Ophthalmology: diseases — симптомы, диагностика и лечение

The white of the eye is covered on the outside with a thin transparent membrane - the episclera, and under it lies the dense white sclera, the frame of the eyeball. Inflammation of the superficial layer is called episcleritis: it gives a limited pink or bright red spot, mild discomfort and almost always goes away on its own. Scleritis is an inflammation of the deep membrane, occurs less frequently, occurs with severe aching pain radiating to the temple and jaw, and can lead to thinning of the sclera and loss of vision. Both conditions are often associated with systemic rheumatic diseases, so it is important not just to drop drops, but to understand the cause.

Corneal erosion is damage to the surface layer of the transparent membrane of the eye, in other words, a scratch. The cornea is very rich in nerve endings, so even a tiny defect causes severe pain, profuse lacrimation, photophobia and the inability to open the eye. Household causes: a branch, a nail, the edge of a paper, sand under the eyelid, careless handling of a contact lens, ultraviolet burn from welding. Superficial erosion usually heals in one to three days, but if done incorrectly, a corneal ulcer may develop in its place or a tendency to repeated ruptures of the epithelium may develop.

Retinal detachment is the separation of the light-sensitive membrane of the eye from the underlying layer that nourishes it. The retina does not have its own large vessels in the outer sections and receives oxygen from the outside, so the exfoliated area begins to starve literally from the first hours. The photoreceptors in it die, and the dead cells are not restored by any operation. Hence the only correct attitude to this state: the count is not for weeks, but for hours and days. And the most insidious thing here is the absence of pain. There are no pain endings in the retina, the eye does not turn red, does not water, does not hurt, and the person who has a dark shadow on the side calmly postpones the visit until Monday. It is this delay, and not the disease itself, that most often decides how vision will remain.

Keratoconus is a gradual thinning and stretching of the cornea, in which it turns from a smooth dome into an irregular cone. The optics of the eye cease to be predictable: the image is distorted so that ordinary glasses no longer collect it into a clear picture, no matter how much you change the glasses. The disease usually debuts in adolescence or about twenty years and progresses slowly, and by the age of 35-40 it most often stabilizes. And here's what makes early diagnosis truly crucial: There is a procedure—corneal collagen crosslinking—that stops the progression. It does not restore lost vision, but fixes the cornea in the condition in which it was found. Therefore, the price of delay here is measured not in money, but in diopters that will remain with the person forever.

Diabetic retinopathy is damage to the small vessels of the retina, which develops with long-term diabetes mellitus and remains one of the leading causes of vision loss in people of working age. Its main feature and main danger is one thing: for a very long time, for years, a person sees well. Changes accumulate in the periphery of the retina, where visual acuity is not formed, and no complaints arise until those stages when it is already difficult to treat. And then vision suddenly decreases - within hours, due to hemorrhage - and the patient is sincerely convinced that “everything happened yesterday.” Hence the only rule that really works: in case of diabetes, the fundus is examined on a schedule, regardless of how you feel. An annual inspection without complaints is not reinsurance, but a way to catch the process at a stage when it can still be stopped with a laser.

A stye and a chalazion are two different conditions that are often confused because they both look like a lump on the eyelid. Barley is an acute purulent inflammation of the hair follicle of the eyelash or sebaceous gland: it appears quickly, hurts and turns red. A chalazion is a chronic, painless lump caused by a blockage of the meibomian gland: it grows slowly and can persist for months. They are treated differently, and the main rule for both is the same: do not squeeze under any circumstances.