第二章视功能检查ChapterTwoVisualFunctionExamination68课件

第二章视功能检查

ChapterTwoVisualFunctionExamination五、眩光检查Ⅴ.

GlareExamination标准视力表所釆取的是具有高度对比度的黑白对比视标，并不能反映患者生活中的真实视力。当患者存在角膜斑翳、圆锥角膜、角膜水肿、白内障、玻璃体混浊时，标准视力表所查得的视力可能是在正常范围内，但在白天较亮或夜间较暗的光线下，由于眩光的出现导致视力明显下降。原因在于眼屈光间质不均一，使得眼内光线散射，从而减低了实际到达视网膜的光线的对比度。Adoptingablackandwhitecontrastindexwithhighcontrast,thestandardvisionchartcannotreflecttherealvisionofthepatientinlife.Whenapatientsuffersfromcornealplaque,keratoconus,cornealedema,cataract,orvitreousopacity,thevisionmaybewithinthenormalrangebyexaminationonthestandardchart,butthevisiondecreasessignificantlyduetotheglareinbrightlightatdayordarklightatnight.Thisisbecausethelightscattersintheeyesduetonon-uniformrefractivestromaoftheeye,whichreducesthecontrastoflightactuallyreachingtheretina.由于各种原因引起低视力患者的眩光，将造成患者的不适或视力下降。特别是物品之间对比度的降低，将导致低视力患者在室内活动的困难。Glareinlowvisionpatientsduetovariousreasonswillcausediscomfortorreductionofvision.Inparticular,areductionincontrastbetweenitemswillmakelow-visionpatientshavedifficultiesinmovingindoor.眩光分为：不适眩光和失能眩光。前者是指由于散射光线导致视觉不适，而不影响分辨率或视力的情况。后者是指由于散射光线在眼内使视网膜成像重叠、视网膜成像的对比度下降，降低了视觉效能和清晰度，甚至不能视物。Glareisdividedinto：

discomfortglareanddisabilityglare.Theformerreferstovisualdiscomfortduetodivergencelight,whichdoesnotaffectresolutionorvision.Thelatterreferstothecasewhenvisualefficiencyandclarityarereducedandthepatientisevenunabletoviewobjectsbecausethedivergencelightcreatesoverlappingretinalimagingintheeye,andthecontrastofretinalimagingisreduced.眩光的检查：常用眩光测试仪,如InnomedTerry视力分析仪、多种视觉敏感度测试仪和Miller-Nadler眩光测试仪等。自动型眩光检查仪及对比敏感度检查仪，能同时进行对比敏感度和眩光敏感度两项检查。Theglareexaminationiscommonlyconductedwithglaretesters,suchasInnomedTerryVisionAnalyzer,MultipleVisualSensitivityTesterandMiller-NadlerGlareTester,etc.Takaci-CGT-1000automaticglareandcontrastsensitivitytestercancheckcontrastsensitivityandglaresensitivityatthesametime.该检查对低视力患者的视觉康复有着重要的指导意义和实用价值。如某些眼人工晶状体患者即使视力为1.0,由于眩光的原因，患者会抱怨在强光下或暗光下无法自如行动。因此眩光检查能反映患者的在日常生活中的实际视功能，并且可以指导患者在日常生活中尽量避免有害的眩光，改善视觉质量。Thisexaminationisimportanttovisualrehabilitationofpatientswithlowvisionbothinguidingsignificanceandpracticalvalue.Forexample,somepatientswithintraocularlenseshave1.0vision,buttheymaycomplainofbeingunabletomovefreelyinhighorlowlightduetoglare.Therefore,itcanreflecttheactualvisualfunctionofthepatient,andguidethepatienttoavoidharmfulglareasmuchaspossibleindailylifeandimprovethevisualqualitythroughtheglaretest.六、立体视觉Ⅵ.StereoscopicVisionExamination深度觉，是感知物体立体形状及不同物体之间远近关系的能力，立体视觉一般须以双眼单视为基础。许多职业要求有良好的立体视觉，如驾驶员、飞行员、画家、雕塑家以及从事机械精细加工和微电子的人员。Stereoscopicvision,alsoknownasdepthperception,istheabilitytoperceivethethree-dimensionalshapeofanobjectandthedistancebetweendifferentobjects,whichisgenerallybasedonbinocularvision.Manyoccupations,suchaspilots,pilots,painters,sculptors,andpersonnelengagedinmechanicalfineprocessingandmicroelectronics,requiregoodstereoscopicvision.在眼科临床中，对斜视、弱视、屈光不正、视力疲劳和某些眼病均需检查立体视觉。Inclinicalophthalmology,stereoscopicvisionshouldbeexaminedforstrabismus,amblyopia,refractiveerror,asthenopiaandsomeeyediseases.检查立体视觉可以使用综合验光仪、同视机、Titmus、Frisby、颜少明立体视觉检查图谱、与计算机相连的立体视觉检测系统等。常用的有：Thestereoscopicvisioncanbeexaminedbyphoropter,synoptophore,Titmus,FrisbyandYanShaomingstereoscopicvisionexaminationatlas,stereoscopicvisionexaminationsystemconnectedwithcomputer,etc.Detailsareasbelow:1.综合验光仪

