GOLDMANN APPLANATION TONOMETER, BIOMICROSCOPY DEVICE AND RELATED METHODS

20110275923

13/037355

February 28, 2011

Apparatus and methods for subjecting a patient to an slit lamp microscopy and/or Goldmann tonometry eye examination are disclosed herein. In some embodiments, the patient is in a side-lying down position at a time of the examination. In some embodiments, it is possible to examine an upper and/or lower eye—for example, a lower eye slightly above a supporting surface. Related apparatus are disclosed herein. In some embodiments, the apparatus includes a bed and/or a headrest and/or a face immobilization assembly are disclosed herein.

Glovinsky, Yosef (Petach Tikva, IL); Shmukler, Vadim (Rishon Lezion, IL); Piven, Ilia (Ramat Gan, IL)

1-57. (canceled)

58. A method of eye examination comprising: a. when a patient's body is in a side-lying position and when the patient's head is oriented sideways so that an inter-pupil vector between the patient's pupils is substantially co-linear with a gravitation vector, subjecting one of the patient's eyes to at least one eye examination selected from the group consisting of: i. a Goldmann tonometer examination; and ii. a slit-lamp biomicroscopy examination such that slices of the patient's eye at different depths are viewed in a binocular microscope, wherein the Goldmann tonometer examination is carried out by means of a horizontal-orientation-constrained applanation tonometry probe in contact with one of the patient's eyes to measure intraocular pressure (IOP) of the patient's eye such that at least one a first condition, a second condition, a third condition and a fourth condition is true, the conditions being defined a follows: i. according to the first condition, the Goldmann tonometer device is mounted to a slit-lamp which provides illumination for the IOP measurement; ii. according to the second condition, the horizontal-orientation-constrained applanation tonometry probe is horizontally moved by titling a stick of a joystick and/or vertically moved by means of a twisting a stick of a joystick so as to bring the tonometer probe into contact with the patient's eye; and/or iii. according to the third condition, cornea-applanation force for the applanation tonometer probe for the IOP measurement is provided by a spring-loaded controller that does not reside a common housing with the applanation tonometer probe; iv. according to the fourth condition, semi-circles of the cornea surface for the IOP measurement are viewable in a microscope assembly that is a Gallilean microscope and/or that is horizontally displaced from a proximal end of the tonometry probe by at least 10 cm.

59. The method of claim 58 wherein at least the Goldman tonometry examination is performed.

60. The method of claim 58 wherein: i) the IOP measurement is carried out when the patient's head lays substantially flat on a stabilizing surface so that contact between a side of the patient's head and the stabilizing surface maintains the orientation of the inter-pupil vector and vertically immobilizes the patient's head; and ii) the IOP measurement is carried out to a patient's lower eye at a time when an elevation difference lower_eye_elevated between an elevation of the patient's lower eye and an elevation of the stabilizing surface is at most than 5 cm.

61. The method of claim 58 wherein the IOP measurement is carried out when the patient's head lays substantially flat on a stabilizing surface so that a majority of a surface area of a side of the patient's head is in contact with the stabilizing surface so that the stabilizing surface maintains the orientation of the inter-pupil vector and vertically immobilizes the patient's head.

62. The method of claim 58 performed on a patient whose head is dimensioned to have a chin-head-top length of at least 20 cm and whose head is vertically and horizontally stabilized.

63. The method of claim 58 wherein the method is carried out at a time when the patient's head lays substantially flat on a stabilizing surface having an indentation region such that: i) both of the patient's eye are directly above the indentation region; and ii) at least a portion of a spring-container which is connected to probe via a vertical-orientation-constrained probe arm has a horizontal location that coincides with at least a portion of the indentation.

64. The method of claim 58 wherein the IOP measurement is carried out at a time when the patient's chin and forehead are simultaneously in contact with the face-stabilization assembly at locations that are horizontally separated from each other by at least 25 cm.

65. The method of claim 58 wherein the Goldmann tonometry examination is carried out by means of a Goldmann tonometry device that lacks an illumination column.

