青光眼损伤形成精品课件

GLAUCOMA QU BO 曲 勃 The 4th Affiliated Hospital of China Medical University It may beIt may be Glaucoma: the concept lGlaucoma is a group of diseases that can damage the eyes optic nerve and result in vision loss and blindness. lHowever, with early treatment, you can often protect your eyes against serious vision loss. lThe damages are mostly caused by increased pressure of water-aqueous humor (房水）in the eye What is Optic Nerve? “Cable “that transmit image signals to brain Higher IOP is the most important cause leading to the damage pressure Optic nerve What causes optic nerve injury in Glaucoma？ Two causes : Mechanical forces (introcular pressure:IOP) and vascular forces Glaucoma damage formation 青光眼损伤形成 Anterior chamber:前房 Posterior chamber:后房 pupil:瞳孔 Iris:虹膜 Anterior chamber angle:前房角 Cornea:角膜 ciliary body:睫状体 Glaucoma damage formation 青光眼损伤形成 Normal Drainage Picture 正常房水流出通道 The meshwork 小梁网 is the eyes drain The Ciliary Body睫状体 When this drainage of the fluid gets blocked, excess pressure is formed leading to Glaucoma Lens Who is most likely to get glaucoma? You are more likely to get glaucoma if you: lHave family members with glaucoma lAre over 45 years of age lHave poor vision lHave diabetes（糖尿病） lTake steroid medication（使用激素） lPrevious eye injury. Classification on Mechanism Aqueous Fluid Normal Drainage : good flow 正常房水流出通道 The Ciliary Body睫状体 When this drainage of the fluid gets blocked, excess pressure is formed leading to Glaucoma anterior chamber angle 前房角 The meshwork 小梁网 is the eyes drain Normal drain Blocked Drainage holes The angle is narrower than normal. If water cant flow easily through the opening in the pupil, the iris pushes forward and blocks the drainage holes. anterior chamber angle 前房角 Closed-angle Glaucoma 闭角型青光眼 Closed-angle glaucoma Closed-angle Glaucoma lThe drainage angle of trabecular meshwork becomes blocked by the iris l IOP builds up very fast. l Symptoms include severe eye or brow pain, redness of the eye,decreased or blurred vision. lMust be treated as a medicalemergency see your ophthalmologist immediately. Open Angle Glaucoma 开角型青光眼 Clogged Drainage holes The angle between the iris and the cornea is normal, but the drainage holes get clogged from the inside. anterior chamber angle 前房角 Open Angle Glaucoma Open Angle Glaucoma lTrabecular meshwork becomes less efficient at draining aqueous humor. lIntraocular pressure (IOP) builds up,which leads to damage of the optic nerve. lDamage to the optic nerve occurs at different eye pressures among different patients. lTypically, glaucoma has no symptoms in its early stages. Vision loss Tunnel vision 管状视野 Red eye, pain in the eye, 眼痛、睫状充血 Halo around lights Blurred vision 视物模糊 SYMPTOMS Glaucoma: Symptoms 症状 虹视 Glaucoma: Symptoms Normal vision 正常视野 Reduced side vision, central vision intact 周边视野局限缺损 Tunnel vision管状视 野 How can I find out if I have glaucoma? A series of test performed by your eye doctor will help to determine whether