What can you learn from a retinal scan? Transmission and amplification of the visual signal in the retina. Diagnosis and treatment

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Diagnostics of eye and common diseases during fundus examination.
An ophthalmological examination allows not only to state good or poor eyesight, but also learn a lot about the health of the body. When examining the fundus, you can obtain information both about the presence of diseases of the eyes themselves, and make a diagnosis for the presence of general diseases.

So after retinal examination, the doctor may look for signs, e.g. diabetes mellitus. Diabetes mellitus is one of the most common diseases, and diabetic retinopathy ranks first among the causes of low vision and blindness.

Posterior retinopathy, in the presence of this disease, is accompanied by pinpoint and spotty hemorrhages that resemble cotton wool. Changes in visual acuity due to changes in blood sugar levels during the day may also indicate the presence of this disease. An ophthalmological examination will detect diabetes in the early stages.

At heart attack the retina looks swollen and pale; the yellow spot appears raised and is red in color (cherry red spot).

One of early symptoms hypertension are uneven and narrowed blood vessels, so an eye examination by an ophthalmologist, in addition to identifying possible vision problems, is also a way to diagnose hypertension in the early stages.

If hypertension is suspected, the patient undergoes a complete neurological examination, as well as of cardio-vascular system to identify the source of thromboembolism. Blood pressure is measured, and palpation of the pulse determines whether the patient has atrial fibrillation, and upon auscultation of the heart and carotid arteries detect the presence of noise.

A patient with glaucoma disk optic nerve takes on a cup-shaped shape (glaucomatous depression in the optic nerve head).

Changes in the fundus can also occur in middle-aged and elderly people due to the gradually developing atherosclerosis, as a result of which blood circulation in the eye worsens.

During an ophthalmological examination, the doctor can notice in time high cholesterol in blood. Fats stick from the inside to the walls of the retinal vessels, changing their structure. Sclerosis and blockage blood vessels Fatty plaques lead to hypertension, heart disease and increase the risk of stroke. Early detection of high blood cholesterol can help prevent such consequences and prolong your life.

Double vision, narrowing of the visual field, uncoordinated or involuntary eye twitching may be the first symptoms of absent-mindedness. sclerosis. Of course, an ophthalmological examination will not replace a thorough examination by a doctor of the appropriate profile, but the eyes can tell a lot about the patient’s health status.

Headache, especially in the forehead and eyes, may be a symptom serious illnesses. The range of diseases whose symptoms are headache, wide enough – from inflammatory processes in the sinuses, undetected tumor or glaucoma, before functional impairment eye muscles leading, for example, to strabismus. That is why it is important to note the importance of timely diagnosis and treatment of the causes of headaches.

Retina - thin shell lining the fundus of the eye from the inside. It has a multilayer structure. On one side it is attached to choroid, on the other - to the vitreous body. The retina is involved in processing information received through the visual organs and conducts this information to the brain. Retinal diseases reduce a person’s quality of life because they lead to vision impairment, including advanced stages lead to its complete loss.

What is retinal detachment

Retinal detachment occurs when the membranes of the eye, the choroid and the retina, begin to separate from each other for various reasons. The process begins with partial delamination and can lead to complete separation of the shells from each other.

A retinal detachment does not cause immediate blindness. The delamination process can take place over several days or even weeks, so a person has the opportunity to stop it. When seeking medical help, there is a high probability of complete preservation of the visual functions of the eye.

A characteristic sign of detachment retina is the so-called Weiss ring. This is a condition when a person sees a circle in front of the affected eye, around which there is a blurred image. There is always a fog or veil before my eyes varying degrees density, some areas fall out of human vision and form blind spots. These signs are observed in the evenings and are absent in the first half of the day.

Causes of pathology

The causes of retinal detachment are usually divided into 2 groups:

Primary.
Secondary.

The primary group of detachments is characterized by a retinal rupture and fluid accumulating in the places where the rupture occurred.

The secondary group is associated with the occurrence of neoplasms, both benign and oncological.

Many factors influence retinal detachment, the causes of this disease may be the following:

diseases of the circulatory system;
stress, short-term or permanent;
viral diseases and infections;
myopia;
consequences of ophthalmological operations;
thinning and dystrophy of the retina;
pregnancy and childbirth;
excessive physical and emotional stress;
diabetes both types;
thinning of the mucous membranes, characteristic of older people;
head injuries and eyeballs received through trauma.

Symptoms of the disease

Retinal detachment and its signs can be tracked independently. Any deterioration in the visual process that does not go away within a day or more requires immediate consultation with a specialist. With retinal detachment, the symptoms of the disease will be as follows:

there is always a fog or veil of varying degrees of density before the eyes;
at the edges of the field of vision there are always shadows that sway if a person moves his head;
small black dots are constantly present in the field of view;
sensation of explosions of light in the eyeball, on the side closest to the temple;
curvature of familiar shapes and lines when looking at familiar objects;
the appearance of Weiss's ring.