双眼前加偏振光镜片，注视立体视检査视标，左右眼能看到的分别是整体图形的一部分。双眼同时观看，可以看到全部图形并有立体感出现，说明有立体视。双眼同时观看，但只能看到一部分图形，且无立体感，说明无立体视。1.Phoropter:addpolarizedlightlensinfrontofbotheyesofthepatient,whofixesonthestereoscopicvisionexaminationtarget,andcanseeapartofthewholefigurerespectivelyfromtheleftandrighteyes.Ifthepatientwatcheswithbotheyesatthesametimeandcanseeallthegraphicsandhavestereoscopicimpression,itindicatesthatthereisstereoscopicvision.Ifthepatientwatcheswithbotheyesatthesametimebutonlyapartofthefigurecanbeseenandthereisnostereoscopicimpression,itindicatesthatthereisnostereoscopicvision.2.同视机把两张立体视画片放入同视机的插片盒内，双臂摆在重合点附近，正常人能够自然地产生立体视觉。根据画片读数和检查中患者的反应，可以了解患者的立体视功能。2.Synoptophore:Whenputtwostereoscopicpicturesintotheinsertboxofthesynoptophore,andputbotharmsnearthecoincidencepoint,thenormalpeoplecannaturallyhavestereoscopicvision.Thestereoscopicvisionfunctionofthepatientcanbeknownbasedonthepicturereadingandthepatient’sreactionduringtheexamination.3.Titmus立体图

双眼戴偏振光眼镜，在33cm处注视Titmus立体图。立体视锐度由粗到细依次检查，检查时要确保立体图凸出于印刷平面，直到不能分辨，记录能分辨的最小视锐度的秒弧数。立体视锐度如果在100秒弧以下为正常立体视，在100秒弧以上为粗的立体视。如双眼同时注视仅仅看到单眼的平面图形或雪花状的散点，无立体感，说明无立体视。3.Titmusstereogram:FixonTitmusstereogramat33cmwithpolarizedglassesinbotheyes.Thepatientshallbeexaminedwithstereosharpnessfromthicktothininsequence,duringwhichitshallbeensuredthatthestereogramisprotrudedoutoftheprintingplaneuntilitcannotbedistinguished,anditshallrecordthesecondsofarcoftheminimumvisionthatcanberesolved.Ifthestereoscopicvisionislessthan100secondsofarc,itisnormalstereoscopicvision,andifitismorethan100secondsofarc,itiscoarsestereoscopicvision.Iffixedonwithtwoeyessimultaneously,onlyasingle-eyeplanefigureorsnowflake-shapeddivergencedotscanbeseen,andthereisnostereoscopicimpression,itindicatesthatthereisnostereoscopicvision.常见的色觉障碍是一种性连锁隐性遗传的先天性异常，后天性色觉异常又称获得性色觉异常，任何从视网膜到大脑视皮层间的视路上所发生的损害都可以引起后天性色觉异常,如颅脑疾病、某些眼病、全身疾病及中毒等。Thecommoncolorvisiondisorderisasex-linkedrecessivecongenitaldisorder,whileposterioritycolorvisiondisorderisalsocalledacquiredcolorvisiondisorder.Anydamagetothevisualpathfromtheretinatothevisualcortexofthebrain,suchascraniocerebraldisease,someeyediseases,systemicdiseases,andpoisoning,etc.,cancauseacquiredcolorvisiondisorder.1.假同色检查法

