Device and method for capturing, analyzing, and sending still and video images of the fundus during examination using an ophthalmoscope

Abstract

A medical imaging binocular indirect ophthalmoscope with computational processing unit, enabling simultaneous or time-delayed viewing and collaborative review of photographs or videos from an eye examination. The invention also claims a method for photographing and integrating information associated with the images, videos, or other data generated from the eye examination.

1 . A system for examining an eye, the system comprising:
 a binocular indirect ophthalmoscope comprising one or more camera, one or more computer processing unit, one or more memory unit, and one or more communication device; and   one or more remote electronic device;   wherein at least one of the one or more computer processing unit, the one or more memory unit, or the one or more communication device, is capable of sending (a) one or more electronic image and (b) information associated with the one or more electronic image, from the binocular indirect ophthalmoscope to the one or more remote electronic device; and   wherein at least one of the one or more computer processing unit or the one or more remote electronic device, in response to executable instructions, is operative to:
 a. removing or reducing glare or visual occluding elements from the one or more electronic image; 
 b. controlling at least one of exposure or focus of the one or more electronic image; 
 c. registering two or more electronic images of a similar portion of a fundus over one or more imaging session; 
 d. montaging of overlapping adjacent portions of the one or more electronic image to provide a wide-field visual representation of one or more of a retina, a fundus, or another portion of the eye; or 
 e. detecting one or more ophthalmic structure, anatomic feature, or pathology, for at least one of automated segmentation, registration, or image quality enhancement, to calculate qualitative or quantitative diagnostic measurements for use of clinical decision support tools to aid in one or more of diagnosis, screening, or treatment. 
   
     
     
         2 . The system for examining an eye of  claim 1 , further comprising a sensor array. 
     
     
         3 . The system for examining an eye of  claim 1 , further comprising a footswitch controller to trigger capturing the one or more electronic image using the one or more camera. 
     
     
         4 . The system for examining an eye of  claim 1 , wherein the remote electronic device is chosen from or includes one or more of a phone, a computer, a tablet computer, a server, a laptop computer, a television, a monitor, a sensor, a second computer processing unit, Internet, local area network-, or wide area network-connected device. 
     
     
         5 . The system for examining an eye of  claim 1 , wherein at least one of the one or more computer processing unit or the remote electronic device perform one or more of the following:
 a. control settings on or related to the one or more camera;   b. operate the one or more camera;   c. redisplay the one or more electronic image captured from the one or more camera; or   d. transmit, receive, analyze, gather, or collect information associated with the one or more camera, the one or more electronic image captured from the one or more camera, or both.   
     
     
         6 . The system for examining an eye of  claim 1 , wherein the one or more electronic image is processed by at least one of a locally stored computer software application, a computer software application stored on the one or more remote electronic device, a computer software application stored remotely on a separate networked device, or a computer software application stored on a remote server. 
     
     
         7 . The system for examining an eye of  claim 1 , wherein the one or more camera provides an extended focal plane, field of view, or both, and is capable of capturing the one or more electronic image corresponding to portions of a human or animal eye as viewed by a user of the binocular indirect ophthalmoscope. 
     
     
         8 . The system for examining an eye of  claim 1 , wherein the one or more camera is positioned above and between eyepieces of the binocular indirect ophthalmoscope, and wherein the one or more camera is mounted centrally or paracentrally to incident light beams in a visual axis of the binocular indirect ophthalmoscope. 
     
     
         9 . The system for examining an eye of  claim 1 , further comprising a lens or combination of lenses having an f-number greater than f−1.8. 
     
     
         10 . The system for examining an eye of  claim 1 , further comprising components communicating one or more of visual or nonvisual ambient notifications to a user of the binocular indirect ophthalmoscope chosen from one or more of visual cues, audio cues, or haptic feedback. 
     
     
         11 . The system for examining an eye of  claim 1 , wherein the system enables one or more of bi-directional networked image or video capture, redisplay, control, or transmission of the one or more electronic image. 
     
     
         12 . The system for examining an eye of  claim 1 , wherein the system enables bi-directional networked automation of one or more of:
 filing or organization of the one or more electronic image; or   associating the one or more electronic image with at least one of a patient, an examining physician, a date of an examination, an ocular feature detected by the system, a binocular indirect ophthalmoscope being used, image quality data, operational data of the binocular indirect ophthalmoscope, or a location of the binocular indirect ophthalmoscope or examination.   
     
     
         13 . The system for examining an eye of  claim 1 , further comprising adjustment knobs or levers on the binocular indirect ophthalmoscope, wherein the adjustment knobs or levers on the binocular indirect ophthalmoscope allow for adjusting one or more of:
 a. interpupillary distance;   b. transmission or manipulation of an illumination source of the binocular indirect ophthalmoscope;   c. instrument illumination intensity, aperture, and/or angle of the binocular indirect ophthalmoscope;   d. optical alignment;   e. stereopsis;   f. viewing angle; or   g. position of the binocular indirect ophthalmoscope on a user's head.   
     
     
         14 . The system for examining an eye of  claim 1 , wherein the one or more computer processing unit is operative to integrate (a) information associated with one or more of an eye examination using the binocular indirect ophthalmoscope, the eye being examined, a patient being examined, or a user examining the eye, and (b) the one or more electronic image, to perform one or more of the following:
 diagnose the patient;   treat the patient;   schedule another examination or appointment;   communicate with the patient, the user, or parties other than the patient and the user; or   create a database or a library of all or part of the integrated information associated with at least one of the eye examination, the eye being examined, the patient being examined, or the user, and the one or more electronic image.   
     
