JP2020146469A - Ophthalmologic examination system and ophthalmologic examination device - Google Patents

Abstract

To preferably transmit, in a remote examination, an intention of an examiner to a subject.SOLUTION: An examination instruction device of an ophthalmologic examination system according to the embodiment transmits instruction information input by an examiner to the ophthalmologic examination device. The ophthalmologic examination device includes, in addition to an examination optical system for examining the subject eye, an information presenting optical system which guides a display light flux from a display part to a subject eye via an optical element of the examination optical system. The ophthalmologic examination device displays a predefined character image on the display part and present to the subject. The ophthalmologic examination device controls operation of the character image based on the instruction information from the examination instruction device. The ophthalmologic examination system further includes a detecting part which detects a predefined event by analyzing an anterior eye part of the subject eye. The control part of the ophthalmologic examination device further controls operation of the character image based on the result of the detection by the detecting part.SELECTED DRAWING: Figure 7

Description

The present invention relates to an ophthalmic examination system and an ophthalmic examination apparatus.

Ophthalmic examination devices are used for eye examinations (measurement of characteristics, imaging, etc.) at medical institutions, opticians, venues for health examinations and examinations, patient homes, and the like. The following are typical examples of ophthalmologic examination devices.
・ Visual acuity test device that measures visual acuity based on the response to the presented optotype ・ Eye refraction test device (refractive meter, keratometer) that measures the refractive characteristics of the eyeball
・ Tonometer for measuring intraocular pressure ・ Specular microscope for obtaining corneal characteristics (corneal thickness, cell distribution, etc.) ・ Wavefront analyzer for obtaining eyeball aberration information using Hartmann-Shack sensor ・ Visual field impairment Perimeters and microperimeters for detection ・ Optical interference tomography (OCT) for obtaining cross-sectional images of the fundus and anterior segment of the eye, three-dimensional data, and analysis data using optical interference
・ Fundus camera for taking pictures of the fundus ・ Scanning Laser Ophthalmoscope (SLO) for obtaining an image of the fundus by laser scanning using a confocal optical system
・ Multifunction device that combines two or more functions

In many ophthalmic examinations, the examiner gives instructions to the subject and operates the ophthalmic examination device. In recent years, a remote examination in which an examiner who is in a place different from the place where the ophthalmic examination device is installed gives an instruction to a subject or an ophthalmic examination device to perform an examination has become widespread (see, for example, Patent Documents 1-6). In the remote examination, the examiner gives visual and auditory instructions to the subject.

Japanese Unexamined Patent Publication No. 2001-286442 JP-A-2002-10978 JP-A-2002-78679 JP-A-2002-78681 Japanese Unexamined Patent Publication No. 2005-342042 International Publication No. 2003/041572

In the remote examination, it may be difficult to convey the intent of the examiner to the examinee, or the examinee may feel anxious. Such a problem is particularly noticeable when there is no examiner who accompanies the subject to support the examination. In addition, although the gender, age, language used, etc. of the subject vary, it has been difficult to convey the examiner's intention according to the attributes of the subject by the conventional technique.

An object of the present invention is to suitably convey the examiner's intention to the examinee in a remote examination.

The ophthalmologic examination system of the embodiment includes an ophthalmologic examination apparatus and an examination instruction apparatus used by an examiner to send instructions to the ophthalmologic examination apparatus. The examination instruction device includes a first input unit for inputting instruction information related to the examination, and a first communication unit for transmitting the instruction information input by the first input unit to the ophthalmologic examination device. The ophthalmologic examination apparatus includes an inspection optical system including an optical element applied to the eye to be inspected and a projection system for projecting an inspection light beam for inspecting the eye to be inspected onto the eye to be inspected via the optical element, a display unit, and the display unit. An information presentation optical system including a light guide system that guides the display light beam output from the eye to the eye to be inspected via an optical element, a second communication unit that receives instruction information transmitted from the inspection instruction device, and a predetermined character image. Is displayed on the display unit, and includes a control unit that controls the operation of the character image based on the instruction information received by the second communication unit. The ophthalmologic examination system of the embodiment further includes a detection unit that detects a predetermined event by analyzing the anterior segment image of the eye to be inspected. The control unit of the ophthalmologic examination device further controls the operation of the character image based on the result of detection by the detection unit.

According to the embodiment, it is possible to suitably convey the intent of the examiner to the examinee in the remote examination.

The schematic diagram which shows an example of the structure of the ophthalmologic examination system which concerns on embodiment. The schematic diagram which shows an example of the structure of the ophthalmologic examination system which concerns on embodiment. The schematic diagram which shows an example of the structure of the ophthalmologic examination system which concerns on embodiment. The schematic diagram which shows an example of the structure of the ophthalmologic examination system which concerns on embodiment. The schematic diagram which shows an example of the structure of the ophthalmologic examination system which concerns on embodiment. The schematic diagram which shows an example of the structure of the ophthalmologic examination system which concerns on embodiment. The sequence diagram which shows an example of the usage form of the ophthalmologic examination system which concerns on embodiment. The schematic diagram for demonstrating the usage form of the ophthalmologic examination system which concerns on embodiment. The sequence diagram which shows an example of the usage form of the ophthalmologic examination system which concerns on embodiment. The sequence diagram which shows an example of the usage form of the ophthalmologic examination system which concerns on embodiment. The sequence diagram which shows an example of the usage form of the ophthalmologic examination system which concerns on embodiment. The schematic diagram which shows an example of the structure of the ophthalmologic examination system which concerns on embodiment. The schematic diagram which shows an example of the structure of the ophthalmologic examination system which concerns on embodiment. The schematic diagram which shows the modification of the ophthalmologic examination system which concerns on embodiment. The schematic diagram which shows an example of the display screen of the ophthalmologic examination system which concerns on embodiment.

Some examples of typical embodiments of the present invention will be described. In addition, the contents of the document cited in this specification and known techniques can be incorporated into embodiments.

The ophthalmologic examination system of the embodiment is used for remote examination using an ophthalmologic examination apparatus installed in various facilities or a portable ophthalmic examination apparatus. In the remote examination in the embodiment, an examiner (internal examiner) who assists the examination at the facility where the ophthalmologic examination device is installed and an examiner (external examiner) who assists the examination from outside the facility are involved. .. Typically, an internal examiner uses a tablet device or wearable device (eg, wireless earphones) to grasp and instruct the situation of all or part of the examinees undergoing inspection in the facility. To send. The external examiner uses the information processing device installed in the facility (management center) for managing the examination using the ophthalmic examination device to check the status of all or some of the subjects currently undergoing the examination. Grasp and send instructions. The subject may proceed with the examination based on instructions from the internal and / or external examiner.

Examples of facilities where ophthalmic examination devices are installed include medical institutions, opticians, health examination venues, examination venues, patients' homes, welfare facilities, public facilities, examination vehicles, and the like. That is, the facility in which the ophthalmologic examination device is installed may include at least one of a fixed facility such as a medical institution and a mobile facility such as an examination vehicle. In addition, the instructions sent from the examiner to the examinee may include support for how to proceed with the examination, operation of an ophthalmologic examination device, advice to the examinee, and the like.

Moreover, the mode of the remote inspection is not limited to the above. For example, it can be configured to send an instruction from an examination instruction device (examiner terminal) installed outside the management center (for example, the examiner's home) to the ophthalmologic examination device via the management center.

The ophthalmologic examination apparatus may be any apparatus used for the examination of the eye to be inspected, and may have at least one of a function as an ophthalmologic measurement apparatus and a function as an ophthalmologic imaging apparatus. The ophthalmic measuring device is a device for measuring the characteristics of the eye to be inspected, and examples thereof include a visual acuity test device (visual field presentation device, phoropta, etc.), an ophthalmoflex test device (refractive meter, keratometer, etc.), and a tonometer. , Specular microscope, wave front analyzer, perimeter, microperimeter, etc. The ophthalmologic imaging device is a device for imaging an eye to be inspected, and examples thereof include an OCT, a fundus camera, and an SLO. Further, the ophthalmologic examination apparatus may include an application for analyzing measurement data and captured images.

<Configuration of ophthalmic examination system>
An example of the configuration of the ophthalmic examination system according to the embodiment will be described. The ophthalmologic examination system 1 illustrated in FIG. 1A is constructed by using a network (communication line N) connecting each of the N facilities (first facility to Nth facility) where the examination is performed and the management center. There is.

Each facility (the n Property: n = 1 to N, N is an integer of 1 or more), the ophthalmologic examination apparatus _{2-i n (i n =} 1~K n, K n is an integer of 1 or more) is installed ing. That is, each facility (n-th facility) is 1 or more ophthalmologic examination apparatus 2-i _n are installed. Ophthalmologic examination apparatus 2-i _n constitutes a part of the ophthalmic examination system 1. The ophthalmic examination system 1 may include an examination device capable of performing an examination other than ophthalmology.

Ophthalmologic examination apparatus 2-i _n in this example, functions as a "computer" as a function of a "check device" carrying out the inspection of the subject (the subject's eye), the communication with the various data processing and an external apparatus It has both. In another example, the inspection device and the computer can be provided separately. In this case, the inspection device and the computer may be configured to be able to communicate with each other. Further, the number of inspection devices and the number of computers are arbitrary, and for example, a single computer and a plurality of inspection devices can be provided.

Further, each facility (nth facility) is equipped with an information processing device (internal examiner terminal 3-n) used by the internal examiner. The internal inspector terminal 3-n is a computer used in the facility, and may be, for example, a mobile terminal such as a tablet terminal or a smartphone, or a server (in-facility server or the like) installed in the facility. Further, the internal examiner terminal 3-n may include a wearable device such as a wireless earphone. The internal inspector terminal 3-n may be a computer (cloud server or the like) installed outside the facility, as long as it is a computer whose function can be used in the facility. In the embodiment, the internal examiner terminal 3-n can be used as an inspection instruction device.

The ophthalmologic examination apparatus 2-i _n and internal examiner terminal 3-n, and a network (Institutional LAN, etc.) that are built into the n site, a wide area network (such as the Internet) or via a short-range communication technology It may be configured to allow communication.

Ophthalmologic examination apparatus 2-i _n may have a function as a server. If this configuration is applied, it is possible and ophthalmologic examination apparatus 2-i _n and internal examiner terminal 3-n is configured to communicate directly. In this case, it is not necessary to provide a function for communicating between the internal examiner terminal 3-n and the management server 4. In other words, it is possible to configure to perform via the ophthalmologic examination apparatus 2-i _n the communication between the management server 4 and the internal examiner terminal 3-n.

A management server 4 is installed in the management center. The management server 4 can communicate with the external inspector terminal 5 m (m = 1 to M, M is an integer of 1 or more) used by the external inspector via a network (LAN, wide area network, etc.). Further, the management server 4 can communicate via at least a portion and a wide area network of the first to N facilities installed ophthalmic examination apparatus 2-i _n.

The management server 4 includes, for example, the function of relaying communication between the ophthalmologic examination apparatus 2-i _n and the external examiner terminal 5 m, and a function of recording the contents of the communication. The management server 4 is provided with functions for associating the ophthalmologic examination apparatus 2-i _n and the external examiner terminal 5 m, i.e., the ability to assign examiner to each of the ophthalmic examination apparatus 2-i _n. Correspondence between the ophthalmologic examination apparatus 2-i _n and the external examiner terminal 5m is one-to-one correspondence, many-to-one correspondence, and it may be any of one-to-many correspondence. Further, the management server 4 detects that the default miss the contents of the communication between the ophthalmologic examination apparatus 2-i _n and the external examiner terminal 5m occurs, and records this, external examiner terminal 5m Etc. may be configured to notify a warning.