假同色图检查法又称色盲本，是由各种颜色色调不同而亮度相同，或各种颜色的色调相同而亮度不同的色点组成的图形或数字所构成。正常人以颜色来辨别：而色盲者以明暗来识别；色弱者能正确认岀图形或数字，但表现出困难或辨认时间延长。标准的假同色图并不适用于后天性获得性色觉异常者，故临床上不推荐用于后天眼病导致视力障碍的低视力患者的检查。1.Pseudoisochromaticplates:Pseudoisochromaticplates,alsoknownascolorblindnessbook,arecomposedoffiguresornumbersconsistingofdifferentcolorswiththesamebrightnessordifferentbrightnesswiththesamecolor.Normalpeopleidentifybycolor;color-blindpeopleidentifybybrightness;color-impairedpeoplecancorrectlyidentifyfiguresornumbers,butwithdifficultyorlongrecognitiontime.Thestandardpseudoisochromaticplatesisnotapplicableforpatientswithacquiredcolorvisiondisorder,soitisnotrecommendedforexaminationoflowvisionpatientswithvisualimpairmentcausedbyacquiredeyediseases.七、色觉检查Ⅶ.ColorVisionExaminationColorvisiontestchart2.彩色毛线试验法

先给被检查者某一种颜色的毛线，然后将该毛线掺杂在各种颜色的毛线中，嘱被检査者尽快挑选出颜色相同的毛线，根据所选毛线的颜色是否正确或在挑选中是否显得犹豫不决来决定有无色觉障碍。Colorwooltestmethod:Firstgiveacertaincolorwooltotheexaminee,thenmixthewoolwithwoolofvariouscolors,asktheexamineetopickoutthewoolwiththesamecolorassoonaspossible,anddecidewhethertheexamineehascolorvisiondisorderbyiftheselectedwooliscorrectoriftheexamineeisindecisiveinselectingthewool.3.FM-100色彩试验和D-16色盘试验

