医学晶状体病ppt课件.pptVIP

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;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;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);临床表现(clinical findings);症状(symptoms) 主要症状是视力模糊、减退、并可致盲。其视力障碍与晶体混浊的位置有关。 自觉症状有以下3点: 1.眼前出现固定不动的黑点; 2.单眼多视,物像变形或出现重影; 3.晶体性近视的出现是由于晶体核硬化。;体征(signs);1. 皮质性白内障(cortical cataract): 最为常见。按其发展过程分为4期。 It is the most common type of senile cataract, according to the development; it is divided into 4 stages. (1) 初期(incipient stage): 晶体皮质内出现空泡、水裂和板层分离。空泡为圆形透明小泡,位于前后皮质中央部或晶状体缝附近。水裂的形态不一,从周边向中央逐渐扩大。板层分离多在皮质深层,呈羽毛状。楔形混浊常见。位于前后皮质,尖端向着晶体中心,基底位于赤道部。;Cuneiform opacity appears at the periphery of anterior and posterior cortex, its base is at the equator, its tip towards the center, often occurring at lower part, then similar opacity occurs at bilateral and upper parts, then forms wheel-like opaque. The pupillary area is not affected, commonly without blurred vision. The early phenomenon is separation of lens fibrous lamina like feather, sometimes vacuole appears.;(2) 未熟期(immature stage):又称膨胀期(intumescent)。晶体混浊继续加重时,渗透压改变,在短期内有许多水分积聚,晶体急剧肿胀,体积变大,将虹膜向前推移,前房变浅,