最新眼科学教学资料 眼肌-本科-english. to教学讲义ppt.ppt

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1、眼科学教学资料眼肌-本科-english.tocase5y,Female，righteyestrabismusafer1ygeneraleyeexamination(-),VA(distance)：OD:4.3(0.2)OS:4.9(0.8)corneallightreflection（nearanddistance）：50Δeso，theangleofdeviationisthesameinalldirectionsofgaze，usuallylefteyefixation,righteyedeviationfullcycloplegi

2、crefactionOD:+2.50DS+0.50X090----4.4OS:+1.50DS+0.25X090----5.0extraocularmusclesfunctionmedialrectus内直肌:adduction内转Lateralrectus外直肌:abduction外转Superiorrectus上直肌:elevation上转adduction,intorsion内转内旋Inferiorrectus下直肌:depression下转adduction,extorsion内转外旋Superioroblique上斜肌:intor

3、sion内旋depression,abduction下转外转Inferioroblique下斜肌:extorsion外旋elevation,abduction上转外转ExaminationHistoryGeneraleyeexaminationVisualacuityDeterminationofrefractiveerrorDeterminationofangleofstrbismusDeterminationofangleofstrbismus斜视的定性和定量检查Covertest遮盖试验uncovertestalternatecov

4、ertestprismandcovertestCornealreflection角膜映光法Prism三棱镜法Synoptophore同视机检查法Determinationofangleofstrabismus1.Corneallightreflection2.Prismpluscorneallightreflection(Krimskytest)150300450FixationeyeDevitationeyephoria隐斜视Adeviationpresentonlyaferbinocularvisionhasbeeninterrupt

5、ed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。phoriaMechanism病因:1.muscularimbalance眼外肌肌力强弱、附着点异常以及节制韧带肌间膜有异常。2．Refractiveerror,accommodation/convergenceimbalance屈光不正的因素，调节与集合的不协调所致。3．Abnormalnervelinnervation眼外肌的神经支配异常所致。

6、4．Abnormalcentralnervelinnervation中枢性集合兴奋强弱异常。Esophoria内隐斜Tendencyforoneeyetoturninward眼位有内斜倾向SymptomsWillingtolookup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EsophoriaCorrectionofrefractiveerrorTrainsurgeryExophoria外隐斜Tendencyforoneeyetoturnoutward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Most

7、yduetotheproblemofconvergence。EasytotireExophoria外隐斜CorrectionofrefractiveerrorTrainsurgeryhyperphoria上隐斜TendencyforoneeyetodeviateupwardEasytotirehyperphoria上隐斜prismSurgery>10∆Nonparalytic,comitantesotropia共同性内斜Infantileesopropia先天性内斜OccurbeforesixmonthofageAlternationof

8、fixation,visionequalDeviationisoftenlarge>25°LowtomoderatehyperopiaVerticaldeviationmaybeobserve