WO2008003807A1 - Method for the in vivo measurement of the alignment of the optical components of the eye and device for implementing same - Google Patents
Method for the in vivo measurement of the alignment of the optical components of the eye and device for implementing same Download PDFInfo
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- WO2008003807A1 WO2008003807A1 PCT/ES2007/000393 ES2007000393W WO2008003807A1 WO 2008003807 A1 WO2008003807 A1 WO 2008003807A1 ES 2007000393 W ES2007000393 W ES 2007000393W WO 2008003807 A1 WO2008003807 A1 WO 2008003807A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
- A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
- A61B3/113—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for determining or recording eye movement
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
- A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
- A61B3/1005—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for measuring distances inside the eye, e.g. thickness of the cornea
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
- A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
- A61B3/117—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for examining the anterior chamber or the anterior chamber angle, e.g. gonioscopes
- A61B3/1173—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for examining the anterior chamber or the anterior chamber angle, e.g. gonioscopes for examining the eye lens
Definitions
- the present invention relates to a method that has been specially designed to measure the alignment of the optical components of the human eye, such as the overall rotation of the eye, the lens / lens offset with respect to the pupil and the inclination of the lens / lens with respect to the pupillary axis.
- the device is also valid for studies on the optics of the eye in normal subjects, as well as in patients with various pathologies.
- the invention is in the field of ophthalmology and visual optics.
- Purkinje images are mainly used to study the alignment of implanted lenses in pseudophakic eyes (cornea and intraocular lens).
- a system of three linear equations that relate the displacements of the Purkinje images with the variables of ocular rotation and offset and inclination of the lens or lens was proposed.
- Several authors have previously analyzed and built systems based on this method. This procedure requires the a priori determination of nine coefficients that represent the variation in position of each of the Purkinje images (the reflection in the cornea and the two reflections coming from the two faces of the lens) with the causes that cause its displacement (global eye rotation and lens offset and tilt). This calculation is usually made from various eye models.
- Guyton et al (1990) proposed an alternative method that consisted of finding the position of superposition of the ocular reflexes coming from the lens or lens.
- a simple hand lamp was used that moved in front of the patient's pupil while it was fixed on the examiner's finger.
- the angular separation between the position of the light and that of the finger when the reflections were aligned provided the value of inclination of the lens, while the distance from the point of superposition to the center of the pupil was an approximation of the offset value of the lens. lens.
- This method was a first clinical approach to problem, but ignored various physiological characteristics of the human eye and is too over-simplified to obtain accurate results.
- the eye itself already constitutes a non-axial offset system, due to the position of the fovea, with a temporal tendency with respect to the approximate optical axis. Therefore, the inclination with respect to the visual axis that Guyton et al measured, already included an intrinsic and systematic value of the eye and that did not correspond to a poor surgical positioning, but to a large extent, to the physiology of the eye itself.
- the method and device for measuring the alignment of the optical components of the human eye that the invention proposes solves in a fully satisfactory manner the above-mentioned problem, allowing to measure in a robust, complete and physiologically correct manner the characteristics of the eye alignment.
- the method is that the patient, with the head properly stabilized and immobilized, the eye be illuminated by a light source, either polarized or natural coherent laser light, incoherent lighting, by object extensive or point, of any wavelength or polychromaty, while it looks towards a reference point, so that through a camera the Purkinje images (PI, PIII and PFV) reflected in the patient's eye are recorded, for different known angular positions and preset between the reference point and the source of illumination with respect to the patient's eye.
- a light source either polarized or natural coherent laser light, incoherent lighting, by object extensive or point, of any wavelength or polychromaty
- the distance from the overlap point to the entrance pupil provides the desired lens / lens offset value.
- the value of the lens inclination is calculated through the values of the angular position in which the Purkinje PIII and PFV images are superimposed, the lens / lens offset value and the kappa angle.
- a device constituted from a base, preferably mobile, in which a chin guard is provided for the stabilization of the patient's head, and in front of it a camera to record the images that are formed by reflection in the cornea and on the two faces of the lens, which will be analyzed later using the method described.
- the device is complemented by a light source, which is arranged so that the light emitted by it falls on the patient's eye, and at least one reference point for fixing the patient's sight, the device having been provided have means to vary the relative angular position between the fixation point and the light source with respect to the patient's eye, relative position that is known at all times, and by which different images of Purkinje are obtained.
- said position will be variable by including several fixing points of the view of the client whose angles are previously fixed, such as luminous warning lights that are turned on sequentially as the different ones are taken simultaneously images with the aforementioned camera, although the device could incorporate a single luminous indicator equipped with means to regulate its position, or it could be the source of illumination that has a system for mobilization while the patient remains staring at one point, without affecting the essentiality of the invention.
- Figure 1 shows a perspective view of a device for live measurement of the alignment of the optical components of the human eye by the proposed method, performed in accordance with the object of the present invention.
- Figure 2. Shows an outline of the eye with the axes with respect to which the alignment of the various ocular surfaces is described.
