Diagnosis, effective treatment and prevention of eye diseases. Diagnosis of eye diseases in ophthalmology: all examination methods Diagnosis of eye diseases

Ophthalmology uses instrumental research methods based on the achievements of modern science, allowing for early diagnosis of many acute and chronic diseases of the organ of vision. Leading research institutes and eye clinics are equipped with such equipment. However, an ophthalmologist of various qualifications, as well as a general practitioner, can, using a non-instrumental research method (external (external examination) of the organ of vision and its adnexal apparatus), conduct express diagnostics and make a preliminary diagnosis for many urgent ophthalmological conditions.

Diagnosis of any eye pathology begins with knowledge of the normal anatomy of the eye tissues. First you need to learn how to examine the organ of vision in a healthy person. Based on this knowledge, the most common eye diseases can be recognized.

The purpose of an ophthalmological examination is to assess the functional state and anatomical structure of both eyes. Ophthalmological problems are divided into three areas according to the place of occurrence: the adnexa of the eye (eyelids and periocular tissues), the eyeball itself and the orbit. A complete baseline survey includes all of these areas except the orbit. For its detailed examination, special equipment is required.

General examination procedure:

1. visual acuity test - determination of visual acuity for distance, for near with glasses, if the patient uses them, or without them, as well as through a small hole if visual acuity is less than 0.6;
2. autorefractometry and/or skiascopy - determination of clinical refraction;
3. intraocular pressure (IOP) study; when it increases, electrotonometry is performed;
4. study of the visual field using the kinetic method, and according to indications - static;
5. determination of color perception;
6. determination of the function of extraocular muscles (range of action in all fields of vision and screening for strabismus and diplopia);
7. examination of the eyelids, conjunctiva and anterior segment of the eye under magnification (using loupes or a slit lamp). The examination is carried out using dyes (sodium fluorescein or rose bengal) or without them;
8. examination in transmitted light - the transparency of the cornea, chambers of the eye, lens and vitreous body is determined;
9. fundus ophthalmoscopy.

Additional tests are used based on the results of anamnesis or initial examination.

These include:

1. gonioscopy - examination of the angle of the anterior chamber of the eye;
2. ultrasound examination of the posterior pole of the eye;
3. ultrasound biomicroscopy of the anterior segment of the eyeball (UBM);
4. corneal keratometry - determination of the refractive power of the cornea and the radius of its curvature;
5. study of corneal sensitivity;
6. examination of fundus parts with a fundus lens;
7. fluorescent or indocyanine green fundus angiography (FAG) (ICZA);
8. electroretinography (ERG) and electrooculography (EOG);
9. radiological studies (x-ray, computed tomography, magnetic resonance imaging) of the structures of the eyeball and orbits;
10. diaphanoscopy (transillumination) of the eyeball;
11. exophthalmometry - determination of the protrusion of the eyeball from the orbit;
12. pachymetry of the cornea - determination of its thickness in various areas;
13. determining the condition of the tear film;
14. mirror microscopy of the cornea - examination of the endothelial layer of the cornea.

T. Birich, L. Marchenko, A. Chekina

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

Based on the analysis of the wavefront of the eye, the aberrometer 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.

An ophthalmological examination begins with collecting an anamnesis (general and special). For examination, the patient should be seated facing the light. First, the healthy eye is examined. During an external examination, the condition of the eyelids, the area of ​​the lacrimal sac, the position of the eyeball, the width of the palpebral fissure, the condition of the conjunctiva, sclera, cornea, anterior chamber of the eye and the iris with the pupil visible within this fissure are determined. The conjunctiva of the lower eyelid and the lower transitional fold is examined by pulling the lower eyelid when the patient looks up. The conjunctiva of the upper eyelid and the upper transitional fold is examined by everting the upper eyelid. To do this, when the patient is looking down, grab the ciliary edge of the upper eyelid with the thumb and forefinger of the right hand, pull it slightly down, moving it away from the eye at the same time; Place the thumb of the left hand (or an eye glass rod) on the upper edge of the cartilage of the eyelid, and, pressing the cartilage down, turn the eyelid upward by the ciliary edge.

