Edge visual field training equipment and training method based on visual field center damageTechnical Field
The invention relates to the field of medical equipment, in particular to edge visual field training equipment and a training method based on visual field center injury.
Background
Different patients with visual impairment have different causes and different manifestations of the impairment, and the requirements for visual rehabilitation are quite different for each patient. In terms of vision impairment recovery, patients with central visual field defects are much more difficult to recover than patients with simple visual impairment.
The central visual field defect mainly shows that the central visual field defect is a blind spot around or beside the center, the central blind spot is accompanied with visual acuity reduction and rare visual field stenosis, and can cause central visual objects of patients to deform and even lose vision in serious conditions, so that the visual disabilities of different degrees are caused, and the life quality of the patients is greatly influenced.
At present, ischemic optic neuropathy, optic neuritis, macular diseases and even intracranial lesions become the main causes of irreversible vision damage of people with visual impairment in China. Especially, typical macular diseases, foveal field loss due to macular diseases is one of the most common blinding eye diseases worldwide, and is the third worldwide blindness reason second to cataract and uncorrected refractive error. In recent years, with the increasing aging of population, the prevalence rate of central visual field defects in China is increasing.
Although when the visual function of the patient is damaged, the patient can carry out necessary visual training by matching proper auxiliary appliances so as to fully utilize the residual vision of the patient, improve the independent living ability and improve the living quality of the patient. However, the auxiliary devices in the market at present, including optical magnifying glasses and electronic visual aids, can only optimize images through the functions of amplifying, changing color and adjusting illumination, so that the images are more easily accepted by residual vision, and the function of forming visual field compensation for the central defective visual field is little and few.
The existing methods for treating the central visual field defect are mainly divided into surgical treatment methods and drug treatment methods, wherein photodynamic therapy is the most common laser surgical treatment method at present. The blood vessel is directly sealed by photochemical effect, the surrounding normal retinal tissue and pigment epithelial cells are not damaged, but the vision of most patients is continuously reduced, and the vision is not ideal; the action principle of the drug therapy is that the drug directly acts on key factors influencing the new blood vessels, so that the new blood vessels are inhibited, and the therapeutic purpose is achieved. The commonly used medicines include ranibizumab and combaici-cept. Compared with other treatments, the vision is obviously improved. But has the disadvantages of multiple treatments, high cost and potential risks of intraocular injection. Such as endophthalmitis, rhegmatogenous retinal detachment, retinal tears, iatrogenic traumatic cataracts, and the like. The prevention and treatment level of eye diseases such as cataract, glaucoma and the like is obviously improved along with the improvement of medical conditions, and besides the modes of operation and drug treatment, the in-vitro auxiliary equipment can help patients with central visual field defects to improve the vision. However, the central visual field damage mainly caused by optic neuropathy and macular diseases becomes the main reason of irreversible vision damage of people with visual impairment in China, and the recovery is difficult to obtain through operations and treatments; the market needs a vision training apparatus and method that provides field compensation for a central defective field of view, and the present invention addresses such a problem.
Disclosure of Invention
In order to overcome the defects of the prior art, the invention aims to provide an edge visual field training device and a training method based on visual field center damage, which can form visual field compensation on the center defect visual field of a patient, solidify the edge visual field center through long-term training, solve the visual disorder of the patient and achieve the rehabilitation effect.
In order to achieve the above object, the present invention adopts the following technical solutions:
an edge visual field training device based on a visual field center lesion, comprising: the eye scanning device inputs pictures, the camera acquires external real-time images, the electronic screen displays the external real-time images to a patient, the eye sensor monitors the rotation angle and the holding time of eyeballs of the patient, the control handle adjusts the pictures, and the processor is connected with all the parts and performs data processing.
The foregoing peripheral visual field training device based on visual field center injury, the eye scanning device includes: laser scanning ophthalmoscope, optical coherence tomography, microflux.
The foregoing peripheral visual field training device based on visual field center injury, the eye sensor includes: a non-contact digital camera, an eye tracker or a contact eye action monitor.