- Figure 3. It shows a series of images taken throughout the procedure, corresponding to a subject with an implanted intraocular lens, and from which it is possible to determine the parameters of global rotation of the eye, lens offset with respect to the pupil and the inclination of the lens with respect to the pupillary axis.
- the method proposed by the invention is part of the immobilization and stabilization of the patient's head, which is used then to illuminate the eye (1) object of study by means of a light source (2) which, as already mentioned above, can be polarized or natural coherent laser light, incoherent illumination, by extensive or specific object, of any length of wave or polychromaty, so that during said lighting the patient keeps his gaze fixed at a fixation point (3), while simultaneously and by means of a camera (4) facing said eye (1) the reflections produced by said light source (2) are captured on the eye, reflexes known as images of Purkinje I (5), III (6) and IV (7).
- a light source (2) which, as already mentioned above, can be polarized or natural coherent laser light, incoherent illumination, by extensive or specific object, of any length of wave or polychromaty, so that during said lighting the patient keeps his gaze fixed at a fixation point (3), while simultaneously and by means of a camera (4) facing said eye (1) the reflections produced by said light source (2) are captured on the eye, reflexes known
- the said process is repeated for different known and pre-established angular positions between the reference point (3) and the light source (2) with respect to the patient's eye, preferably in a number of nine.
- the captured images (8) for the different relative angles between the fixation point (3) and the light source it is calculated by interpolation or extrapolation, depending on the pathology of the patient, the angular position at which the images are superimposed Purkinje PIII (6) and PIV (7) or reflections that come from the lens, locating the optical axis (9) of the infraocular or crystalline lens.
- the distance from the overlap point to the entrance pupil provides the desired lens / lens offset value.
- the physiological angle (10) that the eye is rotated due to the non-axial position of the fovea (11) is calculated from the misalignment between the corneal reflex or image of Purkinje PI (5) and the center of the pupil.
- the value of the inclination of the lens is determined through the values of the angular position in which the Purkinje PIII (6) and PIV (J) images are superimposed, the lens / lens offset value and the physiological angle (10) that the eye is rotated.
- a device consisting of a table or base (12), preferably movable, is provided at one end of which incorporates a chin guard (13) for the stabilization of the patient's head, so that in front of it there is a camera (4), preferably equipped with a telecentric lens (14), on whose periphery there is a light source (2) materialized in a semicircular matrix of infrared light diodes (15), so that these are aligned with the end of the telecentric objective (14) through which the ocular reflections produced by said source are recorded.
- the base (12) there is also a printed circuit board (16) on which nine LED light-emitting diodes that correspond to the different fixing points (3) are established, which are turned on sequentially so that the patient is fix them while the camera (4) captures the different images (8) corresponding to different relative angles between the projected light and the main line of the gaze (17), angles that have previously been predetermined.
- the patient fixes his gaze on the different fixation points (3) through a beam splitter (18) and a mirror (19), although it is possible to perform this operation with other optical elements.
- the device instead of incorporating a printed circuit board (16) with multiple fixing points (3), the device only incorporates a single fixing point provided with means for regulation of its position, or that it is the source of illumination (2) that has a system for its mobilization while the patient remains staring at one point.
Abstract
The invention relates to a method for the in vivo measurement of the alignment of the optical components of the eye and to a device for implementing same. According to the inventive method, a light source (1) is used to illuminate the patient's eye while the head is maintained duly stable and the patient looks towards a fixed point (3), such that a camera (4-14) records the Purkinje images (PI, PIII and PIV) reflected in the eye for different pre-established known angular positions. The angular position in which the PIII and PIV Purkinje images overlap is then calculated using the images obtained and interpolation and extrapolation, thereby locating the optical axis of the intraocular lens. The distance from the point of overlap to the entrance pupil provides the offsetting value of the desired lens. Next, the physiological angle by which the eye is rotated is calculated from the misalignment between the PI Purkinje image and the centre of the pupil. Finally, the value of the inclination of the lens is calculated using the values of the angular position in whcih the PIII and PIV images overlap, the offsetting value of the lens and the kappa angle.
Description
PROCEDIMIENTO PARA LA MEDIDA EN VIVO DEL PROCEDURE FOR LIVE MEASUREMENT OF
ALINEAMIENTO DE LOS COMPONENTES ÓPTICOS DEL OTO YALIGNMENT OF THE OPTICAL COMPONENTS OF THE OTO AND
DISPOSITIVO PARA LA PUESTA EN PRÁCTICA DEL MISMODEVICE FOR PUTTING INTO THE SAME
D E S C R I P C I Ó ND E S C R I P C I Ó N
OBJETO DE LA INVENCIÓNOBJECT OF THE INVENTION
La presente invención se refiere a un procedimiento que ha sido especialmente concebido para medir el alineamiento de las componentes ópticas del ojo humano, tales como la rotación global del ojo, el descentramiento de la lente/ cristalino con respecto a la pupila y la inclinación de la lente/ cristalino con respecto al eje pupilar.The present invention relates to a method that has been specially designed to measure the alignment of the optical components of the human eye, such as the overall rotation of the eye, the lens / lens offset with respect to the pupil and the inclination of the lens / lens with respect to the pupillary axis.
