What is the most important examination by an ophthalmologist? Vision diagnostics. Ophthalmologist instruments for measuring IOP

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What happens at an appointment with an ophthalmologist?

During the examination of the patient ophthalmologist assesses the condition of various structures of the eyeball and eyelids, and also checks visual acuity and other parameters that give him information about the functioning of the visual analyzer.

Where does the ophthalmologist see?

Visit an ophthalmologist ( ophthalmologist ) can be done at the clinic ( in the ophthalmologist's office) or in a hospital where the doctor sees in a specialized ophthalmology department. In both cases, the doctor will be able to conduct a full examination of the person’s visual system and make a diagnosis. At the same time, in a hospital setting, more modern equipment may be available, which allows, in doubtful cases, to conduct a more complete diagnosis. Moreover, if, when examining a patient in a hospital, the doctor identifies a disease or injury that requires urgent surgical intervention ( for example, with retinal detachment), he can hospitalize the patient and perform the necessary operation within the shortest possible period of time, thereby reducing the risk of complications and vision loss.

Examination by an ophthalmologist

As mentioned earlier, when examining a patient, an ophthalmologist examines the condition and functioning of various structures of the visual analyzer. If during a standard examination the doctor discovers any abnormalities, he may conduct additional tests.

An examination by an ophthalmologist includes:

Checking visual acuity. Allows you to evaluate the ability of the eye to clearly see two different points located at a certain distance from each other. Primary impairment of visual acuity can occur with myopia, farsightedness, astigmatism and other pathologies.
Study of the refractive structures of the eye. Allows you to determine the functional state of the refractive system of the eye, that is, the ability of the cornea and lens to focus the image directly on the retina.
Visual field examination. Allows you to examine peripheral vision, which may be impaired due to glaucoma and other pathologies.
Fundus examination. Allows you to study the vessels of the fundus and the retina, damage to which may cause decreased visual acuity, narrowing of the visual fields and other defects of the visual analyzer.
Measuring intraocular pressure. It is the main test in the diagnosis of glaucoma.
Checking color perception. Allows you to determine whether a person can distinguish different colors from each other. This function of the visual analyzer may be impaired in some people suffering from color blindness.

Ophthalmologist's chart for checking visual acuity

The first thing an ophthalmologist checks when examining a patient is visual acuity. As mentioned earlier, this term refers to the ability of the human eye to distinguish between two points located at a certain distance from each other. To conduct the study, the doctor uses special tables on which rows with letters or figures are printed ( for examining the deaf and dumb, children, etc.) of various sizes.

The essence of the study is as follows. The patient sits on a chair located at a distance of 5 meters from a well-lit table mounted on the wall. The doctor gives the patient a special flap and asks him to cover one eye with it, but not to close it completely ( that is, do not close your eyelids). The patient should look at the table with his other eye. Next, the doctor begins to point to the letters in various rows of the table ( first to larger ones, then to smaller ones), and the patient must name them. The result is considered satisfactory when the patient easily ( without squinting) will be able to read letters from 10 ( above) table row. In this case, we are talking about one hundred percent vision, which the ophthalmologist records in the patient’s chart. Next, he asks to cover the other eye with a shutter and repeats the procedure in the same way.

When examining young children ( who can't read yet) tables with images of animals, plants and other objects are used. At the same time, for the examination of deaf and mute patients, instead of letters, the tables depict circles with a cutout on one side ( right, left, top or bottom). During the examination, the patient must indicate to the doctor which side the notch is located on.

An ophthalmologist's device for examining the fundus of the eye

The fundus of the eye is the posterior inner surface of the eyeball. The procedure for examining the fundus itself is called ophthalmoscopy, and the device used to perform it is called an ophthalmoscope.

The essence of the procedure is as follows. The bright lights in the room are turned off, and the patient sits on a chair opposite the doctor. The doctor brings an ophthalmoscope to the patient's eye ( a device consisting of a light source and a magnifying lens) and directs light through the pupil into the eye being examined. Light rays hit the fundus of the eye and are reflected from it, as a result of which the doctor, through a magnifying glass, can observe various structures in this area - the retina, fundus vessels, optic nerve head ( the place in the fundus of the eye where nerve fibers of photosensitive cells leave the eyeball and travel to the brain).

Fundus examination helps in diagnosing:

Glaucoma. Characteristic of this pathology is the so-called excavation of the optic nerve head, which is “squeezed out” as a result of increased pressure inside the eyeball.
Retinal angiopathy. During ophthalmoscopy, the doctor identifies modified, irregularly shaped and sized blood vessels in the fundus.
Retinal detachments. Under normal conditions, the retina is attached to the wall of the eyeball very weakly, supported mainly by intraocular pressure. For various pathological conditions ( for eye injuries, wounds) the retina can become detached from the wall of the eye, which can lead to deterioration or complete loss of vision. During ophthalmoscopy, the doctor can determine the location and severity of the detachment, which will allow planning further treatment tactics.

What does an ophthalmologist put in your eyes to dilate your pupils?