嘱患者按色调将有色棋子依次排列，根据其排列的顺序正常与否，判断有无色觉障碍及其性质和程度。3.FM-100colortestandD-16colordisktest:Instructthepatienttoarrangethecoloredchesspiecesinturnasperthecolor,anddecidewhetherthepatienthascolorvisiondisorderanditsnatureanddegreebyifthearrangementorderisnormalornot4.色觉镜色觉镜(anomaloscope)利用红光与绿光适当混合形成黄光的原理，根据被检者调配红光与绿光的比例是否合适，来判断是否有色觉异常以及色觉异常的性质和种类。4.Anomaloscope:Withtheprincipleofproperlymixingtheredlightandgreenlighttoformyellowlight,anomaloscopedecideswhetherthesubjecthascolorvisiondisorderandthenatureandtypeofcolorvisiondisorderbyiftheproportionofredlightandgreenlightisproperlymixedbythesubject.对低视力患者的色觉检查，目的是全面评价他们的视功能，为进一步的工作定向职业训练和教育提供指导。Thecolorvisionexaminationinpatientswithlowvisionisaimedtoevaluatetheirvisualfunctionandprovideguidanceforfurtherworkorientation,vocationaltraining,andeducation.视觉电生理检査是利用仪器检测眼部生物电活动以了解视觉功能的一种方法。它包括眼电图(electrooculogram,EOG)、视网膜电图(electroretinogram,ERG)和视觉诱发电位(visualevokedpotential,VEP)。Visualelectrophysiologyexaminationisamethodtounderstandthevisualfunctionwithaninstrumenttomeasurethebioelectricactivityoftheeye,whichincludeselectrooculogram(EOG),electroretinogram(ERG)andvisualevokedpotential(VEP).八、视觉电生理检查Ⅷ.VisualElectrophysiologyExamination1.眼电图：EOG记录的是眼的静息电位，产生于视网膜色素上皮细胞。暗适应后眼的静息电位下降，此时最低值称为暗谷；转入明适应后，眼的静息电位上升，逐渐达到最大值,即光峰。产生EOG的前提是光感受器细胞与RPE的接触及离子交换，因此，EOG异常可反映RPE、光感受器细胞的疾病，以及中毒性视网膜疾病。一般情况下，EOG反应与ERG反应一致，EOG可用于某些不接受ERG角膜接触镜电极的儿童被检者。它的异常反映的是视网膜色素上皮和光感受器复合体的异常。眼电图也可用于测定眼球位置及眼球运动的生理变化。1.Electrooculogram:EOGrecordstherestingpotentialoftheeyethatisproducedbyretinalpigmentepithelialcells.Afterthedarkadaptation,therestingpotentialoftheeyedecreasedtothelowestvalueatthistime,whichwascalledthedarktrough;Afterthelightadaptation,therestingpotentialoftheeyeincreasedandgraduallyreachedthemaximum,i.e.thelightpeak.TheEOGproductionisonthepremiseofthecontactandionexchangebetweenphotoreceptorcellsandRPE.Therefore,abnormalEOGcanreflectRPE,diseasesofphotoreceptorcellsandtoxicretinaldiseases.Ingeneral,theEOGresponseisconsistentwiththeERGresponse,soEOGcanbeusedinsomepediatricsubjectswhorejectERGcontactlenselectrodes.Itsdisorderreflectsthedisorderofretinalpigmentepitheliumandphotoreceptorcomplex.EOGcanalsobeusedtodeterminethepositionoftheeyeballandphysiologicalchangesineyeballmovement.2.视网膜电图

ERG记录的是闪光或图形刺激视网膜后，从角膜电极记录到视网膜的动作电位。它又分为闪光ERG、图形ERG和多焦ERG,闪光ERG主要反映整个视网膜的功能状态；图形ERG反映视网膜神经节细胞的功能状态；多焦ERG能同时记录中央30°视野内100多个视网股位点上的ERG,反映不同位点视网膜的功能状态，2.Electroretinogram:ERGrecordstheactionpotentialsfromcorneaelectrodestotheretinaelectrodesafterflashorpatternstimulationoftheretina,whichisdividedintoflashERG,graphicERGandmultifocalERG.TheflashERGmainlyreflectsthefunctionalstateofthewholeretina;thegraphicERGreflectsthefunctionalstateoftheretinalganglioncells;themultifocalERGcan,reflectthefunctionalstateoftheretinaatdifferentsitesbecauseitcansimultaneouslyrecordERGsatmorethan100retinalsitesinthecentral30°FOV.3.视觉诱发电位

VEP是视网膜受到闪光或图形刺激后，经视路传递，在视皮层枕叶诱发出的生物电活动。它可用于判断视神经和视路疾病。3.

