眼科检查法)ppt.ppt

Examination of the EyeExamination of the Eye(眼科检查法眼科检查法)杨霞霞1、History-taking(病史采集)：2、The examination of visual function(视功能检查)：3、Examination of the globe and its accessory organs(眼球及眼附属器检查)：History-taking(病史采集)：Subjective abnormal feelings(主观异常感觉)：Foreign body sensation(异物感)Visual field defect(视野缩小)Sudden visual impairment(视力降低)The amount of secretion(分泌物量增多)Photophobia(畏光)Swelling（肿胀）Metamorphopsia(视物变形症)Flicker sensation（闪光感）The examination of visual function(视功能检查)Optic psycophysics(视觉心理物理学检查)Optic-electro-physiology(视觉电生理检查)Visual acuity(视力，即视锐度)Dark adaption（暗适应）Colour sensation(色觉)Visual field(视野)Contrast sensitivity(对比敏感度)Visual electro-physiology(视觉电生理)一、Visual acuity(视力，即视锐度)The vision indicates visual acuity divided into far,near vision,the latter normally means reading one.1、the examination of far vision:Naked/corrected vision:裸眼、矫正视力Pinhole glass:孔镜Spherical aberration:球面像差Finger count:指数Hand movement:手动Light perception:光感Light-seeking:光定位2、the examination of near vision:Standard reading chart:Jaegers test chart:Myopia:近视Presbyopia:老视3、the theory of visual acuity:The resolving power:分辨力Visual angle:视角The examination of far vision needs abundant light or artificial illumination,the examined is at a distance of 5m from the chart,let the line 1.0 be at the same height of examined eye.二、Dark adaption（暗适应）：Threshold of light irritation:光刺激阈Dark adaptation curve:暗适应曲线Cone:视锥细胞Rod:视杆细胞Contrast method:对比法Dark adaptometer:暗适应计Retinal pigmented degeneration:视网膜色素变性三、Colour sensation(色觉)：四、Visual field(视野)五、Contrast sensitivity(对比敏感度)六、Visual electro-physiology(视觉电生理)Electrooculogram,EOG:眼电图Electroretinogram,ERG:视网膜电图Visual evoked potential,VEP:视觉诱发电图Electrooculogram,EOG:眼电图Retinal pigmented epithelium:视网膜色素上皮Photoreceptor cells:光感受器细胞The retinal static potential:视网膜静息电位Electroretinogram,ERG:视网膜电图The retinal active potential:视网膜动作电位Including a,b,c waves and oscillating potentials:震荡电位 a:photoreceptor cells 光感受器细胞 b:bipolar cells 双极细胞 c:pigmented epithelium 色素上皮细胞 Examination of the globe Examination of the globe and its accessory organs(and its accessory organs(眼眼球及眼附属器检查球及眼附属器检查)：Examination of accessory organs of the eye:眼附属器检查Examination of anterior segment of the eye:眼球前段检查Examination with slit-lamp microscope:裂隙灯显微镜检查Gonioscope:前房角镜检查Tonometry:眼压测量Examination of the fundus:眼底检查一、Examination of accessory organs of the eye:眼附属器检查1、eyelids:眼睑 ecchymoma:,ekimum淤血 emphysema:,emfsim气肿 scar/induration:瘢痕或残留物 entropion or ectropion at palpebral margin：睑内翻/睑外翻 eyelash:睫毛 trichiasis:,trkess;trkass 倒睫 aberrant lash:乱睫 2、lacrimal apparatus:泪道 lacrimal puncta:泪点 eversion:外翻 occlusion:阻塞 lacrimal sac:泪囊 tenderness:压痛 fistula:瘘管Schirmers test:is performed with 5x35mm filter paper,one end is bent at the site of 5mm and inserted into the conjunctival sac at the inner part of 1/3 of the lower eyelid,the rest of the filter paper is hanged on the skin surface of thelower eyelid with both eyes closed gently;after 5 minutes to measure the length of filter paper got wet by tears,normally is more than 15mm on average,less than 5mm is regarded as abnormal.lacrimal gland:泪腺 tear secretion:泪液分泌 stenosis or obstruction:堵塞 Fluorescein sodium test:荧光素钠试验 Washing of lacrimal passage:泪道冲洗3、conjunctiva:结膜 palpebral conjunctiva:睑结膜 bulbar conjunctiva：球结膜 fornical conjunctiva:穹窿结膜 transparent：透明 congestion：充血 papillary hypertrophy:pplrhaptrf乳头肥大 folliculosis:f,likjulusis滤泡增殖 symblepharon:睑球粘连 