Ophthalmology (from the Greek. ὀφθαλμός "eye" + λόγος "teaching") - the field of medicine that studies the eye, its anatomy, physiology and disease, as well as developing methods of treatment and prevention of eye diseases.
Differences from optometry
Ophthalmology originated in ancient times. The name and the image of Peni Ankh Iri, one of the healers who treated eye diseases who lived in Egypt as early as the middle of the second millennium BC, reached our days.
Cornelius Celsus (1st century BC) established the existence of the iris, ciliary body, anterior and posterior chambers. He also divided blindness into irreversible, caused by glaucoma, and reversible, caused by cataracts. Celsus improved the technique of cataract nudging, which was used until the middle of the 17th century.
Arab physicians have merit in systematizing the knowledge of ancient civilizations and their extensive practical application. Ibn al-Khaytham (Alhazen, 10th — 11th centuries AD) wrote a book on optics, which largely contributed to the invention of glasses and the emergence of modern theories of vision in Europe. The well-known work of Abu Ali Ibn Sina (Avicenna, 10th century AD). The Canon of Medical Medicine has been a basic guide to eye diseases in both Arab countries and Europe for more than 500 years.
In the XIX century, the English surgeon George Critchet, who played a significant role in the development of modern ophthalmology, acquired European fame for its ophthalmologic operations and publications.
Differences from optometry
In the USA, ophthalmologists, having studied for 4 years and having received a bachelor's degree, have been studying at a medical school for 4 years to receive a degree of doctor of medicine (MD) or doctor of osteopathy (DO). Ophthalmologists are additionally trained for 3-4 years on residency. Secondary specialization in ophthalmology covers all aspects of the diagnosis and treatment of eye diseases, as well as diseases affecting the eye sockets and neurological systems of the brain. This includes surgical treatment. Many ophthalmologists undergo additional practical training (as a junior research assistant) in various specializations.
In the USA, optometrists also study for 4 years and receive a bachelor's degree, then after 4 years of the Optometric School they receive the degree of Doctor of Optometry (OD). While attending school, optometrist students undergo internal training and, at the end, can choose a 1- or 2-year residency program for further specialization.
Optometrists, having graduated from a residency, can further specialize in a particular area, such as pediatric optometry, geriatric optometry, behavioral (psychological) optometry or neurooptometry.
The curriculum in the United States includes courses such as vision science, health science, pharmacology, comprehensive diagnostics, and medical care for diseases affecting the eyes, eye sockets, and the neurological system of the brain. Examples include courses in visual psychophysics, optics, and the study of aspects of functional vision, such as visual therapy, binocular vision, and reduced vision. Optometrists also learn the basics of anatomy, histology, neurology, and visual perception. They have a basic understanding of the etiology of disease, care and treatment. Most optometrists can do the same thing as ophthalmologists, with the exception of treating diseases (such as ptosis, strabismus, wet degeneration of the macula, proliferative diabetic retinopathy, glaucoma, cataracts), which require surgical qualifications. Depending on the licensing and regulatory requirements, some states limit the prescription of oral medications to optometrists.
Mutual cooperation often takes place in the following two areas:
- Ophthalmologists may refer a patient to an optometrist with the goal of assigning contact lenses or optical devices or rehabilitating low vision, while continuing to treat such a disease / disorder that could cause a decrease in vision.
- Similarly, for eye diseases that are complex or require emergency care, the optometrist guides the patient to an ophthalmologist.
Both optometrists and ophthalmologists conduct mass screening of the population in order to identify individuals with certain eye diseases affecting children (amblyopia and strabismus) and adults (cataracts, glaucoma, and diabetic retinopathy).
Optometrists mainly correct strabismus and amblyopia by visual therapy, while ophthalmologists correct these disorders by refractive, orthoptic, drug therapy and surgical intervention.
What does the oculist doctor do?
An oculist is a doctor who is engaged in the prevention and treatment of eye diseases. He is also called an ophthalmologist or an eye doctor. In addition to in-depth knowledge of the structure of the eye and its diseases, the ophthalmologist must be able to understand the anatomy of the body, since eye diseases can be directly related to disruptions in the work of various organs.
Therefore, an oculist is, first of all, a specialist in general medicine who is able not only to make a diagnosis, but also to reveal its cause.
Ophthalmology is a very responsible science that requires the involvement of modern equipment and instruments. Thanks to the use of new generation equipment and improved methods of examination, the reception of an oculist takes a minimum of time and proceeds completely painlessly.
How often should an eye examination be performed
At a young age, a person who has no problems with vision is recommended to check the eye doctor every 3–5 years.
In the period from 40 to 65 years, it is necessary to undergo examination once every 2–4 years.
People over 65 are advised to check their eyesight once a year. Subject to the presence of problems in this area, it is necessary for the oculist to appoint a treatment and follow-up examination schedule.
People who are in a mature, old age, as well as those suffering from diabetes and other diseases that affect vision are in the risk zone of eye diseases.
