Complex hypermetropic astigmatism of a weak degree. Complex hypermetropic astigmatism in children: possible causes and treatment methods. Which doctor treats astigmatism?

As we know from the school optics course, a light beam entering the eye from the outside is refracted through the transparent cornea and pupil, and then focused on retina(at the bottom eyeball). But sometimes there are problems with this process.

With any such deviation, various disorders vision. In these cases, the light beam also, in general, passes through the retina, but its focusing point is not located on its surface, but either further or closer. Therefore, the image on the retina turns out to be too blurry, and when a person wants to look at an object in more detail, he has to either bring it closer to his eyes, or, conversely, remove it, depending on the type of defect.

What are the types of vision deviations?

The location of the focal point behind the retina is called farsightedness or hyperopia. Such patients have acute distant vision, but their near vision leaves much to be desired. That is why they need to move the objects they are studying further away from themselves in order to “transfer” the point of focus to the retina, as if from behind it.

Similarly, the focal point located in front of the retina leads to the development of myopia (myopia), since a patient with such vision needs to bring objects to the very eyes. But it also happens that a defect in the cornea or pupil leads not just to a shift in the point of optimal focus, but to “defocusing”, when instead of one point of optimal concentration of rays, several suboptimal ones appear. This blurry vision is called astigmatism.

What is complex hypermetropic astigmatism

Naturally, astigmatism can also be nearsighted or farsighted, regardless of whether it is observed in both eyes or only in one - right or left. If at least one of several (usually 2-3) focal points formed during it is located clearly on the retina, creating, albeit partially, normal vision, this form of astigmatism is called simple. If they are all located in front of the retina, doctors talk about complex myopic astigmatism, and if behind it, then about complex hypermetropic astigmatism.

Various forms of astigmatism directly depend on the characteristics of the curvature of the iris.

Therefore, if we are faced with a diagnosis of “complex hypermetropic astigmatism,” we can already understand that we have a farsighted patient with vision in which none of the several focal points falls directly on the retina. If a clarification is added to this diagnosis that it is of the direct type (there are also oblique and reverse types), this concerns the location of the main (most distinct) and additional focal points in relation to the eye sclera and each other.

In 99 cases out of 100, complex hypermetropic astigmatism is congenital. Therefore, it is much easier to encounter this diagnosis in a two- or even six-year-old child than in an adult. The parents of many boys wonder whether they are accepted into the army with such a diagnosis. The correct answer is yes, they do, but only with deviations within 0.5-6 diopters. However, talk about this in childhood It is still early as the extent of the defect may change over the years.

Symptoms of hypermetropic astigmatism

Signs of visual impairment in children are no different from those in adults. The only difference is that if an adult is able to clearly explain to the doctor what is bothering him, then children, especially small ones, are not, because they do not know what vision is and what it should ideally be like. That is why parents usually begin to suspect a visual defect in their child based on the following signs:

• child's complaints of headache (especially in the area of ​​the brow ridges) and eye fatigue after reading or looking at pictures for more than 20 minutes. in a row;
• the child’s reluctance to master reading and, in general, information presented in pictures;
• everything that we initially mistake for inattention and awkwardness is the inability to notice small toys, obstacles on the way, etc.;
• the child's manner of squinting, tilting or turning his head in an unnatural position when reading/looking at small objects;
• difficulties in drawing a straight line on paper without a ruler, since for those suffering from astigmatism they turn out crooked at any age.

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What is hypermetropic astigmatism? - This is astigmatism, which is combined with farsightedness.

Normally, a beam of light passes through the optical medium (cornea and lens) and is focused on the retina at one point. However, under the influence of various factors, the surface of the cornea or lens is distorted and then the image is projected onto the retina at two points at once. This phenomenon is called astigmatism.

Reasons for appearance

There are two main reasons that cause the disease:

• Changes in the shape of the cornea;
• Lens deformation.

