Ophthalmological tests. Diagnosis of eye diseases - methods of eye examination in ophthalmology. What happens at an appointment with an ophthalmologist

The insidiousness of many eye diseases is that with similar symptoms, pathologies can have significant differences and require different, sometimes radically opposite, approaches to treatment. For example, wearing glasses, which is useful in one case, will cause serious harm in another, and all this with the same reduced visual acuity.

In order to choose the right and truly effective treatment,
it is extremely important to conduct a thorough, as objective examination of the visual system as possible
and identify the exact cause of the disease!

What does vision diagnostics include at the Excimer Clinic?

Each of our patients undergoes a comprehensive examination of the visual system, which, depending on the indications, may include:

• Visometry

  The procedure for determining visual acuity using special tables with symbols of different sizes, which the patient views from a certain distance. This is the simplest and most accessible study - and ophthalmologists in minimally equipped optical shops or clinics usually limit themselves to it.
  The disadvantage of visometry is its subjectivity: what the patient said is taken on faith. This is not suitable for testing vision in children or in people who know vision testing tables by heart, as well as in many other cases - therefore, in such modern high-tech clinics as Excimer, along with visometry, which has long become a classic of ophthalmology, they also use other, much more objective research methods.

• Refractometry

  The study of the so-called classical refraction, that is, the ability of the optical system of the eye to refract light rays and focus them strictly on the retina. This procedure is carried out using a special device - an autorefractometer. Based on the results of this study, the doctor determines the type of refraction and the degree of visual impairment by measuring the refractive power of the eye in diopters. The diagnosis of “emmetropia” means that the refraction is normal, vision is fine; “hyperopia” (“farsightedness”) – that there are visual impairments at close range, and “myopia” (“myopia”) – on the contrary, at a distance.

• Tonometry

  A diagnostic procedure necessary to assess the risk of developing glaucoma, which consists of measuring intraocular pressure. Previously, such a study was carried out by installing special weights on the surface of the cornea; this method is still used in ordinary clinics today. At the Excimer clinic, this procedure is carried out using modern equipment, non-contact.
  Non-contact tonometry is performed using a pneumatic tonometer, which produces a directed air flow, which, acting on the cornea of ​​the eye at a certain speed, leads to a certain deformation of the eyeball, which is recorded by special tonometer sensors. This is a quick and painless method that has proven itself in measuring intraocular pressure even in children.

• Perimetry

  Visual field examination, one of the methods for diagnosing glaucoma, partial atrophy of the optic nerve and other eye diseases. Based on the nature of changes in the visual field, the doctor can determine the localization of the pathological process - such changes are different with lesions of the retina, optic nerve, visual centers of the brain, etc.
  This diagnostic procedure is carried out using a device called a perimeter. The Förster perimeter can be used, which is a tabletop metal arc with a special graduation, or an automatic computer perimeter, the procedure on which is performed using points alternately displayed in different parts of the screen. For each eye, the visual field study is carried out separately.

• Optical coherence tomography (OCT)

  Optical coherence tomography (OCT) is the most modern method to date for studying various structures of the visual system. Using OCT, two- and three-dimensional images of the retina and optic nerve head can be taken; such a study allows one to obtain an optical section of the layers of the eye, which provides expanded opportunities for diagnosing dangerous neoplasms of the choroid, macular holes and edema, peripheral retinal dystrophy, glaucoma, and various inflammatory eye diseases, etc.
  This procedure does not require special preparation, but with medicinal dilation of the pupil, the information content of such a study increases.

• Optical coherence tomography angiography (OCT angiography, OCT)

  Optical coherence tomography angiography (OCT angiography) is a modern non-invasive method for studying the vessels of the fundus without the introduction of a contrast agent. This procedure allows you to identify the risk of hemorrhages and other problems that can lead to vision impairment. OCT angiography is successfully used in the diagnosis of such dangerous eye diseases as age-related macular degeneration (macular degeneration), diabetic retinopathy, central retinal vein thrombosis, etc.
  This study has no contraindications; it is performed on children, elderly people and patients with allergic reactions. The procedure takes a few minutes and, due to its harmlessness, can be carried out with any frequency, which allows for high-quality monitoring of the state of the circulatory system of the eye.

• Fluorescein angiography (FA)

  Fluorescein angiography (FA) is a study of different areas of the eye with a contrast agent used to visualize blood vessels. After intravenous administration of the dye, the doctor monitors the distribution of the contrast through video or photography.
  This study allows you to obtain information about the integrity and patency of the veins, arteries and capillaries of the eye; FA makes it possible to diagnose various eye pathologies at the initial stage.

