DEVICES AND/OR METHODS FOR INSPECTING AND/OR ILLUMINATING A HUMAN EYE
20230090020 · 2023-03-23
Inventors
Cpc classification
International classification
Abstract
An optic system assists visualization of eye elements during ophthalmic surgery. The system has optic devices aimed at affecting light emitted by an ophthalmic microscope for observing an eye during surgery. This affecting can be by selecting the wavelength spectrum of the emitted light, tilting a light path of the emitted light and/or by changing the light path of the emitted light from the source to the eye under surgery.
Claims
1. An optic system for use with a visualization device suitable for observing eye elements during surgery along an optical axis X, wherein the optic system comprising optic devices aimed at affecting visualization of the eye elements by the visualization device by selecting a wave-length spectrum of light emitted towards the eye from a light source along a light path and by changing an optical power by which the light emitted towards the eye from the light source along the light path converges, wherein the optic system comprises a beam splitter intercepting the optical axis X for reflecting at least part of the light emitted by the light source along the optical axis X towards the eye and wherein the changing of the optical power is by introducing a lens into the light path before it reaches the beam splitter from the light source.
2. The optic system of claim 1, wherein selecting the wave-length spectrum comprises eliminating from light emitted towards the eye wave lengths ineffective in providing a ‘red reflex’ providing background and contrast necessary for visualization of the eye.
3. The optic system of claim 2, wherein selecting the wavelength spectrum comprises permitting emittance towards the eye of wave length spectrums between about 420 to about 750 nanometers.
4. The optic system of claim 1, wherein the affecting of visualization of the eye elements by the visualization device is also by tilting a light path of light emitted towards the eye, wherein the tilting the light path comprises tilting a light source emitting light towards the eye.
5. The optic system of claim 1, wherein tilting the light path comprises using a different light source for illuminating the eye and/or inserting a prism or a mirror into the light path.
6. (canceled)
7. The optic system of claim 1, wherein changing the optical power comprises urging change in a diopter of a lens through which the light path already passes.
8. The optic system of claim 1, the optic system being an auxiliary optic system outside of the visualization device and arranged to intervene with the optical axis of the device.
9. The optic system of claim 8, wherein the intervention is along a section of the optical axis between the objective lens of the visualization device and the eye.
10-11. (canceled)
12. The optic system of claim 1 and being an integrated optic system located within the visualization device upstream of an objective lens of the visualization device in a direction away from the eye to thus form an enhanced visualization device.
13. The optic system of claim 1, the optic system comprising and/or being used in conjunction with an illumination module placed closely adjacent to the eye for emitting light towards the eye along an axis that is angled relative to an optical axis of the eye.
14. (canceled)
15. The optic system of claim 13, wherein light emitted by the illumination module is in a blue light range, for example between about 400 and about 495 nanometers.
16. (canceled)
17. The optic system of claim 13, wherein the illumination module comprising at least a portion that is inserted to extreme closeness of the eye, for example an optical fiber.
18. The optic system of claim 1, wherein the visualization device is any one of: an ophthalmic microscope, a surgical digital microscope, a 3D video digital microscope and/or video microscope.
19-28. (canceled)
29. An auxiliary optic system for use with a visualization device suitable for observing eye elements during surgery along an optical axis X, the auxiliary optic system comprising optic devices aimed at affecting visualization of the eye elements by the visualization device by selecting a wave-length spectrum of light emitted towards the eye from a light source thereof along a light path and by changing an optical power by which the light emitted towards the eye from the light source along the light path converges, wherein the auxiliary optic system is outside of the visualization device and comprises a beam splitter that is arranged to intervene with the optical axis X of the visualization device in order to reflect at least part of the light emitted by the light source along the optical axis X towards the eye and wherein the changing of the optical power comprises introducing a lens into the light path before it reaches the beam splitter from the light source.
30. The auxiliary optic system of claim 29, wherein the affecting of visualization of the eye elements by the visualization device is also by: tilting a light path of light emitted towards the eye.
31. The auxiliary optic system of claim 29, the auxiliary optic system being a distinct separate system to the visualization device.
32. The auxiliary optic system of claim 30, wherein selecting the wave-length spectrum comprises eliminating from light emitted towards the eye wave lengths ineffective in providing a ‘red reflex’ providing background and contrast necessary for visualization of the eye.