The described signs are noticed by people in the evening. In the morning, patients practically do not track them, since the liquid that accumulated at night in the places where the dissection began has time to resolve naturally. Patients even have a slight improvement in vision in the first half of the day. Because of this, few people immediately seek advice from an ophthalmologist. Therefore, the area of dissection increases, and the disease quickly develops into a more severe and irreversible form.

Diagnosis and treatment

If a retinal detachment is suspected, a complete ophthalmologic examination should be performed immediately. This is the only way to preserve vision and avoid complete blindness.

When examining visual functions, visual acuity is checked, the patient’s field of vision and the presence of blind spots in them are determined. All data is obtained using perimetry: static, kinetic or computer. The disappearance of previously visible zones from the viewing circle is associated with the beginning of the process of shell delamination. Blind spots appear on the side of the eye opposite to where the detachment began.

Biomicroscopy is performed to examine the fundus of the eye and detect pathologies in the vitreous body. Intraocular pressure is measured in both eyeballs. In an eye where there is a separation of the membranes, the pressure is always lower than in a healthy eyeball.

Ophthalmoscopy is one of the most important studies to determine the condition of the visual organs. This study makes it possible to most fully identify the size and extent of damage resulting from delamination. This data helps determine the number of ruptures, their area and location, condition vitreous and the presence of pathologies in it. This examination allows you to identify areas with retinal dystrophy, which is necessary for surgical operations.

There are cases when it is necessary to refuse an ophthalmoscopic examination. This happens when the lens or vitreous body becomes cloudy. Then the patient needs to carry out ultrasonography eyeball.

Electrophysiological testing is used to evaluate the condition of the retina, its viability and the presence of problems in the optic nerve.

Retinal detachment is treated by surgical intervention.There are 2 types of such operations:

Extrascleral. The operation is performed on the surface of the sclera. Similar techniques include operations for filling and ballooning of the sclera.
Endovital. They are carried out inside the eyeball.

In cases where extrascleral filling is used, a specially designed silicone filling is used. It is attached to the sclera and provides the effect of the necessary pressure on its surface. The filling helps block tears in the retina and removes fluid that has accumulated there.

Ballooning of the scleral surface is performed by temporarily attaching a special balloon catheter to the area of the rupture, which can be inflated. Its effect is similar to that of a filling - the process of blocking the gaps occurs and the accumulation of fluid is removed.

Treatment using endovitreal methods is carried out using vitrectomy. During this operation, the damaged vitreous body is removed. Instead, special drugs are introduced that help bring together and press the stratified retina and choroid together.

There are also easier methods for treating retinal detachment. For retinal tears and detachments, laser coagulation and cryocoagulation can be used. These techniques allow the formation of special medical adhesions to prevent further ruptures.

Prognosis and prevention

The prognosis in cases where retinal detachment is detected is associated with the moment the pathology is detected. If the pathology is detected at the very beginning of the disease and surgery is performed on time, then the patient has every chance that vision will remain at the same level.

By paying close attention to your own health, retinal detachment can be avoided. People registered for diabetes mellitus, with traumatic injuries to the head and eyes, patients with myopia, suffering from retinal dystrophy, pregnant women, suffering from various eye diseases, constant preventive examination by an ophthalmologist is necessary. Heavy physical and emotional stress is contraindicated for such people.

Currently, medicine already knows a lot various pathologies retina of the eye. The most dangerous and common of all these ailments is retinal detachment. State of the art modern medicine, fortunately, allows you to successfully resist this disease.

Types of diseases

There are three groups into which all diseases can be divided: inflammatory, dystrophic and vascular, which usually arise as a result of hypertension and diabetes.

The most common dystrophic pathologies include:

Among vascular diseases retinal diseases can be called: retinal angiopathy, diabetic retinopathy, central vein thrombosis (CVT) and central retinal artery embolism (CRA). As a result of pathological processes in the vessels, a local circulatory disorder occurs, which becomes the cause of vein thrombosis and arterial obstruction.

There are also very rare pathologies, for example, retinitis pigmentosa, which occurs in only 1 person out of 5 thousand. To the very rare diseases include: hypoplasia and aplasia of the fovea, angiomatosis and tumors of the retina, as well as anomalies of its development.

Diseases of the posterior part of the eye, in addition to retinal pathology, also include diseases of the vitreous body (VF). The most common ones are:

Developmental anomalies of CT (hyperplasia, remnants of vessels)

Causes

Most common cause Retinal damage is an eye injury, but the pathological process can also develop due to the influence of various other factors:

diseases not directly related to the organs of vision (hypertension, atherosclerosis, diabetes mellitus, kidney and blood diseases, rheumatism, meningitis);
eye diseases (myopia, farsightedness, various inflammatory and degenerative processes);
infectious diseases (syphilis, tuberculosis, toxoplasmosis, all kinds viral diseases and purulent infections);
brain injuries;
allergy;
poisoning;
stress.

Symptoms

Main symptom pathological process in the retina, the appearance of a so-called “veil” is considered, which is localized at the site of the lesion and self-treatment does not lend itself. The "veil" tends to increase in size over time and spread over the entire visual field.