Unfortunately, to date it has not been reliably established why the lens and cornea change their shape. Researchers have several assumptions about this:

• It is believed that lens deformation is congenital anomaly development and is very rarely formed during life.
• Changes in the shape of the cornea can occur due to scar changes (for example, after surgery or injury).

Simple and complex hypermetropic astigmatism

IN clinical practice There are two types of the disease:

• Simple, in which astigmatism is observed in one eye;
• Complex, which is characterized by the presence of hyperopic astigmatism in both eyes. However, the severity of astigmatism in each eye may be different.

Symptoms

Clinical manifestations of hypermetropic astigmatism depend on the degree of its severity.

The mild form is often not accompanied noticeable symptoms . Human can long time ignore the fact that his vision is deteriorating. Usually, mild degree astigmatism is detected during annual preventive examinations.

In moderate cases, complaints such as blurred vision accompanied by double vision, dizziness or headache. At the same time, it is difficult for a person to concentrate on doing work that requires visual strain. It is at this stage that people most often turn to an ophthalmologist for help.

Severe degree of hypermetropic astigmatism is characterized by vivid clinical symptoms. First of all, people complain of double vision and severe blurred vision. During work, there is pain or pain in the eyes, headache, sometimes nausea, irritability. During the examination, a significant decrease in visual acuity is detected.

Treatment

There are two fundamental methods of vision correction:

1. Conservative;
2. Operational.

Neither glasses nor contacts can cure astigmatism.

Astigmatism can only be cured with the help of surgical intervention . Modern ophthalmology offers several types of operations to eliminate astigmatism.

Laser thermokeratoplasty

The essence of the method is that certain areas of tissue are exposed to a laser beam, causing thermal burns. Under the influence high temperature contraction of collagen fibers occurs, which leads to a change in the curvature of the cornea. In the central part it is rounded, and on the periphery, on the contrary, it becomes flattened.

Thermokeratocoagulation

The essence of the operation is the same as in the previous method, however thermal burn It is not done with a laser, but with a special needle.

This technique is considered the most highly effective and safe today.. Used to treat moderate to severe forms of the disease.

Keratomileusis includes several stages:

1. A small piece of tissue is cut out in the area of ​​the upper layer of the cornea and turned to the side.
2. They work with a laser in the freed space and “evaporate” the required area, so that the surface of the cornea becomes smooth again.
3. The top layer flap is returned to its place.

This method has several advantages:

1. This operation can be performed on both eyes at once.
2. Vision after keratomileusis is restored quickly. Already a few hours after the intervention, the patient feels improvement.
3. After the intervention, there is no clouding of the cornea.

For certain indications, interventions such as removal of the lens and replacing it with an implant, keratoplasty, and installation of an intraocular lens can be performed.

Hypermetropic astigmatism in children

Few people know that complex hypermetropic astigmatism in both eyes in children under one year of age is a physiological (normal) phenomenon.

As for older children, the disease manifests itself in them in the same way as in adults. At the same time, the child’s complaints may be vague (indefinite) in nature: fatigue, burning in the eyes, pain in the frontal part of the head, reluctance to read, draw or write.

Astigmatism test for children

To do this, take White list paper and draw 5-10 intersecting lines on it. Now close each of the child’s eyes in turn and ask him to answer: what color are the lines in the picture?

What does he see? healthy child and a child with astigmatism:

If all the lines seem equally dark to the baby, then most likely there are no problems with vision. But if even one line appears gray or blurry, you need to see an eye doctor for further examination.

Correction of disease in children

Mild forms of hypermetropic astigmatism do not require special correction

Mild forms of the disease do not require special correction. Usually doctors select special exercises for the eyes and register the child at the dispensary.

More pronounced forms require mandatory correction, which is achieved by wearing glasses or contact lenses. The correct selection of glasses can only be carried out by an experienced ophthalmologist.. For correction, lenses with varying degrees of refraction are used, which are made individually to order.

