eye disease
Introduction
Introduction to eye disease Eye diseases are diseases that occur in the eye, abnormalities, atrophy, and damage of the eye tissue and its functions, including diseases such as eyelids, eyelids, and eye muscles. Common eye diseases include conjunctivitis, keratitis, periodic ophthalmia, and cataract, which seriously affect behavioral activities. Prevention of eye diseases not only requires early examination, early detection, early treatment, but also pay attention to the usual eye protection, try to protect your eyes and avoid excessive eye fatigue. For reasonable diet, for those who use computers for a long time, they should eat more fresh vegetables and fruits, and increase the intake of vitamins A, B1, C, and E to prevent corneal dryness, dry eyes, decreased vision, and even night blindness. Bean products, fish, milk, walnuts, tomatoes, etc. can be eaten regularly, which is good for the eyes. basic knowledge Probability ratio: depending on the eye disease Susceptible people: all types of people are morbid people Mode of transmission: Individual eye diseases are contagious, such as trachoma Complications: malignant glaucoma glaucoma ciliary inflammatory syndrome acute hemorrhagic conjunctivitis acute catarrhal conjunctivitis gonococcal conjunctivitis
Cause
Cause of eye disease
Infection (15%)
Commonly known as "red eye disease" is infectious conjunctivitis, also known as fulminant fire eye, is an acute infectious eye disease. The disease can occur throughout the year, more common in spring and summer. Pinkeye is a contagious eye disease, such as contact with a patient's used towel, face wash, faucet, door handle, pool water, public toys, etc. Therefore, the disease is widely spread in kindergartens, schools, hospitals, factories and other collective units, causing outbreaks.
Red eye disease generally does not affect vision. If a large amount of mucopurulent secretion adheres to the surface of the cornea, there may be temporary blurred vision or rainbow vision (a rainbow-like aperture in front of the eye). Once the secretion is wiped off, the vision can be clear. . If a bacterial infection affects the cornea, photophobia, tearing, and pain increase, and vision will decrease to some extent.
Eyelid edema (12%)
Because the eyelids are loose and the subcutaneous tissue is loose, edema is prone to occur. There are many causes of eyelid edema, but they all occur on the basis of capillary damage. Common reasons:
(1) inflammation of local or surrounding tissues of the eyelid;
(2) blood or lymphatic reflux block;
(3) Allergies, systemic diseases, etc.
Crying, insomnia, prone, eating too salty, drinking a lot of water within two hours before going to bed, women before menstruation, pregnancy will cause eye edema in the morning when waking up. Long-term lack of sleep or excessive use of the eye is also a common cause of eye edema. In addition, eye diseases such as stye, sputum, conjunctivitis, bacterial infections, eyelid inflammation, eye tumors, etc. can also cause eye edema.
Disease factor (20%)
Eyeball protrusion refers to the position of the eyeball in the eyelid to make the front of the eyeball excessively exposed to the outside of the eyeball, which is an important sign of inflammatory and space-occupying diseases of the eyelid. The direction in which the eyeball protrudes is generally opposite to the location and direction of the lesion. There are many causes of eyeball protrusion and congestion and swelling, such as high myopia, hyperthyroidism, eye diseases such as eye tumors, etc. Special inspections can be made clear.
Bad stimulation (5%)
Anyone who secretes excessive tears due to eye inflammation, foreign body irritation, emotional impulses, etc. is called tears. Anyone with dysfunction in any part of the lacrimal duct causes tears to overflow. The mucosal secretions usually seen on the corners of the eyes, especially in the inner corners of the eyes, are eyelids, commonly known as eyelids. Healthy eyes are not blind. When the eye suffers from eye diseases, due to the stimulation of conjunctivitis inflammation, the secreted mucoids increase, and mixed with pathogenic bacteria, tears, and cells exuded by blood vessels due to inflammation, forming mucosal secretions. Its just a blind eye. Therefore, the eyelid is caused by the lesion of the conjunctiva and is closely related to the disease of the eye.
Bad habits (10%)
In life, we often find some children squinting or squinting at their heads, and some of them are holding their lower jaws or holding their lower jaws. These bad visual phenomena may not be due to bad habits, but because some of the eye muscles of both eyes are paralyzed or not paralyzed by certain diseases.
