Clinic for eye examination. Ophthalmologist (oculist, eye doctor). How is the appointment and consultation going? What treatment does he prescribe? Does an ophthalmologist prescribe glasses for a computer

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. Diagnosis of vision in patients 40-60 years of age is carried out once a year. After the age of 60, ophthalmologists advise to conduct an eye examination 2 times a year.

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

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

So, ten reasons to see an ophthalmologist:

1. A wide range of ophthalmological services provided.
2. Using the most modern scientific developments, professional modern equipment, high-quality consumables.
3. Eye examination, complete comprehensive examination of vision and diagnosis on the day of treatment.
4. Individual approach to examination of patients.
5. Unified computer system for processing and storing information about patients.
6. Accurate calculations of the parameters of operations for myopia, cataracts and other diseases of the organ of vision.
7. Vision diagnostics, initial consultation, surgery and treatment until complete recovery by one specialist.
8. Consultations with the involvement of related specialists (neuropathologist, cardiologist, endocrinologist, nephrologist) according to indications.
9. Preparation for surgery and postoperative rehabilitation.

Thanks to our perfect methods of examination and treatment, we manage to preserve the sight and joy of life for the majority of patients.

Visual impairment can be caused by many reasons. Diagnosis of vision using modern equipment makes it possible to identify these causes, make the correct diagnosis, decide on the possibility and expediency 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 ophthalmic patient performed in our eye clinic.

Visometry

Computer diagnostics of refraction - determination of the optical power (refraction) of the eye. Vision testing is carried out on an autorefkeratometer, which allows you to objectively and accurately determine the degree of refraction of the eye (nearsightedness, 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 during excimer laser correction). Examination data obtained on an autorefkeratometer are necessary for calculating the artificial eye lens (IOL) during cataract removal, refractive surgery for myopia, hyperopia, astigmatism, selection of contact lenses and glasses.

Biomicroscopy of the eye is a method of visual examination of 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 , opacity 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 state of the vitreous body with hemorrhages and opacities in it, to assess the nature, scale and prospects for the subsequent treatment of such pathologies of the retina as vascular lesions of the retina, hereditary retinal diseases, retinal detachment (retinal detachment), retinal dystrophy, retinopathy.

Ophthalmoscopy is a method of studying the choroid, retina, optic nerve in the rays of light that is reflected from the patient's fundus. In the clinic, ophthalmoscopy is performed with a direct ophthalmoscope, a head binocular ophthalmoscope, or with a slit lamp and aspherical lenses or a Goldmann contact lens. Ophthalmoscopy is carried out in conditions of the widest possible pupil, which makes it possible to qualitatively examine not only the central sections of the fundus, but also the peripheral sections of the retina that are difficult to see, to identify peripheral retinal dystrophies, retinal detachment (retinoschisis), subclinical forms of retinal detachment (retinal detachment), then there is a pathology in the fundus, 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, the diagnosis of vision can be expanded with additional studies.

Tonography

Tonography is a method for studying the hydrodynamics of the eye, which consists in graphic recording of the results of multiple 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 for a given period of time. Conducting this study is especially important for verifying the diagnosis in case of suspected glaucoma and as a control of the effectiveness of treatment of those patients in whom glaucoma was detected earlier.

Perimetry

Perimetry is designed to diagnose the state of the visual field - the space that the human eye sees when it is 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 detect eye pathologies such as glaucoma, retinal dystrophy, retinal vascular pathology (occlusion and thrombosis of retinal vessels), retinopathy, retinal detachment at the initial stages. Significantly expanding diagnostic capabilities in inflammatory and vascular pathology of the optic nerve, optic nerve atrophy, neuro-ophthalmic pathology. Perimetry with short screening test methods is reliable enough to detect even minimal visual field defects without a lot 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 you to obtain a two-dimensional image of the vitreous cavity, posterior segment of the eye and orbit. A/B scanning provides a high-resolution image and allows measurement of the dimensions of intraocular structures with an accuracy of 0.01 mm. Ultrasound examination of the eye is performed according to the following main indications:

• Measurement of 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 anterior-posterior 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, due to tumor growth.
• Identification of destruction, exudate, opacities, blood clots, mooring in the vitreous body. Determination of their localization, density and mobility, relationships with the retina of the organ of vision.
• Detection of foreign bodies in the eye in case of injury to the organ of vision, including clinically invisible and X-ray negative. Determination of their location in the eye and relationship with intraocular structures.
• Calculation of the refractive power required for the implantation of an artificial eye lens (IOL).