Injured or illnesses of the eye in the past increase the risk of cataracts, glaucoma, retinal dystrophy, and astigmatism.
Symptoms of eye diseases
If the following signs of visual impairment appear, it is urgent to contact an ophthalmologist:
- change the color of the iris,
- the appearance of pain, itching, burning in the eyes,
- spots, extraneous lines in sight,
- difficulty adapting the eyes in dark rooms,
- the appearance of veil in the eyes, preventing clear vision.
What the eye test includes
During the diagnosis, the doctor will accurately determine visual acuity, measure intraocular pressure, examine the eye with a microscope, measure the thickness of the cornea, determine the length of the eye, carefully examine the retina, and determine the level of tear production.
External eye examination
Examination of the outer surface of the eye in most institutions is performed according to the standard scheme. If necessary, the scope of research expands the oculist. Eye examination begins with a peripheral vision examination. Then there is an external examination of the eyelids for the absence of barley, a tumor, a cyst, or a weakening of the eyelid muscles. The cornea is evaluated, as well as the condition of the outer surface of the eyeballs.
Through a biomicroscope, the doctor examines the sclera - a dense white membrane that covers the eye outside, and the conjunctiva - a transparent mucous membrane that protects the front side of the eyeball. The reaction of the pupils to light is investigated.
Vision Coordination Analysis
An important part of the examination is to check the functioning of the 6 muscles that provide good vision. The oculist selects a suitable test and analyzes the performance of these six muscles for synchronicity. The brain aggregates incoming information from the eyes about surrounding objects, and then a three-dimensional picture is formed. To test the grouping mechanism, the vision is focused on an object. At the same time, with the help of a special blade, both eyes are covered and opened in turn. Through this method, information coming from both eyes terminates the connection. At this point, the oculist identifies possible deviations from the norm. There is another way to check the synchronism of the movement of the eyeballs: tracking a beam of light.
Inspection of the inner surface of the eye
Using biomicroscopy, optical media and eye tissues are examined. For this purpose, a slit lamp is used - a diagnostic tool. It helps to clearly examine the cornea, the inner chamber of the eyes, lens and vitreous body. The ophthalmologist performs a complete analysis to ensure that there is no inflammation, cataracts, tumors or damage to the blood vessels.
With the help of a lamp that allows you to carefully examine the internal state of the eye, eliminates the possibility of an incorrect conclusion of a doctor. An oculist is an expert analyst who, based on a large amount of information collected, is able to establish an accurate and definitive diagnosis.
Examination of dilated pupils
For the convenience of examining the inner surface of the eye, the doctor applies special drops that widen the pupils. At the same time, it may appear difficult to concentrate your gaze on objects located nearby. After the examination is not recommended to get behind the wheel of a car, as well as to go out without sunglasses. If necessary, quickly return the pupil to a normal state, drops are used, which contributed to the constriction of the pupil.
Measurement of intraocular pressure
In order to identify the initial stage of a disease such as glaucoma, the doctor measures eye pressure. To eliminate discomfort during the procedure, anesthetic drops are introduced. After that, a special device is applied to the cornea, exerting pressure on it.
Fundus examination procedure
To examine the internal state of the eye, an ophthalmoscope is used. This tool consists of focusing lenses as well as a slit lamp. They form a deeper picture of the state of the eye, allow us to evaluate the vitreous body, the retina, the macula, the optic nerve and the vessels feeding it.
In some patients, with such a deep examination, dystrophy, tears, retinal detachment are detected - types of fundus pathology that are not manifested clinically, but provide for urgent treatment.
In case of any microsurgical or laser intervention, complex eye examinations are first performed using computer technology. Such a diagnosis helps to identify existing problems, threats of new diseases, as well as to determine the sequence of treatment.
Thus, the oculist is a specialist of a wide profile, possessing an extensive base of knowledge and skills, which allow to identify the signs of any diseases in a timely manner even at the stage of occurrence. In time detected disease and prompt treatment will prolong the health of the eye for many years. In this regard, it must be remembered that the guarantee of excellent vision is a regular check-ups with an ophthalmologist.
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What are the duties of an ophthalmologist?
In the course of his medical practice, the ophthalmologist must follow a number of rules and perform a number of functions that are regulated by current legislation.
An ophthalmologist is required to:
- Advise patients about all sorts of eye problems.
- To conduct an examination of the patient's organ of vision, using modern techniques and technologies.
- To expose the diagnosis on the basis of data obtained during the examination of the patient.
- Provide to the patient (in an accessible, understandable languagea) information about his disease, about existing methods of treatment, as well as about the possible consequences and complications.
- To treat a patient’s existing disease using modern techniques and means (however, only after agreeing the treatment regimen with the patient himself and after receiving consent from him).
- Monitor the effectiveness of treatment.
- Inform the patient about the methods of preventing relapse (redevelopment) diseases.
- To carry out sanitary and educational work among the population, informing people about the methods of prevention of various diseases of the organ of vision.
- Regularly improve their knowledge and skills in the field of ophthalmology (science, studying the visual analyzer and its various pathologies).
