An important but difficult question: will it be possible to preserve vision with a mature cataract? Secondary cataract code according to the ICD Primary cataract code.
A cataract is a pathology of the eyes, which is characterized by clouding of the lens substance or its capsule (both fragments can be involved at once), which is accompanied by a significant decrease in human vision.
Ophthalmologists designate this pathology with a special code, according to the requirements of the Ministry of Health around the world, that is cataract in ICD 10 has the code H25 or H26. The difference in the ciphers is determined by the age of the patient, since the first value is inherent in the elderly population, and the second code is typical for the presence of a disease in young people.
Each of the meanings suggesting damage to the lens of the eye has several varieties that determine the second meaning in the code, for example, senile nuclear cataract (H25.1) or traumatic cataract (H26.2).
Varieties of the disease
There are many different types of pathological changes in the lens of the eye. In general, cataract is considered a disease of the elderly, which causes the normal process of physiological aging, and the second value of the H25 code, following the dot, characterizes the exact localization of damage and morphological features.
Lens involvement at a young age is much less common and always has some precipitating factor, such as one of the following:
- injury to the organs of vision;
- exposure to radiation;
- long-term use of hormonal drugs (corticosteroids);
- prolonged eye disease;
- general diseases of the body;
- toxic lesions;
- vibration related work.
The disease responds well to treatment at a young age, but subject to timely diagnosis.
The latest technologies in modern ophthalmology are able to stop the progression of pathology and preserve human vision.
Clinical signs
The cataract code according to ICD 10 suggests the presence of certain symptoms and subjective sensations in the patient. Usually there are complaints associated with the following disorders of visual acuity:
- vagueness and distortion;
- incorrect color perception;
- flickering of stars, which manifests itself in the dark;
- in patients with farsightedness, there is often a temporary improvement in the perception of objects near.
Cataract tends to affect both eyes, but one of the paired organs is more damaged.
Cataract- a disease characterized by varying degrees of persistent opacities of the substance and / or capsule of the lens, which are accompanied by a progressive decrease in visual acuity of a person.
Classification of cataract varieties according to ICD-10
H25 Senile cataract.
H25.0 Cataract senile initial.
H25.1 Senile nuclear cataract.
H25.2 Cataract senile Morganiev.
H25.8 Other senile cataracts.
H25.9 Cataract, senile, unspecified.
H26 Other cataracts.
H26.0 Childhood, juvenile and presenile cataracts.
H26.1 Traumatic cataract.
H26.2 Complicated cataract.
H26.3 Cataract caused by drugs.
H26.4 Secondary cataract.
H26.8 Other specified cataract.
H26.9 Cataract, unspecified.
H28 Cataracts and other lesions of the lens in diseases classified elsewhere.
H28.0 Diabetic cataract.
H28.1 Cataracts in other diseases of the endocrine system, metabolic disorders, eating disorders, which are classified elsewhere.
H28.2 Cataract in other diseases classified elsewhere.
A pooled analysis of the world's available data on blindness shows that the disease is a particularly common cause of preventable blindness in economically developed and developing countries. According to the WHO, today there are 20 million blind people in the world due to cataracts, and about 3,000 surgeries need to be performed. extraction operations per million population per year. In the Russian Federation, the prevalence of cataracts according to the criterion of negotiability can be 1201.5 cases per 100 thousand of the surveyed population. This pathology of varying severity is detected in 60-90% of persons aged sixty years.
Patients with cataracts make up about a third of the people hospitalized in specialized eye hospitals. These patients account for up to 35-40% of all operations performed by ophthalmological surgeons. By the mid-1990s, the number of cataract extractions per 1,000 population was: in the United States, 5.4; in the UK - 4.5. Available statistics for Russia are highly variable, depending on the region. For example, in the Samara region, this indicator is 1.75.
In the nosological profile of primary disability due to eye diseases, persons with cataracts occupy the 3rd place (18.9%), second only to patients with the consequences of eye injuries (22.8%) and patients with glaucoma (21.6%).
At the same time, 95% of cases of cataract extraction are successful. This operation is generally considered one of the safest and most effective among interventions on the eyeball.
Clinical classification
Due to the inability to find out the causes of lens opacities, their pathogenetic classification does not exist. Therefore, cataracts are usually classified according to the time of occurrence, localization and form of clouding, the etiology of the disease.
According to the time of occurrence, all cataracts are divided into two groups:
congenital (genetically determined) and acquired. As a rule, congenital cataracts do not progress, being limited or partial. In acquired cataracts, there is always a progressive course.
According to the etiological basis, acquired cataracts are divided into several groups:
Depending on the location of the opacities and according to their morphological characteristics, the pathology is divided as follows:
According to the degree of maturity, all cataracts are divided into: initial, immature, mature, overripe.
Cataract - description, causes, symptoms (signs), diagnosis, treatment.
Etiology. Senile cataract.. A long-term (lifelong) increase in the layers of lens fibers leads to compaction and dehydration of the lens nucleus, causing visual impairment. With age, changes occur in the biochemical and osmotic balance necessary for the transparency of the lens; the outer fibers of the lens become hydrated and cloudy, impairing vision. Other types.. Local changes in the distribution of lens proteins leading to light scattering and manifesting as clouding of the lens. Injuries to the lens capsule lead to the ingress of aqueous humor into the lens, clouding and swelling of the lens substance.
Classification by appearance. Blue - cloudy area has a blue or greenish color. Lenticular - clouding of the lens while maintaining the transparency of its capsule. Membranous - foci of clouding of the lens are located in strands, which mimics the presence of the pupillary membrane. Capsular - the transparency of the lens capsule is broken, but not its substance. Trembling - overripe cataract, eye movements are accompanied by trembling of the lens due to degeneration of the fibers of the zinn ligament.
Classification according to the degree of progression. Stationary (most often congenital, turbidity does not change over time). Progressive (almost always acquired, clouding of the lens increases over time).
