眼科学：英文 葡萄膜疾病.pptVIP

* * * * * * * * * * * * * * * * * * * * * * Thank you for your attention! * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ? Clinical clue table suggesting the possibility of serious eye disease causing the red eye --- clinical features that may necessitate immediate ophthalmologist consultation Clinical feature Suggests Severe eye aching Iritis, keratitis, acute angle-closure glaucoma, scleritis, orbital cellulitis Prominent photophobia Iritis, keratitis Impaired vision Iritis, keratitis, acute angle-closure glaucoma, orbital cellulitis Cloudy cornea Keratitis, acute angle-closure glaucoma Corneal opacification Keratitis - chemical or infectious Circumcorneal conjunctival injection Iritis, keratitis Cloudy anterior chamber Iritis Pain on eyeball palpation Scleritis (+++), orbital cellulitis Proptosis Orbital cellulitis, posterior scleritis Impaired, or painful, extraocular eye movements Orbital cellulitis Fever, toxic appearance Orbital cellulitis (+) Hyperpurulent discharge from an angry eye Gonococcal conjunctivitis/endophthalmitis Prominent nausea and vomiting Acute angle-closure glaucoma Small, irregular, poorly-reactive pupil Iritis Fixed mid-dilated pupil Acute angle-closure glaucoma Increased intra-ocular pressure Acute angle-closure glaucoma, iritis (secondary complication) History of connective tissue disease, or granulomatous disease Iritis, scleritis  Treatment of acute anterior uveitis Principle： Treatment against inflammation(steroids and nsaids) Dilation of pupil Prevention of complications Aim ： Relieve pain and discomfort. Prevent sight loss Eliminate causes of disease where possible Mydriatics (pupil dilators) Dilate pupil: remove spasm of ciliary muscle and sphincter, relieve pain , prevent sticking of iris to the lens Steroids Action mainly as being anti-inflammatory and immunosuppressant, although wide ranging effects Make up the major part of uveitis treatment. Used in different forms: E