青光眼中英文版-课件

1、青光眼中英文版青光眼中英文版2Intraocular pressure(IOP) : the pressure of the eye content to the eye wall眼压:眼球内容物作用于眼球内壁的压力Normal IOP: 102l mmHgDouble IOP difference5mmHgIOP curve day and night50y female pain red eye vision loss with headache nausea vomiting病因:具有遗传倾向,解剖结构异常, 常有诱因。临床特征:年龄50岁,女性多见。 主诉为眼胀痛、眼红,视力下降, 伴

2、头痛、恶心、呕吐。12Primary angle-closure glaua13Clinical stages急性闭角型青光眼临床分期Preclinical stage: No symptom, Shallow anterior chamber, One eye get disease, the other eye with no symptom 、1、临床前期:没有自觉症状,具有浅前房,房角窄,虹膜膨隆。 一眼发作,另眼没发作。Precursor stage: Transient Ease fast2、先兆期:一过性,多次小发作,自行缓解。13Clinical stages急性闭角型青光眼临

3、床分期14Acute stage: Symptom: eye: pain, photophobia, tears, severe vision loss、 with headaches, nausea and vomiting、Sign: Eyelid edema, Conjunctival congestion, Corneal epithelium edema, Anterior chamber extremely shallow, The pupil dilated and light reflection disappeared, Anterior chamber angle clos

4、ed、Intraocular pressure increased 50 mmHg、3、急性发作期: 症状:眼部:眼痛、眼胀、畏光、流泪、严重视力下降。 全身:头痛、恶心、呕吐。 体征:眼睑水肿、 结膜混合充血、 角膜上皮水肿、角膜后色素沉着、 前房极浅、虹膜严重缺血、房水浑浊、絮状渗出、 瞳孔中等大、竖椭圆、光反射消失、局限后粘连、 房角关闭、 眼底不清、视网膜动脉搏动, 眼压明显升高50mmHg。14Acute stage: 15闭角青光眼前房与前房角15闭角青光眼前房与前房角16急性闭角型青光眼发作16急性闭角型青光眼发作17Acute onset sequela:Visual acui

5、ty get betterKPIris: atrophy, pigmentation defects and limited stickyThe pupil cant return to normalCloudy-glaua spot on the anterior lens capsuleAnterior chamber Angle extensive stick急性发作后遗症: 视力好转 角膜后色素沉着 虹膜时期性萎缩、色素脱失、局限后粘 瞳孔不能恢复正常 晶体前囊下片状白色混浊-青光眼斑 房角广泛粘连 17Acute onset sequela:18Remission stage : s

6、ymptoms to ease and anterior chamber angle openChronic stage: anterior chamber angle extensive stickFinal stage: the continuous high intraocular pressure, poor eyesight or no light feeling、4 间歇期:小发作后自行缓解,房角开放,不用药或少量缩瞳药。 5 慢性期:房角广泛粘连半周,眼压中度升高,视盘病理凹陷,视 野缺损。6 绝对期:持续高眼压,视力极差或无光感。18Remission stage : symp

7、toms t诊断青光眼激发试验:1、暗室试验2、俯卧试验3、暗室+俯卧试验19诊断青光眼激发试验:1920Differential diagnosis鉴别诊断Eye disease: Conjunctivitis, Anterior uveitisSystemic disease: gastrointestinal disease, brain disease, hypertension, etc眼病:结膜炎、前部葡萄膜炎。全身病:胃肠道疾病、颅脑疾患、高血压病等。 20Differential diagnosis21Treatment of primary angle-closure gla

8、ua 原发性闭角型青光眼的治疗Drugs:increased aqueous eduction : myotic inhibit aqueous generated high permeability agentadjuvant treatment: calm or sleeping,purge, hormone reduce inflammation response、Laser:Operation:药物:1、增加房水排出:缩瞳剂 2、抑制房水生成:醋氮酰胺、塞不酰安 3、高渗剂:20%甘露醇1一1、5gkg、 50%甘油2一3ml/kg 4、辅助治疗:镇静、安眠、 通便、激素减轻炎反应。激光:手术: 21Treatment of primary angle-c22 Chronic angle-closure glaua(二)、慢性闭角型青光眼Clinical symptom: Age is earlierProgressiveHave no acute historyIntraocular pressure increased gradually、临床症状:年龄较急性为早、渐进性、可无明确发病史。一般无急性发作史,房角粘连与眼压增高逐渐进展。眼压0、6 Visual field defects