Optics: eye examining – vision testing and correcting – Eye examining or testing instrument – Objective type
Reexamination Certificate
2002-07-29
2004-12-14
Dvorak, Linda C. M. (Department: 3737)
Optics: eye examining, vision testing and correcting
Eye examining or testing instrument
Objective type
C606S004000, C606S017000, C600S558000, C351S246000
Reexamination Certificate
active
06830335
ABSTRACT:
BACKGROUND OF THE INVENTION
The present invention relates to a binocular indirect ophthalmoscope and to a laser accessory therefor.
Ophthalmologists need to examine the retina for a number of reasons. An indirect ophthalmoscope is one of a number of devices used for this purpose. An indirect ophthalmoscope is, typically in essence, a pair of viewing binoculars, for example with 2× magnification, mounted on a headband with an integrated light source for projecting light into the patient's eye to enable the retina to be viewed by a clinician wearing the ophthalmoscope.
It is known to integrate a laser into the headset of the ophthalmoscope in order to treat disorders observed by the clinician, for example by a photocoagulation treatment of a peripheral portion of a patient's
fundus oculi.
The design of an attachment for providing a laser beam, conventionally involves an optical fibre delivery system for connection to the laser and an associated set of optical elements for focussing the divergent beam from the fibre's distal end to the patient's eye. These may include, dependent on design, a lens for converging the laser beam and possibly a mirror for deflecting the beam out to the patient at a distance of approximately 30 centimetres in front of the ophthalmoscope.
Whatever the delivery method, the output elements of the laser delivery system need to be secured in front of the ophthalmoscope.
Hitherto no one has been able to mount the laser delivery coaxial with the viewing path due to the mechanics of the laser delivery. Having the laser coaxial with the vision is the ideal scenario for the surgeon.
The final deflecting mirror or lens has always been mounted above or below the line if sight in order to preclude obstruction of the surgeons view. The beam therefore converges into the eye at an angle rather than being in the visual plane of the ophthalmoscope.
The mounting of the output optics in front of the ophthalmoscope has been a major problem as the goal is to achieve coaxiality with the vision.
Introducing the laser from above the line of sight of the ophthalmoscope at 12 o'clock necessitates having a mirror angled at 45 degrees to the vertical plane. This is secured on a shaft in the opposite plane if movement of this mirror is to be achieved. A rotatable shaft with a cam mechanism is often employed to tilt the mirror to the required position. This shaft would obscure the vision of the ophthalmoscope if it were in the plane of his line of sight. This alone necessitates the mirror assembly to be mounted above or below the line of vision.
It is possible that if the line of vision is directed through the centre of a patient's pupil, the laser-beam, which is angled to the line of vision, may clip the patient's iris.
This is a common problem and clinicians use eye drops in order to dilate the pupil as much as possible in order to reduce this disadvantage. Unfortunately diabetics have glycogen disorders within the iris structure and dilation is not always possible which hinders further the procedure. If the laser beam were coaxial with the viewing optics the problem would be greatly alleviated.
Accordingly known laser beams projected from the ophthalmoscope are not parallel with the optical axes of the binocular. They converge at an angle of about 5 to 10 degrees.
SUMMARY OF THE INVENTION
It is a principal object of this invention to provide an alternative laser delivery means for an indirect ophthalmoscope.
According to a first aspect the invention comprises a binocular indirect laser ophthalmoscope comprising binocular eyepieces each having an optical axis defining an optical plane, the ophthalmoscope having a central viewing axis lying in said optical plane; and an optical element adapted to position a laser beam into said optical plane substantially on said viewing axis and substantially parallel to said viewing axis.
According to a second aspect the invention comprises a laser-directing attachment for attaching to an indirect ophthalmoscope comprising: an attachment mechanism adapted to attach said attachment to the ophthalmoscope; a laser fibre connector adapted to connect to an optical fibre adapted to carry a laser beam; a director adapted to direct a laser beam in a direction relative to said attachment; and direction controls adapted to control the director to place a laser beam emitted via said connector in a line generally superimposed upon a central viewing axis of said indirect ophthalmoscope.
According to another aspect of the invention a binocular laser indirect ophthalmoscope comprises: a pair of eyepieces for a user to look through, and respective image capture optics associated with respective eyepieces, said eyepieces and associated image capture optics having respective optical axes, said optical axes defining an optical plane, and there being a central line of view of said ophthalmoscope lying in said optical plane; a laser beam coupler for coupling a laser beam delivery device to said ophthalmoscope; a laser beam director for directing a laser beam provided from said laser beam coupler forwards, away from said ophthalmoscope; an adjustment mechanism for controlling the position or orientation of said laser beam director so as to vary the position or direction of a laser beam propagating from said director; and wherein said laser beam coupler is provided disposed laterally to one side of said image capture optics and said laser beam director is provided in front of said image capture optics, and wherein said adjustment mechanism is adjustable to position a laser beam propagating from said director substantially in said optical plane of view, substantially undivergent therefrom and substantially on said central line of view.
According to another aspect the invention comprises a device for attachment to an indirect ophthalmoscope for fitting a laser to said ophthalmoscope, said device comprising: a support member; an attachment formation provided associated with said support member for attaching said support member to said ophthalmoscope; a laser director coupled to said support member by a mechanical coupling mechanism so as to be movable relative to said support member;, a control mechanism for moving said laser director relative to said support member; wherein said device has a forward-facing front portion away from which a laser beam is directed in use, and a rearward facing pack portion which in use is disposed towards an operator's face, and a side portion laterally disposed to one side of said device; and wherein said mechanical coupling mechanism is provided at said side portion.
According to another aspect the invention comprises a method of aligning a laser beam of an indirect binocular laser ophthalmoscope with a visual plane of said ophthalmoscope defined by first and second optical axes of first and second eyepiece optics of said binocular ophthalmoscope, said method comprising providing a reflector between said optical axes such that said reflector intersects said visual plane; directing a laser beam onto said reflector at about the position where said reflector intersects said visual plane; and controlling the orientation or position of said reflector so as to cause a laser beam reflected from said reflector to be in or parallel to said visual plane.
Preferably the binocular ophthalmoscope has a central viewing axis and the method comprises emitting the laser beam generally on the viewing axis.
According to another aspect the invention comprises a method of aligning a laser beam of an indirect binocular laser ophthalmoscope with a visual plane of said ophthalmoscope defined by first and second optical axes of first and second eyepiece optics of said binocular ophthalmoscope, said method comprising providing a beam manipulator between said optical axis, such that said beam manipulator intersects said visual plane, and causing said laser beam to enter said ophthalmoscope laterally to one side thereof.
According to another aspect the invention comprises a method of laser treatment of an eye by contr
Gutridge John Robert
Snellgrove Timothy Ralph
Dvorak Linda C. M.
Litechnica Limited
Mintz Levin Cohn Ferris Glovsky and Popeo P.C.
Sanders John R
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