眼眶爆裂性骺折的诊断和治疗

18 8 9年 ,Ｌａｎｇ首次报道了眶底骨折伴发的眼球内陷[1] 。195 7年 ,Ｃｏｖｅｒｓｅ和Ｓｍｉｔｈ将其命名为眶爆裂性骨折 (Ｏｒｂｉｔａｌｂｌｏｗｏｕｔｆｒａｃｔｕｒｅｓ) [2 ] 。 70年代以前 ,多数医师提出眼眶骨折应作为急诊立即手术治疗 ,大家普遍认为延迟治疗会使病人产生永久的视功能障碍性复视容貌上难以接受的眼球内陷[3～ 5] 。但到了 1974年 ,Ｐｕｔｔｅｒｍａｎ等[6] 首次提出对单纯性眼眶爆裂性骨折应进行保守治疗 ,对其他眼眶骨折应随访 4～ 6月后再决定是否手术治疗。其原因是作者随访观察了 5 7例单纯性眼眶爆裂性骨折而…     

爆裂性眼眶骨折10例临床分析

爆裂性眼眶骨折系指眼前段遭受巨大致伤物撞击,致使眶内压骤然升高,眼眶薄弱部位骨壁断裂,眶内容物嵌入骨折处,引起复视、眼球隐没、眼位改变、眼球运动障碍等一系列临床表现的特殊类型眼眶骨折,通常发生在眶下壁和内侧壁[1]。现就我院自1994年1月以来收治的10例爆裂性眼眶骨折病例分析报告下:临床资料1一般情况:男9例,女1例;右眼,左眼各5例;年龄18～56岁,平均30岁;伤后当日来诊者9例,2天后来诊1例。2病因与骨折部位:车祸4例,砸伤(包括枪托、石块、爆炸锯片)3例,拳击伤2例,撞伤(水管)1例。爆裂眼眶骨折部位:下壁7例,内壁6例,上壁2例,外壁4例…     

眼眶爆裂性骨折

本文报告10例爆裂性眼眶骨折。病人有眼挫伤史、眼球内陷和复视.检查可发现眼内陷和眼球运动障碍。X线及CT检查可证实骨折。     

眼眶爆裂性骨折的临床表现与治疗

爆裂性眼眶骨折是指眶压突然增高引起的眼眶骨折 ,眶内软组织嵌入骨折处 ,造成眼球运动障碍 ,产生复视和眼球内陷 ,多为眶底骨折。本文收集我科 1990年以来不完全统计 95例爆裂性眶骨折 ,经 CT或 X线检查证实诊断 ,临床分析如下。本组 95例 (98眼 ) ,其中男性 79例 ,占总数的 83% ;女性16例占 17%。年龄最小 4岁 ,最大 6 5岁 ,右眼 36例 ,左眼 5 9例。拳击伤 38例 ,摔伤 19例 ,车祸 14例 ,脚踢伤 7例 ,捧棍击伤4例 ,酒瓶击伤 3例 ,木块、砖块砸伤 3例 ,汽车方向盘撞伤 2例 ,钢管扎伤、砂轮伤、膝盖碰伤、头部击伤、汽车摇把击伤各 1例。眶…     

眼眶病的研究进展

眼眶病虽不是常见和多发病,但与全身各系统关系密切。近几年国内外的眼眶病研究进展较快。甲状腺相关眼病的病因研究和动物模型的建立为今后临床治疗带来希望;眼眶横纹肌肉瘤、泪腺肿瘤的分子水平研究为临床治疗提供了依据;新型放疗如敷贴器、各种粒子的临床使用,拓宽了眼眶肿瘤的治疗范围,改善了肿瘤患者的预后;临床上对视神经鞘脑膜瘤与胶质瘤的重新认识和眼眶手术入路的改进及恶性肿瘤综合治疗等方面均有很大进展,为眼眶病的诊断和治疗开辟了新思路。     