Ophthalmology itself is concerned with studying the structure of the visual analyzer, as well as the mechanisms of development and treatment of eye diseases. For therapeutic purposes, ophthalmologists can use not only conservative, but also surgical methods, which allows them to assist patients with the most diverse and complex diseases.
The duties of the ophthalmologist-surgeon include:
- Detection of eye diseases requiring surgical treatment.
- Examination of the patient and his preparation for surgery (if required).
- Conducting surgery on the eyeball, eyelids, eye muscles, and other tissues related to the organ of vision.
- Postoperative management of the patient with the aim of early detection and elimination of possible complications.
- Monitoring the effectiveness of surgical treatment.
- Rehabilitation of the patient who underwent surgery on the eyes.
As mentioned earlier, the lens provides a device for viewing the objects at different distances. This function is provided by the apparatus of accommodation, which, in addition to the lens, includes the ciliary muscle and the cinnamon ligament (connects the muscle with the edges of the lens). When examining a nearby object, a contraction of the ciliary muscle occurs, as a result of which the lens ligaments weaken, it becomes more convex, and its refractive power increases. At the same time, when viewing a distant object, this muscle relaxes, which leads to a flattening of the lens and a decrease in its refractive power.
Accommodation spasm is a pathological condition in which the ciliary muscle contracts, but does not relax (that is, spasms). At the same time, the lens is fixed in the maximum convex state, as a result of which a person cannot properly view far-placed objects.The reason for the development of this state may be overworking of the accommodation apparatus - with prolonged continuous reading, watching TV at close range, working at a computer for several hours without a break, and so on.
Most often, spasmodic ciliary muscle relaxes itself after a sufficient rest, however, if this does not occur, and also if the spasm occurs too often, it is recommended to consult an ophthalmologist. The doctor will explain to the patient everything about the causes of this condition, and also will tell about the methods of its prevention (which include breaks during work, visual gymnastics, and so on).
As mentioned earlier, the main refractive structures of the eye are the cornea and lens. Normally, their surfaces are perfectly smooth (rounded smooth), as a result of which all rays passing through them are focused at one point. When astigmatism is observed deformation, curvature of the surface of the cornea and / or lens, with the result that the rays passing through the curved section are focused separately (aside) from the rest. As a result, human-viewed images (close or far away) seem fuzzy, vague, and the patient can not focus the vision on any object.
Diagnosing astigmatism is a rather complicated process, as it is necessary for a doctor to determine not only the affected structure (cornea or lens), but also the location, direction and nature of the damage. However, you should not delay the diagnosis and treatment of this pathology, since over time its progression can lead to the development of terrible complications (for example, myopia, strabismus, and so on).
After the diagnosis, determination of the degree and other parameters of astigmatism, the doctor prescribes special glasses or lenses to the patient, allowing him to correct the defect, and also talks about various methods of curing the disease.
As mentioned earlier, the retina is a layer of photosensitive nerve cells that provide light perception. These cells need a lot of energy, which is supplied to them through the blood vessels of the retina. These vessels can be affected by various diseases, as a result of which their deformation occurs, and their main function, the delivery of oxygen and energy to the photosensitive nerve cells, is disturbed. This pathological condition is called retinal angiopathy.
The reasons for the development of retinal angiopathy can be:
- Diabetes - endocrine disease in which the walls of small blood vessels are affected throughout the body.
- Arterial hypertension - persistent increase in blood pressure, leading to thickening and deformation of the walls of blood vessels.
- Hypotension - reducing the tone of the walls of the blood vessels of the retina leads to disruption of blood flow through them, resulting in deteriorated delivery of oxygen and nutrients to the retina itself.
- Injury - traumatic damage to blood vessels can lead to retinal hemorrhage, as well as subsequent disruption of the blood supply to certain parts of it.
- Inflammation of the retinal blood vessels.
It is important to note that the treatment of angiopathy should be carried out against the background of treatment or correction of the underlying disease that caused the development of this pathology. Otherwise, no therapeutic measures will not give the desired effect, and the vision will continue to deteriorate. That is why, for therapeutic and diagnostic purposes, an ophthalmologist can refer patients for consultations with other specialists (to a cardiologist with high blood pressure, to an endocrinologist with diabetes, and so on).
Acute purulent damage to the hair follicle of the eyelashes and / or nearby structures caused by various bacteria and manifested in the form of inflammation, redness, swelling and severe pain of the corresponding edge of the eyelid. As the disease progresses (after 3 - 4 days) a yellowish vesicle appears in the area of inflammation, at the opening of which a small amount of pus is released. After that, all the symptoms of the disease quickly regress, completely disappearing after 1 to 2 days.
Quite often, barley passes on its own in 4-6 days, as a result of which people rarely turn to an ophthalmologist. However, in the case of consultation about barley, the doctor may recommend that the patient wipe the skin of the affected eyelid with antiseptic solutions or antibiotics - substances that destroy pathogenic bacteria. Also, the doctor must explain to the patient that it is strictly forbidden to squeeze the resulting abscess, as this may lead to the development of complications (in particular, infection of the conjunctiva of the eye, infection of the surrounding tissues and fever, etc.). With the development of these and other complications, the ophthalmologist corrects them, attracting (if necessary) other professionals.