General symptoms .. Painless progressive decrease in visual acuity .. Veil before the eyes, distortion of the shape of objects .. An ophthalmological examination reveals clouding of the lens of various severity and localization.
Senile cataract .. Initial - decreased visual acuity, clouding of the subcapsular layers of the lens substance .. Immature - visual acuity 0.05-0.1; clouding of the nuclear layers of the lens, swelling of the substance can provoke the development of pain and an increase in IOP due to the appearance of secondary phacogenous glaucoma. Mature - visual acuity below 0.05, complete diffuse clouding of the entire lens. liquid), the lens takes on a pearlescent appearance.
With nuclear cataract, myopia initially occurs against the background of existing presbyopia (myopizing phacosclerosis); the patient discovers that he is able to read without glasses, which is usually perceived positively by the patient ("second sight"). This is due to the hydration of the lens during the initial cataract, which leads to an increase in its refractive power.
Special studies. Qualitative assessment of visual acuity and refraction; in the case of a pronounced decrease in visual acuity, tests are shown to determine the localization of a bright light source in space. Possible hyperglycemia in DM can cause osmotic changes in the lens substance and affect the results of studies. Determination of retinal visual acuity (the isolated ability of the retina to perceive visual objects, while the state of the refractive media of the eye is not taken into account; the determination is made using a directed beam of laser radiation). Such a study is often performed in the preoperative period in order to accurately predict postoperative visual acuity. Retinal angiography with fluorescein is indicated to detect comorbidities in case of inconsistency in visual acuity with the degree of lens opacity.
Lead tactics. Senile cataract. The process develops gradually, so the patient usually does not realize how pronounced the pathological changes are. Against the background of formed habits and skills, even a significant clouding of the lens is perceived as a natural age-related weakening of vision. Hence the need for a thorough explanation to the patient of his condition. However, in the future, there is almost always a need for surgical treatment (cataract extraction). In diabetic cataract, drug antidiabetic therapy can slow down the development of the process, however, with a decrease in visual acuity below 0.1, surgical treatment is indicated. With hypoparathyroidism - correction of metabolic disorders (introduction of calcium, thyroid hormone preparations), with a decrease in visual acuity below 0.1-0.2 - surgical treatment. Tactics for traumatic cataract - surgical treatment 6-12 months after the injury; the delay is necessary for the healing of damaged tissues. Uveal cataract - drugs that slow down the development of the disease, mydriatics. With inefficiency and a drop in visual acuity below 0.1-0.2, surgical treatment is indicated, carried out only in the absence of an active process. Diet. Depending on the etiology of the disease (with diabetes - diet No. 9; with hypothyroidism - an increase in protein content, restriction of fats and easily digestible carbohydrates).
observation. With the progression of cataracts, visual acuity correction with lenses is used until surgery. In the postoperative period, correction of the resulting ametropia due to aphakia is shown. Due to the rapid changes in postoperative visual acuity, frequent examinations and appropriate correction are necessary.
Short description
Cataract- partial or complete clouding of the substance or capsule of the lens, leading to a decrease in visual acuity up to its almost complete loss. Frequency. Senile cataract accounts for more than 90% of all cases. 52-62 years old - 5% of people. 75-85 years old - 46% have a significant decrease in visual acuity (0.6 and below). In 92%, the initial stages of cataract can be detected. Incidence: 320.8 per 100,000 population in 2001
Causes
Risk factors. Age over 50 years. The presence of diabetes, hypoparathyroidism, uveitis, systemic diseases of the connective tissue. Lens injury. History of cataract removal (secondary cataract).
Stages. The initial stage - wedge-shaped opacities are located in the deep layers of the cortex of the peripheral parts of the lens, gradually merge along its equator, moving towards the axial part of the cortex and towards the capsule. Immature (swelling) stage - opacities occupy only part of the lens cortex; signs of its hydration are observed: an increase in the volume of the lens, a decrease in the depth of the anterior chamber of the eye, in some cases an increase in IOP. Mature stage - opacities occupy all layers of the lens, vision is reduced to light perception. Overripe - the last stage of development of senile cataract, characterized by dehydration of the clouded lens, a decrease in its volume, compaction and degenerative degeneration of the capsule.
Classification by etiology
congenital
Acquired .. Senile - dystrophic processes in the substance of the lens. Types of senile cataract... Stratified - clouding is located between the surface of the mature nucleus and the anterior surface of the embryonic nucleus of the lens... Dairy (Morganian cataract) is characterized by the transformation of the clouded cortical layers of the lens substance into a milky-white liquid; the nucleus of the lens moves when the position of the eyeball changes ... Brown cataract (Bourle's cataract) is characterized by diffuse clouding of the lens nucleus and the gradual development of sclerosis, and then clouding of its cortical layers with the acquisition of a brown color of various shades, up to black ... Nuclear cataract is characterized by diffuse homogeneous opacification of the lens nucleus... Posterior capsular cataract - opacification is located in the central parts of the posterior capsule in the form of frost deposition on the glass. myopia, uveitis, melanoma, retinoblastoma), skin diseases (dermatogenic), long-term use of GCs (steroid) .. Copper (lens chalcosis) - anterior subcapsular cataract that occurs when there is a foreign body containing copper in the eyeball and is caused by the deposition of its salts in the lens; with ophthalmoscopy, clouding of the lens is observed, resembling a sunflower flower. .. Traumatic cataract - mechanical impact, exposure to heat (infrared radiation), electric shock (electrical), radiation (radiation), contusion (contusion cataract) ... Hemorrhagic cataract - due to impregnation of the lens with blood; rarely observed ... Ring-shaped cataract (Fossius cataract) - clouding of the anterior part of the lens capsule observed after contusion of the eyeball, due to the deposition of iris pigment particles on it ... Luxed - with dislocation of the lens ... Perforation - with damage to the lens capsule (usually , progresses) ... Rosette - turbidity of the pinnate appearance is located in a thin layer under the lens capsule along the seams of its cortex ... Subluxed - with subluxation of the lens. . Secondary - occurs after cataract removal; in this case, clouding of the posterior capsule of the lens occurs, usually left during its removal ... True (residual) - cataract, caused by leaving elements of the lens in the eye during extracapsular cataract extraction ... False cataract - clouding of the anterior border plate of the vitreous body, due to cicatricial changes after intracapsular cataract extraction.