As stated earlier, during an ophthalmoscopy, the doctor shines a beam of light into the patient's eye through the pupil and then examines the fundus of the eye using a magnifying glass. However, under normal conditions, light entering the retina causes a reflex constriction of the pupil. This physiological reaction is designed to protect photosensitive nerve cells from damage from too much bright light. However, during the examination, this reaction may prevent the doctor from examining parts of the retina located on the lateral parts of the eyeball. It is to eliminate this effect that before the examination, the ophthalmologist instills drops into the patient’s eyes, which dilate the pupil and fix it in this position for a certain time, allowing a full examination of the fundus of the eye.

It is worth noting that these drugs cannot be used if you have glaucoma, since pupil dilation can lead to blockage of the outflow tract of intraocular fluid and provoke an increase in intraocular pressure. The doctor must also inform the patient that for a certain time after the procedure the patient may experience pain or burning in the eyes when exposed to bright light, and will also not be able to read books or work at the computer. The fact is that the drugs used to dilate the pupil also temporarily paralyze the ciliary muscle, which is responsible for changing the shape of the lens when viewing closely spaced objects. As a result of this, the lens is flattened as much as possible and fixed in this position, that is, a person will not be able to focus vision on a nearby object until the effect of the drug wears off.

Ophthalmologist instruments for measuring IOP

IOP ( intraocular pressure) is a relatively constant value and normally ranges from 9 to 20 millimeters of mercury. Marked increase in IOP ( for example, with glaucoma) can lead to irreversible changes in the retina. That is why the measurement of this indicator is one of the important diagnostic measures in ophthalmology.

To measure IOP, the ophthalmologist uses a special tonometer - a cylindrical weight weighing 10 grams. The essence of the study is as follows. After instilling a local anesthetic solution into the patient's eyes ( a drug that temporarily “turns off” the sensitivity of the eyes, as a result of which they will not respond to the touch of foreign objects to the cornea) the patient lies down on the couch face up, directing his gaze strictly vertically and fixing it on some point. Next, the doctor tells the patient not to blink, after which he places the surface of the cylinder on his cornea ( tonometer), which was previously coated with special paint. Upon contact with wet ( moisturized) the surface of the cornea washes off some of the paint from the tonometer. After a few seconds, the doctor removes the cylinder from the patient’s eye and presses its surface onto special paper, on which a characteristic imprint in the form of a circle remains. At the end of the study, the doctor uses a ruler to measure the diameter of the resulting circle-imprint, based on which he establishes the exact intraocular pressure.

Checking color perception ( pictures of an ophthalmologist for drivers)

The purpose of this study is to determine whether the patient is able to distinguish colors from each other. This function of the visual analyzer is especially important for drivers who constantly need to navigate the colors of traffic lights on the road. For example, if a person cannot distinguish the color red from green, he may be prohibited from driving a vehicle.

To check color perception, the ophthalmologist uses special tables. Each of them depicts numerous circles of various sizes, colors ( mostly green and red) and shades, but similar in brightness. Using these circles, a certain image is “masked” in the picture ( number or letter), and a person with normal vision can easily see it. At the same time, for a person who does not distinguish colors, recognizing and naming an “encrypted” letter will be an impossible task.

How else does an ophthalmologist check vision?

In addition to the standard procedures described above, the ophthalmologist has other studies in his arsenal that allow a more accurate assessment of the condition and functions of various structures of the eye.

If necessary, the ophthalmologist may prescribe:

Biomicroscopy of the eye. The essence of this study is that, using a special slit lamp, a narrow strip of light is directed into the patient’s eye, illuminating the cornea, lens and other transparent structures of the eyeball. This method allows you to identify various deformations and damage to the structures under study with high accuracy.
Study of corneal sensitivity. To assess this parameter, ophthalmologists usually use a thin hair or several threads from a bandage, which they touch the cornea of the eye being examined ( first in the center and then along the edges). This makes it possible to identify a decrease in the sensitivity of the organ, which can be observed in various pathological processes.
Study of binocular vision. Binocular vision is the ability of a person to clearly see a specific image with both eyes at the same time, ignoring the fact that each eye is looking at an object from a slightly different angle. To test binocular vision, ophthalmologists use several methods, the simplest of which is the so-called Sokolov experiment. To carry out this experiment, you should take a sheet of paper, roll it into a tube and bring it to one eye ( both eyes must remain open during the entire examination). Next, you need to place your open palm on the side of the paper tube ( its edge should be in contact with the tube). If the patient has normal binocular vision, when the hand is raised to the paper, the effect of the so-called “hole in the palm” will appear, through which what is visible through the paper tube will be visible.

What tests can an ophthalmologist prescribe?

Laboratory diagnosis is not the main diagnostic method in ophthalmology. However, when preparing for eye surgery, as well as when identifying certain infectious pathologies, the doctor may prescribe certain tests to the patient.

An ophthalmologist may prescribe:

General blood analysis– to determine the cellular composition of the blood and identify signs of infection in the body.
Microscopic studies– to identify microorganisms that cause infectious and inflammatory damage to the eye, eyelids or other tissues.
Microbiological examination– to identify and identify the causative agent of an eye infection, as well as to determine the sensitivity of the infectious agent to various antibiotics.
Biochemical blood test– to determine glucose levels ( Sahara) in the blood if diabetic retinal angiopathy is suspected.

