眼科重点.docx

1、眼科重点眼科重点（主观51分，客观49分，无平时分，黄色加双横线为重点中重点，你们懂的）一、Cornea DiameterHorizon, 11-12mmVertical, 10-11mm二、角膜由前向后分为5层：1)Epithelium, can be regenerated2)Bowmans layer3)Stroma, the most thick4)Descemets membrane，can be regenerated5)Endothelium三、Uvea 葡萄膜由向后分iris ,ciliary body, choroid 三个连续部分四、眼内腔包括 anterior chamb

2、er,posterior chamber ,vitrous cavity五、房水循环：Aqueous (watery fluid) is made from the glands located in the ciliary body.It then circulates in the posterior chamber, flow through the pupil and into the anterior chamber where it nourishes the cornea, and finally empties back into the blood stream after

3、passing through the trabecular meshwork and into Schemms Canal.六、Visual pathway包括6部分：1)Optic nerve2)Optic chiasm3)Optic tract4)Lateral geniculate body 5)Optic radiation6)Visual cortex七、眼外肌的神经支配：1.Oculomotor nerve(III): 1)Medial rectus muscle2)Inferior rectus muscle3)Superior rectus muscle4)Inferior

4、oblique muscle2.Trochlear nerve(): 1)Superior oblique muscle3.Abducens nerve(): 1)Lateral rectus muscle八、直接对光反射：when the light shines on one side of the pupil, it causes the pupil to be narrowedPupil light reflexLightpupil retina(macular) optic nerve chaismoptic tract brachium of superior colliculus

5、 epithalamus，pretectal area parasympathetic nerve(via cranial nerve ) ciliary ganglion pupil sphincter muscle九、眼眶orbit的7块骨头：1)Frontal bone2)Sphenoid bone3)Ethmoid bone4)Palatine bone5)Lacrimal bone6)Maxilla7)Zygomatic bone (malar)十、Hordeolum睑腺炎：An acute, painful, purulent, nodular inflammatory lesio

6、n of the eyelid gland tissue, often referred to as sty.内睑腺炎Internal hordeolum meibomian glands外睑腺炎External hordeolum Zeiss or Molls glands十一、外睑腺炎：.The eyelash follicle and its associated sebaceous glands and sweat glands or abnormal Moll (or Zeis) gland infection, called external hordeolum (hordeolu

7、m external) or external hordeolum; 十二、内睑腺炎the Department of meibomian gland is involved,forming a big swelling area, it is called internal hordeoluj namely inner sty.十三、Trichiasis (trichiasis)倒睫aberrant lashes乱睫It is a abnormal situation that refers to the rear of the eyelashes or irregular growth,

8、so that touching the eyeball十四、睑外翻Ectropion (ectropion of eyelid) ： eyelid leaves eyeball, turn outward, different degrees of palpebral conjunctiva exposed, often associated with lagophthalmos十五、近视myopia：the image of distant objects focuses in front of the retina in the unaccommodated eye十六、远视Hypero

9、pia：unaccommodated eye focus the image behind the retina.十七、散光Astigmatism：The eye produces an image with multiple focal points or lines.In regular astigmatism, there are two principal meridians, with constant power and orientation across the papillary aperture, resulting in two focal lines.十八、弱视Ambl

10、yopia ： prolonged abnormal visual experience in a child under the age of 7 years may lead to amblyopia(reduced visual acuity in the absence of detectable organic disease in one eye).十九、弱视的治疗：1)A child can be examined at any age, and treatment for amblyopia should be instituted as soon as the diagnos

11、is is made2)Elimination of causes, 3)occlusion therapy,4) optical drug therapy (suppression therapy), 5)visual stimulation therapy（CAM）, 6)combined therapy二十、Correction of Refractive Errors：1)Spectacle lenses2)Contact lenses3)Keratorefractive sugery4)Intraocular lenses5)Clear lens extraction for myo

12、pia 二十一、结膜充血与睫状充血的鉴别Conjunctival congestionciliary congestionColorFresh red Dark redSiteNear fornixNear corneal margin,vision NormalDecreaseVascular branchesClear Unclearvascular morphology,Coarse, bent,straight straightvascular origin,Posterior conjunctival artery,anterior ciliary arteryvascular le

13、velsThe ocular surface the deep layer under conjunctivasecretions,Yesnoblood vessels movingyesnociliary body compression,noyesresponses to epinephrineCongestion disapearance No disapearanceCommon diseaseConjunctivitisConjunctivitis, episcleritis, glaucoma, iridocyclitis二十二、泪膜Tear Film（重要）Definition:

14、 Tears form a thin layer approximately 7-10m thick that covers the corneal and conjunctival epithelium.Table 1 Composition of Tear FilmTitleThicknessSourceLipidlayer0.1mMeibomianglandsAqueouslayer7mMajor&minorlacrimalglandsMucuslayer2050nmConjunctivalgobletcellFunction of Tear Film1.To make the corn

15、ea a smooth optical surface by abolishing minute surface epithelial irregularities;2.To wet and protect the delicate surface of the corneal and conjunctival epithelium;To inhibit the growth of microorganisms by mechanical flushing and antimicrobial action;3.To provide the cornea with necessary nutri

