干眼症_ppt课件.pptx

干眼症常见症状干涩痒烧灼感异物感刺痛感阵发性视物模糊（晨起）迎风流泪双眼、慢性工作一天以后或长期看书看电脑后加重怀疑干眼症！干眼定义干眼是由于泪液的量或质或流体动力学异常引起的泪膜不稳定和(或)眼表损害，从而导致眼不适症状及视功能障碍的一类疾病。我国临床出现的各种名称(如干眼症、干眼病及干眼综合征等)均统一称为干眼。脂质层水液层粘蛋白层a superficial oily layer表面脂质层：meibomian glands 睑板腺a middle aqueous layer中间水液 层 :main and accessory lacrimal glands主副泪腺a deep mucin layer深层粘蛋白层：conjunctival goblet cells结膜杯状细胞 角膜 泪膜 角膜泪膜In addition to lubricating the surface of the cornea and conjunctiva, tears produce a smooth optical surface, provide oxygen and other nutrients, and contain immunoglobulins, lysozyme,and lactoferrin. Aberrations in the tear film result from a variety of diseases (eg, dry eye)泪膜除了对角膜表面起润滑作用外，还使得角膜更加光滑，为角膜供氧及营养物质，还含有免疫球蛋白，溶菌酶，乳铁蛋白。各种各样的泪膜疾病，比如干眼症，会引起相差而使视觉质量下降。The lacrimal glands are small and do not function fully until approximately 6 weeks after birth. Thisexplains why newborn infants do not produce tears when crying.大约出生后6周前泪腺小而无功能，新生儿哭而无泪！The ducts from the orbital portion run through and join the ducts of the palpebral lobe. Therefore, removal of or damage to the palpebral portion of the gland can seriously reduce secretion from the entire gland. This is the reason that biopsy of the lacrimal gland is generally performed on the orbital lobe.泪腺的眶部导管穿过并加入到眼睑部导管开口于上睑穹隆部。眼睑部泪腺的损伤会严重降低泪液分泌，因此泪腺活检一般取自眶部泪腺。Aqueous lacrimal secretion has traditionally been divided into basal low- level secretion and reflex secretion. Previously, it was argued that the accessory glands provided basal tear secretion and the lacrimal gland was responsible for reflex tearing. However, recent evidence suggests that all tearing may be reflex. The tear film composition is as follows:? Goblet cells within the conjunctiva provide the inner layer of the tear film by secreting mucin, which allows for even distribution of the tear film over the ocular surface.? The main and accessory lacrimal gland secretions form the intermediate aqueous layer of the tear film.? Meibomian glands produce the oily outerlayer of the tear film, which reduces