Classification according to localization in the lens substance. Capsular. Subcapsular. Cortical (anterior and posterior). Zonular. Cup-shaped. Complete (total).
Symptoms (signs)
Clinical picture
Diagnostics
Laboratory research. Examination of peripheral blood for glucose and calcium. Biochemical blood test with the definition of RF, ANAT and other indicators in the presence of a characteristic clinical picture. Active detection of tuberculosis.
Differential diagnosis. Other causes of decreased visual acuity are superficial clouding of the cornea due to cicatricial changes, tumors (including retinoblastoma requiring immediate surgical treatment due to a high risk of metastasis), retinal detachment, retinal scars, glaucoma. A biomicroscopic or ophthalmoscopic examination is indicated. Visual impairment in the elderly often occurs due to the interaction of several factors, such as cataracts and macular degeneration, therefore, when establishing the cause of visual acuity loss, one should not be limited to identifying only one pathology.
Surgery. The main indication for surgical treatment is visual acuity below 0.1-0.4. The main types of surgical treatment are extracapsular extraction or cataract phacoemulsification. The issue of intraocular lens implantation is decided individually. Contraindications .. Severe somatic diseases (tuberculosis, collagenosis, hormonal disorders, severe forms of diabetes) .. Concomitant eye pathology (secondary uncompensated glaucoma, hemophthalmia, recurrent iridocyclitis, endophthalmitis, retinal detachment). Postoperative care.. For 10-12 days, a bandage is applied with daily dressing.. After removing the bandage, 3-6 r / day, instill antibacterial, mydriatic drugs, HA.. Stitches are removed after 3-3.5 months.. Heavy lifting should be avoided. , slopes for several weeks .. Optical correction is prescribed after 2-3 months.
Drug therapy(only by appointment of an ophthalmologist). To slow down the development of cataracts (to improve the trophism of the lens) - eye drops: cytochrome C + sodium succinate + adenosine + nicotinamide + benzalkonium chloride, azapentacene.
Complications. Exotropia. Phacogenic glaucoma.
Current and forecast. In the absence of primary eye disease and cataract extraction, the prognosis is favorable. Progressive development leads to a complete loss of object vision.
Associated pathology. SD. Hypoparathyroidism. Systemic connective tissue diseases. Eye diseases (myopia, glaucoma, uveitis, retinal detachment, pigmentary retinal degeneration).
ICD-10. H25 Senile cataract. H26 Other cataracts.
Appendix. Galactosemia- congenital metabolic disorders in the form of galactosemia, the development of cataracts, hepatomegaly, mental retardation. Characterized by vomiting, jaundice. Possible sensorineural hearing loss, hypogonadotropic hypogonadism, hemolytic anemia. Causes congenital deficiency of galactokinase (230200, EC 2.7.1.6), galactose epimerase (*230350, EC 5.1.3.2) or galactose-1-phosphate uridyltransferase (*230400, EC 2.7.7.10). ICD-10. E74.2 Disorders of galactose metabolism.
Artifakia Code Mkb
Artifakia. artifakia - lens held earlier. pseudophakia with other diseases of both or better seeing eyes of the eye. Code according to ICD 10. International Classification of Diseases 10th revision (ICD-10, By code, Enter at least three characters of the name or characters of the nosology code.
Class III - Diseases of the blood, hematopoietic organs and certain disorders involving the immune mechanism (164) >. Class XV - Pregnancy, childbirth and the puerperium (423) >. Class XVI - Certain conditions arising in the perinatal period (335) >.
Artifakia of the right eye. Primary cataract Russian Artifakia mkb 10 Artifakia of the eye mkb English Artifakia of the eye code mkb.
ICD 10 code: H26 Other cataracts. If it is necessary to identify the cause, use an additional external cause code (class XX). ICD code - 10. H 52.4. Signs and criteria for diagnosis: Presbyopia - senile farsightedness. Develops due to progressive loss. Artifakia. (ICB H25-H28). The degree of violation of body functions, Clinical and functional characteristics of disorders, Degree of limitation.
Class XVII - Congenital anomalies [malformations], deformities and chromosomal abnormalities (624) >. Class XVIII—Symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified (330) >.
Class XIX - Injury, poisoning, and certain other effects of external causes (1278) >. Class XX - External causes of morbidity and mortality (1357) >.
ICb code 10 post-traumatic cataract
Note. All neoplasms (both functionally active and inactive) are included in class II. Appropriate codes in this class (for example, E05.8, E07.0, E16-E31, E34.-) can be used as additional codes, if necessary, to identify functionally active neoplasms and ectopic endocrine tissue, as well as hyperfunction and hypofunction of the endocrine glands, associated with neoplasms and other disorders classified elsewhere.
Excludes: complications of pregnancy, childbirth and the puerperium (O00-O99) symptoms, signs and abnormal findings in clinical and laboratory investigations, not elsewhere classified (R00-R99) transient endocrine and metabolic disorders specific to the fetus and newborn (P70-P74)
This class contains the following blocks:
E00-E07 Diseases of the thyroid gland
E10-E14 Diabetes mellitus
E15-E16 Other disorders of glucose regulation and pancreatic endocrine secretion
E20-E35 Disorders of other endocrine glands
E40-E46 Malnutrition
E50-E64 Other types of malnutrition
E65-E68 Obesity and other types of malnutrition
E70-E90 Metabolic disorders
The following categories are marked with an asterisk:
E35 Disorders of the endocrine glands in diseases classified elsewhere
E90 Nutritional and metabolic disorders in diseases classified elsewhere
E10-E14 DIABETES
If necessary, to identify the drug that caused diabetes, use an additional external cause code (class XX).