16、ent substances.二十三、慢性泪囊炎概念PPT：DacryocystitisCommon in infant and postmenopausal womanSecondary to obstruction of lacrimal ductClinical findingsTearing and dischargeAcute formimflammation, pain, swelling and tendernessPurulent materialChronic formTearingMucoid materialRisk of endophthalmitis书：慢性泪膜炎是一

17、种较常见的眼病，在鼻泪管下端阻塞，泪囊内有分泌物滞留的基础上发生，常见致病菌为肺炎球菌、链球菌、葡萄球菌等。Chronic Dacryocystitis is a relatively common eye disease, in the lower nasolacrimal duct obstruction, stranded on the basis of the lacrimal sac with secretion, common pathogenic bacteria for pneumococcal staphylococcus, streptococcus, etc.二十四、结膜

18、炎临床表现Signs of conjunctivitis1.Hyperemia2.Chemosis3.Exudation4.Subconjunctival hemorrhage5.Papillary hypertrophy6.Follicles7.Pseudomembranes and membranes8.Scar formation9.Granulomas10.Phlyctenules11.Preauricular lymphadenopathy二十五、角膜炎： keratitis定义：Definition:Corneal defence decrease，Exogenous & endo

19、genous etiological factor，Inflammation of corneal organism病理过程：浸润期 (corneal infiltration)溃疡形成期 (corneal ulcer) 溃疡消退期 (Exelcosis extinction period )愈合期(Healing period ) 临床表现：Clinical Manifestation:Pain Photophobia Tearing Spasm of eyelid Visual activity decrease治疗原则：control infection，relieve inflamma

20、tory reaction，promote ulcer healing ，reduce scar formation 二十六、Classification of cataract:CongenitalAge-relatedComplicatedMetabolicToxicTraumaticAfter cataract二十七、clinical manifestations of cataract:Progressive visionMonocular vision or polyvisioncontrast sensitivityrefraction changeGlarecolour sens

21、e changedefect vision field 二十八、Classification of age-related cataract(senile)Cortical cataractNuclear cataractPosterior subcapsular cataract二十九、Morgagnis cataractthe dense brown nucleus will subside within the capsule due to gravity.This condition, referred to as Morgagnis cataract5.congenital cata

22、ractCataract which is hereditary or developmental disorder exists before or after birth,or forms gradually after birth6.after cataractAfter ECCE or lens trauma,the remaining cortex or lens epithelial cells proliferate,forming turbidity.三十、Operation method of cataractCouching of lensICCEECCEPhacoemul

23、sificationFemtosecond laser-assisted cataract surgeryIntraocular lens implantation三十一、after cataract surgery,how to correct vision activityArtificial lens implantationWear corneal contact lensWear high-degree glasses for hypermetropia三十二、Subluxation (partial dislocation): The suspension of the lens

24、(the zonule fibers) is slackened, and the lens is only partially within the hyaloid fossa.瞳孔区仍可见部分晶状体，散瞳后可见到部分晶状体的赤道部Luxation (complete dislocation): The lens is torn completely free and has migrated into the intraocular (vitreous body or, less frequently, into the anterior chamber)三十三、Posterior vit

25、reous detachment:A condition of the eye in which the vitreous membrane separates from the retina.三十四、Concept of glaucoma:it is a group of diseases charactered by optic nerve atrophy and visual function defection and the main pathogenic factor is the pathological IOP increasing.三十五、Clinical manifesta

26、tion of acute angle-closure glaucoma1) acute ACG : (1) It is charactered by the sudden increasing of IOP and thus bringing about symptoms and anterior segment tissues changes. (2) Clinical findings: pre-clinical stage,onset stage,interstitial stage,chronic progressive stage pre-clinical stage: acute

27、 onset ACG of one eye, the other enters this stage even it has no symptom there exists anatomical changes such as shallow anterior chamber, narrow anterior chamber angle with definite family history and the IOP increases after dark room test. aura stage: transient or repeated little attacks such as

28、iridization, foggy vision or headache. These attacks can relief soon . If tested, the IOP may be 30-50mmHg. acute onset : symptoms are severe headache, eyeball pain, blurred vision and nausea, vomiting. signs:mix hyperemia corneal edema high IOP dilated pupil shallow anterior chamber turbid aqueous

29、humor glaucomatous fleck or Vogt spot interstitial stage : refers to the relief after little attacks, the trabecular meshwork has not been damaged.definite little attack history ant.chm.angle is largely or completely openthe IOP can keep in a normal range with little or no drug agents. chronic stage

30、: refers to the relief after repeated little attacks or acute onset, the trabecular meshwork has been severely damaged, there are anterior chamber angle largely adhesion, optic nerve atrophy and visual field defection . absolute stage: refers to the cases with no light sense.三十六、青光眼治疗中视神经保护性治疗：1)Neu

31、rotrophic factors2)Antioxidant3)Glutamate antagonists4)Calcium channel blocker5)gene therapy6)Nerve regeneration or transplantation 三十七、major causes of blood vessel diseases related glaucoma新生血管性青光眼 are retinal vein obstruction视网膜静脉阻塞、diabetic retinopathy糖尿病性视网膜病变 and other diseases.三十八、Uveitis葡萄膜炎 is caused of 4 kinds of hypersensitivity, type hypersensitivity三十九、Anterior Uveit