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(EYE) 1 (, 2543) 1. (Eye lid) : 2. (Conjunctiva) : mucous membrane 3. (Cornea) : corneal epithelium stroma (substantia propria) corneal endothelium (focus) (retina) 4. : (sclera) choroid (retina) choroid 2 rods cones 5. (Iris) : (pupil) 6. (Lens) ciliary body (retina) 7. Ciliary body : ( iris) 2 7.1 Ciliary process : (aqueous humour) 7.2 Ciliary muscle : 8. 2 8.1 Aqueous humour : (Cornea) (Lens) Ciliary process () Cornea Canal of Schlemn Aqueous humour 8.2 Vitreous humour : 9. (Optic nerve) 2 10. : (Lacrimal Gland), (Lacrimal punctum) (Canaliculi) (Lacrimal Sac) (Lacrimal Duct) (Tear) ( globulins lysozyme ) 1 1,200 (l) 2 1. (blepharitis) (hordeolum) (dacryocystitis) 2. (cataract) (glaucoma) (keratitis) (bacterial endophthalmitis) (conjunctivitis) 2 3 3 2 (, 2546) (Red eye) ciliary injection (ciliary injection) intraocular structure : : : : : 4 3 (, 2546) (Blur r ed vision) (diplopia) - 5 (Conjunctivitis) 2 1-3 1. (muco-purulent discharge) Staphylococcus aureus, Streptococcus pneumoniae, Staphylococcus epidermidis Haemophilus influenzae (antibiotic) 1 4 5-7 (antihistamine) 2. Adenovirus (epidemic keratoconjunctivitis) enterovirus type 70 coxsackie virus A type 24 (watery to mucoid discharge) 2 (symptomatic treatment) 7-10 3. 2 1 3- 4 mast cell stabilizers 1 4 2 (steroid) 6 1 (Fiscella RG,2004) ( ) (Ophthalmia neonatorum) 28 Neisseria gonorrhoea, Chlamydia trachomatis, Non gonococal bacteria, Herpes simplex (Chemical) (gonococal conjunctivitis) 2-3 (normal saline) penicillin G sodium (PGS) 100,000 u/cc cefazoline 50 mg/cc PGS 50,000 u/kg/d 2 7 ceftriaxone 25-50 mg/kg (single dose) 1. 1% silver nitrate , 1% tetracycline 0.5% erythromycin 1% silver nitrate Chlamydia trachomatis 7 tetracycline erythromycin tetracycline 1% ophthalmic ointment erythromycin 0.5% ophthalmic ointment 2. (cesarean section) 3. penicillin cetriaxone 4. Herpes 1. 2. (systemic) (Hordeolum) Staphylococcus 2 1. (internal hordeolum) meibomian gland meibomian gland 2. (external hordeolum) gland of Moll Zeiss gland (chalazion) 4-5 8 1 (chalazion) 1. 3-4 10-15 2. oxytetracycline eye ointment chloramphenicol eye drop 2-4 5-7 3. cellulitis cloxacillin 4. 10 24 5. 1 3-4 1. 2. 3. (Cataract) 1. 2. 9 3. 4. 5. 6. (steroid) 1. Extracapsular Cataract Extraction with Introocular Lens (ECCE with IOL) (intraocular lens) 2. Phacoemusification with Introocular Lens 1. Pirenoxine (Catalin ) senile cataract diabetic cataract (quinone substances) (water soluble protein) (water insoluble protein) (metabolism) aromatic amino acid Pirenoxine (Catalin ) ( ) 1-2 4-6 2. Na dihydroazapentacene polysulfonate (Quinax ) congenital cataract traumatic cataract Pirenoxine (quinone substances) (progression) 1-2 3-5 10 (Glaucoma) (retinal ganglion cell) (retinal nerve fiber) (glaucomatous optic neuropathy) 2 (visual filed defect) (Intraocular pressure) ( 21 ) 1. (intraocular pressure fluatuation) 2. 40 3. 4. 