2022年医学专题-眼科检查法

ExaminationoftheEye

(眼科(yǎnkē)检查法)杨霞霞第一页，共八十九页。1、History-taking(病史采集(cǎijí))：2、Theexaminationofvisualfunction(视功能检查)：3、Examinationoftheglobeanditsaccessoryorgans(眼球及眼附属器检查)：第二页，共八十九页。History-taking(病史(bìnɡshǐ)采集)：Subjectiveabnormalfeelings(主观异常(yìcháng)感觉)：Foreignbodysensation(异物感)Visualfielddefect(视野缩小)Suddenvisualimpairment(视力降低)Theamountofsecretion(分泌物量增多)第三页，共八十九页。Photophobia(畏光)Swelling（肿胀）Metamorphopsia(视物变形症)Flickersensation（闪光感）第四页，共八十九页。Theexaminationofvisualfunction(视功能(gōngnéng)检查)Opticpsycophysics(视觉心理物理学检查)Optic-electro-physiology(视觉电生理检查)第五页，共八十九页。Visualacuity(视力(shìlì)，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)第六页，共八十九页。一、Visualacuity(视力(shìlì)，即视锐度)Thevisionindicatesvisualacuitydividedintofar,nearvision,thelatternormallymeansreadingone.第七页，共八十九页。1、theexaminationoffarvision:Naked/correctedvision:裸眼、矫正视力Pinholeglass:孔镜Sphericalaberration:球面(qiúmiàn)像差Fingercount:指数Handmovement:手动Lightperception:光感Light-seeking:光定位第八页，共八十九页。第九页，共八十九页。2、theexaminationofnearvision:Standardreadingchart:Jaeger’stestchart:Myopia:近视(jìnshì)Presbyopia:老视第十页，共八十九页。3、thetheoryofvisualacuity:Theresolvingpower:分辨力Visualangle:视角(shìjiǎo)第十一页，共八十九页。Theexaminationoffarvisionneedsabundantlightorartificialillumination,theexaminedisatadistanceof5mfromthechart,lettheline1.0beatthesameheightofexaminedeye.第十二页，共八十九页。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(duìbǐ)法Darkadaptometer:暗适应计Retinalpigmenteddegeneration:视网膜色素变性第十三页，共八十九页。三、Coloursensation(色觉(sèjué))：第十四页，共八十九页。四、Visualfield(视野(shìyě))第十五页，共八十九页。五、Contrastsensitivity(对比(duìbǐ)敏感度)第十六页，共八十九页。六、Visualelectro-physiology(视觉(shìjué)电生理)Electrooculogram,EOG:眼电图Electroretinogram,ERG:视网膜电图Visualevokedpotential,VEP:视觉诱发电图第十七页，共八十九页。Electrooculogram,EOG:眼电图Retinalpigmentedepithelium:视网膜色素上皮Photoreceptorcells:光感受器细胞(xìbāo)Theretinalstaticpotential:视网膜静息电位第十八页，共八十九页。Electroretinogram,ERG:视网膜电图Theretinalactivepotential:视网膜动作电位Includinga,b,cwavesandoscillatingpotentials:震荡(zhèndàng)电位第十九页，共八十九页。a:photoreceptorcells

光感受器细胞(xìbāo)b:bipolarcells

双极细胞c:pigmentedepithelium

色素上皮细胞

第二十页，共八十九页。Examinationoftheglobeanditsaccessoryorgans(眼球(yǎnqiú)及眼附属器检查)：第二十一页，共八十九页。Examinationofaccessoryorgansoftheeye:眼附属器检查(jiǎnchá)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:眼底检查第二十二页，共八十九页。一、Examinationofaccessoryorgansoftheeye:眼附属(fùshǔ)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(jiémáo)trichiasis:

[,trɪkɪ'eɪsɪs;trɪ'kaɪəsɪs]