The management server 4 includes one or more computers. An example of the case where the management server 4 includes a plurality of computers is shown in FIG. 1B. The management server 4 shown in FIG. 1B includes a master server 6 and R local servers 7-r (R is an integer of 2 or more). The master server 6 and each local server 7-r can communicate with each other via the communication line N. The master server 6, the first to N facility device installed in each of (the ophthalmologic examination apparatus 2-i _n is included. Internal examiner terminal 3-n may be further included.) And the communication line N Communication is possible via. The master server 6 may be installed in a place other than the management center. Further, the master server 6 may include two or more information processing devices.

In this example, two or more management centers may be provided. The local server 7-r is installed in, for example, one of the management centers and manages the external inspector terminal 5m in the management center. The master server 6 manages two or more local servers 7-r.

The configuration of the management server 4 will be described later. When the management server 4 includes a plurality of computers, the components of the management server 4 described later are distributed and arranged on the plurality of computers. In addition, arbitrary components can be duplicated in two or more computers. As a result, for example, distributed processing and redundancy are realized.

External examiner terminal 5m includes a computer used by the examiner to guide and manage the checks carried out using ophthalmologic examination apparatus 2-i _n. In the embodiment, the external examiner terminal 5 m can be used as an inspection instruction device. In the following embodiment, an example in which both the external inspector terminal 5 and the internal inspector terminal 3-n can be used as an inspection instruction device will be described, but an example in which only one of these can be used as an inspection instruction device, or It is also possible to apply an example in which at least one of these and the other computer can be used as an inspection instruction device, or an example in which only the other computer can be used as an inspection instruction device.

<Configuration of ophthalmic examination equipment>
Description will be given of a configuration of an ophthalmologic examination apparatus _{2-i n.} Ophthalmologic examination apparatus illustrated in Figure 2. 2 corresponds to each of the plurality of ophthalmologic examination apparatus 2-i _n shown in FIG. 1A. Similarly, each of the internal examiner terminals 3-n may be described as an internal examiner terminal 3, and each of the external examiner terminals 5 m may be described as an external examiner terminal 5.

The ophthalmologic examination device 2 includes a control unit 20, an examination unit 21, an examination status information generation unit 22a, a communication request generation unit 22b, a user interface (UI) unit 23, and a communication unit 24. These components may be provided integrally (that is, in a single housing) or may be distributed in two or more housings. Examples of the former include reflex meters, keratometers, tonometers, specular microscopes, wavefront analyzers, perimeters, microperimeters, OCTs, fundus cameras, SLOs and the like. An example of the latter is a visual acuity test device that includes a visual acuity display device and a phoropter. Further, a part or all of the control unit 20 can be provided in a personal computer or a mobile terminal. Further, a part or all of the user interface unit 23 can be provided in a personal computer, a mobile terminal, a television receiver, a smart television, or the like.

<Control unit 20>
The control unit 20 executes various controls and calculations. The control unit 20 includes a processor. In the present specification, the "processor" is, for example, a CPU (Central Processing Unit), a GPU (Graphics Processing Unit), an ASIC (Application Specific Integrated Circuit), a programmable logic device (for example, a SPLD), a programmable logic device (for example, a SPLD). (Complex Programmable Logic Device), FPGA (Field Programmable Gate Array)) and the like. The control unit 20 realizes the function according to the embodiment by reading and executing, for example, a computer program stored in a storage circuit or a storage device. The control unit 20 may further include a RAM, a ROM, a hard disk drive, a solid state drive, and the like.

<Output control unit 201>
The control unit 20 includes an output control unit 201. The output control unit 201 controls to output the information transmitted from the internal examiner terminal 3 or the external examiner terminal 5 to the ophthalmologic examination apparatus 2. Visual information and audio information are examples of output information. The visual information is information recognized by the visual system, and includes character string information (text information) and image information. The character string information includes, for example, a character message indicating an instruction of the examiner. The image information includes, for example, a moving image of the examiner's face and hands, and a mark indicating an examiner's instruction. The output control unit 201 outputs visual information by controlling the LCD 214 and the display device 231 described later. The voice information is information recognized by the auditory system and includes a warning sound and a voice message. The output control unit 201 outputs auditory information by controlling the audio output device 233 described later. Specific examples of the processing executed by the output control unit 201 will be described later.

<Character control unit 202>
The output control unit 201 is provided with a character control unit 202. The character control unit 202 controls the output of the above visual information, and in particular, controls for expressing an instruction directed to the subject using a character (character image). The instruction to the subject is an instruction from any of the external examiner, the internal examiner, and the ophthalmologic examination apparatus 2. The character is an image of a person, an animal, a virtual creature, a robot, or the like, and may include a so-called avatar. The avatar is a character that acts as an alter ego of the source of the instruction (external examiner, internal examiner, ophthalmologic examination device 2, etc.).

Examples of the technique for controlling the character are described in JP-A-2006-520053, JP-A-2016-1885, JP-A-2014-149863, JP-A-2015-210547, and the like. The character control unit 202 executes control using known techniques represented by these. The character control unit 202 includes a processor and a computer program for that purpose. An example of the process executed by the character control unit 202 will be described later.

<Inspection Department 21>
The inspection unit 21 executes the inspection of the eye to be inspected under the control of the control unit 20. The examination unit 21 has a configuration according to the type of the ophthalmologic examination device 2. The configuration of the inspection unit 21 may be at least a part of the known configuration, or may include a known configuration. The inspection unit 21 includes the following optical system and a mechanism (actuator, power transmission mechanism, etc.) (not shown).

When the examination unit 21 has a function of measuring the characteristics of the eye to be inspected E, the examination unit 21 is provided with at least an optical system for projecting light onto the eye to be inspected, and receives the return light of the light projected on the eye to be inspected, for example. Further provided with an optical system for detection. Further, the inspection unit 21 may be provided with optical systems having various functions such as an optical system for projecting a fixation target onto the eye to be inspected, an optical system for alignment, and an optical system for focusing. .. Further, the inspection unit 21 may include a processor for processing the detection result (image signal, video signal, etc.) of the return light.

When the examination unit 21 has a function of photographing the eye to be inspected E, the examination unit 21 is, for example, for detecting an optical system for projecting light on the eye to be inspected and a return light of the light projected on the eye to be inspected. Includes optical system. Further, the inspection unit 21 may include various optical systems as in the case of the measurement function. Further, the inspection unit 21 may include a processor for processing the detection result (image signal, video signal, etc.) of the return light.

The optical system as described above corresponds to the inspection optical system 211. The inspection optical system 211 includes an optical element 212 and a projection system 213. The optical element 212 is applied to the eye E to be inspected in order to guide the luminous flux output from the projection system 213 to the eye E to be inspected. The optical element 212 may include any of various optical elements such as a lens (objective lens or the like), a prism (objective prism or the like), a concave mirror (parabolic mirror or the like), or a glass plate.

The projection system 213 projects a luminous flux (inspection luminous flux) for inspecting the eye E to be inspected to the eye E to be inspected via the optical element 212. LCD 214 is provided in the projection system 213. The LCD 214 operates under the control of the control unit 20. The LCD 214 has a function of displaying information used for inspection (inspection information: optotype, fixation target, etc.) and a function of displaying information transmitted from the internal inspector terminal 3 or the external inspector terminal 5. The latter is a function of the information presentation optical system, and the LCD 214 corresponds to the display unit of the information presentation optical system. Further, the projection system 213 is a light guide system that guides a luminous flux (display luminous flux) from the LCD 214 corresponding to the information transmitted from the internal examiner terminal 3 or the external examiner terminal 5 to the eye E to be inspected via the optical element 212. Play a function. That is, in the inspection unit 21 of the present embodiment, the inspection optical system and the information presentation optical system have a common configuration. On the other hand, the inspection optical system and the information presentation optical system can be configured separately, and an example thereof will be described later.

<Inspection status information generation unit 22a>
The inspection status information generation unit 22a generates inspection status information indicating the inspection status of the eye E to be inspected. The examination status information includes the progress of the examination (inspection phase), the intermediate result of the examination (for example, the presentation history of the optotype in the visual acuity test), the examination time (for example, the examination start time, the elapsed time), and the like. When the ophthalmologic examination device 2 has a function of photographing the eye to be examined E and the subject, the examination status information may include a photographed image (still image, moving image) of the eye to be examined E or the like. Further, the inspection status information may include the voice information of the subject input via the voice input device 234. The generated inspection status information is transmitted to, for example, the internal inspector terminal 3 and / or the external inspector terminal 5 and is referred to by the inspector. Further, in the present embodiment, the generated inspection status information is sent to the communication request generation unit 22b. The inspection status information generation unit 22a includes, for example, a processor and a computer program for performing the inspection or a computer program for monitoring the computer program.

It is not necessary for the examination status information generation unit 22a to process all the information transmitted from the ophthalmologic examination apparatus 2 to the internal examiner terminal 3 and / or the external examiner terminal 5. For example, the moving image of the eye E to be examined and the audio information of the subject can be transmitted as they are to the internal examiner terminal 3 and / or the external examiner terminal 5. As a result, the state of the eye E to be examined, the state of the subject, and the request of the subject can be provided to the examiner substantially without a time lag.

<Communication request generation unit 22b>
The communication request generation unit 22b generates a request (communication request) for reading the internal examiner and / or the external inspector. The communication request generation unit 22b has at least a process of generating a communication request in response to an instruction from the subject and a process of generating a communication request based on the inspection status information generated by the inspection status information generation unit 22a. One is configured to be executable.

The instruction from the subject is input using the user interface unit 23. The input of the instruction is performed, for example, via the operation device 232 and / or the voice input device 234 described later. As a specific example, the subject uses the operating device 232 to perform a predetermined operation (pressing a button, tilting a lever, etc.) for calling an internal examiner and / or an external examiner. Further, the subject can operate the software key displayed by the display device 231 described later by using the operation device 242, or by operating the software key displayed on the touch panel display with his or her finger. You can enter a call request. In addition, when the subject utters a message that the inspection content is not understood or a message that the instruction of the internal inspector and / or the external inspector is required, the voice information is detected by the voice input device 234. can do. According to this example, it is possible to provide an assist according to the request of the subject.

An example of generating a communication request based on the inspection status information will be described. The inspection status information generation unit 22a sequentially generates inspection status information while monitoring the inspection status. The communication request generation unit 22b determines whether or not the generated inspection status information meets a predetermined condition. The predetermined conditions are, for example, that the examination is not in progress, that the intermediate result of the examination (for example, the history of presenting the optotype in the visual acuity test) is inappropriate, that the elapsed time from the start of the examination is long, and that the eyelids. It may be closed for a long time, and the fixation of the eye E to be examined may not be applied. The fact that the test is not progressing is recognized, for example, by detecting that the test phase has not shifted for a predetermined time or longer (for example, the same optotype is presented). Inappropriate results during the inspection are recognized, for example, by detecting that the display order of the optotypes is improper (for example, the response contents do not converge). The fact that the eyelids are closed and the fixation state of the eye E to be inspected are recognized by analyzing the captured image of the eye E to be inspected. This image analysis includes, for example, pupil detection. According to this example, it is possible to automatically detect a situation that requires assistance.

The communication request generated by the communication request generation unit 22b is transmitted by the communication unit 24 to the management server 4 and / or the internal examiner terminal 3.

<User interface unit 23>
The user interface unit 23 has a function of outputting information to the subject (and an internal examiner) and a function of inputting information and giving an operation instruction. The user interface unit 23 includes a display device 231 and a voice output device 233 for the former function, and an operation device 232 and a voice input device 234 for the latter function.

The display device 231 includes a display device such as a flat panel display. The operation device 232 includes an operation device such as a button, a key, a joystick, a knob, and an operation panel provided on the housing or the outside of the ophthalmologic examination device 2. Further, the operation device 232 may include an operation device (mouse, keyboard, track pad, button, touch panel, etc.) such as a personal computer connected to the ophthalmologic examination device 2. The user interface unit 23 may include a device such as a touch panel in which the display device 231 and the operation device 232 are integrated, and a graphical user interface (GUI). Further, the user interface unit 23 may include a processor and a computer program for performing operations and inputs based on the voice of the subject input from the voice input device 234.