• Aberrometry

  During the aberrometry procedure, an eye scan is performed to examine all the features and distortions present in the visual system. The unique capabilities of the diagnostic equipment available in the arsenal of specialists at the Excimer Clinic make it possible to record aberrations not only of the cornea, but also of the lens and vitreous body, as well as the condition of the tear film, cameras of the visual apparatus, etc.
  Based on the data obtained from aberrometric analysis, the shape of the cornea can be modeled to fully compensate for the detected distortions - taking this information into account, the laser vision correction procedure is performed with unprecedented accuracy with the highest quality results. If necessary, such an analysis can be carried out as part of a comprehensive examination of the visual system.

• Electroretinography (ERG)

  Electroretinography is a neurophysiological study that allows not only to diagnose diseases of the retina and optic nerve, but also to accurately predict possible changes in the visual system. This unique procedure provides invaluable information that allows for both treatment and timely, targeted and effective prevention of dangerous pathologies of the visual organs.
  To conduct such a study, special electrodes are placed on the patient’s eyes and back of the head, recording bioelectric impulses that appear in response to the action of a light stimulus. ERG can be performed both in a darkened room and in the light; this procedure is carried out under local drip anesthesia, which does not have a negative effect on the body of patients of any age.

• Color vision testing

  Impaired color perception in some cases is one of the symptoms of the development of some dangerous pathology of the visual system (for example, glaucoma, retinal detachment, pigmentary dystrophy, etc.). Underestimation of negative changes in color vision leads to delayed diagnosis, which can reduce the effectiveness of treatment for eye diseases.
  To analyze the characteristics and anomalies of color perception, multicolor pigment tables and various computer tests are used. This diagnostic procedure is mandatory for people whose professional activities involve severe visual stress - pilots, vehicle drivers, railway workers, etc. Research into the capabilities of color vision in these cases is necessary to obtain permission to work.

• Gonioscopy

  During gonioscopy, an examination of the anterior chamber of the eyeball is carried out; this is done to accurately diagnose glaucoma and other eye diseases - for example, with changes in intraocular pressure that accompany tumor processes affecting the organs of vision. Such a study is also performed when anomalies are detected in the structure of the visual apparatus, when a foreign body enters the anterior chamber of the eye, and in other cases.
  The procedure is performed using special goniolenses (also called gonioscopes) in combination with a slit lamp.

• Biomicroscopy

  The procedure for examining various areas of the eye using a special ophthalmological microscope - a slit lamp. During biomicroscopy, the conjunctiva, cornea, iris, vitreous body, lens, and central parts of the fundus are examined in detail.
  This procedure allows you to diagnose various pathologies, examine injured areas of the eyeball, determine the location of the smallest foreign bodies in the conjunctiva, cornea, anterior chamber of the eye and lens. Biomicroscopy is performed in a dark room, this is done in order to create maximum contrast between the darkened and illuminated areas of the eye.

• Ophthalmoscopy

  Ophthalmoscopy is an examination of the fundus of the eye using special optical instruments. This procedure makes it possible to assess the condition of the retina and optic nerve head, and examine the blood vessels of the eye.
  Ophthalmoscopy allows you to determine the localization and extent of various pathological processes occurring in the eye - for example, to examine thinned areas or places of retinal breaks, to estimate the number of affected areas. Ophthalmoscopy is performed both with a narrow and dilated pupil.

• Pupillometry

  A diagnostic procedure during which the size of the pupil is measured under lighting of varying intensities. Photographing the pupil is performed using special equipment equipped with an infrared camera. Pupillometry allows you to determine the condition of the muscles of the iris and is used in the diagnosis of various eye diseases.
  When assessing the results of this diagnostic procedure, changes in the diameter of the pupils are taken into account depending not only on lighting, but also on the direction of gaze, age, and general condition of the patient.

• Lensmetry (lensmetry)

  A method of optical analysis of glasses used by a patient for vision correction. Such a study is carried out using a special lens meter (dioptrimeter), which makes it possible to examine spectacle lenses of any type, including bifocal and progressive.
  During the procedure, the optical power of the lens is measured, the position of the main meridians of its astigmatic glass is revealed, and the optical center is determined and fixed. These measurements allow for the most personalized, precise selection of glasses.

• Pachymetry

  Measuring corneal thickness. This diagnostic procedure is mandatory during the examination before refractive surgery, and it is also necessary after surgical treatment. Pachymetry is also part of the examination for diseases such as glaucoma, corneal edema, degenerative processes in the tissues of the eye, keratoconus, etc.
  This diagnostic procedure can be carried out in two ways - using a slit lamp (for pachymetry, additional equipment is additionally installed on it) or through ultrasound, the results of which are more accurate.

