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闭角型青光眼

最后审阅: 1 Nov 2024
最后更新: 10 Nov 2023

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
完整详情

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
完整详情

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
完整详情

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
完整详情

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
完整详情

新兴检查

  • 角膜滞后量

治疗流程

急症处理

首发症状:急性闭角型青光眼

首发症状:慢性闭角型青光眼

持续性治疗

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.

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