Recently, a new method of acoustic imaging of the intraocular structures of the anterior segment of the eye has been introduced into clinical practice - ultrasound biomicroscopy. This method allows you to explore the anterior segment of the eye at the microstructural level. Ultrasound biomicroscopy is a B-scanning line-scan ultrasound immersion diagnostic procedure that provides quantitative and qualitative information about the structure of the anterior segment of the eye (cornea, iris, anterior chamber angle, lens) in order to diagnose glaucoma, anterior neoplasms, 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 the contrasting of 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 idea of ​​hemodynamics, the state of the permeability of the vascular walls, pigment epithelium and Bruch's membrane, allows you to differentiate inflammatory changes with vascular, dystrophic and tumor processes.

Fluorescent 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 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 zone of the retina (edema, cysts, ruptures), recurrent hemophthalmos and a number of other diseases.

Electroretinography (ERG) is a method of 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 makes it possible 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 makes it possible to assess the functional state of the inner layers of the retina and the axial bundle of the optic nerve.

Electroretinography is performed:

• when it is impossible to visually assess the state of the retina,
• in the presence of an inflammatory process in the eye,
• with suspicion of sympathetic ophthalmia,
• for early diagnosis of retinitis pigmentosa,
• for the diagnosis of macular degeneration,
• with 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 of visualization of biological structures, which makes it possible to obtain in vivo ("in vivo") two-dimensional image 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 optical reflectivity (reflectivity) of biological structures. The operation of the device is based on a new diagnostic technology that allows obtaining a high-resolution two-dimensional image of a section of the membranes of the eyeball and optic nerve, measuring the thickness of their longitudinal section by analyzing the light signal reflected from the boundaries of biological layers. The device makes it possible, with a minimum load on the patient's eye, to conduct an examination of vision even in cloudy environments.

What happens after the vision test?

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

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 bothers you yet. After all, a disease detected 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 make it possible 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 a diagnostic of the organ of vision to identify:

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

When is an eye examination needed?

Diagnostic examination data are necessary in assessing the general state of eye function, as a control of the progression of the disease and in the prevention of eye diseases. Timely diagnostics will help to choose the optimal therapy regimens that prevent serious complications that can threaten with loss of vision. An examination is also mandatory in the case when a decision is to be made on the need and type of surgical intervention or to provide an opinion at the place of demand (to the antenatal clinic, neuropathologist, cardiologist, etc.)

Ophthalmic 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 evidence 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 with a biomicroscope, examining (zones of the optic nerve and retina) with narrow and wide. Sometimes the level is determined or the fields of vision 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, in addition, include ultrasound diagnostics (B-scan) of the eyes and computerized keratotopography. However, according to indications, other types of studies can be carried out.

Capital ophthalmological clinics have all the equipment necessary for high-quality vision diagnostics.
At the end of the examination, the ophthalmologist necessarily explains the results of the diagnosis to the patient. As a rule, after that, an individual treatment regimen is prescribed or several possible schemes are offered to choose from, and preventive recommendations are also given.

Video about complex vision diagnostics

The cost of vision diagnostics in Moscow

The total cost of the examination is the amount 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 a standard primary eye diagnosis, including such studies as determining visual acuity, measuring intraocular pressure, autorefractometry and examining 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.

Turning to a specialized eye clinic for vision diagnostics, the patient receives the following advantages (compared to seeing an ophthalmologist in a polyclinic or an examination in an optical one):

• each visitor can use any necessary equipment located on the territory of the clinic;
• high-precision, detailed diagnostics of the organ of vision, including the study of the fundus, will not take more than 1-2 hours;
• an extract with the results of the diagnosis will be handed over to the patient, in his hands, along with detailed recommendations for treatment, as well as the prevention of an existing disease;
• if necessary, the patient will be referred for a consultation with an ophthalmologist who specializes specifically on the identified pathology.

Remember that timely diagnosis is half the success of the treatment of any disease. Do not skimp on vision, because losing it is much easier than regaining it!

