea 116.
In an embodiment, the processing unit 126 of the ophthalmic examination apparatus 100 may compute a distance of the eye 120 from the examination location 118 in a direction parallel to the optical axis OA of the imaging unit 110.
In an embodiment on example of which is illustrated in
In some embodiments of
When the at least one image forming optical component 300 is used, the image of the imaging plane IP may be in focus or it may be out-of-focus on the retina 116 when the examination is performed within the alignment range AR and/or at the examination location 118. Similarly, the image of the source plane SP may be in focus or it may be out-of-focus on the cornea 116. The image forming component 300 may comprise at least one lens or at least one image forming mirror, for example. The at least one image forming component 300 may refract the beams 104, 104′ such that their envelope 105 converges to and diverge from the waist W, which is within an alignment range AR at a distance from the ophthalmic examination apparatus 100, where the distance may be known. The optical axis OAE of the eye 120 and the optical axis OA of the imaging unit 110 may be at least approximately aligned when the eye 120 is at the examination location 118 with respect to the ophthalmic examination apparatus 100.
In an embodiment, the ophthalmic examination apparatus 100 may capture a still image and/or a video of the eye 120 with the imaging unit 110. The still image and/or the video may be captured from the retina, cornea, crystalline lens or the like, for example.
In an embodiment, the ophthalmic examination apparatus 100 comprises a separate examination unit 110′, which may capture a still image or a video of the eye 120 in a similar manner to the imaging unit 110.
Now the operation of the alignment method is described by using simplified mathematical description. The mathematical formulation contains several approximations of different parameters and relations, which however must not be interpreted as limitations, but need to be understood as simplifications for clarity of the description.
A ray, which may represent a ray in a beam 104, 104′ (for example, a central ray of a beam 104, 104′), propagating in a positive direction with respect to the z-axis of the EFC, may be defined in the EFC by:
r=r
0
+t*r
d,
where r0 is a point vector, rd is a direction vector, and t is a real number. Here, the vector r0 points from a center of the cornea 116 or a pupil of the eye 120 to a point at a propagation path of light of a beam or a ray from the ophthalmic examination apparatus 100. The vector rd, in turn, points to the direction of the propagation of light of the beam or the ray of the beam.
If the ray gets reflected from cornea 116, the resulting ray may be expressed similarly by:
r′=r
0
′+t*r′
d,
where r′0, may be a point vector at ray intersection point with cornea 116, for example.
The intersection point [xj; yj; zj] of the ray r with any plane P parallel to xy-plane can be expressed as:
x
j
=k
x
z
j
+b
x
y
j
=k
y
z
j
+b
y (1)
where kx=rd(1)/rd(3) and ky=rd(2)/rd(3) and b, and by are x- and y-coordinates of the intersection points of the ray with the xy-plane of the EFC.
The ophthalmic examination apparatus 100 comprises the imaging unit 110, and a sensor with the detecting surface 114. For simplifying the following exemplary mathematical description, assume that the imaging unit 110 and the detecting surface 114 are arranged in an approximately conoscopic arrangement. In such an arrangement, a position of a ray/beam 104, 104′ on the detecting surface 114 can be defined by the direction of the ray/beam 104, 104′ only before the imaging unit 110; this can simply be achieved by set-up where the detecting surface 114 is positioned at the focal plane of the imaging unit 110, for example. Assume further that a ray r′ reflected from the cornea 116 is captured by the imaging unit 110 and guided to the detecting surface 114. The position of the ray on the detecting surface 114 depends approximately only from rd but not from r′0.
For simplicity of the following mathematical description, assume a relatively narrow beam 104, 104′ which may be represented by its central ray r, and assume that a shape of the cornea 116 may be approximated to be spherical. However, note that these approximations are not necessary for the operation of the alignment described in this document.
In the CCS, the cornea sag can be expressed by equation z=rc−√{square root over (rc2−x2−y2)}, where rc is a cornea radius of the curvature (approximately 7.8 mm with emmetropic eye. i.e. a standard eye), and x and y are coordinates in CCS along x- and y-axis.
From this it is possible express the cornea surface angle along the x-axis as:
and along y as
where A(rc)>0 is a coefficient which depends on the cornea radius rc.
For simplicity, it is possible to approximate that the ray intersection point with the cornea 116 is at the ray intersection point with the xy-plane going through a cornea apex, i.e. the ray r intersects the cornea 116 at a point [xj; yj; zj] in the EFC, where xj=xc+xi, yj=yc+yi and zj=zc+zi, where [xi; yi; zi] is the intersection point in the CCS.
Now, it is possible to approximate the x- and y-components of a direction vector of a ray or the beam 104, 104′ reflected from the cornea 116 to be
r′
d(1)=−rd(1)+A(rc)xi,
and
r′
d(2)=−rd(2)+A(rc)yi.
It is possible to define the coordinate system, at the sensor such that the coordinate values of the ray or the beam 104, 104′ on the detecting surface 114 are approximately the same as the x- and y-components of its direction vector rd in the EFC multiplicated by a scaling factor K, i.e.:
from which, after combining with Equation (1) it is possible to deduce the following two equations:
This pair of equations (2) can be used to solve a cornea position [xc; yc; zc] from positions of the beams 104, 104′ on the detecting surface 114 [sx; sy] by different ways.
