眼科检查法课件

ExaminationoftheEye

(眼科检查法)杨霞霞1、History-taking(病史采集)：2、Theexaminationofvisualfunction(视功能检查)：3、Examinationoftheglobeanditsaccessoryorgans(眼球及眼附属器检查)：History-taking(病史采集)：Subjectiveabnormalfeelings(主观异常感觉)：Foreignbodysensation(异物感)Visualfielddefect(视野缩小)Suddenvisualimpairment(视力降低)Theamountofsecretion(分泌物量增多)Photophobia(畏光)Swelling（肿胀）Metamorphopsia(视物变形症)Flickersensation（闪光感）Theexaminationofvisualfunction(视功能检查)Opticpsycophysics(视觉心理物理学检查)Optic-electro-physiology(视觉电生理检查)Visualacuity(视力，即视锐度)Darkadaption（暗适应）Coloursensation(色觉)Visualfield(视野)Contrastsensitivity(对比敏感度)Visualelectro-physiology(视觉电生理)一、Visualacuity(视力，即视锐度)Thevisionindicatesvisualacuitydividedintofar,nearvision,thelatternormallymeansreadingone.1、theexaminationoffarvision:Naked/correctedvision:裸眼、矫正视力Pinholeglass:孔镜Sphericalaberration:球面像差Fingercount:指数Handmovement:手动Lightperception:光感Light-seeking:光定位2、theexaminationofnearvision:Standardreadingchart:Jaeger’stestchart:Myopia:近视Presbyopia:老视3、thetheoryofvisualacuity:Theresolvingpower:分辨力Visualangle:视角Theexaminationoffarvisionneedsabundantlightorartificialillumination,theexaminedisatadistanceof5mfromthechart,lettheline1.0beatthesameheightofexaminedeye.二、Darkadaption（暗适应）：Thresholdoflightirritation:光刺激阈Darkadaptationcurve:暗适应曲线Cone:视锥细胞Rod:视杆细胞Contrastmethod:对比法Darkadaptometer:暗适应计Retinalpigmenteddegeneration:视网膜色素变性三、Coloursensation(色觉)：四、Visualfield(视野)五、Contrastsensitivity(对比敏感度)六、Visualelectro-physiology(视觉电生理)Electrooculogram,EOG:眼电图Electroretinogram,ERG:视网膜电图Visualevokedpotential,VEP:视觉诱发电图Electrooculogram,EOG:眼电图Retinalpigmentedepithelium:视网膜色素上皮Photoreceptorcells:光感受器细胞Theretinalstaticpotential:视网膜静息电位Electroretinogram,ERG:视网膜电图Theretinalactivepotential:视网膜动作电位Includinga,b,cwavesandoscillatingpotentials:震荡电位a:photoreceptorcells

光感受器细胞b:bipolarcells

双极细胞c:pigmentedepithelium

色素上皮细胞

Examinationoftheglobeanditsaccessoryorgans(眼球及眼附属器检查)：Examinationofaccessoryorgansoftheeye:眼附属器检查Examinationofanteriorsegmentoftheeye:眼球前段检查Examinationwithslit-lampmicroscope:裂隙灯显微镜检查Gonioscope:前房角镜检查Tonometry:眼压测量Examinationofthefundus:眼底检查一、Examinationofaccessoryorgansoftheeye:眼附属器检查1、eyelids:眼睑

ecchymoma:[,eki'məumə]淤血emphysema

:[,emfɪ'siːmə]气肿scar/induration:瘢痕或残留物

entropionorectropionatpalpebralmargin：睑内翻/睑外翻eyelash:睫毛

trichiasis:

[,trɪkɪ'eɪsɪs;trɪ'kaɪəsɪs]

倒睫aberrantlash:乱睫

2、lacrimalapparatus:泪道

lacrimal

puncta:泪点

eversion:外翻occlusion:阻塞

lacrimalsac:泪囊tenderness:压痛fistula:瘘管Schirmer’stest:isperformedwith5x35mmfilterpaper,oneendisbentatthesiteof5mmandinsertedintotheconjunctivalsacattheinnerpartof1/3ofthelowereyelid,therestofthefilterpaperishangedontheskinsurfaceofthelowereyelidwithbotheyesclosedgently;after5minutestomeasurethelengthoffilterpapergotwetbytears,normallyismorethan15mmonaverage,lessthan5mmisregardedasabnormal.

