Medical examination system enabling interchangeable instrument operating modes

An examination system having separate enabled interchangeable operating modes includes at least one medical device having a housing retaining an optical system. The examination system further includes an adapter that is configured for aligning a plurality of disparate smart devices with the optical system of the medical device when the adapter is attached to the medical device, thereby enabling multiple operating modes without modification to the device. In at least one version, common engagement features are provided on a plurality of medical devices to permit the adapter and an attached smart device to be used therewith interchangeably.

TECHNICAL FIELD

This application is generally directed to the field of diagnostic medicine and more specifically to a system having at least one stand-alone medical examination or diagnostic device, in which the device can assume or be configured to assume separate interchangeable operating modes. These modes can include a visual mode as well as an electronic viewing mode using an attached smart device. An adapter attached to the at least one medical examination or diagnostic device is configured to support and align one or one of a plurality of disparate smart devices relative to the optical axis of the medical device(s).

BACKGROUND

Hand-held diagnostic devices are well known in the medical field for purposes of conducting a patient examination, e.g., a wellness examination that would be typically conducted by a primary physician, physician's assistant (PA) or other health care provider, clinician, or caregiver. To that end, a number of disparate devices are routinely used for examining specific medical targets of interest, such as the eyes (ophthalmoscope), ears (otoscope), nose (rhinoscope), skin (dermatoscope), vagina (vagiscope and colposcope), anus (anoscope) and the like.

Some or all of these medical diagnostic instruments may include optical versions having an eyepiece disposed at one end of an instrument housing. Alternatively, electronic versions are also known having an electronic imager that captures a digital image of the intended medical target. More recently, so-called “smart devices”, (e.g., smart phones, tablets and the like), have been incorporated for use with a medical examination or diagnostic device. One such example is the iExaminer® ophthalmoscope, which is manufactured and sold by Welch Allyn, Inc. of Skaneateles Falls, N.Y. Features relating to use of a smart device with a medical examination or diagnostic device herein are more completely described in greater detail in U.S. Pat. No. 8,944,596 B2 and U.S. Patent Application Publication No. 2015/0103317A1, the entire contents of each being herein incorporated by reference.

Reference is herein made toFIG. 1, which illustrates a known medical diagnostic device (i.e., an ophthalmoscope10), which is configured to retain a smart device (more specifically, a smart phone). The ophthalmoscope10is defined by an instrument housing14that includes a distal end16and an opposing proximal end18and an interior sized and configured to retain a plurality of components. An optical system and an illumination system (not shown) are each retained within the interior of the instrument housing14and configured to enable viewing the eye of a patient (not shown). Features relating to a typical ophthalmoscope for use herein is more completely described in greater detail in U.S. Pat. No. 6,065,837, the entire contents of which is herein incorporated by reference.

A supporting fixture20fixedly secured to the proximal end18of the instrument housing14is configured to support an attached smart device32. More specifically, the supporting fixture20is defined by a frame-like structure having an open top or upper end as well as a pair of parallel channels or slots24that are disposed along opposing lateral sides, enabling a specific smart device32(e.g., an iphone 4.0) to be releasably attached. The supporting fixture20further includes a cylindrically shaped nose section (not shown) made from a flexible material that is configured to fully cover the eyepiece of the ophthalmoscope10. When the smart phone32is attached, the supporting fixture20retains the smart device32in a single defined position that provides the necessary alignment for the optics of the smart device32relative to the contained optical system (not shown) of the ophthalmoscope10.

In use, the display of the attached smart device32is used to provide digital images of an intended medical target and in which a phone application stored into the memory of the smart phone32enables the instrument to be operated by a user. The supporting fixture20enables the optics of the smart phone32to be specifically aligned with the optical system of the ophthalmoscope10, when the smart device32is attached thereto. A shortcoming of this system is that the supporting fixture20is only configured to adequately retain the specific smart device32. Other smart devices cannot be similarly supported.

The foregoing is significant because alignment between the optics of an attached smart device and the optical system of a stand-alone medical diagnostic or examination device is critical to performance. Additionally, there is a general and pervasive need in the field of medical diagnostics to enable or provide medical examination or diagnostic devices with the capability of assuming a plurality of operating modes, as needed, so as to provide greater versatility.

BRIEF DESCRIPTION

Therefore and according to one aspect, there is provided a medical examination system comprising a medical device including a housing having an optical system within an interior of the housing. The optical system is defined by an optical axis and configured to operate in an optical viewing mode using an eyepiece. The system further comprises an adapter for aligning a digital camera of a smart device with the optical system of the medical device to enable a separate electronic operating mode, each of the adapter and the medical device having complementary features to permit attachment of the adapter to the medical device, the adapter having at least one feature configured to permit each of a plurality of different sized smart devices to be attached to the adapter and in alignment with the optical system of the medical device when the adapter is attached thereto.

According to at least one version, an aligning mechanism includes at least one interface plate interconnecting the smart device and the medical examination device. In an embodiment, the at least one interface plate can be secured, such as adhesively, to the housing of the smart device and in which the medical examination device is releasably attached to the secured at least one interface plate. A mount or alignment assembly or fixture can be provided in order to initially position the at least one interface plate relative to the smart device and in a predetermined location, the adapter having an portion configured to engage the at least one interface plate. Preferably, the interface plate is metal and the portion of the adapter includes at least one magnet for releasably securing the interface plate specifically thereon.

The medical device can include a proximal end having a device receiving portion that is configured to releasably engage a device connection portion of the adapter wherein the adapter includes an opening that is aligned with the camera aperture of the digital camera of the smart device when the smart device is attached via the at least one interface plate. The opening of the adapter is aligned with the viewing axis of the medical device when the adapter is attached to the medical device.

According to at least one version, the adapter includes a lever configured for releasing the adapter from the medical device. Additionally, the device connection portion of the adapter can include a spring-loaded pin that is movable into and out of a defined recess sized to engage the proximal receiving portion of the medical device, wherein the lever is movable to a position to release the pin and assist in releasing the adapter from the medical device.

When attached, the adapter can be moved to a plurality of mounting positions relative to the viewing or optical axis of the medical device. Moreover, the adapter positions the smart device at the convergence point of the eyepiece, thereby placing the smart device in the same position as the viewer's eye in the viewing mode.

A plurality of different medical examination or diagnostic devices can be provided, each of the medical devices having a proximal receiving portion that is configured for engaging the device connection portion of the adapter.

According to another aspect, there is provided an adapter configured for attachment to at least one medical device, the adapter comprising a support surface configured to retain one of a plurality of different sized smart devices. The support surface includes a portion that receives an alignment feature of each smart device to align the camera aperture of an attached smart device with a formed opening. Each of the plurality of smart devices includes a digital camera wherein the adapter, when attached, is configured to align the digital camera with the optical system of a medical examination device. The adapter further comprises a device connection portion configured for engaging a proximal receiving portion of a medical device such that, when attached, the opening of the adapter is aligned with the optical axis of the medical device.

The adapter can include at least one feature for enabling release of the adapter from the medical device such as a lever. In one version, the lever is configured to cooperate with a spring loaded pin of the proximal receiving portion of the medical device.

