Vision diagnostics at the Excimer. Basic ophthalmological examination

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

Comprehensive diagnostics of vision is a necessary condition for maintaining its sharpness for many years. The VISION ophthalmological 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 on innovative equipment necessary?

According to statistics, up to 65% of eye diseases proceed without symptoms for a long time, imperceptibly for the patient. Therefore, it is important to regularly examine the entire visual apparatus: check visual acuity, the condition of the tissues of the eyeball, the work 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 right treatment in a timely manner and stop the processes that lead to loss or deterioration of vision.

We take care of patients by choosing the best methods of diagnosis and treatment

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

Advantages of the VISION clinic

1.High-precision diagnostics

The 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 job and have expert knowledge. We do not have visiting doctors, only permanent employees.

3.Innovation 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 of operating equipment - a high chance of maintaining and improving vision even in difficult cases.

5. Responsible approach

Our doctors are responsible for the accuracy of the diagnosis and the effectiveness of the treatment. You will receive a detailed consultation on the state of eye health.

6.Transparent prices

There is a fixed cost in accordance with the price list. No hidden co-payments or unexpected costs once treatment has begun.

7. Social orientation.

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

8.Convenient location

The clinic is located in the center of Moscow, on Smolenskaya Square. From the metro 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 the tactics, prescribe and carry out treatment, as well as predict the course of some 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 of ophthalmological examination of patients in the ophthalmological center "VISION"

1. identification of complaints, collection of anamnesis.

2. visual study anterior segment of the eyes, for the diagnosis of diseases of the eyelids, pathology of the lacrimal organs and the oculomotor apparatus.

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

4. Measurement of intraocular pressure using a non-contact tonometer.

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

6. Definition of character vision (binocular)- test for latent strabismus.

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

8. Point selection taking into account the nature of visual work.

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

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

11. Schirmer's test- determination of tear production.

12. Computer perimetry- examination of the peripheral and central fields of vision using an automatic projection perimeter (diagnosis of diseases of the retina and optic nerve, glaucoma).

13. Ultrasound eye to study the internal structures, measure the size of the eye. This study allows you to identify the presence of foreign bodies, retinal detachment, eye neoplasms in opaque internal environments.

14. Electrophysiological study visual system.

15. Spectral optical coherence tomography(SOCT) allows you to get spatial 3D images of all layers of the retina at the cellular level. The method gives a comprehensive picture of the ultrastructure of the central parts of the retina, the optic nerve, and the cornea.

16. Aberrometry - method of automatic measurement of visual distortions of the human eye with a high degree of accuracy.

17. Formulation of an ophthalmic diagnosis in accordance with the International Classification of Diseases (ICD-10).

18. Appointment, if necessary, of clinical and laboratory studies and consultations of specialists.

19. Appointment of treatment (if necessary) and the optimal method of vision correction.

20. Appointment of control examinations.

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 layered image of the retina and optic nerve head using OCT and a detailed study of the course of blood vessels in the fundus with FAH.

Most studies are conducted on strict indications. However, when going to an ophthalmologist, be prepared to spend half an hour to an hour or more, depending on the number and complexity of the examinations you need, and on 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 signs of the smallest size 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 you see clearer. Or they will install a device called a phoropter in front of you, in which the change of lenses is carried out automatically. Refraction is characterized by the power of the lens, which provides the highest visual acuity for this eye, and is expressed in diopters. Positive lenses are required for farsightedness, negative lenses for nearsightedness, cylindrical lenses for astigmatism.

Automatic refractometry and aberrometry

The aberrometer, based on the analysis of the wave front of the eye, determines even imperceptible optical imperfections of its media. These data are important when planning LASIK.

Study of visual fields

It is carried out using a device - a perimeter, which is a hemispherical screen. You are asked to fix the mark with the examined eye and, as soon as you notice with peripheral vision the luminous dots that appear 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 permanently fixed gaze detects visual stimuli. Characteristic visual field defects occur with eye diseases, such as glaucoma, as well as damage to the optic nerve and brain by a tumor or as a result of a stroke.

Measurement of 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 fix the luminous mark with your eyes. The autotonometer releases a jet of air in the direction of your eye. Based on the resistance of the cornea to air flow, the device determines the level of intraocular pressure. The technique is absolutely painless, the device does not contact your eyes.

The contact technique for measuring intraocular pressure is accepted in Russia as a standard. After instillation of "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 zone. This technique is also painless.

Since glaucoma is a disease associated with an increase in 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 these is the cover test. The doctor asks you to fix an object in the distance with your eyes and, alternately covering one of your eyes with your palm, watches the other one: whether there will be an adjusting movement. If it occurs inside, a divergent strabismus is diagnosed, if outwards, it is convergent.