The following fourth characters are used with categories E10-E14:
.1 With ketoacidosis
Diabetic:
.2+ With kidney damage
.3+ With eye lesions
.4+ With neurological complications
Diabetic:
.5 With peripheral circulatory disorders
.6 With other specified complications
.7 With multiple complications
.8 With unspecified complications
.9 No complications
E15-E16 OTHER DISORDERS OF GLUCOSE AND PANCREATIC INTERNAL SECRETION
Excludes: galactorrhea (N64.3) gynecomastia (N62)
Note. The degree of malnutrition is usually assessed in terms of body weight, expressed in standard deviations from the mean value for the reference population. Lack of weight gain in children, or evidence of weight loss in children or adults with one or more previous body weight measurements, is usually an indicator of malnutrition. If there is evidence from only a single measurement of body weight, the diagnosis is based on assumptions and is not considered definitive unless other clinical and laboratory studies are performed. In exceptional cases, when there is no information about body weight, clinical data are taken as the basis. If the individual's body weight is below the mean for the reference population, then severe malnutrition is highly likely when the observed value is 3 or more standard deviations below the mean for the reference group; moderate malnutrition if the observed value is 2 or more but less than 3 standard deviations below the mean, and mild malnutrition if the observed body weight is 1 or more but less than 2 standard deviations below the mean for the reference group.
Excludes: intestinal malabsorption (K90.-) nutritional anemia (D50-D53) consequences of protein-energy malnutrition (E64.0) wasting disease (B22.2) starvation (T73.0)
Excludes: nutritional anemia (D50-D53)
E70-E90 METABOLIC DISORDERS
Excludes: androgen resistance syndrome (E34.5) congenital adrenal hyperplasia (E25.0) Ehlers-Danlos syndrome (Q79.6) hemolytic anemia due to enzyme disorders (D55.-) Marfan syndrome (Q87.4) 5-alpha-deficiency reductase (E29.1)
Arterial hypertension - ICD code 10
Cardiovascular diseases occupy a leading position in terms of prevalence. This is due to stress, unfavorable environmental conditions, heredity and other factors.
Arterial hypertension code according to ICD-10
The separation depends on the causes and severity of the disease, the age of the victim, damaged organs, etc. Doctors around the world use it to systematize and analyze the clinical course of the disease.
According to the International Classification, an increase in blood pressure is included in the extensive section "Diseases characterized by increased blood pressure" code I10-I15:
I10 Primary hypertension:
I11 Hypertension causing predominantly damage to the heart
I12 Hypertension causing predominantly kidney damage
I13 Hypertension causing predominant damage to the heart and kidneys
I15 Secondary (symptomatic) hypertension includes:
I60-I69 Hypertension involving cerebral vessels.
H35 With damage to the vessels of the eye.
I27.0 Primary pulmonary hypertension
P29.2 In a newborn.
20-I25 With damage to the coronary vessels.
O10 Pre-existing hypertension complicating pregnancy, childbirth and the puerperium
O11 Pre-existing hypertension with associated proteinuria.
O13 Pregnancy-induced without significant proteinuria
O15 Eclampsia
O16 Exlampsia in mother, unspecified.
Definition of hypertension
What is a disease? This is a persistent increase in blood pressure with indicators of at least 140/90. The disease is characterized by a deterioration in the general condition. In medicine, there are 3 degrees of hypertension:
Blood puts more pressure on the vessels, over time, the heart becomes larger due to the load. The left muscle expands and thickens.
Types of classifications
Essential hypertension
In another way, it is called primary. The disease is dangerous because it is constantly progressing. The entire body is damaged.
In 90% of cases, the cause of the disease cannot be found. Most experts believe that the onset of development is caused by some factors, and the transition to a stable form is caused by others.
The following prerequisites for primary hypertension are distinguished:
Symptoms of essential hypertension:
The disease goes through several stages:
- The first is a periodic increase in blood pressure. Organs are not damaged.
- There is a persistent increase in blood pressure. The condition is normalized after taking medication. Possible hypertensive crises.
- The most dangerous period. It is characterized by complications in the form of heart attacks, strokes. The pressure is reduced after a combination of different means.
Arterial hypertension with heart damage
This form of the disease is typical for people over 40 years old. It is caused by an increase in intravascular tension, accompanied by an increase in heart rate and stroke volume.
If the necessary actions are not taken in a timely manner, then hypertrophy (an increase in the size of the left ventricle) is possible. The body needs oxygen.
The characteristic symptoms of this disease are:
- Compressive pain behind the sternum in the form of seizures;
- Dyspnea;
- Angina.
- No damage.
- Enlargement of the left ventricle.
- Heart failure of various degrees.
- Stressful situations, nervous strain.
- Unbalanced nutrition.
- Nephrological ailments of various origins (chronic pyelonephritis, urolithiasis, cysts, tumors, etc.).
- Diabetes.
- Abnormal structure and development of the kidneys and adrenal glands.
- Congenital and acquired vascular pathologies.
- Failure of the thyroid gland, pituitary gland, central nervous system.
- hypertension with damage to the heart and kidneys with heart failure (I13.0);
- GB with a predominance of nephropathy (I13.1);
- hypertension with heart and kidney failure (I13.2);
- HD involving the kidneys and heart, unspecified (I13.9).
- Increased blood pressure.
- Headaches.
- Noise in ears.
- Unpleasant sensations in the region of the heart, etc.
- Sealing of the walls of blood vessels.
- Atherosclerosis. Caused by failure of fat metabolism.
- Tumors and hematomas, which, when enlarged, compress nearby organs, disrupt blood flow.
