裂隙灯检查法北京同仁.ppt

裂隙灯检查法 Direct illumination Diffuse illumination 光学区域照明（窄裂隙） 镜面反射光 内皮观察 Indrect illumination Proximal illumination Sclerotic scatter Retroillumination(iris) Retroillumination(fundus) Transillumination of the iris Vital dyes Fluorescein Fluorescein and rose bengal Seidal test 重点注意 患者进入诊室 自然光照明 寻找不同点 学会如何描述病变（硬度、颜色、形状、大小、位置） 比较各种不同照明的不同 学会使用后照法 用窄裂隙来确定病变深度 角膜溃疡 角膜溃疡 定义： 分类 感染性 非感染性 角膜水肿 Clinical evaluation History Laterality Age Duration Diurnal variation Previous ocular disease Pain Slit lamp examination Epithelium Stroma Endothelium and Descemet’s membrane Lattice dystrophyCorneal foreign bodiesMeesmanns dystrophyFingerprint, map, dot dystrophyCornea farinataDescemets foldsKeratic precipitatesThygesons superficial punctate keratitisCorneal infiltratesEarly edemaFilamentsMicrocystsFuchs dystrophyCorneal scars Lattice dystrophyPseudoexfoliationKeratic precipitatesCorneal scarsMeesmanns dystrophyMap, dot, fingerprint dystrophyLens vacuolesCataractCorneal rejection lines Classification Etiologies Characteristics Primary endothelial failure CHED, Fuchs dystrophy , ICE, PPMD Primarily stromal, diffuse, progressive, irreversible Secondary endothelial failure Acute or chronic trauma, chemical, inflammatory, hypoxia Primarily stromal, focal or diffuse, acute or chronic Normal endothelium Elevated intraocular pressure Primarily epithelial, microcystic, central or diffuse, acute Epithelial failure Epithelial defect Stromal, surrounding defect, acute Causes of corneal edema * 角膜病专科 金涛 宽裂隙照明 EdemaStromal opacitiesMarginal dystrophyKayser-Fleisher ringFuchs dystrophyCorneal pannusEpithelial defectCorneal infiltratesFurrow dystrophyLens opacitiesDellenMicrocystsBullaeEctatic changesAnterior chamber depthTear film deficiencyCorneal thinning Corneal foreign bodiesCorneal edemaKeratic precipitatesVerticillataInterstitial keratitisGranular dystrophyRadial keratotomy scarsHydrops