     
         15 . The system for examining an eye of  claim 1 , further comprising a multiple-camera system having more than one of the one or more camera, wherein the multiple-camera system is coaxial or paracentral with a viewing axis of a user providing for binocularity of captured imagery, and wherein the multiple-camera system is capable of enhancing the captured imagery. 
     
     
         16 . The system for examining an eye of  claim 1 , wherein the system provides an indication of eye laterality and examination orientation of a portion of a fundus being examined to assist in automated or partially-automated joining of two or more electronic images of the one or more electronic image. 
     
     
         17 . The system for examining an eye of  claim 1 , wherein computational photography algorithmic techniques digitally combine multiple images captured by the one or more camera into a composite image, or wherein computational photography algorithmic techniques capture images using the one or more camera set at various combinations of aperture and focal length settings. 
     
     
         18 . The system for examining an eye of  claim 1 , wherein one or more calibration image, including at least one of a printed calibration reference card, a digital image, or a set of images viewed on a screen, is used to set or reset settings of the system, including one or more of focus settings, alignment of a camera image with a user's point of view through the binocular indirect ophthalmoscope, or adjustment of the binocular indirect ophthalmoscope to confirm a same image is being viewed through both eyepieces of the binocular indirect ophthalmoscope. 
     
     
         19 . The system for examining an eye of  claim 1 , further comprising embedded or off-device microphones, wherein the embedded or off-device microphones, in combination with computational and algorithmic elements on the binocular indirect ophthalmoscope or off the binocular indirect ophthalmoscope, detect and recognize voice commands, provide for one- or two-way communication with remotely located telemedicine users, enable annotation of imagery, or combinations thereof. 
     
     
         20 . The system for examining an eye of  claim 1 , further comprising an illumination source within a non-visible spectrum of light, wherein the illumination source is used to flash light to register focus or capture imagery through a nonmydriatic pupil. 
     
     
         21 . The system for examining an eye of  claim 1 , wherein the one or more electronic image is a static image or a video image. 
     
     
         22 . The system for examining an eye of  claim 1 , further comprising at least one of an onboard laser source or a connected laser optical fiber, providing for laser indirect ophthalmoscopy. 
     
     
         23 . The system for examining an eye of  claim 1 , wherein the one or more camera comprise one or more tunable lens. 
     
     
         24 . A binocular indirect ophthalmoscope system comprising a binocular indirect ophthalmoscope, the binocular indirect ophthalmoscope comprising one or more camera, one or more computer processing unit, one or more memory unit, one or more communication device, and one or more image sensor, wherein at least one of the one or more camera or the one or more image sensor enable at least one of enhanced depth of field, increased level of zoom, increased sharpness, expanded dynamic range, or other optical or sensor-based viewing enhancements of captured imagery, thereby rendering the binocular indirect ophthalmoscope system capable of capturing or sensing wavelengths of light from a fundus with or without using photo-emissive dyes, with or without using an illumination source, or combinations thereof. 
     
     
         25 . The binocular indirect ophthalmoscope system of  claim 24 , wherein sensor- or user-assisted feedback timestamps indicate transit phases of the captured imagery during an administration of photo-emissive dyes to a patient. 
     
     
         26 . The binocular indirect ophthalmoscope system of  claim 24 , further comprising one or more of distometers, time of flight sensors, or additional range cameras, which provide feedback data to the one or more camera, including compensation factors for one or more of user working distance, lens type, observation distance, or level of accommodation or accommodation lens add, for use in setting focus and/or exposure settings of the one or more camera. 
     
     
         27 . A binocular indirect ophthalmoscope system comprising a binocular indirect ophthalmoscope, the binocular indirect ophthalmoscope comprising one or more camera, one or more computer processing unit, one or more memory unit, one or more communication device, and at least one of one or more visible light spectrum image sensor, one or more invisible light spectrum image sensor, one or more distometer, one or more mechanical sensor, or one or more antenna, organized in an array and capable of providing feedback to assist a user with one or more of automated focusing, automated field of view, automated recognition of a patient, automated recognition of the user, automated recognition of ocular imagery, or automated triangulation of a location and an orientation of the binocular indirect ophthalmoscope. 
     
     
         28 . The binocular indirect ophthalmoscope system of  claim 27 , further comprising an adaptive optics system, wherein the adaptive optics system compensates for distortions or aberrations in an optical viewing pathway. 
     
     
         29 . The binocular indirect ophthalmoscope system of  claim 27 , further comprising one or more electronically tunable lens, wherein the one or more electronically tunable lens adjusts focus based on examination lens characteristics including one or more of diopter and working distance of a lens being used, user observation distance, or user accommodation. 
     
     
         30 . A binocular indirect ophthalmoscope system comprising a binocular indirect ophthalmoscope and a display screen, the binocular indirect ophthalmoscope comprising one or more camera, one or more computer processing unit, one or more memory unit, one or more communication device, and one or more image sensor, wherein multiple images are captured in rapid succession allowing for a ring buffer of still or video imagery, or wherein multiple images are captured allowing for creation of a set or sets of the multiple captured images, rendering the system capable of displaying clips of video or high-frequency images on the display screen so that a user of the system can select a desired image or images from a series of the multiple captured images displayed to the user.