打一疾病(jíbìng)不红不痛渐昏朦，薄雾轻烟渐渐浓。初时一眼先昏暗，数日逐渐障双瞳(shuānɡtónɡ)。千金难买药见效，金针一拨当日空。cataract胜利(shènglì)医院林雪媛教学(jiāoxué)目的•了解白内障的发生原因及其分型。•掌握老年性白内障各型的特点。•掌握白内障的手术适应症及白内障术后矫正视力的方法(fāngfǎ)。•了解先天性白内障和代谢性白内障的分型及特点。•了解晶状体脱位的分型及临床表现。Whatiscataract?Acataractisanopacity(orcloudychanges)ofthelensthatcancausevisionproblems.•任何先天性或后天性因素引起的晶状体混浊使其透明性下降(xiàjiàng)，称为白内障。•LENS•Thelensissurroundedbyathicklenscapsulewhichisthebasementmembranaeofthelensepithelialcells.•晶状体囊是一层包绕整个晶状体的透明囊状基底膜。•Epithelialcellsatthelensequatorcontinuetobeproducedthroughoutlife,sothatolderlensfibersarecompressedintoacentralnucleus;youngerfibersaroundthenucleusmakeupthecortex.•位于晶状体赤道部囊下的上皮细胞终生增殖，不断形成晶状体纤维(xiānwéi)，将旧的纤维(xiānwéi)挤向中心的核，核外较新较疏松的纤维(xiānwéi)构成皮质。causes•Agingmostcommon•Long-termultraviolet(UV)light,especiallyfromsunlight•Diabetesorothersystemicdisease•Pasteyeinfections,injuriesorsurgery•Smoking•Long-termuseofcertainmedications(suchassteroids)•heredityPathogenesis•Thelensismademostlyofwaterandprotein.Theproteinisarrangedtoletlightpassthroughandfocusontheretina.Sometimessomeoftheproteinclumpstogether.Thiscanstarttocloudsmallareasofthelens,blockingsomelightfromreachingtheretinaandinterferingwithvision.•晶状体主要由水和蛋白组成。发生白内障的晶状体特征性改变是蛋白之间的交联形成聚合物，使光线(guāngxiàn)散射增强，晶状体透明度下降。ClicktoaddTitle•自由基引起的氧化(yǎnghuà)损伤晶状体上皮细胞氧化损伤——膜蛋白降解——细胞膜通透性增加——晶状体内渗透压增高、肿胀；晶体蛋白之间二硫键形成增多——蛋白交联形成高分子量聚合物——光散射增强，晶状体混浊。•细胞凋亡及其调控normalVs.cloudylensClinicalFindingsSymptomsBlurringordimnessofvision视力下降(xiàjiàng)colorsappearfaded色觉改变Sensitivitytolightandglare...