The voice output device 233 includes, for example, a circuit that processes the output voice information (voice signal) and a speaker that outputs the processed voice information. Further, the voice input device 234 includes a microphone that converts voice information into an electric signal, and a circuit that processes the electric signal.

<Communication unit 24>
The communication unit 24 performs data communication with the management server 4. Further, the communication unit 24 may be capable of executing data communication with the internal examiner terminal 3. The data communication method is arbitrary. For example, the communication unit 24 includes a communication interface compliant with the Internet, a communication interface compliant with LAN, a communication interface compliant with short-range communication, and the like. Data communication may be wired communication or wireless communication. The communication unit 24 may be capable of data communication with an external device other than the management server 4 and the internal inspector terminal 3. The data transmitted and received by the communication unit 24 may be encrypted. In that case, for example, the control unit 20 includes an encryption processing unit that encrypts the transmitted data and a decryption processing unit that decrypts the received data.

<Configuration of internal examiner terminal>
The configuration of the internal examiner terminal 3 will be described. The internal examiner terminal 3 illustrated in FIG. 3 includes a control unit 30, a user interface (UI) unit 31, and a communication unit 32.

<Control unit 30>
The control unit 30 controls each unit of the internal examiner terminal 3 and executes various arithmetic processes. The control unit 30 includes a processor. The control unit 30 may further include a RAM, a ROM, a hard disk drive, a solid state drive, and the like.

<User interface unit 31>
The user interface unit 31 has a function of outputting information for the user and a function for the user to input information and give an operation instruction. The user interface unit 31 includes a display device 311, an operation device 312, a voice output device 313, and a voice input device 314, similarly to the user interface 23 of the ophthalmologic examination device 2.

<Communication unit 32>
The communication unit 32 performs data communication with the management server 4 and the ophthalmologic examination device 2. The data communication method and encryption may be the same as those of the communication unit 24 of the ophthalmologic examination device 2.

<Configuration of external examiner terminal>
The configuration of the external examiner terminal 5 will be described. The external examiner terminal 5 illustrated in FIG. 4 includes a control unit 50, a photographing unit 51, a user interface (UI) unit 52, a transmission information generation unit 53, and a communication unit 54.

<Control unit 50>
The control unit 50 controls each unit of the external examiner terminal 5 and executes various arithmetic processes. The control unit 50 includes a processor. The control unit 50 may further include a RAM, a ROM, a hard disk drive, a solid state drive, and the like.

<Shooting section 51>
The photographing unit 51 is used for photographing the examiner as a moving image, and includes, for example, a video camera. The subject to be imaged includes a body part (for example, face, upper body, hands, etc.) used to express instructions to the subject.

<User interface unit 52>
The user interface unit 52 includes a function of outputting information for the examiner and a function for the examiner to input information and give an operation instruction. The user interface unit 52 includes a display device 521, an operation device 522, a voice output device 523, and a voice input device 524, similarly to the user interface 23 of the ophthalmic examination device 2.

For example, the control unit 50 displays the examination status information sequentially transmitted from the ophthalmologic examination device 2, and causes the display device 521 to display a screen (GUI or the like) for inputting an instruction to the subject. Further, the control unit 50 causes the voice output device 523 to output the voice information of the subject. The examiner determines the content of the instruction by referring to the display information and the voice information, and inputs the instruction using the operation device 522. Further, the voice instruction is input via the voice input device 524.

<Transmission information generation unit 53>
The transmission information generation unit 53 generates information (transmission information) for the subject using the ophthalmologic examination device 2 based on the content (instruction) input by the examiner using the user interface 52. The transmission information generation unit 53 includes, for example, a processor and a transmission information generation program executed in cooperation with the screen (GUI).

It is not necessary for the transmission information generation unit 53 to process all the information transmitted from the external examiner terminal 5 to the ophthalmologic examination device 2. For example, the moving image and audio information of the examiner can be transmitted as they are to the ophthalmologic examination apparatus 2. Thereby, the examiner's instruction can be provided to the examinee with substantially no time lag.

<Communication unit 54>
The communication unit 54 performs data communication with the management server 4. The data communication method and encryption may be the same as those of the communication unit 24 of the ophthalmologic examination device 2.

<Management server configuration>
The configuration of the management server 4 will be described. The management server 4 illustrated in FIG. 5 includes a control unit 40, a communication establishment unit 41, a control management unit 42, and a communication unit 43. At least one of these components is realized, for example, by the cooperation of hardware and software distributed in the master server 6 and the local server 7-r shown in FIG. 1B.

<Control unit 40>
The control unit 40 controls each unit of the management server 4. For example, a part of the control unit 40 (master control unit) is provided in the master server 6, and this master control unit controls each local server 7-r. The control unit 40 may be able to execute other arithmetic processing. The control unit 40 includes a processor. The control unit 40 may further include a RAM, a ROM, a hard disk drive, a solid state drive, and the like.

The control unit 40 includes a communication control unit 401 and a transfer control unit 402.

The communication control unit 401 executes control related to the establishment of communication between the ophthalmologic examination device 2, the internal examiner terminal 3, and the external examiner terminal 5. For example, the communication control unit 401 controls for establishing communication toward each of the devices selected by the selection unit 412 described later from the ophthalmologic examination device 2, the internal examiner terminal 3, and the external examiner terminal 5. Send a signal.

The transfer control unit 402 controls the exchange of information between the devices for which communication has been established by the communication establishment unit 41 (and the communication control unit 401). For example, the transfer control unit 402 transfers information transmitted from one of at least two devices for which communication has been established by the communication establishment unit 41 (and the communication control unit 401) to another device. As a specific example, when communication between the ophthalmologic examination device 2 and the external examiner terminal 5 is established, the transfer control unit 402 externally transmits the information transmitted from the ophthalmologic examination device 2 (or the external examiner terminal 5). Transfer to the examiner terminal 5 (or the ophthalmologic examination device 2). At this time, the transfer control unit 402 may process the information transmitted from the ophthalmologic examination device 2 or the like and transmit the information obtained by processing the information to the external examiner terminal 5 or the like. For example, the transfer control unit 402 can extract a part of the information transmitted from the ophthalmologic examination device 2 and the like and transmit it to the external examiner terminal 5 and the like. Further, the information transmitted from the ophthalmologic examination device 2 or the like (for example, the image data of the eye to be inspected E) is analyzed by the management server 4 or another device, and the analysis result (and the original information) is transmitted to the external examiner terminal 5 or the like. You may send it. Note that the processing of information is not limited to such extraction and analysis, and may include arbitrary data processing.

<Communication establishment unit 41>
The communication establishment unit 41 executes a process for establishing communication between at least two devices selected from the ophthalmologic examination device 2, the internal examiner terminal 3, and the external examiner terminal 5. In the present embodiment, "establishment of communication" means, for example, (1) establishing one-way communication from a state in which communication is disconnected, and (2) establishing two-way communication from a state in which communication is disconnected. The concept includes at least one of (3) switching from a state in which only reception is possible to a state in which transmission is possible, and (4) switching from a state in which only transmission is possible to a state in which reception is possible. As a specific example, in "establishment of communication", an instruction can be transmitted to the subject from a state in which the external inspector is monitoring the inspection using the external inspector terminal 5 (a state in which only reception is possible). May include switching to.

Further, the communication establishment unit 41 can execute a process of disconnecting the established communication. In the present embodiment, "disconnecting communication" means, for example, (1) disconnecting communication from a state in which one-way communication is established, and (2) disconnecting communication from a state in which two-way communication is established. (3) Switching from a state in which two-way communication is established to one-way communication, (4) Switching from a state in which transmission and reception are possible to a state in which only reception is possible, (5) A state in which transmission and reception are possible It is a concept including at least one of switching to a state in which only transmission is possible from. As a specific example, in the "disconnection of communication", only the inspection monitoring is performed from the state in which the external inspector can send an instruction to the subject (the state in which the transmission and reception are possible) using the external inspector terminal 5. Switching to a possible state (a state in which only reception is possible) may be included.

Each of the ophthalmologic examination device 2, the internal examiner terminal 3, and the external examiner terminal 5 is used for communication request (call request) for calling another device (the user) and communication between the other two devices. At least one of the communication request (interrupt request) for interrupting can be transmitted to the management server 4. Call requests and interrupt requests are sent manually or automatically. The management server 4 (communication unit 43) receives the communication request transmitted from the ophthalmologic examination device 2, the internal examiner terminal 3, or the external examiner terminal 5.

In the embodiment, the communication establishment unit 41 may include a selection unit 412. Based on the received communication request, the selection unit 412 selects one or more devices other than the device that transmitted the communication request from the ophthalmologic examination device 2, the internal examiner terminal 3, and the external examiner terminal 5. For example, when a communication request is received from the ophthalmologic examination device 2, the selection unit 412 may, for example, use the internal examiner terminal 3 of the facility where the ophthalmologic examination device 2 is installed and one of the management centers (any of them). Select one or both of the external examiner terminals 5 installed on the local server 7-r). The communication establishment unit 41 establishes communication between the selected internal examiner terminal 3 and / or the external examiner terminal 5 and the ophthalmologic examination apparatus 2 that has transmitted the communication request. As a result, it is possible to automatically select an examiner according to the request of the examinee of the ophthalmologic examination apparatus 2 and provide examination support.

The selection of the device according to the communication request is executed based on, for example, preset attributes. Examples of this attribute include the type of inspection, the degree of specialization / proficiency required for assisting the inspection, and the type of language. In order to realize this example, the communication establishment unit 41 may include a storage unit 411 in which the attribute information created in advance is stored. The attribute information represents the attributes of the internal inspector terminal 3 and / or its user (internal inspector) and the attributes of the external inspector terminal 5 and / or its user (external inspector). Here, the internal examiner and the external examiner are identified by, for example, a pre-assigned examiner ID. Further, the internal examiner terminal 3 and the external examiner terminal 5 are identified by, for example, a device ID or a network address assigned in advance. In a typical example, the attribute information is the attribute of each examiner (internal examiner and external examiner), the type of examination that the examiner can support, and the specialty / skill level of the examiner. , Includes the types of languages available to the inspector.

When the selection unit 412 refers to the attribute information, the communication request transmitted from the ophthalmologic examination device 2, the internal examiner terminal 3, or the external examiner terminal 5 may include the information regarding the attribute. For example, a communication request (eg, a call request) transmitted from the ophthalmic examination device 2 may include any of the following: (1) Information indicating the type of examination performed by the ophthalmic examination device 2; (2) ) Information indicating the difficulty of examination support (information indicating that the subject or the subject is difficult to examine, information indicating the progress of the examination, etc.); (3) Disease name and age of the subject, etc. Information indicating; (4) Information indicating the language used by the subject. The selection unit 412 selects at least one of the internal examiner terminal 3 and the external examiner terminal 5 based on the received communication request and the attribute information. At this time, the selection unit 412 collates the information regarding the attribute included in the communication request with the information included in the attribute information. Thereby, the selection unit 412 selects, for example, the internal examiner terminal 3 and / or the external examiner terminal 5 corresponding to any of the following examiners: (1) An examiner who can support the inspection type; (2) Examiners who can support the examination of the difficulty level; (3) Examiners who can support the subjects of the disease and age; (4) Examiners who can use the language. Here, the correspondence between the internal inspector and the internal inspector terminal 3 and the correspondence between the external inspector and the external inspector terminal 5 are, for example, the inspector terminal (device ID is assigned) when logging in to the system. ) Is performed by the examiner ID entered in.

<Control management unit 42>
The control management unit 42 executes a process for managing information output control by the ophthalmologic examination device 2. In particular, the control management unit 42 of this example learns the control executed by the ophthalmologic examination device 2 in response to an instruction from the examiner, and executes a process for reflecting the control in the subsequent control. In order to execute such a process, the control management unit 42 includes a storage unit 421 and a search unit 422.