66. An eye examination system comprising: a. a bed including a bed upper surface that is dimensioned to support an adult human and/or whose width is at least 40 cm and whose length is at least 1 meter and/or whose length is at least 1 meter and whose surface area is at least 5,000 cm2; and b. a slit-lamp device including an illumination column and/or a Goldmann tonometer device that is directly or indirectly attached to the bed so as to mechanically constrain motion of the eye-examination device away from the bed, the system being configured such that at least one of an attached headrest feature and a pivot axis feature is true, the attached headrest and pivot axis features being defined as follows: i) according to the attached headrest feature, the bed is directly or indirectly attached to a headrest such that a height of upper surface exceeds a height of bed surface, a surface area of the upper surface of the headrest is at most 30% of a surface area of the bed upper surface, and the headrest is disposed at or near one end of the bed; ii) according to the pivot axis feature, translational motion of a base of the slit lamp device and/or Goldmann tonometer device is constrained to be around a pivot axis disposed at or near one end of the bed, wherein the Goldmann tonometer device includes an horizontal-orientation-constrained applanation tonometer probe having a thicker proximal end and a thinner distal end, a microscope assembly, a joystick, a lower base and an upper base movable over the lower base to provide in-tandem horizontal motion of the upper base and the tonometer probe over the lower base, the joystick configured to regulate and/or to induce the in-tandem horizontal motion, the microscope assembly being configured to receive light which passes in a proximal direction through tonometer probe so that a location in contact with a distal end of the probe is in a field of view of the microscope assembly.

67. The eye examination system of claim 66 wherein the system includes the Goldmann tonometry device.

68. The eye examination system of claim 66 wherein the Goldmann tonometry device includes an illumination column of a slit lamp device.

69. The eye examination system of claim 66 wherein the system includes the slit lamp device including the illumination column.

70. The eye examination system of claim 66 wherein at least the attached headrest feature is true.

71. The eye examination system of claim 66 wherein at least the pivot axis feature is true.

72. The eye examination system of claim 66 wherein both of the attached headrest feature and the tonometer feature are true.

73. The eye examination system of claim 66 wherein the attached headrest feature is true and the system further includes a face immobilization assembly which when attached to or substantially brought into contact with headrest frames, in combination with the headrest upper surface and/or a planar extension thereof, a given region of space whose elevation exceeds an elevation of the headrest upper surface, the region of space being above headrest upper surface and/or horizontally displaced from the headrest upper surface by no more than 10 cm, a height of the framed given region being at least 8 cm and a length of the framed region being at least 20 cm.

74. The eye examination system of claim 66 wherein the face immobilization assembly includes vertically-disposed forehead rest and chinrest that are horizontally separated from each other by at least 20 cm in a direction that is parallel to a central axis of the bed.

75. The eye examination system of claim 66 wherein: i. the attached headrest feature is true; ii. the headrest defines a first direction substantially parallel to the bed central axis and a second direction perpendicular to the first direction; iii. a length L of the headrest along the first direction is at least 30 cm and a width of the headrest along the second direction is at least 20 cm; iv. the headrest includes first and second edges substantially parallel to the bed central axis and disposed at opposite sides of the headrest; and v. for at least one of the first and second edges, the headrest includes an indentation disposed at the edge, such that a length of the indentation is at least 5 cm and/or at least 25% of the length L of the headrest along the first direction.

76. The eye examination system of claim 74 wherein the headrest respectively includes at least two such indentations that are respectively disposed at the first and second edges.

77. A tonometry system comprising: a. an horizontal-orientation-constrained applanation tonometer probe having a thicker proximal end and a thinner distal end; b. a microscope assembly configured to receive light which passes in a proximal direction through tonometer probe so that a location in contact with a distal end the probe is in a field of view of the microscope assembly; c. a lower base; d. an upper base movable over the lower base to provide in-tandem horizontal motion of the upper base and the tonometer probe over the lower base, e. a dual mode joystick configured: i. to regulate and/or to induce the in-tandem horizontal motion by titling of a stick of the joystick; and ii. to induce in-tandem vertical motion of the microscope assembly and the horizontal-orientation-constrained applanation tonometer probe by twisting the stick of the joystick around its axis, wherein a vertical range of the induced in-tandem vertical motion provided by the twisting of the stick of the joystick is at least 7 cm.

600/398

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edspap.20110275923