As for contact lenses, they are best used by children starting from middle school age. This is due to the fact that small child It will be difficult to use the lenses and properly care for them.

Laser correction can only be performed after reaching 20 years of age when the eyeball is fully formed and stops growing.

To prevent the occurrence of childhood astigmatism, it is necessary to accustom the child from a very early age to the correct distribution of eye strain.

Prevention

The only direction for preventing hypermetropic astigmatism is maintaining visual hygiene and timely contacting an ophthalmologist. The earlier astigmatism is detected, the greater the chance of stopping its progression.

Complex hyperemetropic astigmatism: causes and clinical picture diseases

In medical science, astigmatism is usually understood as visual defects associated with disturbances in the shape of the lens, cornea, and the eyes themselves, resulting in significant visual impairment, in particular, loss of image clarity. With the hyperemetropic form of complex astigmatism, the formation of farsightedness is characteristic.

Hypermetric astigmatism is usually divided into:

• A simple form of hypermetric astigmatism;
• Complex form of hypermetric astigmatism.

Information about the disease

The complex form of hypermetric astigmatism is characterized by damage to both eyes to varying degrees of severity. First of all, deformation of the cornea of ​​the eyes is observed. It becomes non-spherical. In the bulk of clinical cases, the disease is hereditary. In rare cases, the causes of the disease are various injuries organs of vision.

The video contains information about the disease:

The disease manifests itself as a sharp drop in vision, as well as a number of other symptoms, accompanied by amblyopia.

Causes

Based on the nature of the causes, complex hypermetric astigmatism is usually divided into congenital and acquired types of the disease.

The congenital type of hypermetric astigmatism is determined at birth and can also be observed during the first years of life. In the future, vision is corrected and may appear again in old age or may no longer bother you at all. Usually, complex shapes Astigmatism identified during diagnosis in childhood is associated with irregular shapes of the eyeballs or their growth. As the child grows, the cornea returns to normal and vision also normalizes.

It may also be useful for you to learn more about what it looks like and how it is treated.

The video shows the causes:

Acquired forms of astigmatism are the result of injuries to the cornea or eyeballs, which can be caused by mechanical damage, as well as consequences surgical operations. But before that it is worth identifying

Deformations can also be caused inflammatory processes infectious and non-infectious. with acquired types of the disease, the cornea or lens is deformed, in particular, refractive changes may be observed. The most severe form of hypermetric compound astigmatism of the congenital type is when both eyes are damaged. In this case, one eye is characterized by a vertical refractive change, and the other – horizontal.

But what are the symptoms of astigmatism in children, and how to identify it?

Symptoms

It depends on the complexity of the disease. In mild cases, no symptoms of the disease are observed. With moderate severity, the patient may experience slight blurred vision and frequent headaches. Usually when severe fatigue Symptoms intensify in the evening.

Clear symptoms can be observed already when diagnosing a severe degree. At this stage, the patient experiences a sharp decline visual acuity, also accompanied by strabismus.

This is what myopia looks like high degree with astigmatism, and how it is detected, is outlined

In addition, the patient experiences painful sensations in the eye, there is severe tearing, the eyes quickly get tired, which is why the image appears in two.

The video shows the symptoms of the disease:

The patient’s character changes dramatically, mood changes occur constantly, but most often he is in an irritated state, this is noted by everyone who communicates with him.

With complex hyperopic astigmatism in both eyes, the disease is often complicated by albinism.

Diagnostics

Without an eye examination, an accurate diagnosis cannot be made. First of all, viziometry is performed - this is a procedure for determining the degree of visual acuity. The procedure is performed as follows: special lenses are put on the patient in one eye, through which the patient looks at the table. The selection of lenses determines visual acuity. The second eye is closed during the procedure.

In addition to the above-mentioned procedure, others are used: skiascopy, biomicroscopy, ophthalmoscopy, ultrasound and refractometry.

