1 / 47

Lens Disease

Lens Disease. China Medical University NO.4 Affiliated hospital Ophthalmology; Ophthalmology hospital of China Medical University. Introduction. Lens disease: Change of transparency cataract Position and morphological abnormality dislocation malformation. Basic knowledge. Anatomy.

zeno
Télécharger la présentation

Lens Disease

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Lens Disease China Medical University NO.4 Affiliated hospital Ophthalmology; Ophthalmology hospital of China Medical University

  2. Introduction • Lens disease: • Change of transparency • cataract • Position and morphological abnormality • dislocation • malformation

  3. Basic knowledge

  4. Anatomy • Equator • Anterior capsule • Posterior capsule • Diameter:9-10mm • Thickness:4-5mm • Lens zonule

  5. Anatomy • Capsule: integrity—maintain transparency • Lens epi. — PCO • Lens substance: lens fiber • Nucleus • Cortex

  6. ! Function • Refraction • Accommodation • Protection: UV filtration • What is accommodation? • The capability that eyes change refractive condition in order to acquire clear near sight.

  7. What is cataract? • Turbidity of lens • WHO: turbidity of lens + VA<0.5

  8. What is cataract?

  9. Case: turbid lens, but VA=0.8

  10. ! Cataract • Cataract is the No. 1 eye disease that causing blind. • 46% blindness is caused by cataract

  11. Etiology • Any factors that change the intraocular environment to affect lens metabolism. • Such as: ageing, mechanical, chemical, operation, inflammation, metabolic • Malformation • Congenital factors

  12. Risk factors • UV • Diarrhea • Malnutrition • Diabetes • Smoking • Drinking alcohol

  13. Classification • On etiology: • Congenital • Senile • Complicated • Metabolic • Drug induced or toxic • Traumatic • After cataract

  14. Classification • On location: • Cortical • Nuclear • Subcapsular • On degree: • Immature • Intumescent • Mature • Hypermature

  15. ! Pathogenesis • The common route that causing cataract is the oxidation injury by peroxide free radical. • Apoptosis—hot spot of research

  16. Clinical manifestations • Symptoms: • Progressive vision decrease • Contrast sensitivity decrease • Refraction changes • Diplopia • Glare • Change of color sensation • Visual field defect

  17. contrast test Functionality vision contrast test Positive wave contrast test CSF curve

  18. Vision abnormity Color vision excursion glare visual field loss

  19. Clinical manifestations • Signs: Turbidity of lens

  20. Senile Cataract • Now called Age-related Cataract • Most commonly seen • >50 yrs old • >80 yrs old→100% • Degenerative changes

  21. Classification • Cortical • Nuclear • Subcapsular

  22. Cortical cataract • 4 stages Incipient stage: wedge turbidity

  23. Cortical cataract • 4 stages Intumescent stage (immature): • iris projection • Induce acute angle-closure glaucoma

  24. Cortical cataract • 4 stages Mature stage

  25. Cortical cataract • 4 stages • Hypermature stage: • Morgagni cataract • Phacoanaphylactic uveitis • Phacolytic glaucoma

  26. Nuclear cataract

  27. Subcapsular cataract • Affecting vision early

  28. Congenital cataract • Etiology: • Hereditary • Environmental: • Virus infection • Malnutrition • Radiation • Drug • Systemic disease • VD deficiency

  29. Congenital cataract • Morphology

  30. Congenital cataract • Treatment • observation • Early operation • Amblyopia Treatment

  31. Complicated cataract • Caused by other eye diseases • Corneal ulcer • Glaucoma • Uveitis • Retinal detachment • Retinitis pigmentosa • Intraocular tumor • myopia

  32. Kinds of Complicated cataract Old anterior uveitis Complicated cataract glaucoma Complicated cataract（vogt spot） Pigmentosa eye Silicon oil eye

  33. Metabolic cataract • Caused by systemic metabolic diseases • Diabetic cataract • Galactosemia cataract • Hand-foot-twitch cataract

  34. Drug induced or toxic cataract • Glucocorticosteroid cataract • Chlorpromazine cataract • Miotic cataract • TNT cataract • Metal: copper, iron, mercury, silver, zinc

  35. Traumatic cataract • Contusive • Penetrating • Radiative • Electric

  36. ! After cataract • Now usually called PCO (posterior capsular opacification) • Adult: 30-50% • Child: 100% • Pathogenesis: Proliferation, migration & metaplasia of lens epi.

  37. Treatment Drug? NO USE Operation: the only effective therapy ICCE (intracapsular cataract extraction) ECCE (extracapsular cataract extraction) PEA (phacoemulsification) !

  38. ICCE And ECCE ICCE ECCE

  39. Treatment • IOL (intraocular lens) implantation • AC and PC • Hard and foldable

  40. Treatment • IOL (intraocular lens) implantation

  41. Treatment • PEA & F-IOL

  42. PEA & F-IOL (video)

  43. Treatment • Correction of aphakia: • Frame glasses • Contact lens • IOL • Laser

  44. Lens Dislocation • Etiology: • Congenital • Marfan syndrome • Traumatic • Spontaneous

  45. Clinical Manifestations • Subluxation • Dislocation

  46. Clinical Manifestations • Complications: • Uveitis • Secondary glaucoma • Retinal detachment • Corneal turbidity

  47. Trends • Photolysis of cataract • Injective IOL • Accommodative IOL

More Related