眼表面的腺體

淚液有三種成份：LAM (lipid+Aqueous+Mucin)

Lipid(Oil): holocrine
Meibomian glands + Zeis glands

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

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Mucin：屬holocrine
Goblet cells → 位於conjunctiva及caruncle

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Sweat:屬eccrine
Moll gland

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整理：

Aqueous皆是exocrine
Oil及mucous皆是holocrine
Sweat屬eccrine

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！）

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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

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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

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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。