• Keratometry

  A method for analyzing the optical power of the cornea, which consists of studying the radius of curvature of its surface. This procedure is a mandatory part of a comprehensive diagnostic examination for diseases such as keratoconus and keratoglobus, glaucoma, astigmatism, etc. Keratometry is also performed to measure the curvature of the anterior part of the cornea when selecting contact correction and to assess the general condition of the eye in preparation for surgical interventions.
  The examination can be carried out manually, using an ophthalmological ruler, but in modern ophthalmological clinics special keratometer devices are used that scan the cornea literally in seconds.

• Biometrics

  Study of the parameters of the eyeball, the depth of the anterior chamber of the eye, the size of the vitreous body and cornea, the thickness of the lens, etc. This procedure is carried out when preparing the patient for laser vision correction; it is mandatory when examining for myopia, cataracts, glaucoma and other eye diseases.
  In terms of information content, biometrics surpasses many other studies. Such a study is performed using contact ultrasound or a more advanced non-contact optical method.

If indicated, additional diagnostic studies may be performed.

Diagnostic equipment of the Excimer clinic

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  Autorefkeratotonometer is a multifunctional diagnostic device that includes an autorefractometer, an autokeratometer and a non-contact tonometer, and performs several types of studies. Using this device, you can quickly and accurately study the refraction of the eye, measure the distance between the pupils, as well as the radius of curvature of the cornea and the diameter of the pupils (this is necessary to determine the laser exposure zone for excimer laser correction).

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  A multifunctional diagnostic device that includes an autorefractometer, an autokeratometer and a non-contact tonometer, and performs several types of studies. Using this device, you can quickly and accurately study the refraction of the eye, measure the distance between the pupils, as well as the radius of curvature of the cornea and the diameter of the pupils (this is necessary to determine the laser exposure zone for excimer laser correction).

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  It is successfully used to measure refraction in children of any age, starting literally from the first days of life. This device allows you to analyze the corneal reflex (symmetrical or asymmetrical), measure the diameter of the pupils and the distance between them, and build a picture of gaze fixation.

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  Recognized as the “gold standard” of perimetry, this device allows you to obtain highly accurate information about the visual field, violations of which can be diagnosed in pathology of the neuroreceptor apparatus. Thanks to such diagnostics, it is possible to promptly recognize diseases of the retina and optic nerve (such as glaucoma, macular degeneration) and take therapeutic measures to help avoid irreversible loss of vision.

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  A combined system, standardly consisting of a phoropter, an SSC-370 screen sign projector, a built-in printer and a memory card. The COS-5100 system is equipped with a microprocessor and has centralized control, allowing the exchange of research data between connected devices and processing of results. Various configuration options are possible.

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  Designed to determine visual acuity, study binocular and color vision, and identify various visual anomalies. The working distance on this sign projector can be set in the range from 3 to 6 meters in 1 cm increments. The device allows you to conduct high-precision tests aimed at studying visual acuity in conditions of reduced image contrast.

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  Allows you to measure intraocular pressure in a non-contact way, without touching the surface of the eye. This is done using a directed stream of air. The patient feels only a slight whiff of warm air, which eliminates any discomfort and infection. The device has functions of automatic focusing, automatic shooting, as well as a function of minimizing the pressure of the air stream during measurement (APS).

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  Designed for computer topography of the anterior and posterior surfaces of the cornea and a comprehensive study of the anterior segment of the eye. Non-contact measurement takes only 1-2 seconds; in total, up to 25,000 real elevation points are analyzed to build a 3D model of the anterior segment of the eye. Using an automatic measurement guidance control system, important parameters such as the curvature of the anterior and posterior surface of the cornea, the total optical power of the cornea, the depth of the anterior chamber and its 360° angle, etc. are calculated.

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  Allows you to measure intraocular pressure in a non-contact way, without touching the surface of the eye. This is done using a directed stream of air. The patient feels only a slight whiff of warm air, which eliminates any discomfort and infection. The device has functions of automatic focusing, automatic shooting, as well as a function of minimizing the pressure of the air stream during measurement (APS).

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  A combined biometric device for obtaining human eye data necessary for calculating an implantable intraocular lens. Using this device, the length of the eye axis, the radius of curvature of the cornea, the depth of the anterior chamber of the eye, and much more are measured during one session. Such equipment allows for high-precision selection of an artificial lens in just 1 minute!

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  Studies using this diagnostic device make it possible to determine distortions (aberrations) of the visual system of both lower (myopia, farsightedness and astigmatism) and higher orders (coma, distortion, spherical aberrations). High-precision data obtained from an aberrometer study is used to carry out personalized laser vision correction using the Custom Vue method.

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  Designed to obtain two- and three-dimensional images of the retina and optic nerve head, as well as structures of the anterior segment of the eye. Ultra-high scanning speed, increased resolution, and advanced diagnostic protocols allow RTVue-100 to assess the condition of fundus structures with the highest accuracy. The device has such exclusive capabilities as EnFace analysis of detachments of the pigment epithelium and neurosensory retina, retinoschisis, and epiretinal membranes. RTVue-100 is highly informative for the early diagnosis of glaucomatous optic neuropathy, multiple sclerosis and other neurodegerative diseases.

