临床医学晶状体玻璃体病课件.ppt

晶状体病 DISORDERS OF LENS 哈尔滨医科大学第一临床医学院附属 眼科医院 EYE HOSPITAL OF THE 1ST CLINICAL MEDICAL COLLEGE, HMU 晶状体（lens)为双凸形状，有弹性，是无血管的透明组织，具有复杂的代谢过程。营养主要来自房水。它是眼屈光间质重要的组成成分。主要的病变是其透明度和位置的改变，都会严重影响视力。The lens is a kind of avascular transparent tissue with complex metabolic process. Its nourishment mainly comes from aquous humour. The disorder of the lens is commonly loss of its transparency and abnormality of its position; both can induce severe visual disturbance. 白内障 CATARACT 概述(Introduction) 广义上讲晶体发生混浊就可称为白内障（cataract)，但只有对视力有影响时，才有临床意义。 The opacity of lens is generally called cataract. But mild opacity of the lens has no affection to vision without any clinical significance. 病因（Etiology)：许多因素，如老化、遗传、代谢异常、外伤、辐射、中毒、局部营养障碍等，引起晶状体囊膜损伤，使其通透性增加和丧失屏障作用，或导致晶状体代谢紊乱，都可使晶状体蛋白质发生变性，造成混浊。 白内障的分类CLASSIFICATION OF CATARACT 1.按病因(according to etiology)：分外伤性(injuried)、并发性(complicated)、代谢性(metabolic)、中毒性(toxic)、辐射性(radiating)、发育性(develoing)和后发性(after-cataract)白内障。 2. 按发病年龄（according to age of occurring): 先天性（congenital）、婴儿性（ infantile）、 青少年性（juvenile）、成年性（adult）、老年性（senile）。 3. 按混浊部位（according to the site of opacity): 皮质性（cortical）、核性（ nuclear）、囊膜下（subcapsular）、囊膜性（capsular）。 4. 按混浊的程度(according to the degree of opacity)：初期（incipient)、未熟期(immature)、成熟期(mature)、过熟期(hypermature)。 5. 按混浊形态(according to the shape of opacity)：点状(punctate)、冠状(coronary)、板层白内障(lamellar)。 年龄相关性白内障（age-related cataract) 是中老年开始发生的晶状体混浊，随着年龄增加，患病率明显增高。由于它主要发生于老年人中，又称老年性白内障。分为皮质性、核性和后囊下三种类型。 is the most common one, often seen in the elder more than 50 years old. With aging its morbidity rate goes higher. It is gradually appeared degenerative change in the course of lens aging. Its pathologic mechanism isn’t understood completely yet, related with ultraviolet ray, with systemic disease such as diabetes, hypertension, arteriosclerosis, genetic factor as well as lens nourishment and metabolic condition and so on. 临床表现（clinical findings) 常双眼患病，但发病可有先后，严重程度也不一致。主要症状为眼前阴影和渐进性、无痛性视力减退。由于晶体吸收水分后体积增加，屈光力增强。因晶体纤维肿胀和断裂，使屈光度不均一，