To examine the eyeball when the eyelids are swollen or severe, it is necessary, after preliminary instillation of a 0.5% dicaine solution, to move them apart using eyelid lifters inserted behind the upper and lower eyelids. When examining the lacrimal ducts, pressing a finger on the area of ​​the lacrimal sac, the presence or absence of discharge from the lacrimal openings is noted. To examine the cornea, iris and anterior surface of the lens, use the lateral illumination method, focusing the light from a table lamp on the eye with a strong convex lens (+20 D). The changes are even more clearly visible when viewed through a binocular loupe (see). External examination of the eyes ends with the study of pupillary reflexes (see). Next, they examine (see), the fundus of the eye (see), visual functions (see,) and intraocular pressure (see).

Ophthalmological examination
The examination of the organ of vision must be carried out strictly according to plan. This plan should be based on the anatomical principle, i.e., anatomically sequential consideration of the individual parts of the organ of vision.

They start with a preliminary history, in which the patient outlines his complaints (pain, redness of the eye, dysfunction, etc.; a more detailed and targeted history - personal, family, hereditary - should, according to S.S. Golovin, be attributed to the end of the study). After this, they begin to study the anatomical state of the organ of vision: the appendage apparatus, the anterior part of the eyeball, the internal parts of the eye, then they examine the functions of the eye and the general condition of the body.

In detail, the ophthalmological examination includes the following.

General information about the patient: gender, age, profession, place of residence. The patient's main complaint is his gait.

Inspection. General habitus, skull shape, face (asymmetry, condition of facial skin, one-sided graying of eyelashes, eyebrows, scalp hair, etc.).

The eye socket and its neighboring areas. Eyelids - shape, position, surface, mobility; palpebral fissure, eyelashes, eyebrows. Lacrimal organs - lacrimal glands, lacrimal puncta, canaliculi, lacrimal sac, nasolacrimal canal. Connective membrane (conjunctiva) - color, transparency, thickness, surface, presence of scars, nature of the discharge. Position of the eyeball [exophthalmos, enophthalmos (see Exophthalmometry), displacement], size, mobility, intraocular pressure (see Ocular tonometry).

Sclera - surface, color. Cornea - shape, surface, transparency, sensitivity. Anterior chamber of the eye - depth, uniformity, chamber moisture. Iris - color, pattern, position, mobility. Pupils - position, size, shape, reactions. Lens - transparency, opacification (stationary, progressive, its degree), position of the lens (displacement, dislocation). Vitreous body - transparency, consistency, hemorrhages, liquefaction, foreign body, cysticercus. Fundus of the eye (see Ophthalmoscopy), optic disc - size, shape, color, boundaries, course of blood vessels, level; periphery of the fundus - color, condition of blood vessels, presence of foci of hemorrhage, exudation, edema, pigmentation, primary and secondary retinal detachment, neoplasm, subretinal cysticercus; yellow spot - hemorrhage, degeneration, perforated defect, etc.

Special methods for studying the organ of vision - see Biomicroscopy, Gonioscopy, Diaphanoscopy of the eye, Ophthalmodynamometry, Ocular tonometry. An electromagnetic test (see Eye Magnets) makes it possible, using hand-held or stationary magnets, to determine the presence of magnetic foreign bodies in the eye or in the tissues surrounding it.

X-ray diagnostics, which is widely used in ophthalmological examinations, can detect changes in the bones of the skull, orbit, its contents (tumors, etc.), foreign bodies in the eye and surrounding tissues, changes in the tear ducts, etc.

Study of visual functions - see Campimetry, Visual acuity, Visual field.

Refraction of the eyes (see) is determined by subjective (selection of corrective glasses) and objective methods (see Skiascopy, Refractometry of the eye).

Accommodation - the position of the nearest point of view, the strength and width of accommodation are determined.

Color perception (see) - color recognition by central vision - is more often studied using the tables of E. B. Rabkin. Light perception - adaptation to light and darkness - is studied using adaptometers (see) and adaptoperimeters by S. V. Kravkov and N. A. Vishnevsky, A. I. Dashevsky, A. I. Bogoslovsky and A. V. Roslavtsev and etc. Eye movements - determination of the symmetrical position of the eyes, their mobility, fusion ability, binocular vision, latent and obvious strabismus, muscle paralysis and other movement disorders. Electroretinography (see) is of known importance in the diagnosis of certain eye diseases.

Connection with common diseases. Examination of the patient's body with the participation of relevant specialists. Laboratory tests - microbiological, blood, urine, cerebrospinal fluid tests, Wasserman reaction, tuberculin tests; X-ray examinations, etc.