The equation pair (2) has 11 variables, five of which are potentially known properties of the instrument (kx, ky, bx, by, K), one is property of the eye 120 (A(rc)), and the rest five are properties of alignment and vary during the eye alignment (xc, yc, zc, sx, sy). The variables sx and sy are coordinates of the locations of the beams 104, 104′ reflected from the cornea 116 on the detecting surface 114 and are always known when the beams 104, 104′ hit the detecting surface 114.
The values for the properties (kx, ky, bx, by, K) of the ophthalmic examination apparatus 100 may be known by calibration of the ophthalmic examination apparatus 100. It has also been found out that the curvature of the cornea 116 may vary considerable between patients. Therefore when accurate alignment is needed, either the effect of A(rc) needs to be eliminated from the process, or it needs to be solved with sufficient accuracy during the alignment process.
Since there are altogether four unknown variables (A(rc), xc, yc and zc), four linearly independent equations needs to be written. This can be done by using two reflected rays 104, 104′ from the cornea 116 such that for each location of the beams 104, 104′ on the detecting surface 114 the equation (2) is written. This can be presented using the following group of equations below:
where notations 1 and 2 represent different beams 104, 104′ (kx,1 is x-angle component of ray 1 and kx,2 is a corresponding component for ray 2). Here each kx, ky, bx and by and by may be determined and the positions of the beams 104, 104′ on the detection surface 114 sx and sy may be measured before this equation group is solved. Equations may be rewritten in the matrix form:
Here the matrix in the left side contains only measured parameters, and the unknown variables xc, yc, zc and
can De solved oy operating me equations with the inverse matrix of the A in the following manner:
Note that this requires that the matrix A must have an inverse matrix and thus a determinate of the matrix A may not be zero, which can easily be avoided by a proper selection of the coordinate system.
In an embodiment, two substantially yz-symmetric alignment beams 104, 104′ may be used, and they may intersect each other at the cornea 116 when cornea the is at the examining location 118.
Referring to the central rays of the two beams 104, 104′ with sub-indices 1 and 2, in the case of Equation (2), the following approximations may be formed and found valid:
It is also possible to form the following four equations:
Equations (A2) and (A4) are identical so there is infinite amount of solutions. However, if the distance D between the locations on detection surface 114 are measured in the x-direction, it is possible to get the x-distance between the locations of the beams 104, 104′ from equations (A1) and (A3):
D=s
x,1
−s
x,2=2Kkx(1−A(rc)zc) (13)
from which it is possible to solve
As the EFC origin is set to the beams 104, 104′ intersection points at the cornea 116 when the eye 120 is at the examination location 118, the variable zc becomes approximately the distance of the eye 120 along the z-axis from the examination location 118, which is positive or negative depending on which side of the examination position the eye 120 is.
The variable zc has the following properties:
In this manner, alignment instructions may be given by the x-distance between the locations of the reflections 1, 2 of the beams 104, 104′ on the detecting surface 114.
From the equations A1)-A4) it is possible to see that when zc approaches zero (then cornea 116 approaches examination location 116), the xc and yc coordinates (x- and y-positions of the cornea 116) are linear functions of the locations of the reflections of the beams 104, 104′ in the x- and y-coordinates on the detecting surface 114 (sx,1, sx,2, sy) in the following manner:
which means that a position of the eye 120 is correct in
In step 1802, an envelope 105 of the beams 104, 104′ of light is caused to converge to and diverge from a waist W, which is within an alignment range AR of the ophthalmic examination apparatus 100, an eye 120 being at an examination location 118 with respect to the imaging unit 110 in response to a waist W of the envelope 105 being located at least partly inside a pupil 122 of the eye 120, the ophthalmic examination apparatus 100 having the examination location 118 within the alignment range AR. The cornea 116 being within the alignment range AR with respect to the waist W.
In step 1804, receiving 1804, reflections of the beams 104, 104′ of light are received with the imaging unit 110 from a cornea 116 of the eye 120 when the eye 120 similar to a standard eye within standard tolerances is within the alignment range AR.
In step 1806, guidance information based on the locations of the reflections of the beams 104, 104′ of light on the detecting surface 114 of the imaging unit 110 is presented by a user interface 128 of the ophthalmic examination apparatus 100.
In step 1808, which is optional, a processing unit 126 of the ophthalmic examination apparatus 100 provides with the guidance information based on the locations of the reflections of the beams 104, 104′ of light on the detecting surface 114 of the imaging unit 110.
The method and its step 1808 shown in
The computer program may be distributed using a distribution medium which may be any medium readable by the controller. The medium may be a program storage medium, a memory, a software distribution package, or a compressed software package. In some cases, the distribution may be performed using at least one of the following: a near field communication signal, a short distance signal, and a telecommunications signal.
What is taught in this document results in an improved alignment between the eye that is examined and an ophthalmic examination apparatus with potentially the following advantages:
It will be obvious to a person skilled in the art that, as technology advances, the inventive concept can be implemented in various ways. The invention and its embodiments are not limited to the example embodiments described above but may vary within the scope of the claims.
Number | Date | Country | Kind |
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20206350 | Dec 2020 | FI | national |
Filing Document | Filing Date | Country | Kind |
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PCT/FI2021/050887 | 12/16/2021 | WO |