Selection of glasses and lenses from an ophthalmologist

The main and most accessible methods for correcting diseases of the refractive system of the eye is the use of glasses or contact lenses ( which are installed directly on the outer surface of the cornea). The advantages of spectacle correction include ease of use and low cost, while contact lenses provide more precise vision correction and are also less noticeable to others, which is important from a cosmetic point of view.

Using glasses or contact lenses you can correct:

Myopia ( myopia). As mentioned earlier, with this pathology, light rays passing through the cornea and lens are refracted too strongly, as a result of which they are focused in front of the retina. To correct this disease, the doctor selects a diverging lens, which “shifts” the focal length somewhat posteriorly, that is, directly to the retina, as a result of which a person begins to clearly see distant objects.
Hypermetropia ( farsightedness). With this pathology, light rays are focused behind the retina. To correct the defect, the ophthalmologist selects a converging lens that shifts the focal length anteriorly, thereby eliminating the existing defect.
Astigmatism. With this pathology, the surface of the cornea or lens has an uneven shape, as a result of which light rays passing through them hit different areas in front of and behind the retina. To correct the defect, special lenses are made that correct existing irregularities in the refractive structures of the eye and ensure that the rays are focused directly on the retina.

The procedure for selecting lenses for all of these pathologies is similar. The patient sits in front of a table with letters, after which the doctor performs a standard procedure to determine visual acuity. Next, the doctor puts a special frame on the patient’s eyes, into which he places refractive or divergent lenses of varying strengths. Lens selection is carried out until the patient can easily read row 10 in the table. Next, the doctor writes out a prescription for glasses, which indicates the refractive power of the lenses necessary for vision correction ( for each eye separately).

Does an ophthalmologist prescribe computer glasses?

When working at a computer for a long time, the load on the eyes increases significantly, which is caused not only by overstrain of the accommodation apparatus, but also by the radiation from the monitor to the retina. To eliminate the impact of this negative effect, the ophthalmologist may recommend that patients whose activities involve working at a computer use special safety glasses. The lenses of such glasses do not have any refractive power, but they are covered with a special protective film. This eliminates the negative impact of glare ( bright dots) from the monitor and also reduces the amount of light entering the eyes without affecting image quality. As a result, the load on the organ of vision is significantly reduced, which helps prevent ( or slow down) the development of symptoms such as visual fatigue, lacrimation, redness of the eyes, and so on.

Medical examination and certificate from an ophthalmologist

A consultation with an ophthalmologist is a mandatory part of the medical examination that workers of many professions must undergo ( drivers, pilots, doctors, police officers, teachers and so on). During a routine medical examination ( which is usually performed once a year) the ophthalmologist evaluates the patient's visual acuity, and ( if necessary) conducts other studies - measures visual fields and intraocular pressure ( if glaucoma is suspected), examines the fundus ( if the patient has diabetes or high blood pressure) and so on.

It is also worth noting that a certificate from an ophthalmologist may be needed in some other circumstances ( for example, to obtain a permit to carry a firearm, to obtain a driver's license, etc.). In this case, an examination by an ophthalmologist does not differ from that during a regular medical examination ( the doctor evaluates visual acuity, visual fields and other parameters). If during the examination the specialist does not identify any abnormalities in the patient’s organ of vision, he will issue an appropriate conclusion ( certificate). If the patient is diagnosed with a decrease in visual acuity, a narrowing of the visual fields, or any other deviation, the doctor may prescribe appropriate treatment for him, but in the conclusion he will indicate that this person is not recommended to engage in activities that require one hundred percent vision.

Are ophthalmologist services paid or free?

All insured ( having a compulsory health insurance policy) residents of Russia have the right to free consultations with an ophthalmologist, as well as free diagnostic and treatment measures. To receive the listed services, they need to contact their family doctor and explain the essence of their vision problem, after which the doctor ( if necessary) will issue a referral to an ophthalmologist.

It is worth noting that free ophthalmologist services under the compulsory medical insurance policy ( compulsory health insurance) are found only in state medical institutions ( clinics and hospitals). All ophthalmologist consultations and visual analyzer examinations performed in private medical centers are paid.

When is a follow-up appointment with an ophthalmologist indicated?

Dispensary registration is a special form of monitoring a patient, in which the doctor conducts a full diagnosis and prescribes treatment for the patient’s chronic disease of the visual analyzer, and then regularly ( at certain intervals) examines him. During such an examination, the doctor assesses the state of vision and monitors the effectiveness of the treatment, and, if necessary, makes certain changes to the treatment regimen. Also, an important task of dispensary registration of patients with chronic eye diseases is the timely identification and elimination of possible complications.

The reason for a medical check-up with an ophthalmologist may be:

Cataract– clouding of the lens, for which it is recommended to visit an ophthalmologist 2 times a year.
Glaucoma– increased intraocular pressure, which requires visiting a doctor at least 4 times a year.
Retinal detachment and other lesions– consultation with an ophthalmologist is required at least 2 times a year ( if complications occur, an unscheduled consultation is indicated).
Damage to the refractive system of the eye ( myopia, farsightedness, astigmatism) – examination by an ophthalmologist 2 times a year ( provided that before this a full diagnosis was carried out and corrective glasses or contact lenses were selected).
Eye injury– regular ( weekly or monthly) examination by an ophthalmologist until complete recovery.
Retinal angiopathy– you need to visit a doctor at least 1–2 times a year ( depending on the cause of the disease and the severity of retinal vascular damage).