Besides, characteristic features retinal diseases may be the following symptoms: the appearance of sudden flashes in the form of lightning and sparks, distorted images, difficulties in reading, the appearance of black spots in the field of vision, the manifestation of micropsia and macropsia, local loss or narrowing of the visual field, decreased visual acuity, as well as poor vision in dark time days.

Since there is no sensitive innervation in the inner shell of the eye, any pathology of the retina develops painlessly.

Diagnostics

To diagnose diseases of the retina of the eye, they are used the following types research:

tonometry – measurement of IOP (intraocular pressure);
visometry - a study of the level of visual acuity, which allows you to determine the condition of the affected area and vital central areas;
electrophysiological examination of the eye (EPI) - assessment of the viability of retinal and optic nerve cells;
computer perimetry – examination of visual fields to determine the condition of the peripheral areas of the retina;
ophthalmoscopy is an examination of the fundus of the eye, which allows one to determine the lesions of the retina, the location and number of breaks. In addition, in the presence of detached areas of the retina, ophthalmoscopy makes it possible to assess their condition, the strength of their connection with the vitreous body, and also identify areas that require increased attention during treatment procedures;
optical coherence tomography(OCT, OCT);
Amsler test to test the central visual area;
computed tomography of the eye;
ultrasound examination (ultrasound);
magnetic resonance imaging (MRI).

Treatment

Therapeutic measures for diseases of the retina are determined primarily by the cause of the pathological process and its stage. For example, in case of detachments and ruptures, immediate surgical intervention is necessary. For other conditions, as a rule, conservative therapy is used with specifics characteristic of the type of disease.

Thus, for the treatment of dystrophy (including pigmentary dystrophy), special medications are used that help normalize the blood supply and nutrition of the retina and the optic nerve. The therapeutic course is divided into two stages and lasts one year. In the case of Best's disease, drugs to effectively strengthen the walls of blood vessels, antioxidants, and prostaglandin inhibitors are necessarily prescribed.

Modern medicine also has effective methods stimulation of the retina of the eye, which uses a unique infrared laser.

It is necessary to understand that the development of severe complications can only be avoided by promptly provided qualified health care. Therefore, it is very important to consult a doctor at the first symptoms of the disease.

Prevention

Prevention measures for various retinal diseases differ slightly, but agree on the main thing - the most important principles for preventing the disease are: management healthy image life, mandatory disposal bad habits and proper balanced nutrition.

Thank you

The site provides background information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

The retina is a specific structural and functional unit of the eyeball, necessary for capturing the image of the surrounding space and transmitting it to the brain. From an anatomical point of view, the retina is a thin layer of nerve cells thanks to which a person sees, since it is on them that the image is projected and transmitted along the optic nerve to the brain, where the “picture” is processed. The retina of the eye is formed by light-sensitive cells, which are called photoreceptors, since they are able to capture all the details of the surrounding “picture” that appears in the field of vision.

Depending on which area of the retina is affected, they are divided into three large groups:
1. Generalized retinal dystrophies;
2. Central retinal dystrophies;
3. Peripheral retinal dystrophies.

With central dystrophy, only the central part of the entire retina of the eye is affected. Since this central part of the retina is called macula, then the term is often used to denote dystrophy of the corresponding localization macular. Therefore, a synonym for the term “central retinal dystrophy” is the concept of “macular retinal dystrophy”.

In peripheral dystrophy, the edges of the retina are affected, while the central areas remain undamaged. With generalized retinal dystrophy, all parts of the retina are affected - both central and peripheral. A special case is age-related (senile) retinal dystrophy, which develops against the background of senile changes in the structure of microvessels. According to the location of the lesion, senile retinal dystrophy is central (macular).

Depending on the characteristics of tissue damage and the characteristics of the course of the disease, central, peripheral and generalized retinal dystrophies are divided into numerous varieties, which will be discussed separately.

Central retinal dystrophy - classification and brief description of varieties

Depending on the characteristics of the pathological process and the nature of the resulting damage, the following types of central retinal dystrophy are distinguished:

Stargardt's macular dystrophy;
Yellow-spotted fundus (Franceschetti's disease);
Best's vitelline (vitelliform) macular degeneration;
Congenital cone retinal dystrophy;
Colloid retinal dystrophy Doina;
Age-related retinal degeneration (dry or wet macular degeneration);
Central serous choriopathy.

Among the listed types of central retinal dystrophy, the most common are age-related macular degeneration and central serous choriopathy, which are acquired diseases. All other types of central retinal dystrophies are hereditary. Let's consider brief characteristics the most common forms of central retinal dystrophy.

Central chorioretinal retinal dystrophy

Central chorioretinal dystrophy of the retina (central serous choriopathy) develops in men over 20 years of age. The reason for the formation of dystrophy is the accumulation of effusion from the vessels of the eye directly under the retina. This effusion interferes with normal nutrition and metabolism in the retina, resulting in its gradual degeneration. In addition, the effusion gradually detaches the retina of the eye, which is a very serious complication of the disease that can lead to complete loss of vision.

Due to the presence of subretinal effusion characteristic symptom This dystrophy is a decrease in visual acuity and the appearance of wave-like curvatures of the image, as if a person is looking through a layer of water.