33-35. (canceled)
36. The auxiliary optic system of claim 30, wherein changing the optical power comprises urging change in a diopter of a lens through which the light path already passes.
37. (canceled)
38. A visualization device suitable for observing eye elements during surgery along an optical axis X and comprising an integrated optic system for enhancing visualization, the integrated optic system comprising optic devices aimed at affecting visualization of the eye elements by the visualization device by selecting a wave-length spectrum of light emitted towards the eye from a light source thereof along a light path and by changing an optical power by which the light emitted towards the eye from the light source along the light path converges, wherein the integrated optic system is located within the visualization device upstream of an objective lens of the visualization device in a direction away from the eye and comprises a beam splitter that is arranged to intervene with the optical axis X of the visualization device in order to reflect at least part of the light emitted by the light source along the optical axis X towards the eye and wherein the changing of the optical power comprises introducing a lens into the light path before it reaches the beam splitter from the light source.
39-44. (canceled)
45. The visualization device of claim 38, wherein changing the optical power comprises urging change in a diopter of a lens through which the light path already passes.
46. The visualization device of claim 38 and being any one of: an ophthalmic microscope, a 3D surgical digital microscope, a video microscope.
47. (canceled)
Description
BRIEF DESCRIPTION OF THE FIGURES
[0031] Exemplary embodiments are illustrated in referenced figures. It is intended that the embodiments and figures disclosed herein are to be considered illustrative, rather than restrictive. The invention, however, both as to organization and method of operation, together with objects, features, and advantages thereof, may best be understood by reference to the following detailed description when read with the accompanying figures, in which:
[0032]
[0033]
[0034]
[0035]
[0036]
[0037]
[0038]
[0039] It will be appreciated that for simplicity and clarity of illustration, elements shown in the figures have not necessarily been drawn to scale. For example, the dimensions of some of the elements may be exaggerated relative to other elements for clarity. Further, where considered appropriate, reference numerals may be repeated within the figures to indicate like elements.
DETAILED DESCRIPTION
[0040] Attention is first drawn to
[0041] Light within light path 14 is emitted away and back towards the microscope passing, inter alia, through an objective lens 16 of the microscope, which is the closest optical element of the microscope to the patient being treated. The surgeon may view scenes located along optical axis X and light path 14 via an eyepiece 15 of the microscope.
[0042] The surgery procedure here illustrated and discussed herein below will be a cataract surgery, however embodiments disclosed herein may be equally applicable to other procedures that utilize reflex background illumination—such as retina surgery.
[0043] Attention is drawn to
[0044]
[0045] As apparent, these exemplary figures show that while typically emitted wave length spectrums may cover a large spectrum of waves lengths, such as substantially the entire visible spectrum of waves lengths from about 380 to about 740 nanometers (
[0046] The red reflex wave length spectrum can be seen substantially peaking in the red spectrum from about 600 to about 750 nanometers, and in this example the intensity of the peaking back scattered red reflex is about twice that of the remaining other back scattered wavelengths from about 440 to about 570 nanometers.
[0047] Attention is drawn to
[0048]
[0049] The light rays arriving at the retina (in particular macula) are then scattered in various directions 9 with a substantial amount of light being directed by assistance of the eye's lens back out of the eye through the open iris. This outgoing light, which illuminates mainly in red eye elements such as the lens, lens capsule (etc.), travels along optical axis X and light path 14 back towards the microscope to eventually arrive at the surgeon's eyes observing the surgical procedure via eyepiece 15 (see
[0050] In some cases, excess light intensity used by a surgeon for illuminating the eye may result in damage to the retina known as ‘light toxicity’. Thus, an independent aspect of at least certain embodiments of the present invention may be defined as reducing exposure of the eye to relative high light intensities while substantially not compromising and possibly also enhancing the quality of visualization of the eye to a surgeon conducting a surgical procedure to the eye.
[0051] The above may be accomplished by eliminating at least some of the wavelengths found as ineffective in providing the ‘red reflex’ wave length spectrum (while possibly changing the ratio of intensity of the relevant wavelength) from light spectrum being projected into the eye during surgery to thereby form a lower intensity ‘operative-spectrum’ used for illuminating the eye.
[0052] In one example, such ‘operative-spectrum’ being projected into the eye may be substantially in wavelength values identified as those scattered by the retina (in particular macula) as depicted in
[0053] Attention is drawn to
[0054] Consequently, the surgeon operating the eye may be provided with lower background illumination that may affect his/her ability to successfully conduct the surgical procedure taking place. Further shown in this figure is that at least some of the incoming light may be scattered or absorbed by fragments left within the treated eye and by that diverge away light from a direct path towards the macula further reducing visualization for the surgeon.
