1、Examination of the Eye (眼科检查法),杨霞霞,1 、History-taking(病史采集)： 2 、The examination of visual function(视功能检查)： 3 、Examination of the globe and its accessory organs(眼球及眼附属器检查)：,History-taking(病史采集)：,Subjective abnormal feelings(主观异常感觉)：,The examination of visual function(视功能检查),Visual acuity(视力，即视锐度) Dark
2、 adaption（暗适应） Colour sensation(色觉) Visual field(视野) Contrast sensitivity(对比敏感度) Visual electro-physiology(视觉电生理),一、Visual acuity(视力，即视锐度),The vision indicates visual acuity divided into far ,near vision, the latter normally means reading one.,1、the examination of far vision:,Naked/corrected vision:
3、裸眼、矫正视力 Pinhole glass:孔镜 Spherical aberration:球面像差 Finger count: 指数 Hand movement: 手动 Light perception:光感 Light-seeking:光定位,2、the examination of near vision:,Standard reading chart: Jaegers test chart: Myopia :近视 Presbyopia :老视,3、the theory of visual acuity:,The resolving power :分辨力 Visual angle :视角
4、,The examination of far vision needs abundant light or artificial illumination, the examined is at a distance of 5m from the chart, let the line 1.0 be at the same height of examined eye.,二、Dark adaption（暗适应）：,Threshold of light irritation:光刺激阈 Dark adaptation curve:暗适应曲线 Cone :视锥细胞 Rod :视杆细胞 Contra
5、st method:对比法 Dark adaptometer:暗适应计 Retinal pigmented degeneration: 视网膜色素变性,三、Colour sensation(色觉)：,四、Visual field(视野),五、Contrast sensitivity(对比敏感度),六、Visual electro-physiology(视觉电生理),Electrooculogram,EOG: 眼电图,Retinal pigmented epithelium:视网膜色素上皮 Photoreceptor cells: 光感受器细胞 The retinal static potent
6、ial: 视网膜静息电位,Electroretinogram,ERG:视网膜电图,The retinal active potential: 视网膜动作电位 Including a, b, c waves and oscillating potentials: 震荡电位,a: photoreceptor cells光感受器细胞b: bipolar cells双极细胞c: pigmented epithelium色素上皮细胞,Examination of the globe and its accessory organs(眼球及眼附属器检查)：,Examination of accessory
7、 organs of the eye:眼附属器检查 Examination of anterior segment of the eye:眼球前段检查 Examination with slit-lamp microscope:裂隙灯显微镜检查 Gonioscope: 前房角镜检查 Tonometry: 眼压测量 Examination of the fundus: 眼底检查,一、Examination of accessory organs of the eye:眼附属器检查,1、eyelids :眼睑ecchymoma: ,ekimum淤血emphysema :,emfsim气肿scar/
8、induration :瘢痕或残留物entropion or ectropion at palpebral margin：睑内翻/睑外翻eyelash: 睫毛trichiasis: ,trkess; trkass 倒睫aberrant lash: 乱睫,2、lacrimal apparatus: 泪道lacrimal puncta: 泪点eversion: 外翻occlusion: 阻塞 lacrimal sac: 泪囊tenderness: 压痛 fistula: 瘘管,Schirmers test: is performed with 5x35mm filter paper, one en
9、d is bent at the site of 5mm and inserted into the conjunctival sac at the inner part of 1/3 of the lower eyelid ,the rest of the filter paper is hanged on the skin surface of the,lower eyelid with both eyes closed gently ; after 5 minutes to measure the length of filter paper got wet by tears, norm
10、ally is more than 15mm on average, less than 5mm is regarded as abnormal.,lacrimal gland: 泪腺tear secretion: 泪液分泌stenosis or obstruction: 堵塞Fluorescein sodium test: 荧光素钠试验Washing of lacrimal passage: 泪道冲洗,3、conjunctiva: 结膜palpebral conjunctiva: 睑结膜bulbar conjunctiva：球结膜fornical conjunctiva: 穹窿结膜trans
11、parent：透明congestion： 充血papillary hypertrophy: pplr haptrf 乳头肥大,folliculosis :f,likjulusis 滤泡增殖symblepharon: 睑球粘连pigmentation: 色素沉着proliferative tissue: 新生物conjunctival or ciliary hyperemia: 结膜充血或睫状充血,4、position of globe: 眼球的位置palpebral fissure: 睑裂nystagmus: nstgms 眼球震颤strabismus: strbzms斜视Hertel exo