Macular (age-related) retinal degeneration

Macular (age-related) retinal degeneration can occur in two main clinical forms:
1. Dry (non-exudative) form;
2. Wet (exudative) form.

Both forms of macular degeneration of the retina develop in people over 50–60 years of age against the background of senile changes in the structure of the walls of microvessels. Against the background of age-related dystrophy, damage occurs to the vessels of the central part of the retina, the so-called macula, which provides high resolution, that is, allows a person to see and distinguish the smallest details of objects and the environment at close range. However, even with severe age-related dystrophy, complete blindness occurs extremely rarely, since the peripheral parts of the retina remain intact and allow a person to partially see. Preserved peripheral parts of the retina allow a person to navigate normally in his usual environment. In the most severe course of age-related retinal dystrophy, a person loses the ability to read and write.

Dry (non-exudative) age-related macular degeneration The retina is characterized by the accumulation of waste products of cells between the blood vessels and the retina itself. These waste products are not removed in a timely manner due to disruption of the structure and function of the microvessels of the eye. Waste products are chemical substances, which are deposited in the tissues under the retina and look like small tubercles yellow color. These yellow tubercles are called Druze.

Dry retinal dystrophy accounts for up to 90% of cases of all macular degeneration and is a relatively benign form, since its course is slow, and therefore the decrease in visual acuity is also gradual. Non-exudative macular degeneration usually occurs in three successive stages:
1. Early stage Dry age-related macular degeneration of the retina is characterized by the presence of small drusen. At this stage, the person still sees well and is not bothered by any visual impairment;
2. The intermediate stage is characterized by the presence of either one large drusen or several small ones localized in the central part of the retina. These drusen reduce a person's field of vision, as a result of which he sometimes sees a spot in front of his eyes. The only symptom at this stage of age-related macular degeneration is the need for bright light for reading or writing;
3. The pronounced stage is characterized by the appearance of a spot in the field of vision, which is dark in color and large in size. This spot does not allow a person to see most of the surrounding picture.

Wet macular degeneration of the retina occurs in 10% of cases and has an unfavorable prognosis, since against its background, firstly, there is a very high risk of developing retinal detachment, and secondly, vision loss occurs very quickly. With this form of dystrophy, new blood vessels, which are normally absent, begin to actively grow under the retina of the eye. These vessels have a structure that is not typical for the eye, and therefore their membrane is easily damaged, and fluid and blood begin to leak through it, accumulating under the retina. This effusion is called exudate. As a result, exudate accumulates under the retina, which puts pressure on it and gradually peels off. That is why wet macular degeneration is dangerous due to retinal detachment.

With wet macular degeneration of the retina, a sharp and unexpected decrease in visual acuity occurs. If treatment is not started immediately, complete blindness may occur due to retinal detachment.

Peripheral retinal dystrophy - classification and general characteristics of types

The peripheral part of the retina is usually not visible to the doctor during a standard fundus examination due to its location. To understand why the doctor does not see the peripheral parts of the retina, you need to imagine a ball through the center of which the equator is drawn. One half of the ball up to the equator is covered with a mesh. Further, if you look at this ball directly in the region of the pole, then parts of the grid located close to the equator will be poorly visible. The same thing happens in the eyeball, which also has the shape of a ball. That is, the doctor can clearly distinguish the central parts of the eyeball, but the peripheral parts, close to the conventional equator, are practically invisible to him. This is why peripheral retinal dystrophies are often diagnosed late.

Peripheral retinal dystrophies are often caused by changes in the length of the eye against the background of progressive myopia and deterioration of blood circulation in this area. As peripheral dystrophies progress, the retina becomes thinner, resulting in the formation of so-called tractions (areas of excessive tension). These tractions, if they exist for a long time, create the preconditions for a tear in the retina, through which the liquid part of the vitreous seeps under it, lifts it and gradually peels off.

Depending on the degree of danger of retinal detachment, as well as on the type of morphological changes, peripheral dystrophies are divided into the following types:

Lattice retinal dystrophy;
Retinal degeneration of the “snail traces” type;
Frost-like degeneration of the retina;
Cobblestone retinal degeneration;
Small cystic degeneration of Blessin-Ivanov;
Retinal pigmentary dystrophy;
Pediatric Leber's taperetinal amaurosis;
X-chromosomal juvenile retinoschisis.

Let's consider General characteristics each type of peripheral retinal dystrophy.

Lattice retinal dystrophy

Lattice retinal dystrophy occurs in 63% of cases of all types of peripheral dystrophy. This type of peripheral dystrophy provokes the highest risk of developing retinal detachment, and is therefore considered dangerous and has a poor prognosis.

Most often (in 2/3 of cases) lattice retinal dystrophy is detected in men over 20 years of age, which indicates its hereditary nature. Lattice dystrophy affects one or both eyes with approximately equal frequency and then progresses slowly and gradually throughout a person's life.