Additionally, the following diagnostic studies can be carried out:

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

The best eye clinics in Moscow engaged in vision diagnostics

The average cost of some vision diagnostic services in Moscow clinics

Thanks

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Book an Ophthalmologist

To make an appointment with a doctor or diagnostics, you just need to call a single phone number
+7 495 488-20-52 in Moscow

Or

+7 812 416-38-96 in St. Petersburg

The operator will listen to you and redirect the call to the right clinic, or take an order for an appointment with the specialist you need.

Or you can click the green "Sign Up Online" button and leave your phone number. The operator will call you back within 15 minutes and select a specialist that meets your request.

At the moment, an appointment is being made with specialists and clinics in Moscow and St. Petersburg.

What happens at an appointment with an ophthalmologist?

Where does the ophthalmologist take?

Examination by an ophthalmologist

An examination by an ophthalmologist includes:

• Visual acuity test. 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, hyperopia, 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.
• Study of visual fields. Allows you to explore peripheral vision, which can be impaired in glaucoma and other pathologies.
• Examination of the fundus. Allows you to study the vessels of the fundus and the retina, the defeat of which can cause a decrease in visual acuity, narrowing of the visual field and other defects in the visual analyzer.
• Measurement of intraocular pressure. It is the main study in the diagnosis of glaucoma.
• Color vision test. 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 individuals suffering from color blindness.

Table of an ophthalmologist for checking visual acuity

The essence of the study is as follows. The patient sits down on a chair located at a distance of 5 meters from a table fixed on the wall and well lit. The doctor gives the patient a special flap and asks him to cover one eye with it, but not completely close it ( that is, do not close your eyelids). With the second eye, the patient should look at the table. Next, the doctor begins to point to the letters in the various rows of the table ( first into larger ones, then into smaller ones.), and the patient must name them. Satisfactory is the result in which the patient easily ( without squinting) will be able to read letters out of 10 ( above) row of the table. In this case, we are talking about one hundred percent vision, which the ophthalmologist records in the patient's card. Then 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 examining deaf and dumb patients, instead of letters, circles are shown on the tables with a notch on one side ( right, left, up or down). During the examination, the patient must indicate to the doctor which side the tenderloin is on.

Oculist's device for examining the fundus of the eye

The essence of the procedure is as follows. The bright light in the room is turned off, and the patient sits on a chair opposite the doctor. The doctor holds 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. Rays of light enter the fundus of the eye and are reflected from it, as a result of which the doctor can observe various structures in this area through a magnifying glass - the retina, the vessels of the fundus, the optic nerve head ( the place in the fundus where nerve fibers of photosensitive cells leave the eyeball and travel to the brain).

Examination of the fundus helps in the diagnosis of:

• Glaucoma. Characteristic for this pathology is the so-called excavation of the optic disc, which is "squeezed" outward as a result of increased pressure inside the eyeball.
• Angiopathy of the retina. During ophthalmoscopy, the doctor reveals modified, irregularly shaped and sized blood vessels in the fundus.
• Retinal detachments. Under normal conditions, the retina is very weakly attached to the wall of the eyeball, supported mainly by intraocular pressure. Under various pathological conditions ( with eye injuries, wounds) the retina can detach from the wall of the eye, which can lead to deterioration or complete loss of vision. During ophthalmoscopy, the doctor can determine the localization and severity of detachment, which will allow planning further treatment tactics.

What does an ophthalmologist instill into the eye to dilate the pupil?

It is worth noting that these drugs cannot be used in the presence of glaucoma, since pupil dilation can lead to blockage of the aqueous humor outflow pathways and provoke an increase in intraocular pressure. Also, the doctor must inform the patient that for a certain time after the procedure, the patient may experience pain or burning in the eyes when in bright light, and will not be able to read books, 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, the lens is maximally flattened and fixed in this position, that is, a person will not be able to focus on a nearby object until the effect of the drug ends.