眼眶爆裂性骨折的手术治疗

目的:探讨眼眶爆裂性骨折的手术治疗方法和效果。方法:对24例眼眶爆裂性骨折患者进行复位手术,将嵌顿眶内容物复位,以钛板钛钉铆合或植入Medpor植片修补骨折缺损区,术后观察患者眼眶外观、眼球运动、视力、复视等情况。结果:术后眼球内陷改善、眼球运动改善、视力良好、复视基本消失。结论:眼眶爆裂性骨折致复视、眼球运动障碍等及时手术可获得良好眼位及视功能。     

眼眶病的诊断和治疗原则

眼眶病是指眶隔之后的眶骨和眶内软组织发生的疾病 ,或眶周和全身病的眼眶侵犯。眼眶病虽非常见病或多发病 ,但其种类繁多 ,与眶周及全身各系统联系密切。眼眶病的分类、临床表现、诊断及治疗均与眼球疾病有较大差异。一、眼眶病的分类[1 3 ]1.眼眶先天或发育异常 :常见为颅面骨畸形、先天性小眼球合并眼眶囊肿及脑膜 脑膨出等 ,其中以先天性小眼球合并眼眶囊肿最为多见。2 .眼眶炎性病变 :分为 3类 ,即急性炎性病变 ,如蜂窝组织炎、脓肿等 ;特发性炎性病变 ,如炎性假瘤、痛性眼肌麻痹等 ;慢性炎性病变 ,如血管炎、异物性肉芽肿及Ｗｅｇｅｎ…     

爆裂性眶壁骨折整复手术前后的辅助治疗

眼眶爆裂性骨折是因钝性外力直接作用于眼眶 ,使眶压急剧增高 ,导致眶壁薄弱处发生骨折。眶缘多完整 ,常发生在眼眶的下壁 (眶底 )和内壁[1] 。本病主要临床表现为复视、眼球内陷和眼球运动障碍 ,若不及时治疗可遗留终生。治疗包括手术[2 ,3 ] 和非手术两种方法 ,本文介绍我院行眶壁骨折整复手术前、后的辅助治疗方法。1　临床资料北京同仁医院眼科 1999年 1月至 9月收治眶壁骨折患者 5 1例 (5 1只眼 ) ,其中男 44例 ,女 7例。年龄最小 9岁 ,最大 5 3岁 ,平均 38 1岁。左眼 33例 ,右眼 18例。眼眶下壁骨折 2 5只眼 ,内壁骨折 17只眼 ,内、下…     

Visual impairment registration: evaluation of agreement among ophthalmologists

Purpose

To evaluate consistency among consultant ophthalmologists in registration of visual impairment of patients with glaucoma who had a significant visual field component to their visual loss.

Method

Thirty UK NHS consultant ophthalmologists were asked to grade data sets comprising both visual acuity and visual fields as severely sight impaired, partially sight impaired, or neither. To assess intra-consultant agreement, a group of graders agreed to repeat the process.

Results

Kappa for inter-consultant agreement (n=30) for meeting the eligibility criteria for visual impairment registration was 0.232 (95% CI 0.142–0.345), the corresponding inter-class correlation score was 0.2 (95% CI 0.172 to 0.344). Kappa for intra-consultant agreement (n=16) ranged from 0.007 to 0.9118.

Conclusions

When presented with the clinical data necessary to decide whether patients with severe visual field loss are eligible for vision impairment registration, there is very poor intra- and inter-observer agreement among consultant ophthalmologists with regard to eligibility. The poor agreement indicates that these criteria are open to significant subjective interpretation that may be a source of either under- or over-registration of visual impairment in this group of patients in the UK. This inconsistency will affect the access of visually impaired glaucoma patients to support services and may result in inaccurate recording of the prevalence of registerable visual disability among glaucoma patients with severe visual field loss. More objective criteria with less potential for misclassification should be introduced.     