With lattice dystrophy, white, narrow, wavy stripes are visible on the fundus, forming lattices or rope ladders. These stripes are formed by collapsed and hyaline-filled blood vessels. Between the collapsed vessels, areas of thinning of the retina are formed, which have the characteristic appearance of pinkish or red lesions. In these areas of the thinned retina, cysts or tears can form, leading to detachment. The vitreous body in the area adjacent to the area of the retina with dystrophic changes is liquefied. And at the edges of the area of dystrophy, the vitreous body, on the contrary, is very tightly fused to the retina. Because of this, areas of excessive tension on the retina (traction) arise, where small tears are formed that look like valves. It is through these valves that the liquid part of the vitreous penetrates under the retina and provokes its detachment.

Peripheral retinal dystrophy of the “snail traces” type

Peripheral retinal dystrophy of the “snail trace” type develops in people suffering from progressive myopia. Dystrophy is characterized by the appearance of shiny streak-like inclusions and holey defects on the surface of the retina. Typically, all defects are located on the same line and, when examined, resemble a snail's footprint left on the asphalt. It is precisely because of the external resemblance to the track of a snail that this type of peripheral retinal dystrophy received its poetic and figurative name. With this type of dystrophy, breaks often form, leading to retinal detachment.

Frost-like retinal dystrophy

Frost-like retinal dystrophy is a hereditary disease that occurs in men and women. Usually both eyes are affected at the same time. Yellowish or whitish inclusions resembling snow flakes appear in the retinal area of the eye. These inclusions are usually located in close proximity to thickened retinal vessels.

Retinal dystrophy "cobblestone"

Cobblestone retinal dystrophy usually affects the distant parts located directly in the equator of the eyeball. This type of dystrophy is characterized by the appearance on the retina of individual, white, elongated lesions with an uneven surface. Typically these lesions are located in a circle. Most often, cobblestone dystrophy develops in older people or in those suffering from myopia.

Small cystic retinal dystrophy Blessin–Ivanov

Blessin-Ivanov small cystic retinal dystrophy is characterized by the formation of small cysts located on the periphery of the fundus. In the area of the cysts, holes may subsequently form, as well as areas of retinal detachment. This type of dystrophy has a slow course and a favorable prognosis.

Retinal pigmentary dystrophy

Retinal pigmentary dystrophy affects both eyes at once and manifests itself in childhood. Small foci of bony bodies appear on the retina, and the waxy pallor of the optic disc gradually increases. The disease progresses slowly, as a result of which a person’s field of vision gradually narrows, becoming tubular. In addition, vision deteriorates in the dark or twilight.

Pediatric Leber's taperetinal amaurosis

Pediatric Leber taperetinal amaurosis develops in a newborn child or at the age of 2–3 years. The child's vision deteriorates sharply, which is considered the beginning of the disease, after which it slowly progresses.

X-chromosomal juvenile retinoschisis

X-chromosomal juvenile retinoschisis is characterized by the development of retinal separation simultaneously in both eyes. Huge cysts form in the area of the dissections, gradually filling with glial protein. Due to the deposition of glial protein, star-shaped folds or radial lines appear on the retina, resembling the spokes of a bicycle wheel.

Congenital retinal dystrophy

All congenital dystrophies are hereditary, that is, they are transmitted from parents to children. The following types of congenital dystrophies are currently known:
1. Generalized:

Pigmentary dystrophy;
Leber's amaurosis;
Nyctalopia (lack of night vision);
Cone dysfunction syndrome, in which color perception is impaired or complete color blindness is present (a person sees everything as gray or black and white).

2. Central:

Stargardt's disease;
Best's disease;
Age-related macular degeneration.

3. Peripheral:

X-chromosomal juvenile retinoschisis;
Wagner's disease;
Goldman-Favre disease.

The most common peripheral, central and generalized congenital retinal dystrophies are described in the relevant sections. The remaining variants of congenital dystrophies are extremely rare and are not of interest or practical significance for a wide range of readers and non-ophthalmologists, so we present them detailed description seems inappropriate.

Retinal dystrophy during pregnancy

During pregnancy, a woman’s body undergoes a significant change in blood circulation and an increase in metabolic rate in all organs and tissues, including the eyes. But in the second trimester of pregnancy there is a decrease in blood pressure, which reduces blood flow to the small vessels of the eyes. This, in turn, can provoke a deficiency nutrients, necessary for the normal functioning of the retina and other structures of the eye. And inadequate blood supply and deficiency of nutrient delivery is the cause of the development of retinal dystrophy. Thus, pregnant women have an increased risk of retinal dystrophy.

If a woman had any eye diseases before pregnancy, for example, myopia, hemeralopia and others, this significantly increases the risk of developing retinal dystrophy during pregnancy. Because the various diseases eyes are widespread in the population, the development of retinal dystrophy in pregnant women is not uncommon. It is precisely because of the risk of dystrophy with subsequent retinal detachment that gynecologists refer pregnant women for consultation with an ophthalmologist. And for the same reason, women suffering from myopia need permission from an ophthalmologist to give birth naturally. If the ophthalmologist considers the risk of fulminant dystrophy and retinal detachment during childbirth to be too high, he will recommend a cesarean section.

