Ophthalmology: diseases — симптомы, диагностика и лечение

Asthenopia is visual fatigue that occurs with prolonged strain on the eyes: working at a computer, reading, driving, small manual work. The eyes get tired, burn, turn red, blurriness, heaviness and headache appear, often towards the end of the day. This is not a separate disease, but a signal that the visual system is working under strain. Common causes include ill-fitting or outdated glasses, hidden farsightedness and astigmatism, age-related presbyopia, weakness of the adductor muscles, and dry eye syndrome, which worsens with infrequent blinking at the screen. Asthenopia does not permanently damage vision, but it noticeably reduces performance. In most cases, it can be eliminated with proper vision correction, breaks and organization of the workplace.

Keratitis is an inflammation of the cornea, the transparent front layer of the eye through which light enters. The cornea is responsible for a significant part of the refractive power of the eye, so any inflammation or clouding of it immediately affects vision. Keratitis can be infectious - bacterial, viral, fungal or caused by Acanthamoeba - and non-infectious, associated with trauma, dry eyes, ultraviolet radiation or incomplete closure of the eyelids. The main risk factor for infectious keratitis is improper wearing of contact lenses. The disease is manifested by pain, redness, photophobia and lacrimation. Unlike conjunctivitis, keratitis can quickly lead to corneal scarring and permanent vision loss, so if you suspect it, you should contact an ophthalmologist on the same day.

Coloboma is a congenital defect of eye tissue that occurs due to the fact that during intrauterine development the so-called embryonic fissure is not completely closed. Depending on which structure is affected, coloboma can be the iris, lens, choroid, retina, or optic nerve. The most noticeable variant is iris coloboma: the pupil is elongated downwards and resembles a keyhole or a drop. The effect on vision is very different: a defect in the iris alone often does little to interfere and creates only increased sensitivity to light, while involvement of the retina and optic nerve can significantly limit vision. It is impossible to restore the missing tissues, but competent support of the child gives a lot.

Neonatal conjunctivitis is an inflammation of the mucous membrane of the eye in the first month of life. It manifests itself as redness, swelling of the eyelids, lacrimation and discharge, due to which the eyelids stick together after sleep. The reasons can be different: an infection acquired during the passage of the birth canal, bacteria that entered later, irritation with eye drops immediately after childbirth, and very often - not inflammation at all, but obstruction of the nasolacrimal canal, when the tear stagnates and an infection occurs. It is important to distinguish between these conditions because they have different treatments. The eyes of a newborn require caution: any drops and ointments are prescribed only by a doctor; self-medication is unacceptable here.

Strabismus is a condition in which the eyes look in different directions: one is directed at an object, and the other deviates inward, outward, up, or down. The deviation may be permanent or appear periodically, for example due to fatigue. In children, strabismus is most often associated with farsightedness, dysfunction of the eye muscles, or heredity, and the main danger is amblyopia: the brain suppresses the image of the squinting eye, and vision in it is reduced. In adults, sudden strabismus with double vision may be a sign of a stroke, nerve damage from diabetes, or thyroid disease and requires urgent evaluation. Strabismus does not go away on its own with age. It is treated with glasses, training, and, if necessary, surgery on the eye muscles.

Subconjunctival hemorrhage is a collection of blood under the conjunctiva, the thin transparent membrane that covers the white of the eye. In everyday life they say that a blood vessel has burst in the eye. A bright red spot with clear edges appears on the squirrel, which looks scary, but usually does not hurt or affect vision. The small vessels of the conjunctiva are fragile and can rupture with severe coughing, sneezing, vomiting, straining, heavy lifting, rubbing the eyes, or for no apparent reason. Bleeding occurs more often in people with high blood pressure and those taking blood thinning medications. The blood resolves on its own within 1–2 weeks; treatment is usually not required. However, hemorrhage after injury, with pain or decreased vision, should be urgently shown to an ophthalmologist.

Xanthelasmas are soft yellowish plaques on the skin of the eyelids, most often at the inner corner of the eye and usually symmetrical. These are accumulations of lipid-filled cells in the superficial layers of the skin. They do not hurt, do not itch and do not turn into cancer, but they do not disappear themselves, and over time they often increase and merge. About half of people with xanthelasma have impaired fat metabolism - increased cholesterol or its “bad” fraction, so the appearance of such plaques is a good reason to check the lipid spectrum, blood sugar and assess cardiovascular risk, and not just solve the issue of cosmetics.

Night blindness, or nyctalopia, is vision impairment in low light. The rods of the retina are responsible for vision at dusk; for their work, they need visual pigment, which is built from vitamin A. If there are few rods, they are damaged or there is not enough pigment, a person cannot get used to the dark for a long time, stumbles in a poorly lit room, gets lost when leaving a bright room and drives worse at night. Night blindness is a symptom, not a diagnosis: there are many different causes behind it, from vitamin A deficiency to hereditary retinal diseases and advanced glaucoma.

The macula is a tiny central part of the retina responsible for the sharpest vision: reading, recognizing faces, working with small details. Macular edema is an accumulation of fluid in its layers due to the fact that the retinal vessels begin to leak plasma. The tissue thickens, photoreceptors shift, and central vision blurs: letters become blurry, straight lines appear curved, and objects appear smaller or larger than they are. Peripheral vision is preserved, so the person does not go blind, but everyday tasks become difficult. This is not an independent disease, but a complication of diabetes, retinal vein thrombosis, inflammation or eye surgery.

Choroidal melanoma is a malignant tumor that develops from the pigment cells of the choroid. This is the most common primary malignant tumor of the eye in adults, and it is in no way related to cutaneous melanoma in terms of its mechanism of occurrence, although it originates from the same cells. The tricky thing is that the tumor grows asymptomatically for a long time: the choroid has no painful endings, and vision suffers only when the lesion approaches the center of the retina or causes its detachment. Therefore, a significant proportion of cases are detected by chance during a routine fundus examination. Early diagnosis allows you to save the eye and largely determines the prognosis.