According to one version, the portion of the support surface includes at least one magnet for engaging the alignment feature of the smart device.

According to yet another aspect, there is provided a medical device comprising a housing, an optical system disposed within the housing including an eyepiece enabling an optical viewing mode; and a proximal receiving portion configured for engaging an adapter retaining a smart device to enable the medical device to assume an electronic imaging mode.

According to one version, the proximal receiving portion retains a set of eyepiece optics. The proximal receiving portion can be defined in at least one embodiment as a cylindrical section having a channel and a lipped portion configured for releasably engaging a device connection portion of the adapter supporting the smart device.

The medical device can be at least one of a plurality of disparate medical diagnostic instruments including at least one from the group consisting essentially of dermatoscopes, otoscopes, ophthalmoscopes, colposcopes, rhinoscopes, each of the instruments being configured to engage the adapter.

According to yet another aspect, a medical instrument examining system comprises a first medical examination device having a distal end, a proximal end and an optical system aligned along an optical axis and a second medical examination device having a distal end, a proximal end and an optical system aligned along an optical axis. Each of the first and second medical examination devices has a proximal receiving portion configured for releasably engaging a device connection portion of the adapter and in which the adapter includes an opening that is aligned with the optical axis of the first and second medical examination device when the adapter.

The adapter includes a supporting member configured to retain a smart device having a camera, the adapter being configured for retaining the smart device such that the camera of the smart device is automatically aligned with the opening of the adapter and the optical axis of the first and second medical examination devices.

One advantage realized by the herein described medical examination system is greater versatility by permitting interchangeable attachment of an eyepiece and an electronic device, such as a smart device, with at least one stand-alone medical examination device. In the inventive system, for example, a number of smart devices can be separably attached and aligned with the optics contained within at least one or more discrete stand-alone medical devices using a generic adapter and an interface that permits the adapter to be connected without modification to a number of medical devices.

Another advantage provided by the herein described system is that either minor or no modifications are required to enable the interchangeable operating modes and in which the adapter used enables repeatable alignment between the optical elements of the stand-alone medical device and the eyepiece or smart device.

These and other features and advantages will be readily apparent from the following Detailed Description, which should be read in conjunction with the accompanying drawings.

DETAILED DESCRIPTION

The following description relates to certain embodiments of a medical examination system that includes at least one stand-alone medical diagnostic or examination device that is configured for operation in a number (at least two (2)) of interchangeable operating modes. In at least one version, an adapter is configured to generically support one of a plurality of smart devices, such as smart phones, in which the generic adapter is further configured to be attached to one of a plurality of disparate medical examination devices. In another version, a plurality of medical devices are configured with a common or generic interface enabling a smart device to be used interchangeably with the medical devices.

For purposes of explanation, the specific medical examination or diagnostic devices described in the following embodiments include otoscopes for examining the ears of a patient and ophthalmoscopes for examining aspects of the eyes of a patient. However, it will be readily apparent that the concepts discussed herein are further applicable to a varied number of other stand-alone medical diagnostic or examination instruments or devices, such as but not limited to dermatoscopes, vagiscopes, colposcopes, and anoscopes, among other devices capable of viewing of a medical target of interest.

In addition, the following description utilizes a number of terms for the purpose of providing an adequate or suitable frame of reference in relation to the accompanying drawings. These terms, which may include “inner”, “outer”, “external”, “internal”, “distal”, “proximal”, “above”, “below”, “top”, “bottom” and the like should not be interpreted as necessarily limiting the intended scope of the invention, including the claims, unless so specifically indicated.

As used herein, the term “smart device” refers to any apparatus or device that is mobile and connected to other devices via wireless protocols or networks under IEEE 802.11 including but not limited to WiFi, Bluetooth, 3G and the like. The smart device as defined herein includes at least one electronic imaging device (e.g., a digital camera) and related optics, memory and a microprocessor capable of running application software, which may include but is not limited to smart phones and tablets.

As used herein, the term “stand-alone medical diagnostic or examination device” refers to an instrument used to view a medical target of interest of a patient which includes an optical system and optionally includes an illumination system. Examples of these devices may include but are not limited to otoscopes, ophthalmoscopes, dermatoscopes, vagiscopes and anoscopes for viewing a medical target of interest.

A system according to several embodiments is described herein and defined by at least one stand-alone medical diagnostic or examination device that can be used interchangeably using an interface that enables an optical mode as well as an electronic imaging mode. As discussed herein, each of the optical system of the medical device(s) and the camera of the smart device can be repeatably and reliably aligned to enable dual functionalities without significant modification to the stand alone diagnostic or examination device.

With reference toFIGS. 2(a) and 2(b)and according to a first embodiment, an alignment fixture100is provided that is used for indexing a smart device prior to attachment to a medical diagnostic or examination device. As discussed herein, the purpose of the fixture100is to provide placement of an interface or alignment plate(s) on a smart device. The positioning of the interface plate(s) enables proper alignment between the camera of the smart device and the optical system of a medical device to which the smart device is attached. The alignment fixture100according to the depicted version is defined by a raised platform108having a planar upper or top surface112, as well as a plurality of legs116that extend downwardly from the upper surface112. One of the legs116according to this embodiment includes a support flange117that further includes an optical target118, such as a reticle. An elongate slot120formed in the top surface112of the alignment fixture100is sized and configured to receive an interface plate104.

The interface plate104according to this specific embodiment is a substantially planar section made preferably from metal and including a through hole105and a slot107, each aligned and spaced from one another. According to this embodiment, an upper side106of the interface plate104includes an adhesive layer to enable securement to the front facing surface144of a smart device140as shown inFIGS. 2(c)-2(e)using the alignment fixture100. More specifically, the interface plate104is positioned within the elongate slot120of the alignment fixture100, with the upper side106of the interface plate105facing upwardly. The smart device140, which according to this embodiment is a smart phone, is then brought to the alignment fixture100with the front facing surface144of the smart device140facing the top surface112of the alignment fixture100and the contained camera146of the smart device140being aimed at the optical target118.

As shown in these figures, the smart device140is activated by the user and an application stored into memory on the smart device140is configured to provide a target on the display144, including a cross hair or other aiming means (e.g., a target148) in order to verify that the optical target118is centered on the display144. Once the target148is centered on the display144of the smart device140, and as shown inFIGS. 2(d) and 2(e), the smart device140can be brought into contact with the adhesive layer106of the interface plate104. The smart device140and attached interface plate104can be subsequently removed from the alignment fixture100by releasing the interface plate104from the retaining slot120.

With reference toFIGS. 2(f)-2(i), the smart device140having the attached interface plate104can then be attached to a stand-alone medical diagnostic or examination device. According to this depicted embodiment, the stand-alone medical or examination device is an otoscope160that is used for viewing the outer and middle ear of a patient. The otoscope160is defined by a housing164that includes an instrument head attached to the upper end of a downwardly extending handle, the instrument head having a distal end and an opposing proximal end as well as an interior that is sized and configured to retain a number of optical elements. The distal end of the instrument head of the otoscope160includes a conical insertion portion that is configured to releasably receive a hollow speculum tip element, also having a conical configuration that is designed to be fitted only to a predetermined distance into the outer ear of a patient (not shown).