Visualevokedpotential(VEP):VEPisthebioelectricactivityinducedintheoccipitallobeofthevisualcortexaftertheretinaisstimulatedbyflashorpattern,whichcanbeusedforjudgingopticnerveandvisualpathdiseases.视觉电生理检查是一种客观视功能检查方法，因此可用于检查不合作的儿童、智力低下的患者及伪盲者的视功能。对低视力患者，还可以判断使用助视器和功能性训练的治疗效果。Asanobjectivevisualfunctiontest,visualelectrophysiologyexaminationcanbeusedtoexaminethevisualfunctionofuncooperativechildren,mentallyretardedpatients,andpseudo-blindpeople.Forpatientswithlowvision,itcanalsobeusedtojudgethetherapeuticeffectofusingvisualaidsandfunctionaltraining.低视力患者应接受常规的眼科检查，包括一般检查、裂隙灯生物显微镜检查、检眼镜检查和眼科必要的辅助检查，如眼底血管造影和眼科影像学检查等。如果患者的眼部病变仍在活动，则应先治疗眼部活动性病变；只有当眼部活动性病变得到有效地控制变为陈旧性病变时，而且经眼科的各种治疗手段治疗无效时，要考虑使用助视器应用。Patientswithlowvisionshouldacceptroutineophthalmicexaminations,includinggeneralexaminations,slit-lampbiomicroscopeexamination,ophthalmoscopeexamination,andophthalmologicalnecessaryauxiliaryexaminations,suchasfundusangiographyandophthalmicimaging.Theactiveoculardiseasesofpatientshouldbetreatedfirstiftheyarestillactive;onlyiftheactiveoculardiseasesareeffectivelycontrolledtobecomeobsoletediseases,andthetreatmentwithvariousophthalmictreatmentsisineffective,itshallconsidertousevisualaids.眼部的一般检查主要观察对象是眼附属器的情况，包括:Inthegeneralexaminationoftheeye,themainobservationobjectistheconditionoftheadnexaoftheeye,including:1、眼睑：注意眼睑及睑缘的位置是否正常、睑裂是否对称、上睑提起及睑裂闭合是否正常、眼睑及睑缘有无异常充血水肿等。1.Eyelid:Theexaminationincludeswhetherthepositionoftheeyelidandtheeyelidmarginisnormal,whetherthepalpebralfissureissymmetrical,whethertheuppereyelidisliftedandthepalpebralfissureisclosednormally,whetherthereisabnormalcongestionandedemaattheeyelidandtheeyelidmargin,etc.2、泪器：注意泪囊区有无红肿压痛.挤压泪囊有无分泌物溢出。2.Lacrimalsac:Theexaminationincludeswhetherthereisswellingandtendernessinthelacrimalsacarea,andwhetherthereissecretionoverflowwhensqueezingthelacrimalsac.3、结膜：注意结膜有无异常充血水肿.有无滤泡、疤痕、睑球粘连等。3.Conjunctiva:Theexaminationincludeswhetherthereisabnormalcongestionandedema,follicle,scar,symblepharon,etc.atconjunctiva.4、眼球：位置及运动注意眼球大小有无异常、位置是否对称、运动有无障碍。4.Eyeball:Theexaminationincludeswhetherthesizeoftheeyeballisabnormal,whetherthepositionissymmetrical,andwhetherthereisanyobstacleinthemovement.九、眼部一般检查Ⅸ.GeneralExamination5、眼眶：注意两侧眼眶是否对称，眶缘触诊有无缺损、压痛或肿物。5.Orbit:Theexaminationincludeswhetherbothorbitsaresymmetrical,andpalpatetheorbitalmarginsfordefects,tenderness,ormasses.6、眼压：低视力患者的眼压检查是必要的项目之-。因为在低视力门诊经常有患者被检出眼压高于正常而被转回青光眼门诊继续治疗。6.Intraocularpressure:Intraocularpressureexaminationisoneofthenecessaryitemsforpatientswithlowvision,becausemanypatientsweretransferredbacktotheglaucomaclinicforcontinuedtreatmentaftertheyweredetectedwithhigher-than-normalIOPatthelowvisionclinic.裂隙灯显微镜由两系统组成，即供照明的光源投射系统及供观察的放大系统。可在强光下放大6~16倍，不仅能看清楚表浅的病变，而且可以调节焦点和光源宽窄，形成光学切面，看清深部组织及其前后关系。