Es asimismo objeto de la invención proporcionar un dispositivo que permita realizar el seguimiento de pacientes implantados con lentes intraoculares así como permitir la detección precoz de estrabismos o desviaciones anómalas de la mirada. El dispositivo es asimismo válido para la realización de estudios sobre la óptica del ojo en sujetos normales, así como en pacientes con diversas patologías.It is also the object of the invention to provide a device that allows monitoring of implanted patients with intraocular lenses as well as allowing the early detection of strabismus or abnormal deviations of the gaze. The device is also valid for studies on the optics of the eye in normal subjects, as well as in patients with various pathologies.
Así pues, la invención se sitúa en el ámbito de la oftalmología y la óptica visual.Thus, the invention is in the field of ophthalmology and visual optics.
ANTECEDENTES DE LA INVENCIÓNBACKGROUND OF THE INVENTION
Desde los primeros tiempos de la óptica visual, a finales del siglo XIX, los reflejos en las superficies oculares, también conocidos
como imágenes de Purkinje, han sido la principal fuente de información para el estudio de la óptica ocular (radios de curvatura, teorías de la acomodación, alineamiento de la óptica, etc.).From the earliest times of visual optics, at the end of the 19th century, reflections on ocular surfaces, also known as Purkinje images, they have been the main source of information for the study of ocular optics (radii of curvature, theories of accommodation, alignment of optics, etc.).
En la actualidad las imágenes de Purkinje se utilizan principalmente para el estudio del alineamiento de las lentes implantadas en los ojos pseudofáquicos (córnea y lente intraocular). En este contexto, se propuso un sistema de tres ecuaciones lineales que relacionan los desplazamientos de las imágenes de Purkinje con las variables de rotación ocular y descentramiento e inclinación de la lente o cristalino. Diversos autores han analizado y construido previamente sistemas basados en este método. Este procedimiento requiere la determinación a priori de nueve coeficientes que representan la variación en posición de cada una de las imágenes de Purkinje (el reflejo en la cornea y los dos reflejos provenientes de las dos caras de la lente) con las causas que producen su desplazamiento (rotación ocular global y descentramiento e inclinación de la lente). Este cálculo se suele realizar a partir de diversos modelos de ojo.Currently, Purkinje images are mainly used to study the alignment of implanted lenses in pseudophakic eyes (cornea and intraocular lens). In this context, a system of three linear equations that relate the displacements of the Purkinje images with the variables of ocular rotation and offset and inclination of the lens or lens was proposed. Several authors have previously analyzed and built systems based on this method. This procedure requires the a priori determination of nine coefficients that represent the variation in position of each of the Purkinje images (the reflection in the cornea and the two reflections coming from the two faces of the lens) with the causes that cause its displacement (global eye rotation and lens offset and tilt). This calculation is usually made from various eye models.
Con el objeto de obtener una mejor implementación clínicaIn order to obtain a better clinical implementation
Guyton et al (1990) propusieron un método alternativo que consistía en encontrar la posición de superposición de los reflejos oculares provenientes de la lente o cristalino. Para generar los reflejos se usaba una sencilla lámpara de mano que se movía frente a la pupila del paciente mientras este fijaba en el dedo del examinador. La separación angular entre la posición de la luz y la del dedo cuando los reflejos estaban alineados proporcionaba el valor de inclinación de la lente, mientras que la distancia desde el punto de superposición al centro de la pupila era una aproximación del valor del descentramiento de la lente. Este método supuso una primera aproximación clínica al
problema, pero ignoraba diversas características fisiológicas del ojo humano y resulta demasiado sobre-simplificado para obtener resultados precisos. El ojo de por sí ya constituye un sistema descentrado no axial, debido a la posición de la fóvea, con tendencia temporal con respecto al eje óptico aproximado. Por tanto, la inclinación respecto al eje visual que Guyton et al medía, incluía ya un valor intrínseco y sistemático del ojo y que no se correspondía con un mal posicionamiento quirúrgico, sino en gran medida, a la propia fisiología del ojo.Guyton et al (1990) proposed an alternative method that consisted of finding the position of superposition of the ocular reflexes coming from the lens or lens. To generate the reflexes a simple hand lamp was used that moved in front of the patient's pupil while it was fixed on the examiner's finger. The angular separation between the position of the light and that of the finger when the reflections were aligned provided the value of inclination of the lens, while the distance from the point of superposition to the center of the pupil was an approximation of the offset value of the lens. lens. This method was a first clinical approach to problem, but ignored various physiological characteristics of the human eye and is too over-simplified to obtain accurate results. The eye itself already constitutes a non-axial offset system, due to the position of the fovea, with a temporal tendency with respect to the approximate optical axis. Therefore, the inclination with respect to the visual axis that Guyton et al measured, already included an intrinsic and systematic value of the eye and that did not correspond to a poor surgical positioning, but to a large extent, to the physiology of the eye itself.