Myopia and radial keratotomy: a survey among Norwegian ophthalmologists

One hundred and eighty-nine of 200 ophthalmologists in Norway responded to a survey requesting them to report their age, sex, refractive state, use of corrective lenses, and if myopic, their view on radial keratotomy as a possible method to correct their own myopia. According to the answers, 32 (17%) females and 154 (82%) males, with mean age of 49 years, were registered. The reported refractive state was 26.5% emmetropy and 72.0% ametropy. The prevalence of myopia was 45%. The mean refractive status (equivalent sphere) in the right eye was -1.02 +/- 2.28 D with a range from -8.5 D to +7.25 D (n = 184). Of the ametropes, 64.8% used spectacles, 15.3% used both spectacles and contact lenses, whilst 3.6% used only contact lenses for distance vision. With the exception of one, all myopes used corrective lenses. Only 2 myopic ophthalmologists responded positively to the question of whether they would consider having radial keratotomy to correct their own myopia.     

438名眼科医师糖尿病视网膜病变相关知识的认知度调查与影响因素分析

目的 调查438名眼科医师对糖尿病视网膜病变(DR)知识的认知度及影响因素.方法 采用自行设计的调查问卷,选择参加第几届国际眼科学学术会议的山东地区眼科医师以及部分青岛市眼科医师共438名作为研究人群,采用t检验、方差分析及多元线性回归方法进行统计学分析,对其DR知识认知度及影响因素和影响程度进行研究.结果 (1)438名眼科医师"DR知识答卷"平均得分(43.15±21.31)分,其中最高分100分,最低分20分;(2)单因素X2分析后得出医院级别、学历、职称、是否培训这4个因素影响眼科医师对DR知识的认知度(P＜0.05);(3)多元线性回归分析排除混杂因素后,筛选出对其认知度有显著性影响的2个因素为职称和学历,职称越高,得分越高(P＜0.01);学历越高,得分越高(P＜0.01).结论 眼科医师对DR相关知识的认知度低,亟待建立一种正规专业的培训机制,来提高眼科医师,尤其是低年资、低学历人员的DR认知水平.

Abstract：

Objective To investigate the awareness of diabetic retinopathy (DR) and influencing factors in 438 ophthalmologists. Methods A self-designed questionnaire was made. We selected the ophthalmologists from Shandong province to participate in the Ninth International Conference on ophthalmology or working in Qingdao City in a total of 438 as the study population, using t test, variance analysis and multiple linear regression statistical analysis. Their DR knowledge awareness, influencing factors and the extent was under research. Results The average score of "DR knowledge of respondents" of them were (43.15±21.31). The highest score was 100 points, lowest score 20 points.Following an analysis of variance, four factors on ophthalmologists of knowledge awareness of DR was statistically significant (P＜0.05), which were hospital level, education, job title, whether or not training. Under multiple linear regression analysis, excluding confounding factors, only job title and qualifications knowledge affect ophthalmologist DR recognition: higher title higher score (P ＜0.01);more education higher score (P＜0.01). Conclusions The DR related knowledge of ophthalmologists is poor. It is urgent to establish a formal, specialized knowledge training systems for DR, especially focus on those low titles and low academic ophthalmologist.     

Orbital cellulitis complicating isolated unilateral sphenoidal sinusitis: importance of the CT scan.

A case of orbital cellulitis complicating the rare isolated unilateral sphenoidal sinusitis is reported, stressing the importance of a CT scan where plain x-rays fail to show any abnormality.     

Orbital hydatid disease: A case report

Orbital hydatid cysts are a rare cause of proptosis and comprise only 1% of all hydatid cysts. We report a 13-year-old boy with orbital hydatid cyst and investigate radiologic, ultrasonographic and clinical aspects of the disease. The cyst was excised totally without rupture through a lateral orbitotomy approach. Hydatid cyst is endemic in some countries and sporadic cases are seen with increasing international travel. The authors have stated that they do not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article. The authors also do not discuss the use of off-label products, which includes unlabeled, unapproved, or investigative products or devices.