Diagnosis of eye diseases. Diagnosis, effective treatment and prevention of eye diseases

21.10.2019 -

Vision is considered one of the greatest values in a person's life, and few people think about it when they are in good health. But once you encounter any eye disease at least once, you already want to give all the treasures for the very opportunity to see clearly. Timely diagnosis is important here - vision treatment will be effective only if the correct diagnosis is made.

AT modern world exist a large number of a variety of techniques that allow you to identify any problem with the eyes even at the first signs of the manifestation of the disease. All of them make it possible to determine the nature of the threat, and the tactics of further treatment. Such studies are carried out using special equipment in ophthalmological clinics.

Despite the fact that the process of a complete examination by an ophthalmologist takes only an hour, it is better to allocate more free time for additional diagnostics. The whole problem lies in the fact that during the period of the study, the eyes are instilled with a special solution that expands the pupil. This helps to see more of the lens for better inspection. The effect of these drops can last for several hours, so it is worth refraining from any activity during this period.

Why visit an ophthalmologist?

In the life of any person, there may come a time when you have to seek help from an eye doctor. Such a decision is determined by a number of factors that become possible during a visit to an ophthalmologist.

Comprehensive vision diagnostics.
Professional equipment and high quality consumables.
Affordable price for the services provided.
and choice of treatment.
The presence of a special database where all information about any of the patients is stored.
Individual approach and appointment of the required examinations.
Operation followed by rehabilitation.
Consultation of related specialists.

It should be remembered that a person's vision may deteriorate according to different reasons. Only a modern examination will help to find them and eliminate them.

General information

Vision diagnostics is necessary to make an accurate diagnosis or simply identify the causes that impair vision, as well as to choose the best course of treatment for each individual patient. A complex approach to this question will help to reveal the true cause poor eyesight because many eye diseases have similar symptoms.

For this, a comprehensive diagnostics of vision is carried out, which studies a whole list of various indicators:

checking visual acuity;
finding the refraction of the eye;
establishment;
condition optic nerve;
measurement of the depth of the cornea of the eye and so on.

Also on the list comprehensive examination necessarily includes an ultrasound of the internal structures of the eye for the possibility of pathologies.

Preparation for the examination

A complete diagnosis of vision or a partial examination can only be carried out after proper preparation. To do this, you should initially consult a doctor who can see if the vision problem is a concomitant symptom of some other disease. It concerns diabetes or presence in the body chronic infection. When compiling an anamnesis, it is necessary to take into account the issue of the patient's heredity, which can affect his well-being at a certain period of life. Before going to the ophthalmologist itself, no special preparation is needed, except that it is better to get a good night's sleep so that you can adequately interpret the results obtained during the examination.

Vision diagnostic methods

At the moment, ophthalmology has moved far ahead in understanding the eye as a separate element of the whole organism. Thanks to this, it is possible to more accurately and quickly treat a wide variety of eye problems, for which innovative techniques are used. It is simply impossible to list all of them, but it is worth taking a closer look at the most popular and popular ones.

Visometry

Diagnosis of vision begins with the traditional method - determining acuity and refraction. For this, special tables with letters, pictures or other signs are used. In this case, it is considered the most familiar, although in recent years halogen sign projectors have taken the first place. In the latter case, doctors manage to check the acuity of binocular and color vision. Initially, a check is carried out without correction, and then together with a lens and a special spectacle frame. This solution allows the doctor to accurately diagnose the problem and choose the best treatment to eliminate it. Usually, after this, patients can regain 100% vision.

Tonometry

The most common procedure for ophthalmologists, which involves measuring intraocular pressure. Such a diagnosis of vision is of great importance in the appearance of glaucoma. In practice, such a study is carried out by contact or non-contact methods. In the first case, or Goldman is used, which needs to measure the degree of deflection of the cornea of the eye under pressure. With the non-contact method, the pneumotonometer determines the intraocular pressure using a directed air jet. Both methods have the right to exist and can make it possible to judge the possibility of a number of specific eye diseases. Such a procedure is considered mandatory for people over 40 years old, since it is at that age that the risk of developing glaucoma increases.

Ultrasound examination of the eye and orbit

Ultrasound of the eyes is considered a non-invasive and highly informative research method that provides an opportunity to examine the posterior segment of the eye, vitreous body and orbit. Such a technique is carried out exclusively on the recommendation of the attending physician and is considered mandatory before performing certain operations or removing cataracts.

At the present time, conventional ultrasound has been replaced by ultrasound biomicroscopy, which studies the anterior segment of the eye at the micro level. With the help of such an immersion diagnostic procedure, one can obtain comprehensive information about the structure of the anterior part of the eye.

There are several techniques for performing this procedure, depending on which the eyelid can be closed or open. In the first case, the sensor moves along the eyeball, and in order to avoid discomfort superficial anesthesia is performed. When the eyelid is closed, you just need to apply a little special liquid on it, which is removed at the end of the procedure with a regular napkin.

In terms of time, such a technique for examining the state of the eye takes no more than a quarter of an hour. Ultrasound of the eye has no contraindications regarding the appointment, so it can be performed on children, pregnant women and even people with serious illnesses.