Es también importante destacar que recientes investigaciones sobre las propiedades ópticas de la cornea y del ojo en conjunto han resultado en nuevos diseños de lentes intraoculares con superficies asféricas. El beneficio óptico a alcanzar con estos implantes depende en gran medida del grado de alineamiento que se obtenga tras la cirugía.It is also important to note that recent research on the optical properties of the cornea and the eye as a whole has resulted in new designs of intraocular lenses with aspherical surfaces. The optical benefit to be achieved with these implants depends largely on the degree of alignment that is obtained after surgery.
DESCRIPCIÓN DE LA INVENCIÓNDESCRIPTION OF THE INVENTION
El método y dispositivo para la medida del alineamiento de los componentes ópticos del ojo humano que la invención propone resuelve de forma plenamente satisfactoria la problemática anteriormente expuesta, permitiendo medir de una manera robusta, completa y fisiológicamente correcta las características del alineamiento ocular.The method and device for measuring the alignment of the optical components of the human eye that the invention proposes solves in a fully satisfactory manner the above-mentioned problem, allowing to measure in a robust, complete and physiologically correct manner the characteristics of the eye alignment.
Para ello, y de forma más concreta, el método consiste en que al paciente, con la cabeza debidamente estabilizada e inmovilizada, se le ilumine el ojo mediante una fuente de luz, ya sea luz láser coherente polarizada o natural, iluminación incoherente, por objeto extenso o
puntual, de cualquier longitud de onda o policromatía, mientras éste mira hacia un punto de referencia, de manera que mediante una cámara se graban las imágenes de Purkinje (PI, PIII y PFV) reflejadas en el ojo del paciente, para diferentes posiciones angulares conocidas y preestablecidas entre el punto de referencia y la fuente de iluminación respecto del ojo del paciente.To do this, and more specifically, the method is that the patient, with the head properly stabilized and immobilized, the eye be illuminated by a light source, either polarized or natural coherent laser light, incoherent lighting, by object extensive or point, of any wavelength or polychromaty, while it looks towards a reference point, so that through a camera the Purkinje images (PI, PIII and PFV) reflected in the patient's eye are recorded, for different known angular positions and preset between the reference point and the source of illumination with respect to the patient's eye.
A partir de las imágenes tomadas para los diferentes ángulos y por interpolación o extrapolación, en función de la patología del paciente, se calcula la posición angular en la que se superponen las imágenes de Purkinje PIII y PFV o reflejos que provienen del cristalino, localizando el eje óptico de la lente intraocular o cristalino.From the images taken for the different angles and by interpolation or extrapolation, depending on the patient's pathology, the angular position in which the Purkinje PIII and PFV images or reflections that come from the lens are calculated, locating the lens optical axis of the intraocular or crystalline lens.
La distancia del punto de solapamiento a la pupila de entrada proporciona el valor de descentramiento de la lente/ cristalino buscada.The distance from the overlap point to the entrance pupil provides the desired lens / lens offset value.
Seguidamente se calcula el ángulo fisiológico que el ojo está rotado debido a la posición no axial de la fóvea a partir del desalineamiento entre el reflejo corneal o imagen de Purkinje PI y el centro de la pupila, ángulo que en la literatura de la óptica se denomina ángulo kappa.Next, the physiological angle that the eye is rotated due to the non-axial position of the fovea is calculated from the misalignment between the corneal reflex or image of Purkinje PI and the center of the pupil, an angle that in the optics literature is called Kappa angle
Por último se calcula el valor de la inclinación de la lente a través de los valores de la posición angular en la que se superponen las imágenes de Purkinje PIII y PFV, el valor de descentramiento de la lente/ cristalino y el ángulo kappa.Finally, the value of the lens inclination is calculated through the values of the angular position in which the Purkinje PIII and PFV images are superimposed, the lens / lens offset value and the kappa angle.
Para llevar a cabo el procedimiento que se acaba de describir, se ha previsto la utilización de un dispositivo constituido a partir de una base, preferentemente móvil, en la que se dispone una mentonera para
para la estabilización de la cabeza del paciente, y frente a ésta una cámara para grabar las imágenes que se forman por reflexión en la córnea y en las dos caras del cristalino, las cuales serán analizadas con posterioridad mediante el método descrito.In order to carry out the procedure just described, the use of a device constituted from a base, preferably mobile, in which a chin guard is provided for for the stabilization of the patient's head, and in front of it a camera to record the images that are formed by reflection in the cornea and on the two faces of the lens, which will be analyzed later using the method described.