Retinal dystrophy - causes

Retinal dystrophy develops in 30–40% of cases in people suffering from myopia (myopia), in 6–8% against the background of hypermetropia (farsightedness), and in 2–3% with normal vision. The entire set of causative factors of retinal dystrophy can be divided into two large groups - local and general.

Local causative factors of retinal dystrophy include the following:

Hereditary predisposition;
Myopia of any severity;
Inflammatory eye diseases;
Previous eye surgeries.

Common causative factors for retinal dystrophy include the following:

Hypertonic disease;
Diabetes;
Past viral infections;
Intoxication of any nature (poisoning with poisons, alcohol, tobacco, bacterial toxins, etc.);
Increased blood cholesterol levels;
Deficiency of vitamins and minerals entering the body with food;
Chronic diseases (heart, thyroid, etc.);
Age-related changes in the structure of blood vessels;
Frequent exposure to direct sun rays on the eyes;
White skin and blue eyes.

In principle, retinal dystrophy can be caused by any factors that disrupt normal metabolism and blood flow in the eyeball. In young people, the cause of dystrophy is most often severe myopia, and in older people it is age-related changes in the structure of blood vessels and existing chronic diseases.

Retinal dystrophy - symptoms and signs

At the initial stages, retinal dystrophy, as a rule, does not manifest itself with any clinical symptoms. Various signs of retinal dystrophies usually develop in the moderate or severe stages of the disease. With different types of retinal dystrophies, a person experiences approximately the same symptoms, such as:

Decreased visual acuity in one or both eyes (the need for bright light for reading or writing is also a sign of decreased visual acuity);
Narrowing of the field of view;
The appearance of scotoma (spot or sensation of a curtain, fog or obstruction in front of the eyes);
A distorted, wave-like image before the eyes, as if a person is looking through a layer of water;
Poor vision in darkness or twilight (nyctalopia);
Impaired color discrimination (colors are perceived as different, not corresponding to reality, for example, blue is seen as green, etc.);
Periodic appearance of “floaters” or flashes before the eyes;
Metamorphopsia (incorrect perception of everything related to the shape, color and location in space of a real object);
Inability to correctly distinguish a moving object from a stationary one.

If a person experiences any of the above symptoms, they should immediately consult a doctor for examination and treatment. You should not delay a visit to an ophthalmologist, since without treatment, dystrophy can quickly progress and provoke retinal detachment with complete loss of vision.

In addition to the above clinical symptoms Retinal dystrophy is characterized by the following signs, identified during objective examinations and various tests:
1. Distortion of lines on Amsler test. This test involves a person looking with each eye in turn at a point located in the center of a grid drawn on a piece of paper. First, the paper is placed at arm's length from the eye, and then slowly brought closer. If the lines are distorted, this is a sign of macular degeneration of the retina (see Figure 1);

Figure 1 – Amsler test. At the top right is a picture seen by a person with normal vision. At the top and bottom left is the image that a person sees with retinal dystrophy.
2. Characteristic changes in the fundus (for example, drusen, cysts, etc.).
3. Reduced electroretinography readings.

Retinal dystrophy - photo

This photograph shows retinal dystrophy of the “snail track” type.

This photograph shows retinal dystrophy of the “cobblestone” type.

This photo shows dry age-related macular degeneration retina.

Retinal dystrophy - treatment

General principles of treatment of various types of retinal dystrophy

Since dystrophic changes in the retina cannot be eliminated, any treatment is aimed at stopping further progression of the disease and, in fact, is symptomatic. For the treatment of retinal dystrophies, medications, lasers and surgical methods treatments to stop the progression of the disease and reduce the severity of clinical symptoms, thereby partially improving vision.

Drug therapy for retinal dystrophy consists of the following groups: medicines:
1. Antiplatelet agents– drugs that reduce thrombus formation in blood vessels (for example, Ticlopidine, Clopidogrel, acetylsalicylic acid). These drugs are taken orally in tablet form or administered intravenously;
2. Vasodilators And angioprotectors – drugs that dilate and strengthen blood vessels (for example, No-shpa, Papaverine, Ascorutin, Complamin, etc.). The drugs are taken orally or administered intravenously;
3. Lipid-lowering drugs – drugs that lower blood cholesterol levels, for example, Methionine, Simvastatin, Atorvastatin, etc. The drugs are used only in people suffering from atherosclerosis;
4. Vitamin complexes , which contain elements important for the normal functioning of the eyes, for example, Okyuvit-lutein, Blueberry-forte, etc.;
5. B vitamins ;
6. Drugs that improve microcirculation , for example, Pentoxifylline. Typically, drugs are injected directly into the structures of the eye;
7. Polypeptides, obtained from the retina of cattle (the drug Retinolamine). The drug is injected into the structures of the eye;
8. Eye drops containing vitamins and biological substances that promote repair and improve metabolism, for example, Taufon, Emoxipin, Ophthalm-Katachrome, etc.;
9. Lucentis– a remedy that prevents the growth of pathological blood vessels. Used for the treatment of age-related macular degeneration of the retina.

The medications listed above are taken in courses, several times (at least twice) throughout the year.