[0055]
[0056] An additional situation that may occur during surgery, in which incoming light may be shifted away from being focused towards a vicinity the macula, may be due to movement of the eye caused e.g. as the surgeon presses surgical tools against the eye. The eye in such situation may e.g. rotate slightly and by that rotate the macula from being aligned with the microscope's optical axis X along which the incoming light travels. Such a situation can be seen in
[0057] An independent aspect of at least certain embodiments of the present invention may thus be related to ‘focal-corrections’ aimed at maintaining e.g.
[0058] incoming light focused at the eye's retina and in particular a vicinity of the macula. It is noted that this independent aspect may be combinable if desired with the former independent aspect of reducing likelihood to light toxicity by projecting into the eye an ‘operative-spectrum’ of light.
[0059] In an embodiment, such ‘focal-correction’ may be accomplished by an ‘intervening lens’ that may be arranged to intervene with incident light emitted towards the eye in order to restore during surgery at least part or substantially most of the focal power lost due to removal of the eye's natural lens—so that light entering the eye may substantially maintain a focused route targeting a vicinity of the macula during the surgical procedure.
[0060] In another embodiment, such ‘focal-correction’ may be accomplished in addition and/or alternatively to use of an ‘intervening lens’—by tilting a light beam used for illuminating the eye, so that incident light of such tilted light beam assumes a modified route that resumes focus towards a vicinity of the macula during movements of the eye. Possible, such “tilting” may be accomplished by introducing an optical wedge into the beam.
[0061] The above mentioned independent aspects (i.e. ‘operative spectrum’, ‘intervening lens’, ‘tilted light beam’)—possibly combinable one with the other but not necessarily—may be implemented by utilizing optic systems according to various embodiments of the present invention. Such optic systems may be embodied as so-called ‘auxiliary’ and/or ‘integrated’ with an ophthalmic visualization device such as an ophthalmic microscope used for eye surgery.
[0062] With attention drawn back to
[0063] Attention is drawn to
[0064] Auxiliary optic system 181 may be attachable to the microscope possibly by a rotating hinge or the like (not shown) so that it can be urged (e.g. rotated) into and/or out of intervention with light path 14.
[0065] Light controller 1811 may be arranged to control operation of light source 1815, which may in turn be in the form of a COB LED (or the like). Light source 1815 may be mounted in thermal contact with heat sink 1813.
[0066] Light emitted by light source 1815 may be arranged to initially follow a route that may be transverse (e.g. generally orthogonal but not necessarily) to an optical axis X of a microscope with which it cooperates (the microscope not being shown in
[0067] Light emitted by auxiliary optic system 181 may be in various spectrums such as those illustrated in
[0068] In certain embodiments, this may be accomplished by using a light source 1815 that is designed to emit an ‘operative-spectrum’. In other embodiments, various type light sources 1815 may be used (such as that emitting one of the spectrums seen in
[0069] Light 141 emitted by auxiliary optic system 181 and entering the eye may be scattered from the retina (in particular macula) with some of this light exiting back out of the eye along axis X. This light exiting back out of the eye forms part of light path 14 and a portion of this light that passes through beam splitter 1818 is indicated in
[0070] A portion of this light may be directed by beam splitter 1818 into optic system 181 while another portion 142 continues along optical axis X towards the microscope to provide the surgeon with a view of the eye being treated.
[0071] In certain embodiments, beam splitter 1818 may be configured to allow a larger percentage of incoming incident light to transmit through it while reflecting a smaller percentage of light. Such configuration of beam splitter 1818 may be useful in allowing a larger percentage of light scattered and reflected back from the eye to arrive into the microscope in order to provide the surgeon with a detailed as possible view of the eye being treated.
[0072] In a non-binding example, beam splitter 1818 may be designed to be of a 90/10 type, permitting about 90% of incoming incident light to transmit and pass through it while reflecting about 10% of the light.
[0073] In the case where incoming incident light is from light source 1815, about 90% of this light transmits onwards through beam splitter 1818 (and thus does not illuminate the eye) while only about 10% is reflected along axis X into the eye. In the case where the incoming incident light is scattered light reflected back from the eye, about 90% of this light transmits onwards along axis X through beam splitter 1818 towards the microspore while only about 10% is reflected into the auxiliary optic system 181.