Ophthalmologist instruments for measuring IOP

To measure IOP, the ophthalmologist uses a special tonometer - a cylindrical weight with a mass of 10 grams. The essence of the study is as follows. After instillation of a local anesthetic solution into the patient's eye ( 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 on the cornea) the patient lies 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 the cornea ( tonometer), which was previously coated with a special paint. Upon contact with wet ( hydrated) part of the paint is washed off the tonometer by the surface of the cornea. After a few seconds, the doctor removes the cylinder from the patient's eye and presses its surface against a special paper, which leaves a characteristic imprint in the form of a circle. At the end of the study, the doctor measures the diameter of the formed circle-imprint with a ruler, on the basis of which he sets the exact intraocular pressure.

Color vision test ( ophthalmologist pictures for drivers)

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. With the help of these circles in the picture, a certain image is “masked” ( number or letter), and a person with normal vision can easily see it. At the same time, for a person who does not distinguish between colors, recognizing and naming an “encrypted” letter will be an impossible task.

How else does an ophthalmologist check vision?

If necessary, the ophthalmologist may prescribe:

• Biomicroscopy of the eye. The essence of this study is that with the help of a special slit lamp, a narrow strip of light is directed into the patient's eye, translucent to the cornea, lens and other transparent structures of the eyeball. This method makes it possible to detect various deformations and damages of the studied structures with high accuracy.
• Study of corneal sensitivity. To assess this parameter, ophthalmologists usually use a thin hair or several threads from a bandage that touch the cornea of ​​the examined eye ( first in the center and then along the edges). This allows you 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 certain image with both eyes at the same time, ignoring the fact that each eye looks at the object from a slightly different angle. To check binocular vision, ophthalmologists use several methods, the simplest of which is the so-called Sokolov experiment. To conduct 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, on the side of the paper tube, you need to place an open palm ( its edge must be in contact with the tube). If the patient has normal binocular vision, at the moment of bringing the hand to the paper, the effect of the so-called “hole in the palm” will appear, through which what is seen through the paper tube will be seen.

What tests can an optometrist prescribe?

The 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 have caused infectious and inflammatory lesions of the eye, eyelids or other tissues.
• Microbiological research- to identify and identify the causative agent of an eye infection, as well as to determine the sensitivity of an infectious agent to various antibiotics.
• Biochemical blood test– to determine the level of glucose ( Sahara) in the blood if diabetic retinal angiopathy is suspected.

Selection of glasses and lenses at the ophthalmologist

Eyeglasses or contact lenses can correct:

• Myopia ( myopia). As mentioned earlier, with this pathology, the light rays passing through the cornea and lens are refracted too much, as a result of which they are focused in front of the retina. To correct this disease, the doctor selects a diverging lens that “shifts” the focal length somewhat backwards, that is, directly onto the retina, as a result of which the 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 the light rays passing through them fall on different areas in front of the retina and behind it. To correct the defect, special lenses are made that correct the existing irregularities in the refractive structures of the eye and ensure that the rays are focused directly on the retina.

Does an ophthalmologist prescribe glasses for a computer?

Medical examination and certificate from an ophthalmologist

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, and so on). In this case, the examination by an ophthalmologist does not differ from that during a regular physical examination ( the doctor evaluates visual acuity, visual fields and other parameters). If during the examination the specialist does not reveal any deviations from the organ of vision in the patient, he will issue an appropriate conclusion ( certificate). If the patient has a decrease in visual acuity, narrowing of the visual fields, or some 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?

It is worth noting that the free services of an ophthalmologist under the MHI policy ( compulsory health insurance) are found only in state medical institutions ( clinics and hospitals). All ophthalmological consultations and examinations of the visual analyzer performed in private medical centers are subject to a fee.

When is a dispensary registration with an ophthalmologist shown?

The reason for dispensary registration with an ophthalmologist may be:

• Cataract- clouding of the lens, in which it is recommended to visit an ophthalmologist 2 times a year.
• Glaucoma- an increase in intraocular pressure, in which you need to visit a doctor at least 4 times a year.
• Detachment and other retinal 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-recommended 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 damage to the retinal vessels).

When can an ophthalmologist admit you to the hospital?

The reason for hospitalization in this case may be a severe course of the patient's disease ( for example, retinal detachment in several places) or the 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 the constant supervision of doctors during the entire period of treatment. Before the operation, all the studies necessary for an accurate diagnosis and determination of the operation 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 ( e.g. bleeding).

After discharge from the hospital, the doctor gives the patient recommendations on further treatment and rehabilitation, and also sets the dates for follow-up consultations, which will allow you to control the recovery process and identify possible late complications.