The control management unit 42 collects the examination status information generated by the examination status information generation unit 22a of the ophthalmologic examination device 2. Specifically, at least a part of the inspection status information generated by the inspection status information generation unit 22a is transmitted to the management server 4 and stored in the control management unit 42.

In addition, the control management unit 42 can collect instruction contents (instruction information) from the examiner. Specifically, the instruction information transmitted from the external examiner terminal 5 (or the internal examiner terminal 3) to the ophthalmologic examination device 2 is stored in the control management unit 42. Examples of the instruction information include transmission information generated by the transmission information generation unit 53 of the external inspector terminal 5 and information similarly generated by the internal inspector terminal 3.

Further, the control management unit 42 can collect control information representing the control executed by the ophthalmologic examination device 2 in response to the instruction information from the examiner. Specifically, control information representing the control executed by the control unit 20 (particularly the output control unit 201) is sent to the management server 4 and stored in the control management unit 42. The control management unit 42 may be configured to generate control information based on instruction information from the external examiner terminal 5 (or the internal examiner terminal 3). Alternatively, the control management unit 42 may be configured to regard the instruction information from the external examiner terminal 5 (or the internal examiner terminal 3) as the control information.

<Memory unit 421>
The control management unit 42 is executed by the ophthalmologic examination device 2 based on (at least a part of) the examination status information from the ophthalmologic examination device 2 and the instruction information from the external examiner terminal 5 (and / or the internal examiner terminal 3). It is stored in the storage unit 421 in association with (at least a part of) the control information representing the controlled control. An example of this process will be described below.

When the ophthalmologic examination device 2 generates the examination status information, the examination status information is sent to the external examiner terminal 5 via the management server 4. The external inspector inputs an instruction corresponding to the inspection status information to the external inspector terminal 5. The external examiner terminal 5 generates instruction information according to the input instruction. This instruction information is sent to the ophthalmologic examination apparatus 2 via the management server 4. The output control unit 201 of the ophthalmic examination device 2 causes the user interface unit 23 to output information (visual information, auditory information, etc.) corresponding to this instruction information. Control information representing at least a part of this output control is sent to the management server 4. The control management unit 42 stores the inspection status information and the control information (or instruction information) in this series of flows in the storage unit 421 in association with each other. According to this example, the content of the control instructed by the examiner is stored according to the inspection situation. As a result, the relationship between the inspection status and the instruction content of the examiner is accumulated in the storage unit 421.

The control management unit 42 can classify the accumulated inspection status information and / or control information. Examples of classification of test status information include classification according to the attributes of the subject (age, gender, disease, etc.), classification according to the type of test, and classification according to the progress of the test (test phase). Further, there are classification according to the intermediate result of the examination (for example, the presentation history of the optotype in the visual acuity test) and classification according to the examination time (for example, the length of elapsed time). Examples of classification of control information include, in addition to the above-mentioned classification example of inspection status information, classification according to the degree of specialization and skill of the examiner, classification according to the language used, and the like.

<Search unit 422>
When the examination status information is newly generated by the examination status information generation unit 22a of the ophthalmologic examination apparatus 2, the search unit 422 searches the storage unit 241 for the control information corresponding to the new examination status information. An example of this search process will be described below.

When new examination status information is generated by the examination status information generation unit 22a of the ophthalmologic examination device 2, the new examination status information is sent to the management server 4. The control management unit 42 identifies the past inspection status information (for example, any kind in the above classification) corresponding to this new inspection status information, and stores the control information associated with the specified past inspection status information. Obtained from part 421. The "control information corresponding to the new inspection status information" includes not only the control information associated with the past inspection status information that is the same as the new inspection status information, but also the same or similar to the new inspection status information. It also includes control information associated with deemed past inspection status information (eg, including new inspection status information).

<Communication unit 43>
The communication unit 43 performs data communication with each of the ophthalmologic examination device 2, the internal examiner terminal 3, and the external examiner terminal 5. The data communication method and encryption may be the same as those of the communication unit 24 of the ophthalmologic examination device 2.

<Usage pattern>
A typical example of the usage pattern of the ophthalmologic examination system 1 of the present embodiment will be described.

<First example of usage pattern>
As a first example of the usage pattern of the ophthalmologic examination system 1, a usage pattern for providing an assist using a character in response to a call from a subject will be described with reference to FIG.

(S1: Start of inspection)
The examination of the eye E to be inspected using the ophthalmologic examination apparatus 2 is started. Note that communication (two-way communication) between the ophthalmologic examination device 2 and the internal examiner terminal 3 and / or the external examiner terminal 5 may be started from this stage. Further, upon the start of the inspection, the control unit 20 causes the inspection status information generation unit 22a to start the generation of the inspection status information.

(S2: Inspector call request)
When the examinee needs assistance, the examinee calls the examiner by using the user interface unit 23. Examples of cases where the examiner's assistance is required include when you do not know how to perform the inspection, when you are tired, or when you want to return to the inspection step. Further, as an example of how to use the user interface unit 23 for inputting a call request, there are execution of a predetermined operation by the operation device 232 and voice input by the voice input device 234.

(S3: Transmission of request / information)
The control unit 20 controls the communication unit 24 so that the examiner call request (communication request) input in step S2 is transmitted to the management server 4 together with the predetermined information. As an example of the information transmitted together with the examiner call request, the identification information (device ID) pre-assigned to the ophthalmologic examination device 2, the identification information (examinee ID) pre-assigned to the subject, and the ophthalmic examination device 2 There are identification information (facility ID) pre-assigned to the facility where the is installed, at least a part of the inspection status information generated up to the present time, the content of the examiner call request, and the like.

(S4: Selection of examiner terminal)
The management server 4 receives the examiner call request and information transmitted from the ophthalmologic examination apparatus 2 in step S3 by the communication unit 43. The selection unit 412 selects an examiner who assists the examinee. That is, the selection unit 412 selects either the internal examiner terminal 3 and / or the external examiner terminal 5 existing in the facility where the subject is inspecting.

For this purpose, the selection unit 412 has, for example, a function of monitoring the operating state (communication establishment information) of each external inspector terminal 5, and the external inspector terminal 5 (currently assisting the subject) that is not currently in operation. You can choose one of the examiners who have not done so. Thereby, an external examiner who is not currently assisting another subject can be assigned to assist the subject who sent the call request. Such a selection process can be realized, for example, by managing the operating state of each external inspector terminal 5 depending on the presence or absence of a flag or the like.

As another example, the selection unit 412 determines whether or not the communication of one of the internal examiner terminal 3 and the external examiner terminal 5 corresponding to the communication request is actually established, and when it is not established. Can establish communication between the one device and the ophthalmologic examination device 2, and if established, can establish communication between the other device and the ophthalmologic examination device 2. As a specific example, when all the internal examiner terminals 3 in the facility are in operation (that is, when communication with another ophthalmic examination device 2 or an external examiner terminal 5 is established), the selection unit The 412 can select any of the external examiner terminals 5 that are not in operation. Further, when any of the internal inspector terminals 3 in the facility is not in operation, the selection unit 412 can select the internal inspector terminal 3. According to such a configuration, it is possible to promptly provide assistance to the subject by comprehensively considering the operating states of the internal examiner terminal 3 and the external examiner terminal 5. It should be noted that this example can also be realized by managing the operating state of each internal inspector terminal 3 and the operating state of each external inspector terminal 5 depending on the presence or absence of a flag or the like.

(S5: Transmission of control signal for establishing communication)
The communication control unit 401 establishes communication between the examiner terminal and the ophthalmologic examination device 2 at the examiner terminal (internal examiner terminal 3 and / or external examiner terminal 5) selected in step S4. Control signal of. The example of FIG. 6 shows a case where a control signal is transmitted to the external examiner terminal 5.

(S6: Start of two-way communication)
The control signal transmitted in step S5 establishes bidirectional communication between the external examiner terminal 5 and the ophthalmologic examination device 2. At this time, at least one of the establishment of communication between the internal examiner terminal 3 and the external examiner terminal 5 and the establishment of communication between the internal examiner terminal 3 and the ophthalmologic examination device 2 is further performed. You can also do it. As described above, it is also possible to configure communication to be established at a stage prior to this.

(S7: Start shooting)
The transfer control unit 402 of the management server 4 sends the information transmitted from the ophthalmologic examination device 2 in step S3 to the external examiner terminal 5. The control unit 50 of the external examiner terminal 5 controls the photographing unit 51 to start the examiner's moving image shooting. At this time, the input of the voice emitted by the examiner is also started. The frames sequentially acquired by the imaging unit 51 are transferred to the ophthalmologic examination apparatus 2 via the management server 4 in real time. This process is executed by the transfer control unit 402.

(S8: Start of character display / audio output)
The ophthalmologic examination device 2 receives frames and audio information sequentially transmitted from the external examiner terminal 5. The output control unit 201 controls any one of the LCD 214, the display device 231 and the audio output device 233 based on the information received sequentially.

In this example, the character control unit 202 causes the LCD 214 to display a character (avatar) that is the alter ego of the examiner. When a plurality of characters are prepared, the character control unit 202 can select the characters according to, for example, the attributes of the subject, the attributes of the examiner, the type of inspection, and the like. Further, the output control unit 201 causes the voice output device 233 to output the voice emitted by the examiner, the synthetic voice, and the like. The output control unit 201 can synchronize the movement of the character with the output of the voice (that is, these can be linked). In addition, the output control unit 201 can display the moving image of the examiner in real time. By such a process, the instruction of the examiner can be transmitted to the examinee by a character or the like.

The examiner can grasp the voice and operation of the subject in real time. Such two-way information exchange is mainly realized by the transfer control unit 402 of the management server 4.

(S9: Start displaying information)
In order to facilitate the assist work by the examiner, the control unit 50 of the external examiner terminal 5 displays the above-mentioned screen (GUI or the like) on the display device 521 and transfers it from the ophthalmologic examination device 2 via the management server 4. The information (especially the inspection status information) can be displayed on this screen. Upon receiving new inspection status information, the control unit 50 updates the displayed contents. As a result, it is possible to grasp the status of the examination performed using the ophthalmic examination device 2 in substantially real time, and to provide appropriate assistance at an appropriate timing by using visual information and audio information. it can.

(S10: Start inputting instructions)
The examiner inputs an instruction using the operation device 522 (GUI). Examples of the contents of the instruction include change of inspection, presentation of character string information, presentation of image information, and the like. In addition, as instructions using means other than GUI, there are instructions by gesturing and gesturing, instructions by voice, and the like.

(S11: Start of information generation)
The transmission information generation unit 53 generates transmission information for the subject based on the content (instruction) input in step S10. The generation of transmission information is executed, for example, every time the examiner inputs an instruction.

(S12: Start of information transmission)
The external examiner terminal 5 transmits the transmission information generated in step S11 to the ophthalmologic examination apparatus 2 via the management server 4. This process is realized by the transfer control unit 402.

(S13: Character control start)
The ophthalmologic examination apparatus 2 receives the transmission information transmitted from the external examiner terminal 5 in step S12. The output control unit 201 controls the operation of the character displayed on the LCD 214 and controls the voice output device 233 based on the transmission information. At this time, the output control unit 201 can synchronize the operation of the character with the output of the voice. Further, the output control unit 201 can display the character string information and the image information based on the transmission information on the LCD 214 and the display device 231.

An example of character control will be described. As described in step S10, the instructions input by the examiner include an instruction using the operation device 522, an instruction by gesturing and gesturing, and an instruction by voice. The method of inputting instructions is not limited to these.