- Heredity;
- Dysfunction of the thyroid gland;
- Disease of the central nervous system;
- Traumatic brain injury;
- Diabetes;
- Overweight;
- Excessive alcohol consumption;
- Psycho-emotional disorders;
- Hypodynamia;
- Menopause.
- Increased blood pressure.
- Irritability.
- Head and heart pains.
- Insomnia.
- fatigue.
- dyspnea,
- obesity,
- murmurs in the heart area,
- rare urination,
- increased sweating,
- stretch marks,
- liver enlargement,
- limb edema,
- labored breathing,
- nausea,
- malfunction of the central nervous system and digestion,
- ascites
- blood chemistry;
- An electrocardiogram, which may indicate left ventricular enlargement;
- EchoCG. Detects thickening of blood vessels, the condition of the valves.
- Arteriography.
- Dopplerography. Reflects the assessment of blood flow.
- diuretics;
- means to reduce pressure;
- statins directed against "bad" cholesterol;
- blockers for blood pressure and reducing the oxygen that the heart uses;
- aspirin. Prevents the formation of blood clots.
- Restriction or complete exclusion of salt.
- Replacement of animal fats with vegetable ones.
- Refusal of certain types of meat, spicy foods, preservatives, marinades.
- Stop smoking and drinking alcoholic beverages.
There are three stages of heart damage:
If even one of the symptoms is found, it is necessary to contact a specialist to solve the problem. If you do not deal with this issue, then a myocardial infarction is possible.
Hypertension with kidney damage
The ICD-10 code corresponds to I12.
What is the relationship between these organs? What are the causes and signs of the disease?
The kidneys act as a filter, helping to remove decay products from the body. If their functioning is disturbed, fluid accumulates, the walls of blood vessels increase. This contributes to hypertension.
The task of the kidneys is to regulate the water-salt balance. In addition, thanks to the production of renin and hormones, they control the activity of blood vessels.
Causes of the disease:
Hypertension with damage to the heart and kidneys
In this case, the following conditions are distinguished separately:
For diseases of this group, violations of both organs are characteristic. Doctors assess the condition of the victim as severe, requiring constant monitoring and taking appropriate medications.
Symptomatic hypertension
Another naming is secondary, since it is not an independent disease. It is formed as a result of dysfunction of several organs at the same time. This form occurs in 15% of cases of hypertension.
The symptomatology depends on the disease against which it appeared. Signs:
Vascular pathology of the brain and hypertension
An increase in ICP is a fairly common form of the disease. It is formed due to the accumulation of fluid inside the skull. Causes of occurrence:
and other types, if any
Hypertension with damage to the vessels of the eyes.
An increase in blood pressure entails pathological processes in the visual organ: the retinal arteries become denser and can be damaged. Prolonged ignoring of the symptoms leads to hemorrhage, swelling, complete or partial loss of vision.
There are a lot of factors contributing to the appearance and development of arterial hypertension. Among them are:
Symptoms
Unfortunately, hypertension can be latent for a long time.
General signs of the disease:
Additional symptoms:
How to recognize arterial hypertension?
The main difference of any of the forms is the increase in pressure. When examining a patient, procedures such as:
Treatment
When the first signs of the disease appear, it is necessary to contact a therapist who will study the history of the disease, prescribe the appropriate diagnosis and give a referral to another doctor, usually a cardiologist. The course of treatment depends on the form of hypertension, lesions. Of the drugs prescribed are the following:
In addition to medication, the patient must adhere to a certain diet. What is its essence?
As preventive measures, it is necessary to control weight, adhere to a healthy lifestyle, walk more in the fresh air, play sports, organize the correct daily routine (alternating work and rest), and avoid stressful situations.
You can also use folk methods. But remember that a preliminary consultation with a specialist is necessary.
Since ancient times, chamomile, lemon balm, valerian, mint have been used as sedatives, and rosehip tincture will help in removing excess fluid from the body.
Cataract - complete or partial turbidity lens inside the eyeball.
The mechanism of the development of the disease consists in a change in the biochemical composition of the lens tissues due to the influence of various factors.
Most often, the disease develops after 70 years, but also occurs in those who have reached forty-year-old age, which is associated with age-related changes.
Causes of cataracts
Common causes of cataracts in the eye:
- injury(protein compaction is formed due to mechanical effects on the eye);
- electricity(disruption of the lens from exposure to electric current, alpha rays, ultraviolet rays).
ICD-10 disease code
In the international classification of cataract diseases (ICD-10), code values are assigned from H25 (age-related cataract and its main forms) to H26 (juvenile, traumatic, secondary, and so on).
Reference! According to statistics, cataracts develop due to age-related changes in 90% patients aged 50-70 years old, y 4% the cause is mechanical damage to the eyes, radiation cataract develops in 3% cases.
3% babies suffer from congenital cataracts. Also, the disease manifests itself in patients with endocrine disorders (diabetes mellitus, hormonal imbalance).
initial stage
At the initial stage, clouding of the lens begins - usually along the periphery, less often from the middle of the lens. Gradually, before the eyes begin to appear dark stripes, which are noticeable to the patient, but visual acuity is preserved.
Subsequently, protein seals partially begin to block the view, so vision deteriorates faster. The initial stage of cataract may develop from several months to ten years.
Diagnostics
With the help of modern equipment, it is possible to diagnose the slightest changes in the eye. The following are used for testing:
- Ophthalmoscopy.
- Biomicroscopy.
- Optical coherence tomography.
Treatment in the underdeveloped phase
After diagnosis, it is customary to prescribe first vitamin eye drops. For a long period it is necessary to use solutions ascorbic and nicotine acids. With the use of certain drugs, the eyeball can be significantly strengthened ( Vitafacol, Quinax, Taufon).
Medications intended for the treatment of cataracts contain vitamins, minerals, antioxidants and other beneficial substances that can significantly reduce blurred vision. For a better effect of the drops, it is recommended to take multivitamin preparations.
Photo 1. Quinax, eye drops, 15 ml, manufacturer - Alcon.