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  Using this device, the quantitative and qualitative composition of the corneal endothelium is determined. The layer of endothelial cells ensures the transparency of the cornea; analysis of its condition is necessary before deciding to perform microsurgical operations for patients with corneal pathologies, as well as for those who use contact lenses.

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  This slit lamp is easy to handle, easily moved in all directions, and has built-in microscopes with high resolution, depth of field and ideal stereo imaging. Using this device, a detailed ophthalmological examination is carried out, and biomicroscopy of the eye is performed. The device is equipped with a set of special filters that allow you to examine the blood vessels of the eye, the cornea and other eye structures with maximum accuracy.

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  An automatic dioptrimeter (lensmeter) is used to measure the optical characteristics of various types of spectacle lenses, reducing the time of this operation to a minimum. Using this device, the optical power of the lens, expressed in diopters, can be measured, the positions of the main meridians of the astigmatic glass of the lens can be identified in order to determine and fix its optical center. The software on which the dioptrimeter operates ensures the highest accuracy of all measurements.

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  A computer tonograph accurately measures fluctuations in intraocular pressure, the rate of production and outflow of intraocular fluid. A CT scan is very important for those diagnosed with glaucoma (with glaucoma, the circulation of fluid in the eye is usually impaired). Studying the hydrodynamics of the eye using this device significantly expands the possibilities of early diagnosis of glaucoma.

The quality of a diagnostic examination directly depends on the level of technical equipment of the clinic. Modern computerized diagnostic devices that our doctors have at their disposal are capable of recording any deviations from the norm, which ensures an accurate diagnosis even at the earliest stages of the disease.

How to properly prepare for a diagnostic examination?

• Some types of studies in complex vision diagnostics are carried out using drops that dilate the pupil. Considering this factor, you should not plan visual work for the next few hours after undergoing diagnostic procedures. Also, you should not come for diagnostics while driving; driving a car with a dilated pupil is dangerous.
• In order for studies such as measuring corneal thickness, etc. to be as accurate as possible, it is recommended not to use hard contact lenses 2 weeks before diagnosis. It is advisable to remove soft contact lenses in the morning on the day of diagnosis, but this can also be done in the clinic, half an hour before the examination.
• On the day of vision diagnostics, it is recommended to refrain from using decorative eye cosmetics.

Who should get tested first?

Regular monitoring of the state of the visual system is necessary for those who have suffered any injuries or inflammatory eye diseases, people with a family history, those suffering from high degrees of myopia and farsightedness, and anyone undergoing a long course of hormonal therapy.

It is also worth visiting eye specialists more often:

• For those who have crossed the 45-year mark. Age-related changes affecting the eyes increase the risk of developing diseases such as cataracts and glaucoma, and problems with the retina are also possible. Almost all patients of this age begin to develop presbyopia (age-related farsightedness).
• Pregnant women. Pregnancy affects a woman’s entire body and the visual system is no exception. Particular attention should be paid to the condition of the retina, since during natural childbirth there is a risk of its ruptures and detachments.
• Suffering from diabetes mellitus, heart and vascular diseases, etc. For diseases that can have a negative impact on the state of the visual system, regular examinations are necessary in order to take timely measures to maintain eye health.
• For everyone who uses contact lenses, even the most modern lenses are a foreign body to the eyes, so it is necessary to constantly monitor the condition of the cornea, which is regularly exposed to traumatic effects.

Do I need to be examined if there are no vision problems?

Some visual pathologies in the early stages may be asymptomatic. For example, a disease such as glaucoma may not initially manifest itself, but if appropriate measures are not taken in time, glaucoma leads to irreversible loss of vision. The same applies to retinal pathology. Certain disturbances in its functioning can only be identified during a detailed examination of the fundus of the eye - and without the intervention of a specialist, there is a risk of serious deterioration in visual functions.

Many modern people spend long hours at the computer, forgetting to take at least minimal breaks. At the same time, the visual system may undergo changes that are not immediately noticeable, similar to ordinary fatigue, and without urgent treatment can lead to serious problems.

If we talk about children, then we cannot do without the professional attention of an ophthalmologist - there are often cases when an objective, competent diagnosis of possible deviations in the development of the child’s visual system and timely treatment help prevent the development of dangerous ailments.

For pregnant women, ophthalmological examinations are required with a thorough examination of the condition of the fundus at 6, 10 - 14 and 32 - 36 weeks of pregnancy.

