Eyelid illumination systems and method for imaging meibomian glands for meibomian gland analysis

• US 10,278,587 B2
• Filed: 05/05/2014
• Issued: 05/07/2019
• Est. Priority Date: 05/03/2013
• Status: Active Grant

• Current Assignee: TearScience Inc. (Johnson & Johnson)
• Original Assignee: TearScience Inc. (Johnson & Johnson)
• Inventors: Grenon, Stephen M., Korb, Donald R., Grenon, Joshua, Liddle, Scott, Bacich, Steve, Jans, John M.
• Primary Examiner(s): Roy, Baisakhi
• Assistant Examiner(s): Mehl, Patrick M
• Application Number:
  US14/269,646
• Publication Number:
  US 20140330129A1
• Time in Patent Office: 1,828 Days
• Field of Search: None
• CPC Class Codes: A61B 3/0008 provided with illuminating means A61B3/117 takes precedence; goniolenses used for laser treatment A61F9/009; illuminating means for optical instruments G02B27/00
• CPC Class Codes: A61B 3/101 for examining the tear film
• CPC Class Codes: A61B 5/0077 Devices for viewing the surface of the body, e.g. camera, magnifying lens
• CPC Class Codes: A61B 5/0082 adapted for particular medical purposes
• CPC Class Codes: A61B 5/6821 Eye

Abstract

Eyelid illumination systems and methods for imaging meibomian glands for meibomian gland analysis are disclosed. In one embodiment, a patient'"'"'s eyelid is IR trans-illuminated with an infrared (IR) light. A trans-illumination image of the patient'"'"'s eyelid is captured showing meibomian glands in dark outlined areas, whereas non-gland material is shown in light areas. This provides a high contrast image of the meibomian glands that is X-ray like. The lid trans-illumination image of the meibomian glands can be analyzed to determine to diagnose the meibomian glands in the patient'"'"'s eyelid. The eyelid may be trans-illuminated by a lid-flipping device configured to grasp and flip the eyelid for imaging the interior surface of the eyelid. Also, an IR surface meibography image of the meibomian glands may also be captured and combined with the trans-illumination image of the meibomian glands to provide a higher contrast image of the meibomian glands.

Claims

1. A method of trans-illuminating a meibomian gland in an eyelid of a patient to image the meibomian gland, comprising:

flipping the eyelid to expose an interior portion of an interior surface of the eyelid to an imaging path of an imaging device, wherein the flipping of the eyelid is done using a lid flipping device comprising a body and a curved lid flipping end surface disposed on an end of the body, wherein the curved lid flipping end surface is anatomically shaped to contain a radius that is intended to mimic a curvature of the patient'"'"'s eyelid, so that the curved lid flipping end surface will contact and grasp an exterior surface of the patient'"'"'s eyelid equally along the exterior surface;

directing an infrared (IR) light from an IR light source to an exterior portion of the eyelid to IR trans-illuminate meibomian glands in the eyelid;

imaging the eyelid with the imaging device during IR trans-illumination to produce an IR trans-illumination image of meibomian glands in the eyelid, wherein the imaging of the eyelid with the imaging device during IR trans-illumination is performed while the eyelid is flipped;

receiving the IR trans-illumination image of the eyelid at a computer control system associated with the imaging device;

storing the IR trans-illumination image in a non-transitory memory associated with the imaging device;

directing a second IR light from a second IR light source to the interior portion of the interior surface of the eyelid to surface illuminate the interior portion of the interior surface of the eyelid;

imaging the interior portion of the interior surface of the eyelid with the imaging device when the interior portion is illuminated with the second IR light to produce a surface meibography image of meibomian glands in the eyelid, wherein the imaging of the interior portion of the interior surface of the eyelid to produce the surface meibography image is performed while the eyelid is flipped; and

subtracting the IR trans-illumination image of meibomian glands from the surface meibography image of meibomian glands to generate a resultant image of meibomian glands.

2. The method of claim 1, wherein directing the IR light from the IR light source to the exterior portion of the eyelid comprises directing the IR light from the IR light source to the exterior portion of the exterior surface of the eyelid to IR trans-illuminate the meibomian glands in the eyelid.

3. The method of claim 2, wherein imaging the eyelid with the imaging device during IR trans-illumination comprises imaging the interior portion of the interior surface of the eyelid with the imaging device during IR trans-illumination to produce the IR trans-illumination image of meibomian glands in the eyelid.

4. The method of claim 1, wherein directing the IR light from the IR light source to the eyelid further comprises directing the IR light from the IR light source to the interior portion of the interior surface of the eyelid to IR trans-illuminate the meibomian glands in the eyelid.

