Summary
Samenvatting Klopto
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- Institution
Leerjaar 2 Blok A Samenvatting Hoorcolleges Klopto Alle hoorcolleges zijn zeer uitgebreid samengevat op HC6 na.
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KLOPTO BLOK2AInhoudsopgave
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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