敬請指教

本人才疏學淺,懇請諸位先進前輩不吝指正。歡迎光臨:空中視力保健室

2009年7月31日 星期五

眼表面的腺體


淚液有三種成份:LAM (lipid+Aqueous+Mucin)

Lipid(Oil): holocrine
Meibomian glands + Zeis glands



Aqueous:屬exocrine
lacrimal glands → 主淚腺
Krause,Wolfring glands → 位於eyelid上的副淚腺



Mucin:屬holocrine
Goblet cells → 位於conjunctiva及caruncle



Sweat:屬eccrine
Moll gland



整理:

Aqueous皆是exocrine
Oil及mucous皆是holocrine
Sweat屬eccrine

2009年7月27日 星期一

青光眼分類大表

依流出受阻機轉不同而作的青光眼分類(必考!)



Open-angle

一、Pretrabecular (membrane overgrowth)

 NVG, ICE,PPMD (也有機會發生在angle closure)
 Fuchs heterochromic iridocyclitis
 NV與PAS無關、也不屬於secondary angle-closure

二、 Trabecular (直接阻塞)

 Idiopathic : POAG, JOAG
 RBC: Ghost cell glaucoma
 Pigment : Pigmentary glauacoma, exfoliation syndrome
 Protein: uveitic glaucoma, lens-induced glaucoma
 Tumor: juvenile xanthogranuloma, metastasis, primary ocular tumors
 Viscoelastics: 眼內手術後,viscoat / healon沒吸乾淨
 α-chymotrypsin-induced glaucoma
 Trabeculum結構改變: steroids, trabeculitis, alkali burn, angle recession  IOFB: hemosiderosis, chalcosis

三、 Post-trabecular

 C-C fistula
 Sturge-Weber syndrome
 Mediastinal tumors , retrobulbar tumors
 Sup. vena cava syndrome
 Thyroid eye



Angle closure

一、 Anterior (Pulling)

 ICE, NVG, PPMD
 考題:NVG與pupillary block無關!而是與peripheral ant. synechiae相關
 Trauma(penetrating or non-penetrating皆可能)
Secondary angle-closure with NV : OIS, CRVO, chronic retinal detachment

二、 Posterior (Pushing)

 有pupillary block (考!)
 phacomorphic lens
 pseudophakia,
 intumescent lens
 micropherophakia
 uveitis
 ectopia lentis (如Marfan syndrome)

三、 無pupillary block

 PHPV, ROP
 Tumors: melanoma, retinoblastoma (記得要掃B-scan)
 Anterior chamber angle發育異常
 Axenfile-Rieger syndrome
 Peters anomaly



補充:

Angle Recession

cleavage between circular and the longitudinal fibers of the ciliary muscle.
Trabeculum往後轉,若範圍夠大,眼壓會升高。