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Samenvatting Klopto

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Leerjaar 2 Blok A Samenvatting Hoorcolleges Klopto Alle hoorcolleges zijn zeer uitgebreid samengevat op HC6 na.

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  • November 29, 2021
  • 66
  • 2021/2022
  • Summary
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KLOPTO BLOK2A

Inhoudsopgave

Hoorcollege 1 Oogdruk .............................................................................................................................. 2

Hoorcollege 2 Keratitis .............................................................................................................................. 6

Hoorcollege 3 (kerato)conjunctivitis ........................................................................................................ 15

Hoorcollege 4 Gonioscopie & Trauma ..................................................................................................... 21

Hoorcollege 5 Uveïtis .............................................................................................................................. 29

Hoorcollege 6 Pigment en andere afwijkingen in de VOK ........................................................................ 38

Hoorcollege 7 Hobbels en bobbels .......................................................................................................... 41




1

,Hoorcollege 1 Oogdruk

Productie kamerwater & afvoer:
❖ Aanmaak:
1. Ciliary processes
2. Iris
❖ Afvoer:
1. Trabecular meshwork
2. Uveo scleral pathway
3. Iris

Kamerwater bestaat uit:
❖ Water (H2O)
❖ Bicarbonaat (HCO3- dit regelt de pH waarde)
❖ Ca
❖ H+ (sterk zuur)
❖ CO2

formation rate is ~2.5 μl × min
Aqueous humor flow is normally:
❖ 3.0 μl/min morning
❖ 2.4 μl/min afternoon
❖ 1.5 μl/min night

De normale waarde van de oogdruk ligt tussen 10-21
MMHG (16 +/- 2.5 MMHG)




2

,Oogdruk in verband met glaucoom

Normale circadiaanse variatie oogdruk (blauw)

Primair openkamerhoek glaucoom (rood)

Normal Tension Glaucoom (groen)




Kamerhoek kan je beoordelen met: Penlight test, van herick, OCT/UBM, Gonioscopie
Kamerwater: Conical Beam
Oogdruk: GAT (referentie standaard), Perkins, Icare, NCT

Kamerhoek
Penlight test
❖ Je let op hoe diep de VOK is
➢ Penlight schijn je temporaal op de cornearand, de iris licht dan op
➢ Is de schaduw nasaal op de iris meer dan 1/3 totaal pupil opp → mogelijk nauwe kamerhoek
❖ Gradering




Van Herick
Voordelen:
❖ Snelle methode kamerhoek in
te schatten
❖ Niet invasief
Nadelen:
❖ Spleetlamp nodig
❖ Soms niet zichtbaar door:
pterygium, litteken, band
keratopathie
Limitaties:
❖ Nasale hoek wordt overschat



3

, Andere manier van Herick:




Gradatie




Kamerwater
Conical Beam
❖ Gebruikt om flare (proteïne) of zwevende cellen in VOK
te zien
❖ Procedure
➢ Alle kamerverlichting uit
➢ Spleetlamp hoek van 45 graden en vergroting
16/25x
➢ Beperk hoogte en breedte van 1 bij 1 mm
➢ Verplaatst het scherptepunt tussen cornea en lens
➢ Door te bewegen kan je focussen op cellen
❖ Cellen zijn een teken van een actieve ontsteking
❖ Waterige flare is resultaat van lekkage eiwit door beschadigde irisbloedvaten




4

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