小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 虹视
- 眼痛或眉弓部疼痛
- 头痛
- 恶心、呕吐
- 视力下降
- 眼红
- 眼压升高
- 角膜水肿
- 瞳孔散大且固定
其他诊断因素
- 偶然发现的眼部阳性体征
- 视力模糊
- 角膜滞后量
- 视力改变
危险因素
- 女性
- 远视
- 浅前房
- 对侧眼发生房角关闭
- 因纽特人种和亚洲人种
- 高龄
- 家族史
- 药物作用引起房角变窄
- 角膜滞后量
诊断性检查
首要检查
- 房角镜检查,针对房角的检查。
- 裂隙灯检查
- 静态自动视野检查
需考虑的检查
- 超声生物显微镜检查
- 前节OCT检查(评估房角形态)
- 眼底镜检查评估视盘情况
- OCT检查
- HRT
- GDx神经纤维分析仪检查
新兴检查
- 角膜滞后量
治疗流程
首发症状:急性闭角型青光眼
首发症状:慢性闭角型青光眼
激光周边虹膜切开术后残余闭角伴眼压升高
急性闭角型青光眼复发
撰稿人
作者
Brian A. Francis, MD, MS
Riffenburgh Professorship in Glaucoma
Associate Professor of Ophthalmology
Doheny Eye Institute
Department of Ophthalmology
Keck School of Medicine
University of Southern California
Los Angeles
CA
利益声明
BAF is a consultant for Diopsys, Endo Optiks, Glaukos, NeoMedix, and Bausch Health. BAF is a speaker for Bausch + Lomb, and has given expert opinion to Valentine Law Group and Reback, McAndrews, Kjar, Warford & Stockalper, LLP.
Stephanie Midtling, MD
Glaucoma Fellow
Department of Ophthalmology
UCLA Stein Eye Institute
Doheny Eye Centers UCLA
Los Angeles
CA
利益声明
SM declares that she has no competing interests.
鸣谢
Dr Brian A. Francis and Dr Stephanie Midtling would like to gratefully acknowledge Dr Ani Khondkaryan, Dr Yaniv Barkana, and Dr Noa Chetrit, previous contributors to this topic. AK, YB, and NC declare that they have no competing interests.
同行评议者
Gus Gazzard, MA, MBBChir, MD, FRCOphth
Consultant Ophthalmic Surgeon
King's College Hospital
Honorary Research Fellow
Institute of Ophthalmology
London
UK
利益声明
GG declares that he has no competing interests.
Edward J. Rockwood, MD
Associate Professor of Ophthalmology
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
Cole Eye Institute
Cleveland Clinic
Cleveland
OH
利益声明
EJR has received one honorarium from Pfizer, Inc. (manufacturers of Xalatan) for a speaking engagement.
鉴别诊断
- 开角型青光眼(原发性和继发性)
- 其他视神经病变
- 眼外伤
更多 鉴别诊断指南
- 青光眼概要基准
- 视力康复的首选实践模式
更多 指南患者教育信息
青光眼(开角型)
更多 患者教育信息- 登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容
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