斜视和弱视(英文版)课件

Nonparalytic ,comitant esotropia 共同性内斜
Infantile esopropia
先天性内斜
❖Occur before six month of age ❖Alternation of fixation ,vision equal ❖Deviation is often large >25° ❖Low to moderate hyperopia ❖Vertical deviation may be observed ,overaction
❖History ❖General eye examination ❖Visual acuity ❖Determination of refractive error ❖Determination of angle of strbismus
Determination of angle of strbismus斜 视的定性和定量检查
50Δeso，the angle of deviation is the same in all directions of gaze，usually left eye fixation ,right eye deviation full cycloplegic refaction
OD: +2.50DS+0.50X090----4.4 OS: +1.50DS+0.25X090----5.0
Esophoria 内隐斜
❖Tendency for one eye to turn inward眼位有
内斜倾向 ❖ Symptoms
❖Willing to lookup病人喜欢向上看以减轻症状，因向
上眼位可略分开而克服部分内隐斜
Esophoria
❖Correction of refractive error ❖Train ❖surgery
Exophoria 外隐斜
❖Tendency for one eye to turn outward指眼位
有外斜倾向，平时受融合反射控制不出现偏斜，能保持双 眼单视
❖Mosty due to the problem of convergence。 ❖Easy to tire
Exophoria外隐斜
2．Refractive error, accommodation /convergence imbalance屈光不正的因素，调节与集合的不
协调所致。
3．Abnormal nervel innervation眼外肌的神经支配异常 所致。
4． Abnormal central nervel innervation 中枢性集 合兴奋强弱异常。
Strabismus & Amblyopia
case
5y, Female ，right eye strabismus afer 1 y
general eye examination (-) , VA(distance)： OD: 4.3(0.2) OS: 4.9(0.8) corneal light reflection（near and distance）：
❖Cover test 遮盖试验 uncover test alternate cover test prism and cover test
❖Corneal reflection 角膜映光法 ❖Prism 三棱镜法 ❖Synoptophore 同视机检查法
Determination of angle of strabismus
extraocular muscles function
❖medial rectus 内直肌: adduction 内转
❖Lateral rectus 外直肌: abduction 外转
❖Superior rectus 上直肌: elevation上转 adduction,intorsion内转内旋
Binocular Vision 双眼单视分级
❖Simultaneous perception ❖Sensory fusion ❖ Stereopsis
Sensory changes in strbismus 斜视的双眼视觉改变
❖Diplopia 复视 ❖Suppression 抑制
❖Anomalous retinal correspondence异常 视网膜对应
❖Correction of refractive error ❖Train ❖surgery
hyperphoria上隐斜
❖Tendency for one eye to deviate upward ❖Easy to tire
hyperphoria上隐斜
❖ prism ❖Surgery >10∆
❖Eccentric fixation 偏心 注视
❖Amblyopia 弱视
Strabismus 斜视
❖ Deviation from perfect ocualr alignment 斜视指的是两眼向前注视 时，两只眼位不平行，有 一只眼向内斜（内斜视） 或向外斜（外斜视）,或向 上(上斜)。
Examination
1.Corneal light reflection
2.Prism plus corneal light 150 300 450
reflection (Krimsky test)
Fixation eye
Devitation eye
phoria隐斜视
❖A deviation present only afer binocular vision has been interrupted
隐斜视是指二眼在分离情况下（如遮一眼），融 合功能被打断而出现偏斜，除去遮盖，融合功能 恢复，则眼球又成正位 ❖ Duke-Elder统计在人群中正位眼仅占10％左右， 而90％的人都有一定程度的隐斜。
phoria
❖Mechanism 病因 :
1.muscular imbalance 眼外肌肌力强弱、附着点异常以及节 制韧带肌间膜有异常。
❖Inferior rectus下直肌: depression 下来自百度文库 adduction ,extorsion内转外旋
❖Superior oblique 上斜肌: intorsion内旋 depression,abduction下转外转
❖Inferior oblique下斜肌: extorsion外旋 elevation,abduction上转 外转