Computer vision diagnostics

The noted method of diseases is considered one of the most accurate. Thanks to his help, you can find any disease of the eye. The use of specific medical devices makes it possible to assess the condition of all structures visual organ. It is worth noting that such a procedure is performed without direct contact with the patient, therefore it is completely painless.

Computer diagnostics, depending on the age of the patient, can last from 30 minutes to an hour. To do this, the person who applied for the announced study will have to take a position near a special device that will fix their eyes on the image that appears. Immediately after this, the autorefractometer will be able to measure a number of indicators, the results of which can be used to judge the condition of the eyes.

Computer diagnostics of vision can be prescribed by an ophthalmologist to assess the condition of the patient's eyes for the presence of diseases or pathogenic processes, determine the most optimal treatment plan, or confirm the need for subsequent surgical intervention.

Ophthalmoscopy

Another method for examining the human eye, in which case particular importance is attached to the choroid of the marked organ, as well as the optic nerve and retina. During the procedure, a special device ophthalmoscope is used, which directs a beam of direct light to the eye. The main condition for this method is the presence of a maximum that makes it possible to examine hard-to-reach peripheral departments retina. Thanks to the ophthalmoscope, doctors can detect retinal detachment and its peripheral dystrophy, as well as the pathology of the fundus, which does not manifest itself clinically. To dilate the pupil, you only need to use some kind of short-acting mydriatic.

Of course, this list of existing methods for diagnosing problems of the organs of vision is far from complete. There are a number of specific procedures that can detect only certain diseases of the eye. But only the attending physician can prescribe any of them, so at the very beginning you just need to make an appointment with an ophthalmologist.

Diagnosis of eye problems in children

Unfortunately, eye diseases can manifest themselves not only in adults - children also often suffer from similar problems. But in order to conduct a qualitative examination of a baby frightened by the mere presence of a doctor, an assistant is necessary. Diagnosis of vision in children is carried out in almost the same way as in adults, only the head, arms and legs of the child must be fixed in one position to obtain the most accurate results.

It is worth noting that the diagnostic methods in this case will be identical to the above, however, an eyelid lifter may be needed. Children from the age of 3 undergo pyrometry in the form of a fun game with colorful pictures. If the matter concerns instrumental research, it is worth using painkillers for the eyes.

For a better examination of the child, it is worth contacting a pediatric ophthalmologist who has special training.

Where to go for diagnostics?

If the issue of conducting one of the methods for diagnosing eye diseases has become a priority, it's time to contact an ophthalmologist. But where to make a vision diagnosis so that it is accurate, correct and really makes it possible to understand the root causes of vision problems?

Of course, the most experienced specialists in this regard are located in the capital, which houses many ophthalmological medical institutions with special innovative equipment. That is why even district ophthalmologists are assigned vision diagnostics in Moscow. The best Russian clinics located in this city will help you make the correct diagnosis as quickly and accurately as possible and decide on the tactics of subsequent treatment. Considering the reputation of modern medical institutions in the capital and the number of clients who turn to them, it is worth highlighting the following options.

Moscow Eye Clinic.
Ophthalmological center Konovalov.
MNTK "Eye Microsurgery".
Medical center "Excimer".
Medical center "Okomed".

All that remains for a person who has vision problems is simply to contact one of the indicated institutions and get the necessary assistance.

Why is it so important to undergo a comprehensive high-tech diagnostics of vision?

Comprehensive vision diagnostics - necessary condition to keep it sharp long years. The VISION ophthalmological clinic uses innovative diagnostic equipment to detect eye diseases at the earliest stage, and the qualifications of doctors ensure an accurate diagnosis. The experience of our specialists and advanced examination methods guarantee the selection effective methods treatment. We have been working for more than 11 years so that you can enjoy the bright colors of the world.

Why is early vision diagnostics on innovative equipment necessary?

According to statistics, up to 65% of eye diseases proceed without symptoms for a long time, imperceptibly for the patient. Therefore, it is important to regularly examine the entire visual apparatus: check visual acuity, condition of tissues eyeball, work visual analyzer. The VISION clinic has technological capabilities for diagnosing all parts of the eye, including at the cellular level. This allows you to prescribe the right treatment in a timely manner and stop the processes that lead to loss or deterioration of vision.

We take care of patients by choosing the best methods of diagnosis and treatment

Examination at the VISION clinic is suitable for patients of any age. So, the initial manifestations of retinal dystrophy can occur as early as 18-30 years. An optical tomograph allows you to get a 3D image of the structure of the retina and see the slightest changes in it. After 30 years, prerequisites for retinal detachment, glaucoma, and the first stages of neoplasms are revealed. And after 50 years, you can detect cataracts or macular degeneration - diseases that lead to complete blindness. The diagnosis always includes a consultation with an ophthalmologist who will select the optimal therapy regimen or recommend surgery to correct vision. Surgical treatment can also be performed by experienced ophthalmic surgeons of our clinic.