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 instrument stand. 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 (retina, optic nerve head and blood vessels). Biomicroscopy allows diagnosing almost the entire spectrum 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 in 15-30 minutes. During their action, sometimes for several hours, you may experience difficulty in focusing your eyes on objects located nearby. In addition, the sensitivity of the eye to light increases, it is recommended to wear sunglasses on the way home after the examination.

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Book an Ophthalmologist

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 the treatment of strabismus;
• with retinal detachment;
• with traumatic eye damage;
• to correct the shape of the eyelids;
• with damage to the iris of the eye;
• for vision correction myopia, farsightedness, astigmatism);
• for fitting phakic lenses ( These lenses are placed on the inner surface of the cornea and act in the same way as regular contact lenses.) and so on.

Laser vision correction

Jokes about the optometrist

At the appointment with the ophthalmologist, the doctor asks the patient:
Do you see what letter I'm pointing to now?
-Doctor, where are you?

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A one-eyed pirate at an ophthalmologist's appointment:
Now let's check the visual acuity. Close one eye and look at the table ...

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The optometrist teaches the patient:
-Remember, dear - every person with myopia should have at least two pairs of glasses. One glasses for reading, and the second - in order to find the first.

The insidiousness of many eye diseases lies in the fact 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 as possible examination of the visual system and identify the exact cause of the disease!

What does vision diagnostics at the Excimer clinic include?

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 optics salons or clinics are usually limited to it.
  The disadvantage of visometry is its subjectivity: what the patient said is taken for granted. This is not suitable for checking eyesight in children or in people who know the tables for checking eyesight 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 methods of research.

• 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. According to 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 refraction is normal, vision is in order; "Hypermetropia" ("farsightedness") - that there are visual impairments at close range, and "myopia" ("nearsightedness") - on the contrary, at a distance.

• Tonometry

  Diagnostic procedure necessary to assess the risk of developing glaucoma, which consists in 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. In the Excimer clinic, this procedure is carried out on modern equipment, without contact.
  Non-contact tonometry is performed using a pneumatic tonometer, which produces a directed air flow, and that, acting on the cornea of ​​​​the eye at a certain speed, leads to a certain deformation of the eyeball, which is fixed by special sensors of the tonometer. This is a quick and painless method that has proven itself in measuring intraocular pressure, even in children.

• Perimetry

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

• Optical coherence tomography (OCT, OCT)

  Optical coherence tomography (OCT) is currently the most modern method for studying various structures of the visual system. With the help of OCT, two- and three-dimensional images of the retina and optic nerve head can be taken, such a study allows you to get an optical section of the layers of the eye, which provides enhanced opportunities for diagnosing dangerous neoplasms of the choroid, macular holes and edema, peripheral retinal dystrophy, glaucoma, various inflammatory diseases of the eye, etc.
  This procedure does not require special training, but with a medical expansion 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 fundus vessels without the introduction of a contrast agent. This procedure allows you to identify the risk of hemorrhage and other problems that can lead to visual impairment. OCT angiography is successfully used in the diagnosis of dangerous eye diseases such as age-related macular degeneration (macular degeneration), diabetic retinopathy, central retinal vein thrombosis, etc.
  This study has no contraindications, it is carried out in children, the elderly and patients with allergic reactions. The procedure takes a few minutes and, due to its harmlessness, can be carried out at 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 an examination of different parts of the eye with a contrast agent that is used to visualize blood vessels. After intravenous administration of the coloring preparation, the doctor monitors the distribution of 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, FAG makes it possible to diagnose various eye pathologies at the initial stage.

• Aberrometry

  During the aberrometry procedure, an eye scan is performed to study all the features and distortions present in the visual system. The unique capabilities of the diagnostic equipment available in the arsenal of the Excimer clinic specialists make it possible to record aberrations not only of the cornea, but also of the lens and vitreous body, as well as the state of the tear film, cameras of the visual apparatus, etc.
  Based on the data obtained during the aberrometric analysis, the shape of the cornea can be modeled, fully compensating for the detected distortions - taking into account this information, the laser vision correction procedure is performed with unprecedented accuracy and 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 predict possible changes in the visual system with high accuracy. This unique procedure provides invaluable information that allows both treatment and timely, targeted and effective prevention of dangerous pathologies of the organs of vision.
  To conduct such a study, special electrodes are placed on the eyes and back of the patient's head, fixing 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 performed under local drip anesthesia, which does not adversely affect the body of patients of any age.