In the complex treatment of cataracts, it can be used massage and electrophoresis(10-20 sessions), as well as a special gymnastics for eyes. A set of exercises is agreed with the doctor (for example, basic movements - rotation of the eyeballs up, down, right, left).
Important! Self-medication and the use of folk methods can significantly worsen vision. Medical treatment should be under the strict supervision of an ophthalmologist.
Immature cataract
The disease is characterized by clouding and change in the shape of the lens: it takes convex form, and the protein spot extends from the periphery to the center of the review. The patient notices changes in clarity vision.
It is possible to examine the object in detail only from a close distance.
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Is an operation needed
In the early stages of immature cataracts, vitamins and drugs in the form eye drops- this will help slow down the development of the disease and improve the metabolism of the eyeball.
The patient should be under the supervision of an ophthalmologist, and with a sharp deterioration in vision, it will be necessary to surgical intervention.
Reference! The main indication for surgical intervention is not the cataract stage, but well-being patient and ability to perform elementary work.
Surgical treatment is removal of the lens and the installation of an artificial one, which makes it possible to fully restore vision. Modern technologies allow you to quickly perform the operation, reduce the likelihood of complications and shorten the rehabilitation period.
mature cataract
Mature cataract is characteristic complete turbidity lens, and the pupil acquires lactic shade. The patient is unable to focus on an object - he notices only the movement of objects, but cannot see the details.
Observed double vision objects, weakening the perception of colors and deterioration of vision in the dark (up to its complete loss).
Photo 2. At the mature stage of cataract, the pupil acquires a milky tint.
Diagnostics
Methods for diagnosing cataracts:
- Standard techniques that are necessary for all patients with suspected disease:
- visometry- assessment of visual acuity (from normal to blindness). If the passage of light is normal, the patient will see normally. Any serious visual impairment is a strong argument for surgical intervention;
- perimetry- study of visual fields;
- biomicroscopy– examination of eye tissues, the method is effective in the selection of treatment tactics;
- ophthalmoscopy– method of diagnosing the retina, optic nerve;
- gonioscopy- Examination of the anterior chamber of the eye.
- refractometry- a method for detecting visual disorders (hyperopia, myopia, astigmatism);
- ophthalmometry- a study carried out by means of a special apparatus-ophthalmometer, the essence is the determination of the radius of curvature of the cornea, lens;
- size estimate eyeball;
- skiascopy- observation of the movement of shadows and light in the pupil area;
- electrophysiological study used to determine the sensitivity of the optic nerve.
Diagnostics allows assessing the clinical course of the disease and determining the exact dimensions of the artificial lens that will be installed during the operation.
Additional techniques
Additional methods that are used as prescribed by a doctor:
- densitometry;
- biomicroscopy(ultrasound, endothelial);
- laboratory research methods.
If the performed studies are not enough for the diagnosis, additional tests are prescribed for the diagnosis: blood sugar, complex examinations by specialists.
This makes it possible to eliminate the risks of serious complications in case of surgery.
Diagnosis, which is assigned to patients before hospitalization, includes blood tests for HIV, hepatitis B and C, general blood and urine tests.
Treatment
If the diagnosis of mature cataract is confirmed, treatment should begin immediately. Eye drops, vitamins, and amino acids can be used to stop the progression of the disease, but the only way to restore vision is surgery, "replacement of the lens."
Important! After surgery, patients need medical treatment to improve tissue nutrition and reduce intraocular pressure.
overripe cataract
In the last stage of a cataract, the lens begins to collapse, acquires yellow shade and decreases sharply in sizes. With head movements, he can move around his camera, vision remains at the same level or deteriorates sharply after a while.
Cataract- a disease characterized by varying degrees of persistent opacities of the substance and / or capsule of the lens, which are accompanied by a progressive decrease in visual acuity of a person.
Classification of cataract varieties according to ICD-10
H25 Senile cataract.
H25.0 Cataract senile initial.
H25.1 Senile nuclear cataract.
H25.2 Cataract senile Morganiev.
H25.8 Other senile cataracts.
H25.9 Cataract, senile, unspecified.
H26 Other cataracts.
H26.0 Childhood, juvenile and presenile cataracts.
H26.1 Traumatic cataract.
H26.2 Complicated cataract.
H26.3 Cataract caused by drugs.
H26.4 Secondary cataract.
H26.8 Other specified cataract.
H26.9 Cataract, unspecified.
H28 Cataracts and other lesions of the lens in diseases classified elsewhere.
H28.0 Diabetic cataract.
H28.1 Cataracts in other diseases of the endocrine system, metabolic disorders, eating disorders, which are classified elsewhere.
H28.2 Cataract in other diseases classified elsewhere.
A pooled analysis of the world's available data on blindness shows that the disease is a particularly common cause of preventable blindness in economically developed and developing countries. According to the WHO, today there are 20 million blind people in the world due to cataracts, and about 3,000 surgeries need to be performed. extraction operations per million population per year. In the Russian Federation, the prevalence of cataracts according to the criterion of negotiability can be 1201.5 cases per 100 thousand of the surveyed population. This pathology of varying severity is detected in 60-90% of persons aged sixty years.
Patients with cataracts make up about a third of the people hospitalized in specialized eye hospitals. These patients account for up to 35-40% of all operations performed by ophthalmological surgeons. By the mid-1990s, the number of cataract extractions per 1,000 population was: in the United States, 5.4; in the UK - 4.5. Available statistics for Russia are highly variable, depending on the region. For example, in the Samara region, this indicator is 1.75.
In the nosological profile of primary disability due to eye diseases, persons with cataracts occupy the 3rd place (18.9%), second only to patients with the consequences of eye injuries (22.8%) and patients with glaucoma (21.6%).
At the same time, 95% of cases of cataract extraction are successful. This operation is generally considered one of the safest and most effective among interventions on the eyeball.