After one or more of the eye muscles have paralyzed, the muscle strength is weakened or completely disappeared, which will inevitably lead to the muscle strength of the healthy eye muscle corresponding to it being stronger than the paralyzed eye muscle, which makes the position of the eyeball unbalanced and cannot Maintaining a positive position creates a bias. This is strabismus. This type of strabismus is called paralytic strabismus. If the eyes are not in the right position, the object can not fall in the corresponding position in both eyes when the eyes are viewed, and double vision will occur. In order to overcome double vision, the child uses the hoe to compensate for the deviation of the eyeball and promotes fusion to avoid double vision. This is also called the ocular torticollis or the compensatory head position.
Prevention
Eye disease prevention
Prevention of eye diseases not only requires early examination, early detection, early treatment, but also pay attention to the usual eye protection, try to protect your eyes and avoid excessive eye fatigue.
First, don't use your eyes too close
When looking at the near object, in order to make the object accurately image on the retina, the eye ciliary muscle loop fiber begins to shrink, the crystal suspensory ligament relaxes, the lens protrudes to the front by its own elasticity, the lens convexity becomes larger, and the refractive power is enhanced. In this way, the scattered light emitted by the near object can also be imaged on the retina, and the human eye can see the near object. The regulation of the eye is closely related to age. The older the age, the smaller the crystal regulation power, and the farther the eye is near. Long-term close-up use of the eye, excessive adjustment of the eye, there is not enough residual adjustment force for spare, so the eyes are prone to fatigue, forming pseudo myopia. Over time, it causes the anterior and posterior diameter of the eyeball to become longer, forming true myopia, severely reduced vision, and some develop into high myopia. Long-term close-up use of the eye is the most important reason for the formation of myopia.
Educate the children to do the right posture, the head is neck and neck, the body is straight, and the eyesight should be at right angles to the book plane. Pay attention to three distances: one foot, one punch, one inch. That is, when reading and writing, the distance between the eye and the book should be more than one foot; the distance between the body and the desk should be kept at a fist; when holding the pen, the hand and the tip should be kept at an inch distance.
Second, do not use the eyes for a long time
The burden of the coursework is too heavy. In order to complete a lot of homework, I will continue to read and write for a few hours without rest. In this way, the eyes are used for a long time, so that the eyesight burden is too heavy. When there is no relaxation, the intraocular and extraocular muscles continue to be tense, and the increased intraocular pressure is caused by sputum and gradually forms myopia.
Third, do not walk, read a book while riding
When walking, the hand will often shake. When you ride, the car will move from time to time. The distance between the book and the eyes will change constantly. The two eyes see more moving targets, and the center receives a blurred image. If you want to see the font on the book, you have to put the book close to your eyes. In the myopic environment, it is also necessary to constantly change the adjustment of the eyes in order to see the font. The intraocular muscles are constantly stressed, which can easily cause visual fatigue and regulate paralysis.
4. Don't read or write in glare or daylight.
Too much or too weak light can have an adverse effect on the eyes. People regulate the light entering the eye by zooming in or out of the pupil. We only need 100 meters of candlelight to read and write on a daily basis, while reading in the sun, the illumination can reach 80,000 to 120,000 meters of candlelight, which is 800 to 1000 times of daily illumination. In addition, because the light is too glaring, look at it for a while, it feels that there are black shadows in front of the eyes, which is the post-image effect of the macular area of the retina after being stimulated by strong light. Long-term reading in strong light, excessive regulation of intraocular muscles, will promote the occurrence and development of myopia, glare damage to the retina, especially the macular area, so that visual acuity declines, and even cause permanent vision loss. Reading in strong sunlight for a long time, strong ultraviolet radiation can easily damage the cornea and lens.
Five, don't watch TV for a long time
Form an important cause of myopia. The radiation emitted by the TV tube can consume a large amount of rhodopsin in the retina. Nowadays, people are spending more and more time with TV, which is even more harmful to students' vision. Pay special attention to protecting your eyes when watching TV.
Complication
Eye disease complications Complications malignant glaucoma glaucoma ciliary inflammatory syndrome acute hemorrhagic conjunctivitis acute catarrhal conjunctivitis gonococcal conjunctivitis
The complications of eye diseases mainly depend on the primary eye diseases. Complications include malignant glaucoma, glaucoma ciliary inflammatory syndrome, acute hemorrhagic conjunctivitis, acute catarrhal conjunctivitis, and gonococcal conjunctivitis.
Symptom
Symptoms of eye disease Common symptoms Eye redness increased eye pain Eye itch corneal detachment Eyelid edema eyelids have obvious ... Vision deformation fever with eye congestion eyes tingling
First, trachoma
Chlamydia trachomatis mainly invades the palpebral conjunctiva, which may have congestion and blood vessel blur, nipple hypertrophy, follicular hyperplasia, corneal vasospasm, and finally end with scar formation.
