Ophthalmology: diseases — симптомы, диагностика и лечение

A cataract is clouding of the lens, the natural lens inside the eye. Light stops passing freely to the retina, and vision becomes as if through foggy glass. It is the most common cause of reversible blindness in the world, and the word “reversible” is key here: cataracts are completely cured by surgery, during which the cloudy lens is replaced with a clear artificial lens. At the same time, there are no drops that resolve cataracts - and this is the main thing you should know so as not to waste years.

Glaucoma is a group of diseases in which the fibers of the optic nerve gradually die due to increased intraocular pressure. It is called the “silent thief of vision”: the most common, open-angle form does not give any symptoms for years, and the field of vision narrows so slowly and from the edges that a person does not notice it. When complaints appear, a significant part of the optic nerve has already died. And here’s the main thing you need to understand: dead fibers are not restored. Treatment can stop the process, but cannot restore what was lost - so early detection makes all the difference.

Conjunctivitis is an inflammation of the thin transparent membrane that covers the white of the eye and the inner surface of the eyelids. This is the most common cause of red eye, and in most cases the condition is benign and goes away on its own. The problem is different: under the mask of conjunctivitis, diseases that threaten vision can be hidden - keratitis, iridocyclitis, an acute attack of glaucoma. A few simple signs help to distinguish them, and knowing them is useful for everyone.

Amblyopia, or “lazy eye,” is a decrease in vision that develops in childhood due to the fact that the brain receives a blurry or displaced image from one eye and begins to suppress it. The eye itself may be healthy, but the connection between it and the visual centers of the brain is formed incorrectly. Common causes are strabismus, a large difference in the visual power of the two eyes, high farsightedness or astigmatism, as well as obstacles to light, such as congenital cataracts or drooping eyelids. The child usually does not complain because he sees well with the other eye. Amblyopia is well treated with glasses and training the weak eye, but it is most effective in preschool age, so early preventive examinations by an ophthalmologist are very important.

Retinal angiopathy is a change in the vessels of the fundus of the eye, which an ophthalmologist sees during examination: narrowing or expansion of arteries and veins, their tortuosity, cross-clamping, minor hemorrhages. This is not an independent disease, but a reflection of the state of the blood vessels of the whole body. Most often, angiopathy is associated with arterial hypertension, diabetes mellitus and atherosclerosis, less often with kidney diseases, blood, injuries and pregnancy. The retina is the only place where the vessels can be seen directly, so such changes serve as an important signal for the cardiologist and endocrinologist. In the early stages, vision does not suffer, but without control of the underlying disease, hemorrhages, swelling and thrombosis of retinal vessels are possible. The main treatment is to normalize blood pressure, sugar and cholesterol.

Anisometropia is a condition in which the optical power of the right and left eyes differs. One eye may be nearsighted and the other normal or farsighted, or the difference may be in the degree of astigmatism. A small discrepancy exists for many people and does not interfere in any way. But when the difference becomes noticeable, the brain receives two images of different clarity and size and cannot combine them. In adults, this manifests itself as visual fatigue and headaches, but in a child, the brain simply suppresses the signal from the worse eye - amblyopia, or “lazy eye,” develops. This is why it is important to detect anisometropia as early as possible.

Optic nerve atrophy is not an independent disease, but the result of damage to the nerve fibers that transmit images from the retina to the brain. The dead fibers are not restored, so the doctor sees a pale optic disc in the fundus, and the patient notes a persistent decrease in vision, loss of parts of the visual field and deterioration in color perception. The causes are varied: glaucoma, impaired blood supply, inflammation, tumors, trauma, hereditary and toxic lesions. The point of the examination is to find the cause and stop the process: preserving the remaining fibers is much more realistic than returning the lost ones.

The cornea is the transparent window of the eye through which light enters. Its transparency is based on the strictly ordered arrangement of collagen fibers. Any deep injury - an ulcer, burn, severe infection, injury - heals with a scar in which the order of the fibers is disturbed and the area becomes cloudy. This is how a thorn is formed. Depending on its density, it is called a cloud, a spot or a leukoma. How much vision will be affected depends not on the size, but on the location: a small scar exactly in the center of the pupil interferes much more than a large clouding on the periphery. The cataract itself does not resolve, but modern surgery in many cases restores vision.

Blepharitis is a chronic inflammation of the eyelid margins, one of the most common eye diseases in adults. The edges of the eyelids become red and thick, there is itching, burning, a sandy feeling, and in the morning crusts appear on the eyelashes. Causes include overgrowth of bacteria on the skin of the eyelids, seborrheic dermatitis, rosacea, demodex mites, and blockage of the meibomian glands, which secrete the fatty layer of the tear film. Blepharitis is not harmful to vision with proper care, but is often accompanied by dry eye syndrome, styes and chalazions. The disease is prone to exacerbations, so the goal of treatment is not a one-time cure, but long-term control. The basis is daily eyelid hygiene, which is supplemented with medications prescribed by an ophthalmologist.

Blepharospasm is a form of muscular dystonia in which the orbicularis oculi muscles contract involuntarily and the eyelids forcefully close. A person cannot open his eyes by force of will, although his vision and the eyes themselves may be healthy. It usually starts with increased blinking, a feeling of sand and increased sensitivity to bright light, and then prolonged squinting of the eyes. Symptoms are worsened by exposure to sunlight, screen time, and stress and are relieved by sleep or talking. In severe cases, the person effectively becomes functionally blind, although the eyes can see. The condition responds well to treatment with botulinum toxin injections.