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病例:患者,女,87岁。右眼失明伴出血不止一小时来我院就诊。右眼曾于1982年在我院行白内障拔除术。术后4年出现右眼胀痛、视物不清,伴头痛及恶心呕吐,检查发现眼压高,前房内大量灰白色絮状渗出。诊断:右眼晶状体溶解性青光眼。给予糖皮质激素、降眼压、扩瞳等对症处理,症状缓解。此后症状反复发作,视力持续下降。近一年出现虹膜面大量新生血管。一周前,患者右眼胀痛加剧,伴头痛及恶心呕吐。自用甘露醇静滴二次,无好转。1小时前突发右眼出血,视力丧失,随之疼痛减轻。眼科检查:右眼内少量出血,球结膜充血水肿+++,角膜无异常结构,眼内组织呈紫褐色暴露嵌顿于眼球外,不能还纳。予行右眼内容剜除术,术后5天拆线出院。 讨论
Case: Patient, female, 87 years old. Right blindness with bleeding more than an hour to our hospital. The right eye was in our hospital in 1982 cataract extraction. 4 years after the right eye pain, visual acuity, with headache and nausea and vomiting, examination revealed high intraocular pressure, anterior chamber a large number of white fluffy exudate. Diagnosis: Right lens dissolve glaucoma. Given glucocorticoid, intraocular pressure, dilation and other symptomatic treatment, symptoms relieved. Symptoms after repeated attacks, vision continued to decline. Nearly a year a large number of iris surface neovascularization. A week ago, the patient’s right eye increased pain, headache and nausea and vomiting. Use mannitol intravenously twice, no improvement. Sudden right eye bleeding 1 hour ago, loss of vision, followed by pain relief. Eye examination: a small amount of bleeding in the right eye, conjunctival hyperemia and edema +++, no abnormal corneal structure, intraocular tissue purple brown exposed incarcerated in the eye, can not be satisfied. To the right eye content surgery, stitched 5 days after discharge. discuss