The instruction using the operation device 522 is an operation using various keys (hardware key, software key). Character control contents are associated with each key and each operation content in advance. This correspondence information is stored in advance in at least one of the ophthalmologic examination device 2, the external examiner terminal 5 (internal examiner terminal 3), and the management server 4. When stored in the external examiner terminal 5, for example, the control unit 50 identifies the control content corresponding to the operated key (and / or its operation content) and outputs this as transmission information. When the corresponding information is stored in the ophthalmologic examination device 2 or the management server 4, the control unit 20 or 40 specifies the control content based on the transmission information (instruction information) transmitted from the external examiner terminal 5. The character control unit 202 moves the character displayed on the LCD 214 based on the control content. For example, the character control unit 202 controls the character so as to point to an object (for example, an optotype) displayed together with the character. When synchronous control with the voice output is performed, the character control unit 202 can move the mouth portion of the character or move another part or the whole body according to the voice output.

When the instruction is input by gesturing, the character can be controlled based on the moving image obtained by the photographing unit 51. For example, at least one of the ophthalmologic examination device 2, the external examiner terminal 5 (internal examiner terminal 3), and the management server 4 includes the following elements: the examiner's operation and the control content are associated with each other. A storage device that stores correspondence information in advance; a processor that analyzes a moving image from an external examiner terminal 5 to detect an examiner's operation, and specifies control contents corresponding to the detected operation based on the correspondence information. The process of analyzing the moving image to detect the movement of the examiner is realized by using a known image analysis technique.

When the instruction is input by voice, it is possible to control the character or the like based on the voice information input via the voice input device 524. For example, at least one of the ophthalmic examination device 2, the external examiner terminal 5 (internal examiner terminal 3), and the management server 4 includes the following elements: a predetermined character string and a control content are associated with each other. A storage device that stores the corresponding information in advance; the voice information from the external examiner terminal 5 is analyzed to identify the character string uttered by the examiner, and the control content corresponding to the specified character string is specified based on the corresponding information. Processor to do. The process of analyzing voice information to identify a character string is realized by using a known voice analysis technique.

FIG. 7 shows an example of a display for a visual acuity test using a Randold ring. In this example, the inspection information 600 displayed on the LCD 214 includes a Randold ring for a visual acuity test, a character string “visual acuity value: 0.5” representing a visual acuity value corresponding to the Randold ring, and a notch portion of the Randold ring. Includes arrow images in each of the up, down, left, and right directions arranged around the Randold ring for selective input of the direction of.

Further, the character 550 is displayed in the vicinity of the inspection information 600. In the balloon 560, a character string or the like representing the voice emitted by the character 550 is displayed. The character string displayed in the balloon 560 and the voice output from the voice output device 233 may be the same or different. The character string (and voice) can be switched according to the attributes of the subject, the examiner, the character, and the like. For example, it is possible to switch the tone of the character string (and voice) according to the age of the subject and the gender of the subject.

Some examples of the contents output as character strings and voice are shown below. By referring to the anterior segment image of the eye E to be inspected, the examiner grasps that the eyelids are lowered and the eyes are squinting, and sends a message to point out that and a message to urge the eyes to open. Input to the external examiner terminal 5. The output control unit 201 executes control for outputting a character string or voice according to the input message. As a result, it is possible to prevent the improvement of visual acuity due to the pinhole effect and the deterioration of visual acuity due to the eyelids hanging on the pupil, and it is possible to perform the visual acuity test with high accuracy. The ophthalmologic examination device 2, the management server 4, the external examiner terminal 5, and the like can be configured to detect the above-mentioned event by analyzing the anterior ocular segment image. In this case, it is possible to automatically output a character string or voice, or to notify the examiner of the occurrence of a predetermined event.

When it is found that the subject has not blinked for a predetermined time, the examiner inputs a message prompting the examinee to blink to the external examiner terminal 5. The output control unit 201 executes control for outputting a character string or voice corresponding to this message. This can prevent the cornea from drying out and reducing visual acuity. The ophthalmic examination device 2, the management server 4, the external examiner terminal 5, and the like can be configured to detect that blinking has not been performed for a predetermined time by analyzing the anterior ocular segment image. In this case, it is possible to automatically output a character string or voice, or to notify the examiner that blinking has not been performed for a predetermined time.

During the test, the method of the test can be presented and instructions for promoting the progress of the test can be presented. For example, in the visual acuity test, it is possible to output a message according to the correct / incorrect answer of the subject's response. In addition, the character can be used for the inspection itself. For example, a character in the form of a snake can be rotated to attract the attention of the subject, and the character can be switched to the Randold ring at a predetermined timing for display. Further, in a binocular vision function test such as an unequal vision test, a character in the form of an animal is presented at a presentation position of a fusion target (fixation target), and the fixation is promoted by rotating the character. it can. The character in the form of an animal is switched and displayed as a normal fusion target (fixation target) at a predetermined timing. As an example of the timing for switching from the character to the optotype, there is a timing when a predetermined time has elapsed and a timing when it is detected from the anterior segment image that the eye E to gaze at the character.

After the test is completed, the test results and medical matters may be explained to the subject. A character can be used for that purpose. At this time, an image or a character string for facilitating the understanding of the explanation can be further displayed. For example, it is possible to explain by voice information while displaying an image showing the mechanism of occurrence of emmetropia, myopia, and hyperopia together with a character.

The character can be used to conduct an interview before the examination. In the interview, for example, the subject may be asked about the presence / absence / frequency of use of vision correction tools (glasses, contact lenses, intraocular lenses, etc.), medical history, etc. by combining characters, character strings, voice, etc. it can.

The voice of the examiner input by the voice input device 524 of the external examiner terminal 5 can be converted into a synthetic voice according to the character and output. The voice conversion is performed by the external examiner terminal 5, the management server 4, or the ophthalmologic examination device 2. The output control unit 201 causes the voice output device 233 to output the synthesized voice obtained by converting the voice of the examiner.

The voice of the examiner input by the voice input device 524 of the external examiner terminal 5 can be converted according to the attributes of the examinee. For example, the examiner's voice can be translated into the subject's language. Language conversion (translation) is realized by using known speech analysis technology and translation technology. The hardware and software for that purpose are provided in any of the external examiner terminal 5, the management server 4, and the ophthalmologic examination device 2. The output control unit 201 can generate a synthetic voice representing the content obtained by translating the voice of the examiner, and output this to the voice output device 233. Further matters concerning processing according to the language used by the subject will be described later.

When information on the visual acuity of the eye E to be inspected (visual acuity value, refractive power, etc.) is acquired in advance, the output control unit 201 can adjust the display size of the character, character string, or image based on this information. The output control unit 201 stores in advance table information in which the visual acuity value and / or the refractive power and the display size are associated with each other. The output control unit 201 selects a display size associated with the visual acuity value and / or the refractive power of the eye E to be inspected, and displays a character or the like on the LCD 214 with the selected display size.

<Second example of usage pattern>
As a second example of the usage pattern of the ophthalmologic examination system 1, a usage pattern for assisting a single subject via each character (avatar) by two or more examiners will be described with reference to FIG. To do.

In this example, one internal examiner and one external examiner assist a single subject, but two or more internal examiners assist a single subject, or Two or more external examiners assisting a single subject, one or more internal examiners and two or more external examiners assisting a single subject, or two It is also possible for the above internal examiner and one or more external examiners to assist a single subject.

Further, in this example, the case where the examiner is selected according to the language used by the examinee will be described, but the types of attributes that can be referred to in the examiner's selection are not limited to the language and are arbitrary attributes. It may be. For example, even when the test cannot be performed smoothly because the subject is elderly or the like, the same processing as below can be executed. The description of the same steps and processes as in the first example may be omitted.

(S21: Inspection started)
In this example, a subject whose mother tongue is a language other than Japanese (for example, English) and whose understanding of Japanese is insufficient uses an ophthalmologic examination device 2 installed in a facility in Japan. The case of performing the inspection will be described. The examination of the eye E to be inspected using the ophthalmologic examination apparatus 2 is started.

It should be noted that the character can be displayed from this stage (or a stage such as an interview before that). Since the examiner's assistance is not provided at this stage, the output control unit 201 (character control unit 202) autonomously controls the character based on the inspection status information. Such autonomous control is performed according to a computer program.

(S22: I can't understand the language)
The ophthalmologic examination device 2 gives explanations and instructions (automatic navigation) of the examination to the subject in a preset language. In this example, it is set to explain in Japanese. The subject in this example cannot understand the automatic navigation performed in Japanese.

(S23: Call the examiner)
When the subject performs a predetermined operation or voice input to request the examiner's assistance, the communication request generation unit 22b generates a communication request (call request) based on the operation request, and the communication unit 24 generates the communication request and the communication request. The predetermined information is transmitted to the management server 4. Alternatively, the examination status information generation unit 22a of the ophthalmic examination apparatus 2 generates the examination status information, the communication request generation unit 22b generates a communication request (call request) based on the information, and the communication unit 24 generates the call request and a predetermined call request. The information is transmitted to the management server 4.

(S24: Select the internal inspector terminal)
The management server 4 receives the examiner call request and information transmitted from the ophthalmologic examination apparatus 2 in step S23 by the communication unit 43. At this stage, the selection unit 412 selects any of the internal examiner terminals 3 existing in the facility where the examinee is inspecting as the examiner who assists the examinee.

(S25: Control of communication establishment)
The communication control unit 401 transmits a control signal for establishing communication between the internal examiner terminal 3 and the ophthalmologic examination device 2 to the internal examiner terminal 3 selected in step S24.

(S26: Start of avatar control)
When the communication between the ophthalmologic examination device 2 and the internal examiner terminal 3 is established by the control of step S25, the character control unit 202 uses the internal examiner terminal 3 as the character of the internal examiner (internal examiner). Avatar) is displayed on LCD 214. When the internal examiner inputs an instruction using the internal examiner terminal 3, the instruction information including the instruction content is transmitted to the ophthalmologic examination apparatus 2 via the management server 4 or directly. The output control unit 201 controls the operation of the internal examiner avatar based on this instruction information. Thereby, the internal examiner can confirm the situation of the examinee and send an instruction.

(S27: Assist NG)
If this internal examiner can handle the situation, the examinee's assistance will be continued (not shown). On the other hand, if it is determined that the situation cannot be dealt with, the internal inspector proceeds to step S28 to request assistance from the external inspector. The latter case will be described below.

(S28: Calling an external inspector)
The internal inspector performs a predetermined operation using the internal inspector terminal 3 in order to request assistance from the external inspector. This operation may include, for example, a selection operation of the language used by the subject. If the call request or information transmitted from the ophthalmologic examination device 2 to the management server 4 in step S23 includes information indicating the language (English) used by the subject, the internal examiner uses it. There is no need to select a language. The communication unit 32 transmits a communication request (and predetermined information) for calling an external inspector to the management server 4.

(S29: Select an external inspector terminal)
The management server 4 receives the communication request or the like transmitted from the internal inspector terminal 3 in step S28 by the communication unit 43. At this stage, the selection unit 412 selects an external examiner (or an external examiner terminal 5) who can use English by referring to the attribute information. At this time, one external inspector can be selected according to the operating status of each external inspector who can use English.

(S30: Control of communication establishment)
The communication control unit 401 connects the external examiner terminal 5 selected in step S29 (or the external examiner terminal 5 used by the external examiner selected in step S29) to the external examiner terminal 5. A control signal for establishing communication with the ophthalmologic examination apparatus 2 is transmitted.

(S31: Start of two-way communication)
The control signal transmitted in step S30 establishes bidirectional communication between the external examiner terminal 5 and the ophthalmologic examination device 2. At this time, it is possible to establish communication between the internal examiner terminal 3 and the external examiner terminal 5. It is also possible to continue establishing communication between the internal examiner terminal 3 and the ophthalmologic examination apparatus 2.

(S32: Start of avatar control)
When bidirectional communication between the ophthalmologic examination device 2 and the external examiner terminal 5 is started in step S31, the character control unit 202 uses the external examiner terminal 5 to display the character of the external examiner (external examiner). Avatar) is displayed on LCD 214. As a result, both the internal examiner avatar and the external examiner avatar are displayed on the LCD 214. The operation control of the internal examiner avatar is executed as described in step S26.