Advantages of the VISION clinic

1.High-precision diagnostics

The use of modern equipment, including optical tomographs. Some of the diagnostic methods are unique.

2. Qualification of doctors

The clinic employs qualified specialists - ophthalmologists and ophthalmic surgeons who love their job and have expert knowledge. We do not have visiting doctors, only permanent employees.

3.Innovation in treatment

The latest methods of surgical and non-surgical treatment of myopia, cataracts, glaucoma and other pathologies. Compliance with the international quality standard GOST ISO 9001-2011.

4. Top level eye surgery

Ophthalmic surgeons with unique experience works and operating equipment latest generation- a high chance of maintaining and improving vision even in difficult cases.

5. Responsible approach

Our doctors are responsible for the accuracy of the diagnosis and the effectiveness of the treatment. You will receive a detailed consultation on the state of eye health.

6.Transparent prices

There is a fixed cost in accordance with the price list. No hidden co-payments or unexpected costs once treatment has begun.

7. Social orientation.

Our clinic has loyalty programs and social discounts for veterans, pensioners, and the disabled. We want new technologies in ophthalmology to be accessible to everyone.

8.Convenient location

The clinic is located in the center of Moscow, on Smolenskaya Square. From the metro Smolenskaya Filevskaya line just 5 minutes on foot.

The cost of the examination includes a consultation with a highly professional ophthalmologist.

The level and depth of research enable the ophthalmologist, based on the analysis of the data obtained, to make a complete diagnosis, determine tactics, prescribe and carry out treatment, as well as predict the course of some pathological processes in the vascular, nervous and endocrine systems organism.

A complete ophthalmological examination takes from one to one and a half hours.

Protocol of ophthalmological examination of patients in the ophthalmological center "VISION"

1. identification of complaints, collection of anamnesis.

2. visual study anterior segment eye, for the diagnosis of diseases of the eyelids, pathology of the lacrimal organs and the oculomotor apparatus.

3.Refractometry and Keratometry- study of the total refractive power of the eye and cornea separately in order to detect myopia, hyperopia and astigmatism with a narrow pupil and in conditions of cycloplegia.

4. Measurement of intraocular pressure using a non-contact tonometer.

5. Determination of visual acuity with and without correction, using a character projector and a set of trial lenses.

6. Definition of character vision (binocular)- test for latent strabismus.

7. Keratotopography- study of the relief of the cornea using automatic computer keratotopograph in order to determine congenital, degenerative and other changes in the shape of the cornea (astigmatism, keratoconus, etc.).

8. Point selection taking into account the nature of visual work.

9. Biomicroscopy- study of eye structures (conjunctiva, cornea, anterior chamber, iris, lens, vitreous body, fundus) using a slit lamp - biomicroscope.

10. Gonioscopy- study of the structures of the anterior chamber of the eye using special lens and biomicroscope.

11. Schirmer's test- determination of tear production.

12. Computer perimetry- examination of the peripheral and central fields of vision using an automatic projection perimeter (diagnosis of diseases of the retina and optic nerve, glaucoma).

13. Ultrasound eye to study the internal structures, measure the size of the eye. This study allows you to identify the presence of foreign bodies, retinal detachment, eye neoplasms in opaque internal environments.

An ophthalmological examination begins with an anamnesis (general and special). To examine the patient should be planted facing the light. First examine the healthy eye. During external examination, the condition of the eyelids, the region of the lacrimal sac, the position of the eyeball, the width of the palpebral fissure, the state of the conjunctiva, sclera, cornea, anterior chamber of the eye and the iris with the pupil visible within this fissure are established. The conjunctiva of the lower eyelid and the lower transitional fold is examined by pulling back the lower eyelid while looking at the patient upwards. conjunctiva upper eyelid and the upper transitional fold is inspected by turning upper eyelid. To do this, when looking at the patient from top to bottom, they are captured with a large and index fingers right hand the ciliary edge of the upper eyelid, pull it slightly downward, moving it away from the eye at the same time; on the upper edge of the cartilage of the eyelid is placed with an edge thumb left hand (or eye glass rod) and, pushing the cartilage down, turn the eyelid upwards by the ciliary edge.

To examine the eyeball in case of eyelid edema or strong eyelids, after preliminary instillation of a 0.5% solution of dicain, it is necessary to push them apart with the help of eyelid lifters inserted behind the upper and lower eyelids. When examining the lacrimal ducts, pressing a finger on the area of the lacrimal sac, note the presence or absence of discharge from the lacrimal puncta. To examine the cornea, iris and the anterior surface of the lens, the side illumination method is used, focusing the light from a table lamp on the eye with a strong convex lens (+20 D). Even more clearly visible changes when viewed through a binocular loupe (see). An external examination of the eyes is completed with a study of pupillary reflexes (see). Next, they examine (see), the fundus of the eye (see), visual functions (see,) and intraocular pressure (see).

Ophthalmological examination
The study of the organ of vision must be carried out strictly according to plan. This plan should be based on an anatomical principle, that is, an anatomically consistent examination of individual parts of the organ of vision.