Theslitlampbiomicroscopeisconsistedoftwosystems,includingalightsourceprojectionsystemforilluminationandamagnificationsystemforobservation.Itcanbemagnified6~16timesunderstronglight,notonlytoseethesuperficialdiseaseclearly,butalsotoclearlyseethedeeptissueandtherelationshipbetweenthefrontandbackafteradjustingthefocusandthewidthofthelightsourcetoformanopticalsection.（一）裂隙灯显微镜检查（Ⅰ）SlitlampBiomicroscopeExamination裂隙灯显微镜检查是眼科最常见的检査方法，主要用于眼前节如结膜、角膜、前房、虹膜、晶状体和前部玻璃体的检查。附加前置镜、接触镜、前房角镜、三面镜，可检查前房角、玻璃体和眼底。再配备前房深度计、压平眼压计、照相机，其用途更为广泛。Asthemostcommonmethodofexaminationinophthalmology,slitlampbiomicroscopeismainlyusedtoexamineanteriorsegmentsoftheeyesuchasconjunctiva,cornea,anteriorchamber,iris,lens,andanteriorvitreous.Theanteriorchamberangle,vitreousandfunduscanbeexaminedafteraddingfront-endlenses,contactlenses,gonioscopes,andthree-mirrorcontactlens.Anditcanprovidemoreextensivefunctionsafterequippedwithanteriorchamberdepthgauge,applanationtonometer,camera.角膜检查是裂隙灯显微镜检查的重点。在对低视力患者的病因的所作研究中，角膜混浊是低视力的常见病因之一，而病毒性角膜炎又是导致角膜混浊的常见病因之一。裂隙灯显微镜检査首先要辨别角膜是否有活动性病变存在，如有，则应转诊至角膜病门诊继续治疗；其次，要辨别角膜混浊的程度，是云翳、斑翳还是白斑，角膜混浊程度是否与实际视力相符合，如果角膜仅有轻度云翳而视力低于0.1,应该进一步检查（如扩瞳检查眼底、电生理检査等），有助于发现角膜以外的眼病。Cornealexaminationisthefocusofslitlampbiomicroscope.Inthestudyofthecausesoflowvisionpatients,cornealopacityisoneofthecommoncauses,meanwhile,viralkeratitisisoneofthecommoncausesofcornealopacity.Intheexaminationofslitlampbiomicroscope,itshallfirstidentifywhetherthereisanactivediseaseinthecornea.Ifso,itshouldbetransferredtothekeratopathyclinicforfurthertreatment;Secondly,itshallidentifythedegreeofcornealopacity,whetheritisnebula,maculaorleucoma,andwhetherthedegreeofcornealopacityisconsistentwiththeactualvision.Ifthecorneaisonlywithslightnebulabutthevisionislessthan0.1,itshallperformfurtherexamination(suchasmydriaticexaminationoffundus,electrophysiologicalexamination,etc.)tohelpfindouttheoculardiseasesotherthanthecornea.常用的检眼镜有直接和间接两种。Therearetwocommontypesofophthalmoscope,directandindirect.直接检眼镜检查,所见眼底为正像，放大约16倍。通常可不散瞳检查，若需详细检查则应散瞳。Forthedirectophthalmoscopeexamination,thefunduswasseenasapositiveimageatapproximately16Xmagnification.Ingeneral,thepupilmaynotbedilated,butifdetailedexaminationisrequired,thepupilshouldbedilated.