On the other hand, when the external examiner inputs an instruction using the external examiner terminal 5, the instruction information including the instruction content is transmitted to the ophthalmologic examination apparatus 2 via the management server 4. The output control unit 201 controls the operation of the external examiner avatar based on this instruction information. This allows the external examiner to check the subject's situation and send instructions while using English. The internal and external examiners can cooperate with each other to assist the subject.

It is possible to control not to present at least part of the interaction between the internal and external examiners to the subject. At that time, the internal examiner and the external examiner can perform an operation for distinguishing whether the information input by the internal examiner is for the subject or for another examiner. For example, a software key (and / or a software key for inputting information for a subject) for inputting information for another examiner can be provided in the GUI. When information for another examiner is input, the management server 4 (transfer control unit 402) transfers the information only to the other examiner terminal. For example, when such information is input to the external examiner terminal 5, the transfer control unit 402 transmits this information only to the internal examiner terminal 3. As another processing example, when information for another examiner is input, the output control unit 201 of the ophthalmologic examination apparatus 2 switches whether to output the information based on the incidental information (flag, etc.) of the information. Can be done. For example, when receiving the information input from the external examiner terminal 5 or the internal examiner terminal 3, the output control unit 201 sets a predetermined flag (for example, a flag indicating that the information is for another examiner) to this information. Is attached, and if it is not attached, the control to output this information is executed, and if it is attached, the control is not performed.

According to this example, when there is a subject who cannot perform the examination smoothly, direct communication with the subject can be started quickly. As a result, the subject can be given a sense of security. Even if the problem is not solved by this direct communication, it is possible to automatically select an external examiner suitable for the solution and provide remote assistance. Therefore, it is possible to deal with various subjects without having to constantly assign internal examiners with various attributes to each facility. Further, a plurality of examiners (for example, an internal examiner and an external examiner) can jointly assist the examinee. In particular, since instructions can be transmitted to the subject through the avatar of each examiner, it is possible to provide an appropriate assist while giving the examinee a sense of security.

<Third example of usage pattern> Use of learning content In the third example of usage pattern of the ophthalmic examination system 1, the process of learning the control executed in response to the instruction from the examiner and the control of this learning content. The processing for reflecting in is described. An example of the former process is shown in FIG. 9, and an example of the latter process is shown in FIG.

(S41: Start of assist)
First, the learning process will be described with reference to FIG. For example, the inspector's assistance is started as described above. In this example, the case where the external inspector assists will be described, but the same processing can be performed when the internal inspector assists.

(S42: Transmission of inspection status information, etc.)
The ophthalmologic examination device 2 transmits examination status information and the like to the management server 4. As described above, the test status information includes the progress of the test (test phase), the intermediate result of the test (for example, the display history of the optotype in the visual acuity test), the test time (for example, the test start time, the elapsed time), and the like. Is generated and transmitted, especially when there is a problem with the inspection.

(S43: Memory of inspection status information)
The management server 4 receives the examination status information transmitted from the ophthalmologic examination apparatus 2 in step S42. The control management unit 42 stores this examination status information in the storage unit 421 together with the device ID of the ophthalmologic examination device 2.

(S44: Transfer of inspection status information, etc.)
The transfer control unit 402 transfers the examination status information and the like from the ophthalmologic examination device 2 to the external examiner terminal 5. The order in which steps S43 and S44 are executed is arbitrary, and it is also possible to execute these in parallel.

(S45: Input of instructions)
The external examiner terminal 5 receives the inspection status information or the like transferred in step S44 and outputs the information (display of information, output of voice, etc.). The external inspector refers to the output information and inputs the instruction.

(S46: Transmission of instruction information)
The external examiner terminal 5 generates instruction information according to the content of the instruction input in step S45, and transmits this to the management server 4.

(S47: Memory of instruction information)
The management server 4 receives the instruction information transmitted in step S46. The control management unit 42 stores this instruction information in the storage unit 421. At this time, the control management unit 42 associates this instruction information with the examination status information stored in step S43 by referring to, for example, the device ID of the ophthalmic examination device 2. At this time, as described above, the inspection status information can be classified.

(S48: Transfer of instruction information)
The transfer control unit 402 transfers the instruction information from the external examiner terminal 5 to the ophthalmologic examination device 2. The order in which steps S47 and S48 are executed is arbitrary, and it is also possible to execute these in parallel.

(S49: Information output (character control, etc.))
The ophthalmologic examination apparatus 2 receives the instruction information transferred in step S48. The output control unit 201 controls the LCD 214, the display device 231 and the audio output device 233 based on the instruction information. For example, the character control unit 202 controls the movement of the character based on the instruction information.

(S50: Transmission of control information)
The ophthalmologic examination apparatus 2 generates control information indicating the content of the control executed in step S49, and transmits this to the management server 4.

(S51: Memory of control information)
The management server 4 receives the control information transmitted from the ophthalmologic examination apparatus 2 in step S50. The control management unit 42 stores this control information in the storage unit 421. At this time, the control management unit 42, for example, by referring to the device ID of the ophthalmologic examination device 2, obtains this control information, the examination status information stored in step S43, and (the instruction information stored in step S47). Associate with each other. At this time, as described above, the inspection status information can be classified.

It should be noted that it may be configured to execute only one of the storage of instruction information (step S47) and the storage of control information (step S51). When only the storage of the instruction information (step S47) is executed, the control information can be generated from the instruction information as described above.

By repeating the above processing, the situation (event, etc.) that occurred in the examination and the content of the inspector's instruction (that is, the content of the control executed by the ophthalmologic examination device 2 for that situation) Correspondence relationships are accumulated. An example of how to use the accumulated information will be described below with reference to FIG.

(S61: Start of assist)
For example, the inspector's assistance is started as described above. Since the examiner does not appear in the following processing, the description of the external examiner terminal 5 and the like in FIG. 10 is omitted.

(S62: Transmission of inspection status information)
The ophthalmologic examination device 2 transmits the examination status information to the management server 4.

(S63: Search for control information)
The management server 4 receives the examination status information transmitted from the ophthalmic examination apparatus 2 in step S62. The search unit 422 searches for the examination status information (or the like) stored in the storage unit 421 that corresponds to the examination status information received this time from the ophthalmologic examination device 2, and the searched examination status information (or similar). Or the like) to acquire the control information associated with it. As a result, the control information corresponding to the inspection status information transmitted in step S62 is searched.

If the control information corresponding to the new inspection status information is not searched, the external inspector terminal 5 is requested to assist as in the case of FIG. Then, new examination status information is stored in the storage unit 421 together with the instruction information from the external examiner terminal 5 and the control information indicating the content of the control executed by the ophthalmologic examination device 2 in response to the instruction information.

(S64: Transmission of control information)
The management server 4 transmits the control information searched in step S63 to the ophthalmologic examination device 2.

(S65: Information output (character control, etc.))
The ophthalmologic examination apparatus 2 receives the control information transmitted in step S64. The output control unit 201 controls the LCD 214, the display device 231 and the audio output device 233 based on this control information. For example, the character control unit 202 controls the movement of the character based on the control information.

If a problem occurs during the examination using the ophthalmologic examination device 2 by such processing, the assist actually performed by the examiner when this problem (or a similar problem) occurs in the past is automatically reproduced. It becomes possible.

<Switching control mode according to inspection type>
In an embodiment, the ophthalmologic examination apparatus may be capable of performing a plurality of examinations. In this case, the control mode of the character (and information display, voice output, etc.) can be switched according to the type of inspection. Hereinafter, an example of a system capable of performing such mode switching will be described.

FIG. 11 shows an example of the configuration of the ophthalmic examination apparatus included in the ophthalmic examination system according to the embodiment. In this example, the ophthalmologic examination apparatus is provided with an element for switching the control mode, but it is also possible to provide a part or all of the element in another apparatus (for example, a management server).

The ophthalmic examination device 2A shown in FIG. 11 is different from the ophthalmic examination device 2 shown in FIG. 2 in that the control unit 20 is provided with the mode switching unit 220. Other configurations of the ophthalmologic examination apparatus 2, the configuration of the internal examiner terminal 3, the configuration of the management server 4, and the configuration of the external examiner terminal 5 may be the same as those in the above embodiment.

The mode switching unit 220 executes various processes related to the control mode. The mode switching unit 220 includes a processor, a storage device, and the like. The mode switching unit 220 is provided with a mode information storage unit 221. The first control mode information is stored in advance in the mode information storage unit 221. The first control mode information is associated with a control mode for each type of examination that can be performed using the ophthalmologic examination apparatus 2A.

In a typical example, the ophthalmologic examination device 2A is configured to function as a visual acuity test device, a refractometer and a keratometer. The visual acuity test device includes an optical system that projects an optotype (Randolt ring, etc.) for visual acuity test on the fundus, an input device that receives the response of the subject to the projected optotype, and a processor that executes various processes. Including. The processor executes a process of switching the optotype projected on the fundus according to the response of the subject, a process of determining the visual acuity value of the eye to be examined based on the history of the response of the subject, and the like. The refractometer analyzes an optical system that projects a ring-shaped luminous flux onto the fundus, an optical system that detects the return light of the ring-shaped luminous flux from the fundus with an image sensor, and an output (ring-shaped image) from the image sensor. It is equipped with a processor that calculates the sphericality, astigmatism, astigmatism axis angle, etc. of the eye to be inspected. The keratometer analyzes the optical system that projects a ring-shaped luminous flux onto the cornea, the optical system that detects the return light of the ring-shaped luminous flux from the cornea with an image sensor, and the output (ring-shaped image) from the image sensor to the cornea. It is equipped with a processor for obtaining the curvature distribution and the like.

For the first control mode information, for example, the control content in the visual acuity test mode applied when the visual acuity test device is used, the control content in the reflex mode applied when the refractometer is used, and the keratometer are used. It contains the control contents in the kerato mode that are sometimes applied.

The type of examination performed using the ophthalmologic examination apparatus 2A is input using, for example, the user interface 23. It should be noted that the desired inspection can be selectively specified, or a plurality of inspections can be specified to be performed in a predetermined order. The mode switching unit 220 acquires the information of the control mode corresponding to the designated inspection type from the mode information storage unit 221 (first control mode information) and sends it to the output control unit 201.

The output control unit 201 controls the LCD 214, the display device 231 and the audio output device 233 based on the information sent from the mode switching unit 220. For example, the character control unit 202 selects a character to be displayed on the LCD 214 and controls the operation of the character based on the information sent from the mode switching unit 220. According to such an embodiment, it is possible to preferably execute character motion control and the like according to the type of inspection.

<Switching of control mode according to subject attributes>
Subjects of various attributes use ophthalmologic examination equipment. Typical examples of the attributes of the subject include the language used, the presence or absence of a disease, the name of the disease, gender, age, and the like. Hereinafter, an example of a system capable of switching the control mode according to the subject attribute will be described.

FIG. 12 shows an example of the configuration of the management server included in the ophthalmologic examination system according to the embodiment. In this example, the management server is provided with an element for switching the control mode, but it is also possible to provide a part or all of the element in another device (for example, an ophthalmologic examination device).

The management server 4A shown in FIG. 12 is different from the management server 4 shown in FIG. 5 in that the mode management unit 44 is provided. The other configurations of the management server 4, the configuration of the ophthalmologic examination apparatus 2, the configuration of the internal examiner terminal 3, and the configuration of the external examiner terminal 5 may be the same as those in the above embodiment. The management server 4A may or may not include the control management unit 42 shown in FIG.

The mode management unit 44 executes various processes related to the control mode of the ophthalmologic examination apparatus 2. The mode management unit 44 includes a processor, a storage device, and the like. The mode management unit 44 is provided with a mode information storage unit 441, a mode information retrieval unit 442, and a mode processing unit 443.

The second control mode information is stored in advance in the mode information storage unit 441. A control mode is associated with each of the subject attributes in the second control mode information.

