美国眼科医生手册简版.doc

1. DIFFERENTIAL DIAGNOSIS OF OCULAR SYMPTOMS.33 1.1 BURNING.33 1.2 CROSSED EYES IN CHILDREN.33 1.3 DECREASED VISION.33 1.4 DISCHARGE.34 1.5 DISTORTION (OF VISION).34 1.6 DOUBLE VISION.34 1.7 DRY EYES.35 1.8 EYELID CRUSTING.35 1.9 EYELID DROOP.35 1.10 EYELID SWELLING.35 1.11 EYELID TWITCH FATIGUE.35 1.12 FLASHES OF LIGHT.35 1.13 FLOATERS.35 1.14 FOREIGN-BODY SENSATION.35 1.15 HALOS AROUND LIGHTS.35 1.16 HEADACHE.35 1.17 ITCHY EYE.35 1.18 LIGHT SENSITIVITY.35 1.19 NIGHT BLINDNESS.36 1.20 PAIN (OCULAR).36 1.21 PHOTOPHOBIA.36 1.22 PROPTOSIS.36 1.23 PTOSIS.36 1.24 RED EYE.36 I. Discharge present.36 II. No discharge present.36 1.25 SPOTS IN FRONT OF THE EYES.36 1.26 TEARING.36 1.27 WATERY EYES.37 1.28 WHITE PUPIL.37 2. DIFFERENTIAL DIAGNOSIS OF OCULAR SIGNS.37 2.1 ANTERIOR CHAMBER/ANTERIOR CHAMBER ANGLE.37 Blood in Schlemms Canal on Gonioscopy.37 Hyphema.37 Hypopyon.37 2.2 CORNEA/CONJUNCTIVAL FINDINGS.37 Band Keratopathy.37 Corneal Crystals.37 Corneal Edema.37 Corneal Filaments.38 Dilated Episcleral Vessels (in the Absence of Ocular Irritation or Pain) .38 Enlarged Corneal Nerves.38 Membranous Conjunctivitis.38 Opacification of the Cornea in Infancy.38 Pannus (Superficial Vascular Invasion of the Cornea).38 Large Papillae on the Superior Tarsus.38 Pigmentation of the Conjunctiva.38 Pseudomembranous Conjunctivitis.38 Symblepharon Fusion of the Eyelid (Palpebral) Conjunctiva with the Conjunctiva Covering the Globe (Bulbar Conjunctiva).39 Whorl-like Opacity in the Corneal Epithelium.39 2.3 EYELID ABNORMALITIES.39 Eyelid Edema or Swelling.39 Eyelid Lesion.39 Pseudoptosis.39 Ptosis.39 2.4 FUNDUS FINDINGS.39 Bone Spicules (Widespread Pigment Clumping).39 Bulls-Eye Macular Lesion.39 Choroidal Folds.40 Choroidal Neovascularization (Gray-Green Membrane or Blood Seen Deep to the Retina).40 Cotton-Wool Spots, without Other Abnormalities (White Fluffy Lesions with Feathered Edges, Often Obscuring Retinal Vessels).40 Embolus.40 Macular Exudates.40 Normal Fundus in the Presence of Decreased Vision.41 Optociliary Shunt Vessels on the Disc.41 Retinal Neovascularization.41 Roths Spots (Hemorrhages with White Centers).41 2.6 Glaucoma.41 2.7 Iris.41 2.8 Lens.42 2.9 Neuro-ophthalmic Abnormalities.42 2.10 Orbit.43 2.11 Pediatrics.44 2.12 Postoperative Problems.44 2.13 Refractive Problems.44 2.14 Visual Field Abnormalities.45 2.15 Vitreous.46 3. TRAUMA.46 3.1 CHEMICAL BURN.46 Emergent Treatment.46 A. Mild-to-Moderate Burns.46 3.2 CORNEAL ABRASION.49 3.3 CORNEAL FOREIGN BODY/RUST RING.50 3.4 CONJUNCTIVAL/SUBCONJUNCTIVAL FOREIGN BODY .52 3.5 CONJUNCTIVAL LACERATION.53 3.6 EYELID LACERATION.54 3.7 TRAUMATIC IRITIS.57 3.8 HYPHEMA AND MICROHYPHEMA.58 3.9 COMMOTIO RETINAE.61 3.10 TRAUMATIC CHOROIDAL RUPTURE.62 3.11 ORBITAL BLOW-OUT FRACTURE.63 3.12 TRAUMATIC RETROBULBAR HEMORRHAGE.64 3.13 INTRAORBITAL FOREIGN BODY.66 3.14 CORNEAL LACERATION.68 3.15 RUPTURED GLOBE AND PENETRATING OCULAR INJURY.68 3.16 INTRAOCULAR FOREIGN BODY.69 3.17 TRAUMATIC OPTIC NEUROPATHY.71 4. CORNEA.73 4.1 SUPERFICIAL PUNCTATE KERATITIS (SPK).73 Symptoms.73 Critical Signs.73 Other Signs.73 Etiology.73 Work-up.74 Treatment.74 Follow-up.74 4.2 DRY EYE SYNDROME.75 Symptoms.75 Critical Signs.75 Other Signs.75 Differential Diagnosis.75 Etiology.75 Work-up.76 Treatment.76 Follow-up.77 4.3 FILAMENTARY KERATOPATHY.77 Symptoms.77 Critical Signs.77 Other Signs.77 Etiology.77 Work-up.78 Treatment.78 Follow-up.78 4.4 EXPOSURE KERATOPATHY.78 Symptoms.78 Critical Signs.78 Other Signs.78 Etiology.78 Differential Diagnosis.79 Work-up.79 Treatment.79 Follow-up.79 4.5 NEUROTROPHIC KERATOPATHY.79 Symptoms.79 Critical Signs.79 Other Signs.79 Etiology.80 Work-up.80 Treatment.80 Follow-up.80 4.6 RECURRENT CORNEAL EROSION.81 Symptoms.81 Critical Signs.81 Other Signs.81 Etiology.81 Work-up.81 Treatment.81 Follow-up.82 4.7 THERMAL/ULTRAVIOLET KERATOPATHY.82 Symptoms.82 Critical Sign.82 Other Signs.82 Differential Diagnosis.82 Work-up.82 Treatment.82 Follow-up.83 4.8 THYGESONS SUPERFICIAL PUNCTATE KERATOPATHY.83 Symptoms.83 Critical Sign.83 Other Signs.83 Differential Diagnosis.83 Treatment.83 Follow-up.83