System for glaucoma treatment
An apparatus ( 20 ) includes a probe ( 36 ) and a processor ( 144 ). The probe is positioned adjacent to an eye ( 28 ) of a patient ( 32 ) and is configured to irradiate a trabecular meshwork ( 56 ) of the eye with one or more optical beams ( 52 ). The processor is configured to select one or more target regions ( 80 ) of the trabecular meshwork, and to control the probe to irradiate the selected target regions with the optical beams.
1. Apparatus, comprising:
a probe, which is adapted to be positioned adjacent to an eye of a patient and is configured to irradiate a trabecular meshwork of the eye with one or more optical beams;
a fixture, adapted to position the probe at a predefined distance in front of the eye such that the probe does not make physical contact with the eye, wherein the probe comprises a beam directing device that is controllable to direct at least one of the optical beams, through the fixture, toward the eye; and
a processor, which is configured to:
receive an acquired image of the eye;
identify in the image a limbus of the eye;
define, on a surface of the eye in a vicinity of the limbus, based on identification of the limbus in the image, a shape having a radius, a size of the radius selected such that any one or more irradiation regions on the shape, when irradiated with the one or more optical beams, cause the one or more optical beams to hit respective target regions of the trabecular meshwork that are hidden from view; and
control the beam directing device in the probe, based on the image, to irradiate selected irradiation regions on the shape defined on the surface of the eye in the vicinity of the limbus, thereby irradiating the hidden target regions of the trabecular meshwork with the one or more optical beams.
2. The apparatus according to claim 1 , wherein the processor is configured to receive a selection of one or more of the target regions from an operator.
3. The apparatus according to claim 1 , wherein the probe comprises a laser source selected from a group consisting of a laser diode, a NdYag laser source and a 532 nm laser source, which is configured to generate the optical beams.
4. The apparatus according to claim 1 , wherein the beam directing device is selected from a group consisting of:
a rotating wedge prism;
a scanner comprising one or more rotating mirrors;
a bundle of optical fibers; and
a Diffractive Optical Element (DOE).
5. The apparatus according to claim 4 , wherein the beam directing device comprises the bundle of the optical fibers, and wherein ends of the fibers in the bundle are tilted such that the target regions fall on an arc having a radius of curvature that depends on a distance of the ends from the eye.
6. The apparatus according to claim 1 , wherein the processor is configured to store a record of one or more regions of the trabecular meshwork that were treated previously, and to select the target regions depending on the record.
7. The apparatus according to claim 6 , wherein the processor is configured to select different groups of the irradiation regions in the vicinity of the limbus of the eye in different respective treatment sessions.
8. The apparatus according to claim 1 , wherein the processor is configured to control the probe such that the target regions fall on a sclera around the limbus of the eye.
9. The apparatus according to claim 1 , and comprising an input device operated by a user, wherein the processor is configured to irradiate the selected target regions in response to a single activation of the input device.
10. The apparatus according to claim 1 , wherein the probe is configured to display to the patient an object on which to focus the eye, in order to fix the eye during irradiation of the target regions.
11. The apparatus according to claim 1 , wherein the processor is configured to detect a movement of the eye, and to inhibit the irradiation in response to the detected movement.
12. The apparatus according to claim 1 , wherein the processor is configured to detect a movement of the eye, and to control the probe so as to track the movement of the eye with the optical beams.
13. The apparatus according to claim 1 , and comprising a protective mask, which is adapted to be coupled to the eye, is opaque to the optical beams and has one or more openings surrounding the selected target regions.
14. The apparatus according to claim 1 , wherein the probe is further configured to irradiate the eye with a visible aiming beam that is aligned with the optical beams used for irradiating the target regions.
15. The apparatus according to claim 1 , wherein the processor is configured to automatically adjust, or direct an operator to adjust, a distance between the probe and the eye.
16. The apparatus according to claim 1 , wherein the shape comprises a circle or an ellipse having the radius.
17. A method, comprising:
positioning a probe adjacent to an eye of a patient, using a fixture that positions the probe at a predefined distance in front of the eye, such that the probe does not make physical contact with the eye, so as to irradiate a trabecular meshwork of the eye with one or more optical beams, wherein the probe comprises a beam directing device that is controllable to direct at least one of the optical beams, through the fixture, toward the eye; and
using a processor:
receiving an acquired image of the eye;
identifying in the image a limbus of the eye;
defining, on a surface of the eye in a vicinity of the limbus, based on identification of the limbus in the image, a shape having a radius, a size of the radius selected such that any one or more irradiation regions on the shape, when irradiated with the one or more optical beams, cause the one or more optical beams to hit respective target regions of the trabecular meshwork that are hidden from view; and
controlling the beam directing device in the probe, based on the image, to irradiate selected irradiation regions on the shape defined on the surface of the eye in the vicinity of the limbus, thereby irradiating the hidden target regions of the trabecular meshwork with the one or more optical beams.
18. The method according to claim 17 , and comprising receiving a selection of one or more of the target regions from an operator.
19. The method according to claim 17 , wherein irradiating the vicinity of the limbus comprises treating glaucoma in the eye.
20. The method according to claim 17 , wherein irradiating the vicinity of the limbus comprises reducing intraocular pressure in the eye.
21. The method according to claim 17 , and comprising generating the optical beams using a laser source selected from a group consisting of a laser diode, a NdYag laser source, and a 532 nm laser source.
22. The method according to claim 17 , wherein the beam directing device is selected from a group consisting of:
a rotating wedge prism;
a scanner comprising one or more rotating mirrors;
a bundle of optical fibers; and
a Diffractive Optical Element (DOE).
23. The method according to claim 22 , wherein the beam directing device comprises the bundle of the optical fibers, and wherein ends of the fibers in the bundle are tilted such that the target regions fall on an arc having a radius of curvature that depends on a distance of the ends from the eye.
24. The method according to claim 17 , and comprising storing a record of one or more regions of the trabecular meshwork that were treated previously, and selecting the target regions depending on the record.
25. The method according to claim 24 , and comprising selecting different groups of the irradiation regions in the vicinity of the limbus of the eye in different respective treatment sessions.
26. The method according to claim 17 , wherein irradiating the vicinity of the limbus comprises causing the target regions to fall on a sclera around the limbus of the eye.
27. The method according to claim 17 , wherein irradiating the vicinity of the limbus comprises irradiating the vicinity of the limbus in response to a single activation of an input device operated by a user.
28. The method according to claim 17 , and comprising displaying to the patient an object on which to focus the eye, in order to fix the eye during irradiation of the target regions.
29. The method according to claim 17 , and comprising detecting a movement of the eye, and inhibiting the irradiation in response to the detected movement.
30. The method according to claim 17 , and comprising detecting a movement of the eye, and tracking the movement of the eye with the optical beams.
31. The method according to claim 17 , and comprising coupling to the eye a protective mask that is opaque to the optical beams and has one or more openings surrounding the selected target regions.
32. The method according to claim 17 , and comprising irradiating the eye with a visible aiming beam that is aligned with the optical beams used for irradiating the target regions.
33. The method according to claim 17 , and comprising automatically adjusting, or directing an operator to adjust, a distance between the probe and the eye.
34. The method according to claim 17 , wherein defining the shape comprises defining a circle or an ellipse having the radius.