Clinical classification
Due to the inability to find out the causes of lens opacities, their pathogenetic classification does not exist. Therefore, cataracts are usually classified according to the time of occurrence, localization and form of clouding, the etiology of the disease.
According to the time of occurrence, all cataracts are divided into two groups:
congenital (genetically determined) and acquired. As a rule, congenital cataracts do not progress, being limited or partial. In acquired cataracts, there is always a progressive course.
According to the etiological basis, acquired cataracts are divided into several groups:
- age (senile);
- traumatic (caused by contusion or penetrating wounds of the eyes);
- complicated (arising with a high degree of myopia, uveitis and other eye diseases);
- beam (radiation);
- toxic (arising under the influence of naphtholanic acid, etc.);
- caused by systemic diseases of the body (endocrine diseases, metabolic disorders).
Depending on the location of the opacities and according to their morphological characteristics, the pathology is divided as follows:
- anterior polar cataract;
- posterior polar cataract;
- spindle cataract;
- layered or zonular cataract;
- nuclear cataract;
- cortical cataract;
- posterior cataract subcapsular (bowl-shaped);
- complete or total cataract.
According to the degree of maturity, all cataracts are divided into: initial, immature, mature, overripe.
Megalocornea refers to ophthalmic diseases. It is characterized by an increase in the diameter of the cornea by at least 2 mm. For example, in a baby, the diameter should be 9 mm, and if it is increased to 11 mm, then this is already considered a disease.
Quite often, this deviation is only a sign of glaucoma, but there is also true megalocornea in children. It should be noted that at the very beginning of the development of the pathology, the cornea is still transparent, turbidity is not observed. But in the chamber of the eyeball in front, there are increases in size, due to which it acquires a deeper shape. It is generally accepted that pathology begins to develop even inside the womb. During this period, the ends in front of the eye cup do not fully close, which leads to the formation of free space for the cornea. The disease may be hereditary. In this case, recessive linkage to the X chromosome occurs. Therefore, a genetic predisposition is observed in boys. Megalocornea - photo:
Distinctive features of megalocornea
- No clouding of the cornea.
- There is no thinning of the limbus.
- There is no limb expansion.
- Descemet's membranes remain intact.
- Intraocular pressure is normal.
- The depth of the anterior chamber changes.
- The occurrence of iridodonesis.
- Simultaneous development of ametropia, anisometry, strabismus, amblyopia, mycosis, embryotoxon, ectopia.
- Pigmentation on the back of the cornea.
- The lens moves.
The International Classification of Diseases equates this disease to congenital glaucoma, so megalocornea - ICD 10 code is Q15.0.
Possible complications, diagnosis
If megalocornea occurs, you should immediately contact an ophthalmologist, as the disease carries many complications, among which the following should be noted:
- Increasing the amount of fluid between chambers.
- Pathological changes in the retina and lens.
- Cataract.
- Retinal detachment.
- Ectopia, that is, when the lens is displaced.
- Pigmentary glaucoma.
- spastic miosis.
Diagnosis includes a differentiated examination, ophthalmological examination and measurement of pressure inside the eyes. During the study, all structures of the visual organ are studied, pathological abnormalities and concomitant diseases are revealed.
How to treat megalocornea
As such, the disease does not require treatment. It is enough to carry out preventive measures to avoid the development of ophthalmic diseases. If the pathology is accompanied, for example, by glaucoma, then the treatment is aimed at eliminating the causes of glaucoma. In general, the prognosis is favorable, as visual acuity does not decrease. The most important thing is timely diagnosis, correct diagnosis and a qualified approach to preventive measures. In the presence of megalocornea in children, it is necessary to periodically check with an ophthalmologist.
Preventive actions
No one knows whether a baby will be born with megalocornea or not, so expectant mothers should take preventive measures. First of all, it is necessary to avoid infection and the development of various kinds of diseases. Particular attention should be paid to nutrition. After all, the formation of the fetus depends on this. Therefore, each organ separately. Be sure a pregnant woman should eat seasonal fruits, berries and vegetables. It is very important to eat fresh food, not frozen. You need to eat dairy products, and refuse fatty, salty, smoked dishes. It is strictly forbidden to expose the expectant mother to stressful situations, because the psychological instability of a woman negatively affects the development of the fetus.
IMPORTANT! Only an ophthalmologist should prescribe preventive measures, and even more so treatment for a child with megalocornea. The fact is that each specific case requires an individual approach, since the visual organs have their own characteristics.
Amblyopia: ICD-10 code, causes and treatments
Amblyopia is a visual impairment of a secondary nature. For all types of such visual pathology, it is characteristic that in adulthood the deterioration in the quality of vision persists after the removal of the main problem that caused amblyopia. The diagnosis of "amblyopia" in medical records can be indicated by a code. There is an International Classification of Diseases (ICD), according to which this or that disease is designated. Currently, the tenth classification is used - MBK-10. According to this classification, amblyopia due to anopia (defect in visual fields) is indicated by the code H53.0
Disease Definition
The term "amblyopia" refers to a decrease in visual acuity due to functional disorders of the visual analyzer. Such a problem most often cannot be corrected with glasses (contact lenses). This disease is also called lazy eye syndrome.
There are several types of functional disorder:
- Anisometropic amblyopia, which can manifest itself in case of serious differences in the refractive power of the left and right eyes;
- Deprivation amblyopia develops as a result of deprivation (reduction or complete deprivation of the ability to see) of one of the eyes due to the presence, for example, of a cataract or clouding of the cornea. After the elimination of the problem, low vision persists;
- Dysbinocular amblyopia, which is caused by the presence of strabismus;
- Hysterical amblyopia, which can also be referred to as psychogenic blindness;
- Refractive amblyopia;
- Obscurative amblyopia develops in the presence of congenital (acquired at an early age) clouding of the optical environment of the eyes.
Amblyopia is caused by the non-participation of one of the eyes in the process of "seeing", which is explained by an already existing problem in the area of \u200b\u200bthe organs of vision.