This term refers to chronic inflammation of the sebaceous glands of the century, which develops as a result of blockage of the excretory duct of the gland, accumulation and subsequent infection of the secret in it. Externally, chalazion is a small focus of inflammation (the size of a bead or a pea), the skin around which is inflamed, red in color, may be slightly painful when touched.
It is worth noting that the development of chalazion is most often observed after insufficiently treated barley, as a result of which ophthalmologists pay special attention to the treatment of acute inflammatory lesions of the hair follicles of the eyelashes. With the development of chalazion, antibacterial drops in the eyes are also shown (and you need to bury them in both eyes at the same time, and not just in the affected), warming up with dry heat and so on.
This is a parasitic disease caused by acne mites, which settle and develop in the hair follicles of the eyelashes and in the sebaceous glands. The reaction of the immune system to the development of infection is manifested by periodic inflammatory lesions of the eyelids, eye mucosa, cornea, development of barley, chalazion, and so on.
To confirm the diagnosis, the ophthalmologist uses microscopic examination data, in which the infectious agent is detected in skin particles taken from the affected area. For the treatment of demodicosis, the doctor may prescribe various antiparasitic and antibacterial agents used in the form of eye drops or gel.
This is an inflammatory lesion of the mucous membrane of the eye, manifested by its redness, the appearance of a pronounced vascular pattern, itching, burning orless often) pain in the affected eye, sometimes enhanced by lacrimation and photophobia. The cause of the disease may be a viral, bacterial or other infection, as well as various allergic reactions (for example, if you are allergic to pollen).
When examining a patient with conjunctivitis, the primary task of the ophthalmologist is to determine its cause. To this end, he can prescribe various laboratory tests. Also, the physician should immediately inform the patient that this pathology is infectious (can be transferred to other family members through shared towels, bed linen and so on.), in connection with which the patient must comply with increased safety measures and personal hygiene.
After identifying the cause of conjunctivitis, the ophthalmologist prescribes the necessary treatment (antiallergic drugs for allergic conjunctivitis, antibiotics for the bacterial form of the disease and so on), and also controls the treatment process, identifying and promptly eliminating possible complications.
What symptoms should be referred to an ophthalmologist?
The main complaint of patients who get an ophthalmologist consultation is visual impairment. It is worth noting that most often the decrease in visual acuity occurs gradually, over several years in a row, that is, when a person notices something is wrong, his disease already significantly disrupts the normal functioning of the visual analyzer. That is why all people should know and remember the main symptoms of eye diseases, and when they first appear as soon as possible, consult an ophthalmologist.
The reason for contacting an ophthalmologist can be:
- blurry vision of distant objects
- blurry vision of closely spaced objects,
- double vision
- eye fatigue
- Pain in the eyes,
- photophobia (pain in eyes and tearing in bright light),
- flashes of light before your eyes
- the appearance of "fly" before the eyes,
- narrowing of visual fields (peripheral vision),
- conjunctival redness,
- corneal damage
- clouding of the lens (in the pupil area),
- eyeball injuries,
- penetration of a foreign body into the eye,
- redness of the century (in the development of barley, chalazion),
- squint and so on.
Why do you need to consult an ophthalmologist during pregnancy?
During pregnancy, there may be a violation of the functions and damage to almost any organ of the female body, including the organ of vision.
Violation of the eyes during pregnancy may be due to:
- The defeat of the cardiovascular system. During pregnancy, an increase in circulating blood volume, as well as an increase in blood pressure (at least 15 - 20%). Under normal conditions (if the woman did not suffer from hypertension before pregnancy) This condition is relatively easy to tolerate, without harming the female body. At the same time, if the woman’s pressure was elevated for a long time (that is, with untreated hypertension), it could lead to defeat (restructuring) small blood vessels, including the retina. Moreover, during childbirth (through the birth canala) the pressure can increase to critical values, which can provoke the development of complications from the retinal vessels and other structures of the visual analyzer.
- The defeat of the endocrine system. Even with a normal pregnancy, there is an increase in the blood glucose of a woman. The goal of this adaptive response is to provide the growing fetus with enough energy. However, if a woman has diabetes (a disease characterized by a marked increase in blood glucose), pregnancy can aggravate its course, contributing to the defeat of the blood vessels of the retina and other organs.
Do you need a consultation of a pediatric ophthalmologist for premature babies, newborns and infants?
The pediatric ophthalmologist is engaged in the identification, diagnosis, treatment and prevention of lesions of the visual analyzer in children. The need for the emergence of this narrow specialty is due to the fact that many eye diseases (particularly strabismus) are congenital, and the methods of their early treatment and prevention may differ from those in adults. The pediatric ophthalmologist has certain knowledge and practical skills that allow him to correctly assess the state of the child’s visual analyzer and to carry out the necessary treatment (including surgical) existing diseases, which will allow the child to avoid vision problems in adulthood.
