以青光眼首诊的眼眶病特征分析  

Clinical analysis of glaucoma related to orbital diseases

作　　者：李肖春[1] 舒锦尔[1] 王晓鹏[1] 俞瑞[1] 吕志刚[1] 

机构地区：[1]金华市中心医院眼科,浙江金华321000

出　　处：《中国实用眼科杂志》2013年第3期362-364,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的回顾4例首诊为“青光眼”的眼眶病患者的诊治经过，为眼眶病的正确诊断和治疗提供帮助。方法对1年来以“青光眼”首诊的4例住院病人的初诊和最后诊断结果进行分析。结果4例患者均以“眼压高”首诊，入院前均多次就诊。人院以后进一步检查，结合眼部MRI及CT、彩色多普勒超声等检查，发现均存在眼眶相关疾病，分别为：颈动脉海绵窦瘘、副鼻窦粘液囊肿侵犯眼眶、眼眶纤维脂肪瘤、甲状腺相关性眼病。结论眼压高是眼眶病患者常见的体征，常合并眼位异常、结膜及巩膜血管异常、眼球突出等表现。当现有诊断无法完全解释存在的症状时，应完善检查，认真对待患者的病史叙述，密切注意患者的特征性体征，并合理利用影像学分析，提高眼眶病诊断的正确率。ObJective To review the diagnosis process of the patients with orbital diseases diag- nosed as glaucoma first. Methods Four sequence cases diagnosed as ＂primary glaucoma＂ in recent years were collected. The initial and final diagnoses were analyzed. Results Four patients were all admitted to our department of ophthalmology with ＂high intraocular pressure＂, whose first diagnoses was ＂primary glaucoma＂. After hospitalized for further examination, final diagnosis was improved, namely： Carotid-cavernous fistula （CCF）, paranasal sinus mucocele violation of orbit, orbital fat and fibrous tumors, thyroid-associated ophthalmopathy （TA0）. Conclusions 0rbital diseases are complex in its manifestation, and often represent with high intraocular pressure. Inquiry on the detailed case history and complete inspection thoroughly, analyze the positive signs carefully, combine with imaging examination properly can improve the rate of correct diagnosis in the orbital diseases. Further examinations are needed when the diagnosis can not fully explain＇ the presence of symptoms for improving diagnosis.

关 键 词：眼眶病 “青光眼 误诊 漏诊 

分 类 号：R777.5[医药卫生—眼科]