In addition, for wet macular degeneration, Dexamethasone is injected into the eye, and Furosemide is administered intravenously. When hemorrhages develop in the eye, heparin, Etamsylate, aminocaproic acid or Prourokinase are administered intravenously in order to quickly resolve and stop it. To relieve swelling in any form of retinal dystrophy, Triamcinolone is injected directly into the eye.

The following physiotherapy methods are also used in courses for the treatment of retinal dystrophies:

Electrophoresis with heparin, No-shpa and nicotinic acid;
Photostimulation of the retina;
Stimulation of the retina with low-energy laser radiation;
Electrical stimulation of the retina;
Intravenous laser blood irradiation (ILBI).

If there are indications, then perform surgical operations for the treatment of retinal dystrophy:

Laser coagulation of the retina;
Vitrectomy;
Vaso-reconstructive operations (crossing the superficial temporal artery);
Revascularization operations.

Approaches to the treatment of macular degeneration of the retina

First of all, a comprehensive drug treatment, which consists of a course of taking vasodilators (for example, No-shpa, Papaverine, etc.), angioprotectors (Ascorutin, Actovegin, Vazonit, etc.), antiplatelet agents (Aspirin, Thrombostop, etc.) and vitamins A, E and group B. Typically, courses of treatment with these groups of drugs are carried out several times during the year (at least twice). Regular courses of drug treatment can significantly reduce or completely stop the progression of macular degeneration, thereby preserving a person’s vision.

If macular degeneration is in a more severe stage, then along with drug treatment, physiotherapy methods are used, such as:

Magnetic stimulation of the retina;
Retinal photostimulation;
Laser stimulation of the retina;
Electrical stimulation of the retina;
Intravenous laser blood irradiation (ILBI);
Surgeries to restore normal blood flow in the retina.

The listed physiotherapeutic procedures, along with drug treatment, are carried out in courses several times a year. The specific method of physiotherapy is selected by an ophthalmologist depending on the specific situation, type and course of the disease.

If a person has wet dystrophy, then first of all laser coagulation of sprouting, abnormal vessels is performed. During this procedure, a laser beam is directed to the affected areas of the retina, and under the influence of its powerful energy, blood vessels are sealed. As a result, fluid and blood stop sweating under the retina and peeling it off, which stops the progression of the disease. Laser coagulation of blood vessels is a short-term and completely painless procedure that can be performed in a clinic.

After laser coagulation, it is necessary to take drugs from the group of angiogenesis inhibitors, for example, Lucentis, which will inhibit the active growth of new, abnormal vessels, thereby stopping the progression of wet retinal macular degeneration. Lucentis should be taken continuously, and other medications should be taken in courses several times a year, as with dry macular degeneration.

Principles of treatment of peripheral retinal dystrophy

The principles of treatment of peripheral retinal dystrophy consist in carrying out the necessary surgical interventions (primarily laser coagulation of blood vessels and delimiting the zone of dystrophy), as well as subsequent regular courses of medication and physiotherapy. If you have peripheral retinal dystrophy, you must completely stop smoking and wear sunglasses.

Retinal dystrophy - laser treatment

Laser therapy is widely used in the treatment various types dystrophies, since a directed laser beam with enormous energy makes it possible to effectively influence the affected areas without affecting the normal parts of the retina. Laser treatment is not a homogeneous concept that includes only one operation or intervention. On the contrary, laser treatment of dystrophy is a combination of various therapeutic techniques that are carried out using a laser.

Examples of therapeutic treatment of dystrophy with a laser are retinal stimulation, during which the affected areas are irradiated in order to activate metabolic processes in them. Laser stimulation of the retina in most cases gives an excellent effect and allows you to stop the progression of the disease for a long time. An example of surgical laser treatment dystrophy is coagulation of blood vessels or delimitation of the affected area of the retina. In this case, the laser beam is directed to the affected areas of the retina and, under the influence of the released thermal energy, literally glues and seals the tissue and, thereby, delimits the treated area. As a result, the area of the retina affected by dystrophy is isolated from other parts, which also makes it possible to stop the progression of the disease.

Retinal dystrophy - surgical treatment (operation)

Operations are performed only in severe cases of dystrophy, when laser therapy and drug treatment are ineffective. All operations performed for retinal dystrophies are conventionally divided into two categories - revascularization and vasoreconstruction. Revascularization operations are a type of surgery during which the doctor destroys abnormal vessels and opens normal ones as much as possible. Vasoreconstruction is an operation during which the normal microvascular bed of the eye is restored using grafts. All operations are performed in a hospital setting by experienced doctors.

Vitamins for retinal dystrophy

In case of retinal dystrophy, it is necessary to take vitamins A, E and group B, since they ensure the normal functioning of the organ of vision. These vitamins improve the nutrition of eye tissue and, with long-term use, help stop the progression of dystrophic changes in the retina.

Vitamins for retinal dystrophy must be taken in two forms - in special tablets or multivitamin complexes, as well as in the form of food products rich in them. Richest in vitamins A, E and group B fresh vegetables and fruits, grains, nuts, etc. Therefore, these products must be consumed by people suffering from retinal dystrophy, since they are sources of vitamins that improve the nutrition and functioning of the eyes.