1. Phase I (progress)
That is, during the active period, the nipple and the follicle coexist at the same time, the conjunctival tissue of the upper iliac crest is unclear, and there is corneal vasospasm.
2. Phase II (regression period)
From the onset of scarring to the majority of scars, only a few active lesions remain.
Stage 3 (complete fecal period)
The active lesion disappeared completely and replaced with a scar and was not contagious. The criteria for grading: according to the total area of the upper conjunctiva of active lesions, divided into light (+), medium (++), heavy (+++) secondary, accounting for less than 1/3 of the area (+ ), accounting for 1/3 to 2/3 (++), accounting for 2/3 or more (+++).
Second, cataract
Single or bilateral, the incidence of both eyes may be sequential, vision decline, due to crystal cortical opacity, different refractive power of different parts of the lens, may have glare, or single eye double vision, increased myopia, clinically senile cataract It is cortic, nuclear and subcapsular.
1, cortical cataract
The main characteristics of crystal cortical gray turbidity, its development process can be divided into four phases: initial stage, immature stage, mature stage, over-ripe period.
2, nuclear cataract
Crystal opacity increases from the center of the lens, that is, the position of the embryonic nucleus, gradually increases and gradually expands to the periphery. It is pale yellow in the early stage. As the turbidity increases, the color gradually deepens as deep yellow, dark brownish yellow, and the density of the nucleus increases. The refractive index increased, the patient often complained that the reduction of myopia or the increase of myopia, the early peripheral cortex is still transparent, therefore, the dilated pupils in the dark place increased visual acuity, while in the strong light, the pupil reduces the visual acuity but decreases, so generally do not wait for the cortex Surgery is complete turbidity.
3, posterior capsule cataract
The opacity is located in the subcapsular cortex of the lens, and if it is located in the visual axis, it affects vision early.
Third, glaucoma
1, ametropia (ie, myopia, hyperopia) secondary glaucoma due to refractive system adjustment disorders, ciliary muscle dysfunction, imbalance of aqueous humor secretion, combined with the iris root compression anterior chamber angle, aqueous drainage is blocked, so cause eye pressure rise High, the clinical characteristics of such patients are self-conscious fatigue symptoms or no obvious discomfort, wearing glasses can not correct vision, easy to misdiagnose.
2, cornea, conjunctiva, uveitis and other secondary glaucoma inflammation caused by aqueous humor, ciliary muscle, iris, corneal edema, shallow angle of the horn or adhesion of the pupil, trabecular mesh obstruction, aqueous humor can not be properly discharged caused by the eye The pressure rises.
3, cataract secondary glaucoma crystal opacity in the development process of edema enlargement, or translocation leading to relatively narrow anterior chamber, drainage of aqueous humor is blocked, causing elevated intraocular pressure, once cataract surgery, the optic nerve atrophy and blindness.
4, traumatic glaucoma corner tear, iris root break, or anterior chamber blood, vitreous hemorrhage, retinal shock, so that the secretion of aqueous humor, discharge pathway blocked, secondary glaucoma optic atrophy.
Fourth, red eye disease
1. Severe pain, photophobia, tearing and other severe irritation and watery secretions;
2, eyelid swelling, conjunctival hyperemia, edema, subconjunctival point, flaky or extensive bleeding;
3, corneal diffuse punctate epithelial shedding, fluorescein coloring;
4, the ear or submandibular lymph nodes.
Five, conjunctivitis
The foreign body sensation, burning sensation, heavy eyelids, and increased secretions may cause photophobia, tearing, and varying degrees of visual loss when the lesion involves the cornea.
Six, keratitis
In addition to paralytic keratitis, most patients with keratitis have symptoms of inflammation, such as pain, shame, tearing, and eyelids. Patients with keratitis not only have ciliary congestion, but also iris congestion. Edema can occur in the conjunctiva of the severe patient or even in the eyelids.
Corneal inflammation necessarily affects vision more or less, especially if inflammation invades the pupil area. The scar formed by the healing of the ulcer not only hinders the light from entering the eye, but also changes the curvature of the cornea surface and the refractive power of the refractive lens, so that the object cannot be focused on the retina to form a clear image, and thus the vision is lowered. The degree of vision involvement depends entirely on the location of the scar. If it is in the middle of the cornea, even if the scar is small, it affects vision.
Seven, scleritis
1, anterior scleritis
The lesion is located in front of the equator. Both eyes have developed disease and the eye pain is severe. It lasts for several weeks and can last for months or even years. Can be complicated by keratitis, uveitis, cataract, elevated intraocular pressure. Can be divided into three categories:
(1) Nodular scleritis lesion area sclera purple red congestion, inflammation infiltration swelling, nodular bulge, hard, tender, nodules can be multiple.