The foregoing peripheral visual field training device based on visual field center injury, the processor includes: and the CPU, the MCU or the FPGA supports the processing of image signals and control signals.
A method for training an edge visual field based on visual field center injury comprises the following steps:
step one, importing data;
a) positioning a retina fixation point and a scotoma of a patient by using an eye scanning device;
b) after the optimal retina fixation point of a patient with central visual field defect is obtained, calculating an offset value of a central concave vision center on an equipment image processor, respectively marking the offset value as delta X and delta Y by taking the visual field center as an origin of a coordinate axis, and changing the central coordinate of an imaging point into (delta X, delta Y) in a dynamic guidance mode set by equipment;
step two, monitoring the patient;
after the data test is finished, the data are imported into a system of training equipment, a processor acquires an external real-time image through a camera, the processor assists a guide system to generate preliminary guide data and image parameters according to measured data, a patient is guided to enter a training state, a motion change line of an auxiliary image is set according to a visual field center deviation value, and the image seen by the patient is located at the optimal retinal fixation point in a peripheral visual field;
step four, adjusting the image;
a) in the training process, the eyeball rotation angle and the holding time are collected through the eye movement sensor, the collection angle is compared with a specified value of the position of the best fixation point of the measured visual field, the auxiliary guide system and the image adjusting system are adjusted according to the difference, when the eyeball rotation angle is larger than the specified value, the guide system is weakened, the image contrast is enhanced, and more attention of a patient is transferred to an external real image; when the eyeball rotation angle is smaller than a specified value, the guide system is enhanced, the guide mark effect is enhanced, the mark moving distance is prolonged, the image contrast is reduced, and the attention of a patient is focused on the guide mark;
b) recording the maintenance time of the eyeball rotation, reducing the intervention time of a guide system along with the prolonging or shortening of the maintenance time, recording the maintenance time as effective data for more than 3 seconds, and taking the data within 3 seconds as a training examination certificate;
c) according to the number of the eyes with the central visual field defect of the patient, the auxiliary guide system carries out distinguishing guide; if central visual fields of both eyes are defective, the left eye and the right eye are required to respectively test the best fixation point of the visual fields, and the electronic screen in the training system is used for carrying out auxiliary marking on different movement paths of the left eye and the right eye; if only a single eye has central visual field defect, the eye-care position auxiliary mark flickers in the middle, and the position auxiliary mark in the training eye moves according to the optimal fixation point deviation value.
The method for training the peripheral visual field based on the visual field center injury,
step one, importing data;
a) positioning a retina fixation point and a scotoma of a patient by using an eye scanning device;
if the patient can not fix the central dark point of the target, the visual field offset angle of the patient is measured to automatically track and compensate the eyeground position offset caused by the eyeball movement in a training instrument, and the central dark point and the retina fixation point are positioned under the condition of non-central fixation.
b) After the optimal retinal fixation point of a patient with central visual field defect is obtained, calculating the offset value of the central concave vision center on an equipment image processor, respectively marking the offset value as delta X and delta Y by taking the visual field center as the origin of a coordinate axis, and changing the central coordinates of an imaging point into (delta X and delta Y) in a dynamic guiding mode set by equipment.
The method for training the peripheral visual field based on the visual field center injury,
step two, monitoring the patient;
after the data test is finished, the data are imported into a system of training equipment, a processor acquires an external real-time image through a camera, the processor assists a guide system to generate preliminary guide data and image parameters according to measured data, a patient is guided to enter a training state, a motion change line of an auxiliary image is set according to a visual field center deviation value, and the image seen by the patient is located at the optimal retinal fixation point in a peripheral visual field; the guiding mode comprises the following steps: line-graph tracking, reading guidance, raster change.
The method for training the peripheral visual field based on the visual field center injury,
step two, monitoring the patient;
after the data test is finished, the data are imported into a system of training equipment, a processor acquires an external real-time image through a camera, the processor assists a guide system to generate preliminary guide data and image parameters according to measured data, a patient is guided to enter a training state, a motion change line of an auxiliary image is set according to a visual field center deviation value, and the image seen by the patient is located at the optimal retinal fixation point in a peripheral visual field; the specific setting mode of the motion change line of the auxiliary image is as follows:
ΔX=D×tanθx
ΔY=D×tanθY
wherein D is the distance between the screen image and the fundus;
θXthe value of the X-direction angle from the optimal watching point to the center of the visual field;
θYthe value of the Y-direction angle of the optimal fixation point from the center of the field of view.
