Question 1

什么是轨道间隔综合征，为什么它是医疗紧急情况？

Accepted Answer

轨道腔室综合征（OCS）是由眼球后部压力增加引起的，最常见的原因是球后血肿。随着压力升高，视神经及其血供都受到压迫，如果不迅速缓解，将迅速导致神经损伤和失明。这种情况需要立即进行紧急治疗以防止永久性视力损失。

Question 2

外侧角膜腱膜的解剖结构与眼眶隔综合征有何关系？

Accepted Answer

外侧和内侧结膜腱将眼睑牢固地固定在适当的位置，形成一个对眼球空间有限的解剖隔室。外侧结膜腱分裂成上臂和下臂。在OCS中，高于眼球后的压力迫使眼球向前推压这些腱，需要通过手术释放这些腱来减压。

Question 3

什么是马库斯·冈瞳，如何检测它？

Accepted Answer

马库斯·甘恩瞳孔（或称相对性传导性瞳孔缺损，RAFD）发生在视神经损伤导致正常瞳孔收缩时出现问题。使用摇摆手电筒测试可检测到：光线照射未受影响的眼睛时，两个瞳孔都会收缩，但光线照射受影响的眼睛时，两个瞳孔都不会收缩，表明视神经受到了影响。

Question 4

如何测量眼内压以确认眼眶间隔综合征？

Accepted Answer

使用四卡因或丙氧卡因局部麻醉后，用手持式眼压计测量眼内压。轻轻将眼压计尖端按压角膜，直到设备发出嘟嘟声并显示读数。连续几次测量结果大于 40 mm Hg 可确认 OCS 诊断。

Question 5

外侧角膜切开术和下角膜松解术需要哪些用品和麻醉技术？

Accepted Answer

必备物品包括无菌纱布、生理盐水、含1:100,000肾上腺素的1%利多卡因、25号或27号针头注射器、齿状钳、直钳和虹膜剪刀。局部麻醉剂从侧面注射1.5-2厘米，然后重新定向45度向下，同时持续注射以麻醉侧面和下部区域。

Question 6

进行外侧角膜切开的关键程序步骤是什么？

Accepted Answer

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Question 7

什么时候进行下结膜切开术，应该监测哪些并发症？

Accepted Answer

在进行外侧结膜切开术后，通过拉开下眼睑并用90度角的虹膜剪切断下腱，进行下角膜松解术。重新测量眼内压；如果仍然高于40 mm Hg，还需要释放上腱。潜在并发症包括出血、感染、组织损伤和罕见的眼球穿刺，尽管与未经治疗的视力丧失相比，这些风险是最小的。

外眦切开术与下眦切开术 - 评估测验