The present disclosure relates to ultrasound imaging and treatment of an eye and in particular directed to an apparatus and method for reducing intraocular pressure by 1) ablating the ciliary process which is the structure responsible for production of aqueous humor and 2) by vibrating the trabecular mesh to stimulate better drainage of fluid through the trabecular mesh and out of the eye. The present disclosure describes an apparatus and method for forming a high precision image of the eye wherein the resolution is sufficient to image, for example, ciliary body and region around the trabecular mesh. The present disclosure further discloses an imaging transducer and an irradiating therapeutic transducer that can be mounted such that they are movable between a plurality of positions.

An ophthalmic laser system for generating a first beam at a first wavelength on a first beam path and a second beam at a second wavelength on a second beam path, and directing optics to selectively direct the first beam or the second beam to a treatment beam path. The ophthalmic laser system incorporates a reflex coaxial illuminator comprising a reflex mirror movable on an axis from a position out of the treatment beam path to a position in the treatment beam path to direct illumination into an illumination path coaxial with the treatment beam path. The reflex mirror is adapted to transmit a beam that follows the second beam path.

A system (20) includes a radiation source (48) and a controller (44). The controller is configured to define a treatment zone (88) on a capsule (86) of an eye (25) of a subject (22), and to form an opening (96) in the capsule, subsequently to defining the treatment zone, by irradiating multiple target regions (94) within the treatment zone in an iterative process that includes, during each one of multiple iterations of the process, acquiring an image (98) of at least part of the capsule, designating one of the target regions based on the acquired image, and causing the radiation source to irradiate the designated target region. Other embodiments are also described.

A method for laser eye surgery that accommodates patient movement includes: generating a first and a second electromagnetic radiation beam, the second beam configured to modify eye tissue; propagating the first beam to a scanner along a an optical path length that changes in response to eye movement; focusing the first beam to a first focal point within the eye; scanning the first focal point at different locations within the eye; propagating a portion of the first beam reflected from the first focal point location back along the variable optical path to a sensor; generating an intensity signal indicative of the intensity of the portion of the reflected first beam; propagating the second beam to the scanner along the variable optical path; focusing the second beam to a second focal point and scanning the second focal point to create an incision in the cornea of the eye.

An adjustment system for an Optical Coherence Tomography (OCT) imaging system includes an OCT light source; a beam splitter, splitting the OCT light beam into an imaging beam to an imaging arm, and a reference beam to a reference arm; a probe, guiding the imaging beam onto a target and receiving a returned imaging beam from the target; the beam splitter generating an interference beam from the returned imaging beam and a returned reference beam from the reference arm; an imaging detector, detecting the interference beam; an imaging processor, generating an OCT image from the detected interference beam; and an adjustment device, removably coupled to the probe, the adjustment device comprising the target attached to a distal region of a target holder at a working distance from a distal end of the imaging probe, wherein an optical length of the reference arm is adjustable to improve a calibration of the OCT image.

A multiple-fiber scanning ophthalmic transscleral laser probe system capable of firing multiple laser spots sequentially on the perilimbal area through the use of multiple fibers and an optical switching mechanism is disclosed. The design aims to reduce probe motion on the surface of the eye during transscleral cyclophotocoagulation and pulsed transscleral laser therapy by allowing multiple laser shots to be fired sequentially in a partial circular pattern without any probe movement and without the use of moving parts inside the probe. Sequential firing from a fixed probe location allows precise power level for each treatment spot and prevents the probe tip getting caught on or damaging the conjunctiva.

A method of treating a subject having glaucoma comprises performing excimer laser trabeculostomy (ELT) on a subject having glaucoma and having previously undergone a failed treatment or a treatment that has been rendered ineffective by progression of the disease. In some examples, the failed treatment is a non-surgical treatment comprising administering medicated eye drops. In some examples, the failed treatment is a laser treatment or surgical treatment, such as a trabeculoplasty, iridotomy, iridectomy, trabeculectomy, trabeculotomy, goniotomy, surgical insertion of a shunt or implant, deep sclerectomy, viscocanalostomy, or a combination thereof.

A method and delivery system are disclosed for creating an aqueous flow pathway in the trabecular meshwork, juxtacanalicular trabecular meshwork and Schlemm's canal of an eye for reducing elevated intraocular pressure. Pulsed laser radiation is delivered from the distal end of a fiber-optic probe sufficient to cause photoablation of selected portions of the trabecular meshwork, the juxtacanalicular trabecular meshwork and an inner wall of Schlemm's canal in the target site. The fiber-optic probe may be advanced so as to create an aperture in the inner wall of Schlemm's canal in which fluid from the anterior chamber of the eye flows. The method and delivery system may further be used on any tissue types in the body.

A first optical subsystem includes a window with a refractive index n.sub.w and an exit lens having a refractive index n.sub.x. The exit lens is configured to couple to the window to define a first optical axis extending through the window and the exit lens. A second optical subsystem is configured to output a light beam. The light beam is directed to be incident at a convex surface of the exit lens along a second optical axis at an angle α that is offset from the first optical axis. The window is configured to detachably couple to the cornea of the eye such that the first optical axis is generally aligned with a direction of view of the eye. The respective refractive indices n.sub.w and n.sub.x are configured to direct the light beam incident at the convex surface of the exit lens through the cornea of the eye toward the irido-corneal angle.

The invention provides personalized laser probes for use in laser systems, wherein each laser probe includes one or more characteristics tailored to a given user to thereby improve performance of and outcome of a laser treatment procedure.