How to get a sick leave from an ophthalmologist?

Can I call an ophthalmologist at home?

At home, an ophthalmologist can perform:

• external examination of the eye;
• assessment of visual acuity;
• study of visual fields ( tentatively);
• fundus examination;
• measurement of intraocular pressure.

When an ophthalmologist sends for a consultation with other specialists ( oncologist, endocrinologist, ENT specialist, allergist, neuropathologist, cardiologist)?

The ophthalmologist can refer the patient for a consultation:

• To the oncologist- if you suspect a tumor disease of the eye or adjacent tissues.
• To the endocrinologist- in case of diabetic retinal angiopathy.
• TO LOR ( otorhinolaryngologist) - in case of detection of diseases of the nose or paranasal sinuses, which could be complicated by damage to the eyes.
• To the allergist– in case of allergic conjunctivitis ( damage to the mucous membrane of the eye).
• To a neurologist- if there is a suspicion of damage to the optic nerve, the brain ( visual center) and so on.
• To the cardiologist- with retinal angiopathy caused by hypertension ( persistent increase in blood pressure).

What treatment can an ophthalmologist prescribe?

Vitamins for the eyes

• Vitamin A- to improve the condition of the retina.
• Vitamin B1- improves metabolism in the nervous tissue, including in the retina and in the 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

For therapeutic purposes, the ophthalmologist may prescribe:

• Antibacterial drops- for the treatment of barley, 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.

Operations on the eyes

Surgical treatment in ophthalmology may be required:

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

An ophthalmological examination begins with an anamnesis (general and special). To examine the patient should be planted facing the light. First examine the healthy eye. During 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 state of the conjunctiva, sclera, cornea, anterior chamber of the eye and the iris with the pupil visible within this fissure are established. The conjunctiva of the lower eyelid and the lower transitional fold is examined by pulling back the lower eyelid while looking at the patient upwards. The conjunctiva of the upper eyelid and the upper transitional fold is examined by turning the upper eyelid inside out. To do this, when the patient is looking down, they capture the ciliary edge of the upper eyelid with the thumb and forefinger of the right hand, pull it slightly downward, moving it away from the eye at the same time; on the upper edge of the cartilage of the eyelid, the thumb of the left hand (or eye glass rod) is placed with an edge and, pressing the cartilage downwards, the eyelid is turned upwards by the ciliary edge.

To examine the eyeball in case of eyelid edema or strong eyelids, after preliminary instillation of a 0.5% solution of dicain, it is necessary to push them apart with the help of eyelid lifters inserted behind the upper and lower eyelids. When examining the lacrimal ducts, pressing a finger on the area of ​​the lacrimal sac, note the presence or absence of discharge from the lacrimal puncta. To examine the cornea, iris and the anterior surface of the lens, the side illumination method is used, focusing the light from a table lamp on the eye with a strong convex lens (+20 D). Even more clearly visible changes when viewed through a binocular loupe (see). An external examination of the eyes is completed with a 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 study of the organ of vision must be carried out strictly according to plan. This plan should be based on an anatomical principle, that is, an anatomically consistent examination of individual parts of the organ of vision.

They start with a preliminary history, in which the patient states 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 that, they begin to study the anatomical state of the organ of vision: the adnexa, 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, an ophthalmic examination includes the following.

General information about the patient: gender, age, profession, place of residence. The main complaints of the patient, his gait.

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

Eye socket and adjacent areas. Eyelids - shape, position, surface, mobility; palpebral fissure, eyelashes, eyebrows. Lacrimal organs - lacrimal glands, lacrimal puncta, tubules, lacrimal sac, lacrimal canal. The connective sheath (conjunctiva) - color, transparency, thickness, surface, presence of scars, nature of the discharge. The 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, clouding (stationary, progressive, its degree), position of the lens (displacement, dislocation). Vitreous body - transparency, consistency, hemorrhage, liquefaction, foreign body, cysticercus. The fundus of the eye (see Ophthalmoscopy), the optic disc - the size, shape, color, boundaries, course of blood vessels, level; the periphery of the fundus - the color, condition of the vessels, the presence of foci of hemorrhage, exudation, edema, pigmentation, primary and secondary retinal detachment, neoplasms, subretinal cysticercus; yellow spot - hemorrhage, degeneration, perforated defect, etc.