[0074] Intensity of light arriving back from the eye and reflected into auxiliary optic system 181 by beam splitter 1818 may be sensed by feedback sensor 1814.
[0075] As already discussed, during surgery the eye may move (e.g. rotate as seen in
[0076] Intensity of light detected by feedback sensor 1814 and communicated to controller 1811 may assist in detecting such movement of the eye, by e.g. detecting a drop in the intensity of the light relative to former measurements.
[0077] In certain embodiments, auxiliary optic system 181 via controller 1811 that receive such incoming data from sensor 1814—may be arranged tilt light source 1815 be means of an actuator, such as the optional actuator 1812 shown herein. Controller 1811 may trigger one or more of the actuating members 18122 of actuator 1812 to distort and by that urge light source 1815 to tilt.
[0078] The tilting of the light beam causes incident light emitted by the light beam to travel along altering optical paths towards the retina (see optical paths of the dashed lines of tilted position 1815′ relative to the solid lines prior to tilting). As the controller 1811 receives signals form sensor 1814 indicating an optimal peak in light arriving back from the retina—the tilting of the light beam may be halted—since such optimal peak may be indicative of light being re-focused back towards a vicinity of the macula.
[0079]
[0080] Controller 1811 may be in communication via for example Bluetooth with a mobile device 1820 such as a tablet that can be used for displaying to the surgeon data relating to auxiliary optic system 181 and/or for allowing the surgeon to control auxiliary optic system 181, e.g. by changing intensities of light source 1815 e.g. by voice activation, touch screen (or the like).
[0081] When the surgical procedure to the natural lens of the eye starts (e.g. removal of the eye's natural lens commences), the reduced optical power due to the diminishing natural lens—results in light not being focused on the retina and in particular a vicinity of the macula (see, e.g.,
[0082] Determination that the cause for such decrease in brightness is due to lens removal (and not e.g. eye movement)—may be provided by the surgeon performing the surgical procedure that is aware to the surgical stage he/she initiated. The surgeon may e.g. via voice activation provide such feedback to the controller—so that the suitable correction may be performed to compensate for the removed optical power of the removed natural lens.
[0083] In certain embodiments, the controller when receiving such inputs from sensor 1814 indicative of removal of the natural lens (or as aforementioned directly from the surgeon), may be programmed to urge the tunable lens 1816 (which initially may be flat and thus with substantially no optical power)—to assume a curvature. Example of such lens 1816 are VectorLens, OptoTune, VariOptic. Such curvature may urge the tunable lens 1816 to assume an optical power that intervenes with incident light arriving from light source 1815 to re-focus the light towards the retina and preferably towards a vicinity of the macula.
[0084] Attention is drawn to
[0085] An example of an element unique to integrated optic system 182 shown in
[0086] Beam splitter 18288, feedback sensor 18144 and tunable lens 18166 all marked by the dashed lines in
[0087] As seen in
[0088]
[0089] Consequently, the surgeon operating the eye is provided as here seen with lower background illumination that may affect his/her ability to successfully conduct the surgical procedure at stake. Further shown in this figure is that at least some of the incoming light may impact lens' fragments left within the treated eye and scatter away from the macula or absorbed in fragments further reducing visualization for the surgeon.
[0090] As seen in
[0091] Intervening-lens 1826 may be arranged to interact with incident light arriving from light source 1825 in order to compensate for optical power lost due to removal of eye's natural lens—so that the light emitted by light source 1825 will remain focused towards a vicinity of the macula during stages of a surgical operation where there is substantially no lens present within the lens capsule (i.e. until the intraocular plastic lens is inserted into the lens capsule).
[0092] Attention is drawn to
[0093] As seen in
[0094]
[0095]
[0096] Attention is drawn to
[0097] As seen in these figures, the scattered light forms a pattern that follows an axis Y along which incoming light 180 arrives—in that the vector of scattered light is generally largest along axis Y in the light direction as shown in the arrow 180, while the intensity of scattered light diminishes as it diverges away from axis Y.
[0098] Therefore, when incoming light as seen in
[0099] Attention is drawn to
[0100] Such illumination module embodiments 190, 191, 192 may possibly be used in conjunction with existing microscope illumination or the integrated and auxiliary optic system embodiments described herein above—and may be useful in particular during stages of optical surgery where the part of the front capsule is removed and the natural lens is being breached and removed, stages during which there may be an increased formation of particles/fragments/folds within elements of the eye such as the lens, lens capsule (etc.)
