青光眼中英文版-課件

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眼壓:眼球內(nèi)容物作用于眼球內(nèi)壁的壓力Normal IOP: 102l mmHgDouble IOP difference5mmHgIOP curve day and night50y female pain red eye vision loss with headache nausea vomiting病因:具有遺傳傾向,解剖結(jié)構(gòu)異常, 常有誘因。臨床特征:年齡50歲,女性多見(jiàn)。 主訴為眼脹痛、眼紅,視力下降, 伴

2、頭痛、惡心、嘔吐。12Primary angle-closure glaua13Clinical stages急性閉角型青光眼臨床分期Preclinical stage: No symptom, Shallow anterior chamber, One eye get disease, the other eye with no symptom 、1、臨床前期:沒(méi)有自覺(jué)癥狀,具有淺前房,房角窄,虹膜膨隆。 一眼發(fā)作,另眼沒(méi)發(fā)作。Precursor stage: Transient Ease fast2、先兆期:一過(guò)性,多次小發(fā)作,自行緩解。13Clinical stages急性閉角型青光眼臨

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、急性發(fā)作期: 癥狀:眼部:眼痛、眼脹、畏光、流淚、嚴(yán)重視力下降。 全身:頭痛、惡心、嘔吐。 體征:眼瞼水腫、 結(jié)膜混合充血、 角膜上皮水腫、角膜后色素沉著、 前房極淺、虹膜嚴(yán)重缺血、房水渾濁、絮狀滲出、 瞳孔中等大、豎橢圓、光反射消失、局限后粘連、 房角關(guān)閉、 眼底不清、視網(wǎng)膜動(dòng)脈搏動(dòng), 眼壓明顯升高50mmHg。14Acute stage: 15閉角青光眼前房與前房角15閉角青光眼前房與前房角16急性閉角型青光眼發(fā)作16急性閉角型青光眼發(fā)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急性發(fā)作后遺癥: 視力好轉(zhuǎn) 角膜后色素沉著 虹膜時(shí)期性萎縮、色素脫失、局限后粘 瞳孔不能恢復(fù)正常 晶體前囊下片狀白色混濁-青光眼斑 房角廣泛粘連 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 間歇期:小發(fā)作后自行緩解,房角開(kāi)放,不用藥或少量縮瞳藥。 5 慢性期:房角廣泛粘連半周,眼壓中度升高,視盤病理凹陷,視 野缺損。6 絕對(duì)期:持續(xù)高眼壓,視力極差或無(wú)光感。18Remission stage : symp

7、toms t診斷青光眼激發(fā)試驗(yàn):1、暗室試驗(yàn)2、俯臥試驗(yàn)3、暗室+俯臥試驗(yàn)19診斷青光眼激發(fā)試驗(yàn):1920Differential diagnosis鑒別診斷Eye disease: Conjunctivitis, Anterior uveitisSystemic disease: gastrointestinal disease, brain disease, hypertension, etc眼病:結(jié)膜炎、前部葡萄膜炎。全身病:胃腸道疾病、顱腦疾患、高血壓病等。 20Differential diagnosis21Treatment of primary angle-closure gla

8、ua 原發(fā)性閉角型青光眼的治療Drugs:increased aqueous eduction : myotic inhibit aqueous generated high permeability agentadjuvant treatment: calm or sleeping,purge, hormone reduce inflammation response、Laser:Operation:藥物:1、增加房水排出:縮瞳劑 2、抑制房水生成:醋氮酰胺、塞不酰安 3、高滲劑:20%甘露醇1一1、5gkg、 50%甘油2一3ml/kg 4、輔助治療:鎮(zhèn)靜、安眠、 通便、激素減輕炎反應(yīng)。激光:手術(shù): 21Treatment of primary angle-c22 Chronic angle-closure glaua(二)、慢性閉角型青光眼Clinical symptom: Age is earlierProgressiveHave no acute historyIntraocular pressure increased gradually、臨床癥狀:年齡較急性為早、漸進(jìn)性、可無(wú)明確發(fā)病史。一般無(wú)急性發(fā)作史,房角粘連與眼壓增高逐漸進(jìn)展。眼壓0、6 Visual field defects