最新【临床医学】晶状体、玻璃体病PPT课件

• (2) 未熟期（immature stage)：又称膨胀期 (intumescent)。晶体混浊继续加重时，渗 透压改变，在短期内有许多水分积聚，晶 体急剧肿胀，体积变大，将虹膜向前推移， 前房变浅，可诱发急性闭角型青光眼。晶 体呈不均匀的灰白色混浊，视力明显减低。
• The opacity gradually becomes obvious, the cortex absorbs water to swollen. Lens
volume increases to push iris forward and the anterior chamber shallows, and may induce acute attack of glaucom.
• 4. 按混浊的程度(according to the degree of opacity)：初期（incipient)、 未熟期(immature)、成熟期(mature)、 过熟期(hypermature)。
• 5. 按混浊形态(according to the shape of opacity)：点状(punctate)、冠状 (coronary)、板层白内障(lamellar)。
• (1) 初期（incipient stage): 晶体皮质内出现 空泡、水裂和板层分离。空泡为圆形透明 小泡，位于前后皮质中央部或晶状体缝附 近。水裂的形态不一，从周边向中央逐渐 扩大。板层分离多在皮质深层，呈羽毛状。 楔形混浊常见。位于前后皮质，尖端向着 晶体中心，基底位于赤道部。
• Cuneiform opacity appears at the periphery of anterior and posterior cortex, its base is at the equator, its tip towards the center, often occurring at lower part, then similar opacity occurs at bilateral and upper parts, then forms wheel-like opaque. The pupillary area is not affected, commonly without blurred vision. The early phenomenon is separation of lens fibrous lamina like feather, sometimes vacuole appears.
【临床医学】晶状体、玻璃体 病
• 晶状体（lens)为双凸形状，有弹性，是 无血管的透明组织，具有复杂的代谢过 程。营养主要来自房水。它是眼屈光间 质重要的组成成分。主要的病变是其透 明度和位置的改变，都会严重影响视力。
The lens is a kind of avascular transparent tissue with complex metabolic process. Its nourishment mainly comes from aquous humour. The disorder of the lens is commonly loss of its transparency and abnormality of its position; both can induce severe visual disturbance.
临床表现（clinical findings)
• 常双眼患病，但发病可有先后，严重程度 也不一致。主要症状为眼前阴影和渐进性、 无痛性视力减退。由于晶体吸收水分后体 积增加，屈光力增强。因晶体纤维肿胀和 断裂，使屈光度不均一，可出现单眼复视 或多视。因光线通过部分混浊的晶状体时 产生散射，干扰视网膜上成像，可出现畏 光和眩光。
• 症状（symptoms) • 主要症状是视力模糊、减退、并可致盲。
其视力障碍与晶体混浊的位置有关。
• 自觉症状有以下3点： • 1.眼前出现固定不动的黑点； • 2.单眼多视，物像变形或出现重影； • 3.晶体性近视的出现是由于晶体核硬化。
体征(signs)
• 表现为各种类型的混浊，形态多样， 完全混浊的晶体，白瞳症是最明显 的体征，而在此之前受白内障种类 及程度的影响，瞳孔区可呈现灰白 色、淡黄、棕色等色调。
• 1. 皮质性白内障（cortical cataract): 最为常 见。按其发展过程分为4期。
• It is the most common type of senile cataract, according to the development; it is divided into 4 stages.
年龄相关性白内障
（elated cataract)
• 是中老年开始发生的晶状体混浊，随着年龄增加， 患病率明显增高。由于它主要发生于老年人中， 又称老年性白内障。分为皮质性、核性和后囊下 三种类型。
• is the most common one, often seen in the elder more than 50 years old. With aging its morbidity rate goes higher. It is gradually appeared degenerative change in the course of lens aging. Its pathologic mechanism isn’t understood completely yet, related with ultraviolet ray, with systemic disease such as diabetes, hypertension, arteriosclerosis, genetic factor as well as lens nourishment and metabolic condition and so on.