As a typical example, a case where the subject attribute includes a language type will be described. The types of languages include, for example, Japanese, English, Chinese, Korean, German, French, Spanish, and the like. The second control mode information includes control contents in the operation mode corresponding to each of these languages. For example, the second control mode information may include any of the following: character string information and voice information corresponding to each language; an ID of an external examiner corresponding to each language or an ID of an external examiner terminal; each. Language-compatible translation processors, translation dictionaries, etc. Although not shown, the translation processor and the translation dictionary are provided on either the management server 4A or the external examiner terminal 5.

The attributes (language used in this example) of the subject who uses the ophthalmologic examination device 2 are input using, for example, the user interface 23 of the ophthalmologic examination device 2. It is also possible for an examiner who monitors the status of the subject (inspection status) to input the subject attribute using his / her own terminal. In addition, the voice input by the subject may be analyzed to identify the type of language. These are examples of the attribute reception department.

When the language used by the subject is input, the mode information retrieval unit 442 acquires the control mode information corresponding to the input language type from the mode information storage unit 441 (second control mode information). The mode processing unit 443 executes, for example, the following processing based on the acquired control mode information.

When the information searched by the mode information search unit 442 includes character string information or voice information corresponding to the language, the mode processing unit 443 causes the searched information to be transmitted to the ophthalmologic examination device 2. Controls the communication unit 43. The output control unit 201 of the ophthalmologic examination device 2 controls the LCD 214, the display device 231 and the voice output device 233 based on the information sent from the management server 4A. For example, the character control unit 202 selects a character to be displayed on the LCD 214 and controls the operation of the character based on this information. As a result, the language of the information output by the ophthalmologic examination apparatus 2 can be automatically switched to the language used by the subject.

When the information searched by the mode information retrieval unit 442 includes the ID of the external examiner corresponding to the language or the ID of the external examiner terminal, the mode processing unit 443 directs the external examiner terminal 5 to the ID. The communication unit 43 is controlled so as to send an assist request. As a result, it is possible to automatically search for an external examiner who can provide assistance in the language used by the examinee.

When the information searched by the mode information retrieval unit 442 includes information such as a translation processor and a translation dictionary corresponding to the language, the mode processing unit 443 is provided with a reference language (for example, an ophthalmic examination device 2). Send a process start request to the translation processor that supports the translation between the subject's language (standard language in your country or region) and the subject's language. As a result, the examiner's instructions are translated into the language used by the subject and output from the ophthalmologic examination device 2, and the voice uttered by the examinee is translated into the reference language to be translated into the external examiner terminal 5 and the internal examination. It is possible to output from the personal terminal 3.

<Modification example of ophthalmic examination device>
FIG. 13 shows an example in which the inspection optical system and the information presentation optical system are arranged separately. In the inspection unit 21A of the ophthalmic examination apparatus 2B, the inspection optical system used for the inspection of the eye E to be inspected includes the optical element 215 applied to the eye E to be inspected and the optical element 215 to inspect the eye E to be inspected. Includes a projection system 216 that projects onto the eye E to be inspected through. Further, the information presentation optical system for presenting information to the subject includes an LCD 217 (display unit) and a light guide system 218 that guides the display luminous flux output from the LCD 217 to the eye E to be inspected via the optical element 215. Including. The information presented by the information presentation optical system includes information automatically presented by the ophthalmologic examination device 2B, information transmitted from the internal examiner terminal 3 (instructions from the internal examiner, etc.), and an external examiner terminal. There is information (instructions from an external inspector, etc.) sent from 5. Further, a character is displayed on the LCD 217. The operation of the character displayed on the LCD 217 is controlled by the character control unit 202 in the output control unit 201 (not shown). The display of the character and the operation control are the same as those in the above embodiment.

The optical path of the inspection optical system and the optical path of the information presentation optical system are combined by the beam splitter 219. The beam splitter 219 is, for example, a half mirror, a dichroic mirror or a polarizing beam splitter. The components other than the inspection unit 21 may be the same as those in FIG.

Whether the inspection optical system and the information presentation optical system are configured in common as shown in FIG. 2 or individually configured as shown in FIG. 13 is determined according to, for example, the function of the ophthalmologic examination apparatus. ..

<Presentation of information by the examiner terminal>
The configuration and processing for presenting information to the examiner will be described. As described above, the external examiner assists the examinee from a remote location. Therefore, it is desirable to be able to present information for appropriately grasping the situation of the subject at an appropriate timing and at an appropriate interface. It is also possible to present information to the internal inspector in the same manner. In this case, the management server 4 (particularly the transfer control unit 402) can control so that the presentation of the information on the external examiner terminal 5 and the presentation of the information on the internal examiner terminal 3 are synchronized.

The control unit 50 of the external examiner terminal 5 causes the display device 521 to display the screen 1000 shown in FIG. The screen 1000 is provided with presentation information display areas 1010L and 1010R, communication content display area 1020, usage status display area 1030, subject information display area 1040, and presentation information operation area 1050.

Information presented to the left eye and the right eye of the subject is displayed in the presentation information display areas 1010L and 1010R, respectively. In this example, the ophthalmologic examination device 2 is configured to be able to present information to both the left and right eyes of the subject at the same time. The ophthalmologic examination apparatus 2 is provided with, for example, an inspection optical system and an information presentation optical system for the left eye and an inspection optical system and an information presentation optical system for the right eye independently of each other (for example, the left eye). An optical head for the right eye and an optical head for the right eye are provided). As another example, the ophthalmologic examination apparatus 2 may be configured to divide the luminous flux from a single examination optical system into two and guide one to the left eye and the other to the right eye. As yet another example, the ophthalmologic examination apparatus 2 may be configured to divide the luminous flux from a single information presentation optical system into two and guide one to the left eye and the other to the right eye. The configuration in which information can be presented to both the left and right eyes at the same time is not limited to these, and may be any configuration.

In the presentation information display areas 1010L and 1010R shown in FIG. 14, optotypes for binocular vision function test are displayed. These are the optotypes currently presented to the subject by the ophthalmologic examination apparatus 2. The information indicating the optotype currently presented is transmitted from the ophthalmologic examination apparatus 2 to the management server 4, and further transferred to the external examiner terminal 5 by the transfer control unit 402. The control unit 50 identifies the type of the optotype currently presented by the ophthalmologic examination device 2 based on the information transferred from the management server 4, and presents an image representing the identified optotype in the presentation information display area 1010L and Display on 1010R. The image representing the optotype is stored in advance in a storage device (not shown) in the control unit 50, for example, as a thumbnail. When the optotype presented by the ophthalmologic examination apparatus 2 is changed, the transfer process is executed in real time. As a result, the external examiner can recognize the optotype presented by the ophthalmologic examination apparatus 2 in substantially real time.

The character presented to the subject can be displayed in the presentation information display area 1010 or the like. For example, the avatar of the examiner (external examiner) who is looking at the screen 1000 can be displayed. Further, it is also possible to control the operation of the avatar displayed in the presentation information display area 1010 or the like by acquiring the control contents by the character control unit 202 of the ophthalmologic examination device 2 in real time via the management server 4. .. The area in which the character is displayed is not limited to the presentation information display area 1010 or the like, and may be another display area or a dedicated display area may be provided.

In the communication content display area 1020, the communication content between the examiner and the subject, particularly the content of the support provided by the examiner to the examinee is displayed. The content of the displayed support is at least the content of the support provided by the external examiner, the content of the support provided by the internal examiner, and the information (question content, response content, etc.) from the subject. Any may be included. Further, the information for each user (external examiner, internal examiner, examinee) may be switched and displayed in the communication content display area 1020. It is also possible to display information from one or more users in chronological order.

In the example shown in FIG. 14, the content of the question posed by the external examiner (the person using the screen 1000) in the management center "A" and the content of the subject's response to the question are displayed in the communication content. It is displayed in the area 1020. It is also possible to display the voice information emitted by the examiner or the subject as text using a known voice recognition technique. Further, the text information associated with the predetermined operation in advance may be displayed.

In the usage status display area 1030, the names “store A”, “store B”, and the like of a plurality of facilities in which the ophthalmologic examination device 2 is installed are displayed. Further, the identification information "device 1", "device 2", etc. of a plurality of ophthalmic examination devices 2 installed in the facility (for example, store B) selected by the external examiner or the management server 4 or the like from these facilities are displayed. ing.

In the example shown in FIG. 14, the mark presented on the left side of the name of the facility indicates the presence or absence of selection. For example, the white star mark attached to the store A or the store C indicates that the facility is not selected, and the black star mark attached to the store B indicates that the facility is selected. In addition, such a star mark group can be configured as a radio button. In this case, the external examiner can select the desired one from these facilities.

Further, the mark presented on the left side of the identification information of the device installed in the selected store B also indicates whether or not the selection is made by the external inspector, the management server 4, or the like. In the example shown in FIG. 14, the white circle mark indicates that it is not selected, and the black circle mark indicates that it is selected. In the example shown in FIG. 14, the ophthalmologic examination device 2 of the identification information “device 1” installed in the store B is selected as the ophthalmic examination device 2 (examinee) for which the external examiner is in charge of support. It should be noted that such a group of round marks can be configured as a radio button. In this case, the external examiner can select a desired one from these ophthalmologic examination devices 2.

On the right side of the identification information of the ophthalmologic examination device 2, time information (for example, the time when the support is started, the elapsed time from the start of the support, etc.) and the communication establishment state (communication mode) regarding the ophthalmic examination device 2 are presented. There is.

The communication mode will be described here. In this embodiment, four communication modes can be selectively applied. Further, it is possible to arbitrarily shift from one communication mode to another communication mode.

The communication mode 1 indicates a state in which the subject is independently performing the examination by the ophthalmic examination apparatus 2. In the communication mode 1, the subject is not supported by either the internal examiner or the external examiner, and the ophthalmologic examination device 2 also communicates with the internal examiner terminal 3 with the external examiner terminal 5. Communication between them has not been established either. As described above, even when the communication mode 1 is applied, the information from the ophthalmologic examination device 2 (examination status information, information displayed on the screen 1000, etc.) is transmitted to the internal examiner terminal 3 and the outside. It can be transferred to at least one of the examiner terminals 5. As a result, the examination by the ophthalmologic examination apparatus 2 can be monitored, and the examiner can issue a communication request and start support as needed. In addition, when the subject requests support, the request can be promptly responded to.

The communication mode 2 indicates a state in which the inspection is performed with the support of an external inspector. In the communication mode 2, communication between the ophthalmologic examination device 2 and the external examiner terminal 5 is established. As described above, the information from the ophthalmologic examination device 2 can be transferred to the internal examiner terminal 3 even when the communication mode 2 is applied. This allows the interior examiner to respond quickly, for example, when the need for direct assistance arises.

The communication mode 3 indicates a state in which the inspection is performed with the support of the internal inspector. In the communication mode 3, communication between the ophthalmologic examination device 2 and the internal examiner terminal 3 is established. As described above, the information from the ophthalmologic examination apparatus 2 can be transferred to the external examiner terminal 5 even when the communication mode 3 is applied. Thereby, for example, the external inspector can quickly respond when a situation occurs that the internal inspector cannot handle.

The communication mode 4 indicates a state in which the inspection is performed with the support of both the internal inspector and the external inspector. In the communication mode 4, communication between the ophthalmologic examination device 2, the internal examiner terminal 3, and the external examiner terminal 5 is established. The communication mode 4 is applied, for example, when the internal inspector and the external inspector need to talk with each other, or when the external inspector educates the internal inspector. The transfer control unit 402 of the management server 4 can control so that the communication content between the internal examiner and the external examiner is not transferred to the ophthalmologic examination apparatus 2. That is, the transfer control unit 402 can perform the following control: Transfer the information from the internal examiner to the external examiner only to the external examiner terminal 5: From the external examiner to the internal examiner. Transfer information only to the internal examiner terminal 3; Transfer information from the internal examiner to the subject to the external examiner terminal 5 and ophthalmic examination device 2; Transfer information from the external examiner to the internal examiner Transfer to the internal examiner terminal 3 and the ophthalmic examination device 2; transfer the information output from the ophthalmic examination device 2 to the external examiner terminal 5 and the internal examiner terminal 3.

