临床医学眼科学课件眼睑疾病.ppt

医学课件园 Diseases of eye lids 北京大学人民医院眼科 陈晶华 the anatomy of lids upper and lower lids上下睑 palpebral margine 睑缘(Zeis Moll) palpebral fissure 睑裂 内外眦angulus oculi 泪阜caruncula lacrimalis the anatomy of lids Skin 皮肤层 Subcutaneous tissue皮下组织层 Orbicularis muscle肌层 Tarsus 睑板层 Meibomian Conjunctiva 结膜层 The blood supply of eye lids 眼睑动脉弓由颈外动脉的面动脉支和颈内动脉的眼动脉支组成 浅—颈内颈外静脉 深—海绵窦 耳前、腮腺、颌下淋巴结 The function of the lids and treatment Diseases of lids Inflammation Tumor Dislocation and malfunction Blepharitis睑缘炎 Squamous blepharitis鳞屑性 Ulcerative blepharitis溃疡性 Angular blepharitis 眦部 Squamous blepharitis鳞屑性 病因：睑缘皮脂溢出造成的慢性炎症 症状：痒、痛、烧灼 检查：红、鳞屑、分泌物、痂、睫毛脱落可再生 治疗：去因、3%硼酸 Ulcerative blepharitis溃疡性 病因：多为金葡菌引起的睫毛及腺体慢性或亚急性化脓炎症。 症状：严重痒、痛、烧灼 检查：分泌物多、小脓泡、痂、溃疡、睫毛脱落不再生 治疗：去因、3%硼酸、抗生素膏 Angular blepharitis 眦部 病因：Morax-Axenfeld, deficiency of Vit B2 。 症状：痒、异物、烧灼 检查：双侧红、糜烂 治疗：0.2%-0.25%硫酸锌眼水、 Vit B2 Staphylococcal blepharitis Chronic staphylococcal blepharitis. A. Chronic erythema and induration of the lid margin due to colonization of the lid margin with pathogenic staphylococci. B. Characteristic features of the lid margin with staphylococcal disease including collarettes and hordeola. Differentiation diagnosis Sebaceous gland carcinoma in the upper and lower lids that resembles chronic blepharitis Hordeolum 睑腺炎 外睑腺炎－麦粒肿 内睑腺炎－睑板腺感染 临床特点：红、肿、热、痛、淋巴结 治疗：热敷、抗生素、切开排脓、全身治疗 Deterioration 恶化 蜂窝组织炎－全身感染 Chalazion睑板腺囊肿 睑板腺特发的无菌性慢性肉芽肿 特点：无痛结节 治疗：热敷、激素、手术 Granulomas 肉芽肿 Pyogenic granulomas in conjunctiva over chalazions in the upper and lower eyelids Differentiation diagnosis（1） Sebaceous gland carcinoma in the lower lid. Differentiation diagnosis（2） Differentiation diagnosis（3） Normal lid positions 眼睑与眼球 睫毛 闭合 眼睑与瞳孔 泪点 Trichiasis aberrant lashes倒睫与乱睫 病因：睑内翻、炎症、外伤 临床：眼疼、流泪、异物感、角膜损伤 治疗：拔、电解、手术 Entropion睑内翻 Classification: Congenital Spastic Cicatricia Manifestation: stimulation and cornea Treatment Ectropion睑外翻 Classification: Cicatricia Senile Paralytic Manifesitation: tearing dry eye Tre