老年人的视力问题__培训课件.ppt

青光眼的患病率 占总人口的1-2％。 40岁以上者为2.5%。 70岁以上者为5.0%。 与年龄相关性强。 5％患者可导致盲。 青光眼的危险因素 黑人。 家族史。 40岁以上人群。 近视。 糖尿病。 高血压。 青光眼 青光眼患者早期视野的丢失从周边开始，晚期管视。 晚期青光眼患者尽管还残存一些阅读视力，可主要问题是远视力的丢失 对比敏感度和明暗视的降低 0.02或更好的视力患者半数都可以独立生活。 一个视力在短期内下降的老人不可能像年轻人容易适应视力下降 康复训练 放大，提高高度对比度 很好的利用残存视力 训练适应日常的生活活动 咨询服务 助视器 放大镜 手持放大镜 台式放大镜 望远镜 视频放大器 助视器 大的阅读字体 大的电话按钮 会说话的闹钟 烤箱的显示面板上突出标记 * Neovascular AMD is characterized by choroidal neovascularization (CNV), in which new blood vessels proliferate and grow through breaks in Bruch’s membrane. CNV is responsible for approximately 80–90% of cases of severe, irreversible central vision loss associated with AMD. Other causes of vision loss, including serous detachment and geographic atrophy, account for a much smaller proportion of vision loss. References: Hyman 1992 Ferris III et al. 1984 Figure taken from Monograph Figure 2.3 * While laser photocoagulation is beneficial in some patients, it has several limitations. It has been estimated that only 13 to 26% of patients with neovascular AMD are eligible for treatment. Patients may be considered ineligible if they have lesions that: do not contain some classic CNV, lack a well-defined boundary, or that exceed 3.5 MPS disc areas. Although laser photocoagulation may reduce the risk of vision loss in selected patients in the long term, the thermal laser often causes irreversible retinal damage and an absolute scotoma, which can lead to an immediate loss of visual acuity. Furthermore, a 3-year follow-up of eyes with subfoveal CNV that were treated with laser photocoagulation showed that leakage from CNV persisted or recurred in approximately 50% of eyes. References: Ciulla 1998 MPS Study Group 1994 Text derived from Key Message Data Support Compendium: fact sheet B4 * AMD is a degenerative retinal disease that can cause distortion of vision accompanied by a rapid loss of central vision. In the western world, AMD is becoming more prevalent as the population ages and is now the leading cause of severe vision loss