5. The method of claim 4, wherein imaging the eyelid with the imaging device during IR trans-illumination comprises imaging an exterior portion of the exterior surface of the eyelid with the imaging device during IR trans-illumination to produce the IR trans-illumination image of meibomian glands in the eyelid.

6. The method of claim 1, wherein:

directing the IR light from the IR light source to the exterior portion of the eyelid to IR trans-illuminate the meibomian glands in the eyelid further comprises directing the IR light from the IR light source to a lower eyelid; and

imaging the eyelid with the imaging device during IR trans-illumination further comprises imaging the lower eyelid with the imaging device during IR trans-illumination to produce the IR trans-illumination image of meibomian glands in the lower eyelid.

7. The method of claim 1, wherein:

directing the IR light from the IR light source to the exterior portion of the eyelid to IR trans-illuminate the meibomian glands in the eyelid further comprises directing the IR light from the IR light source to an upper eyelid; and

imaging the eyelid with the imaging device during IR trans-illumination further comprises imaging the upper eyelid with the imaging device during IR trans-illumination to produce the IR trans-illumination image of meibomian glands in the upper eyelid.

8. The method of claim 1, wherein directing the IR light from the IR light source to the exterior portion of the eyelid to IR trans-illuminate the meibomian glands in the eyelid further comprises directing the IR light from the IR light source in an IR spectrum between 890 and 940 nanometers (nm) to the eyelid.

9. The method of claim 1, further comprising displaying the IR trans-illumination image of meibomian glands in the eyelid on a computer display.

10. The method of claim 1, wherein the IR light source and the second IR light source are different IR light sources.

11. The method of claim 1, further comprising not directing the IR light from the IR light source to the exterior portion of the eyelid when directing the second IR light from the second IR light source to the interior portion of the interior surface of the eyelid.

12. The method of claim 1, further comprising not directing the second IR light from the second IR light source to the interior portion of the interior surface of the eyelid when directing the IR light from the IR light source to the exterior portion of the eyelid.

13. The method of claim 1, further comprising displaying the surface meibography image of meibomian glands in the eyelid on a computer display.

14. The method of claim 1, wherein directing the second IR light from the second IR light source further comprises:

directing the second IR light from a first angle to a first angle end of the interior portion of the eyelid while not directing the second IR light from a second angle, opposite the first angle, to the interior portion of the eyelid; and

directing the second IR light from the second angle, opposite the first angle, to a second angle end of the interior portion of the eyelid while not directing the second IR light from the first angle to the interior portion of the eyelid;

wherein imaging the interior portion of the interior surface of the eyelid with the imaging device further comprises;

imaging the interior portion of the interior surface of the eyelid with the imaging device when the interior portion is illuminated with the second IR light at the first angle to produce a first surface meibography image of meibomian glands in the eyelid; and

imaging the interior portion of the interior surface of the eyelid with the imaging device when the interior portion is illuminated with the second IR light at the second angle to produce a second surface meibography image of meibomian glands in the eyelid; and

wherein the method further comprises combining the second angle end of the first surface meibography image of meibomian glands with the first angle end of the second surface meibography image of meibomian glands to produce the surface meibography image of meibomian glands having reduced glare resulting from imaged reflections of the second IR light from the interior portion of the interior surface of the eyelid.

15. The method of claim 14, wherein the second angle end of the first surface meibography image of meibomian glands only includes a portion of the first surface meibography image of meibomian glands that does not include glare from reflected IR light from a first IR light source, and the first angle end of the second surface meibography image of meibomian glands only includes a portion of the second surface meibography image of meibomian glands that does not include glare from the reflected second IR light.

16. A meibomian gland imaging system for lid trans-illumination imaging of meibomian glands in an eyelid of a patient, comprising:

an infrared (IR) light source configured to direct an IR light to an exterior portion of the eyelid to IR trans-illuminate the meibomian glands in the eyelid;

a second IR light source configured to direct a second IR light to an interior portion of an interior surface of the eyelid;

an imaging device configured to image the eyelid during IR trans-illumination;

a lid flipping device comprising a body and a curved lid flipping end surface disposed on an end of the body, the curved lid flipping end surface configured to grasp and flip the eyelid to expose the interior portion of the interior surface of the eyelid to an imaging path of the imaging device, wherein the curved lid flipping end surface is anatomically shaped to contain a radius that is intended to mimic a curvature of the patient'"'"'s eyelid, so that the curved lid flipping end surface will contact and grasp an exterior surface of the patient'"'"'s eyelid equally along the exterior surface; and

a computer control system configured to;

control the IR light source to direct the IR light to the exterior portion of the eyelid to IR trans-illuminate the meibomian glands in the eyelid;