倒睫aberrantlash:乱睫

第二十三页，共八十九页。2、lacrimalapparatus:泪道lacrimalpuncta:泪点eversion:外翻occlusion:阻塞(zǔsè)

lacrimalsac:泪囊tenderness:压痛fistula:瘘管第二十四页，共八十九页。Schirmer’stest:isperformedwith5x35mmfilterpaper,oneendisbentatthesiteof5mmandinsertedintotheconjunctivalsacattheinnerpartof1/3ofthelowereyelid,therestofthefilterpaperishangedontheskinsurfaceofthe第二十五页，共八十九页。lowereyelidwithbotheyesclosedgently;after5minutestomeasurethelengthoffilterpapergotwetbytears,normallyismorethan15mmonaverage,lessthan5mmisregardedasabnormal.第二十六页，共八十九页。lacrimalgland:泪腺tearsecretion:泪液分泌stenosisorobstruction:堵塞Fluoresceinsodiumtest:荧光(yíngguāng)素钠试验Washingoflacrimalpassage:泪道冲洗第二十七页，共八十九页。3、conjunctiva:结膜(jiémó)palpebralconjunctiva:睑结膜bulbarconjunctiva：球结膜fornicalconjunctiva:穹窿结膜transparent：透明congestion：充血papillaryhypertrophy:[pə'pɪlərɪ]

[haɪ'pɜːtrəfɪ]

乳头肥大第二十八页，共八十九页。folliculosis:[fə,likju'ləusis]

滤泡增殖(zēngzhí)symblepharon:睑球粘连pigmentation:色素沉着proliferativetissue:新生物conjunctivalorciliaryhyperemia:结膜充血或睫状充血第二十九页，共八十九页。4、positionofglobe:眼球的位置palpebralfissure:睑裂nystagmus:

[nɪ'stægməs]

眼球震颤strabismus:[strə'bɪzməs]斜视Hertelexophthalmometertomeasuretheprotrusion:Hertel突眼计测量(cèliáng)眼球突出度第三十页，共八十九页。二、Examinationofanteriorsegmentoftheeye:眼球(yǎnqiú)前段检查1、cornea:角膜(jiǎomó)keraticprecipitate(KP):角膜后沉着物cornealperception:角膜感觉/viralkeratitis病毒性角膜炎/thedamageoftrigeminalnerve三叉神经受损第三十一页，共八十九页。opacity：混浊(hùnzhuó)、不透明第三十二页，共八十九页。stainingwithfluoresceinsodium:荧光素钠染色(rǎnsè)/cornealepithelium:角膜上皮第三十三页，共八十九页。Thecornealcurvature:角膜弯曲度的检查(jiǎnchá)Placido’scornealdisk:Keratometer:角膜曲率计Cornealtopography:角膜地形图第三十四页，共八十九页。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(yuánzhuī)角膜第三十五页，共八十九页。Placido’s板第三十六页，共八十九页。2、sclera:巩膜(gǒngmó)nodule:结节(jiéjié)/hyperemia:充血第三十七页，共八十九页。jaundice:黄染第三十八页，共八十九页。3、Anteriachamber:前房aqueoushumor:房水

第三十九页，共八十九页。hypopyon:前房积脓第四十页，共八十九页。4、Iris:虹膜dipigmentation:脱色素atrophy:萎缩nodule:结节(jiéjié)iridodialysis:虹膜根部离断coloboma:缺损

第四十一页，共八十九页。第四十二页，共八十九页。5、Pupil：瞳孔(tóngkǒng)retardative:迟钝relativeafferentpupillarydefect,RAPD:相对性传入性瞳孔障碍第四十三页，共八十九页。6、Lens:晶状体todilatepupil:散瞳