They begin with a preliminary history, in which the patient states his complaints (pain, redness of the eye, dysfunction, etc.; a more detailed and targeted history - personal, family, hereditary - should, according to S. S. Golovin, be attributed to the end of the study). After that, they begin to study the anatomical state of the organ of vision: the adnexa, the anterior part of the eyeball, the inner parts of the eye, then examine the functions of the eye and general state organism.

In detail, an ophthalmic examination includes the following.

General information about the patient: gender, age, profession, place of residence. The main complaints of the patient, his gait.

Inspection. General habitus, skull shape, face (asymmetry, facial skin condition, one-sided graying of eyelashes, eyebrows, hair on the head, etc.).

Eye socket and adjacent areas. Eyelids - shape, position, surface, mobility; palpebral fissure, eyelashes, eyebrows. Lacrimal organs - lacrimal glands, lacrimal puncta, tubules, lacrimal sac, lacrimal canal. The connective sheath (conjunctiva) - color, transparency, thickness, surface, presence of scars, nature of the discharge. The position of the eyeball [exophthalmos, enophthalmos (see Exophthalmometry), displacement], size, mobility, intraocular pressure (see Ocular Tonometry).

Sclera - surface, color. cornea- form, surface, transparency, sensitivity. Anterior chamber of the eye - depth, uniformity, chamber moisture. Iris - color, pattern, position, mobility. Pupils - position, size, shape, reactions. Lens-transparency, clouding (stationary, progressive, its degree), position of the lens (displacement, dislocation). Vitreous body - transparency, consistency, hemorrhage, liquefaction, foreign body, cysticercus. The fundus of the eye (see Ophthalmoscopy), the optic disc - the size, shape, color, boundaries, course of blood vessels, level; the periphery of the fundus - the color, condition of the vessels, the presence of foci of hemorrhage, exudation, edema, pigmentation, primary and secondary retinal detachment, neoplasms, subretinal cysticercus; yellow spot - hemorrhage, degeneration, perforated defect, etc.

Special methods for examining the organ of vision - see Biomicroscopy, Gonioscopy, Diaphanoscopy of the eye, Ophthalmodynamometry, Ocular Tonometry. An electromagnetic test (see Eye magnets) makes it possible, using hand-held or stationary magnets, to determine the presence of magnetic foreign bodies in the eye or in the tissues surrounding it.

X-ray diagnostics, which is widely used in ophthalmological examination, allows you to detect changes in the bones of the skull, orbit, its contents (tumors, etc.), foreign bodies in the eye and its surrounding tissues, changes in the tear ducts, etc.

The study of visual functions - see Campimetry, Visual acuity, Field of view.

Eye refraction (see) is determined by subjective (selection of corrective glasses) and objective methods (see Skiascopy, Refractometry of the eye).

Accommodation - the position of the nearest point of view, the strength and width of the accommodation are determined.

Color perception (see) - color recognition by central vision - is more often studied using the tables of E. B. Rabkin. Light perception - adaptation to light and darkness - is studied with the help of adaptometers (see) and adaptometers of S. V. Kravkov and N. A. Vishnevsky, A. I. Dashevsky, A. I. Bogoslovsky and A. V. Roslav-tsev and other Eye movements - determination of the symmetrical position of the eyes, their mobility, fusion ability, binocular vision, latent and overt strabismus, muscle paralysis and other movement disorders. Electroretinography (see) is of known importance in the diagnosis of certain eye diseases.

Association with general diseases. Examination of the patient's body with the participation of relevant specialists. Laboratory research- microbiological, blood, urine tests, cerebrospinal fluid, the Wasserman reaction, tuberculin tests; x-ray studies, etc.

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Diagnosis of eye diseases. What symptoms of eye diseases help to correctly establish the causes of the pathology

Signs of eye disease detected during a traditional consultative examination

Diagnostics eye diseases, like any other pathologies, begins with the collection of patient complaints. There are certain combinations of symptoms that allow you to make a preliminary diagnosis. eye diseases based solely on patient complaints. So, for example, a combination of such symptoms as morning gluing of the eyelids, copious discharge from the conjunctival cavity and redness of the eye without reducing its function indicate acute conjunctivitis. A triad of symptoms is characteristic of corneal lesions - severe lacrimation, painful spasm of the eyelids and photophobia.

However, in many cases, this kind of combination is also non-specific, like individual symptoms. In particular, complaints of blurred vision combined with a gradual painless decrease in visual function may indicate diseases of such different nature as cataracts, open-angle glaucoma, optic nerve atrophy, etc.

So diagnostic search in diseases of the eye, it can be quite difficult and require the use of special equipment. To save time, money and nerves, it is better for the patient to prepare for visiting an ophthalmologistby preparing answers to the most popular questions, such as:
1. When the symptoms of eye disease first appeared (in cases where the pathology develops gradually, it is often not so easy to remember the first minor symptoms - quickly appearing eye fatigue, flies before the eyes, gluing of the eyelids in the morning, etc.);
2. What measures were taken to eliminate unpleasant symptoms, and was there an improvement;
3. Did any of the relatives suffer from eye diseases or diseases related to the eyes ( hypertonic disease, atherosclerosis, diabetes mellitus, increased thyroid function, etc.);
4. Is the patient's work related to occupational hazards in terms of vision;
5. What eye diseases and eye surgeries have been transferred.

