Ophthalmology: diseases — симптомы, диагностика и лечение

Redness of the eyes occurs when the small vessels of the conjunctiva and sclera dilate or blood flows under the conjunctiva. This is one of the most common reasons to consult an ophthalmologist. In most cases, the causes are harmless: lack of sleep, screen time, dry air, smoke, irritation from chlorinated water, allergies or viral conjunctivitis. However, redness can also be a sign of serious illnesses - keratitis, uveitis, an acute attack of glaucoma, a chemical burn or injury, which can lead to loss of vision. Associated symptoms help to distinguish one from the other: pain, photophobia, decreased vision, rainbow circles, discharge. If redness is accompanied by pain or blurred vision, an examination is needed on the same day, and not after a week of self-medication with drops.

Presbyopia is an age-related decrease in the eye's ability to see clearly at close range. To view a close object, the lens changes shape and becomes more convex; this process is called accommodation. Over the years, the lens thickens and loses elasticity, so after about 40–45 years a person begins to move the phone and book away, and in low light, small print becomes unreadable. Presbyopia develops in all people, it is not a disease, but a natural change, and it cannot be prevented by exercise. It can be easily corrected with glasses, contact lenses or surgery. The first appearance of complaints is a good reason to undergo a full examination by an ophthalmologist: after 40 years, the risk of glaucoma and other eye diseases increases.

Pterygium is a triangular-shaped growth of the conjunctiva that slowly creeps onto the cornea, usually from the side of the nose. The tissue thickens, blood vessels grow in it, and the eye looks as if a film has appeared on it. The main reason is long-term exposure to ultraviolet radiation, so pterygium is common in sunny climates, among people working outside: builders, drivers, farmers. A small pterygium causes only a cosmetic defect and periodic irritation, but when it grows towards the center of the cornea, it distorts its shape, causes astigmatism and reduces vision. Then it is removed surgically.

Ptosis is a drooping of the upper eyelid, in which its edge is located below normal and partially or completely covers the pupil. The eyelid is raised by a muscle innervated by the oculomotor nerve and a small muscle associated with the sympathetic nervous system. Ptosis can be congenital, when the muscle is underdeveloped, and acquired: most often the muscle tendon is stretched with age, less often the cause is nerve damage, myasthenia gravis, injury or tumor. In a child, ptosis, which covers the pupil, interferes with the development of vision and can lead to amblyopia. In an adult, it limits the field of vision and causes fatigue. Sudden drooping of the eyelid with double vision, dilated pupils or headache is a reason to immediately call 103, as this may be a sign of an aneurysm or stroke.

A sharp deterioration in vision is a decrease in acuity or a narrowing of the field of vision that occurs suddenly: over minutes, hours or several days. It can affect one or both eyes and may appear as a blur, dark spot, blinders, distorted lines, or complete loss of vision. This symptom is often accompanied by emergency conditions: blockage of the retinal artery, retinal detachment, acute attack of glaucoma, inflammation of the optic nerve or stroke. In many of these cases, the outcome of treatment depends on the clock, so waiting for vision to recover on its own is dangerous. The main conclusion: sudden loss of vision is a reason to see an ophthalmologist on the same day, and if combined with neurological symptoms, call an ambulance at 103.

Retinoblastoma is a malignant tumor of the retina that develops in young children, most often before the age of five. It arises from immature retinal cells when the gene that controls their division is damaged. The tumor can be hereditary, and then often affects both eyes, or sporadic, occurring accidentally in one eye. A small child does not complain of vision, so the disease is usually noticed by parents by an unusual white reflection of the pupil or by a sudden squint. This is a disease in which timely treatment decides not only the fate of vision, but also the life of the child: with early detection, the prognosis is good.

The retinal vessels grow from the center to the periphery and complete their path only towards the end of pregnancy. In case of premature birth, this process is interrupted: the retina at the edge remains without blood vessels, experiences a lack of oxygen and, in response, triggers the growth of defective new vessels. They are fragile, bleed and drag along scar tissue, which can detach the retina. This is retinopathy of prematurity - one of the leading causes of childhood blindness, completely preventable with timely examination. Externally, the child’s eyes look absolutely normal, and it is impossible to notice the disease without a special examination.

Photophobia, or photophobia, is an increased painful sensitivity to light, in which ordinary lighting causes pain, lacrimation and the desire to close your eyes. This is not a separate disease, but a symptom that occurs when the trigeminal nerve is irritated, inflammation of the anterior segment of the eye, or increased excitability of the visual pathways of the brain. The most common causes are related to the eyes: dryness, corneal erosion, foreign body, conjunctivitis, inflammation of the iris. Neurological ones are no less important: migraine, concussion, and in combination with headache, fever and tension in the neck muscles - meningitis, which requires emergency help. An examination by an ophthalmologist, and, if necessary, a neurologist, helps to understand.

Dry eye syndrome is not just a lack of tears, but a disruption of the entire tear film, the thinnest three-layer coating that every blink re-spreads over the surface of the eye. The film can tear due to the fact that little tears are produced, but more often it simply evaporates too quickly: there is not enough fatty layer to hold it. Hence the main paradox of this condition, which confuses both patients and sometimes doctors: with dry eyes, very often they water, and profusely, and a person spends years being treated for anything other than the real cause. And one more thing that is worth knowing before going to the pharmacy: vasoconstrictor “drops for redness” for dry eyes do not help, but perpetuate the problem - they remove the symptom for a couple of hours and make the next redness stronger than the previous one.

Sjogren's syndrome is an autoimmune disease in which the immune system attacks the glands that produce saliva and tears. The mucous membranes stop moisturizing: the eyes turn red and hurt, as if sand had gotten into them, the mouth is constantly dry, it is difficult to eat dry food and talk for a long time. Caries develops quickly, the tongue becomes inflamed, and jams occur. The disease can be primary when it occurs on its own, and secondary when it occurs against the background of rheumatoid arthritis, systemic lupus erythematosus or another rheumatic disease. In addition to the glands, the entire body can suffer: joint pain, severe fatigue, dry skin and vagina, and sometimes the lungs, kidneys and nerves are affected.