lacrimalgland:泪腺tearsecretion:泪液分泌

stenosisorobstruction:堵塞

Fluoresceinsodiumtest:荧光素钠试验Washingoflacrimalpassage:泪道冲洗3、conjunctiva:结膜

palpebralconjunctiva:睑结膜bulbarconjunctiva：球结膜

fornicalconjunctiva:穹窿结膜transparent：透明congestion：充血papillaryhypertrophy:[pə'pɪlərɪ]

[haɪ'pɜːtrəfɪ]

乳头肥大

folliculosis:[fə,likju'ləusis]

滤泡增殖

symblepharon:睑球粘连pigmentation:色素沉着proliferativetissue:新生物

conjunctivalorciliaryhyperemia:结膜充血或睫状充血4、positionofglobe:眼球的位置

palpebralfissure:睑裂

nystagmus:

[nɪ'stægməs]

眼球震颤strabismus:[strə'bɪzməs]斜视

Hertel

exophthalmometertomeasuretheprotrusion:Hertel

突眼计测量眼球突出度二、Examinationofanteriorsegmentoftheeye:眼球前段检查1、cornea:角膜

keraticprecipitate(KP):角膜后沉着物cornealperception:角膜感觉/viralkeratitis

病毒性角膜炎/thedamageoftrigeminalnerve三叉神经受损opacity：混浊、不透明stainingwithfluoresceinsodium:荧光素钠染色/cornealepithelium:角膜上皮Thecornealcurvature:角膜弯曲度的检查Placido’scornealdisk:Keratometer:角膜曲率计Cornealtopography:角膜地形图Normal:正常/aregularandclearconcentricring:规则而清晰的同心圆Oval:椭圆形/regularatigmatism:规则散光Distortedshape:扭曲者/irregularatigmatism:不规则散光Pearshape:梨形/keratoconus

圆锥角膜Placido’s

板2、sclera:巩膜nodule:结节/hyperemia:充血jaundice:黄染3、Anteriachamber:前房aqueoushumor: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relativeafferentpupillarydefect,RAPD:相对性传入性瞳孔障碍6、Lens:晶状体todilatepupil:散瞳

三、Examinationwithslit-lampmicroscope:裂隙灯显微镜检查Projectivesystemoflightsource:光源投射系统Opticalmagnifyingsystem:光学放大系统Diffuseillumination(弥散光线照明法)Itmaybeusedtoexaminethetissueofanteriorsegmentsuchasconjunctiva,cornea,scleraandothers.检查前节组织：如，结膜，角膜，巩膜等。Directillumination(直接照明法)Specularreflection(后部反光照明法):Indirectillumination(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-closureglaucoma:闭角型青光眼Angle-openglaucoma：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)Theanteriorchamberangle(前房角)Anteriorwalls：1、Schwalbe’sline:TheterminalofcornealDescemet’slayer:角膜后弹力层终止处Theboundarybetweenthecorneaandthetrabecula:角膜与小梁网的边界2、trabecularnetwork:小梁网Alittleyellowbandstructure:Thecanalofschlemm:Drainageaqueoushumoroutflow:房水排出的通路3、scleralspur:巩膜突Crypts:隐窝Ciliaryband:睫状体带Pectinateligament:梳状韧带Posteriorwall:后壁Irisroot:虹膜根部Classification：分类Wideangle:宽角Narrowangle:窄角Wideangle:宽角Narrowangle:窄角Grade1:Eminenceindifferentdegreeattheirisperiphery,underdynamicconditiontheciliarybodymaybeseentobewiderorfrominvisibletobeseen.Grade2:thescleralspurmaybeseenbutciliarybandindynamicobservation.Grade3:thescleralspurandtheposteriorpartofthetrabecularnetworkcan’tbeseenindynamicobservation,butdisplacementofthefocallinemaybeseen.Grade4:underdynamicobservation,apartfromschwalbe’sline,otheranglestructurescan’tbeseen,butdisplacementofthefocalline.五、

Tonometry:眼压测量Measurementbyfinger:指测法Measurementbytonometer:眼压计测量法1、Measurementbyfinger:指测法Theborderoftheuppertarsus:上眼睑Tn------normalIOPT+1----slightincreaseT+2----m