Special methods for examining 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 examination, 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 lacrimal ducts, etc.

The study of visual functions - see Campimetry, Visual acuity, Field of view.

Eye refraction (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 the 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 with the help of adaptometers (see) and adaptometers of S. V. Kravkov and N. A. Vishnevsky, A. I. Dashevsky, A. I. Bogoslovsky and A. V. Roslav-tsev and other 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.

Association with general diseases. Examination of the patient's body with the participation of relevant specialists. Laboratory studies - microbiological, blood, urine, cerebrospinal fluid tests, Wasserman reaction, tuberculin tests; x-ray studies, etc.

vision diagnostics- this is an important step in the prevention of eye diseases and maintaining good vision for many years! Timely detection of ophthalmic pathology is the key to successful treatment of many eye diseases. As our practice shows, the occurrence of eye diseases is possible at any age, so everyone needs to undergo a high-quality ophthalmological examination at least once a year.

Why is a complete eye examination necessary?

Vision diagnostics is necessary not only to identify the primary ophthalmic pathology, but also to resolve the issue of the possibility and expediency of performing a particular operation, the choice of patient treatment tactics, as well as the accurate diagnosis of the state of the organ of vision in a dynamic aspect. In our clinic, a complete ophthalmological examination is carried out using the most modern diagnostic equipment.

The cost of vision diagnostics

The cost of a diagnostic examination (diagnostics of vision) depends on its volume. For the convenience of patients, we have formed complexes, in accordance with common eye diseases, such as cataracts, glaucoma, myopia, hyperopia, pathology of the fundus.

What studies are included in a complete diagnostic examination of the visual system and what are they?

Any ophthalmological examination begins, first of all, with a conversation, identifying complaints from the patient and taking an anamnesis. And only after that they proceed to the hardware methods of studying the organ of vision. The hardware diagnostic examination includes determining visual acuity, studying the patient's refraction, measuring intraocular pressure, examining the eye under a microscope (biomicroscopy), pachymetry (measuring the thickness of the cornea), echobiometry (determining the length of the eye), ultrasound examination of the eye (B-scan), computed keratotopography and careful (fundus) with a wide pupil, determination of the level of tear production, assessment of the patient's field of view. When an ophthalmic pathology is detected, the scope of the examination is expanded for a specific study of clinical manifestations in a particular patient. Our clinic is equipped with modern, highly professional ophthalmological equipment from such companies as ALCON, Bausch & Lomb, NIDEK, Zeiss, Rodenstock, Oculus, which allows for examinations of any level of complexity.

In our clinic, special tables with pictures, letters or other signs are used to determine the visual acuity and refraction of the patient. With the help of an automatic phoropter NIDEK RT-2100 (Japan), the doctor, alternately changing the diopter glasses, selects the most optimal lenses that provide the best vision for the patient. In our clinic, we use NIDEK SCP - 670 halogen sign projectors with 26 test charts and analyze the result obtained under narrow and wide pupil conditions. A computer study of refraction is carried out on a NIDEK ARK-710A autorefkeratometer (Japan), which allows you to determine the refraction of the eye and the biometric parameters of the cornea as accurately as possible.

Intraocular pressure is measured using a NIDEK NT-2000 non-contact tonometer. If necessary, the measurement of intraocular pressure is carried out by contact method - Maklakov's or Goldman's tonometers.

To study the state of the anterior segment of the eye (eyelids, eyelashes, conjunctiva, cornea, iris, lens, etc.), a NIDEK SL-1800 slit lamp (biomicroscope) is used. On it, the doctor evaluates the condition of the cornea, as well as deeper structures such as the lens and vitreous body.

All patients undergoing a complete ophthalmological examination are required to undergo an examination of the fundus, including areas of its extreme periphery, in conditions of maximum pupil dilation. This makes it possible to detect dystrophic changes in the retina, to diagnose its ruptures and subclinical detachments - a pathology that is not clinically determined by the patient, but requires mandatory treatment. To dilate the pupils (mydriasis), fast and short-acting drugs (Midrum, Midriacil, Cyclomed) are used. When changes in the retina are detected, we prescribe prophylactic laser coagulation using a special laser. Our clinic uses the best and most modern models: YAG laser, NIDEK DC-3000 diode laser.