control the imaging device to capture an image of the eyelid during IR trans-illumination, wherein the image of the eyelid is captured by the imaging device during IR trans-illumination while the eyelid is flipped;

receive the image of the eyelid;

store an IR trans-illumination image of meibomian glands in the eyelid from the received image of the eyelid in a non-transitory memory;

control the second IR light source to direct the second IR light to the interior portion of the interior surface of the eyelid to surface illuminate the interior surface of the eyelid, when not directing the IR light source to direct the IR light to the exterior portion of the eyelid;

control the imaging device to image, in a surface meibography image of the eyelid, the interior portion of the interior surface of the eyelid when the second IR light source is directed to direct the second IR light to the interior portion of the interior surface of the eyelid, wherein the image of the interior portion of the interior surface of the eyelid in the surface meibography image is captured by the imaging device while the eyelid is flipped;

receive the surface meibography image of the eyelid;

store a surface meibography image of meibomian glands in the eyelid from the received surface meibography image of the eyelid; and

subtract the IR trans-illumination image of meibomian glands from the surface meibography image of meibomian glands to generate a resultant image of meibomian glands.

17. The meibomian gland imaging system of claim 16, further comprising a wherein the lid flipping device comprising further comprises:

a body;

a curved lid flipping end surface disposed on an end of the body, the curved lid flipping end surface configured to grasp and flip the eyelid;

the IR light source disposed in the body and configured to generate the IR light under control of the computer control system; and

an elongated slot disposed in the curved lid flipping end surface of the body to receive the IR light from the IR light source to form an IR light pipe.

18. The meibomian gland imaging system of claim 17, wherein the computer control system is configured to:

control the IR light source to direct the IR light through the elongated slot in the lid flipping device to an exterior portion of an exterior surface of the eyelid, to IR trans-illuminate the meibomian glands in the eyelid when the curved lid flipping end surface of the lid flipping device is engaged with the eyelid to flip the eyelid; and

control the imaging device to image the interior portion of the interior surface of the eyelid during IR trans-illumination when the eyelid is flipped by the lid flipping device.

19. The meibomian gland imaging system of claim 17, wherein the IR light source comprises:

a central IR emitter disposed along a central portion of the elongated slot;

a first end IR emitter disposed adjacent to a first end of the elongated slot; and

a second end IR emitter disposed adjacent to a second end of the elongated slot;

each of the central IR emitter, the first end IR emitter, and the second end IR emitter are configured to independently emit the IR light under control of the computer control system.

20. The meibomian gland imaging system of claim 19, wherein the computer control system is further configured to provide a uniform or substantially uniform trans-illumination of meibomian glands by the IR light source along an outer surface of the flipped eyelid, wherein the computer control system is configured to adjust an intensity of the first end IR emitter and the second end IR emitter to be greater than an intensity of the central IR emitter to provide for the uniform or substantially uniform trans-illumination of the meibomian glands by the IR light source.

21. The meibomian gland imaging system of claim 16, wherein the imaging device is comprised of a high definition IR camera.

22. The meibomian gland imaging system of claim 16, further comprising a computer display, the computer control system further configured to display the IR trans-illumination image of meibomian glands in the eyelid on the computer display.

23. The meibomian gland imaging system of claim 16, wherein the computer control system is further configured to:

direct the second IR light at a first angle to a first angle end of the interior portion of the eyelid while not directing the second IR light from a second angle, opposite the first angle, to the interior portion of the eyelid;

direct the second IR light to the second angle, opposite the first angle, to a second angle end of the interior portion of the eyelid while not directing the second IR light from the first angle to the interior portion of the eyelid;

image the interior portion of the interior surface of the eyelid with the imaging device when the interior portion is illuminated with the second IR light at the first angle to produce a first surface meibography image of meibomian glands in the eyelid;

image the interior portion of the interior surface of the eyelid with the imaging device when the interior portion is illuminated with the second IR light at the second angle to produce a second surface meibography image of meibomian glands in the eyelid; and

combine the second angle end of the first surface meibography image of meibomian glands with the first angle end of the second surface meibography image of meibomian glands to produce the surface meibography image of meibomian glands having reduced glare resulting from imaged reflections of the second IR light from the interior portion of the interior surface of the eyelid.

24. The meibomian gland imaging system of claim 23, wherein the second angle end of the first surface meibography image of meibomian glands only includes a portion of the first surface meibography image of meibomian glands that does not include glare from reflected IR light from a first IR light source, and the first angle end of the second surface meibography image of meibomian glands only includes a portion of the second surface meibography image of meibomian glands that does not include glare from the reflected second IR light.