In ophthalmology, thanks to modern equipment and the latest medical techniques, eye examinations take a short time, are painless and give very accurate results in identifying diseases of the eye organ.

Vision examination

At an appointment with an ophthalmologist, the patient is examined with basic standard diagnostic methods, which include checking visual acuity, measuring intraocular pressure, examining the cornea and retina.

If necessary, a more accurate and in-depth study is prescribed using modern devices using laser technology and computer programs.

Symptoms for mandatory contact with an ophthalmologist

For timely detection of eye diseases and treatment, it is necessary to pay attention to the following symptoms:

• swelling and redness of the eyelids;
• presence of itching and burning in the eyes;
• pain when blinking;
• redness of the inner surface;
• severe tearing;
• the presence of a film in front of the eyes, obstructing vision;
• spots and spots before the eyes;
• flickering light flashes;
• blurry or foggy vision of objects;
• duality of objects;
• increased sensitivity to light;
• long orientation in a dark room;
• sudden disappearance of the image;
• curvature or break of lines when looking at straight lines;
• observation of dark spots in the field of view;
• rainbow circles that blur around the light source;
• difficulty focusing on near and far objects;
• observation of spots in the center of the visual field;
• beginning to squint their eyes;
• poor vision of the peripheral zone.

Who should have their eyes checked?

People with 100% good vision should have it checked for preventive purposes once a year. For those who have vision loss due to certain reasons, it is necessary to undergo an examination by an ophthalmologist to correct their vision.

For those who wear lenses, an examination is necessary to identify adaptation of the lens material on the surface of the eye. To determine allergic reactions to this material. Clarify the correct care and storage of contact lenses.

It is necessary to visit an ophthalmologist for pregnant women at 10–14 weeks and 34–36 weeks. Pregnancy can cause changes in visual acuity or complications of existing eye diseases.

For people aged 40–60 years, it is advisable to schedule a visit to the ophthalmologist for preventive purposes once every 2–4 years. Over 65 years old – once every 1–2 years. Children need to be tested up to three times during the first year of life and as needed.

It is advisable for people with cardiovascular diseases, hypertension and diabetes, after eye injuries or taking hormonal medications to visit an ophthalmologist.

Examination methods

There are many serious diseases of the human eye organ that significantly affect the visual process. These are cataracts, glaucoma, retinal detachment and many infectious diseases.

Early diagnosis, as well as timely treatment, can prevent further development of diseases, partial loss of vision and blindness. The earlier the diagnosis is made and treatment started, the greater the percentage of vision that can be saved.

Basic examination methods

Basic and additional examination methods used:

• Visometry is the determination of vision, its acuity using tables of letters, where letters of different sizes are written on each line. While reading lines, vision is established at the moment in percentage terms.
• Tonometry is the determination of the existing pressure inside an organ. The method is aimed at identifying glaucoma.
• Refractometry – determination of the refraction of the eye (optical power). It can detect myopia, farsightedness and astigmatism.
• Color vision testing is aimed at recognizing color blindness and other color vision deviations.
  The perimetry method diagnoses glaucoma and determines the degree of optic nerve death.
• Biomicroscopy is a method of examining the constituent parts of the eye organ, such as the cornea, external conjunctiva, lens, iris, and vitreous body.
• Ophthalmoscopy is a way to examine the fundus, retina, and nearby vascular tissues. Determines the degree of strabismus.
• Gonioscopy is a contact technique that allows you to examine the front of the eye to detect a foreign body or neoplasm.
• Pachymetry is a method of studying the cornea of ​​the eye using instruments, measuring its thickness.
• Skiascopy - a shadow test is carried out by observing the shadows on the surface of the pupil when a beam of light falls on it.
• Campimetry is a method of studying central vision to determine the size of the blind spot.
• To fully examine the eyeball, Goldmann lenses are used. This device consists of three mirrors. Using the lens, you can remove tumors on the retina and completely examine it.

Today, methods for examining the organ of vision are sufficient to accurately and correctly make a diagnosis by looking into the most inaccessible and deep layers of the visual organ.

The eye is a very important and at the same time vulnerable organ. Therefore, ophthalmological diseases are one of the most common diseases. Most of them are inflammatory diseases.

