o F Pedunculaire hallucinose
1
,Inhoud
ZVB Week D1 Werkcollege 1: Casuïstiek operatie voorstellen .............................................................. 8
Oorzaken van een niet succesvolle operatie ....................................................................................... 8
Inter-beoordelaarsvariabiliteit............................................................................................................. 9
Harada-Ito transpositie........................................................................................................................ 9
Posterior fixation suture (Faden operatie / retroequatorial myopexy) ............................................ 10
Anteropositie ..................................................................................................................................... 13
J-loop ................................................................................................................................................. 14
ZVB Week D1 Werkcollege 2: Asthenope klachten & Fixatie disparatie ............................................. 15
Fixatie disparatie curve ...................................................................................................................... 15
Klachten patroon ........................................................................................................................... 16
Voorafgaand onderzoek................................................................................................................. 17
Doel fixatie disparatie onderzoek .................................................................................................. 17
Componenten FD-curve ................................................................................................................ 18
Notatie uitslag FD-curve (voorbeelden) ........................................................................................ 21
Therapie bij afwijkende curve ....................................................................................................... 22
Prognose ............................................................................................................................................ 23
Intracraniële aandoeningen .............................................................................................................. 23
GVB Week B3 werkcollege 1: Witte pupil en Klein oog ....................................................................... 27
Oorzaak witte pupil ........................................................................................................................... 27
Microphtalmie ................................................................................................................................... 27
ZVB Week D2 Werkcollege 1 & 2: Diverse kinderoogheelkundige afwijkingen.................................. 29
Ptosis ................................................................................................................................................. 29
Congenitaal ptosis ......................................................................................................................... 29
Neurogene defecten ...................................................................................................................... 29
Myogene ptosis ............................................................................................................................. 29
Pseudoptosis.................................................................................................................................. 30
Syndromen met ptosis................................................................................................................... 31
Ptosis correctie .................................................................................................................................. 31
Ooglid afwijkingen ............................................................................................................................. 31
Peters anomalie ................................................................................................................................. 34
Lensafwijkingen ................................................................................................................................. 35
Congenitaal cataract .......................................................................................................................... 36
Unilateraal ..................................................................................................................................... 37
Bilateraal ........................................................................................................................................ 37
Morfologische classificatie van infantiele staar ............................................................................. 38
2
, Behandeling ................................................................................................................................... 38
Cataract extractie .............................................................................................................................. 39
Oculaire motiliteitstoornissen secundair aan cataract extractie ....................................................... 44
Congentiaal rubella syndroom (CRS) ................................................................................................. 48
Ectropia lentis / lensluxatie ........................................................................................................... 49
Congenitaal glaucoom ....................................................................................................................... 56
Complicaties bij een glaucoom drainage implantaat .................................................................... 65
Keratoconus ....................................................................................................................................... 66
Coats dissease (exsudatieve retinitis) ................................................................................................ 70
Neurofibromatose ............................................................................................................................. 70
Refractie afwijkingen ......................................................................................................................... 74
Postnatale groei en emmetropisatie ............................................................................................. 74
Astigmatisme ................................................................................................................................. 75
Hypermetropie .............................................................................................................................. 75
Myopie........................................................................................................................................... 76
Hydrocephalus (waterhoofd)............................................................................................................. 81
Premature retinopathie (ROP)........................................................................................................... 82
Retinoblastoom ................................................................................................................................. 84
Samenvatting refractiechirurgie ........................................................................................................ 86
ZVB Week B2 Werkcollege 2: Sensoriek (wel of niet opereren).......................................................... 89
Gedecentreerd lichtreflex.................................................................................................................. 89
Sensorisch onderzoek ........................................................................................................................ 89
Partiële suppressie ............................................................................................................................ 90
Oefencasussen senoriek .................................................................................................................... 91
Relatie tussen chirurgisch succes gedefinieerd bij motoriek ............................................................ 93
ZVB Week B3 Werkcollege 2: Down syndroom.................................................................................... 94
Oogheelkundige kenmerken.............................................................................................................. 94
Obstructie van de nasolacrimale ductus ........................................................................................... 95
Keratoconus ....................................................................................................................................... 96
Ooglidafwijkingen .............................................................................................................................. 96
Iris afwijkingen................................................................................................................................... 97
Cataract ............................................................................................................................................. 97
Oogzenuwafwijkingen ....................................................................................................................... 97
Glaucoom .......................................................................................................................................... 98
Wanneer oogheelkundig onderzoek? ............................................................................................... 98