El dispositivo se complementa con una fuente de luz, la cual se dispone para que la luz emitida por la misma incida sobre el ojo del paciente, y al menos un punto de referencia para la fijación de la vista del paciente, habiéndose previsto que el dispositivo cuente con medios para variar la posición angular relativa entre el punto de fijación y la fuente de luz con respecto al ojo del paciente, posición relativa que en todo momento es conocida, y mediante la cual se obtienen diferentes imágenes de Purkinje.The device is complemented by a light source, which is arranged so that the light emitted by it falls on the patient's eye, and at least one reference point for fixing the patient's sight, the device having been provided have means to vary the relative angular position between the fixation point and the light source with respect to the patient's eye, relative position that is known at all times, and by which different images of Purkinje are obtained.
De forma más concreta, se ha previsto que dicha posición sea variable mediante la inclusión de varios puntos de fijación de la vista del cliente cuyos ángulos están previamente fijados, tales como testigos luminosos que se van encendiendo secuencialmente según se van tomando de forma simultánea las diferentes imágenes con la citada cámara, si bien el dispositivo podría incorporar un único testigo luminoso dotado de medios de regulación de su posición, o bien ser la fuente de iluminación la que disponga de un sistema para su movilización mientras el paciente permanece con la mirada fija en un punto, sin que ello afecte a la esencialidad de la invención.More specifically, it is envisaged that said position will be variable by including several fixing points of the view of the client whose angles are previously fixed, such as luminous warning lights that are turned on sequentially as the different ones are taken simultaneously images with the aforementioned camera, although the device could incorporate a single luminous indicator equipped with means to regulate its position, or it could be the source of illumination that has a system for mobilization while the patient remains staring at one point, without affecting the essentiality of the invention.
Por último se ha previsto que en sustitución de la fuente de iluminación dotada de medios para su movilización se dispongan múltiples fuentes de iluminación fijas convenientemente distribuidas en diferentes posiciones preestablecidas respecto del ojo del paciente.
DESCRIPCIÓN DE LOS DIBUJOSFinally, it has been foreseen that in replacement of the lighting source provided with means for its mobilization, multiple fixed lighting sources are conveniently distributed in different pre-established positions with respect to the patient's eye. DESCRIPTION OF THE DRAWINGS
Para complementar la descripción que se está realizando y con objeto de ayudar a una mejor comprensión de las características del invento, de acuerdo con un ejemplo preferente de realización práctica del mismo, se acompaña como parte integrante de dicha descripción, un juego de dibujos en donde con carácter ilustrativo y no limitativo, se ha representado lo siguiente:To complement the description that is being made and in order to help a better understanding of the characteristics of the invention, according to a preferred example of practical implementation thereof, a set of drawings is attached as an integral part of said description. In an illustrative and non-limiting manner, the following has been represented:
La figura 1.- Muestra una vista en perspectiva de un dispositivo para la medida en vivo del alineamiento de los componentes ópticos del ojo humano mediante el método propuesto, realizado de acuerdo con el objeto de la presente invención.Figure 1 shows a perspective view of a device for live measurement of the alignment of the optical components of the human eye by the proposed method, performed in accordance with the object of the present invention.
La figura 2.- Muestra un esquema del ojo con los ejes respecto de los cuales se describe el alineamiento de las diversas superficies oculares.Figure 2.- Shows an outline of the eye with the axes with respect to which the alignment of the various ocular surfaces is described.
La figura 3.- Muestra una serie de imágenes tomadas a lo largo del procedimiento, correspondientes a un sujeto con una lente intraocular implantada, y a partir de las cuales es posible determinar los parámetros de rotación global del ojo, descentramiento de la lente con respecto a la pupila y la inclinación de la lente con respecto al eje pupilar.Figure 3.- It shows a series of images taken throughout the procedure, corresponding to a subject with an implanted intraocular lens, and from which it is possible to determine the parameters of global rotation of the eye, lens offset with respect to the pupil and the inclination of the lens with respect to the pupillary axis.
REALIZACIÓN PREFERENTE DE LA INVENCIÓNPREFERRED EMBODIMENT OF THE INVENTION
A la vista de las figuras reseñadas puede observarse como el método que la invención propone parte de la inmovilización y estabilización de la cabeza del paciente, al cual se procede
seguidamente a iluminar el ojo (1) objeto de estudio mediante una fuente de luz (2) que, como ya se ha dicho con anterioridad puede ser luz láser coherente polarizada o natural, iluminación incoherente, por objeto extenso o puntual, de cualquier longitud de onda o policromatía, de manera que durante dicha iluminación el paciente mantenga su mirada fija en un punto de fijación (3), a la vez que, de forma simultánea y mediante el concurso de una cámara (4) enfrentada a dicho ojo (1) se capturen los reflejos producidos por dicha fuente de luz (2) sobre el ojo, reflejos conocidos como imágenes de Purkinje I (5), III (6) y IV (7).In view of the figures outlined, it can be seen how the method proposed by the invention is part of the immobilization and stabilization of the patient's head, which is used then to illuminate the eye (1) object of study by means of a light source (2) which, as already mentioned above, can be polarized or natural coherent laser light, incoherent illumination, by extensive or specific object, of any length of wave or polychromaty, so that during said lighting the patient keeps his gaze fixed at a fixation point (3), while simultaneously and by means of a camera (4) facing said eye (1) the reflections produced by said light source (2) are captured on the eye, reflexes known as images of Purkinje I (5), III (6) and IV (7).