According to this version, the rear or proximal facing side surface176of the instrument housing164includes a pair of spaced magnets180. When assembled and as shown inFIGS. 2(h) and 2(i), the hole105and slot107of the fixedly secured interface plate104provides a specific and repeatable datum with regard to the smart device140to enable optical alignment when the smart device140is attached to the otoscope160. When attached, the camera146of the attached smart device140is specifically aligned with the optical system of the otoscope160and more specifically a rear or proximal opening169of the instrument housing164.

It will be understood that variations of the alignment fixture are also contemplated given the need determined by Applicants to precisely and very accurately align the interface plate properly onto a smart device for the herein described examination system. For example and as shown inFIGS. 2(j)-2(l), another alignment fixture100A is depicted for purposes of aligning a smart device for positioning of at least one interface plate (not shown). The alignment fixture100A, according to this version, is defined by a structure having a planar support surface109A. Respective x-axis and y-axis adjustment assemblies130A,134A are engageable with lateral sides of a smart device, and more specifically a smart phone140A that is positioned onto the top of the planar support surface109A. According to this version, the interface place (not shown) can be placed within a shelf (not shown) located directly beneath the planar support surface109A. More specifically, the interface plate(s) is positioned within a defined recess(es) or slot(s) (not shown) in the shelf with an exposed adhesive side of the interface plate(s) facing a slot110A,FIG. 2(l), of the alignment fixture100A.

According to this embodiment, the alignment fixture100A includes respective x-axis and y-axis adjustment assemblies130A and134A that include respective spring-loaded adjustment or support blocks138A and139A, each set orthogonally to one another on the top of the planar support surface109A. Respective x-axis and y-axis screw adjustment members137A and141A, according to this embodiment, are fixedly and threadingly disposed within the center of a corresponding beam-like member143A and145A in spaced parallel relation to the spring-loaded adjustment blocks138A and139A. Each of the beam-like members143A,145A further include a recessed interior portion146A and147A, respectively, that is sized to be placed onto and cover a lateral edge of a smart device (e.g., smart phone140A) that is introduced onto the fixture100A. When mounted, the relative position of the smart phone140A can be laterally shifted wherein vertical movement is restricted by the beam-like members143A,145A, as well as the lateral support surface109A of the alignment fixture100A.

When the camera of the smart phone140A is activated, an alignment application stored by the phone memory is programmed to display a set of cross hairs or other suitable target148A. The smart phone140A is then placed on the planar support surface109A with the display side facing upwardly and the camera of the smart phone140A aligned with a pinhole111A,FIG. 2(l)formed on the planar support surface109A that is aligned with an optical target118A disposed beneath the planar support surface109A. A back light (not shown) can be disposed beneath the optical target118A to enhance illumination and visualization by the smart device140A.

The smart phone140A is initially set with lateral edges of the smart phone140A being placed against the spring-loaded support blocks138A and139A. The screw adjustment members137A,141A and the beam-like members143A,145A are retracted sufficiently to allow the smart phone140A to be initially positioned onto the planar support surface109A. Once crudely positioned and aligned, the x-axis and y-axis adjustment members130A,134A are then moved into position using the screw adjustment members137A,141A with the beam-like members143A,145A, and more specifically the interior recessed portions146A and147A covering and engaging the lateral edges of the smart phone140A. Fine adjustments can then be made against the bias of the spring loaded support blocks138A,139A to accurately center the image149A of the optical target118A on the display144A and more specifically the cross hairs (target148A) as needed, until the image149A of an optical target119A disposed beneath the planar support surface109A is centered on the display144A, and more specifically within the defined cross hairs148A.

The above procedure can also detect misalignment and tolerancing issues of the smart device140A and permit the image149A of the optical target118A to be as effectively and accurately centered relative to the cross hairs148A on the display144A as possible. Such tolerancing and misalignment issues are minor for typical use of the smart device, but are magnified when used for purposes of optically aligning to a medical diagnostic or examination device. Once centered, the shelf retaining the at least one interface plate can be pressed upwardly into contact with the front facing side of the smart device140A, adhesively and reliably securing the at least one interface plate.

It will be understood that the alignment fixture100A can be easily modified to accept smart devices having different configurations and footprints to permit optical alignment and placement of an interface plate(s) as herein described.

When attached in the manner shown herein, the optical parameters of the entire assembly can be calibrated using a calibration target198, such as shown inFIG. 3using the display144of the mounted smart phone140. Optical parameters such as white balance, gray scale and color can be optimized using an application stored within the smart device or other suitable means.

It should be understood that the number and location of interface plates used for alignment to a stand-alone medical device can be suitably varied provided that the interface plate(s) accurately align a mounted smart device and more specifically the contained optics of the attached smart device with the optical system of the medical diagnostic or examination device. One alternative embodiment is shown inFIGS. 4(a)-4(f)in which a pair of interface plates204,208, are provided for disposition between the rear facing surface207of a stand-alone medical diagnostic or examination device200, in this instance an otoscope, and the front facing surface223of a smart device220, for example, a smart phone. Initially, a pair of interface plates204,208are attached to the front facing surface223of the smart device220using an alignment fixture (not shown) that is similar to that previously shown and depicted inFIGS. 2(a)-2(l). Though not shown, the process of assembly is similar in that the alignment fixture includes a raised platform or an upper or top planar surface that further includes a pair of slots that are spaced from one another and configured for retaining each of the interface plates in a spaced relation. According to this embodiment, the pair of interface plates include a first interface plate204and a second interface plate208. Also and as in the proceeding, an optical target can be provided on the alignment fixture.

To assemble, each of the first and second interface plates204,208are placed within the retaining slots on the top surface of the alignment fixture with the camera of the smart device220being aimed at the optical target and viewed using a cross hair or similar aiming means provided on the display of the smart device220using an application stored within the smart device220. When the camera of the smart device220is properly aimed such that the optical target is centered on the cross hairs provided on the display, the smart device220can then be brought into contact with the top surface of the alignment fixture in which each of the facing sides of the interface plates204and208include an exposed adhesive layer in order to secure same to the smart device220.

The smart device220can then be removed from the alignment fixture and secured to the rear facing side or surface207of the medical examination device200, which according to this embodiment is an otoscope. In at least one version, the rear facing side207of the medical examination device200includes a pair of magnets214,217spaced from one another that receive the smart device220and more specifically the interface plates204,208, the latter being positioned to ensure the attached smart device220, and more specifically the camera of the smart device220, is aligned properly with the optical system of the examination device200.

With reference toFIGS. 5(a)-5(d), there are depicted a number of varied arrangements between a stand-alone medical diagnostic or examination device300, an eyepiece320and a smart device360, each of the latter being interchangeably attached to the proximal end of the medical diagnostic device300.