Orthoptische behandeling ................................................................................................................. 98
3
, ZVB Week B4 Werkcollege 1: Genetica .............................................................................................. 100
Celdeling .......................................................................................................................................... 101
Celdeling van een lichaamscel / mitose ...................................................................................... 101
Mitose.......................................................................................................................................... 102
Meiose ......................................................................................................................................... 104
Schematisch weergegeven verschil van meiose en mitose ......................................................... 105
Genen .............................................................................................................................................. 105
Erfelijkheidspatronen ...................................................................................................................... 106
Overerving voorspellen ................................................................................................................... 108
Monohybryde kruising / Het vierkant van Punnet ...................................................................... 108
Dihybryde kruising ....................................................................................................................... 110
Polygene erfelijkheid ................................................................................................................... 112
Geslachtsgebonden (X-chromosomale) erfelijkheid ................................................................... 113
Stamboomonderzoek .................................................................................................................. 114
Het menselijk genoomproject en daarna .................................................................................... 115
DNA diagnostiek .............................................................................................................................. 116
Reproductieve opties....................................................................................................................... 117
ZVB Week B4 Werkcollege 3: Complicaties na operatie en endophthalmitis .................................. 119
Chirurgische Complicaties en Incidenten ........................................................................................ 119
Sclera ............................................................................................................................................... 122
Losgeschoten spier / slipped muscle ............................................................................................... 125
Endoftalmitis.................................................................................................................................... 128
Algemene problemen van her-operaties......................................................................................... 130
Postoperatief verzorging.................................................................................................................. 131
Hygiëne ............................................................................................................................................ 132
ZVB Week D4 Werkcollege 1: decentrale LR, kinderen die “vreemde dingen zien, psychische
gevolgen van scheelzien ..................................................................................................................... 134
Entopic phenomeen ........................................................................................................................ 134
Afwijking in het zien van de grootte van objecten .......................................................................... 135
Afwijking in het zien van de vorm van objecten.............................................................................. 136
Bradyopsie ....................................................................................................................................... 137
Visuele volharding en andere zeldzame cerebrale visuele stoornissen .......................................... 137
Hallucinaties .................................................................................................................................... 138
Charles Bonnet-syndroom ........................................................................................................... 138
Hallucinaties in het donker en bij sociale deprivatie ................................................................... 138
Hypnagogische en hypnopompische hallucinaties...................................................................... 138
4
1
,Inhoud
ZVB Week D1 Werkcollege 1: Casuïstiek operatie voorstellen .............................................................. 8
Oorzaken van een niet succesvolle operatie ....................................................................................... 8
Inter-beoordelaarsvariabiliteit............................................................................................................. 9
Harada-Ito transpositie........................................................................................................................ 9
Posterior fixation suture (Faden operatie / retroequatorial myopexy) ............................................ 10
Anteropositie ..................................................................................................................................... 13
J-loop ................................................................................................................................................. 14
ZVB Week D1 Werkcollege 2: Asthenope klachten & Fixatie disparatie ............................................. 15
Fixatie disparatie curve ...................................................................................................................... 15
Klachten patroon ........................................................................................................................... 16
Voorafgaand onderzoek................................................................................................................. 17
Doel fixatie disparatie onderzoek .................................................................................................. 17
Componenten FD-curve ................................................................................................................ 18
Notatie uitslag FD-curve (voorbeelden) ........................................................................................ 21
Therapie bij afwijkende curve ....................................................................................................... 22
Prognose ............................................................................................................................................ 23
Intracraniële aandoeningen .............................................................................................................. 23
GVB Week B3 werkcollege 1: Witte pupil en Klein oog ....................................................................... 27
Oorzaak witte pupil ........................................................................................................................... 27
Microphtalmie ................................................................................................................................... 27
ZVB Week D2 Werkcollege 1 & 2: Diverse kinderoogheelkundige afwijkingen.................................. 29
Ptosis ................................................................................................................................................. 29
Congenitaal ptosis ......................................................................................................................... 29
Neurogene defecten ...................................................................................................................... 29
Myogene ptosis ............................................................................................................................. 29
Pseudoptosis.................................................................................................................................. 30
Syndromen met ptosis................................................................................................................... 31
Ptosis correctie .................................................................................................................................. 31
Ooglid afwijkingen ............................................................................................................................. 31
Peters anomalie ................................................................................................................................. 34
Lensafwijkingen ................................................................................................................................. 35
Congenitaal cataract .......................................................................................................................... 36
Unilateraal ..................................................................................................................................... 37
Bilateraal ........................................................................................................................................ 37
Morfologische classificatie van infantiele staar ............................................................................. 38
2