• Color vision test

  Violation of color perception in some cases is one of the symptoms of the development of any dangerous pathology of the visual system (for example, glaucoma, retinal detachment, pigmentary dystrophy, etc.). Underestimation of the negative changes in color vision leads to delayed diagnosis, which can reduce the effectiveness of the treatment of eye diseases.
  To analyze the features and anomalies of color perception, multi-color pigment tables and various computer tests are used. This diagnostic procedure is mandatory for people whose professional activities are associated with serious visual stress - pilots, drivers of vehicles, railway workers, etc. The study of the possibilities 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 that affect 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 carried out using special goniolenses (also called gonioscopes) in combination with a slit lamp.

• Biomicroscopy

  The procedure for examining various parts of the eye using a special ophthalmic microscope - a slit lamp. During biomicroscopy, the conjunctiva, cornea, iris, vitreous body, lens, central sections of the fundus are examined in detail.
  This procedure allows you to diagnose various pathologies, examine the 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 carried out 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 disc, to 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 with both narrow and dilated pupils.

• Pupillometry

  A diagnostic procedure in which the size of the pupil is measured under illumination of various intensities. Photographing the pupil is performed using special equipment equipped with an infrared camera. Pupillometry allows you to find out the condition of the muscles of the iris, is used in the diagnosis of various eye diseases.
  When evaluating 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 the general condition of the patient.

• Lensmetry (lensmetry)

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

• pachymetry

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

• Keratometry

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

• Biometrics

  Examination 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 myopia, cataracts, glaucoma and other eye diseases.
  In terms of information content, biometrics surpasses many other studies. Such a study is performed by contact ultrasonic or more advanced non-contact optical method.

Additional diagnostic tests may be performed as indicated.

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 examinations. 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 during 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 examinations. 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 during 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 asymmetric), measure the diameter of the pupils and the distance between them, build a picture of fixing the gaze.

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  Recognized as the "gold standard" of perimetry, this device allows obtaining high-precision information about the visual field, violations of which can be diagnosed in the pathology of the neuroreceptor apparatus. Thanks to such diagnostics, diseases of the retina and optic nerve (such as glaucoma, macular degeneration) can be recognized in a timely manner and therapeutic measures can be taken to help avoid irreversible loss of vision.

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  Combined system, as standard, consisting of a phoropter, screen projector SSC-370 characters, built-in printer and memory card. The COS-5100 system is equipped with a microprocessor and has a centralized control that allows the exchange of research data between connected instruments and processing of results. Various configuration options are possible.

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

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

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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. With the help of an automatic measurement guidance control system, such important parameters 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 angle of 360 °, etc. are calculated.

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

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  Combined biometric device for obtaining data of the human eye, necessary for the calculation of an implantable intraocular lens. With the help of this device, the length of the axis of the eye, the radii 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 on this diagnostic device allow you to determine the distortions (aberrations) of the visual system, both lower (nearsightedness, farsightedness and astigmatism) and higher orders (coma, distortion, spherical aberrations). The highly accurate data obtained from the aberrometer study is used to perform a personalized laser vision correction procedure using the Custom Vue method.

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

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  With the help of 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 making a decision to perform microsurgical operations in patients with corneal pathologies, as well as those who use contact lenses.

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  This slit lamp is easy to handle, easy to move in all directions, has built-in microscopes with high resolution, depth of field and perfect stereo image. With the help of this device, a detailed ophthalmological examination is carried out, 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 structures of the eye 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 are identified in order to determine and fix its optical center. The software on the basis of which the dioptrimeter works ensures the highest accuracy of all measurements.

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

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

How to prepare for a diagnostic examination?

• Some types of studies in the complex diagnostics of vision are carried out using drops that expand the pupil. Given this factor, you should not plan visual work for the next few hours after undergoing diagnostic procedures. Also, you should not come to the diagnostics while driving, driving a car with a dilated pupil is dangerous.
• In order to ensure that studies such as measuring the thickness of the cornea, etc. are as accurate as possible, it is recommended not to use hard contact lenses 2 weeks before the 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 start of the examination.
• On the day of the diagnosis of vision, it is recommended to refrain from using decorative cosmetics for the eyes.

Who should get tested first?

Regular monitoring of the state of the visual system is necessary for those who have suffered any injuries and inflammatory diseases of the eyes, people with aggravated heredity, suffering from high degrees of myopia and hyperopia, and everyone undergoing a long course of hormonal therapy.

It is also worth visiting an eye specialist more often:

• Those who have crossed the 45-year milestone. Age-related changes affecting the eyes increase the risk of developing diseases such as cataracts and glaucoma, as well as problems with the retina. Almost all patients of this age begin to develop presbyopia (age-related farsightedness).
• Pregnant women. Pregnancy affects the entire body of a woman 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, diseases of the heart and blood vessels, etc. In case of 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.
• Everyone who uses contact lenses - even the most modern lenses are a foreign body for the eyes, so it is necessary to constantly monitor the condition of the cornea, which is regularly exposed to traumatic effects.