Consultation of a pediatric ophthalmologist is shown to all children within 1 month of life. During the examination, the doctor examines the refracting structure of the eye (cornea and lens), examines the fundus of the eye ((the back of the inner wall of the eye, which is attached to the retina), and also assesses the child’s visual response to various stimuli (how a child fixes eyesight, follows a moving object). All this allows us to identify possible diseases of the visual apparatus and start their treatment in a timely manner.
At the same time, it is worth noting that the consultation of an ophthalmologist may be necessary for the baby in the first days of his life. The reason for this may be a visible eye defect, detected immediately after birth (for example, strabismus, corneal deformity, deformity of the eyeballs, and so on). Also, an ophthalmologist's consultation is shown to absolutely all preterm children (premature is considered a child whose prenatal period has not reached 37 weeks). This is explained by the fact that premature babies are more likely to experience various congenital developmental anomalies, including damage to the organ of vision. The purpose of the consultation of an ophthalmologist in this case is also the timely detection and correction of possible eye defects.
Diseases that are treated by an optometrist
The oculist performs correction and prescribes a course of treatment for diseases of the organs of vision associated with a violation in the light-transmitting structures of the eye and the structure of the vitreous body, retinal detachment, and destructive changes in the tissues of the eye and cornea.
An eye specialist treats myopia, hyperopia, glaucoma, cataracts, astigmatism and other diseases associated with visual impairment.
Visual impairment is not always a consequence of pathological processes in the visual organs, in 80% of cases the quality of vision decreases with the following diseases and conditions:
Thyroid dysfunction - hypothyroidism or hyperthyroidism,
Renal failure and urinary system pathology,
Atherosclerosis, diseases of the blood and blood vessels,
Inflammation of the pancreas,
Pathological course of pregnancy.
Difficult to correct visual impairment, the cause of which is the deviation of intraocular pressure from the norm, which occurs in a number of diseases, for example, in diabetes mellitus. Visual impairment can develop gradually over many years, so in order to prevent irreversible changes in the visual organs and restore their function, consultation with an ophthalmologist is necessary, during which the cause of the pathology is determined and a course of treatment is prescribed.If visual impairment is associated with pathological processes in the endocrine or other systems of the body, the treatment should be comprehensive and aimed primarily at the underlying disease.
The most common pathological conditions and diseases that are sought by an optometrist are given in this list with a description of the symptoms or characteristics of the course of the disease for some of them:
Conjunctivitis is an inflammatory disease of the mucous membrane of the eyelid (conjunctiva), during which it turns red and swollen, painful sensations, burning and itching appear. Conjunctivitis can occur in the initial stages of ARVI.
Blepharitis - inflammation of the ciliary edge of the eyelid with swelling, formation of sores and crusts, oily consistency can be observed.
Trachoma - a disease with symptoms characteristic of viral conjunctivitis, the duration without treatment can be several months.
Cataracts - clouding of the lens, which often develops in older people, but can occur at a young age, is innate. A cataract leads to a gradual and painless loss of vision or a decrease in its quality over several years.
Glaucoma is a disease that develops against the background of constantly increased intraocular pressure, leading to severe damage to the optic nerve fibers and impaired visual function,
Spring Qatar is a disease of an allergic nature, usually the period of its aggravation falls in the spring, after which inflammation lasts from several months to a year.
Trichiasis - arises due to the deformation of the cartilage tissue of the eyelid, due to which eyelashes begin to grow in different directions, exerting mechanical pressure on the mucous membrane of the eyelid and eyeball. This condition leads to a number of pathologies of the organs of vision, increases the risk of conjunctivitis.
Barley - a purulent abscess appears on the skin of the eyelid or conjunctiva, causing inflammation and swelling of the area,
Tearing - may occur as a result of squeezing of the tears or appear as an allergic reaction due to increased secretion of the lacrimal gland,
Keratitis - corneal clouding, in which vision is impaired, and there are painful sensations, viral and bacterial infections, constant wearing of contact lenses, allergic reactions can provoke keratitis,
Scleritis and episcleritis - inflammatory diseases of the outer membrane of the eyeball - sclera,
Inversion of the eyelids - the deformation of the cartilage of the eyelids, in which they turn out without signs of inflammation, do not set in place,
Iridocyclitis is a disease of the iris and ciliary body of the eye,
Presbyopia is a visual impairment in which the ability to focus the vision on closely spaced objects is lost. Also called age farsightedness.
Keratoconus is a pathological condition in which the cornea from a spherical shape takes the form of a cone, which causes visual impairment of myopia and astigmatism.
Mechanical damage and injury to the eyes,
Ptosis is the omission of the eyelid, its elevation is difficult, but a sign of inflammation like swelling, burning, itching and redness is not observed if ptosis is the only pathology detected. If there are foci of inflammation in the organs of vision, ptosis may be their symptom.
