Transillumination of the iris
•
Vital dyes
Fluorescein
•
Fluorescein and rose bengal
•
Seidal test
•
重点注意
• 患者进入诊室 • 自然光照明 • 寻找不同点 • 学会如何描述病变（硬度、颜色、形E, PPMD
failure
Secondary Acute or chronic trauma,
endothelial chemical, inflammatory,
failure
hypoxia
Normal
Elevated intraocular
endothelium pressure
Clinical evaluation
• History • Laterality • Age • Duration • Diurnal variation • Previous ocular disease • Pain
Slit lamp examination
• Epithelium • Stroma • Endothelium and Descemet’s membrane
•
裂隙灯检查法
角膜病专科 金涛
Direct illumination
Diffuse illumination
宽裂隙照明
光学区域照明（窄裂隙）
•
Edema Stromal opacities Marginal dystrophy Kayser-Fleisher ring Fuchs' dystrophy Corneal pannus Epithelial defect Corneal infiltrates Furrow dystrophy Lens opacities Dellen Microcysts Bullae Ectatic changes Anterior chamber depth Tear film deficiency Corneal thinning
镜面反射光
•
内皮观察
•
Indrect illumination
Proximal illumination
•
Sclerotic scatter
•
Corneal foreign bodies Corneal edema Keratic precipitates Verticillata Interstitial keratitis Granular dystrophy Radial keratotomy scars Hydrops
Retroillumination(fundus)
•
Lattice dystrophy Pseudoexfoliation Keratic precipitates Corneal scars Meesmann's dystrophy Map, dot, fingerprint dystrophy Lens vacuoles Cataract Corneal rejection lines
Retroillumination(iris)
•
Lattice dystrophy Corneal foreign bodies Meesmann's dystrophy Fingerprint, map, dot dystrophy Cornea farinata Descemet's folds Keratic precipitates Thygeson's superficial punctate keratitis Corneal infiltrates Early edema Filaments Microcysts Fuchs' dystrophy Corneal scars
Epithelial Epithelial defect failure
Primarily stromal, diffuse, progressive, irreversible
Primarily stromal, focal or diffuse, acute or chronic Primarily epithelial, microcystic, central or diffuse, acute Stromal, surrounding defect, acute
位置） • 比较各种不同照明的不同 • 学会使用后照法 • 用窄裂隙来确定病变深度
角膜溃疡
角膜溃疡
• 定义： • 分类
感染性 非感染性
•
角膜水肿
Causes of corneal edema
Classificati Etiologies on
Characteristics
Primary CHED, Fuchs' dystrophy