[0101] The illumination module 190 seen in
[0102] As seen in these figures, the angled axis Y along which light is emitted into the eye relative to the eye's optical axis O—allows some light being scattered off fragments formed within the eye or folds in the capsule—to escape out of the eye to be picked up by e.g. a microscope (here not shown) through which a surgeon observes the eye during surgery.
[0103]
[0104] The illumination module of
[0105]
[0106] Illumination module 192 in
[0107] Articulating member 22 in this example can also be seen including an eye speculum 26 that may be used for retracting the eyelid during ophthalmic surgery.
[0108] In an aspect of the preset invention, fitting various illumination module embodiments to an articulating member, either by coupling such illumination module(s) to a distinct articulating member such as 22 here shown, or by integrally forming such illumination module(s) with an articulating member generally similar to 22 (see e.g.,
[0109] Such targeting of the emitted light as seen, e.g. in
[0110]
[0111] In experimental tests conducted for various illumination module embodiments of the present disclosure, it has been found that illumination module embodiments utilizing blue light source(s) for illuminating an eye—have been found to enhance image details and increase e.g. by about 50% the resolution apparent to the surgeon (e.g. increase the ability to detect details of about 15 micron in size from about 30 micron in size under red light background illumination scattered from the retina).
[0112] Such light sources emitting light in the blue wavelength may be optimal for increasing visualization of elements within the eye such as the eye lens and/or fragments of or within an eye lens when the lens is being removed (or the like), since such wave length may be generally similar to or larger than the eye particle size a physician would like to observe within the eye.
[0113] In an aspect of the present invention, “optimization” may be provided to an angle of incidence at which light may be emitted towards a lens region of an eye by various illumination module embodiments. Such “optimization” may be aimed at providing a surgeon with enhanced visualization of the lens region (e.g. lens fragments possibly not yet removed from an eye during cataract surgery). In a preferred embodiment, such optimization may be to light emitted in the blue light range, for example between about 400 and about 495 nanometers, from illumination module embodiments described herein.
[0114] Attention is drawn to
[0115] The ‘auxiliary’ type optic system here illustrated may be generally similar to that shown e.g. in
[0116]
[0117] In an embodiment of the present invention, signals received by light sensor 779 may be used for computing/assessing an “optimized” angle at which light may be emitted by an illumination module (such as that shown in
[0118]
[0119] A portion thereof 96 passing through secondary beam splitter 18188 may then be reflected by beam splitter 1818 along axis X to form a light path 97 towards the eye for creating the ‘red reflex’ phenomena providing background illumination of eye elements. Some of the light 98 reflected by secondary beam splitter 18188 may be blocked by light absorber 777 is so desired.
[0120] Attention is drawn to
[0121] In the description and claims of the present application, each of the verbs, “comprise” “include” and “have”, and conjugates thereof, are used to indicate that the object or objects of the verb are not necessarily a complete listing of members, components, elements or parts of the subject or subjects of the verb.
[0122] Further more, while the present application or technology has been illustrated and described in detail in the drawings and foregoing description, such illustration and description are to be considered illustrative or exemplary and non-restrictive; the technology is thus not limited to the disclosed embodiments. Variations to the disclosed embodiments can be understood and effected by those skilled in the art and practicing the claimed technology, from a study of the drawings, the technology, and the appended claims.
[0123] In the claims, the word “comprising” does not exclude other elements or steps, and the indefinite article “a” or “an” does not exclude a plurality. A single processor or other unit may fulfill the functions of several items recited in the claims. The mere fact that certain measures are recited in mutually different dependent claims does not indicate that a combination of these measures can not be used to advantage.
[0124] The present technology is also understood to encompass the exact terms, features, numerical values or ranges etc., if in here such terms, features, numerical values or ranges etc. are referred to in connection with terms such as “about, ca., substantially, generally, at least” etc. In other words, “about 3” shall also comprise “3” or “substantially perpendicular” shall also comprise “perpendicular”. Any reference signs in the claims should not be considered as limiting the scope.
[0125] Although the present embodiments have been described to a certain degree of particularity, it should be understood that various alterations and modifications could be made without departing from the scope of the invention as hereinafter claimed.