Hemorrhages - occur when there is insufficient blood clotting, due to friction or mechanical impact on the eyelids, it can also manifest itself during physical exertion or coughing.
Any inflammatory diseases and pathological conditions of the eyelids, conjunctiva, eyeball and buccal gland require referral to an ophthalmologist.
Optometrist and ophthalmologist: what is the difference?
An optometrist and an ophthalmologist are specialists of the same profile who are engaged in the diagnosis and treatment of eye diseases. However, the ophthalmologist-surgeon has a narrow specialization and conducts therapy of the organs of vision only when surgery is necessary, whereas for conservative treatment they turn to an ophthalmologist.
When should go with the child to the optometrist?
Examination by an ophthalmologist is necessary for children from the first months of life - this allows you to identify congenital abnormalities - cataracts, glaucoma, retinal tumors - and take appropriate measures to prevent further visual impairment. In the absence of timely diagnosis and treatment of diseases of the organs of vision can lead to partial or complete blindness. The first visit to a specialist is carried out at two months of age, after it, in the absence of pathologies, an inspection is carried out every year.
Treatment of eye diseases in childhood gives good results, since during this period the visual system is flexible and highly regenerative. By the age of 12-14, when the formation of the organs of vision ends, the treatment of eye diseases occurs more slowly.
The optometrist in the process of routine inspection, which must be conducted annually, determines the state of the organs of vision and identifies possible lesions and pathological processes. This is a necessary preventive measure to preserve vision and improve it. There is also an urgent examination, it is necessary when the patient needs emergency care.
Scheduled examination of the child by an oculist
The first routine inspection is carried out in an infant at the age of 2 months. The oculist determines how well the organs of vision are developed, whether the child has strabismus or other pathologies, during the examination the doctor uses special drops that are harmless to the infant, and the effect of their use disappears completely within two to three hours by the end of the examination. It is necessary for the timely diagnosis of congenital cataracts, glaucoma, retinoblastoma and other eye diseases.
If a child is born prematurely before the onset of 34 weeks gestation, then he has a high risk of developing retinopathy. Among the serious complications of this disease are visual impairment, including blindness, low vision. Therefore, premature babies undergo a routine inspection ahead of time, at the age of one month. After the first routine examination, it is necessary to regularly visit an ophthalmologist every two weeks until the child reaches three months of age.
Further, preventive examinations are carried out in 1 year, 3 years before entering kindergarten and at the age of 6 years before school. After the child enters school, his visual system begins to be subjected to increased workloads associated with studies, which determines the need for an annual routine examination afterwards.
An additional visit to the oculist doctor prescribes, depending on the state of the organs of vision, changes that occur in them in the development process.
Urgent examination of the child by an oculist
Emergency help of an ophthalmologist is required for a child if his organs of vision were susceptible to injury, as well as if there are any foreign objects in the tear fluid or other parts of the eye that threaten the health of the eyes.
There are a number of specific symptoms that must be noticed by parents in order to provide the child with ophthalmological assistance in time:
The disappearance of the infant from 2 months of the reflex tracking for moving within 20 cm from the face of objects,
Incomplete cover of the century,
Squint of any type,
Barley on the eye,
There is swelling and redness of the eyelids,
Soreness and itching, which are expressed in constant rubbing of the eyes,
Light sensitivity, bordering on photophobia, or clear photophobia (if the child gets bright light in the eyes, it avoids it)
Strong tearing or discharge from the eyes of any other character
Serious head injuries,
Pathological conditions that a child can tell about according to personal feelings (flies, lightning in front of his eyes, out of focus, blurred or split vision).
These symptoms are characteristic not only for children, but it is for babies that complications arise, since they are often not able to express their complaints in a language understandable to parents. When observing at least one of the above signs of ocular pathologies, an urgent appeal to an optometrist is indicated.
How is the reception at the oculist
For high-quality inspection you need a good psychological state of the child, calm mood, openness and readiness for conversation. Both parents and the oculist himself must take care of this, who must show the qualities of a good psychologist in order to get more complete information about the state of vision from the child himself.
The order of the examination depends on the age of the patient. In the process of conducting a routine inspection, the oculist conducts the following studies:
The condition of the eyelids and lacrimal ducts is determined,
The presence or absence of strabismus is determined - for this motility and the location of the eyeballs are investigated,
The process of skiascopy determines the degree of refraction, the optical properties of the visual system. This procedure allows you to identify such pathologies as myopia, hyperopia and astigmatism,
The state of the pupils, their reaction to light,
The study of the fundus is necessary for the timely diagnosis of diseases such as glaucoma, cataracts and hydrocephalus,
The ability to distinguish colors is determined to prevent color blindness - children as young as three years old may confuse blue with green or red, this is not considered a pathology.
Visual acuity is determined - younger children are shown pictures, while checking their eyes in schoolchildren and adults they are shown tables with letters.
According to the results of a comprehensive examination, the doctor prescribes a course of treatment of the identified pathologies, which may include medication, physical therapy, exercises for correcting vision. If necessary, the optometrist makes the selection of points.