El citado proceso se repite para diferentes posiciones angulares conocidas y preestablecidas entre el punto de referencia (3) y la fuente de iluminación (2) respecto del ojo del paciente, preferentemente en un número de nueve.The said process is repeated for different known and pre-established angular positions between the reference point (3) and the light source (2) with respect to the patient's eye, preferably in a number of nine.
Mediante las imágenes capturadas (8) para los diferentes ángulos relativos entre el punto de fijación (3) y la fuente de iluminación se calcula por interpolación o extrapolación, en función de la patología del paciente, la posición angular en la que se superponen las imágenes de Purkinje PIII (6) y PIV (7) o reflejos que provienen del cristalino, localizando el eje óptico (9) de la lente infraocular o cristalino.Using the captured images (8) for the different relative angles between the fixation point (3) and the light source, it is calculated by interpolation or extrapolation, depending on the pathology of the patient, the angular position at which the images are superimposed Purkinje PIII (6) and PIV (7) or reflections that come from the lens, locating the optical axis (9) of the infraocular or crystalline lens.
La distancia del punto de solapamiento a la pupila de entrada proporciona el valor de descentramiento de la lente/ cristalino buscada.The distance from the overlap point to the entrance pupil provides the desired lens / lens offset value.
A continuación se calcula el ángulo fisiológico (10) que el ojo está rotado debido a la posición no axial de la fóvea (11) a partir del desalineamiento entre el reflejo corneal o imagen de Purkinje PI (5) y el centro de la pupila.
Finalmente el valor de la inclinación de la lente se determina a través de los valores de la posición angular en la que se superponen las imágenes de Purkinje PIII (6) y PIV (J), el valor de descentramiento de la lente/ cristalino y el ángulo fisiológico (10) que el ojo está rotado.Next, the physiological angle (10) that the eye is rotated due to the non-axial position of the fovea (11) is calculated from the misalignment between the corneal reflex or image of Purkinje PI (5) and the center of the pupil. Finally, the value of the inclination of the lens is determined through the values of the angular position in which the Purkinje PIII (6) and PIV (J) images are superimposed, the lens / lens offset value and the physiological angle (10) that the eye is rotated.
Para la puesta en práctica del procedimiento se ha previsto un dispositivo constituido a partir de una mesa o base (12), preferentemente móvil, en uno de cuyos extremos incorpora una mentonera (13) para la estabilización de la cabeza del paciente, de manera que frente a ésta se disponen una cámara (4), preferentemente dotada de un objetivo telecéntrico (14), sobre cuya periferia se dispone una fuente de iluminación (2) materializada en una matriz semicircular de diodos (15) de luz infrarroja, de manera que éstos se encuentran alineados con el extremo del objetivo telecéntrico (14) a través de los que se graban los reflejos oculares producidos por dicha fuente.For the implementation of the procedure, a device consisting of a table or base (12), preferably movable, is provided at one end of which incorporates a chin guard (13) for the stabilization of the patient's head, so that in front of it there is a camera (4), preferably equipped with a telecentric lens (14), on whose periphery there is a light source (2) materialized in a semicircular matrix of infrared light diodes (15), so that these are aligned with the end of the telecentric objective (14) through which the ocular reflections produced by said source are recorded.
Esta disposición semicircular permite una rápida y unívoca identificación de la cuarta imagen de Purkinje (7) al estar esta invertida con respecto a las demás.This semicircular arrangement allows a quick and unique identification of the fourth image of Purkinje (7) as it is inverted with respect to the others.
Sobre la base (12) se dispone asimismo una placa de circuito impreso (16) sobre la que se establecen nueve diodos led luminosos que se corresponden con los diferentes puntos de fijación (3), los cuales se van encendiendo secuencialmente para que el paciente se fije en ellos mientras la cámara (4) captura las diferentes imágenes (8) correspondientes a diferentes ángulos relativos entre la luz proyectada y la línea principal de la mirada (17), ángulos que previamente han sido predeterminados.
El paciente fija su mirada en los distintos puntos de fijación (3) a través de un divisor de haz (18) y un espejo (19), si bien es posible realizar esta operación con otros elementos ópticos.On the base (12) there is also a printed circuit board (16) on which nine LED light-emitting diodes that correspond to the different fixing points (3) are established, which are turned on sequentially so that the patient is fix them while the camera (4) captures the different images (8) corresponding to different relative angles between the projected light and the main line of the gaze (17), angles that have previously been predetermined. The patient fixes his gaze on the different fixation points (3) through a beam splitter (18) and a mirror (19), although it is possible to perform this operation with other optical elements.