you have glaucoma or likely to develop glaucoma. Glaucoma: Diagnosis 1st History and General Examination 2nd Tonometry眼压计 4th Perimetry视野计 3rd Ophthalm oscopy眼 底镜 How is glaucoma treated? Eye drops Pills Laser surgeryEye operations Combination method Treatment Options lThe purpose of treatment is to prevent further loss of vision. lThis is important because loss of vision due to glaucoma is irreversible. Will I go blind because of glaucoma? If glaucoma is left untreated, damage increases, which may eventually lead to blindness. Regular eye examinations Regular intake of medications as instructed by the eye doctors Therefore, you should have How often should I get my eye examined If you have no risk factors for glaucoma* If you have risk factor for glaucoma* Under 45 years old:Every 4 yearsEvery 2 years 45 years and older:Every 2 yearsEvery year If you are diagnosed with glaucoma, your doctor will set a treatment cycle based upon your medical needs. * Risk factors for glaucoma危险因素: Family history, hyperopia,myopia (nearsightedness), previous eye injury, low blood pressure, diabetes, long exposure to cortisone家族史、远视近视眼、外伤史、低 血压、糖尿病、激素长期使用 Does diet, exercise, or change in behaviors help? Exercise may be beneficial as it : lLowers eye pressure lImproves blood flow to the optic nerve. Avoid smoking or second-hand smoke. Tobacco can worsen the disease. Remember lTreatment for glaucoma requires a “team” made up of both you and your doctor (ophthalmologist)( 患者和医生组成治疗团队） lGlaucoma is a lifetime disease(青光眼为终身性疾 病) lYour doctor can prescribe treatment for glaucoma, but only you can make sure to put your eye drops regularly（患者自己保证按时用药） lDo not stop taking or changing your medications without first consulting your doctor (不能私自改 变用药） lFrequent eye examinations and tests are critical to monitor your eyes for any changes（定期检查） lRemember, It is your vision, and therefore its your responsibility to maintain it 40)&#XUQNKGDAwtqmjfc952+*$ZVSPLIFByvrolheb741)&#XUQNKGDAwtqmjgc962+($ZWSPLIFByvrolheb741)&!XURNKHDAxtqmjgc962+($ZWSPMIFCyvsolieb741)&!XURNKHDAxtqnjgd963+(%ZWSPMIFCyvsolieb841-&!YUROKHEAxtqnjgd963+(%ZWTPMJFCzvsplieb841-&!YUROKHEAxuqnkgda630(%ZWTPMJFCzvsplifb851-*!YVROLHEAxuqnkgda630(%#WTQMJGCzwsplifb851-*!YVROLHEBxurnkhda730(%#WTQMJGCzwspmifc852-*$YVROLHEBxurnkhda730)%#XTQNJGDzwspmifc852- *$YVSOLIEByurokhea730)%#XTQNJGDzwtpmjfc952+*$YVSOLIEByurokhea740)&#XUQNKGDzwtpmjfc952+*$ZVSPLIFByvrokhea740)&#XUQNKGDAwtqmjgc962+*$ZVSPLIFByvrolheb741)&!XURNKGDAwtqmjgc962+($ZWSPMIFCyvrolheb741)&!XURNKHDAxtqnjgd962+($ZWSPMIFCyvsolieb841-&!YURNKHDAxtqnjgd963+(%ZWTPMJFCyvsolieb841-&!YUROKHEAxuqnkgd963+(%ZWTPMJFCzvsplifb851-&!YUROKHEAxuqnkgda630(%#WTQMJFCzvsplifb851-*!YVROLHEBxurnkgda630(%#WTQMJGCzwspmifc851- *!YVROLHEBxurnkhda730)%#XTQMJGCzwspmifc852-*$YVSOLIEByurnkhda730)%#XTQNJGDzwtpmjfc852-*$YVSOLIEByurokhea740)&#XTQNJGDzwtpmjfc952+*$ZVSPLIEByurokhea740)&#XUQNKGDAwtqmjfc952+*$ZVSPLIFByvrolheb741)&#XUQNKGDAwtqmjgc962+($ZWSPLIFByvrolheb741)&!XURNKHDAxtnjgd963+($ZWSPMIFCyvsolieb841-&!YUROKHDAxtqnjgd963+(%ZWTPMJFCzvsplieb841-&!YUROKHEAxuqnkgda63+(%ZWTPMJFCzvsplifb851-*!YVROKHEAxuqnkgda630(%#WTQMJGCzwsplifb851- *!YVROLHEBxurnkhda630(%#WTQMJGCzwspmifc852-*$YVROLHEBxurnkhda730)%#XTQNJGCzwspmifc852-*$YVSOLIEByurokhda730)%#XTQNJGDzwtpmjfc952+*$YVSOLIEByurokhea740)&#XUQNJGDzwtpmjfc952+*$ZVSPLIFByvrokhea740)&#XUQNKGDAwtqmjgc962+*$ZVSPLIFByvrolheb741)&!XUQNKGDAwtqmjgc962+($ZWSPMIFCyvrolheb741)&!XURNKHDAxtqnjgc962+($ZWSPMIFCyvsolieb841-&!XURNKHDAxtqnjgd963+(%ZWTPMJFCyvsolieb841-&!YUROKHEAxuqnjgd963+(%ZWTPMJFCzvsplifb851- &!YUROKHEAxuqnkgda630(%#WTQMJFCzvsplifb851-*!YVROLHEBxuqnkgda630(%#WTQMJGCzwspmifc851-*!YVROLHEBxurnkhda730)%#WTQMGDzwtpmifc852-*$YVSOLIEByurokhea740)%#XTQNJGDzwtpmjfc952+*$ZVSOLIEByurokhea740)&#XUQNKGDAwtpmjfc952+*$ZVSPLIFByvrolhea740)&#XUQNKGDAwtqmjgc962+($ZVSPLIFByvrolheb741)&!XURNKHDAwtqmjgc962+($ZWSPMIFCyvsolheb741)&!XURNKHDAxtqnjgd963+($ZWSPMIFCyvsolieb841-&!YUROKHDAxtqnjgd963+(%ZWTPMJFCzvsolieb841- &!YUROKHEAxuqnkgda63+(%ZWTPMJFCzvsplifb851-*!YUROKHEAxuqnkgda630(%#WTQMJGCzvsplifb851-*!YVROLHEBxurnkhda630(%#WTQMJGCzwspmifc852-*!YVROLHEBxurnkhda730)%#XTQNJGCzwspmifc852-*$YVSOLIEByurokhda730)%#XTQNJGDzwtpmjfc952-*$YVSOLIEByurokhea740)&#XUQNJGDzwtpmjfc952+*$ZVSPLIFByurokhea740)&#XUQNKGDAwtqmjgc952+*$ZVSPLIFByvrolheb741)&!XUQKHDAxtqmjgc962+($ZWSPMIFCyvsolieb841)&!XURNKHDAxtqnjgd963+(%ZWSPMIFCyvsolieb841- &!YUROKHEAxtqnjgd963+(%ZWTPMJFCzvsplifb841-&!YUROKHEAxuqnkgda630(%ZWTPMJFCzvsplifb851-*!YVROLHEAxuqnkgda630(%#WTQMJGCzwspmifb851-*!YVROLHEBxurnkhda730(%#WTQMJGCzwspmifc852-*$YVSOLHEBxurnkhda730)%#XTQNJGDzwspmifc852- *$YVSOLIEByurokhea730)%#XTQNJGDzwtpmjfc952+*$ZVSOLIEByurokhea740)&#XUQNKGDzwtpmjfc952+*$ZVSPLIFByvrolhea740)&#XUQNKGDAwtqmjgc962+($ZVSPLIFByvrolheb741)&!XURNKGDAwtqmjgc962+($ZWSPMIFCyvsolheb741)&!XURNKHDAxtqnjgd962+($ZWSPMIFCyvsolieb841-&!YURNKHDAxtqnjgd963+(%ZWTPMJFCzvsolieb841-&!YUROKHEAxuqnkgd963+(%ZWTPMJFCzvsplifb851-*!YUOLHEBxuqnkgda630(%#WTQMJGCzwspmifc851-*!YVROLHEBxurnkhda730)%#XTQMJGCzwspmifc852- *$YVSOLIEBxurnkhda730)%#XTQNJGDzwtpmjfc852-*$YVSOLIEByurokhea740)&#XTQNJGDzwtpmjfc952+*$ZVSPLIEByurokhea740)&#XUQNKGDAwtqmjfc952+*$ZVSPLIFByvrolheb740)&#XUQNKGDAwtqmjgc962+($ZWSPLIFByvrolheb741)&!XURNKHDAxtqmjgc962+($ZWSPMIFCyvsolieb741)&!XURNKHDAxtqnjgd963+(%ZWSPMIFCyvsolieb841-&!YUROKHEAxtqnjgd963+(%ZWTPMJFCzvsplieb841-&!YUROKHEAxuqnkgda630(%ZWTPMJFCzvsplifb851-*!YVROKHEAxuqnkgda630(%#WTQMJGCzwsplifb851- *!YVROLHEBxurnkhda730(%#WTQMJGCzwspmifc852-*$YVROLHEBxurnkhda730)%#XTQNJGDzwspmifc85+*$YVSOLIEByurokhea740)&#XUQNJGDzwtpmjfc952+*$ZVSPLIFByvrokhea740)&#XUQNKGDAwtqmjgc952+*$ZVSPLIFByvrolheb741)&!XUQNKGDAwtqmjgc962+($ZWSPMIFCyvrolheb741)&!XURNKHDAxtqnjgc962+($ZWSPMIFCyvsolieb841-&!XURNKHDAxtqnjgd963+(%ZWTPMIFCyvsolieb841-&!YUROKHEAxuqnjgd963+(%ZWTPMJFCzvsplifb851-&!YUROKHEAxuqngda630(%#WTQMJGCzwspmifb851- *!YVROLHEBxurnkhda730)%#WTQMJGCzwspmifc852-*$YVSOLHEBxurnkhda730)%#XTQNJGDzwtpmifc852-*$YVSOLIEByurokhea730)%#XTQNJGDzwtpmjfc952+*$ZVSOLIEByu