Due to the fact that in many cases, visual impairment is not associated with pathologies of the organs of the visual system, but other systemic diseases, the ophthalmologist may prescribe tests and write out a referral to specialists of a different profile - a neuropathologist, an endocrinologist, an infectious diseases specialist. Chronic pathologies of vision that progress over time require constant monitoring by an oculist to prevent the occurrence of serious complications and loss of vision.
Analyzes and studies conducted by an oculist
In addition to the standard examination, an ophthalmologist may prescribe some additional tests that provide information on factors mediating to eye health. Such diagnostic procedures include the immunogram, which shows the state of cellular and humoral immunity, and immunodiagnostics - a study of the effect of infectious invasions, oncological and hormonal diseases on the health of the eyes.
Additional diagnostics may be required to detect infectious and parasitic diseases, for which the detrimental effect on vision has been proven:
Optometrist and ophthalmologist: what is the difference
At first glance, these are different specialties. The “ophthalmologist” sounds more powerful, so it seems that his qualifications are higher, he owns complex medical tools and uses the most modern equipment.
The clinics actively promoting the services of their ophthalmologists and opposing them to oculists, who are often perceived as doctors who can only check their visual acuity and write out simple drops, contribute to misinformation.
In fact, the difference from the ophthalmologist of the ophthalmologist is only in the name.
However, the names have the same origin. The word “ophthalmologist” is formed in two parts: “ophthalmos”, translated from Greek, means “eye”, and “logos” - “teaching”. The second name came from the Latin language. "Oculus" means the same eye.
Summarizing, we can say that the ophthalmologist is the official name of the specialty, which until 1981 was called “oculist”. For many, the option that is outdated for today has been deposited in memory - and this is the main reason for the confusion in concepts. There is also a common name - "eye".
Who are the optometrist and ophthalmologist
Both names are used to denote the medical specialty devoted to the study of the organ of vision. The competence of the doctor (it does not matter, it is an oculist or an ophthalmologist, there is no difference) includes prevention, diagnosis and treatment of eye diseases.
An ophthalmologist is a specialist who has received a higher medical education, has undergone training (internship, residency) in the field of ophthalmology. Contrary to the well-established fallacy, the difference between an oculist and an ophthalmologist in professional training is a myth.
The medical profession associated with the treatment of pathologies of the organ of vision, involves the division into narrow specializations, but not the ophthalmologist and oculist.
- Ophthalmologistengaged in the surgical treatment of eye diseases. He performs operations on his eyes, removes tumors on the eyelids and foreign bodies that are in the organ of vision, provides urgent assistance with injuries and burns.
- Children's ophthalmologistManaging eye diseases in patients under the age of 18.
An eye disease specialist conducts admission in polyclinics, in ophthalmologic departments of hospitals, medical centers, clinics.
It is believed that the ophthalmologist works in the hospital and performs complex medical procedures on the eyes, and the lot of the oculist is an outpatient appointment. In fact, the difference here is that the hospital is usually equipped with more modern equipment that expands diagnostic capabilities. And the alleged lack of qualifications of an oculist is just another myth.
What does the ophthalmologist (optometrist)
The organ of vision is a complex and fragile system, subject to the negative influence of a large number of factors. Therefore, the front work at the "eye doctor", regardless of whether it is called an ophthalmologist or ophthalmologist, is very broad.
What diseases treats ophthalmologist
This doctor is responsible for diagnosing and treating abnormalities of the organ of vision. Here are the most common ones:
- Inflammatory diseases: conjunctivitis (damage to the mucous membrane of the eyes), keratitis (inflammation of the cornea), barley (damage to the hair ciliary follicle, which has a bacterial nature), demodicosis (a parasitic disease, provoked by acne mites), etc.
- Glaucoma - a condition associated with an increase in intraocular pressure caused by impaired outflow of intraocular fluid. As a result, the optic nerve and retina are affected. If adverse events occur, it can lead to blindness.
- Cataract. A clouding of the lens located behind the iris develops. Normally, it is transparent. As a result, its ability to transmit light and refract rays is impaired. It develops due to age-related changes, eye injuries, etc. It is treated surgically.
- Myopiaor myopia. The picture of the observed objects is focused in front of the retina, and not on it. Perception is disturbed, all objects appear fuzzy, with a blurred outline. If no action is taken, this state will progress: the vision will deteriorate more and more.
- Farsightedness (hypermetropia). The light rays in this case are focused behind the retina, so there are difficulties in looking at nearby objects. Causes - congenital anomalies, as well as damage to the eyeball, cornea, lens.Many who have crossed the 60-year-old milestone appear age-sightedness.
- Accommodation spasm. Associated with spasm of the ciliary muscle: it contracts, but does not relax. The patient can not normally consider distant objects. It can occur with long reading, staying at the computer or watching TV at close proximity to the screen.