In difficult cases, the doctor may prescribe computer keratotopography, during which the visual organ is examined for dilation, to identify possible deformations and pathologies of the fundus and vitreous eyes. But what does low myopia with astigmatism look like and how is it diagnosed?

Treatment

For radiation to be successful, doctors use a whole range of different measures. First of all, the patient is prescribed devices to improve vision, in other words, glasses. They can be replaced with lenses.

In this case, the shape of the glasses lenses should be spherocylindrical. Glasses are selected for each patient individually. That is, glasses that suit one person will not suit another with the same diagnosis. Moreover, and so poor eyesight, may get completely worse. The selection is carried out taking into account many factors - the shape of the patient’s face, the distance between the eyes, the degree of visual impairment. The selection may also be affected by existing pathologies and concomitant diseases.

But don’t think that with the selection of glasses your vision will instantly be restored. Glasses are only a corrective device designed to stop the loss of vision. But they will not get rid of astigmatism. For this purpose, along with the selection of glasses, other methods are used.

Correcting the shape of the cornea will help you completely get rid of farsightedness. Microsurgery can help correct it. For this purpose, a laser is now used to cause pinpoint burns in the peripheral vision zone. This causes contraction of collagen fibers, due to which the shape of the cornea changes - it becomes convex-flat in the center, as nature intended.

Make sure there is adequate lighting when reading. Don't let your eyes get tired.

Here's what glasses look like for astigmatism, and how they should be used.

But now the following method is increasingly used - a small flap is cut from the cornea using a laser. This allows the physician to reach the middle layers of the cornea. Then a laser is used to correct the shape of the organ, after which the cut flap is returned to its place. In most cases, it can be argued that the vision pathology disappears forever.

Note that every inhabitant of the planet has physiological astigmatism. It is caused by the asymmetry of the eyeball, which is inherent in all people. Ophthalmologists consider it a normal phenomenon that does not interfere with good vision. However, with severe astigmatism (above 0.5 diopters), a person’s vision deteriorates, and surrounding objects seem blurry to him. In this case we are talking about pathology.

Causes

Hypermetropic astigmatism in both eyes is often detected in childhood. Most babies have it from birth. A vision defect develops due to improper development of the eyeball. As a result, the child develops astigmatism: the cornea or lens, the intraocular structures responsible for refraction of light, bends. Their deformation leads to the fact that the image of surrounding objects does not reach the retina.

Causes of congenital hypermetropic astigmatism:

• burdened heredity;
• the effect of harmful factors in the prenatal period;
• premature birth;
• complicated pregnancy.

In adults, the disease develops after injuries that cause curvature of the cornea or deformation of the lens. Quite often, astigmatism occurs after or other operations on the anterior segment of the eyeball. This is caused by the fact that during the intervention the surgeon makes incisions in the cornea. Subsequently, their edges may not grow together correctly, which will lead to astigmatism.

In a healthy eye, light rays are refracted evenly and fall directly on the retina. Thanks to this, a person sees a clear image of objects. When the cornea or lens is deformed, light rays are refracted unevenly, causing them to focus behind the retina.

Symptoms

Astigmatism causes blurred vision and blurred images. At the same time, a person sees poorly near and far, and surrounding objects seem blurry to him. In addition, the patient experiences significant difficulties when reading and working at close distances. Specially selected glasses help him see better.

The following symptoms may appear with astigmatism:

• distorted perception of surrounding objects;
• double vision and fog before the eyes;
• rapid visual fatigue;
• redness and irritation of the eyes;
• frequent headaches;
• discomfort in the eyebrows and bridge of the nose.

It is much more difficult to detect astigmatism in a child than in an adult. Children usually do not notice strange symptoms, perceiving the world as they see it. Parents may suspect that their baby has astigmatism. A child with a visual impairment moves books away from his eyes and for a long time cannot find a comfortable position for reading. He has difficulty distinguishing small objects and details.