When can an ophthalmologist admit you to the hospital?

The reason for hospitalization of ophthalmic patients is most often preparation for performing various surgical interventions on the structures of the eyeball ( on the cornea, iris, lens, retina and so on). It is worth noting that today most operations are performed using modern technologies, as a result of which they are low-traumatic and do not require a long stay for the patient in the hospital.

The reason for hospitalization may be the severe course of the patient’s disease ( for example, retinal detachment in several places) or development of complications of the underlying disease ( for example, retinal hemorrhage, penetrating injury to the eyeball with damage to adjacent tissues, and so on). In this case, the patient is placed in a hospital, where he will be under constant medical supervision throughout the entire period of treatment. Before the operation, all studies necessary for an accurate diagnosis and determination of the surgical plan are performed. After surgical treatment, the patient also remains under the supervision of doctors for several days, which allows timely identification and elimination of possible complications ( for example, bleeding).

After discharge from the hospital, the doctor gives the patient recommendations regarding further treatment and rehabilitation, and also sets dates for follow-up consultations, which will allow monitoring the recovery process and identifying possible late complications.

How to get a sick leave certificate from an ophthalmologist?

A sick leave certificate is a document confirming that for a certain time the patient was unable to perform his job duties due to health problems. To receive a sick leave certificate from an ophthalmologist, first of all, you need to make an appointment with him and undergo a full examination. If the doctor determines that the patient cannot engage in his professional activity due to his illness ( for example, a programmer after performing eye surgery is prohibited from being at the computer for a long time), he will issue him the corresponding document. The sick leave certificate will indicate the reason for temporary disability ( that is, the patient's diagnosis), as well as the time period ( with dates), during which he is released from the work he performs for medical reasons.

Is it possible to call an ophthalmologist at home?

Today, many paid clinics offer such a service as calling an ophthalmologist at home. This may be necessary in cases where the patient, for one reason or another, cannot visit a doctor at the clinic ( for example in the case of older people with limited mobility). In this case, the doctor can visit the patient at home, conducting a consultation and some vision tests. However, it is immediately worth noting that a full examination of the visual analyzer requires special equipment, which is available only in the ophthalmologist’s office, therefore, in doubtful cases, the doctor may insist on a second consultation at the clinic.

At home, an ophthalmologist can perform:

external examination of the eye;
assessment of visual acuity;
visual field examination ( approximately);
fundus examination;
measurement of intraocular pressure.

When an ophthalmologist refers you to other specialists for consultation ( oncologist, endocrinologist, ENT specialist, allergist, neurologist, cardiologist)?

During an examination of the visual analyzer, the ophthalmologist can determine that the patient’s vision problems are caused by a disease of some other organ or other system of the body. In this case, he can refer the patient for a consultation with an appropriate specialist to clarify the diagnosis and prescribe treatment for the underlying disease that caused the vision problems.

The ophthalmologist may refer the patient for consultation:

To an oncologist– if there is a suspicion of tumor diseases of the eye or adjacent tissues.
See an endocrinologist– when detecting diabetic retinal angiopathy.
To the ENT ( otorhinolaryngologist) – when identifying diseases of the nose or paranasal sinuses that could be complicated by eye damage.
See an allergist– in case of allergic conjunctivitis ( lesions of the mucous membrane of the eye).
To a neurologist– if there is suspected damage to the optic nerve or brain ( visual center) and so on.
See a cardiologist– with retinal angiopathy caused by hypertension ( persistent increase in blood pressure).

What treatment can an ophthalmologist prescribe?

After making a diagnosis, the doctor prescribes to the patient various methods of correction and treatment of his existing disease. These methods include both conservative and surgical measures.

Vitamins for eyes

Vitamins are special substances that enter the body with food and regulate the activity of almost all organs and tissues, including the organ of vision. An ophthalmologist can prescribe vitamins for chronic eye diseases, as this helps improve metabolism in the affected tissues and increases their resistance to damaging factors.

An ophthalmologist may prescribe:

Vitamin A– to improve the condition of the retina.
Vitamin B1– improves metabolism in nervous tissue, including the retina and nerve fibers of the optic nerve.
Vitamin B2– improves metabolism at the cellular level.
Vitamin E– prevents tissue damage during various inflammatory processes.
Lutein and zeaxanthin– prevent damage to the retina when exposed to light rays.

Eye drops

Eye drops are the most effective method of prescribing medications for eye diseases. When the medicine is instilled into the eyes, it immediately reaches the site of its action, and is practically not absorbed into the systemic bloodstream, that is, it does not cause systemic adverse reactions.

For therapeutic purposes, an ophthalmologist may prescribe:

Antibacterial drops– for the treatment of stye, chalazion, bacterial conjunctivitis and other infectious eye diseases.
Antiviral drops– for the treatment of viral conjunctivitis and other similar diseases.
Anti-inflammatory drops– to eliminate the inflammatory process in infectious and inflammatory eye diseases.
Antiallergic drops– with allergic conjunctivitis.

