Collignon N J
Service d'Ophtalmologie, CHU Sart-Tilman, 4000 Liège, Belgique.
Bull Soc Belge Ophtalmol. 2005(296):71-81.
Most severe eye diseases and injuries ultimately require intervention by an ophthalmologist. The urgency of referral depends on various factors, including level of vision loss, duration of symptoms, and presence of comorbid diseases. Of special importance are five acute eye problems in which emergency management by primary care physicians can be critical to visual outcome: high-velocity injuries, chemical injuries, acute angle-closure glaucoma, arteritic ischemic optic neuropathy, and central retinal artery occlusion. This paper will focus on emergencies in glaucoma, especially primary and secondary closed-angle glaucoma and secondary open-angle glaucoma. Delay in presentation, and unresponsiveness to medical treatment of the acute ocular hypertension attack carry a significant risk of chronic glaucoma, whatever the mechanism of disease is. Whenever the acute glaucoma crisis does not cease with an appropriate medical treatment, a laser and/or surgical intervention needs to be urged.
大多数严重的眼部疾病和损伤最终都需要眼科医生进行干预。转诊的紧迫性取决于多种因素，包括视力丧失程度、症状持续时间以及合并疾病的存在情况。特别重要的是五种急性眼部问题，基层医疗医生的紧急处理对视力预后可能至关重要：高速损伤、化学伤、急性闭角型青光眼、动脉炎性缺血性视神经病变和视网膜中央动脉阻塞。本文将重点关注青光眼的急症，尤其是原发性和继发性闭角型青光眼以及继发性开角型青光眼。无论疾病机制如何，就诊延迟以及对急性高眼压发作的药物治疗无反应都有患慢性青光眼的重大风险。每当急性青光眼危机经适当药物治疗仍未缓解时，就需要尽快进行激光和/或手术干预。