The communication mode is switched by the management server 4 that receives a communication request (call request, interrupt request) from the subject, the internal examiner, or the external examiner. For example, when a call request is generated from the subject in the communication mode 1, the communication mode 2, 3 or 4 is switched. Which communication mode can be switched to is determined, for example, according to the designation by the subject, the content of the inspection status information, the above-mentioned attributes, and the like.

When an interrupt request from the internal inspector occurs in the communication mode 1, the communication mode 3 or 4 is switched. Similarly, when an interrupt request from an external inspector occurs in the communication mode 1, the communication mode 2 or 4 is switched. Further, the disconnection of communication (withdrawal from the communication establishment state) is performed, for example, according to the selection of the person, the selection of the subject, the end of the examination, or the like.

Information about the subject is presented in the subject information display area 1040. In the example shown in FIG. 14, the measured values (refraction, astigmatism, astigmatism axis angle, addition degree, visual acuity value, etc.) of each eye of the subject, the anterior segment image of each eye, and the face of the subject. Images etc. are displayed. Furthermore, it is also possible to present arbitrary information about the subject such as name, age, gender, disease name, language used, and degree of examination difficulty.

The presentation information manipulation area 1050 is provided with a GUI (software key or the like) for manipulating the information presented to the subject. In the example shown in FIG. 14, a GUI (target selection, frequency change dial, etc.) for selecting an optotype presented to the subject and various operation buttons (print, export, etc.) are provided. ing. The external examiner operates the software key or the like provided in the presentation information operation area 1050 by using the operation device 522.

The character presented to the subject can be displayed on the examiner terminal whose communication with the ophthalmologic examination apparatus 2 is established. For example, the avatars of one or more examiners assisting the examinee can be displayed. Further, it is also possible to control the operation of each avatar by acquiring the control contents by the character control unit 202 of the ophthalmologic examination device 2 in real time via the management server 4.

<Action / effect>
The actions and effects of the embodiments will be described.

The ophthalmic examination system of the embodiment includes an ophthalmic examination device (ophthalmic examination device 2 and the like) and an examination instruction device (internal examiner terminal 3, external examiner terminal 5 and the like). The examination instruction device is used by the examiner to send instructions to the ophthalmologic examination device.

The inspection instruction device is input by a first input unit (operation device 312, voice input device 314, photographing unit 51, operation device 522, voice input device 524, etc.) for inputting instruction information related to inspection, and a first input unit. It is provided with a first communication unit (communication unit 32, communication unit 54, etc.) that transmits the given instruction information to the ophthalmic examination device.

The ophthalmologic examination apparatus includes an examination optical system (inspection optical system 211, etc.), an information presentation optical system (LCD 214, projection system 213, etc.), a second communication unit (communication unit 24, etc.), and a control unit (output control unit 220, etc.). Etc.) and. The inspection optical system includes an optical element (optical element 212, etc.) applied to the eye to be inspected, and a projection system (projection system 213, etc.) that projects an inspection luminous flux for inspecting the eye to be inspected onto the eye to be inspected via the optical element. including. The information presentation optical system includes a display unit (LCD 214 or the like) and a light guide system (projection system 213 or the like) that guides the display luminous flux output from the display unit to the eye to be inspected via an optical element. The second communication unit receives the instruction information transmitted from the inspection instruction device. The control unit displays a predetermined character image on the display unit, and controls the operation of the character image based on the instruction information received by the second communication unit.

According to such an embodiment, it is possible to convey the intent (instruction, advice, etc.) of the examiner to the examinee by using a character such as an avatar. Therefore, in the remote inspection, it is possible to convey the intent of the examiner to the examinee in an easy-to-understand manner. In addition, by using a familiar character, it is possible to reduce the anxiety felt by the subject.

In the embodiment, the ophthalmologic examination apparatus may include an audio output unit (audio output device 233, etc.) that outputs audio information. Further, the control unit can cause the voice output unit to output voice information based on the instruction information received by the second communication unit. According to this configuration, in addition to visual assistance by the character, instructions and advice can be sent by voice.

In the embodiment, the control unit can display at least one of the character string information and the image information based on the instruction information received by the second communication unit on the display unit. As a result, in addition to assist by characters, instructions and advice can be sent using character strings and images.

The ophthalmologic examination system of the embodiment may include an information generation unit (examination status information generation unit 22a, etc.) that generates examination status information indicating the examination status using the ophthalmic examination apparatus. Further, the control unit can control the operation of the character image based on the inspection status information generated by the information generation unit. According to this configuration, it is possible to provide assist using a character quickly and autonomously according to the subject and the situation of the examination.

The ophthalmologic examination system of the embodiment may include an information generation unit (examination status information generation unit 22a and the like), a first storage unit (memory unit 421 and the like), and a search unit (search unit 422 and the like). The information generation unit generates examination status information indicating the status of the examination using the ophthalmologic examination device. The first storage unit stores the inspection status information generated by the information generation unit in association with the control information representing the control executed by the control unit based on the instruction information received by the second communication unit. The search unit searches the first storage unit for control information corresponding to the new inspection status information generated by the information generation unit. Further, the control unit of the ophthalmologic examination device can control the operation of the character image based on the control information searched by the search unit. According to this configuration, the content of the instruction actually given by the examiner can be reproduced according to the subject and the situation of the examination. In other words, it is possible to learn the content of the instruction actually given by the examiner and autonomously control the character.

The ophthalmologic examination system of the embodiment may include a first examination instruction device and a second examination instruction device as examination instruction devices. Examples of the first and second inspection instruction devices include one or more internal examiner terminals 3 and one or more external examiner terminals 5. The control unit of the ophthalmologic examination device can display the first character image and the second character image on the display unit. Further, the control unit controls the operation of the first character image based on the instruction information from the first inspection instruction device, and controls the operation of the second character image based on the instruction information from the second inspection instruction device. can do. According to this configuration, simultaneous assistance by two (or more) examiners can be provided by using the characters corresponding to each examiner.

The ophthalmologic examination system of the embodiment may include a second storage unit (mode information storage unit 221 or the like) and a designated unit (user interface unit 23 or the like). In the second storage unit, the first control mode information in which the control mode is associated with the type of examination that can be performed using the ophthalmologic examination device is stored in advance. The designation unit has a function for designating the type of examination performed by using the ophthalmologic examination apparatus. Further, the control unit of the ophthalmologic examination apparatus can control the operation of the character image in the control mode corresponding to the examination type designated by the designated unit. According to this configuration, the character and its operation can be switched according to the inspection type, so that it is possible to convey instructions and advice to the subject in an easy-to-understand manner.

The ophthalmologic examination system of the embodiment includes a third storage unit (mode information storage unit 441, etc.), an attribute reception unit (user interface 23, etc.), and a control mode processing unit (mode information retrieval unit 442, mode processing unit 443, etc.). And may be provided. The second control mode information in which the control mode is associated with the subject attribute is stored in advance in the third storage unit. The attribute reception unit receives the attributes of the subject who uses the ophthalmologic examination device. The control mode processing unit acquires the control mode corresponding to the attribute received by the attribute receiving unit from the second control mode information. Further, the control unit of the ophthalmologic examination apparatus can control the operation of the character image in the control mode acquired by the control mode processing unit. According to this configuration, the character and its movement can be switched according to the subject's attributes (language, disease, gender, age, etc.), so that it is possible to convey instructions and advice to the subject in an easy-to-understand manner. It will be possible.

In embodiments, the subject attribute may include a language type. In this case, the control mode processing unit can perform processing for outputting information in the language corresponding to the attribute received by the attribute receiving unit. Examples of the processing executed by the control mode processing unit include processing related to translation of instructions from the examiner, processing for selecting the examiner according to the language, and processing for outputting character string information and voice information according to the language. .. According to this configuration, the language used for assist can be matched with the language used by the subject.

In the embodiment, the ophthalmologic examination device may include a second input unit (operation device 232, voice input device 234, etc.) for the subject to input information. In this case, the second communication unit of the ophthalmologic examination device transmits the information input by the second input unit to the examination instruction device. The first communication unit of the examination instruction device receives the information transmitted from the ophthalmologic examination device. Further, the inspection instruction device is an output control that outputs information received by the information output unit (display device 311, voice output device 313, display device 521, voice output device 523, etc.) and the information output unit to the information output unit. A unit (control unit 30, control unit 50, etc.) is provided. According to this configuration, bidirectional communication is possible between the ophthalmologic examination device and the examination instruction device, and interactive assistance can be provided.

Further, according to the embodiment, it is possible to deal with various situations that occur in the remote inspection. For example, it is possible to quickly assist the subject according to the request of the subject and the judgment of the examiner. In addition, it is possible to give appropriate instructions at appropriate timings according to the degree of understanding of the subject regarding the inspection contents. Further, even when the examinee is not accompanied by the examinee, it is possible to assist the examinee by grasping the state of the examinee and the progress of the examination in substantially real time. In addition, it is possible to accurately assign examiners (highly specialized examiners, experts, examiners who can speak foreign languages, etc.) who have the necessary abilities to perform assists appropriately. ..

<Modification example>
The embodiments described above are merely typical examples of the present invention. Therefore, any modification (omission, substitution, addition, etc.) within the scope of the gist of the present invention can be appropriately applied.

For example, it is possible to record the instruction content provided by an expert such as an external inspector and configure it so that it can be reproduced. The recording mode of the instruction content includes, for example, recording, recording, and text conversion.

In addition, the embodiments and modifications described above can be arbitrarily combined.

1 Ophthalmic examination system 2 Ophthalmic examination device 20 Control unit 201 Output control unit 202 Character control unit 21 Inspection unit 214 LCD
24 Communication unit 3 Internal examiner terminal 4 Management server 5 External examiner terminal 51 Imaging unit 522 Operation device 524 Voice input device 54 Communication unit

Claims (3)

Ophthalmic examination equipment and
An ophthalmic examination system including an examination instruction device used by an examiner to send an instruction to the ophthalmic examination device.
The inspection instruction device
The first input section for inputting instruction information related to inspection,
It is provided with a first communication unit that transmits the instruction information input by the first input unit to the ophthalmologic examination apparatus.
The ophthalmologic examination device
An inspection optical system including an optical element applied to the eye to be inspected and a projection system for projecting an inspection luminous flux for inspecting the eye to be inspected onto the eye to be inspected via the optical element.
An information presentation optical system including a display unit and a light guide system that guides a display luminous flux output from the display unit to the eye to be inspected via the optical element.
A second communication unit that receives the instruction information transmitted from the inspection instruction device, and
A control unit that displays a predetermined character image on the display unit and controls the operation of the character image based on the instruction information received by the second communication unit is provided.
It further includes a detection unit that detects a predetermined event by analyzing the anterior segment image of the eye to be inspected.
The control unit is an ophthalmologic examination system, further characterized in that the operation of the character image is controlled based on the result of detection by the detection unit. The predetermined event according to claim 1, wherein the predetermined event includes any one or more of lowering the eyelids, squinting the eyes, and not blinking for a predetermined time. Ophthalmic examination system. An inspection optical system including an optical element applied to the eye to be inspected and a projection system for projecting an inspection luminous flux for inspecting the eye to be inspected onto the eye to be inspected via the optical element.
An information presentation optical system including a display unit and a light guide system that guides a display luminous flux output from the display unit to the eye to be inspected via the optical element.
A communication unit that receives instruction information related to the inspection entered by the inspector using the inspection instruction device,
A detection unit that detects a predetermined event by analyzing the anterior segment image of the eye to be inspected,
A predetermined character image is displayed on the display unit, the operation of the character image is controlled based on the instruction information received by the communication unit, and the operation of the character image is performed based on the result of detection by the detection unit. An ophthalmologic examination device including a control unit for controlling.