Eye surgeries

For some diseases, a full-fledged surgical intervention is performed to eliminate defects in the visual analyzer.

Surgical treatment in ophthalmology may be required:

for diseases of the cornea;
for lens transplantation;
for treatment

Modern people are hostages of a hectic life in huge cities, with virtually no time left to take care of their own health. Therefore, visits to the doctor, especially preventive ones, are very rare, but it is easier to prevent or treat diseases at an early stage than to bravely fight the consequences of an advanced disease.

This truth is 100% true in relation to eye diseases, which have recently become “younger”, like other diseases of the body. Taking care of the health of the visual system of our patients, and taking into account the total lack of free time, Dr. Shilova’s Clinic has introduced an effective method for comprehensive diagnostics of the visual organ in one visit to an ophthalmologist.

This technique is universal, but at the same time, it is individual and allows you to fully take into account the characteristics of the eyes of each individual person. After the initial appointment, analysis of symptoms and study of possible available medical documentation, an experienced specialist determines a set of necessary diagnostic procedures that will create a complete picture of the health of the visual system on the same day.

Equipment for computer diagnostics is a source of special pride for our clinic. It is considered one of the most high-precision not only in Moscow, but also in the world. Advanced diagnostic technology, the use of innovative research methods and the experience of ophthalmologists working in the clinic guarantee the success of a complete examination of the visual system.

Video about types of vision examinations

Our eye clinic in the television program “Diagnostic Method”.

At the Clinic of Dr. Shilova, the patient is offered:

Checking visual acuity using traditional (subjective) and computer methods, with and without correction (when only a consultation is needed).
Selection of contact lenses and glasses of any complexity.
Autorefkeratometry – determination of the clinical refraction of the eye (detection of myopia, farsightedness, astigmatism).
Pneumotonometry is a non-contact, computerized study of IOP using an air jet, which is indispensable in the early diagnosis of glaucoma.
Echobiometry is a non-contact measurement of the parameters of the human eye (its length, thickness of the lens, pupil diameter, depth of the anterior chamber, etc.), using a unique ultrasound device AL-Scan (NIDEK, Japan). This study is mandatory when calculating the power of an intraocular lens in cataract surgery, to identify the progression of the myopic process, etc.
Biomicroscopic examination is an examination of the fundus using a fundus lens, revealing pathologies in the central as well as peripheral areas of the retina and optic nerve. It is necessary for patients with any degree of myopia and retinal dystrophy.
Perimetry is a study of the visual fields for each eye using a special computer perimeter. The study is mandatory in diagnosing the degree of glaucoma, damage to the optic nerve, and diseases of the central nervous system.
Echoscopy using the A-method is an ultrasound examination of the intraocular membranes and media to detect retinal detachment, tumors and hemorrhages in the eye.
Echoscopy using the B-method is an ultrasound of the eyeball to determine existing pathologies in the case of opaque optical media, which is prescribed as an addition to a full diagnostic examination of the eyes.
Keratopachymetry is an ultrasound examination of the thickness of the cornea, important in the diagnosis of keratoconus, as well as during laser vision correction.
Computer keratotopography is a study of the curvature of the corneal surface, which is mandatory to clarify the degree of astigmatism and diagnose keratoconus, and is also necessary when performing laser vision correction.

Specialists at Dr. Shilova’s Clinic strongly recommend that every patient undergo a set of diagnostic procedures if:

The last visit to the ophthalmologist was a year or more ago.
Work involves overexertion or eye strain.
Parents or close relatives have been diagnosed with eye diseases.

Do not put off an ophthalmological examination “for later”. Be sure to make an appointment with your doctor at a time that is convenient for you. Come see us after work or on a weekend with the whole family and turn your routine inspection into a fun adventure. Needless to say, good vision costs much more than the 60 minutes spent on the examination!

Regular and thorough eye examination is the best prevention of eye diseases. Vision testing in patients under the age of 40 in the absence of complaints and hereditary risk factors should be carried out every 3-5 years. Vision diagnostics in patients aged 40-60 years is carried out once a year. After 60 years, ophthalmologists recommend having vision examinations 2 times a year.

However, if you have such aggravating factors as a hereditary predisposition, previous inflammatory eye diseases or eye trauma, concomitant general somatic diseases (diabetes mellitus, rheumatism and others), vision diagnostics should be carried out more often.

A thorough vision diagnosis includes a number of instrumental and hardware examination methods. And if you have never had your vision tested, now is the time. The latest generation diagnostic equipment allows you to measure most of the necessary eye parameters completely painlessly, without touching the surface of the eye. This significantly reduces the risk of any eye inflammation and shortens the time of the vision examination procedure itself.

So, ten reasons to see an ophthalmologist:

Wide range of ophthalmological services provided.
Using the most modern scientific developments, professional modern equipment, high-quality consumables.
Vision examination, full comprehensive vision examination and diagnosis on the day of treatment.
Individual approach to patient examination.
A unified computer system for processing and storing patient information.
Accurate calculations of surgical parameters for myopia, cataracts and other diseases of the organ of vision.
Vision diagnostics, initial consultation, surgery and treatment until complete recovery with one specialist.
Consultations with the involvement of related specialists (neurologist, cardiologist, endocrinologist, nephrologist) according to indications.
Preparation for surgery and postoperative rehabilitation.