First and as shown inFIGS. 5(a) and 5(b), the eyepiece320can be releasably engaged with the stand-alone medical examination device300(i.e., an otoscope). The eyepiece320according to this depicted embodiment is defined by a substantially cylindrical housing324having an interior that is configured to retain at least one optical element, such as an objective lens (not shown). The eyepiece320can be releasably attached to the stand-alone medical examination device300by means of a magnetic interface309formed at the proximal end of the medical device300. According to this embodiment, the magnetic interface309includes a plurality of retained magnets which are disposed in a circumferential configuration about a proximal opening of the medical device300. The distal end of the eyepiece320is configured to engage the magnetic interface309in a manner in which the contained optics of the eyepiece320are optically aligned with the contained optics of the medical examination device300.

The eyepiece320, according to this specific embodiment. further includes an external focusing knob328disposed on the housing324, that when rotated, is configured to axially shift the position of the contained optical element, as needed. When coupled to the stand-alone medical device300, the external focusing knob328can be accessed by the user and rotated to permit adjustments to be made optically while the magnetic interface309continues to maintain support and optical alignment of the eyepiece320with the optics of the stand-alone medical device300.

As shown inFIGS. 6(a) and 6(b), a similar arrangement can be provided for another stand-alone medical diagnostic or examination device400(e.g., an ophthalmoscope) in which the eyepiece320can also be releasably and interchangeably attached to the proximal end405of the device400. As in the prior embodiment, the device400includes a magnetic interface409in which a plurality of retained magnets are disposed in a circumferential pattern to enable optical alignment with the stand-alone medical examination device, when the eyepiece320is attached. This attachment further enables a user to view the intended target through the proximal end of the eyepiece320. In use, the eyepiece320can be interchangeably attached to either medical diagnostic or examination device300,400without modifications being required to either the devices300,400or the eyepiece320.

Still further and with reference toFIGS. 5(c) and 5(d), andFIGS. 6(c) and 6(d), a smart device360can also be separably and interchangeably attachable to the proximal surface305,405of either medical examination or diagnostic device (otoscope300or ophthalmoscope400) in lieu of the eyepiece320to provide a separate electronic imaging or viewing mode. According to each of these depicted embodiments, at least one interface plate is first provided and attached to the front or distal facing side of the smart device360such as using an alignment fixture (not shown) in a manner previously described—seeFIGS. 2(a)-2(i). Once the interface plate(s) are attached, the smart device360can be interchangeably attached to the rear facing or proximal surface305,405of either medical examination device300,400using at least a portion of the magnetic interface309,409as well as at least one other suitably spaced magnet311,411, the latter being separately provided on the rear facing surface305,405of the otoscope300or ophthalmoscope400in spaced relation to the interface309,409to properly locate the smart device360in alignment with the contained optics of the medical examination device300,400. It should be understood that other configurations are possible.

It should be noted that the design of the medical examination device can be suitably altered to better accommodate an attached and optically aligned smart device for purposes of operation. For example and according toFIGS. 7(a)-7(d)andFIGS. 8(a)-8(d), another embodiment of a medical examination assembly is depicted in which stand-alone medical examination devices (otoscope500or ophthalmoscope600) are commonly defined by a body or housing504,604in which the upper portion of the handle508,608is curved so as to create an offset of the instrument head510,610relative to the handle508,608of the device500,600to enable an attached smart device360to be more efficiently centered and balanced due to the off-center nature of an attached smart device360. Other suitable variations and configurations will be readily evident, for example, depending on the smart device to be supported in the herein described assembly.

In each of the latter examples, an eyepiece320and a smart device360can be interchangeably used in connection with either medical examination device500,600. The eyepiece320is releasably attached by engagement of the distal end of the eyepiece housing324with a magnetic interface509,609formed about the periphery of the proximal optics opening of the device500,600. The smart device360is interchangeably mounted using at least one interface plate (not shown in these views) using a technique that is similar to that described inFIGS. 2(a)-2(l), including a suitable alignment fixture having retention slots that permit specific placement or positioning of the smart device360to further provide suitable optical alignment relative to an optical target on the alignment fixture that is configured to represent the optical system of the otoscope500or ophthalmoscope600and attached to magnets511,611of the medical devices500,600respectively.

In accordance with another embodiment and with reference toFIGS. 9(a) and 9(b)there is shown another stand-alone medical diagnostic or examination device that can be configured to support a smart device to provide versatility through an enhanced electronic viewing mode According to this version, the medical examination or examination device is an otoscope700, such as the Macroview otoscope manufactured and sold by Welch Allyn, Inc. of Skaneateles Falls, N.Y. This device is described more completely in U.S. Pat. No. 7,399,275, the entire contents of which are herein incorporated by reference. The otoscope700according to this embodiment includes a cylindrical handle portion704having an upper necked portion706that supports an instrument head708. The handle portion704includes a battery compartment (not shown) that retains a set of stacked batteries (not shown) that are coupled to a light source (not shown) retained in the necked portion706. Light is transmitted from the contained light source through a distal end711of the instrument head708, using a fiberoptic bundle or other suitable means. The fiberoptic bundle (not shown) is configured as a ringlet of fibers that surround a distal optical element (not shown) contained within the instrument head708. The interior of the instrument head708is essentially hollow and includes a conical insertion portion712at the distal end711, as well as a proximal opening including a proximally extending eyepiece710. In use, an otoscopic tip element (a speculum tip) is releasably attached to a conical insertion portion712of the instrument head708in which the target of interest (e.g., the tympanic membrane) can be viewed through contained optics via the proximal opening along a defined optical axis. As noted, further details relating to the construction and features of the otoscopic device700, including the speculum tip, are discussed in greater detail in U.S. Pat. No. 7,399,275, herein previously incorporated by reference.

As further shown inFIGS. 9(a) and 9(b), an adapter720is provided that is attached to the proximal end of the otoscopic device600. According to this embodiment, the adapter720is defined by a distal engaging portion724that is configured for engaging the instrument head708of the otoscope700and a proximal supporting portion728that is configured to receive a smart device750, such as a smart phone, as shown. The distal engaging portion724, according to this specific embodiment, is defined by a pair of resilient fingers732that are configured to engage a slot or slotted portion713formed on an upper or top surface of the instrument head708. The proximal supporting portion728of the adapter720includes a recessed slot736sized for receiving an interface plate738(partially shown in the exploded view ofFIG. 9(b)) that is first attached to the distal facing side or surface of the smart device750, using an alignment and indexing fixture in a manner similar to that previously described with regard toFIGS. 2(a)-2(l). In this specific version, the slot736(or other part of the adapter720) is further defined by at least one magnet, the adapter720further having a through opening740that aligns the optics of the device700and those of the optics of the smart device750opposite a connector758at the lower portion of the adapter720. The connector758is configured to engage with and cover the eyepiece710of the otoscope700.

When attached, the smart device750, including the display754, is situated substantially above the instrument700as is depicted inFIG. 9(a)with the optics of the smart device750being disposed in proper alignment with the optical system of the otoscope700.