Is it necessary to be examined if there are no problems with vision?

Some visual pathologies in the early stages may be asymptomatic. For example, a disease such as glaucoma may not initially manifest itself in any way - but meanwhile, if appropriate measures are not taken in time, glaucoma leads to irreversible loss of vision. The same applies to retinal pathology. Certain violations in its work can be detected only during a detailed study of the fundus of the eye - and without the intervention of a specialist, there is a risk of a 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 unusual fatigue, and without urgent treatment can lead to serious problems.

If we talk about children, then here one cannot do without the professional attention of an ophthalmologist - there are not rare 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 mandatory with a thorough examination of the state of the fundus at 6, 10 - 14 and 32 - 36 weeks of pregnancy.

Diagnostic examinations of the visual system are mandatory performed 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, only highly qualified specialists with extensive experience in carrying out all types of modern diagnostic procedures conduct appointments.
• The modern equipment available in the arsenal of doctors at the Excimer clinic makes it possible to analyze the state of the visual system with the highest accuracy, which, if any abnormalities in the work 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

Diagnosis of eye diseases is carried out by an ophthalmologist in a specially equipped ophthalmological room.

There are serious eye diseases that have a significant impact on vision. These are cataracts, glaucoma, retinal detachment, 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, among such studies:

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

Special tools 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 you to control and effectively manage the process of treating diseases.

Eye examination methods in ophthalmology

A comprehensive examination by an ophthalmologist includes the following procedures:

Visometry is the definition 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 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 the age of 40 that the risk of developing glaucoma increases significantly, and this study is aimed at identifying it.

Refractometry- This is the definition of the optical power of the eye (refraction). The procedure is currently carried out on automatic refractometers, which greatly facilitates the work of an ophthalmologist and saves the patient's time. Using this method, refractive errors are diagnosed: myopia, hyperopia and astigmatism.

Color vision test- this is a given method of eye examination, carried out using special tables (Rabkin's 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 on 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 atrophy of the optic nerve, etc.

Biomicroscopy- This is a method for examining the anterior segment of the eye using a slit lamp (special microscope). With the help of biomicroscopy, an ophthalmologist can see at high magnification such eye tissues as the conjunctiva, cornea, as well as deeper structures - this is 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 the diagnosis of eye diseases. The procedure is carried out contactlessly, using a special device - an ophthalmoscope or a lens.
Where to get an eye exam

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 with 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 the definition 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.

Determining the angle of strabismus- this is a fairly simple procedure, the Grishberg method can be cited as an example - the patient looks into the 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 medical procedure, more commonly in infants, but also in the elderly, who often have narrowing of the lacrimal openings. It is performed under local anesthesia with the help of special expanding probes.

Lacrimal duct lavage- this procedure is carried out for diagnostic purposes in case of suspected obstruction of the lacrimal ducts. It can also be used for medicinal purposes. Special cannulas are inserted into the lacrimal points on the eyelid, to which a syringe with a solution is attached. With the patency of the lacrimal ducts, the liquid from the syringe enters the nasal cavity, but if there is an obstruction of the lacrimal ducts, the liquid spills out or does not pass at all.

As a rule, these methods are quite enough to diagnose the most common eye diseases (for example, myopia, conjunctivitis, cataracts, etc.). However, if an ophthalmologist has doubts about the diagnosis, then 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 is the definition of a central field of view, often of color. The device for conducting this study is called a campimeter and is a special 2x2 meter screen on which markers are presented to the patient (alternately by 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 a foreign body.

Electrophysiological study (EPS)- this allows you to assess the state of the retina, optic nerve, 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- this is the registration of intraocular pressure (IOP) in dynamics. The procedure takes about 4-5 minutes, but during this time important information about the outflow can be obtained.

Keratotopogram- this is a study showing the surface of the cornea, its "topographic map". The study is carried out before laser operations on the cornea, with suspicion of keratoconus and keratoglobus.

pachymetry is the thickness of the cornea. This study is mandatory for laser operations.

Fluorescent angiography- this is one of the methods that shows the state of the vessels of the retina. The study is carried out by intravenous administration of a contrast agent and a series of images in the vessels of the retina.

Examination of eyelashes for Demodex- this procedure is a collection of eyelashes with subsequent examination under a microscope. Depending on the number of ticks found, the diagnosis of demodicosis is made.

OTS (optical coherence tomography) is optical coherence tomography. Used to assess the condition of the retina and optic nerve. It is 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 the examination for glaucoma.

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

Examination of the fundus with a Goldmann lens is a method used to assess 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.