第四十四页，共八十九页。第四十五页，共八十九页。三、Examinationwithslit-lampmicroscope:裂隙(lièxì)灯显微镜检查Projectivesystemoflightsource:光源投射(tóushè)系统Opticalmagnifyingsystem:光学放大系统第四十六页，共八十九页。Diffuseillumination(弥散(mísàn)光线照明法)第四十七页，共八十九页。Itmaybeusedtoexaminethetissueofanteriorsegmentsuchasconjunctiva,cornea,scleraandothers.检查前节组织(zǔzhī)：如，结膜，角膜，巩膜等。第四十八页，共八十九页。Directillumination(直接照明法)第四十九页，共八十九页。Specularreflection(后部(hòubù)反光照明法):第五十页，共八十九页。Indirectillumination(间接照明法）第五十一页，共八十九页。血粘度增高患者球结膜(jiémó)血管的“淤泥化现象”，可见颗粒状血柱第五十二页，共八十九页。圆锥角膜(jiǎomó)并混浊第五十三页，共八十九页。色素(sèsù)KP第五十四页，共八十九页。羊脂(yánɡzhī)状KP第五十五页，共八十九页。浅前房第五十六页，共八十九页。Tyndall现象(xiànxiàng)第五十七页，共八十九页。虹膜(hóngmó)植入性囊肿第五十八页，共八十九页。虹膜(hóngmó)新生血管第五十九页，共八十九页。晶状体脱位(tuōwèi)第六十页，共八十九页。核性晶状体混浊(hùnzhuó)第六十一页，共八十九页。绕核性晶状体混浊(hùnzhuó)第六十二页，共八十九页。正常玻璃体支架(zhījià)组织第六十三页，共八十九页。四、Gonioscope:前房角镜检查Angle-closureglaucoma:闭角型青光眼Angle-openglaucoma：开角型青光眼第六十四页，共八十九页。Direct/refractive(直接房角镜/光线(guāngxiàn)的折射)第六十五页，共八十九页。Indirect/reflective(间接房角镜/光线(guāngxiàn)的反射)第六十六页，共八十九页。Theanteriorchamberangle(前房角)第六十七页，共八十九页。Anteriorwalls：1、Schwalbe’sline:TheterminalofcornealDescemet’slayer:角膜后弹力(tánlì)层终止处Theboundarybetweenthecorneaandthetrabecula:角膜与小梁网的边界第六十八页，共八十九页。2、trabecularnetwork:小梁网Alittleyellowbandstructure:Thecanalofschlemm:Drainageaqueoushumoroutflow:房水排出(páichū)的通路3、scleralspur:巩膜突第六十九页，共八十九页。Crypts:隐窝Ciliaryband:睫状体带Pectinateligament:梳状韧带第七十页，共八十九页。Posteriorwall:后壁Irisroot:虹膜(hóngmó)根部第七十一页，共八十九页。Classification：分类(fēnlèi)Wideangle:宽角Narrowangle:窄角第七十二页，共八十九页。Wideangle:宽角第七十三页，共八十九页。Narrowangle:窄角Grade1:

Eminenceindifferentdegreeattheirisperiphery,underdynamicconditiontheciliarybodymaybeseentobewiderorfrominvisibletobeseen.第七十四页，共八十九页。Grade2:

thescleralspurmaybeseenbutciliarybandindynamicobservation.第七十五页，共八十九页。Grade3:thescleralspurandtheposteriorpartofthetrabecularnetworkcan’tbeseenindynamicobservation,butdisplacementofthefocallinemaybeseen.第七十六页，共八十九页。Grade4:underdynamicobservation,apartfromschwalbe’sline,otheranglestructurescan’tbeseen,butdisplacementofthefocalline.第七十七页，共八十九页。五、Tonometry:眼压(yǎnyā)测量Measurementbyfinger:指测法Measurementbytonometer:眼压计测量法第七十八页，共八十九页。1、Measurementbyfinger:指测法Theborderoftheuppertarsus:上眼睑(yǎnjiǎn)Tn------normalIOPT+1----slightincreaseT+2----moderateincreaseT+3----veryhighIOPT-1-----softthannormalT-2-----moderatesoftT-3-----verysoft第七十九页，共八十九页。2、Measurementbytonometer:眼压计测量法压陷式眼压计（SchiötzTonometer）

压平(yāpínɡ)式眼压计（GoldmannTo