（二）检眼镜检查（Ⅱ）OphthalmoscopeExamination双目间接检眼镜

一般需散瞳检查。所成的倒虚像位于检查者和透镜之间，具有立体感。与直接检眼镜相比，放大倍数较小，但可见范围较大，能比较全面地观察眼底,不易漏诊眼底病变。辅以巩膜压迫器，可看到锯齿缘，有利于查找视网膜裂孔。Forindirectbinocularophthalmoscopeexamination,usuallythepupilshouldbedilated.Theresultinginvertedvirtualimageislocatedbetweentheexaminerandthelenswithastereoscopicimpression.Comparedwiththedirectophthalmoscope,themagnificationoftheindirectissmallerbutthevisiblerangeislargertocomprehensivelyobservethefundussothatthefundusdiseasesarenoteasytobemissed.Withascleralcompressor,itcanseetheserratededgetohelptofindretinaltears.眼底检查记录内容:视盘大小、形状、颜色、边界和病理凹陷;视网膜血管的管径大小是否均匀致、颜色、动静脉比例、形态、有无搏动及交叉压迫征:黄斑部及中心凹光反射情况:视网膜有否出血、渗出、色素增生或脱失，描述其大小形状、数量等;视网膜有无裂孔、网脱:眼底有无隆起不平，如肿物、炎症.渗出和寄生虫等:眼内有无异物。

Recordcontentsoffundusexamination:Size,shape,color,boundaryandpathologicaldepressionofopticdisc;whetherthediameterofretinalbloodvesselisuniformandconsistent,color,ratioofarteryandvein,andshapeofretina,whetherthereispulsationandcrosscompressionsign;lightreflexofmaculaandfovea;whetherthereishemorrhage,exudation,hyperpigmentationorlossofretina,anditssize,shapeandquantity,etc.shallbedescribed;whetherthereistearordetachmentofretina;whetherthereisbulgeandunevennessoffundus,suchastumor,inflammation,exudationandparasite;whetherthereisforeignbodyineye.十、眼科影像检查Ⅹ.OphthalmicImagingExamination1.X线检查和电子计算机断层扫描(computedtomography,CT)

通常的X线和CT扫描，在评价眼眶和颅内病变等方面很有用。特别是CT扫描已经成为外眼视觉通道的组织结构病变定位和定性最广泛应用的方法。眼部异常包括眼眶骨折、异物、肿瘤、肿瘤钙化、炎性肿物等，都可由X线或CT扫描显示出来。1.X-rayandcomputedtomography(CT):ConventionalX-rayandCTscanplayagreatroleinevaluatingorbitalandintracranialdiseases.Inparticular,CTscanninghasbecomethemostwidelyusedmethodforthelocalizationandcharacterizationofdiseasesintheexternalvisualchannels.X-rayorCTscancanalsorevealocularabnormalities,includingorbitalfractures,foreignbodies,tumors,tumorcalcification,inflammatorymasses,etc.2.磁共振成像(magneticresonanceimaging,MRI)

MRI在眼眶和颅内诊断方面有很多应用。MRI可以很好地分辨含水量不同的组织，所以在水肿、脱髓鞘及血管等病变的成像方面优于CT。但MRI禁忌探测磁性异物。2.Magneticresonanceimaging(MRI):MRIiswidelyappliedinorbitalandintracranialdiagnosis.Asitcandistinguishtissueswithdifferentwatercontents,MRIisbetterthanCTintheimagingofedema,demyelination,andvasculardiseases.However,MRIisforbiddentodetectmagneticforeignbodies.3.眼部超声检查