pigmentation:色素沉着 proliferative tissue:新生物 conjunctival or ciliary hyperemia:结膜充血或睫状充血4、position of globe:眼球的位置 palpebral fissure:睑裂 nystagmus:nstgms眼球震颤 strabismus:strbzms斜视 Hertel exophthalmometer to measure the protrusion:Hertel 突眼计测量眼球突出度二、Examination of anterior segment of the eye:眼球前段检查1、cornea:角膜 keratic precipitate(KP):角膜后沉着物 corneal perception:角膜感觉/viral keratitis 病毒性角膜炎/the damage of trigeminal nerve三叉神经受损opacity：混浊、不透明staining with fluorescein sodium:荧光素钠染色/corneal epithelium:角膜上皮The corneal curvature:角膜弯曲度的检查Placidos corneal disk:Keratometer:角膜曲率计Corneal topography:角膜地形图Normal:正常/a regular and clear concentric ring:规则而清晰的同心圆Oval:椭圆形/regular atigmatism:规则散光Distorted shape:扭曲者/irregular atigmatism:不规则散光Pear shape:梨形/keratoconus 圆锥角膜Placidos 板2、sclera:巩膜 nodule:结节/hyperemia:充血 jaundice:黄染3、Anteria chamber:前房 aqueous humor:房水 hypopyon:前房积脓4、Iris:虹膜 dipigmentation:脱色素 atrophy:萎缩 nodule:结节 iridodialysis:虹膜根部离断 coloboma:缺损 5、Pupil：瞳孔 retardative:迟钝 relative afferent pupillary defect,RAPD:相对性传入性瞳孔障碍6、Lens:晶状体 to dilate pupil:散瞳 三、Examination with slit-lamp microscope:裂隙灯显微镜检查Projective system of light source:光源投射系统Optical magnifying system:光学放大系统Diffuse illumination(弥散光线照明法)It may be used to examine the tissue of anterior segment such as conjunctiva,cornea,sclera and others.检查前节组织：如，结膜，角膜，巩膜等。Direct illumination(直接照明法)Specular reflection(后部反光照明法):Indirect illumination(间接照明法）血粘度增高患者球结膜血管的“淤泥化现象”，可见颗粒状血柱圆锥角膜并混浊色素KP羊脂状KP浅前房Tyndall 现象虹膜植入性囊肿虹膜新生血管晶状体脱位核性晶状体混浊绕核性晶状体混浊正常玻璃体支架组织 四、Gonioscope:前房角镜检查Angle-closure glaucoma:闭角型青光眼Angle-open glaucoma：开角型青光眼Direct/refractive(直接房角镜/光线的折射)Indirect/reflective(间接房角镜/光线的反射)The anterior chamber angle(前房角)Anterior walls：1、Schwalbes line:The terminal of corneal Descemets layer:角膜后弹力层终止处The boundary between the cornea and the trabecula:角膜与小梁网的边界2、trabecular network:小梁网A little yellow band structure:The canal of schlemm:Drainage aqueous humor outflow:房水排出的通路3、scleral spur:巩膜突Crypts:隐窝Ciliary band:睫状体带Pectinate ligament:梳状韧带Posterior wall:后壁Iris root:虹膜根部Classification：分类Wide angle:宽角Narrow angle:窄角Wide angle:宽角Narrow angle:窄角Grade 1:Eminence in different degree at the iris periphery,under dynamic condition the ciliary body may be seen to be wider or from invisible to be seen.Grade 2:the scleral spur may be seen but ciliary band in dynamic observation.Grade 3:the scleral spur and the posterior part of the trabecular network cant be seen in dynamic observation,but displacement of the focal line may be seen.Grade 4:under dynamic observation,apart from schwalbes line,other angle structures cant be seen,but displacement of the focal line.五、Tonometry:眼压测量Measurement by finger:指测法 Measurement by tonometer:眼压计测量法1、Measurement by finger:指测法The border of the upper tarsus:上眼睑Tn-normal IOPT+1-slight increaseT+2-moderate increaseT+3-very high IOPT-1-soft than normalT-2-moderate softT-3-very soft2、Measurement by tonometer:眼压计测量法压陷式眼压计（Schitz Tonometer）压平式眼压计（Goldmann Tonometer）非接触式眼压计(noncontact tonometer,NCT)、To examine disorders of the vitreous(玻璃体),the retina（视网膜）,the choroid（脉络膜）,the optic nerve（视神经）.“the window of the body”Dilate the pupil/mydriasis:散瞳六、Examination of the fundus:眼底检查Ophthalmoscopy:检眼镜Observal of the fundus:眼底检查Record of fundus examination:眼底检查的记录Ophthalmoscopy:检眼镜Direct Ophthalmoscope:直接检眼镜Indirect Ophthalmoscope:间接检眼镜Observal of the fundus:眼底检查1、optic disc/optic papillae(视盘/视乳头)2、central retinal artery,vein3、macular region:黄斑区 fovea centralis:黄斑中心凹 edema: