Ophthalmology: diseases — симптомы, диагностика и лечение

Refractive errors are conditions in which the image is focused away from the retina and vision becomes blurry. These include myopia, farsightedness and astigmatism. These are not diseases of the eye in the usual sense, but features of its optics, and they are corrected with glasses, lenses or surgery. Childhood myopia deserves special attention: it progresses while the eye is growing, and modern ophthalmology can slow down this process - but only if it starts on time.

Pain in the eyes can be superficial - cutting, stabbing, with a feeling of sand - or deep, pressing, aching, radiating to the head. Superficial pain is most often associated with the cornea and conjunctiva: mote, erosion, keratitis, dry eye, conjunctivitis. Deep pain occurs with uveitis, scleritis, acute attack of glaucoma, optic neuritis and inflammation of the tissues of the orbit. Sometimes the eye hurts due to migraine, sinusitis, visual fatigue or neuralgia. Most causes are highly treatable, but some can cause permanent vision loss within hours or days. Therefore, pain along with decreased vision, redness, photophobia, rainbow circles, or after an injury requires immediate examination by an ophthalmologist rather than home treatment.

Age-related macular degeneration, or macular degeneration, is a chronic disease of the central area of ​​the retina, the macula, which is responsible for clear vision, reading, and recognizing faces and colors. The disease usually develops after 50–55 years and is one of the main causes of irreversible decline in central vision in older people. There is a dry form, which progresses slowly, and a wet form, in which pathological vessels grow under the retina, and vision can deteriorate over weeks. The main symptoms are curvature of straight lines, a blurry or dark spot in the center. Peripheral vision is preserved, so AMD does not cause complete blindness. The wet form responds well to treatment with injections if started early, so at the first signs you should immediately consult an ophthalmologist.

Congenital cataract is a clouding of the lens that is present at birth or appears in the first months of life. The cloudy lens does not transmit a clear image to the retina, and the child’s visual system is only being adjusted during this period. If the signal is not received, connections between the eye and the brain are not formed, and deep amblyopia develops, which can no longer be corrected. Therefore, time is of decisive importance: they try to operate on severe cataracts in the first weeks and months of life. The most noticeable sign is a white or grayish pupil, lacking the usual red glow in flash photographs. In this case, the child may not follow the mother’s face and may not fix his gaze.

Secondary cataract is not a return of the previous disease, but clouding of the thin posterior capsule into which an artificial lens was placed during surgery. The lens itself remains transparent and does not become cloudy: the film behind it becomes cloudy. The remaining epithelial cells grow throughout the capsule, and the light begins to scatter. Months or years after successful surgery, vision becomes blurry again, and glare and halos appear around the lights. The condition is common, is not dangerous to the eye, and is completely resolved with an outpatient laser procedure without incisions or anesthesia that takes a few minutes.

Hemophthalmos is the entry of blood into the vitreous body, a transparent gel that fills the eye cavity. Normally, light passes through it unhindered to the retina; the blood scatters the rays, and the person suddenly sees a veil, many floating shadows, or almost loses vision in one eye. There is usually no pain. The hemorrhage itself is not a disease, but a signal: a vessel is damaged somewhere. Most often it is caused by diabetic retinopathy, retinal rupture or detachment, retinal vein thrombosis, and trauma. Therefore, the main task is not to wait for the blood to resolve, but to find its source as quickly as possible.

Dacryocystitis is an inflammation of the lacrimal sac located at the inner corner of the eye. Tears normally flow through the lacrimal puncta and sac along the nasolacrimal duct into the nasal cavity. If the channel is blocked, the tear stagnates, bacteria multiply in it, and inflammation develops. In newborns, the cause is usually a thin film at the end of the canal, which did not have time to open before birth: the eye waters and festers, and when pressing on the area of ​​the sac, pus is released. In many children, patency is restored on its own or after massage. In adults, dacryocystitis is associated with acquired narrowing of the canal and often requires surgery. Acute dacryocystitis with painful swelling can spread to the orbit, so such symptoms require urgent examination.

Color blindness is a color vision disorder in which a person is less able to distinguish certain shades. Three types of cones in the retina are responsible for the perception of color, sensitive to red, green and blue parts of the spectrum. If one of the types does not work correctly or is missing, some of the shades merge. Most often, red-green discrimination suffers, and this feature in the vast majority of cases is congenital and hereditary, and therefore stable throughout life. Acquired color vision disorders occur in diseases of the retina and optic nerve and, unlike congenital ones, require examination and treatment of the underlying disease.

Diplopia is the perception of one object as two. Normally, the brain merges images from both eyes into a single picture; To do this, the eyes must move in strict coordination. If the work of the eye muscles or the nerves that control them is disrupted, the axes of the eyes diverge, and the person sees two images. Less commonly, double vision occurs in one eye and is associated with optics - clouding of the lens, cornea, dryness. Diplopia is not an independent disease, but a symptom, and its value is that it indicates to the doctor the cause: from banal eye fatigue to conditions requiring emergency care.

The eyelid normally fits tightly to the eyeball, and the eyelashes are directed outward. With inversion (entropion), the edge of the eyelid turns inward and the eyelashes begin to rub the cornea - pain, a feeling of sand and the risk of ulcers occur. With eversion (ectropion), the eyelid, on the contrary, moves away from the eye: the lacrimal punctum stops collecting tears, the eye constantly waters, and the conjunctiva dries out and turns red. Both conditions are most often associated with age-related weakening of the tissues of the eyelid, but can be a consequence of scarring, facial paralysis, or a congenital condition. Drops relieve symptoms, but the position of the eyelid can only be corrected by surgery.