After a detailed collection of information, the ophthalmologist proceeds to examine the patient. Inspection begins with a healthy eye. In cases where pathological process Both eyes are affected, traditionally starting with the right.

The doctor pays attention to the mobility of the eyes, the condition of the palpebral fissure, the position of the eyelids, then, slightly pulling the lower eyelid, examines the mucous membrane of the conjunctival cavity.

A standard examination aimed at identifying eye diseases is carried out in daylight. Consultation with an ophthalmologist, as a rule, includes the well-known procedure for determining visual acuity using special tables (Golovin-Sivtsev table or children's visometric tables). If necessary, more complex methods of examination are prescribed.

What methods do ophthalmologists use when diagnosing eye diseases?

Most patients, after undergoing a traditional examination-consultation with an ophthalmologist, receive only preliminary diagnoses of eye diseases, to clarify which it is necessary to carry out one or another additional methods examinations, in particular:

biomicroscopy (study of the optical media of eye tissues, such as the cornea, iris, anterior chamber of the eye, vitreous body, using a slit lamp);
gonioscopy (examination of the angle of the anterior chamber of the eye, formed by the inner surface of the cornea and the outer surface of the iris and ciliary body);
study of intraocular pressure;
assessment of the sensitivity of the cornea (carried out in the "old-fashioned" way by gently touching a cotton swab to the surface of the membrane covering the pupil in the center and four places along the periphery);
conifocal intravital microscopy of the cornea (examination of corneal tissues using a specially adapted microscope);
studies of tear production and tear drainage, which determine the uniformity of the distribution of tears, the total amount of tear fluid production, the patency of the lacrimal ducts;
diaphanoscopy and transillumination of the eye (widely used for penetrating wounds and tumor processes of the eye, assessment of the state of the internal structures and membranes of the eyeball using diaphanoscopes that direct light through the sclera (diaphanoscopy) or the cornea (transillumination of the eye));
ophthalmoscopy (standard method of objective examination of the fundus);
study of the central and peripheral fields of vision (study of the light sensitivity of the retina by establishing the boundaries of the fields of view and determining the usefulness of vision (absence / presence of blind spots in the field of view));
the study of color vision, which is carried out using a special anomaloscope device, or / and special color tables and tests;
assessment of binocular vision (friendly work of the eyes), which is used in professional selection (pilots, drivers, etc.), scheduled examinations, as well as in the pathology of the oculomotor apparatus (strabismus, professional ophthalmopathy, etc.);
ultrasound examination of the eye;
fluorescein angiography eye day allowing for a detailed examination of the choroid eyes by introducing a special substance fluorescein into the blood;
optical coherence tomography (OCT) is a modern method for studying the optical structures of the eye, which allows obtaining information at the microscopic level;
Heidelberg retinal tomography, which uses laser scanning to obtain ultra-precise information about the condition of the optic nerve head and the retina as a whole;
laser polarimetry – latest way objective examination of the state of the optic nerve head;
electrophysiological methods, which are the study of the activity of the visual analyzer based on changes in bioelectric potentials that occur in the cells of the cerebral cortex in response to light stimulation of the retina.

Treatment of eye diseases

How can eye diseases be treated in humans?
Treatment of eye diseases with folk remedies and methods
official medicine (surgical,
physiotherapy, medicine)

The main methods of official medicine are surgical and conservative. As a rule, to surgical intervention resort in cases where to get a reliable and sustainable result with help conservative therapy impossible.

Predominantly surgical method heals congenital malformations of the eye, corrects age-related changes(surgery to replace the lens for cataracts, surgical treatment senile ptosis, inversion and eversion of the eyelids), restore normal circulation intraocular fluid with glaucoma, eliminate many malignant tumors and etc.

However, most eye diseases can and should be treated without resorting to a scalpel. So the need for surgery in many cases indicates untimely intervention or inadequate treatment of pathology (infectious eye diseases, "eye" complications of diabetes, etc.).

The main methods conservative treatment eye diseases are medical and physiotherapeutic. The medical method is understood as the treatment of eye diseases with the help of local medicines (special eye drops and ointments) and, much less often, general action (drugs for oral administration and injections). Physiotherapy treatment is a fight against the disease with the help of physical factors (heat, electric current, magnetic field, etc.).

Modern medicine allows and welcomes the use of so-called folk remedies (beaver stream, honey, etc.) in the complex treatment of eye diseases. However, they should be used on the recommendation and under the supervision of the attending ophthalmologist.

What are the drugs for the treatment of eye diseases

All drugs for the treatment of eye diseases are divided into seven large groups according to their purpose and principle of action.