, Behandeling ................................................................................................................................... 38
Cataract extractie .............................................................................................................................. 39
Oculaire motiliteitstoornissen secundair aan cataract extractie ....................................................... 44
Congentiaal rubella syndroom (CRS) ................................................................................................. 48
Ectropia lentis / lensluxatie ........................................................................................................... 49
Congenitaal glaucoom ....................................................................................................................... 56
Complicaties bij een glaucoom drainage implantaat .................................................................... 65
Keratoconus ....................................................................................................................................... 66
Coats dissease (exsudatieve retinitis) ................................................................................................ 70
Neurofibromatose ............................................................................................................................. 70
Refractie afwijkingen ......................................................................................................................... 74
Postnatale groei en emmetropisatie ............................................................................................. 74
Astigmatisme ................................................................................................................................. 75
Hypermetropie .............................................................................................................................. 75
Myopie........................................................................................................................................... 76
Hydrocephalus (waterhoofd)............................................................................................................. 81
Premature retinopathie (ROP)........................................................................................................... 82
Retinoblastoom ................................................................................................................................. 84
Samenvatting refractiechirurgie ........................................................................................................ 86
ZVB Week B2 Werkcollege 2: Sensoriek (wel of niet opereren).......................................................... 89
Gedecentreerd lichtreflex.................................................................................................................. 89
Sensorisch onderzoek ........................................................................................................................ 89
Partiële suppressie ............................................................................................................................ 90
Oefencasussen senoriek .................................................................................................................... 91
Relatie tussen chirurgisch succes gedefinieerd bij motoriek ............................................................ 93
ZVB Week B3 Werkcollege 2: Down syndroom.................................................................................... 94
Oogheelkundige kenmerken.............................................................................................................. 94
Obstructie van de nasolacrimale ductus ........................................................................................... 95
Keratoconus ....................................................................................................................................... 96
Ooglidafwijkingen .............................................................................................................................. 96
Iris afwijkingen................................................................................................................................... 97
Cataract ............................................................................................................................................. 97
Oogzenuwafwijkingen ....................................................................................................................... 97
Glaucoom .......................................................................................................................................... 98
Wanneer oogheelkundig onderzoek? ............................................................................................... 98
Orthoptische behandeling ................................................................................................................. 98
3
, ZVB Week B4 Werkcollege 1: Genetica .............................................................................................. 100
Celdeling .......................................................................................................................................... 101
Celdeling van een lichaamscel / mitose ...................................................................................... 101
Mitose.......................................................................................................................................... 102
Meiose ......................................................................................................................................... 104
Schematisch weergegeven verschil van meiose en mitose ......................................................... 105
Genen .............................................................................................................................................. 105
Erfelijkheidspatronen ...................................................................................................................... 106
Overerving voorspellen ................................................................................................................... 108
Monohybryde kruising / Het vierkant van Punnet ...................................................................... 108
Dihybryde kruising ....................................................................................................................... 110
Polygene erfelijkheid ................................................................................................................... 112
Geslachtsgebonden (X-chromosomale) erfelijkheid ................................................................... 113
Stamboomonderzoek .................................................................................................................. 114
Het menselijk genoomproject en daarna .................................................................................... 115
DNA diagnostiek .............................................................................................................................. 116
Reproductieve opties....................................................................................................................... 117
ZVB Week B4 Werkcollege 3: Complicaties na operatie en endophthalmitis .................................. 119
Chirurgische Complicaties en Incidenten ........................................................................................ 119
Sclera ............................................................................................................................................... 122
Losgeschoten spier / slipped muscle ............................................................................................... 125
Endoftalmitis.................................................................................................................................... 128
Algemene problemen van her-operaties......................................................................................... 130
Postoperatief verzorging.................................................................................................................. 131
Hygiëne ............................................................................................................................................ 132
ZVB Week D4 Werkcollege 1: decentrale LR, kinderen die “vreemde dingen zien, psychische
gevolgen van scheelzien ..................................................................................................................... 134
Entopic phenomeen ........................................................................................................................ 134
Afwijking in het zien van de grootte van objecten .......................................................................... 135
Afwijking in het zien van de vorm van objecten.............................................................................. 136
Bradyopsie ....................................................................................................................................... 137
Visuele volharding en andere zeldzame cerebrale visuele stoornissen .......................................... 137
Hallucinaties .................................................................................................................................... 138
Charles Bonnet-syndroom ........................................................................................................... 138
Hallucinaties in het donker en bij sociale deprivatie ................................................................... 138
Hypnagogische en hypnopompische hallucinaties...................................................................... 138
4