One of the important methods for diagnosing a patient's vision before any refractive surgery for vision correction is computer topography of the cornea, aimed at examining the surface of the cornea and its pachymetry - measuring the thickness.

One of the anatomical manifestations of refractive errors (myopia,) is a change in the length of the eye. This is one of the most important indicators, which is determined in our clinic by a non-contact method using the IOL MASTER device from ZEISS (Germany). This is a combined biometric device, the results of which are also important for calculating the IOL in cataracts. Using this device, during one session, directly one after another, the length of the axis of the eye, the radius of curvature of the cornea and the depth of the anterior chamber of the eye are measured. All measurements are carried out using a non-contact method, which is extremely comfortable for the patient. Based on the measured values, the built-in computer can suggest optimal intraocular lenses. The basis for this is the current international calculation formulas.

Ultrasound examination is an important addition to the generally recognized clinical methods of ophthalmic diagnostics; it is a widely known and informative instrumental method. This study makes it possible to obtain information about the topography and structure of normal and pathological changes in the tissues of the eye and orbit. The A-method (one-dimensional imaging system) measures the thickness of the cornea, the depth of the anterior chamber, the thickness of the lens and the inner membranes of the eye, as well as the length of the eye. The B-method (two-dimensional imaging system) allows assessing the state of the vitreous body, diagnosing and assessing the height and extent of detachment of the choroid and retina, identifying and determining the size and localization of ocular and retrobulbar neoplasms, as well as detecting and determining the location of a foreign body in the eye.

Study of visual fields

Another of the necessary methods for diagnosing vision is the study of visual fields. The purpose of determining the field of view (perimetry) is:

• diagnosis of eye diseases, in particular glaucoma
• dynamic monitoring to prevent the development of eye diseases.

Also, using a hardware technique, it is possible to measure the contrast and threshold sensitivity of the retina. These studies provide an opportunity for early diagnosis and treatment of a number of eye diseases.

In addition, other parametric and functional data of the patient are examined, for example, determining the level of tear production. The most diagnostically sensitive functional studies are used - the Schirmer test, the Norn test.

Optical tomography of the retina

Another modern method for studying the inner shell of the eye is. This unique technique allows you to get an idea of ​​the structure of the retina throughout its depth, and even measure the thickness of its individual layers. With its help, it became possible to detect the earliest and smallest changes in the structure of the retina and optic nerve, which are not available to the resolving abilities of the human eye.

The principle of operation of an optical tomograph is based on the phenomenon of light interference, which means that the patient is not exposed to any harmful radiation during the examination. The study takes several minutes, does not cause visual fatigue and does not require direct contact of the sensor of the device with the eye. Similar devices for diagnosing vision are available only in large clinics in Russia, Western Europe and the United States. The study provides valuable diagnostic information about the structure of the retina in diabetic macular edema and allows you to accurately formulate a diagnosis in complex cases, as well as get a unique opportunity to monitor the dynamics of treatment based not on the doctor's subjective impression, but on clearly defined digital retinal thickness values.

The study provides comprehensive information about the state of the optic nerve and the thickness of the layer of nerve fibers around it. Highly accurate measurement of the latter parameter guarantees the detection of the earliest signs of this formidable disease, even before the patient has noticed the first symptoms. Considering the ease of implementation and the absence of discomfort during the examination, we recommend repeating control examinations on the scanner for glaucoma every 2-3 months, for diseases of the central retina - every 5-6 months.

A re-examination allows you to determine the activity of the pathology, clarify the correctness of the chosen treatment, as well as correctly inform the patient about the prognosis of the disease, which is especially important for patients suffering from macular holes, since the likelihood of such a process developing on a healthy eye can be predicted after a tomography examination. Early, "preclinical" diagnosis of fundus changes in diabetes mellitus is also within the power of this amazing device.

What happens after hardware research is completed?

After the completion of hardware studies (diagnostics of vision), the doctor carefully analyzes and interprets all the information received about the state of the patient's organ of vision and, based on the data obtained, makes a diagnosis, on the basis of which a treatment plan for the patient is drawn up. All research results and treatment plan are explained in detail to the patient.