Anti-infective drugs are used to treat inflammatory processes caused by the action of microorganisms. This large group of drugs includes the following types of drugs:

Antiseptics or disinfectants are drugs that do not penetrate into the inner layers of the skin and mucous membranes, but have a powerful local anti-infective and anti-inflammatory effect. The most popular are Vitabact eye drops, combined preparations containing boric acid, silver salts, etc.;
Antibiotics are substances of biological origin, as well as their synthetic analogues, which have a pronounced antimicrobial effect. For the treatment of infectious eye diseases, antibiotics from the group of chloramphenicol (eye drops levomycetin 0.25%), aminoglycosides (eye drops tobramycin (Tobrex)) and the latest broad-spectrum antibiotics fluoroquinolones (eye drops Tsipromed (ciprofloxacin)) are most often used.
Sulfonamides are one of a group of chemotherapy drugs that are effective against most types of bacterial infection. In ophthalmic practice, sulfonamides are represented by such a well-known drug as eye drops Albucid (sulfacyl sodium).
As antifungal drugs for the treatment of eye diseases, as a rule, drugs intended for oral administration (Nystatin tablets, etc.) are used.
Antiviral drugs used to treat eye diseases are divided into antiviral chemotherapeutic agents that directly eliminate viruses (for example, 3% Acyclovir ointment) and immune drugs that activate the body's defenses (drug for intramuscular injection Cycloferon).

Anti-inflammatory drugs are typically used to treat non-infectious inflammatory eye conditions. It is also possible to use drugs of this group for protracted infections in combination with anti-infective therapy.

At the same time, a distinction is made between steroidal anti-inflammatory drugs, for example, dexamethasone drops, and non-steroidal anti-inflammatory drugs, such as eye drops containing a 0.1% solution of diclofenac sodium.

In addition, there are combined drugs with anti-infective and anti-inflammatory effects. Such drugs include Sofradex, Tobradex and Maxitrol drops, which are successfully used in infectious and inflammatory eye diseases with an allergic component.

Antiallergic drugs are intended for the treatment of eye diseases allergic origin and include medicines of several groups. First of all, these are the so-called membrane-stabilizing drugs that prevent the release of inflammatory mediators from mast cells responsible for the development of the allergic process (Lekrolin and Ketatifen eye drops).

Dacryocystitis is an inflammation of the lacrimal sac, a special cavity for collecting lacrimal fluid located at the inner corner of the eye.

The lacrimal fluid performs the most important function, protecting the mucous membranes of the organ of vision from drying out and the development of dangerous infectious and degenerative eye diseases. Tears are produced by a specialized lacrimal gland located in the upper lateral part of the orbit.

The lacrimal fluid is evenly distributed in the cavity of the conjunctiva, while excess tears are removed through the lacrimal canaliculus, the mouths of which open on the conjunctiva of the inner corner of the eye below.

Through the lacrimal ducts, the lacrimal fluid enters the lacrimal sac, which ends blindly from above, and downwards passes into the nasolacrimal canal, which opens into the nasal cavity.

During fetal development, the opening of the nasolacrimal canal is closed, so that normally it opens with the first loud cry of the newborn. In cases where the thin film that blocks the nasolacrimal canal remains intact, there is a real threat of developing dacryocystitis in newborns.

The fact is that the lacrimal fluid is a good breeding ground for microorganisms that begin to multiply intensively in the overflowing lacrimal sac, causing an inflammatory reaction.

Symptoms of dacryocystitis in newborns are in many ways reminiscent of signs of conjunctivitis: the affected eye begins to fester, increased lacrimation is observed, and cilia may stick together in the morning.

Such a characteristic symptom as damage to only one eye and an increased amount of tears in the conjunctival sac will help to suspect dacryocystitis in newborns.

Finally, you can verify the presence of inflammation in the lacrimal sac by slightly pressing on the area of \u200b\u200bits projection (the lateral surface of the nose at the inner corner of the eye) - while from the lacrimal openings, which are the mouths lacrimal ducts droplets of pus and / or blood will appear.

Neonatal dacryocystitis is a infectious diseases eyes that should not be treated antimicrobial agents. After all purulent inflammation is only a consequence of pathological obstruction of the nasolacrimal canal.

So the most adequate treatment for dacryocystitis in newborns is to massage the lacrimal sac, which helps open the nasolacrimal canal. This is a simple procedure, the video of which can be easily found on the Internet. With clean hands, the mother gently presses on the projection of the lacrimal sac from top to bottom.

In the vast majority of cases, with the help of regularly repeated simple manipulations, it is possible to get rid of the film that covers the mouth of the nasolacrimal canal. As soon as the lacrimal fluid stops accumulating in the lacrimal sac, the infectious process is spontaneously eliminated.

In cases where a weekly course of massage of the lacrimal sac does not lead to success, the patency of the nasolacrimal canal is restored by surgical methods (probing and washing lacrimal ducts performed under general anesthesia).

Eye diseases in premature babies. Retinopathy (pathology of the retina) of premature babies: causes, symptoms, treatment

The main problem of premature babies is the immaturity of all body systems, as well as the need for many resuscitation saving the life of an infant, but capable of having an adverse effect on its further development.