In the method for training the peripheral vision based on the damage of the center of the vision, the image contrast is respectively set to 10%, 20%, 30% and 40%. 100%, wherein 100% is the original image contrast.
In the method for training the peripheral visual field based on the visual field center damage, when the patient uses the peripheral visual field training device, the myopic lens is adapted according to the offset value.
The invention has the advantages that:
the invention improves the defect problem of the central visual field by electronic image training equipment of the edge visual field, the original picture obtained from the center of the eyes of a patient with the defect of the central visual field is shifted by the retina fixation point by means of external equipment with an electronic screen, the patient is trained to form special eye position observation by adopting reading practice or line-figure tracking practice, the image is shifted to the edge visual field, the eye movement sensor is synchronized to obtain the correction feedback value, an auxiliary guide system and image contrast parallax are adjusted, and benign correction is formed; the peripheral visual field center is solidified through long-term training, so that the visual disorder is solved, and the rehabilitation effect is achieved;
through the marginal visual field training of the invention, the improvement effect of the central visual field of the patient is obvious, and the visual field is obviously improved.
Drawings
FIG. 1 is a process flow for the operation of one embodiment of the present invention;
FIG. 2 is a schematic illustration of the position of one embodiment of the imaging point center coordinates of the present invention;
FIG. 3 is a schematic illustration of a patient producing refractive error using the training method of the present invention;
FIG. 4 is a schematic diagram of the auxiliary guiding system for guiding the binocular vision with central visual field defect;
fig. 5 is a schematic diagram of the auxiliary guiding system for guiding the monocular distinction when there is a central visual field defect.
Detailed Description
The invention is described in detail below with reference to the figures and the embodiments.
An edge visual field training device based on a visual field center lesion, comprising: the eye scanning device inputs pictures, the camera acquires external real-time images, the electronic screen displays the external real-time images to a patient, the eye sensor monitors the rotation angle and the holding time of eyeballs of the patient, the control handle adjusts the pictures, and the processor is connected with all the parts and performs data processing. As an embodiment, an eye scanning apparatus includes: laser scanning ophthalmoscope, optical coherence tomography, microflux. The eye sensor includes: a non-contact digital camera, an eye tracker or a contact eye action monitor. The processor includes: and the CPU, the MCU or the FPGA and the like support a processing system for processing image signals and control signals.
The electronic screen includes: computer, cell-phone, intelligent glasses. It should be noted that the examples are not exhaustive, and any hardware device suitable for the method is within the scope of the present invention.
As shown in fig. 1, the training method provided by the present invention is mainly divided into three stages, namely data import, patient monitoring and image adjustment, and a hardware system includes: the device comprises a processor, a camera, an electronic screen, a control handle, an eye movement sensor and other main components; the software system includes: a guidance support system, an image adjustment system, and the like.
A method for training an edge visual field based on visual field center injury comprises the following steps:
step one, importing data;
a) positioning a retina fixation point and a scotoma of a patient by using an eye scanning device;
for a patient with a central dark spot who cannot fix a target, preferentially measuring the visual field offset angle of the patient, automatically tracking the patient, compensating the eyeground position offset caused by eyeball movement in a training instrument, and realizing the positioning of the central dark spot and a retina fixation point under the condition of non-central fixation;
b) after the optimal retinal fixation point of the patient with the central visual field defect is obtained, the offset value of the central concave vision center is calculated on the equipment image processor, the visual field center is taken as the origin of a coordinate axis and respectively marked as delta X and delta Y, and the central coordinates of the imaging point are changed into (delta X and delta Y) in a dynamic guidance mode set by the equipment, as shown in fig. 2.