Diagnostic examinations of the visual system are mandatory before microsurgical interventions for the patient. This allows you to identify possible contraindications, determine the individual parameters of the operation as accurately as possible and predict its result.

advantages of diagnostics at the excimer clinic

• In our clinic, consultations are conducted only by highly qualified specialists who have extensive experience in conducting all types of modern diagnostic procedures.
• Modern equipment available in the arsenal of doctors at the Excimer clinic allows you to analyze the state of the visual system with the highest accuracy, which, if any abnormalities in the functioning of the eyes are detected, is extremely important for making the correct diagnosis and choosing an effective treatment method.
• All studies are carried out in a short time.

Question answer

Cost of basic services

Surprisingly, a huge arsenal of examinations and diagnostic procedures is aimed at such a small organ of vision: from simple alphabetic tables to obtaining a layer-by-layer image of the retina and optic nerve head using OCT and a detailed study of the course of blood vessels in the fundus during FA.

Most studies are carried out according to strict indications. However, when going to see an ophthalmologist, be prepared to spend from half an hour to an hour or more, depending on the number and complexity of the tests you need and the workload of your doctor.

Determination of visual acuity and refraction

Visual acuity is determined for each eye separately. In this case, one of them is covered with a shield or palm. At a distance of 5 meters you will be shown letters, numbers or signs of various sizes that you will be asked to name. Visual acuity is characterized by the smallest signs that the eye can distinguish.

Next, you will be given a frame in which the doctor will put different lenses, asking you to choose which one allows you to see more clearly. Or they will install in front of you a device called a phoropter, in which lenses are changed automatically. Refraction is characterized by the power of the lens, which provides the highest visual acuity for that eye, and is expressed in diopters. Positive lenses are required for farsightedness, negative lenses for myopia, and cylindrical lenses for astigmatism.

Automatic refractometry and aberrometry

An aberrometer, based on an analysis of the wavefront of the eye, determines even imperceptible optical imperfections of its media. These data are important when planning LASIK.

Visual field examination

It is carried out using a device - a perimeter, which is a hemispherical screen. You are asked to fixate the mark with your eye and, as soon as you notice with your peripheral vision the luminous dots appearing in different parts of the screen, press the signal button or say “yes”, “I see”. The visual field is characterized by the space in which the eye, with a constantly fixed gaze, detects visual stimuli. Characteristic visual field defects occur due to eye diseases, such as glaucoma, as well as when the optic nerve and brain are damaged by a tumor or as a result of a stroke.

Measuring intraocular pressure

Non-contact measurement is carried out using an automatic tonometer. You are asked to place your chin on the stand of the device and fixate your gaze on the luminous mark. The autotonometer releases a stream of air in the direction of your eye. Based on the cornea's resistance to air flow, the device determines the level of intraocular pressure. The technique is absolutely painless, the device does not come into contact with your eyes.

The contact method for measuring intraocular pressure has been accepted as standard in Russia. After instilling the “freezing” drops, the doctor touches your cornea with a weight with a colored area. The level of intraocular pressure is determined on paper by the diameter of the imprint of the unpainted area. This technique is also painless.

Since glaucoma is a disease associated with increased intraocular pressure, regular measurement of it is a necessary condition for maintaining the health of your eyes.

Cover test

There are many methods for diagnosing strabismus. The simplest of them is the “cover” test. The doctor asks you to fix your gaze on an object in the distance and, alternately covering one of your eyes with your palm, watches the other to see if there is an orientation movement. If it occurs inwardly, divergent strabismus is diagnosed, if outwardly, convergent strabismus is diagnosed.

Biomicroscopy of the eye

A slit lamp or biomicroscope allows you to examine the structures of the eye under high magnification. You are asked to place your chin on the stand of the device. The doctor illuminates your eye with the light of a slit lamp and, under high magnification, first examines the anterior part of the eye (eyelids, conjunctiva, cornea, iris, lens), and then, using a strong lens, examines the fundus of the eye (retina, optic nerve head and blood vessels). Biomicroscopy allows you to diagnose almost the entire range of eye diseases.

Retinal examination

Using an ophthalmoscope, the doctor directs a beam of light into your eye and examines the retina, optic nerve head and blood vessels through the pupil.

Often, for a more complete view, you are first instilled with drops that dilate the pupil. The effect develops after 15-30 minutes. While they last, sometimes for several hours, you may experience difficulty focusing on nearby objects. In addition, the eye's sensitivity to light increases; it is recommended to wear sunglasses on the way home after the examination.

Diagnosis of eye diseases is carried out by an ophthalmologist in a specially equipped ophthalmology office.

There are serious eye diseases that have a significant impact on vision. These are cataracts, glaucoma, retinal detachment, and a number of inflammatory and infectious diseases. Early diagnosis and treatment of these diseases is the main way to prevent partial loss of vision and sometimes blindness.