A typical eye disease of those born ahead of time children is retinopathy of prematurity - a severe pathology, often leading to irreparable loss of vision.

The immediate cause of retinopathy of prematurity is the immaturity of the vasculature of the retina - inner shell eyeball, which is responsible for the actual perception of light.

The vascular network of the retina begins to develop only at the 17th week of development. At the same time, by the 34th week of pregnancy (the gestational age is calculated from the first day of the last menstruation), the formation of vessels located at the nasal part of the retina is completed, so that the optic disc and macula (the area of \u200b\u200bthe retina responsible for the best vision) are already normally supplied with blood, however, the temporal part the retina is still extremely poor in blood vessels. Fully formation of retinal vessels ends only by the last - 40th week of gestation.

If a child is born prematurely, many unfavorable external and internal factors begin to affect his still immature retina, which can cause the main manifestation of retinopathy of prematurity - a violation of the normal formation of retinal vessels, expressed in their germination inward into the vitreous body of the eye.

As a result, hemorrhages form in the vitreous body, and pathological tension of the retina by improperly growing vessels leads to its local or even complete detachment, ruptures, and other irreversible changes.

Retinopathy of prematurity as an eye disease varying degrees severity develops in 76% of children born at 24-25 weeks of gestation, and in 54% of children born at 26-27 weeks of gestation. At the same time, retinopathy of prematurity, threatening retinal detachment, occurs in 5% of children born at terms up to 32 weeks of pregnancy, and the risk of developing this formidable complication in children born at 24-25 weeks reaches 30%.

It should be noted that retinopathy of prematurity also occurs in children born at term. This happens in cases where we are talking about an immature fetus and / or exposure to extremely aggressive factors in the first hours and days of life.

born at less than 32 weeks of gestation;
born at any time with a weight of less than 1500 g;
born at a gestational age of 32 to 36 weeks and receiving oxygen for more than 3 days;
all premature infants with episodes of complete apnea (lack of breathing requiring emergency resuscitation).

During this eye disease, three periods are distinguished:
1. Active(about six months), when abnormal development of blood vessels occurs, hemorrhages occur in the vitreous body, as well as detachment, detachment and ruptures of the retina.
2. reverse development (second half of life), when there is a partial, and in mild cases and full recovery functions of the retina and vitreous body.
3. Cicatricial period or a period of residual manifestations, which can be judged a year after birth. Most frequent complications transferred retinopathy of prematurity are:

cicatricial changes after ruptures and retinal detachment;
moderate or high myopia;
clouding and / or displacement of the lens;
glaucoma (increased intraocular pressure);
subatrophy of the eyeballs;
corneal dystrophy with the subsequent formation of a walleye.

Specific prevention of retinopathy of prematurity has not been developed to date. All at-risk infants at the 5th week of life (but not earlier than at the 44th week of the estimated gestation) undergo an examination of the fundus.

When real threat retinal detachments, ruptures or tears in this eye disease, either cryotherapy (cauterization of germinating vessels with cold), which can reduce the risk of irreversible blindness by half, or laser therapy (laser exposure to abnormal vessels), which is just as effective, but much less painful.

What to do with dacryocystitis in a child - video

Prevention of eye diseases in adults and children

Primary and secondary prevention of eye diseases in humans

There are primary and secondary prevention of eye diseases in children and adults. At the same time, primary prevention is aimed at preventing the development of eye diseases, and includes a set of hygiene and health measures (compliance with correct mode work and rest, the use of special gymnastics for the eyes, reducing the time spent doing eye-tiring activities, the use of protection factors in the presence of occupational hazards, etc.).

Secondary prevention is a measure taken for the timely detection and treatment of eye pathology (scheduled examinations by an ophthalmologist, refusal of self-treatment, strict adherence to all doctor's prescriptions). Thus, if primary prevention is powerless, adequate treatment of a timely detected pathology helps to avoid severe consequences for the organ of vision and the body as a whole.

Prevention of eye diseases in children

Primary prevention of eye diseases in children primarily includes occupational and rest hygiene during all activities that require eye strain (reading, writing, drawing, working at a computer, playing with small details of designers, etc.).

It is necessary to observe the daily routine so that children's eyes rest well during sleep. Rational lighting and teaching the child the rules of reading and writing hygiene will help protect against eye diseases.

Many children like to read lying down, as well as while riding in transport, often using material on electronic media, which puts a significant strain on the organs of vision. Parents should warn offspring that such behavior, as well as the use of material with small print and poor contrast, can lead to the development of serious eye diseases.

The hygiene of school classes provides for sufficiently long breaks between lessons, during which it is strongly recommended to provide complete rest to the eyes. After attending school, children should walk outdoors or indoors, and do homework only after a sufficient break (at least 2 hours).

Many parents ask when watching TV and using a computer can pose a risk of eye disease. It all depends on the overall load on the organ of vision. Of course, if a student is forced to spend a lot of time with textbooks, it is better for him to choose another type of entertainment ( active games, sport sections, walks, etc.).

Secondary prevention of eye diseases in children is the timely passage scheduled inspections an ophthalmologist and timely referral for a specialized medical care when any warning signs from the organ of vision.