Step two, monitoring the patient;
after the data test is finished, the data are imported into a system of training equipment, and the processor assists the guide system to generate preliminary guide data and image parameters according to the measured data through the acquired external real-time image, which can be acquired by a camera as an embodiment, and guides the patient to enter a training state at the moment; the guidance mode, as an embodiment, includes: the method comprises the following steps of line-pattern tracking, reading guidance, grating change and other auxiliary image dynamic change modes, wherein a motion change line of an auxiliary image is set according to a visual field center deviation value, and the specific setting mode is as follows:
ΔX=D×tanθx
ΔY=D×tanθY
wherein D is the distance between the screen image and the fundus;
theta X is an X-direction angle value of the optimal watching point from the center of the visual field;
theta Y is the angle value of the optimal watching point from the Y direction of the center of the visual field;
the eye rotation is guided by the change of the auxiliary image at the dark spot edge, whereby the image that the patient needs to see falls on the optimal retinal fixation point in the peripheral field of view.
After the central defect visual field position is shifted, the distance between the image and the retina of the eye is increased, so that the visual object is blurred, and the method is improved by a conventional distance and near vision glasses matching scheme, as shown in figure 3. When based on original correction lens operation, can form the forward movement phenomenon of formation of image point in the people's eye bottom, new visual field image is in the vision cell top, forms ametropia, the near-sighted effect of saying always, borrow this electronic training auxiliary assembly need according to the different degree's of deviant adaptation near-sighted lens, correct its because eyeball formation of image wheel base extension brings ametropia to reach better effect.
Step four, adjusting the image;
a) in the training process, the eyeball rotation angle and the holding time are collected through the eye movement sensor, the collection angle is compared with a specified value of the position of the best fixation point of the measured visual field, the auxiliary guide system and the image adjusting system are adjusted according to the difference, when the eyeball rotation angle is larger than the specified value, the guide system is weakened, the image contrast is enhanced, and more attention of a patient is transferred to an external real image; when the eyeball rotation angle is smaller than a specified value, the guide system is enhanced, the guide mark effect is enhanced, the mark moving distance is prolonged, the image contrast is reduced, and the attention of a patient is focused on the guide mark; the image contrast is respectively provided with 10%, 20%, 30% and 40%. 100% gears, and the specific mode is tested and adjusted according to the specific condition of the patient, wherein 100% is the original image contrast;
b) the processor records the eyeball rotation maintaining time, reduces the intervention time of the guiding system along with the prolonging or shortening of the maintaining time, records the maintaining time as one-time effective data more than 3 seconds, and does not take the data within 3 seconds as a training examination certificate;
c) according to the number of the eyes with the central visual field defect of the patient, the auxiliary guide system carries out distinguishing guide; if both eyes have central visual field defects, the left eye and the right eye are required to respectively test the best fixation point of the visual field, and the electronic screen in the training system marks the auxiliary marks of the left eye and the right eye on different movement paths, as shown in fig. 4; if only a single eye has a defective central visual field, the eye-care position auxiliary marker blinks in the middle, and the position auxiliary marker in the training eye moves according to the optimal fixation point offset value, as shown in fig. 5.
The training method of the present invention is described below by specific cases;
example 1:
a peripheral visual field training method based on invisible left-eye vision and 0.6-degree damage range of the center of right-eye visual field comprises the following specific implementation methods:
measuring the damage range of the central visual field of the right eye of the patient, wherein the left eye of the patient is invisible, the central damage visual field of the right eye is within 0.6 degrees, and the region can be watched by the lateral fovea; the left eye vision is less than 0.05, the right eye vision is 0.8, the remaining part outside the center of the macula lutea is available, and the position falls on the center theta of the macula lutea according to the measured optimal retina fixation pointXIs +0.9 DEG thetaYThe position is-1.1 degrees, the training distance of the patient is 1m according to the picture display, and the calculation is carried out according to the formula:
△X=1000×tan 0.9°=15.7mm;
△Y=1000×tan 1.1°=19.2mm;
according to the angle landing point, the delta X is in negative movement, and the delta Y is in positive movement. Setting the position change of a screen X axis of an auxiliary guide icon to be-15.7 mm, the position change of a delta Y axis to be +19.2mm, carrying out contrast reduction processing on a screen image picture, wherein the change sequence of the guide icon is that the guide icon moves from the X axis and then moves from the Y axis, the moving speed is adjusted according to the sight following condition of a patient, the position is set to be 10mm/s, the guide icon flickers for 2 seconds and then starts to move from the original point again after being guided to the optimal fixation point of sight of the visual field, the training is controlled to be 1 hour every day, the training period is 1 month, the guide effect is gradually weakened after the fixed vision is formed, and the image contrast is enhanced; after the training is finished, the central visual field of the patient is improved, the vision is reduced from 0.8 to 0.6, the visual field is improved, only partial dark spots remain in the upper left corner, and the right eye is in slight oblique vision.