12、phthalmometer to measure the protrusion: Hertel 突眼计测量眼球突出度,二、Examination of anterior segment of the eye:眼球前段检查,1、cornea: 角膜keratic precipitate(KP): 角膜后沉着物corneal perception: 角膜感觉/viral keratitis 病毒性角膜炎/ the damage of trigeminal nerve三叉神经受损,opacity：混浊、不透明,staining with fluorescein sodium: 荧光素钠染色/ cor
13、neal epithelium: 角膜上皮,The corneal curvature :角膜弯曲度的检查 Placidos corneal disk : Keratometer: 角膜曲率计 Corneal topography: 角膜地形图,Normal: 正常/ a regular and clear concentric ring: 规则而清晰的同心圆 Oval :椭圆形/ regular atigmatism: 规则散光 Distorted shape: 扭曲者/ irregular atigmatism: 不规则散光 Pear shape: 梨形/ keratoconus 圆锥角膜
14、,Placidos 板,2、sclera: 巩膜,nodule: 结节/ hyperemia: 充血,jaundice: 黄染,3、Anteria chamber: 前房aqueous humor :房水,hypopyon: 前房积脓,4、Iris: 虹膜dipigmentation: 脱色素atrophy: 萎缩nodule: 结节iridodialysis: 虹膜根部离断coloboma: 缺损,5、Pupil ：瞳孔retardative: 迟钝relative afferent pupillary defect, RAPD: 相对性传入性瞳孔障碍,6、Lens: 晶状体to dilat
15、e pupil : 散瞳,三、Examination with slit-lamp microscope:裂隙灯显微镜检查,Projective system of light source: 光源投射系统 Optical magnifying system: 光学放大系统,Diffuse illumination(弥散光线照明法),It may be used to examine the tissue of anterior segment such as conjunctiva, cornea, sclera and others. 检查前节组织：如，结膜，角膜，巩膜等。,Direct
16、illumination(直接照明法),Specular reflection(后部反光照明法):,Indirect illumination(间接照明法）,血粘度增高患者球结膜血管的“淤泥化现象”，可见颗粒状血柱,圆锥角膜并混浊,色素KP,羊脂状KP,浅前房,Tyndall 现象,虹膜植入性囊肿,虹膜新生血管,晶状体脱位,核性晶状体混浊,绕核性晶状体混浊,正常玻璃体支架组织,四、Gonioscope: 前房角镜检查,Angle-closure glaucoma: 闭角型青光眼 Angle-open glaucoma：开角型青光眼,Direct/refractive(直接房角镜/光线的折射),
17、Indirect/reflective(间接房角镜/光线的反射),The anterior chamber angle(前房角),Anterior walls：,1、Schwalbes line: The terminal of corneal Descemets layer: 角膜后弹力层终止处 The boundary between the cornea and the trabecula: 角膜与小梁网的边界,2、trabecular network: 小梁网 A little yellow band structure: The canal of schlemm: Drainage
18、aqueous humor outflow: 房水排出的通路 3、scleral spur: 巩膜突,Crypts: 隐窝,Posterior wall: 后壁,Iris root: 虹膜根部,Classification：分类,Wide angle:宽角,Narrow angle:窄角,Grade 1: Eminence in different degree at the iris periphery, under dynamic condition the ciliary body may be seen to be wider or from invisible to be seen.
19、,Grade 2: the scleral spur may be seen but ciliary band in dynamic observation.,Grade 3: the scleral spur and the posterior part of the trabecular network cant be seen in dynamic observation ,but displacement of the focal line may be seen.,Grade 4: under dynamic observation ,apart from schwalbes lin
20、e , other angle structures cant be seen ,but displacement of the focal line.,五、 Tonometry: 眼压测量,Measurement by finger: 指测法Measurement by tonometer: 眼压计测量法,1、Measurement by finger: 指测法,The border of the upper tarsus: 上眼睑 Tn-normal IOP T+1-slight increase T+2-moderate increase T+3-very high IOP T-1-so
21、ft than normal T-2-moderate soft T-3-very soft,2、Measurement by tonometer: 眼压计测量法,压陷式眼压计（Schitz Tonometer） 压平式眼压计（Goldmann Tonometer） 非接触式眼压计(noncontact tonometer,NCT),、,To examine disorders of the vitreous(玻璃体), the retina（视网膜） ,the choroid（脉络膜）, the optic nerve（视神经）. “the window of the body” Dilate the pupil/mydriasis: 散瞳,六、Examination of the fundus: 眼底检查,Ophthalmoscopy: 检眼镜,Direct Ophthalmoscope: 直接检眼镜 Indirect Ophthalmoscope: 间接检眼镜,Observal of the fundus:眼底检查,1、optic disc/ optic papillae(视盘/ 视乳头),2、central retinal artery, vein,3、macular region: 黄斑区fovea centralis: 黄斑中心凹edema:,
