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1、2020/6/30,1,Introduction,Ophthalmology is a special medical science, a branch of clinical medicine,which deals with research for development,treatment and prevention of the disorders of visual organs. Ocular disease have close relation to systemic ones. Learning Ophthalmology and understanding its d
2、evelopment and present state are helpful to eatabilish foundations of clinic,teaching and science research.,2020/6/30,2,第一章 眼科学基础 Chapter one Basic ophthalmology,2020/6/30,3,第一节 眼的组织解剖 anatomy of eyeball 眼球 The globe (eyeball) anterior and posterior distance of normal eyeball is 16mm in born. At age
3、 3 23mm. At adult 24mm.,2020/6/30,4,The vetical one is average23mm，the horizontal one is average 23.5mm in normal adult. The anterior pole of the globe,protruded about 12-14mm bryond the prbital rim. The difference of the two eyes is usually less than 2mm.It is easy to be injuried,especially in its
4、external part,the anterior part of the globe is protected by the eyelids.,2020/6/30,6,The eyecoat is mainly divided into three layers.,Outer layer Cornea Sclera Middle layer Iris Ciliary body Choroid Inner layer Retina,2020/6/30,7,外层 The outer coat,The outer coat consists of the cornea and the scler
5、a. The anterior one sixth is transparent cornea,other five sixths is white sclera. The transitional srea of both is the limbus. The function is to maintain the shape of the globe and to protect inteaocular tissue.,2020/6/30,8,（1）角膜 Cornea,横径The horizontal diameter is 11.5-12mm 垂直径The vertical diamet
6、er is 10.5-11mm 中央部 The central thickness 0.6mm 周边部 The periphery thickness 1mm,2020/6/30,9,前表面曲率半径 The radius of cornea curvature in front 7.8mm 后表面曲率半径 The radius of cornea curvature in back 6.8mm Its refractive power is equal to that of +43 diopter lens,角膜 Cornea,2020/6/30,10,The central thicknes
7、s 0.6mm,The radius of cornea curvature in front 7.8mm,The radius of cornea curvature in back 6.8mm,The periphery thickness 1mm,2020/6/30,11,组织学分层 from anterior to posterior,the cornea has five distinct layers:,上皮细胞层 Epithelium 前弹力层 Bowmans membrane 基质层 Stroma 后弹力层 Descemets membrane 内皮细胞层 Endotheliu
8、m,2020/6/30,12,Epithelium Basement layer Bowmans membrane Stroma Descemets membrane endothelium regenerate after injery,2020/6/30,13,(2)巩膜 Sclera,表层巩膜 The episclera 巩膜实质层 The scleral stroma 棕黑板层 The lamina fascia,组织学分层 the sclera includes:,2020/6/30,14,Sclera,Thickness: 0.3 to 1.0 mm,at the insertio
9、n of the rectus musles,it is about 0.3mm, elsewhere about 1mm. Anterior part covered by bulbar conjunctiva Connected to 6 extraocular muscles Thinner and translucent in children,2020/6/30,15,角巩膜缘 the cornea scleral limbus :is a transitional zone of the cornea and the scleral,where the cornea inserts
10、 into the sclera its anterior border is Bowmans layer Its posterior margin is Descemets membrane Its width is 1 mm Surgical landmark of important structures,2020/6/30,16,前房角 Anterior chamber angle:,Include: Schwalbe line trabecular reticulum Schlenm cannel Sclera spur Ciliary body Iris root,包括: Schw
11、albe 线 小梁网 Schlenm 管 巩膜突 睫状带 虹膜根部,2020/6/30,17,中层 The middle coat,Including three parts: Iris Ciliary body Choroid Rich in pigment and blood vessels,2020/6/30,18,虹膜 Iris,It situates in the most anterior part of the middle coat,infront of the lens,connected with the cilliary body in perphery. The iri
12、s includs layers : Anterior surface layer Stroma layer Pigment epithelial threre is a round hole in the centre called Pupil 直径2.5-4mm,2020/6/30,19,虹膜 Iris,2020/6/30,20,睫状体 Ciliary body,Connect iris root and choroid A distence of about 6mm，corona：2mm ，Pars plana：4mm The ciliary body is divided into 5
13、 layers from inner to outer 1、ciliary musle 2、 Vascular layer 3、Bruchs membrane 4、Epithelium layer 5、The internal limiting membrane,1睫状肌,4,2020/6/30,21,睫状体 Ciliary body,扁平部,睫状突,锯齿缘,睫状冠pars plicata,2020/6/30,22,脉络膜 Choroid,It is situated beween the sclera and the retina,anterior to ora serrata,going
14、behind to the surrounding of the optic nerve. Full of the pigment acts as a dark room and a shade of light. Including： 1、大血管层 Large vascular layer 2、中血管层Middle vascular layer 3、毛细血管层Capillary layer,2020/6/30,23,内层the Inner coat,is the retina,which covers the hr inner aspect of the posterior two-thri
15、ds of the wall of the globe. The outside of the retina is the choroid,the inside is the vitreous. The optic never fixes the retina to the wall of the globe. The retina is 0.1mm thick at the ora serrata and 0.23mm thick at the posterior pole.,2020/6/30,24,内层the Inner coat,The 黄斑 Macula area is a spec
16、ial region of the retina with the sharpest visual sensation.its diameter is about 1-3mm a small foveola is in its centre called 黄斑中心凹Fovea centralis,with the direct ophthalmoscope the Fovea centralis produce a clearly fovea reflaction. A pink area located at nasal side about 3mm to the macula is the 视盘 Optic disc.thevisual fibers on the retina come together to go out of the globe to visual centre.there are artery and vein. A
