小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 杯盘比>0.5
- 视神经杯切迹
- 周边视力缺损
- 眼压升高
- 暗点
- 视网膜神经纤维层丢失
- 视网膜出血
危险因素
- 眼压＞21 mmHg
- 年龄＞50 岁
- 青光眼家族史
- 黑种人族裔或西班牙裔
- 近视
- 糖尿病
- 高血压
- 低眼灌注压
- 薄中央角膜
诊断性检查
首要检查
- 眼压测量
- 前房角镜检查
- 直接检眼镜检查
- 间接检眼镜检查
- 裂隙灯生物显微镜检查
- 视野检测
需考虑的检查
- 视盘照相
- 超声角膜测厚
- 光学相干断层扫描
- 视网膜神经纤维层分析
治疗流程
首选滴眼液或有激光小梁成形术禁忌/激光小梁成形术治疗失败
首选激光小梁成形术或有滴眼液使用禁忌/滴眼液治疗失败
滴眼液禁忌/治疗失败和疾病快速进展
治疗失败
撰稿人
作者
Nishani Amerasinghe, MBBS, BSc(Hons), FRCOphth
Consultant Ophthalmic Surgeon
Glaucoma Specialist
University Hospital Southampton NHS Trust
Southampton
UK
利益声明
NA is president-elect of the UK and Éire Glaucoma Society and has acted as an unpaid advisor to NICE and The Royal College of Ophthalmologists. NA has served on an advisory panel for Santen and has received travel honoraria and speaker's fees from Thea Pharmaceuticals, Santen, and Allergan. NA has received research funding from AbbVie Pharmaceuticals.
Irena Serov-Volach, MD
Senior Glaucoma and Cataract Fellow
Ophthalmology department
Eye Unit
Epsom and St Helier University Hospitals NHS Trust
London
UK
利益声明
ISV has received consultancy/travel fees from Glaukos.
鸣谢
Dr Nishani Amerasinghe and Dr Irena Serov-Volach would like to gratefully acknowledge Dr Robert B. Avery and Dr Michael N. Wiggins, the previous contributors to this topic.
利益声明
RBA and MNW declare that they have no competing interests.
同行评议者
Richard A. Harper, MD
Associate Professor of Ophthalmology
Department of Ophthalmology
Jones Eye Institute
University of Arkansas for Medical Sciences
Little Rock
AR
利益声明
RAH declares that he has no competing interests.
Roshini Sanders, FRCS, FRCOphth
Consultant Ophthalmologist
Queen Margaret Hospital
Dunfermline
Fife
UK
利益声明
RS declares that she has no competing interests.
鉴别诊断
- 正常/低眼压性青光眼
- 闭角型青光眼
- 高度近视
更多 鉴别诊断指南
- 全面的眼睛和视力检查
- 青光眼：诊断和管理
更多 指南患者教育信息
青光眼
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
内容使用需遵循免责声明