Modern ophthalmology allows you to perform all the necessary studies to make an accurate diagnosis, including the following studies:

• determination of visual acuity (computer and subjective methods);
• examination and determination of the condition of the anterior segment of the eyeball;
• measurement of intraocular pressure;
• fundus examination;
• computer keratotopography (examination of the cornea for accurate diagnosis of astigatism and keratoconus);
• fluorescein digital angiography - computer images of the fundus and examination of retinal vessels for selective treatment of areas of retinal damage (diabetic retinopathy, macular degeneration, etc.);
• complex of electrophysiological studies;
• complex of laboratory tests for preoperative preparation.

Special means for diagnosing eye diseases include: computed tomography of the eye, computer perimetry, ultrasound examination of the eye, topography of the fundus, tonography, determination of color vision, gonioscopy, skiascopy.

Modern diagnostic tools in ophthalmology contribute not only to making an accurate diagnosis, but also allow monitoring and effectively managing the process of treating diseases.

Methods of eye examination in ophthalmology

A comprehensive examination by an ophthalmologist includes the following procedures:

Visometry- This is a measurement of distance visual acuity. In this case, the patient looks at a table with letters, numbers or other signs and names the objects that the ophthalmologist points to. Determination of visual acuity is carried out first without correction, then, if there are violations, with correction (using a special frame and lenses). Decreased vision is an important symptom in the diagnosis of eye diseases.

Tonometry- This is a measurement of intraocular pressure. It can be carried out in several ways (using a pneumotonometer, weights (according to Maklakov), palpation, etc.). This procedure is mandatory for people over 40 years old, because... It is after 40 years that the risk of developing glaucoma increases significantly, which is what this study is aimed at identifying.

Refractometry- this is a determination of the optical power of the eye (refraction). The procedure is currently carried out using automatic refractometers, which greatly facilitates the work of the ophthalmologist and saves the patient’s time. Using this method, refractive errors are diagnosed: myopia, farsightedness and astigmatism.

Color vision testing- this is a method of examining the eyes, carried out using special tables (Rabkin tables) and serves to determine such color vision disorders as protanopia, deuteranopia or color weakness (types of color blindness).

Perimetry is the definition of a person's peripheral vision. The procedure is carried out using special devices, which are a hemisphere, on the inner surface of which light signals are projected. This is an important method for diagnosing eye diseases such as glaucoma, partial optic atrophy, etc.

Biomicroscopy is a method of examining the anterior segment of the eye using a slit lamp (special microscope). Using biomicroscopy, an ophthalmologist can see at high magnification such eye tissues as the conjunctiva, cornea, as well as deeper structures - the iris, lens, vitreous body.

Ophthalmoscopy- this is a study that allows the doctor to see the fundus (inner surface of the eye) - this is the retina, blood vessels. This is one of the most common and important methods in diagnosing eye diseases. The procedure is carried out contactlessly, using a special device - an ophthalmoscope or lens.
Where to get an eye examination

Despite the large number of ophthalmological centers, not all of them have all the necessary equipment and specialists capable of working on it and correctly interpreting the results. One of the few institutions that has the most modern equipment and world-class specialists is the Moscow Eye Clinic. Along with this, affordable prices and impeccable service make this eye clinic one of the best in Russia.

Ophthalmometry- this is a determination of the refractive power of the cornea in different meridians. In this way, the degree of corneal astigmatism can be determined. The study is carried out using a special device - an ophthalmometer.

Determination of the angle of strabismus- this is a fairly simple procedure, an example is the Grishberg method - the patient looks through an ophthalmoscope, and the doctor monitors the reflection of light on his cornea and, depending on this, determines the angle of strabismus.

Probing (bougienage) of the lacrimal canals is a procedure performed for therapeutic purposes, most often in infants, but also in older people, who often experience narrowing of the lacrimal openings. It is performed under local anesthesia using special dilating probes.

Washing the tear ducts- this procedure is carried out for diagnostic purposes if there is a suspicion of obstruction of the lacrimal ducts. It can also be used for medicinal purposes. Special cannulas are inserted into the lacrimal openings on the eyelid, to which a syringe with a solution is attached. If the lacrimal ducts are blocked, the liquid from the syringe enters the nasal cavity, but if there is obstruction of the lacrimal ducts, the liquid pours out or does not pass at all.

As a rule, these methods are quite sufficient to diagnose the most common eye diseases (for example, myopia, conjunctivitis, cataracts, etc.). However, if an ophthalmologist has doubts about the diagnosis, he can use additional methods for diagnosing eye diseases, which require special equipment and are carried out in specialized ophthalmological centers or departments.
Special methods used in the diagnosis of eye diseases

Campimetry- this is the determination of the central field of vision, often in terms of colors. The device for this study is called a campimeter and is a special 2x2 meter screen on which markers are presented to the patient (alternately with the right and left eyes). This method can be used to diagnose eye diseases such as glaucoma, diseases of the retina and optic nerve.