The above described adapter720can be utilized with other stand-alone medical diagnostic or examination devices. For the sake of clarity, similar parts are herein labeled with the same reference numbers. With reference toFIG. 9(c), an ophthalmoscope800includes a handle portion804that further includes a necked portion806for supporting an instrument head808. The instrument head808retains a plurality of components to enable viewing of a patient's eye (not shown) and more specifically the retina (not shown). According to this embodiment, the device800is configured to with an eyepiece810at the proximal end of the instrument head808in which the interior of the instrument head808includes a plurality of optical elements as well as an illumination system, the latter having a contained light source for viewing portions of the eye of the patient. Details relating to the salient features of the ophthalmoscope800are provided in U.S. Pat. No. 6,065,837, the entire contents of which are herein incorporated by reference.

The adapter720is attached to the instrument800to permit interchangeability between instruments and operating modes (between an optical viewing mode using the eyepiece810and an electronic viewing mode using an attached smart device750). As previously discussed, the adapter720includes a distal engaging portion724and a proximal supporting portion728. The distal engaging portion724includes a pair of resilient fingers732that are configured to engage a recessed slot or slotted portion813provided in an upper surface of the instrument head808. The proximal supporting portion728is defined by a vertical support surface including a recessed slot (not shown) that receives an interface plate attached, adhesively or otherwise, to the distal or front facing side of the smart device750preferably in the manner previously described. The adapter720further includes a cylindrically shaped connector portion758in a lower portion of the adapter720that is sized to engage the eyepiece810of the ophthalmoscope800or other medical stand-alone device and in which a gusset727engages a top portion of the instrument head808to optionally provide additional support and stability.

With reference toFIG. 9(d), an alternative adapter is depicted for use with a stand-alone medical diagnostic or examination device (e.g., the otoscope700previously discussed). According to this version, the adapter920includes a proximal supporting portion928that includes an open end929and a pair of laterally disposed guide rails930, the latter being sized to receive a smart device750. According to this specific embodiment, the adapter920includes a distal engaging portion924having a set of resilient fingers932that are configured to engage the slotted portion713formed on the upper or top surface of the instrument head708. The adapter920also includes a lower connector portion758that is sized to engage the eyepiece710of the diagnostic or examination device700. Each of the herein described adapters720,920enable a smart device, such as device750, to be attached to at least one stand-alone medical instrument and permit interchangeable operating modes (optical and electronic).

Yet another embodiment of a medical instrument assembly or system is illustrated inFIGS. 10(a)-10(b). According to this version, a stand-alone medical examination or diagnostic device (e.g., an otoscope1000) is provided that is defined by a housing1004further defined by a handle1008that downwardly extends from an instrument head1010. The instrument head1010is defined by a distal end1012including a conically shaped insertion portion (not shown). The insertion portion is configured to releasably support a conically shaped and hollow speculum tip element1014, the tip element1014being releasably attached by means of a rotatable actuator knob1015. Alternatively, the tip element1014can be secured by manually twisting the element in place onto the conical insertion portion using bayonet or other suitable engagement features. Details relating to the speculum tip element and an exemplary attaching and releasing mechanism are described in greater detail in U.S. Pat. Nos. 7,354,399 and 8,197,403, each of which are herein incorporated by reference in their entirety.

Within the interior of the otoscope1000is a light source (not shown) such as an incandescent lamp or at least one LED, which is disposed in a lower portion of the instrument head1010. A bundle of optical fibers (not shown) are coupled to the light source and directed as a ringlet at the distal end of the conical insertion portion in order to effectively illuminate the target of interest. The handle1008includes an interior compartment that retains at least one battery (not shown) for energizing the light source. A series of optical elements are disposed within the interior of the instrument head1010and aligned along an optical axis with a separate optical train being provided within the confines of an eyepiece1024, the latter being releasably attached to the otoscope1000in order to create an optical viewing mode.

According to this embodiment an adapter1020, which is provided at a proximal end of the otoscope1000, permits attachment of the eyepiece1024. The adapter1020includes a set of magnets (not shown) that permits releasable and interchangeable attachment of the eyepiece1024or a smart device1050, as described below. As noted, the eyepiece1024includes an interior retaining a series of optical elements that are suitably aligned with optical elements provided in the interior of the instrument head1010. According to this specific embodiment, the eyepiece1024is defined by a housing1027that is coextensive with the handle1008of the otoscope1000, including a substantially planar distal facing surface1029.

With further reference toFIG. 10(a), the adapter1020is attached to or according to this embodiment is directly integrated as a part of the device housing1004. More specifically, the adapter1020is defined by a planar section1022which is disposed within a rear receiving slot1036of the device housing1004. This planar section1022includes a proximal face surface1026having at least one recessed slot (not shown) that permits the selective engagement of a smart device1050,FIG. 10(b). In accordance with prior embodiments discussed, such as depicted inFIGS. 2(a)-2(l), an attachment device includes at least one retaining slot that receives an interface plate. The smart device1050is then positioned in relation to the alignment fixture and the camera of the smart device1050is aimed at an optical target of the alignment fixture until centered in the display of the smart device1050. Upon centering and as previously discussed, the smart device1050is then engaged with the supported interface plate(s), the latter having an adhesive layer to provide securement. The indexing and positioning of the interface plate(s) guarantees proper alignment of the smart device1050to the otoscope1000and more specifically between the interface plate(s) and the at least one recessed slot (not shown) formed in the proximal facing surface1026of the adapter1020. The at least one magnet (not shown) is provided in the adapter1020in alignment with the recessed slot(s) to releasably secure the smart device1050.

According to this embodiment, the adapter1020is supported for pivotal movement from the rear receiving slot1036of the device housing1004about the optical axis of the device1000. This pivotability permits the attached smart device1050to assume a plurality of adjustable mounting orientations enabling the position of the smart device1050to be changed selectively. Advantageously, this latter feature permits enhanced operation and versatility.

In terms of operation, the herein described system can be used initially in an optical viewing mode as depicted inFIG. 10(a)with the eyepiece1024being releasably engaged with the proximal facing surface1026of the adapter1020. The eyepiece1024is releasably attached and can be released from the adapter1020by disrupting the magnetic attachment. As shown inFIG. 10(b), the smart device1050, having an attached interface plate(s) (not shown) can then be interchangeably attached in lieu of the eyepiece1024by engaging the interface plate with the recessed receiving slot of the adapter1020. The magnets according to this embodiment are directly aligned with the recessed receiving slot on the adapter1020to insure attachment. In this latter mode, the camera of the smart device1050is aligned with the optical axis of the otoscope1000and the smart device1050is further configured to assume a plurality of mounting configurations based on the pivotal connection of the adapter1020with the remainder of the otoscope1000.

In either operational mode, the user inserts the speculum tip element1014a predetermined distance into the outer ear of a patient and the image of the intended target, as illuminated by the contained light source is viewed or transmitted directly along the optical axis to either the eyepiece1024or the smart device1050for viewing on the display1054,FIG. 10(b).