En un segundo ejemplo de realización práctica de la invención se ha previsto que en vez de incorporar una placa de circuito impreso (16) con múltiples puntos de fijación (3), el dispositivo únicamente incorpore un único punto de fijación dotado de medios para la regulación de su posición, o bien que sea la fuente de iluminación (2) la que disponga de un sistema para su movilización mientras el paciente permanece con la mirada fija en un punto.In a second example of practical embodiment of the invention it is provided that instead of incorporating a printed circuit board (16) with multiple fixing points (3), the device only incorporates a single fixing point provided with means for regulation of its position, or that it is the source of illumination (2) that has a system for its mobilization while the patient remains staring at one point.
Por último se ha previsto una última solución equivalente, en la que únicamente se dispone de un punto de fijación, incorporando múltiples fuentes de iluminación fijas convenientemente distribuidas en diferentes posiciones preestablecidas respecto del ojo del paciente.
Finally, a final equivalent solution is provided, in which only one fixing point is available, incorporating multiple fixed lighting sources conveniently distributed in different preset positions with respect to the patient's eye.
Claims
R E I V I N D I C A C I O N E SR E I V I N D I C A C I O N E S
Ia.- Procedimiento para la medida en vivo del alineamiento de los componentes ópticos del ojo humano, tales como la rotación global del ojo, el descentramiento de la lente/ cristalino con respecto a la pupila y la inclinación de la lente/ cristalino con respecto al eje pupilar caracterizado porque comprende las siguientes fases operativas:I a .- Procedure for live measurement of the alignment of the optical components of the human eye, such as the overall rotation of the eye, the lens / lens offset with respect to the pupil and the lens / lens inclination with respect to to the pupillary axis characterized in that it comprises the following operational phases:
- Estabilizar la cabeza del paciente.- Stabilize the patient's head.
- Iluminar el ojo mediante una fuente de luz (2), ya sea luz láser coherente polarizada o natural, iluminación incoherente, por objeto extenso o puntual, de cualquier longitud de onda o policromatía, mientras éste mira hacia un punto de referencia, de manera que mediante una cámara (4-14) se graban las imágenes que se forman por reflexión en la córnea y en las dos caras del cristalino, (imágenes de Purkinje PI (5), PIII (6) y- Illuminate the eye by means of a light source (2), whether it is a polarized or natural coherent laser light, incoherent illumination, by extensive or specific object, of any wavelength or polychromaty, while it looks towards a reference point, so that through a camera (4-14) the images that are formed by reflection in the cornea and on both sides of the lens are recorded, (images of Purkinje PI (5), PIII (6) and
PW(T)), para diferentes posiciones angulares conocidas y preestablecidas entre el punto de referencia (3) y la fuente de iluminación (2) respecto del ojo del paciente.PW (T)), for different known and preset angular positions between the reference point (3) and the light source (2) with respect to the patient's eye.
- A partir de las imágenes tomadas para los diferentes ángulos y por interpolación o extrapolación, se calcula la posición angular en la que se superponen las imágenes de Purkinje PIII- From the images taken for the different angles and by interpolation or extrapolation, the angular position at which the Purkinje PIII images are superimposed is calculated
(6)y PIV (7) o reflejos que provienen del cristalino, localizando el eje óptico de la lente intraocular o cristalino.(6) and PIV (7) or reflections that come from the lens, locating the optical axis of the intraocular or crystalline lens.
- Cálculo del valor de descentramiento de la lente/ cristalino a partir de la distancia del punto de solapamiento a la pupila de
entrada.- Calculation of the lens / lens offset value from the distance of the overlap point to the pupil of entry.
- Cálculo el ángulo fisiológico (10) que el ojo está rotado (ángulo kappa) debido a la posición no axial de la fóvea (11) a partir del desalineamiento entre el reflejo corneal o imagen de- Calculation of the physiological angle (10) that the eye is rotated (kappa angle) due to the non-axial position of the fovea (11) from the misalignment between the corneal reflex or image of
Purkinje PI (5) y el centro de la pupila.Purkinje PI (5) and the center of the pupil.
- Cálculo el valor de la inclinación de la lente a través de los valores de la posición angular en la que se superponen las imágenes de Purkinje PIII (6) y PIV (7), el valor de descentramiento de la lente/ cristalino y el ángulo kappa.- Calculate the value of the inclination of the lens through the values of the angular position in which the Purkinje PIII (6) and PIV (7) images are superimposed, the lens / lens offset value and the angle kappa.