Causes
Since such a functional visual disorder is a secondary pathology, the causes of its occurrence can be called both the factors that caused functional disorders of the visual analyzer and the processes that explain the decrease in vision. The likelihood of amblyopia increases due to the presence of a number of genetic features. There are some types of inherited diseases that can cause amblyopia:
- Benche syndrome, which is characterized by the presence of strabismus and asymmetric facial hyperplasia;
- Reciprocal balanced translocation;
- mental retardation;
- Low growth;
- Kaufman's syndrome;
- Ophthalmoplegia.
In cases where one of the parents suffers from amblyopia, the likelihood of its manifestation in the child is increased. Most often, this visual disorder manifests itself in families whose members suffer from the presence of strabismus and severe refractive errors. The immediate causes of the development of functional visual impairment are a large number of specific factors that cause amblyopia. For example, in the case of amblyopia caused by strabismus, the pathology develops in the squinting eye. This is due to the fact that the brain is forced to suppress the "picture" that comes to it from the squinting eye.
Manifestations of hysterical amblyopia provoke psychogenic factors that cause visual impairment, color perception, photophobia and other functional disorders.
The appearance of obscurative amblyopia is caused by clouding, dystrophy or injury of the cornea, cataracts, ptosis of the upper eyelid, and serious changes in the vitreous body. The cause of anisometropic amblyopia is a high degree of anisometropia. Visual impairment in this case manifests itself in the eye with more pronounced refractive errors (the process of refraction of light rays in the optical system of the eye). Amblyopia can develop in the case of long-term failure to correct farsightedness, nearsightedness, or astigmatism.
A high risk of developing amblyopia occurs when children are born with a deep degree of prematurity or mental retardation.
Symptoms
Different forms of amblyopia also manifest themselves in different ways. Mild amblyopia may not have symptoms. In babies, the possibility of developing amblyopia can be suspected in the presence of diseases that provoke such a visual disorder. The reason for concern may be the inability of a small child to fix his eyes on a bright object.
Amblyopia may be indicated by a deterioration in visual acuity that cannot be corrected. Also, manifestations of a functional disorder can be:
- Violation of the ability to orient in visually unfamiliar places;
- Deviation of one eye from the normal position;
- Developing the habit of covering your eyes when you need to see something qualitatively or when reading;
- Automatic tilt (turn) of the head when looking at something;
- Violation of color perception or adaptation to the dark.
The hysterical form of amblyopia can occur with severe stress or emotional overstrain. This condition manifests itself as a sudden deterioration in vision, lasting from several hours to several months. The deterioration in the quality of vision in amblyopia can be different. This is an almost imperceptible decrease in visual acuity and its almost complete loss.
In order to diagnose amblyopia, it is important to conduct a comprehensive ophthalmological examination.
Possible Complications
In the absence of treatment or untimely correction of visual disorders, visual acuity can be significantly reduced. Over time, this process is steadily progressing.
Treatment
Treatment of this visual pathology can give the most qualitative result if it is carried out in the early stages. Therapeutic methods are selected individually. All ways of "working" with a problem require consistency and perseverance. Correction of this kind of visual disorders is best done at an early age (children 6-7 years old), in patients 11-12 years old amblyopia may not be correctable. It is important to conduct visual acuity testing for children before the time they enter school.
Methods of treatment of amblyopia are directly dependent on the causes of visual impairment. However, most of the existing methods of treatment consist in reducing or completely eliminating the “competition” of the leading eye with the help of its direct occlusion (“closing” in various ways), which lasts for a long time. In parallel, the function of the amblyopic eye is stimulated.
Therapeutic measures for refractive or anisometropic amblyopia involve the use of conservative methods. This is the optimal vision correction, which is carried out with the help of a careful selection of glasses, night or contact lenses. Laser correction can also be performed. Three weeks after the start of the correction, the doctor prescribes pleoptic treatment (elimination of the predominant role of the better seeing eye, as well as strengthening the functioning of the "weak" eye). Treatment of amblyopia includes physiotherapeutic procedures: vibromassage, reflexology, electrophoresis.
After the end of the pleopty stage, the process of restoring binocular vision begins, which is achieved by the method of orthooptic treatment.
In a medical way
In young children (1-4 years old), the functioning of the organs of vision is corrected using penalization, instilling an atropine solution into the "stronger" eye. This leads to a decrease in visual acuity of the leading eye and activation of the amblyopic eye. In the case of the development of hysterical amblyopia in adults, sedatives may be prescribed, as well as psychotherapy sessions.
With the manifestation of obscurative amblyopia, resolving therapy is performed.
Surgically
In the case of diagnosing obscurative amblyopia, surgical removal of the cataract and correction of ptosis are performed. With dysbinocular amblyopia, strabismus needs to be corrected, which is also performed by surgical methods.
Folk remedies
Most of the folk remedies used cannot improve vision with amblyopia. In most cases, this is wasted time, as well as real harm to health.
Prevention
Prevention of this visual disorder consists in measures that allow as early as possible to detect the pathology leading to the development of amblyopia. To do this, it is necessary to conduct regular examinations of babies by ophthalmologists. It is important to carry out such examinations starting from the first month of life. If visual defects are detected, they must be eliminated at an early age.
Levomycetin eye drops: instructions for use
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Hernia of the upper eyelid - treatment without surgery http://eyesdocs.ru/zabolevaniya/gryzha/izlechima-li-nizhnego-veka.html
Video
findings
Amblyopia is called lazy eye syndrome. This visual disorder is secondary and is characterized by the non-participation of one of the eyes in the process of vision. Amblyopia is a disease that develops mainly in childhood. That is why it is important to detect and correct it as early as possible.
Treatment of amblyopia brings a qualitative result only with the responsible passage of a long course of treatment and compliance with absolutely all prescriptions of an ophthalmologist.
Also read about children's conjunctivitis and about methods of treating chalazion in children.