Prevention of retinal dystrophy

Prevention of retinal dystrophy consists of following simple rules:

Do not overstrain your eyes, always give them rest;
Do not work without eye protection from various harmful radiation;
Do eye exercises;
Eat well, including fresh vegetables and fruits, as they contain a large number of vitamins and microelements necessary for the normal functioning of the eye;
Take vitamins A, E and group B;
Take zinc supplements.

The best prevention of retinal dystrophy is proper nutrition, since it is fresh vegetables and fruits that provide the human body with essential vitamins and minerals that ensure normal functioning and health of the eyes. Therefore, include fresh vegetables and fruits in your diet every day, and it will reliable prevention retinal dystrophy.

Retinal dystrophy - folk remedies

Traditional treatment of retinal dystrophy can only be used in combination with traditional medicine methods, since this disease is very serious. TO traditional methods Treatments for retinal dystrophy include the preparation and use of various vitamin mixtures, which provide the visual organ with the vitamins and microelements it needs, thereby improving its nutrition and inhibiting the progression of the disease.
Before use, you should consult a specialist.

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How you want to be a sorceress - look into the eyes and... make a diagnosis! But there are certain signs that appear in the eyes, under the eyes, which will indicate a developing disease. Yes, and by the lines on the iris one can suspect one or another diagnosis.

Of course, this is not a 100% diagnosis, but it is better to be warned and take preventive measures in time to improve your health, than to remember the roasted rooster again and again.

How many times have we heard in our lives: "Take care of your health from a young age..."

Did you take care of it?

That's it! And when it’s not so easy to get up in the morning, there are unclear migrating pains in the body, general malaise... In general, to put it in simple language: “the paws, ears and tail hurt,” but it’s not clear why!

In this case, you can conduct a small diagnosis of the eyes at home. Of course, this will not be the ultimate truth, but in which medical direction of the disease to look for, you will decide.

How to identify a disease by the eyes and make a diagnosis

Exist 19 main signs of incipient diseases that can be easily “read” in the eyes.

1. Swelling of the eyes (bags under the eyes) in the morning indicates kidney and heart diseases.

2. Swelling and redness of the eyelids allows you to think about the manifestation of an allergy (of course, if you do not take into account the banal infectious conjunctivitis, which you can determine by the absence of itching and purulent discharge from the eyes)

3. Involuntary twitching of the eyelids signals neuroticism and the associated lack of magnesium in the body.

4. Bags under the eyes indicate chronic fatigue and stress.

5. The appearance of red veins on the sclera (threads of blood vessels) indicates hypertension.

6. Dark circles under the eyes - overwork, chronic fatigue, stress. If the color turns brown or purple, it is worth checking your kidneys, blood sugar levels, thyroid gland and cardiovascular system.

7. Blueness of proteins - lack of hemoglobin, developing anemia.

8. Yellowness of proteins - first of all, you should think about hepatitis A. Then about other diseases of the liver and biliary tract.

9. Increased tearfulness may indicate a cold (if there is additional symptoms acute respiratory infection), may indicate an allergy, especially seasonal to pollen. Watery eyes for no reason (for example, strong wind outside) along with a red appearance of the vessels of the cornea will force an ophthalmologist to check whether you have developed glaucoma.

10. Protrusion of the eyeballs suggests the development of hyperthyroidism ( increased level hormones thyroid gland), but it is also worth checking with an ophthalmologist regarding the development of glaucoma.

11. Deterioration of vision at dusk ( night blindness) indicates a lack of vitamin A.

12. Darkening of the edges of the eyes - allows one to suspect a metabolic disorder.

13. Flashes or fiery circles before the eyes occur when there is a violation cerebral circulation, frequent migraines.

14. Swollen upper eyelids can report the emerging process of stone formation in the gallbladder.

15. Small dark spots under the eyes will allow you to suspect the same process, but only in the kidneys.

16. The frequent appearance of barley in front of your eyes will indicate not only a banal infection with dirty hands (most often), but there is also the possibility that there are problems with the liver and gall bladder.

17. A light, almost white color of the inner surface of the eyelid will indicate a lack of blood circulation (most likely there will be low level hemoglobin in the blood), gastrointestinal disorders or genitourinary problems.

18. A red-orange tint on the same inner surface of the eyelids will indicate that there may be problems with the pancreas, spleen, and liver. (Normally, it should be a light pink shade).

19. If a whitish mucous coating regularly appears in the eyes, making it difficult to see, it is worth checking for developing cataracts.

Iridology - diagnosis by the iris of the eyes

Iridodiagnostics can also tell about diseases and all kinds of disorders in the functioning of the body.

Iridodiagnosis - diagnosis of dashes, lines, specks that appear with age on the iris of the eyes. This science appeared in the 19th century, and now, thanks to the precision of instruments, it is becoming more and more perfect.

Yes, you can see for yourself a very impressive table of correspondence of target organs to the places where dots and dashes appear on the iris of the eyes: