眼科检查法

Examination of the Eye(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)：,The examination of visual function(视功能检查),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,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 and its accessory organs(眼球及眼附属器检查)：,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 the,lower 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: pplr haptrf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,Posterior wall: 后壁,Iris root: 虹膜根部,Classification：分类,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-