If you experience redness of the eyes, watery eyes, swelling, pain, discharge from the eyes, or decreased vision, you should consult an ophthalmologist as soon as possible. Often these symptoms indicate development of the inflammatory process in one of the parts of the eyeball or nearby tissues. Without the participation of a qualified ophthalmologist who will accurately diagnose and prescribe timely (and in some cases emergency) treatment, eye inflammation can become chronic and cause such unpleasant problems as eyelid closure (blepharospasm), purulent inflammation, uveitis and others. , which pose a serious threat, including complete loss of vision.

Ophthalmological center ON CLINIC provides a full range of services for the diagnosis and treatment of inflammatory eye diseases.

ON CLINIC ophthalmologists have modern diagnostic equipment, time-tested and proprietary methods of complex eye treatment in their arsenal, allowing to achieve positive results.

What inflammatory eye diseases are treated at ON CLINIC?

Experienced doctors at the ON CLINIC Ophthalmological Center provide effective treatment for various inflammatory eye diseases. Including viral and infectious nature, autoimmune eye diseases such as iridocyclitis, uveitis, chorioretinitis and others.

Inflammatory eye diseases vary depending on the area affected. In particular, inflammation of the following eye structures is distinguished:

• eyelids (stye, blepharitis, demodicosis of the eyelids, chalazion, etc.);
• conjunctiva (conjunctivitis of bacterial, viral nature, acute, chronic, etc.);
• lacrimal organs (canaliculitis, dacryoadenitis, etc.);
• corneas (viral, fungal, etc. keratitis);
• blood vessels of the eye (iritis, iridocyclitis, endophthalmitis, etc.);
• orbits (exophthalmos, thrombophlebitis of the orbit, etc.).

Thanks to the introduction of modern equipment and extensive practical experience of doctors at the Ophthalmological Center ON CLINIC, it is possible to carry out high-precision diagnosis of inflammatory eye diseases and timely initiation of treatment to prevent the development of unpleasant complications.

There are many reasons for the development of eye inflammation:

• infection from the external environment or blood;
• toxins and allergens;
• working at the computer for long periods of time, watching TV for many hours;
• injuries;
• systemic connective tissue diseases;
• foci of chronic infection;
• exposure to ultraviolet radiation, etc.

As a rule, there are several factors that provoke the development of eye inflammation, which requires careful diagnosis.

The administrator will contact you to confirm your appointment. IMC "ON CLINIC" guarantees complete confidentiality of your request.

Diagnosis of inflammatory eye diseases

An examination allows you to prescribe the most effective treatment package. First, ON CLINIC ophthalmologists carefully examine and study the condition of the patient’s eyes and collect anamnesis.

If we are talking about an inflammatory eye disease, then a set of laboratory tests, which are prescribed individually in each case, allows us to identify the agent or pathogen (bacteria, virus, fungus, mite, etc.).

Differential diagnosis is of particular importance in the examination process, since many eye diseases have similar symptoms. In any case, it is necessary to carry out complete diagnosis of inflammatory eye diseases, which may include the following studies:

ON CLINIC has its own clinical diagnostic laboratory, which provides the opportunity to conduct comprehensive laboratory and instrumental examination for inflammatory eye diseases.

Treatment of inflammatory eye diseases at ON CLINIC

In some cases, inflammatory eye damage can develop against the background of a general systemic disease. Thanks to the versatility of the ON CLINIC medical center, our patients have the opportunity to undergo not only an ophthalmological examination, but also general diagnostics with consultation with a specialist doctor.

Treatment of inflammatory eye diseases is always complex. The patient may be prescribed:

• effective medications (antibacterial, antiviral, etc.) that can destroy the infectious agent;
• specific immunotherapy and allergy therapy;
• special eyelid massage;
• ozone therapy (intravenous infusions and/or irrigation of the conjunctival cavity);
• physiotherapeutic methods, in particular magnetic stimulation, color therapy, etc.;
• in case of complications development – ​​gentle microsurgical intervention, etc.

Ophthalmologists at ON CLINIC have in their arsenal all types of modern high-precision diagnostic methods, which allow you to recognize the disease at an early stage, effectively eliminate its cause and painful manifestations, and restore the joy of a full and vivid perception of the world around you. Contact us!

ON CLINIC – comprehensive diagnosis and effective treatment of inflammatory eye diseases!

Cost of services