Prevention of eye diseases in adults. How to prevent the development of eye disease from the computer

Everyone knows that scientific and technological progress has not only led to tremendous advances in medicine, but also caused the emergence of many diseases, including eye diseases.

The most common eye disease associated with the new conditions of human life is a computer syndrome, manifested by the following symptoms:

eye fatigue;
feeling of "sand" in the eyes;
soreness of the eyeballs;
pain when moving the eyes;
eye redness;
color vision disorders;
slow refocusing of the eyes from distant objects to near ones and vice versa;
the appearance of blurred vision, doubling of objects, headache during prolonged work with a computer.

The main reason for the development of computer syndrome is a violation of hygiene rules that protect the organ of vision. Therefore, in order to protect yourself from such an eye disease, it is enough just to follow all the simple requirements.
1. If the job is related to long stay at the computer, it is necessary to spare the eyes during off-hours. For example, instead of reading, you can listen to audio books, and learn the news from radio programs. It is necessary to drastically reduce the time for visiting social networks, reading forums, etc. It should be noted that "sedentary" work generally adversely affects health, therefore, in the list of entertainment, it is better to replace a computer and TV with outdoor walks, going to the pool or a trip to the country.
2. While working at the computer, you should observe the alternation of work and rest: 10 minutes break every 50 minutes of work.
3. It is advisable to complete every 20 minutes of work with a 20-second break for elementary gymnastics for the eyes (fixing the gaze on objects located at a distance of 6 meters and further from the monitor).
4. In the presence of eye diseases such as myopia, hyperopia or astigmatism, you should work at the computer with glasses or corrective lenses.
5. The optimal distance to the display (80 cm) should be observed, while it is desirable that the center of the screen be 10-20 cm below eye level.
6. Use high-resolution screens when using your computer regularly.
7. In order to choose the ideal working font size, it is necessary to empirically determine the minimum readable font size. The working size should be three times larger. The best type of text is black and white. Avoid dark backgrounds whenever possible.
8. Watch out for lighting, do not work near bright light sources, flickering lamps. In bright natural light, it is better to curtain the window, and cover the table surface with a matte material.

Prevention of eye diseases

Before use, you should consult with a specialist.

Used in ophthalmology instrumental methods achievement-based research modern science, allowing to carry out early diagnosis many acute and chronic diseases organ of vision. Leading research institutes and clinics of eye diseases are equipped with such equipment. However, an ophthalmologist of various qualifications, as well as a doctor general profile can, using a non-instrumental research method (external (external examination) of the organ of vision and its adnexa) conduct express diagnostics and make a preliminary diagnosis in many urgent ophthalmological conditions.

Diagnosis of any eye pathology begins with knowledge of the normal anatomy of eye tissues. First you need to learn how to examine the organ of vision in healthy person. Based on this knowledge, the most common eye diseases can be recognized.

The purpose of an ophthalmological examination is to assess the functional state and anatomical structure both eyes. Ophthalmological problems are divided into three areas according to the place of occurrence: the adnexa of the eye (eyelids and periocular tissues), the eyeball itself and the orbit. A complete baseline survey includes all of these areas except the orbit. For its detailed examination, special equipment is required.

General examination procedure:

visual acuity test - determination of visual acuity for distance, for near with glasses, if the patient uses them, or without them, as well as through a small hole with visual acuity less than 0.6;
autorefractometry and / or skiascopy - determination of clinical refraction;
study of intraocular pressure (IOP); with its increase, electrotonometry is performed;
study of the visual field by the kinetic method, and according to indications - by the static method;
determination of color perception;
determination of extraocular muscle function (range of action in all fields of view and screening for strabismus and diplopia);
examination of the eyelids, conjunctiva and anterior segment of the eye under magnification (using magnifiers or a slit lamp). The examination is carried out with or without dyes (sodium fluorescein or rose Bengal);
a study in transmitted light - the transparency of the cornea, eye chambers, lens and vitreous body is determined;
ophthalmoscopy of the fundus.

Additional tests are applied based on the results of an anamnesis or primary examination.

These include:

gonioscopy - examination of the angle of the anterior chamber of the eye;
ultrasound examination of the posterior pole of the eye;
ultrasound biomicroscopy of the anterior segment of the eyeball (UBM);
corneal keratometry - determination of the refractive power of the cornea and the radius of its curvature;
study of corneal sensitivity;
examination with a fundus lens of the details of the fundus;
fluorescent or indocyanine-green fundus angiography (FAG) (ICZA);
electroretinography (ERG) and electrooculography (EOG);
radiological examinations (X-ray, CT scan, magnetic resonance imaging) structures of the eyeball and orbits;
diaphanoscopy (transillumination) of the eyeball;
exoophthalmometry - determination of the protrusion of the eyeball from the orbit;
corneal pachymetry - determination of its thickness in various areas;
determination of the state of the tear film;
mirror microscopy of the cornea - examination of the endothelial layer of the cornea.

T. Birich, L. Marchenko, A. Chekina