2a.- Dispositivo para la puesta en práctica del procedimiento de la reivindicación Ia, caracterizado porque comprende una base (12) sobre la que se dispone una mentonera (13) para la estabilización de la cabeza del paciente, y frente a ésta una cámara (4) para grabar las imágenes que se forman por reflexión en la córnea y en las dos caras del cristalino mediante el empleo de una fuente de luz (2), incorporando asimismo al menos un punto de fijación (3) para la fijación de la vista del paciente, habiéndose previsto que el dispositivo cuente con medios para variar la posición angular relativa entre el punto de fijación (3) y la fuente de luz (2) con respecto al ojo del paciente, entre distintas posiciones preestablecidas.2 .- Device for implementing the method of claim I to, wherein it comprises a base (12) on which a chin guard (13) to stabilize the patient's head is disposed, and against this one camera (4) to record the images that are formed by reflection in the cornea and on both sides of the lens through the use of a light source (2), also incorporating at least one fixing point (3) for fixing the view of the patient, the device having been provided with means to vary the relative angular position between the fixation point (3) and the light source (2) with respect to the patient's eye, between different preset positions.
3a.- Dispositivo, según reivindicación 2a, caracterizado porque la fuente de iluminación (2) se materializa en una matriz semicircular de diodos (15) de luz infrarroja, mientras que los puntos de fijación se materializan en una pluralidad de diodos led (3), preferentemente en número de nueve, distribuidos sobre una placa de circuito impreso (16) cuya iluminación se activa selectivamente.
4a.- Dispositivo, según reivindicación 2a, caracterizado porque la citada cámara (4) incorpora un objetivo telecéntrico (14) sobre cuya extremidad libre se dispone la matriz semicircular de diodos (15) de luz infrarroja.3 .- Device according to claim 2, characterized in that the light source (2) is embodied in a semicircular diode array (15) of infrared light, while attachment points are materialized in a plurality of LED diodes ( 3), preferably in number of nine, distributed on a printed circuit board (16) whose lighting is selectively activated. 4 .- Device according to claim 2, characterized in that said chamber (4) includes a telecentric lens (14) on the free end of the semicircular diode array (15) of infrared light is available.
5a- Dispositivo, según reivindicación 2a, caracterizado porque la base (12) incorpora un divisor de haz (18) y un espejo (19) frente a la fuente de iluminación (2) para que el paciente pueda fijar la mirada en los puntos de fijación (3).5 a - Device according to claim 2 a , characterized in that the base (12) incorporates a beam splitter (18) and a mirror (19) in front of the light source (2) so that the patient can fix the gaze on the fixing points (3).
6a.- Dispositivo, según reivindicación 2a, caracterizado porque opcionalmente el punto de fijación (3) puede ser único, en cuyo caso éste o la fuente de iluminación (2) dispondrán de medios de regulación de su posicionamiento.6 .- Device according to claim 2, characterized in that optionally the fixing point (3) may be unique, in which case the light source or (2) will have means for adjusting its position.
7a.- Dispositivo, según reivindicación 2a, caracterizado porque opcionalmente el punto de fijación (3) puede ser único, incorporando el dispositivo múltiples fuentes de iluminación fijas convenientemente distribuidas en diferentes posiciones preestablecidas.
7 .- Device according to claim 2, characterized in that optionally the fixing point (3) may be unique, the device incorporating multiple fixed sources of illumination conveniently distributed in different predetermined positions.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| ES200601816A ES2300193B1 (en) | 2006-07-06 | 2006-07-06 | PROCEDURE FOR LIVE MEASUREMENT OF THE ALIGNMENT OF OPTICAL EYE COMPONENTS AND DEVICE FOR PRACTICE OF THE SAME. |
| ESP200601816 | 2006-07-06 |
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| Publication Number | Publication Date |
|---|---|
| WO2008003807A1 true WO2008003807A1 (en) | 2008-01-10 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| PCT/ES2007/000393 WO2008003807A1 (en) | 2006-07-06 | 2007-06-29 | Method for the in vivo measurement of the alignment of the optical components of the eye and device for implementing same |
Country Status (2)
| Country | Link |
|---|---|
| ES (1) | ES2300193B1 (en) |
| WO (1) | WO2008003807A1 (en) |
Cited By (1)
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|---|---|---|---|---|
| US20140268042A1 (en) * | 2013-03-15 | 2014-09-18 | Amo Development, Llc. | System and method for eye orientation |
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| EP0066562A2 (en) * | 1981-05-19 | 1982-12-08 | Kari Allan Kaakinen | Procedure and means for establishing and recording errors of the eye |
| JPH024311A (en) * | 1988-06-13 | 1990-01-09 | Kamiya Sadayoshi | Inspection instrument for contact lens |
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| US20140268042A1 (en) * | 2013-03-15 | 2014-09-18 | Amo Development, Llc. | System and method for eye orientation |
| US10028654B2 (en) * | 2013-03-15 | 2018-07-24 | Amo Development, Llc | System and method for eye orientation |
| US20180325371A1 (en) * | 2013-03-15 | 2018-11-15 | Amo Development, Llc | System and method for eye orientation |
| US10863899B2 (en) | 2013-03-15 | 2020-12-15 | Amo Development, Llc | System and method for eye orientation |
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| Publication number | Publication date |
|---|---|
| ES2300193B1 (en) | 2009-05-08 |
| ES2300193A1 (en) | 2008-06-01 |
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