5. ocular perfusion pressure (optic nerve head/ optic disc) (ischemia hypoxia) nocturnal hypotension vasospasm 6. (diabetic retinopathy) (neovascular glaucoma) (chronic ischemic process) 2 1. (Open-angle glaucoma) (Iris) (Cornea) Canal of Schlemn ( "Trabecular meshwork") (Aqueous humour) Normal tension glaucoma uveitic glaucoma 2. (Close-angle glaucoma) (Iris) (Cornea) (Aqueous humour) (Aqueous outflow obstruction) acute angle closure glaucoma intraocular tumor induced glaucoma 11 (primary open angle glaucoma; POAG) (congenital glaucoma developmental glaucoma) (outflow system) 1. (visual field defect) (splinter hemorrhage) 21 2. 50-100 1. () acetazolamide 2. laser iridoplasty laser trabeculoplasty 3. 1. 1.1 bata blocker 0.5% timolol 1 1.2 carbonic anhydrase inhibitor acetazol amide (Diamox ) 250 2 1.3 osmotic 50% glycerine 2 1 (100% glycerin 1 1 ) 1.4 30 miotic 4% pilocarpine 15 2 1.5 20% mannitol 5 1 (intravenous) 30-45 1 12 2. 2.1 4% pilocarpine 4-6 2.2 acetazolamide (Diamox ) 1 6 2.3 beta blocker 2 2.4 glycerine 4 manitol 3. 90 5 1 % pilocarpine ( ) Steroid glaucoma (steroid) 1. (steroid) mucopolysaccharide trabecular meshwork (intertrabecular space) (aqueous humour) 2. (steroid) (episcleral venous pressure) (aqueous outflow) steroid responder 30 steroid responder (topical form) (systemic form) Steroid glaucoma (pinguecular) 13 (hyaline and elastiic tissue) 40 (pingueculitis) vasoconstrictor (pterygium) vasoconstrictor 14 Cloxacillin Staphylococus Acetazolamide (Ophthalmic solution) (Ophthalmic ointment) (Ophthalmic suspension) (ocular insert) (contact lens solution) (powder for reconstitution) 1. ( ) ( ) 2. 3. Packs pledget Disks Packs 4. Iontophoresis 5. (Subconjunctival injection) 6. (Retrobulbar injection) retrobulbar space 7. (Intraocular injection) Vitreous 0.1-0.2 8. (Irrigations) catheter 15 1. : 1.1 : (preservative) B.P.C. 4 " 4 " 4 1.2 : 1 1.3 : 1 (cross infection) B.P.C. 1.4 : 2. : 3. : prednisolone 0.12 % (Pred-mild) prednisolone 1% (Pred-forte, Inf-oph) 4. 4.1 (cool place) adrenaline, chloramphenicol, cyclopentolate, hydrocortisone acetate 4.2 (2-8C) proxymethacaine (freezer) 4.3 chloramphenicol 25C 4 2-8C 18 ( chloramphenicol eye drop ) 5. : " " "" (freezer) (bioavailability) 1. BE OU RE OD LE OS ** ED eye drop EO eye ointment 16 Chloramphenicol ED OS qid 1-2 3 Bior tear RE q 2 hr 1-2 2 2. -/- 8 2 6 3 5 4 4 4 3 3 2 2 1 1 FML ED 4/2 4 2 Terramycin EO 1/1 1 1. 10 (l) 25-50 l 1 ( 1-2 ) isotonic solution 1 17 2. (turnover rate fluid) 16 4 50 10 17 2 5 10 3. (corneal penetration) 3.1 (concentration) 3.2 (viscosity) (contact time) 3.3 - (pH) - (4 7) (reflex tearing) 3.4 4. (lipid soluble) (lipid insoluble) - (pH) - 2 - - timolol (pH = 6.8) pilocarpine (pH = 5) 5. (Nasolacrimal duct) (lacrimal sac) 1-2 6. 7. 5 8. 4 beta-blocker timolol 2 9. 2-4 () contact lens (0.5 cm) 2 10 10. 1 11. ( ) 18 12. Ocusert

(pilocarpine) 7 13. (ocular side effect) (systemic side effect) Timolol eye drop 10