Another medical examination system is depicted inFIGS. 11(a)-11(b). According to this embodiment, the medical diagnostic or examination device used is an ophthalmoscope1100defined by a housing1104having a handle portion1108and an instrument head1110. The instrument head1110is defined by a distal end1112that receives an elastomeric eye cup1116configured to engage against the patient and a proximal end that includes an adapter1120. The interior of the instrument head1110includes an optical and illumination system that is configured to view the eye (e.g., the retina) of a patient (not shown) including a defined optical axis extending between the distal and proximal ends of the device1100. The adapter1120, which is similar to that previously described in the prior embodiment, is configured to interchangeably receive either an eyepiece1124,FIG. 11(a), or a smart device1050,FIG. 11(b), respectively.

As in the prior otoscopic version, the adapter1120is defined by a planar section1122which is disposed within a rear receiving slot of the device housing1104. This planar section1122includes a proximal or rear face surface1126having at least one recessed slot (not shown) that permits the selective engagement of a smart device1050. In accordance with prior embodiments discussed, such as depicted inFIGS. 2(a)-2(l), an alignment fixture includes at least one retaining slot that receives an interface plate. The smart device1050is then positioned in relation to the alignment fixture and the camera of the smart device is aimed at an optical target of the alignment fixture until centered in the display of the smart device. Upon centering and as previously discussed, the smart device is then engaged with the supported interface plate(s), the latter having an adhesive layer to provide securement. The indexing and positioning of the interface plate(s) guarantees proper alignment of the smart device1050to the ophthalmoscope1100and more specifically between the interface plate(s) and the at least one recessed slot formed in the rear facing surface1126of the adapter1120. At least one magnet (not shown) is provided in the adapter1120in alignment with the recessed slot(s) to releasably secure the smart device1050.

According to this embodiment, the adapter1120is supported for pivotal movement from the rear receiving slot1136of the device housing1104about the optical axis of the device1100. The adapter1120includes a distal engagement portion (not shown) that is disposed over a proximally extending end (not shown) of the instrument head1110in overlaying relation. This pivotability feature permits the attached smart device1050to assume a plurality of adjustable mounting orientations about the optical axis wherein the position of the smart device1050can be changed selectively upon attachment to the adapter1120without otherwise disturbing optical alignment. For example, the engagement portion can include at least one or more detents (not shown) to provide specific mounting orientations (e.g., each 90 degrees to create four (4) mounting orientations). Advantageously, this latter feature permits enhanced operation and versatility.

With reference toFIGS. 12(a) and 12(b), there is shown another embodiment of a medical examination system that permits pivotal movement of an attached smart device. This system includes a medical examination device (i.e., an ophthalmoscope1200) having a cylindrical handle portion1206with an instrument head1210attached to an upper part of the handle portion1206. The instrument head1210is defined by a distal end1211and an opposing proximal end1213, the distal and proximal ends1211,1213defining an aligned optical axis of the assembly. The adapter1220, according to this embodiment, is defined by a substantially planar section having a distal facing surface1226and a proximal facing surface1228. The proximal facing surface1228includes at least one recessed slot (not shown) that is configured for receiving an interface plate (not shown) attached to the front facing side of a smart device1050, in a manner as previously described. According to this embodiment, the distal facing surface1226of the adapter1220includes at least one magnet directly aligned with the recessed slot, as well as a distal engagement portion including an open upper end and a channel that is configured to receive an eyepiece portion of the instrument head1210. The eyepiece portion according to this embodiment includes a necked portion including a proximal lip that axially secures the adapter1220once attached to the device1200.

When attached, the necked portion can be slidingly engaged within the defined channel with the proximal lip being retained within the channel. In at least one variation, the channel and the proximal lip are configured to permit the adapter (and attached smart device) to assume a plurality of mounting orientations, such as shown inFIGS. 12(a) and 12(b), as well asFIGS. 13(a) and 13(b)depicting another stand-alone medical device, i.e., an otoscope1300having a handle portion1306downwardly extending from an instrument head1310having respective distal and proximal ends1311,1313. As in the preceding, the otoscope1300can be similarly configured with the same or similarly configured adapter1320that permits the further attachment of a smart device that, upon attachment, can be oriented in various orientations based on a pivotal connection between the medical device and the adapter. As in the preceding, the adapter1320is a planar section having a distal facing surface1326, a proximal facing surface1328and a distal engagement portion (not shown) that is sized to overlay the proximal eyepiece end of the instrument head1310.

With reference toFIGS. 14(a)-15(c), an adapter1500in accordance with another embodiment is herein described. The adapter1500is preferably fabricated from a lightweight structural material, such as a moldable plastic, having a supporting member or body1504that includes a forward or front facing side1507and a rear facing side1509, respectively. The adapter1500is further configured with a device connection portion1512extending from the front facing side1507that is configured for attaching the adapter1500to a medical examination device. The adapter1500is further configured such that a smart device1550can be releasably or otherwise attached to the rear facing side1509of the supporting member1504. A center portion1520located on the rear facing side1509is sized for accommodating an interface plate (not shown) that is attached to the smart device1550(e.g., a smart phone). The interface plate can be properly located and positioned on the smart device1550by means of a fixture such as shown inFIGS. 2(a)-2(l)or a similar technique for purposes of aligning the camera of the smart device1550with the optical system of the medical examination device, as further discussed herein. A set of magnets1511provided in the center portion1520releasably secures the smart device1550in position on the adapter1500.

According to this embodiment, the device connection portion1512is defined by an outer surface1515which is parallel to the front facing surface1507with a shaped recess1530formed between the surfaces1507,1515that is configured for releasable engagement with a proximal receiving portion1564,FIG. 15(c), of a medical examination device1560,FIG. 15(c). A portion of the outer surface1515is cutout as shown by1517, the cutout portion1517being aligned with a through opening1519formed in the supporting member1504. One end of a release lever1524is disposed in relation to the device attachment portion1512, wherein the opposite end of the lever1524is accessed by a user to move the lever1524between undepressed and depressed positions as shown inFIGS. 14(a) and 14(c), respectively. The end of the release lever1524disposed in relation to the device connection portion1512is engaged by a spring-loaded pin1540, partially shown, that is movable into and out of the shaped recess1530of the device connection portion1512. A stop1544disposed on the front facing side1507of the adapter1500provides a limit for movement of the release lever1524for the depressed position.

The design of the adapter1500enables a plurality of smart devices, such as smart phones, each being different in terms of overall footprint to be releasably attached in a specific orientation. As noted and for locating the smart phone according to this version, an interface plate such as previously described above is placed specifically on the front facing side of the smart device1550before releasably securing the smart device1550to the rear facing side1509of the adapter1500. When attached in this manner, the camera aperture1554of the smart device1550is aligned with the through opening1519of the adapter1550.