(2) diffuse scleritis diffuse congestive, conjunctival edema, sclera is characteristic blue.
(3) necrotizing scleritis is highly destructive, often causing inflammation of visual impairment. Eye pain is obvious, early local scleral inflammatory plaque, marginal inflammation is heavier than the center. Late scleral necrosis thins, sees the choroid, and even perforation. The lesion can spread rapidly and backwards and around. After the inflammation subsided, the sclera was blue-gray and the large blood vessels surrounded the lesion. Often accompanied by severe autoimmune diseases such as vasculitis.
2, posterior scleritis
Less common, for a granulomatous inflammation, located in the posterior equator sclera. There are varying degrees of eye pain and decreased vision. There was no significant change in the anterior segment of the eye. There may be slight redness. The posterior segment is characterized by mild vitreitis, optic disc (visual papillary) edema, serous retinal detachment, and choroidal folds.
Examine
Eye examination
Eyelid examination: It is usually used for observation and palpation in natural light.
Main observations:
1 eyelids have congenital anomalies, such as eyelid defects, cleft palate, ptosis and so on.
2 eyelid skin abnormalities, such as red, swollen, hot, pain, subcutaneous emphysema, lumps and so on.
3 The position of the eyelid is abnormal, such as the width and width of the bilateral cleft palate, and the presence or absence of internal and external valgus.
4 edge and eyelashes are abnormal. Laryngeal examination: including the lacrimal gland and the lacrimal duct. Check the presence or absence of a lump in the lacrimal gland area, pay attention to the presence or absence of internal and external valgus and occlusion in the location of the punctum, whether there is redness, tenderness and fistula in the lacrimal sac area, whether the secretions overflow from the punctum when the lacrimal sac is squeezed, and the secretion of tears is checked by the device. Quantity, whether the lacrimal duct is narrow and obstructed. Conjunctival examination: pay attention to the color of the conjunctiva, smooth and transparent, with or without congestion and edema, nipple hyperplasia, follicles, scars, ulcers and new masses. Eyeball and eyelid examination: When checking, pay attention to the size of the eyeball, the shape and position of the eyeball, and whether there is any involuntary nystagmus.
Anterior segment examination: including examination of the cornea, anterior segment of the sclera, anterior chamber, iris, pupil, and crystal. Corneal examination: pay attention to the size and transparency of the cornea, surface smoothness, neovascularization, curvature and perception. Scleral examination: pay attention to the sclera with or without yellow staining, nodules, congestion and tenderness. Anterior examination: pay attention to the depth of the anterior chamber, whether there is turbidity, blood, empyema, foreign body, etc. in the aqueous humor. Iris examination: pay attention to iris color, texture, presence or absence of new blood vessels, atrophy, nodules, cysts, adhesions, presence or absence of iris roots, defects, tremors and bulging. Pupil examination: pay attention to the size, position and shape of the pupil, whether there is exudate, mechanical film and pigment in the pupil area, whether the pupil directly reflects light, indirectly reflects light, and has near reflection. Crystal inspection: Pay attention to crystal transparency, position and crystal presence.
Laboratory tests include:
Eye CT: Also known as computed tomography, it uses X-rays, ultrasound, isotopes, etc. as energy sources to obtain tomographic images through scanning of the examined site and reconstruction of the computer.
MRI: Chinese is called magnetic resonance imaging, the original name is nuclear magnetic resonance. Because "nuclear" is suspected of being unstable and radioactive in medicine, it has been collectively referred to as magnetic resonance imaging in recent years. It uses the principle of magnetic resonance (when the nucleus placed in a strong magnetic field is excited by electromagnetic waves of a specific frequency to absorb energy, it transitions from a low energy level to a high energy level. This phenomenon is called magnetic resonance, and the subsequently excited nucleus will return. In the original state, while releasing energy, the energy released from the hydrogen nuclei of the human body is detected in the form of electromagnetic waves, and then input into an electronic computer, and processed to obtain a tomographic image of the human body.
Hess' screen test is used to help check the relative state of nerve excitement during the movement of the two eyeballs, and to identify muscles that are under-functioning and over-expressed.
Eye A: A is the abbreviation of A-type ultrasound. It is based on the relationship between time and amplitude of sound waves to detect the echo of sound waves, and its positioning accuracy is high. The eye A is to place the probe in front of the eye, and the sound beam propagates forward. Whenever an interface occurs, a reflection occurs. The echo is arranged in the form of a peak on the baseline according to the return time. The height of the peak indicates the echo intensity. The stronger the echo, the peak. The higher the height.
