临床医学眼科学ppt课件眼睑疾病

Diseases of eye lids,北京大学人民医院眼科 陈晶华,the anatomy of lids,upper and lower lids上下睑 palpebral margine 睑缘(Zeis Moll) palpebral fissure 睑裂 内外眦angulus oculi 泪阜caruncula lacrimalis,the anatomy of lids,Skin 皮肤层 Subcutaneous tissue皮下组织层 Orbicularis muscle肌层 Tarsus 睑板层 Meibomian Conjunctiva 结膜层,The blood supply of eye lids,眼睑动脉弓由颈外动脉的面动脉支和颈内动脉的眼动脉支组成 浅颈内颈外静脉 深海绵窦 耳前、腮腺、颌下淋巴结,The function of the lids and treatment,Protection保护 Twinkling 瞬目,Integrity 完整 Beauty 美观 Function 功能,Diseases of lids,Inflammation Tumor Dislocation and malfunction,Blepharitis睑缘炎,Squamous blepharitis鳞屑性 Ulcerative blepharitis溃疡性 Angular blepharitis 眦部,Squamous blepharitis鳞屑性,病因：睑缘皮脂溢出造成的慢性炎症 症状：痒、痛、烧灼 检查：红、鳞屑、分泌物、痂、睫毛脱落可再生 治疗：去因、3%硼酸,Ulcerative blepharitis溃疡性,病因：多为金葡菌引起的睫毛及腺体慢性或亚急性化脓炎症。 症状：严重痒、痛、烧灼 检查：分泌物多、小脓泡、痂、溃疡、睫毛脱落不再生 治疗：去因、3%硼酸、抗生素膏,Angular blepharitis 眦部,病因：Morax-Axenfeld, deficiency of Vit B2 。 症状：痒、异物、烧灼 检查：双侧红、糜烂 治疗：0.2%-0.25%硫酸锌眼水、 Vit B2,Staphylococcal blepharitis,Chronic staphylococcal blepharitis. A. Chronic erythema and induration of the lid margin due to colonization of the lid margin with pathogenic staphylococci. B. Characteristic features of the lid margin with staphylococcal disease including collarettes and hordeola.,Differentiation diagnosis,Sebaceous gland carcinoma in the upper and lower lids that resembles chronic blepharitis,Hordeolum 睑腺炎,外睑腺炎麦粒肿 内睑腺炎睑板腺感染 临床特点：红、肿、热、痛、淋巴结 治疗：热敷、抗生素、切开排脓、全身治疗,Deterioration 恶化,蜂窝组织炎全身感染,Chalazion睑板腺囊肿,睑板腺特发的无菌性慢性肉芽肿 特点：无痛结节 治疗：热敷、激素、手术,Granulomas 肉芽肿,Pyogenic granulomas in conjunctiva over chalazions in the upper and lower eyelids,Differentiation diagnosis（1）,Sebaceous gland carcinoma in the lower lid.,Differentiation diagnosis（2）,Nodular basal cell carcinoma with rolled edges,Pigmented nodular basal cell carcinoma.,Differentiation diagnosis（3）,Cystic basal cell carcinoma,Notching of lid from a fibrosing basal cell carcinoma involving the whole lower eyelid (loss of eyelashes occurred 7 years earlier).,Normal lid positions,眼睑与眼球 睫毛 闭合 眼睑与瞳孔 泪点,Trichiasis & aberrant lashes 倒睫与乱睫,病因：睑内翻、炎症、外伤 临床：眼疼、流泪、异物感、角膜损伤 治疗：拔、电解、手术,Entropion睑内翻,Classification: Congenital Spastic Cicatricia Manifestation: stimulation and cornea Treatment,Ectropion睑外翻,Classification: Cicatricia Senile Paralytic Manifesitation: tearing & dry eye Treatment,Lagophthalmus 眼睑闭合不全,Cause: Paralysis of the facial nerve Cicatricia Volume Unconsciousness Manifestation: tearing & dry eye Treatment,Ptosis 上睑下垂,Cause: Congenital Acquired Manifestation: Treatment,Patient with myasthenia attempts to overcome right ptosis.,Contact dermatitis involving the face, eyelids, and conjunctiva.,Cause: Allergy Manifestation: Red Anthema Exudation Scab Treatment,Trauma,Tumors,Hemangioma,Capillary hemangioma in the right upper lid,Summery,The anatomy of lids The classification,manifesitation and treatment of Blepharitis. The cause, classification, man