Referring toFIGS. 15(a)-15(c), the adapter1500is shown as attached to a medical examination device1560that includes an instrument head or housing1568having a proximal receiving portion1564. The proximal receiving portion1564according to this embodiment is a substantially cylindrical portion that extends rearwardly from the proximal end of the instrument head1568. The receiving portion1564further includes a channel1572, the latter preferably having a plurality of flats (not shown in this view, but shown as1430in a similar medical device shown inFIG. 22(b). The formed recess1530is aligned so that the adapter1500can be slid over the proximal receiving portion1564(in a direction into and out of the plane of the drawing). When engaged, the upper surface1515engages the channel1572and the formed recess1530is engaged by an outer ringed portion1575of the proximal receiving portion1564. When engaged, the through opening1519of the adapter1500is aligned with the optical axis of the medical examination device, including a set of eyepiece lenses1580,1582disposed in the interior of the proximal receiving portion1564. According to this embodiment, the adapter1500can assume one of a plurality of mounting orientations by placing the device connection portion1512of the adapter1500and more specifically the shaped recess1530relative to the proximal end of the medical device1560.

In operation and when the adapter1500is not attached, the medical device1560can be used in an optical viewing mode to view the target of interest through the proximal end, which includes a brow rest1590. The medical device1560can be alternatively used in an electronic imaging mode when the adapter1500is attached in which the aperture1554of the attached smart device1550is aligned with regard to the convergence point of the optics of the medical device1560such that the smart device1550receives a focused image of the medical target of interest. According to this embodiment, the adapter1500enables the attachment of one of a plurality of disparate smart devices and in which the attached smart device1550is fully aligned with the optical system of the medical device1560. Each of the above operating modes can be realized without modification to the medical device1560by the inclusion or removal of the adapter1500. That is, no additional optical module is required.

In addition to being configured to receive one of a plurality of different smart devices, the herein described adapter1500can be used with a plurality of disparate medical diagnostic instruments, each having a proximal end and receiving portion as described for purposes of attachment. These instruments can include, but are not limited to a ophthalmoscope, an otoscope, a colposcope, a dermatoscope, a rhinoscope, an anoscope or other hand-held medical examination device. For example and in a wellness examination, the adapter1500(and attached smart device1550) can be interchangeably used with an otoscope and an ophthalmoscope for viewing the ears and the eyes, respectively, using the display of the connected smart device1550. It will be understood, however, that the connective features of this embodiment is an example wherein other suitable configurations are possible for enabling the above-described functions.

With reference toFIGS. 16-19, a number of optical configurations are depicted based on the various operating modes of the herein described examination system and as typified by the preceding structural embodiments. For purposes of this discussion, these schematic diagrams pertain to otoscopes and ophthalmoscopes in keeping with the embodiments previously discussed. It should be understood that other versions could be contemplated.

In certain ophthalmoscopes, optical adjustments can be accomplished in the removable eyepiece of the instrument. For purposes of interchangeability and additional operating modes for the herein described examination system and when a smart device was used in the combination with the ophthalmoscope during tests, it was determined that the device needed a focus range of about +/−10 diopters to accommodate all patients, while the imaging system of known smart devices typically only had a focus range of about +/−3 diopters. Based on the foregoing, it was concluded that there is a need to move the focus adjustment to the patient end (distal) of the instrument to permit focusing in both operational modes of the system; that is either with or without a smart device being attached.

FIGS. 16 and 17herein present schematic views of the optical system of the ophthalmoscope1200that is configured to provide focusable adjustment of an optical element (objective lens) retained within the instrument head (not shown). First and with reference toFIG. 16, a focusable objective lens1230is disposed within the instrument head distally of a beam splitter1234and a set of focusing or imaging lenses1238, each commonly aligned along a defined optical axis1244. An image sensor1248of a smart device attached to the proximal end of the medical device1200is also aligned with above optical elements. The beam splitter1234is configured to receive illumination from an off-axis light source1260such as an LED or an incandescent bulb, the light emitted by this source1260being directed to the eye1280of a patient (shown schematically) while further permitting reflected light from the patient's eye1280to be transmitted and focused at the camera sensor1248by the focusing lenses1238.

By optionally making the objective lens1230axially movable according to this embodiment, an increased focus range can be achieved. In this configuration, the autofocus function of the attached smart device should be disabled. The optical system of the instrument1200and more specifically the contained objective lens1230can be optionally adjustable according to one version using a focusing mechanism, such as a focusing knob (not shown) provided on the instrument head. Details relating to one example of a focusing mechanism for use in a medical examination device is more completely described in U.S. Pat. No. 7,399,275, previously incorporated by reference. The focusable objective lens can according to one embodiment be adjusted +/−20 diopters, or minimally +/−10 diopters.

In lieu of the smart device, an optical layout is presented inFIG. 17that again includes the objective lens1230, the beam splitter1234and the focusing or imaging lenses1238each commonly disposed along the defined optical axis1244of the device1200extending through the distal and proximal ends of the instrument head along with the aligned optical train of an attached eyepiece, such as shown. In this version, the optical train of the attached eyepiece includes a plurality of fixed eyepiece lenses1288and a distal aperture stop1292, each also aligned along the defined optical axis1244for viewing by the eye1296of the doctor. As in the previous example, the objective lens1230contained within the instrument head is axially movable to increase the focusing range of the device1200.

Similar arrangements can be provided in another medical examination or diagnostic device. Referring toFIGS. 18 and 19, imaging and optical (eyepiece) modes are shown schematically for an otoscope1300that is defined by a distal lens1332disposed in relation to the speculum tip element shown partially as1336, the latter being releasably attached to the distal end of the instrument head. The distal lens1332according to this embodiment is covered by a plano window1338wherein a field stop1342is provided in relation to a focusable objective lens1346, which in this version is a doublet defined by a first lens1347and a second lens1348. The first distalmost lens1347is defined by a distal plano surface and an opposing concave surface. The second adjacent lens1348of this doublet is defined by a distal concave surface and an opposing plano surface. Each of the above optical elements are commonly aligned along a defined optical or imaging axis1350extending through the distal and proximal ends with the instrument having an attached speculum tip element1336, also shown schematically according to these examples. In the version shown inFIG. 18, the system includes an optically aligned smart device, shown diagrammatically as1354, the device including a camera aperture as well as an image sensor disposed and aligned along the defined optical axis1350, such as through use of an interface plate and adapter as described with regard toFIGS. 12(a)-15(c).

As shown inFIG. 19, the otoscope1300alternatively receives the attached eyepiece, which includes a set of fixed eyepiece optics1364and an aperture stop1368that is aligned with the eye of the doctor or caregiver along the defined optical or imaging axis of the assembly. In each depicted version, the focusable objective lens1346is disposed adjacent the proximal end of the instrument head (not shown) and aligned with the camera lens and the image sensor of the attached smart device or the eyepiece. A focusing mechanism can also be provided, such as described, by way of example, in previously incorporated U.S. Pat. No. 7,399,275. In terms of operation, an image of the tympanic membrane, shown schematically as1312, is transmitted through a plano window at the distal end of the conical insertion portion and through an adjacent distal lens through a field stop and then to the focusable objective lens1346, which condenses the image taken through either the attached eyepiece to the doctor's eye1362or smart device. It should be noted that the optical systems described are merely exemplary and other optical systems can be similarly aligned, for example, with an adapter such as1500to permit separate operating modes.

With additional reference toFIGS. 16 and 17,FIG. 20illustrates an optical layout of the corresponding off-axis illumination system. Light from the contained light source1260, such as an LED or an incandescent bulb is directed through a condenser lens1264along a defined illumination axis1268and reflected from the angled surface of the beamsplitter1234. This light is then further directed through the objective lens1230and is focused at the eye of the patient1280. According to this version, a series of fixation lights1270are provided at the distal end of the instrument head. The number of fixation lights used can be varied. According to one example, at least two fixation lights can be provided that are diametrically opposed about the distal aperture of the instrument1200that are separately operated from the contained illumination source1260. In terms of operation, the caregiver would move the device toward the eye of the patient and activate one of the fixation lights1270. The patent would be requested to concentrate his or her vision on the fixation light1270. By including multiple fixation lights, different portions of the retina can be examined by requesting the patient focus on the fixation lights in sequence and obtain measurements. In one example, a ringlet of several fixation lights could be disposed in which the images obtained using a smart device or other can be stitched and effectively cover a larger portion of the retina (15-30 degrees or more, enabling the determination of diabetic retinopathy. In another version, various other eye-related diagnoses can be obtained such as, but not limited to hypertension (artery-to-vein ratio), macular degeneration, glaucoma, diabetes, and those relating to retinal detachments.

With reference toFIG. 21, each of the herein described instruments can be provided for access to a user in kit form, by defining a mounting unit1800that includes a plurality of slots1808formed in a support surface1804for accommodating various stand-alone medical diagnostic or examination devices1814, as well as interchangeably mounted smart devices, adapters and eyepieces. Each of the various embodiments that are depicted can be provided for mounting to either a wall or similar structure (not shown) or can be mounted to other fixturing such as a movable cart in which the mounting can be permanent to releasable depending on the application. The mounting unit according to at least one version can include a supporting frame that is filled with a soft compliant material. The number of shaped slots formed in the filled compliant material can be are sized to receive, for example a pair of medical diagnostic or examination devices and accessories such as eyepieces and the like. The medical devices1814can be stored by positioning the distal end of the medical devices within the shaped slots1808with a portion of the devices1814being directly inserted into the slots1808and remaining portion being accessible, as needed, for removal by a user. The mounting units1800can be appropriately shaped with either the mounting surface1804or the supporting surfaces of the units1800being angled to provide additional versatility. In the depicted version, the mounting unit1800is configured to accommodate various forms of stand-alone medical devices, including versions previously discussed with reference toFIGS. 5(a)-6(d). It will be readily apparent to the person of sufficient skill in the field that other modifications and variations are possible, including versions in which the batteries of each of the retained instruments can be charged.

FIGS. 22(a) and 22(b)herein depict another medical examination device made in accordance with aspects of the present invention and more specifically an ophthalmoscope1400. More specifically, the ophthalmoscope1400is defined by a handle portion1406(partially shown) and an instrument head1410that is releasably connected to a necked upper portion1409of the handle portion1406. A light source1415forming a portion of an illumination system is powered by batteries (not shown) that are contained in the handle portion1406. Optics are contained and aligned along respective optical and illumination axes within the interior of the instrument head1410. The illumination axis extends upwardly from the contained light source1415through a number of optical elements1417including a rotatable aperture wheel1420formed in a lower portion of the instrument head1410in which light is directed to a distal end1412of the instrument head1410for directing to the eye of a patient (not shown). The optical system includes a series of optical elements1419that are aligned along an optical axis extending through the distal end1412and a proximal end1416of the instrument head1410. A rotatable diopter wheel1424is also disposed along the defined optical axis near the proximal end1416of the device1400. Additional details relating to an optical and illumination system useful with this design can be found in U.S. Patent Application Publication No. 2016/0073875A1 and U.S. Patent Application Publication No. 2015/0103317A1, the entire contents of which are herein incorporated by reference.

The proximal end1416of the herein described instrument1400can include an interface that permits the attachment of an adapter, such as previously described with regard toFIGS. 14(a)-15(c). More specifically, the proximal end1416of the instrument1400is defined by an outer lipped portion1426, as well as a channel1430disposed between the lipped portion1426and a rear wall1431of the instrument head1410. An adapter1500,FIGS. 14(a)-14(c), as previously discussed, is defined by a supporting member having respective front and rear facing surfaces. The rear facing surface of the adapter1500includes a recessed area that is positioned to receive at least one interface plate of an attached smart device in a releasable fashion. As in the prior described embodiment, the adapter1500is further defined by an open-ended engagement portion that is sized and configured to engage the proximal end1416of the instrument1400with the lipped portion1426of the proximal end1416fitting within a formed channel of the open-ended device engagement portion and the channel1430of the proximal end fitting engaging a shoulder of the engagement portion. According to this embodiment, the channel1430is defined by four substantially flat sides to enable the adapter1500to be fitted in a plurality of mounting orientations. Alternatively, the channel can be defined by a cylindrical or other shaped surface. According to one version, detents can be provided to enable rotation of the attached smart device to a plurality of mounting orientations while still maintaining the optical alignment between the camera of the attached smart device and the optical system of the instrument1400. Other suitable configurations such as flats in the channel can be contemplated for providing similar capabilities.

PARTS LIST FOR FIGS.1-22(b)

10stand-alone medical diagnostic or examination device (ophthalmoscope)

20frame or supporting structure

24parallel channels or slots

105hole, interface plate

107slot, interface plate

109A planar support surface

112upper or top surface

118A optical target

137A screw adjustment member

138A spring-loaded adjustment or support block

139A spring-loaded adjustment or support block

140A smart device

141A screw adjustment member

146camera, smart device

149A image of optical target

169rear or proximal opening

176rear or proximal facing surface

200stand-alone medical examination device

204first interface plate

208second interface plate

223front facing surface

300medical diagnostic or examination device

305back or proximal surface

364display, smart device

400medical diagnostic or examination device

500medical diagnostic or examination device

504body or housing

600medical diagnostic or examination device

604body or housing

713slotted portion or slot

728proximal supporting portion

758connector or connector portion

813slot or slotted portion

928proximal supporting portion

958connector or connector portion

1014speculum tip element

1026proximal facing or face surface

1116elastomeric eye cup

1226distal facing or face surface, adapter

1326distal facing surface

1328proximal facing surface

1346focusable objective lens

1504supporting member or body

1507forward or front facing side, adapter

1512device connection portion

1560medical examination device

1564proximal receiving portion

1600medical examination device

1700medical examination device

The invention is inclusive of combinations of the aspects described herein. References to “a particular aspect” (or “embodiment” or “version”) and the like refer to features that are present in at least one aspect of the invention. Separate references to “an aspect” or “particular aspects” or the like do not necessarily refer to the same aspect or aspects; however, such aspects are not mutually exclusive, unless so indicated or as are readily apparent to one of skill in the art. The use of singular or plural in referring to “method” or “methods” and the like is not limiting. The word “or” is used in this disclosure in a non-exclusive sense, unless otherwise explicitly noted.

The invention has been described in detail with particular reference to certain preferred aspects thereof, but it will be understood that variations, combinations, and modifications can be effected by a person of ordinary skill in the art within the intended spirit and scope of the invention.