同济大学：《眼科学》课程电子教案（PPT课件讲稿）青光眼 Glaucoma

Glaucoma TENTH PEOPLE'S HOSPITAL OF TONGJIUNIVERSITY WANG HAO

Glaucoma TENTH PEOPLE ’S HOSPITAL OF TONGJI UNIVERSITY WANG HAO

☒无法显示该图 片。 Definition Glaucoma refers to a group of diseases or syndrome,they share certain features,including cupping and atrophy of the optic nerve head, which has attendant visual field AREA nE BLOCKAGE loss and is frequently related to the Diagram shows blockage preventing natural drainage and causing an increase in pressure within the eye level of intraocular pressure (IOP) Visual field loss Atrophy of optic nerve head

Definition Glaucoma refers to a group of diseases or syndrome, they share certain features, including cupping and atrophy of the optic nerve head, which has attendant visual field loss and is frequently related to the level of intraocular pressure (IOP) Visual field loss Atrophy of optic nerve head

☒秀法显示该圈 The concept of IOP 608205 IOP:ocular contents acting on the eye wall Ocular contents aqueous,lens,vitreous,intraocular blood volume Physiological role:inflates the globe;constant curvature of the cornea ensure normal intraocular fluid circulation provides an optically clear medium to allow good visual function. Stable:Lens,vitreous,intraocular blood volume Unstable:aqueous humor (circulation dynamic balance can affect IOP

The concept of IOP ◼ IOP: ocular contents acting on the eye wall ◼ Ocular contents ： aqueous, lens, vitreous , intraocular blood volume Physiological role : inflates the globe; constant curvature of the cornea ; ensure normal intraocular fluid circulation ; provides an optically clear medium to allow good visual function. Stable: ： Lens, vitreous , intraocular blood volume Unstable:： aqueous humor (circulation dynamic balance can affect IOP )

☒秀法品示该留 Aqueous Humor Outflow 9pse以al Inflow aqueous humor (75%~85%)through anterior angle trabecular meshwork into Schlemm canal 10%~20%aqueous humor through uveoscleral flow 5%aqueous humor is absorbed by the surface of the iris

Aqueous Humor Outflow ▪ aqueous humor （75％～85％）through anterior angle trabecular meshwork into Schlemm canal ▪10％～20％ aqueous humor through uveoscleral flow ▪ 5% aqueous humor is absorbed by the surface of the iris

☒秀法显示该图 IOP↑ aqueous humor formation aqueous humor outflow increase normal decrease ↓ IOPt IOP IOP↑ Any factors that led to the outflow of aqueous humor formation and destruction of the balance can lead to increased intraocular pressure,causes glaucoma

IOP↑ aqueous humor formation aqueous humor outflow normal IOP Any factors that led to the outflow of aqueous humor formation and destruction of the balance can lead to increased intraocular pressure , causes glaucoma increase IOP↑ decrease IOP↑

☒无法显示该图 片 IOP↑ ■ aqueous humor formation increase: Ciliary body secrete aqueous humor increase aqueous humor outflow decrease Trabecular meshwork outflow increased resistance (common) Episcleral venous pressure increase

IOP↑ ◼ aqueous humor formation increase: Ciliary body secrete aqueous humor increase ◼ aqueous humor outflow decrease • Trabecular meshwork outflow increased resistance (common) • Episcleral venous pressure increase

☒无法是示该图 Classification of the glaucomas Primary glaucoma:not caused by another systemic or local disease Secondary glaucoma:Due to another ocular or systemic disease developmental glaucoma:Anomalies of the anterior segment are present at birth

Classification of the glaucomas ◼ Primary glaucoma : not caused by another systemic or local disease ◼ Secondary glaucoma: Due to another ocular or systemic disease ◼ developmental glaucoma: Anomalies of the anterior segment are present at birth

☒无法显示该图 片 Evaluation of glaucoma ▣IoP:normal1021mmHg ▣Tonometry: Applanation tonometer Goldmann Indentation tonometer Schiotz

Evaluation of glaucoma  IOP： normal 10～21mmHg  Tonometry: ◼ Applanation tonometer ：Goldmann ◼ Indentation tonometer ：Schiotz

☒无法是示该图 Evaluation Gonioscopy

Evaluation Gonioscopy

☒无法显示该图 片 Evaluation ophthalmoscopy Macula 金 Optic Nerve Normal Glaucoma

Evaluation ophthalmoscopy Normal Glaucoma