Thanks to our advanced examination and treatment methods, we are able to preserve vision and joy in life for most patients.

Deterioration of vision can be caused by many reasons. Vision diagnostics using modern equipment makes it possible to identify these causes, make the correct diagnosis, decide on the possibility and advisability of performing a particular operation, and determine the tactics of conservative treatment of the patient. Below we will try to give a brief description of the main and most informative methods of examining an ophthalmological patient, performed in our eye clinic.

Visometry

Computer diagnostics of refraction - determination of the optical power (refraction) of the eye. The vision test is carried out using an autorefkeratometer, which allows you to objectively and accurately determine the degree of refraction of the eye (myopia, farsightedness, astigmatism), measure the radius of curvature and refractive power of the cornea, the diameter of the pupils (which is necessary to determine the laser exposure zone for excimer laser correction). Examination data obtained on an autorefkeratometer are necessary for calculating an artificial eye lens (IOL) for cataract removal, refractive surgery for myopia, farsightedness, astigmatism, selection of contact lenses and glasses.

Measuring intraocular pressure is of great importance in the diagnosis of glaucoma, as well as a number of eye diseases accompanied by an increase or decrease in intraocular pressure. In clinical practice, tonometry is performed using applanation (non-contact) and impression (contact) methods. With non-contact tonometry, a pneumotonometer, using a directed stream of air, without touching the surface of the eye, quickly and safely measures intraocular pressure. This technology makes the measurement process more comfortable for the patient. The procedure speed is only 3 ms. If necessary, measurement of intraocular pressure is carried out with a Maklakov contact tonometer or Goldman tonometer, which consists of instilling anesthetic drops and measuring the degree of deflection of the cornea under the pressure of a weight (plunger) lowered onto the surface of the eye.

Biomicroscopy of the eye is a method of visual examination of the optical media and tissues of the eye using a slit lamp, based on creating a sharp contrast between illuminated and unlit areas, which allows you to study in detail the condition and identify diseases of the auxiliary apparatus of the organ of vision (eyelids, lacrimal organs, conjunctiva), pathology of the cornea , opacities in the lens under high magnification. The use of special lenses makes it possible to perform gonioscopy (examination of the drainage system of the eye) for glaucoma. Biomicroscopy of the eye allows you to study the condition of the vitreous body during hemorrhages and opacities in it, to assess the nature, scale and prospects for subsequent treatment of retinal pathologies such as vascular lesions of the retina, hereditary diseases of the retina, retinal detachment (retinal detachment), retinal dystrophy, retinopathy.

Ophthalmoscopy is a method for examining the choroid, retina, and optic nerve in rays of light that is reflected from the patient’s fundus. In the clinic, ophthalmoscopy is performed using a direct ophthalmoscope, a head-mounted binocular ophthalmoscope, or using a slit lamp and an aspheric lens or Goldmann contact lens. Ophthalmoscopy is carried out under conditions of the widest possible pupil, which makes it possible to qualitatively examine not only the central parts of the fundus of the eye, but also the peripheral parts of the retina that are difficult to examine, identify peripheral retinal dystrophies, retinal dissection (retinoschisis), subclinical forms of retinal detachment (retinal detachment), then There is a pathology in the fundus of the eye, which is not clinically manifested, but requires mandatory treatment. Short-acting mydriatics are used to dilate the pupil.

This is the so-called “standard complex of primary diagnostics”. If necessary and in agreement with the patient, vision diagnostics can be expanded with additional studies.

Tonography

Tonography is a method for studying the hydrodynamics of the eye, which consists of graphically recording the results of repeated measurements of intraocular pressure against the background of prolonged compression of the eyeball with a tonometer. Tonography allows you to measure fluctuations in intraocular pressure, the rate of production and outflow of intraocular fluid over a given period of time. Conducting this study is especially important for verifying the diagnosis when glaucoma is suspected and as a control of the effectiveness of treatment for those patients in whom glaucoma was previously identified.

Perimetry

Perimetry is intended to diagnose the state of the visual field - the space that the human eye sees when fixed. Often a person does not notice the appearance of defects (losses) in the field of vision due to the ability given by nature to look at the world with two eyes. Modern perimeter models have a wide range of threshold studies and highly specialized tests, which makes it possible to identify at the initial stages such eye pathologies as glaucoma, retinal dystrophy, retinal vascular pathology (occlusions and thrombosis of retinal vessels), retinopathy, retinal detachment. Diagnostic capabilities for inflammatory and vascular pathology of the optic nerve, optic nerve atrophy, and neuro-ophthalmological pathology are significantly expanding. Perimetry with short screening testing methods is reliable enough to detect even minimal visual field defects without a large investment of time.