- Strabismus - deviation of the visual axis of one or two eyes in a certain direction. It can be congenital or appears as a result of injuries, lesions of the eye muscles of a different nature, complications after illness, etc. In such a condition, it is difficult for the patient to focus on the object simultaneously with two eyes.
- Astigmatism - deformation of the cornea or lens (they can be affected at the same time). It becomes difficult for a person to focus on a particular subject.
- Retinal Angiopathy - Damage to blood vessels, occurring on the background of other diseases (diabetes, etc.), as a result of injuries. There are flashes and darkening in the eyes, vision suffers.
A useful video about what vision problems are found in children:
The ophthalmologist assists with injuries and burns of the eye resulting from accidents, falls, in everyday situations, etc. Eye injuries are often accompanied by head injuries, so the oculist interacts with a neurologist in such situations.
Optometrist for pregnant women: why it is necessary
Examination of this doctor is mandatory for all pregnant women: a visit to an ophthalmologist will have to be paid immediately upon registration. If there are problems, a second consultation will be needed in the second half of the pregnancy.
In future mothers, the vision functions may be impaired. This is due to an increase in pressure, an increase in circulating blood volume. At birth, the pressure can increase to critical values, causing damage to the retinal vessels.
Having found a retinal lesion in a pregnant woman, the ophthalmologist may recommend her to consult another specialized specialist to clarify the cause of the problem.
Prophylactic examinations by an ophthalmologist
Consultation "eye doctor" - an important stage of the medical examination, which are representatives of many professions (teachers, civil servants, drivers, pilots, etc.). This event is planned, usually held once a year.
For the detection of visual impairment in the early stages, an annual visit to an ophthalmologist is recommended for all adults. This is especially true for those who constantly and actively use gadetes, spends a lot of time at the computer.
Of great importance are preventive examinations at a pediatric ophthalmologist. The first of them is carried out in the maternity hospital, and then they are carried out in 1-2 months, in 6 months and in 1 year (for premature babies, examinations are performed more often). If no pathology has been identified, the ophthalmologist examines the child once a year up to 7 years, if there are any problems, an individual schedule of visits is drawn up.
The ophthalmologist issues certificates that are necessary for obtaining a driver's license, permission to carry a weapon, etc. He first conducts a survey similar to the standard professional examination.
When to contact an optometrist
The most common reason for visiting this doctor is blurred vision. In most cases, this happens gradually and for several years can be ignored. People go to the optometrist when the functioning of the visual analyzer is so disrupted that it begins to interfere with a full life. Therefore, it is important to know the early symptoms of poor organ of vision, such as:
- fuzzy vision of objectsfar or near, double vision,
- painful sensations in the eye area in bright light, often combined with lacrimation (photophobia),
- eye contact with a foreign object,
- rapid fatigue and soreness of the organ of vision
- the appearance of light flashes before the eyes, the feeling of "fly",
- tangible peripheral vision impairment,
- eye redness (including eyelids).
At the first symptoms of eye damage, you should go to the doctor, and it does not matter what inscription is on the door of his office, an optometrist or an ophthalmologist: the only difference is in the title.
Many ophthalmologic pathologies in the absence of timely treatment lead to irreversible changes, up to complete blindness.
How is the reception
This doctor equally examines the state and features of the functioning of the structures of the organ of vision, regardless of whether it is called an oculist or an ophthalmologist - there is no difference.
Examination begins with checking visual acuity. Here special tables with printed letter rows are used. For special categories of patients (children, deaf-and-dumb, etc.) there are tables with figures, as well as with images of circles in which a fragment is cut from one side.
For a comprehensive assessment of the state and functioning of the organ of vision is applied:
- Fundus examination, its retina and blood vessels. It is carried out with a special device - an ophthalmoscope.
- Determination of intraocular pressure.
- Assessment of color perception. Used to determine the ability to distinguish colors. It uses tables depicting circles of different shades.
- Study of the light refractive structures of the eye.
- Examination of visual field boundaries (the totality of all points of space that the fixed eye can simultaneously perceive).
For a more accurate diagnosis may require biomicroscopy of the eye (allows you to accurately identify the deformation of the eye structures), assessing the degree of sensitivity of the cornea, the study of binocular vision (the ability to see objects with two eyes at once).
Having determined the diagnosis, the oculist develops a scheme for correcting the problem. Conservative and surgical techniques are used here.
- Conservative methods include the selection of glasses or lenses, the appointment of vitamins and eye drops (antibacterial, antiviral, anti-inflammatory, or aimed at combating an allergic reaction - it all depends on the pathology identified).
- Surgical treatment It may be necessary if corneal disease, lesion of the iris of the eye, retinal detachment, etc. are diagnosed. It is used for myopia, astigmatism, and hyperopia. Most of these operations are low-impact and do not require hospitalization.
To get rid of myopia, farsightedness, astigmatism today laser correction is actively used, the essence of which is to change the refractive ability of the cornea under the influence of a laser beam.
If you have problems with vision, you should immediately go to the doctor. No matter what will be written on the door of his office, "Ophthalmologist" or "Ophthalmologist": there is no difference between them.