Example 2:
an edge visual field training method based on binocular visual field center injury comprises the following specific implementation processes:
measuring the central visual field damage ranges of the left eye and the right eye of the patient respectively, wherein the central visual field damage degree of the left eye is slightly light, the range is within 0.3 degrees, and the region can be watched by the lateral fovea; the damage range of the central visual field of the right eye is within 2.3 degrees, and a region is watched beside the macula lutea; left eye residual vision is 0.8, right eye residual vision is 0.6; preferentially training better eyes of patients with central damage on both eyes, and measuring the optimal retinal fixation point theta of the left eyeXThe position is +0.5 DEG thetaYIs +0.4 degrees, the training distance of the patient is 1m according to the picture display, the contrast ratio of the screen image picture is reduced, and the calculation is carried out according to a formula:
△X=1000×tan 0.5°=8.7mm;
△Y=1000×tan 0.4°=7.0mm;
setting the screen position of the auxiliary guide icon to be changed from-8.7 mm in X-axis position and-7.0 mm in Y-axis position according to the angle falling point, the negative movement of the delta X and the negative movement of the delta Y, wherein the change sequence of the guide icon is that the guide icon moves from the X axis and then moves from the Y axis, the movement rate is adjusted according to the sight following condition of the patient, the distance is set to be 20mm/s, the guide icon flickers for 2 seconds and then starts to move from the original point again after being guided to the optimal fixation point of the visual field, and the training control is 1 hour per dayThe training period is 15 days, the guiding effect is gradually weakened after the fixed vision is formed, and the image contrast is enhanced; at the moment, the retina fixation point of the right eye is measured, because the vision of the patient is greatly reduced when the macula lutea is fixed on the right eye, the problem of difficult distinguishing exists, the measurement is needed for multiple times, and the optimal fixation point is theta after the measurement is finishedXOffset by-3.5 deg., thetaYAnd (3) shifting by +3.3 degrees, keeping the training distance of the patient to display 1m according to the picture, reducing the contrast ratio of the screen image picture, and calculating according to a formula:
△X=1000×tan 3.5°=61.1mm;
△Y=1000×tan 3.3°=57.6mm;
setting the screen position of an auxiliary guide icon according to the angle falling point, wherein the delta X is moved in the positive direction, the delta Y is moved in the negative direction, the position of the delta X axis is changed to be +61.1mm, the position of the delta Y axis is changed to be-57.6 mm, the change sequence of the guide icon is that the guide icon is moved from the X axis and then moved from the Y axis, the moving speed is adjusted according to the sight following condition of a patient, the position is set to be 5mm/s, after the guide icon is guided to the best fixation point of the visual field, the guide point flickers for 2 seconds and then starts to move from the original point again, the training is controlled to be 3 hours every day, and the; after training is finished, the central vision of the two eyes of a patient is obviously improved, except that the right eye has obvious vision reduction, the vision is reduced from 0.6 to 0.3, the vision of the left eye does not have obvious vision reduction, and the left eye and the right eye both have strabismus.
The two cases show that the improvement effect of the central visual field of the patient is obvious and the visual field is obviously improved by the marginal visual field training of the invention.
The foregoing illustrates and describes the principles, general features, and advantages of the present invention. It should be understood by those skilled in the art that the above embodiments do not limit the present invention in any way, and all technical solutions obtained by using equivalent alternatives or equivalent variations fall within the scope of the present invention.