Ultrasound examination of the eye and orbit

Ultrasound examination of the eye and orbit is a highly informative, safe, non-invasive instrumental research method that allows one to obtain a two-dimensional image of the vitreous cavity, the posterior segment of the eye and the orbit. A/B scanning provides high-resolution images and allows measuring the size of intraocular structures with an accuracy of 0.01 mm. Ultrasound examination of the eye is performed for the following main indications:

Measuring the thickness of the cornea, the depth of the anterior chamber of the eye, the thickness of the lens, the size of the vitreous body, the anteroposterior size of the eyeball. This information is necessary when performing a variety of operations, including cataract removal.
Identification and determination of the size and topography of neoplasms of the ciliary body, choroid and retina, retrobulbar tumors. Quantitative assessment of their changes in dynamics. Differentiation of clinical forms of exophthalmos.
Identification, assessment of the height and prevalence of retinal detachment, detachment of the ciliary (ciliary) body and choroid and their relationship with the vitreous body. Differentiation of primary retinal detachment from secondary retinal detachment caused by tumor growth.
Detection of destruction, exudate, opacities, blood clots, mooring in the vitreous body. Determination of their localization, density and mobility, relationship with the retina of the organ of vision.
Detection of foreign bodies in the eye due to trauma to the organ of vision, including clinically invisible and X-ray negative ones. Determination of their location in the eye and relationship with intraocular structures.
Calculation of the refractive power required for implantation of an artificial eye lens (IOL).

Recently, a new method of acoustic visualization of intraocular structures of the anterior segment of the eye has been introduced into clinical practice - ultrasound biomicroscopy. This method allows you to examine the anterior segment of the eye at the microstructural level. Ultrasound biomicroscopy is a B-scanning ultrasound immersion diagnostic procedure with linear scanning, which provides quantitative and qualitative information about the structure of the anterior segment of the eye (cornea, iris, anterior chamber angle, lens) for the purpose of diagnosing glaucoma, anterior tumors, and the consequences of eye injuries.

Fluorescein angiography with computer registration

Today, not a single clinic in the world can do without this informative diagnostic study. Fluorescein angiography, based on contrasting retinal vessels with a special dye, is the only method of its kind for accurate and effective diagnosis of diseases of the retina, optic nerve and choroid. It reveals the structure of the vascular bed of the retina, gives a clear picture of hemodynamics, the state of permeability of the vascular walls, pigment epithelium and Bruch's membrane, and allows one to differentiate inflammatory changes from vascular, dystrophic and tumor processes.

Fluorescein angiography is performed on a retinal camera both for diagnostic purposes and to determine the indications, tactics and timing of laser treatment, as well as to evaluate the results of the treatment. This study allows us to identify ischemic zones and newly formed vessels, which is important to identify in diseases such as diabetic retinopathy, thrombosis of the central retinal vein and its branches, occlusion of the central retinal artery and its branches, vasculitis, anterior ischemic neuropathy, pathology of the central retinal zone (edema, cysts, ruptures), recurrent hemophthalmos and a number of other diseases.

Electroretinography (ERG) is a method for recording changes in the bioelectric potential of the retina, graphically expressing the electrical activity of the cellular elements of the retina in response to light stimulation. Electroretinography allows one to judge the functional state of the photopic and scotopic systems of the organ of vision, regardless of the transparency of the optical media of the eye. The study of the thresholds of electrical sensitivity and electrical lability of the visual analyzer allows us to assess the functional state of the inner layers of the retina and the axial fascicle of the optic nerve.

Electroretinography is performed:

if it is impossible to visually assess the condition of the retina,
in the presence of an inflammatory process in the eye,
if sympathetic ophthalmia is suspected,
for early diagnosis of retinitis pigmentosa,
for the diagnosis of macular degeneration,
for acute circulatory disorders in the retina,
for early diagnosis of metallosis,
in case of poisoning with neurotropic poisons.

Keratotopography

Optical coherence tomography (OCT)

Optical coherence tomography (OCT) is a non-invasive method for visualizing biological structures that allows one to obtain in vivo (“intravital”) two-dimensional images of transverse optical sections of biological tissues with a resolution approaching the cellular level (10-15 microns). The technological basis of this method is the measurement of the optical reflectivity of biological structures. The device is based on a new diagnostic technology that allows you to obtain a high-resolution two-dimensional image of a section of the membranes of the eyeball and optic nerve, and measure the thickness of their longitudinal section by analyzing the light signal reflected from the boundaries of biological layers. The device makes it possible to conduct a vision examination even in cloudy environments with minimal strain on the patient’s eye.

What after vision diagnostics?

So, the vision test is completed. What's next? After a thorough and complete examination, our specialist will have a conversation with you and, based on all the diagnostic data received, will prescribe the appropriate conservative or

"First Eye Clinic" offers residents of Moscow and the region a comprehensive computer vision test at a competitive price using professional equipment. Individual approach and favorable conditions for each patient.

An annual examination by an ophthalmologist is recommended for adults and children.

Timely detection of deviations and disorders in the visual system allows you to quickly and effectively eliminate the problem.

Computer vision diagnostics: description, indications

Computer vision testing is the main tool for detecting even minor changes in the structure of the eye.

The examination allows not only to make a diagnosis, but also to develop an optimal treatment plan.

Diagnostics using modern equipment is distinguished by accuracy and versatility.

What does vision diagnostics include:

Determination of visual acuity

Pneumotonometry/measurement of intraocular pressure according to Maklakov

Biomicroscopy

Determination of subjective refraction

Study of binocular functions

Pachymetry

Echobiometry (A-method)

Perimetry (screening)

Computer topographic analysis of the cornea

Determining your dominant eye

Fundus examination in conditions of mydriasis

Study of the fundus, retina and cornea, lens, vitreous and ciliary body.

Examination by an ophthalmologist at the First Eye Clinic

Vision testing at the First Eye Clinic in Moscow is carried out on an outpatient basis at an affordable price. No special preparation is required for the procedures. The benefits of regular inspection include the ability to eliminate existing problems in a timely and cost-effective manner.

At the First Eye Clinic in Moscow, vision testing includes all modern research methods. Based on the data obtained, the ophthalmologist makes a diagnosis and suggests optimal correction procedures.

The clinic has advanced equipment and a staff of experienced international doctors. By collaborating with us, the patient receives:

guarantee of quality of treatment and correction;

the opportunity to save due to low prices, discounts, promotions and special offers on social programs.

Convenient work hours and location allow you to visit the clinic at any convenient time from 9:00 to 20:00 daily.

To maintain high visual acuity, each of us needs to undergo regular ophthalmological examinations. An annual comprehensive eye examination should become the norm, even if nothing is bothering you yet. After all, a disease identified at an early stage will be easier and cheaper to cure without resorting to emergency or radical measures.

Modern high-tech equipment and highly qualified specialists of the Virtual Eye Clinic allow us to identify possible eye pathologies at the initial stages of the onset of the disease. In our Clinic, adults and children (over 3 years old) are offered to undergo diagnostics of the visual organ to identify:

pathologies ( , ),
pathologies of the oculomotor system (,),
changes in the anterior segment of the eye of various nature (diseases, conjunctiva,),
changes in the posterior segment of the eye in vascular or inflammatory diseases, as well as in the optic nerve (including conditions in hypertension, diabetes mellitus),
injuries to the organ of vision.

When is vision diagnostics necessary?

Diagnostic examination data is necessary in assessing the general state of eye function, as a control for the progression of the disease and in the prevention of eye diseases. Timely diagnosis will help to select optimal treatment regimens that prevent serious complications that can lead to vision loss. The examination is also mandatory in cases where a decision has to be made on the need and type of surgical intervention or to provide an opinion at the place of request (to the antenatal clinic, neurologist, cardiologist, etc.)

Ophthalmological examination procedure

The diagnostic procedure can take from 30 minutes. up to 1.5 hours, which depends on the nature of the complaints and the age of the patient, as well as on the objective indications that served as the basis for the examination. During the diagnosis, visual acuity, changes in refraction are determined, and intraocular pressure is measured. The specialist examines the eyes using a biomicroscope, examining (the zones of the optic nerve and retina) with narrow and dilated vision. Sometimes the level is determined or visual fields are examined in detail (according to indications). Additionally, the thickness of the cornea () or the length of the anteroposterior axis of the eye (echobiometry, PZO) can be measured. Hardware studies also include ultrasound diagnostics (B-scan) of the eyes and computer keratotopography. However, other types of studies can be carried out if indicated.

The capital's ophthalmological clinics have all the equipment necessary for high-quality vision diagnostics.
At the end of the examination, the ophthalmologist must explain the diagnostic results to the patient. As a rule, after this an individual treatment regimen is prescribed or several possible regimens are offered to choose from, and preventive recommendations are given.

Video about comprehensive vision diagnostics

Cost of vision diagnostics in Moscow

The final cost of the examination is the amount consisting of the volume of prescribed diagnostic procedures, which is due to the patient’s objective complaints, a pre-established diagnosis, or an upcoming planned operation.

The price of standard primary eye diagnostics, including studies such as determination of visual acuity, measurement of intraocular pressure, autorefractometry and examination of the fundus with a narrow pupil, starts from 2,500 rubles. and depends on the level of the clinic, the qualifications of the doctor and the equipment used.

By visiting a specialized eye clinic for vision diagnostics, the patient receives the following advantages (compared to seeing an ophthalmologist in a clinic or having an examination at an optical office):

each visitor can use any necessary equipment located on the premises of the clinic;
highly accurate, detailed diagnostics of the organ of vision, including examination of the fundus, will not take more than 1-2 hours;
an extract with the diagnostic results will be handed to the patient, along with detailed recommendations for treatment, as well as prevention of the existing disease;
if necessary, the patient will be referred for consultation to an ophthalmologist who specializes in the identified pathology.

Remember that timely diagnosis is half the success of treatment for any disease. Don’t skimp on your vision, because losing it is much easier than regaining it!

Additionally, the following diagnostic studies can be performed:

determination of the angle of strabismus
ophthalmometry
tonography
(including computer)
pachymetry
echobiometry
determination of CFC (Critical flicker fusion frequency)
study of visual acuity in conditions of cycloplegia
determination of the nature of vision
determination of the dominant eye
fundus examination with a wide pupil

The best eye clinics in Moscow specializing in vision diagnostics

Average cost of some vision diagnostic services in Moscow clinics

Name of diagnostic procedure	Price, rub
Initial consultation with an ophthalmologist (without examinations)
Repeated consultation with an ophthalmologist (without examinations)

Fundus examination with a narrow pupil
Computer perimetry