眼部超声检查就是利用声能的反射特性，构成波形或图像，来研究一些不能直接看到的组织结构，可以用来探测眼球或眼眶。目前临床常用的有A型超声、B型超声、超声Doppler、超声生物显微镜(ultrasoundbiomicroscope,UBM),用于眼部活体组织生物测量以及眼内或眶内肿物、视网膜和脉络膜脱离、眼外伤和眼内异物探査等。3.Ocularultrasoundexamination:Byusingthereflectioncharacteristicsofacousticenergytoformwaveformsorimages,ocularultrasoundexaminationistostudysometissuestructuresthatcannotbeseendirectly,applicabletodetectingtheeyeballororbit.Atpresent,thecommonlyusedmethodsinclinicalpracticeincludeA-modeultrasound,B-modeultrasound,Dopplerultrasound,ultrasoundbiomicroscope(UBM),whichareusedforbiometryofocularbiopsy,intraocularororbitaltumor,retinalandchoroidaldetachment,oculartrauma,andintraocularforeignbodyexamination.4.眼底血管造影

将造影剂从肘静脉注入，利用特定滤光片和眼底照相机，拍摄眼底血管及其灌注特征。分为荧光素眼底血管造影(fundusfluorescenceangiography,FFA)及吲哚青绿血管造影(indocyaninegreenangiography,ICGA)两种。前者以荧光素钠为造影剂，主要反映视网膜血管的情况；后者以吲哚青绿为造影剂，反映脉络膜血管的情况，有助于发现脉络膜新生血管、渗漏等。4.Fundusangiography:Afterinjectingcontrastmediumfromthecubitalvein,itcanphotographthefundusvesselsandtheirperfusioncharacteristicswithaspecificfilterandfunduscamera.Thereweretwotypesofcontrastmedium,includingfundusfluoresceinangiography(FFA)andindocyaninegreenangiography(ICGA).Theformerusesfluoresceinsodiumascontrastmediumtomainlyreflectretinalbloodvessel,whilethelatterusesindocyaninegreenascontrastmediumtoreflecttheconditionofchoroidalbloodvessel,whichishelpfultofindchoroidalneovascularizationandleakage.5.光学相干断层扫描(opticalcoherencetomography,OCT)

OCT技术是一种高分辨率、非接触性的生物组织成像技术，这项技术可以在活体上获得类似于眼组织病理改变的影像，提高了人们对一些疾病发生发展过程的认识，是继眼科放射诊断、磁共振技术、超声诊断后又一全新的影像学诊断技术。5.Opticalcoherencetomography(OCT):Asahigh-resolution,non-contactbiologicaltissueimagingtechnology,OCTtechnologyisusedtoobtainimagessimilartothepathologicalchangesoftheeyetissueinvivotoimprovepeople'sunderstandingoftheoccurrenceanddevelopmentprocessofsomediseases,whichisabrand-newimagingdiagnosistechnologyaftertheophthalmicradiologicaldiagnosis,magneticresonancetechnologyandultrasonicdiagnosis.6.光相干断层扫描血管成像技术(OCTA)

是一种快速、无创的新型血管成像技术，可实现视网膜脉络膜血管分层成像，量化病灶血流面积和指定区域血流指数；同时避免了眼底血管造影等有创检査的潜在风险。应用于视网膜血管性疾病、脉络膜新生血管、特发性黄斑中心凹旁毛细血管扩张症及视神经炎等眼底疾病的诊断和治疗随访，在分层显示视网膜各层血管及其血流状态方面表现出独具特色的优势。6.Opticalcoherencetomographyangiography(OCTA):Itisanovel,rapid,non-invasivevascularimagingtechnologythatcanrealizestratifiedimagingoftheretinalandchoroidalvesselsandquantificationoftheflowareaofthediseaseandtheflowindexofagivenregion;whileitavoidsthepotentialrisksofinvasiveexaminationssuchasfundusangiography.Itisappliedtothediagnosisandtreatmentfollow-upofretinalvasculardiseases,choroidalneovascularization,idiopathicparafovealtelangiectasia,opticneuritis,andotherfundusdiseases,showinguniqueadvantagesintheaspectofstratifiedimagingoftheretinalandchoroidalvesselsandflowstatus.7.广角数码儿童视网膜成像系统(RetCam)