Ultrasound examination of the eyeball (ultrasound)- This is a fairly common research method that has gained popularity due to its efficiency, lack of complications and information content. This study is used to diagnose eye diseases such as retinal detachment, neoplasms of the eye and orbit, and foreign bodies.

Electrophysiological study (EPS)- this allows you to assess the condition of the retina, optic nerve, and cerebral cortex. Those. functions of the entire nervous tissue of the visual apparatus. This method has found wide application in the diagnosis of diseases of the retina and optic nerve.

Tonography is a recording of intraocular pressure (IOP) over time. The procedure takes about 4-5 minutes, but during this time important information about outflow can be obtained.

Keratotopogram is a study showing the surface of the cornea, its “topographic map”. The study is carried out before laser operations on the cornea, if keratoconus and keratoglobus are suspected.

Pachymetry- This is a determination of the thickness of the cornea. This study is mandatory for laser operations.

Fluorescein angiography- this is one of the methods that shows the condition of the retinal vessels. The study is carried out by intravenous administration of a contrast agent and taking a series of images in the retinal vessels.

Examination of eyelashes for demodex- this procedure involves collecting eyelashes followed by examination under a microscope. Depending on the number of mites found, the disease “demodicosis” is diagnosed.

OTC (optical coherence tomography) is optical coherence tomography. Used to assess the condition of the retina and optic nerve. Used in eye examinations for diseases such as retinal dystrophy and detachment, glaucoma, and optic nerve diseases.

Gonioscopy is a procedure in which an ophthalmologist examines the angle of the anterior chamber using a special lens. The study is carried out during examination for glaucoma.

Schirmer test- This is a study that allows you to determine tear production. A special paper strip is placed behind the patient’s lower eyelid, after which it is determined how saturated it is with tears. This test is performed for a disease such as dry eye syndrome.

Fundus examination with Goldmann lens is a method used to evaluate the peripheral parts of the retina that are not visible during normal fundus examination. It is used to diagnose eye diseases such as retinal detachment and dystrophy.

Why is it so important to undergo a comprehensive high-tech vision diagnostics?

Comprehensive vision diagnostics is a necessary condition for maintaining visual acuity for many years. The VISION ophthalmology clinic uses innovative diagnostic equipment to detect eye diseases at the earliest stage, and the qualifications of doctors ensure an accurate diagnosis. The experience of our specialists and advanced examination methods guarantee the selection of effective treatment methods. We have been working for more than 11 years so that you can enjoy the bright colors of the world.

Why is early vision diagnostics using innovative equipment necessary?

According to statistics, up to 65% of eye diseases proceed without symptoms for a long time, imperceptible to the patient. Therefore, it is important to regularly examine the entire visual apparatus: check visual acuity, the condition of the tissues of the eyeball, and the operation of the visual analyzer. The VISION clinic has technological capabilities for diagnosing all parts of the eye, including at the cellular level. This allows you to prescribe the necessary treatment in a timely manner and stop the processes leading to loss or deterioration of vision.

We take care of patients by selecting optimal diagnostic and treatment methods

Examination at the VISION clinic is suitable for patients of any age. Thus, the initial manifestations of retinal dystrophy can occur as early as 18-30 years of age. An optical tomograph allows you to obtain a 3D image of the structure of the retina and see the slightest changes in it. After 30 years, the prerequisites for retinal detachment, glaucoma, and the first stages of neoplasms are identified. And after 50 years, you can discover cataracts or macular degeneration - diseases that lead to complete blindness. Diagnosis always includes a consultation with an ophthalmologist, who will select the optimal treatment regimen or recommend surgery to correct vision. Surgical treatment can also be performed by experienced ophthalmic surgeons at our clinic.

Advantages of the VISION clinic

1.Highly accurate diagnostics

Use of modern equipment, including optical tomographs. Some of the diagnostic methods are unique.

2.Qualification of doctors

The clinic employs qualified specialists - ophthalmologists and ophthalmic surgeons who love their work and have expert knowledge. We do not have visiting doctors, only permanent employees.

3.Innovations in treatment

The latest methods of surgical and non-surgical treatment of myopia, cataracts, glaucoma and other pathologies. Compliance with the international quality standard GOST ISO 9001-2011.

4.Top level eye surgery

Ophthalmic surgeons with unique experience and the latest generation operating equipment provide a high chance of preserving and improving vision even in difficult cases.

5.Responsible approach

Our doctors are responsible for the accuracy of diagnosis and effectiveness of treatment. You will receive detailed advice about your eye health.

6.Transparent prices

There is a fixed price in accordance with the price list. There are no hidden co-payments or unexpected costs once treatment begins.

7.Social orientation.

Our clinic has loyalty programs and social discounts for veterans, pensioners, and the disabled. We want new ophthalmology technologies to be accessible to everyone.

8. Convenient location

The clinic is located in the center of Moscow, on Smolenskaya Square. From the metro station Smolenskaya Filevskaya line just 5 minutes on foot.

The cost of the examination includes a consultation with a highly professional ophthalmologist.

The level and depth of research enable the ophthalmologist, based on the analysis of the data obtained, to make a complete diagnosis, determine tactics, prescribe and carry out treatment, and also predict the course of certain pathological processes in the vascular, nervous and endocrine systems of the body.

A complete ophthalmological examination takes from one to one and a half hours.

Protocol for ophthalmological examination of patients at the VISION ophthalmological center

1. identifying complaints, collecting anamnesis.

2. Visual exploration anterior segment of the eyes, for diagnosing diseases of the eyelids, pathology of the lacrimal organs and oculomotor system.

3.Refractometry and keratometry- study of the total refractive power of the eye and cornea separately in order to identify myopia, farsightedness and astigmatism with a narrow pupil and in conditions of cycloplegia.

4. Measuring intraocular pressure using a non-contact tonometer.

5. Determination of visual acuity with and without correction, using a sign projector and a set of trial lenses.

6. Character Definition vision (binocularity)- test for hidden strabismus.

7. Keratotopography- study of the cornea relief using automatic computer keratotopograph in order to determine congenital, dystrophic and other changes in the shape of the cornea (astigmatism, keratoconus, etc.).

8. Selection of glasses taking into account the nature of visual work.

9. Biomicroscopy- examination of the structures of the eye (conjunctiva, cornea, anterior chamber, iris, lens, vitreous body, fundus) using a slit lamp - biomicroscope.

10. Gonioscopy- examination of the structures of the anterior chamber of the eye using a special lens and biomicroscope.

11. Schirmer test- determination of tear production.

12. Computer perimetry- study of peripheral and central visual fields using automatic projection perimeter (diagnosis of retinal and optic nerve diseases, glaucoma).

13. Ultrasound of the eye for studying internal structures, measuring the size of the eye. This study allows us to detect the presence of foreign bodies, retinal detachment, and eye tumors in opaque internal environments.

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Diagnostics in ophthalmology requires high accuracy and good equipment. For a general examination of the eyeball, you need a microscope with a special illuminator - slit lamp, and for fundus examination - several types ophthalmoscopes(direct, reverse).

Determination of visual acuity (visometry) is carried out using projection equipment and a set of trial lenses or a phoropter. To determine a patient’s nearsightedness, farsightedness and astigmatism, a device is needed autorefkeratometer, which automatically focuses on the retina, determines the refraction, the optical power of the cornea and prints the result. To determine intraocular pressure, several methods are usually used: non-contact pneumotonometer, Maklakov tonometer and Goldmann applanation tonometer or tonograph.

Computer perimetry allows you to determine the boundaries of the field of vision in patients. Ultrasound research methods(A-method, B-scan) allow you to measure the size of the eyeball and its internal structures, study the acoustic transparency of the vitreous body and the position of the membranes of the eyeball. Keratotopograph and pachymeter give an idea of ​​the refractive power, topography of the corneal surface and its thickness. All these devices are available at the Ophthalmological Center of the SM-Clinic holding. But we are also equipped with equipment that few clinics can afford: an optical coherence tomograph, a fundus camera, an optical non-contact biometer, a digital slit lamp.

The parameters of the eyeball are measured in diopters, millimeters and microns, and pressure in millimeters of mercury. The most thorough examinations are carried out before eye surgeries, since an error in measuring the optical axis of the eye of 1 mm corresponds to 3 diopters in glasses. And an error in measuring intraocular pressure can lead to serious damage to the optic nerve during dynamic monitoring of glaucoma.

Diagnosis of eye diseases is carried out according to certain generally accepted schemes, but may also include the use of additional equipment. Patients with cataracts undergo a slit-lamp examination, visual acuity, intraocular pressure, corneal power, and ultrasound examinations. In patients with glaucoma, in addition, intraocular pressure is measured using several methods and the boundaries of the visual field are checked. For patients with refractive diseases (myopia, farsightedness, astigmatism), refraction is measured not only with a narrow, but also with a wide pupil.

allows for ultra-fine diagnostics of the condition of the optic nerve and diseases of the central zone of the retina. allows you to show the patient the condition of his fundus, as well as discuss the features of vascular changes with related specialists - cardiologists, neurologists, endocrinologists. The digital photo-slit lamp allows the patient to be shown a picture of the anterior part of the eye before and after surgical treatment. A non-contact optical biometer measures the parameters of the eyeball and automatically calculates artificial lenses for a given refractive result. Each disease requires an individual approach and the use of special equipment, just as each patient needs special care and attention.

Prices for diagnostic services of an ophthalmologist "SM-Clinic" (Moscow)