Three-sided mirror inspection: The three-sided mirror plays a large role in the inspection of the fundus of the slit lamp, and it is easy to operate. With the aid of a three-sided mirror, it is easy to identify the difference between the optic nerve head, the retina, and the choroid, the identification of cysts, hemangiomas, retinal tears, choroidal tumors, and the relationship between the retinal surface and the posterior vitreous membrane, and the serous and interstitial serosa. Retinal detachment is very helpful in the observations below it.
Ophthalmoscope inspection: Ophthalmoscope can be divided into direct ophthalmoscope and indirect ophthalmoscope. Direct ophthalmoscopy can directly check the fundus, do not need to loose the pupil, check in the dark room, the examiner's eyes must be close to the patient's eyes, the right eye is used to check the patient's right eye, the right hand is taken with the ophthalmoscope, sitting or standing on the patient's right Side, left eye is the opposite, the other hand of the doctor retracts the patient's eyelid, first place the ophthalmoscope about 20cm in front of the patient's eye, check whether the patient's refractive interstitial is transparent with +10D lens, check the refractive interstitial, after Begin to inspect the parts of the fundus, and rotate the lens of the lens to correct the refractive error of the doctor and the patient. If the doctor is emmetropic or has corrective glasses, the diopter used to see the fundus indicates the refractive condition of the eye to be examined. Generally, the cephalic eye is directly looked forward, the optic nipple is examined, and the uveal vessels are examined along the omental vessels, and the quadrants are placed on the upper and lower sides of the nose, and finally the eyes are gaze to the temporal side to check the macula. The size of the fundus lesion is expressed as the diameter of the optic papilla, and the degree of unevenness of the lesion is measured by the diopter of the lens, and 3D is equivalent to 1 mm. Some ophthalmoscopes are accompanied by green filters, which are better for optic nerve fibers and macula.
Diagnosis
Diagnosis of eye disease
1. The eyes are dry, the eyes are itchy, the eyes are swelled and fatigued, and when there is fear of light and tears, it may be dry eye syndrome.
2. Eyelids or sputum conjunctiva redness, commonly known as "stealing eye", is an acute suppurative inflammation of the eyelids.
3. There are pains around the eyes or slight pain in the eye movements, narrow vision, and even partial visual field defects, red and green fields are involved, hemianopia or dark spots occur, often one eye onset, the other eye has a sharp decline in vision, and even completely blind in the short term, often Headache and pain in the jaw. Pain in the ankle is aggravated by the rotation of the eyeball or the pressure of the eyeball. It may be due to optic neuritis.
4. Conscious eye itching and burning sensation, the skin of the skin is red, mostly blepharitis, also known as "bad eye" or "red eye".
5. When waking up in the morning, the upper and lower eyelids are often stuck by a lot of sticky or purulent secretions. There is a sense of foreign body or burning in the eye, and there is slight tearing or pain, mostly acute contagious conjunctivitis, commonly known as " Red eye disease or "burstful fire eye".
6. The eyes have significant irritation symptoms, fear of seeing light, tearing, pain, vision loss, grayish white or yellow-white ulcer on the surface of the cornea, mostly keratitis.
7. At night or in the dark, you can't see things clearly. The bulbar conjunctiva is dry and loses the moist luster. It is mostly night blindness. Night blindness often occurs in malnourished children, often accompanied by systemic malnutrition, such as weight loss, low crying and hoarseness, and apathetic.
8. Consciously distorted, there is a dark area in the field of vision, there is often flash or Mars in front of the eyes, creating a flashing illusion, or often feel that there are black shadows fluttering back and forth, you may have choroiditis. If the object is often consciously deformed, the straight line is seen as a curve, sometimes the object is slightly larger, sometimes smaller, and sometimes the white object is seen as yellow, which may have central retinal choroiditis. If there is yellow reflection in the eye, visual impairment or vision disappears completely, and with systemic infectious disease, it may be suppurative choroiditis.
9. Consciously there are flies in front of the eyes, there are black spots or black block floating in front of the eyes, vision loss and other symptoms, should consider the possibility of liquefaction, turbidity or degeneration of the vitreous.
10. There is no change in the shape of the eye, suddenly blindness overnight, or even no light perception, it may be central retinal arteriosclerosis or venous thrombosis. If there is a black spot floating in front of the eyes, vision loss, or sudden vision loss, or only the residual light, should consider retinal vein inflammation.