Classification

There are two types of astigmatism: simple and complex. With the first, light rays are refracted incorrectly only in one of the two main meridians. Simple hyperopic astigmatism is easily corrected with conventional cylindrical lenses. A person with this disease can easily choose glasses.

Complex hypermetropic astigmatism is characterized by improper refraction of rays in both main meridians. A patient with such a vision defect needs toric lenses, one part of which corrects farsightedness, the other corrects astigmatism. Optical correction means are selected individually, after a thorough examination.

Note that congenital hypermetropic astigmatism of both eyes is often complex, while acquired one is simple.

Degrees of the disease

Hypermetropic astigmatism is divided into 3 degrees, each of which has its own symptoms.

Depending on the location of the main meridians, simple and reverse hypermetropic astigmatism is also distinguished. This distribution plays a significant role in the selection of points and.

Which doctor treats astigmatism?

The disease is treated by an ophthalmologist. He spends full examination patient, identifies concomitant diseases and complications, and then selects the optimal treatment regimen. The selection of glasses and contact lenses can be performed by an optometrist - a specialist who works in optics.

Diagnostic methods

To diagnose the disease, refractometry and skiascopy are used. These methods make it possible to identify the degree of astigmatism and determine the location of the main meridians. To assess the condition of the cornea, the patient may undergo ophthalmometry. During preparation for laser vision correction, pachymetry is performed.

Treatment

To date, there are no drugs that can completely cure astigmatism. To combat the disease, correction devices (glasses, lenses) and surgical interventions are used. All available methods help improve human vision. Note that timely treatment allows you to avoid unwanted complications.

Conservative

Its essence lies in the selection of glasses or contact lenses. Corrective means allow the patient to see and live well full life. If amblyopia or strabismus develops, the child is prescribed treatment aimed at preserving and restoring binocular vision.

Operational

Keratotomy, which was previously used to correct astigmatism, is no longer used today. The method is considered outdated and imperfect. In the case of lenticular astigmatism, the patient may have the lens removed and an intraocular lens placed in its place. As a rule, such an operation is performed with concomitant cataracts.

Laser

Using a modern laser, a small layer of the cornea is removed from the patient, giving it the desired thickness and shape. As a result, a person gets the opportunity to see well without glasses and lenses. Laser correction is performed for astigmatism of less than 3 diopters. The procedure can only be performed by persons over 18 years of age. High degree hypermetropia with astigmatism is a contraindication to laser treatment.

Prevention measures

There is no specific prevention of astigmatism today, but there are methods that help prevent the development of its complications. In order to detect the disease in time, you need to undergo routine examinations with an ophthalmologist at least once a year. If your vision deteriorates for no reason, you should immediately go to the doctor.

Hypermetropic astigmatism develops due to changes in the shape of the cornea and lens. The disease manifests itself as blurred vision, blurred vision, and double vision. If a farsighted person sees poorly only at close range, then a patient with astigmatism has difficulty distinguishing objects at any distance. The disease causes a lot of discomfort and often leads to complications. A person with astigmatism can improve their vision with glasses, contact lenses, or laser correction.

Useful video about the treatment of astigmatism

Conservative treatment is usually carried out for a simple form and involves spectacle correction using glasses with cylinders or contact correction with toric ones (with a shifted center of gravity). The disadvantage of spectacle correction in this pathological condition is the need for frequent replacement due to gradually increasing astigmatism. The selection of glasses should only be done by an ophthalmologist to avoid further deterioration of vision. The ophthalmologist should tell parents of children with astigmatism what it is and how complications can be avoided.

There are several types of operations for the disease:

1. Thermokeratocoagulation. Today, the operation is outdated and is being replaced by safer ones. Pinpoint coagulates (burns) are applied to the cornea with a special instrument. In this case, the periphery of the cornea becomes flattened, and the central part becomes more convex.
2. Thermokeratoplasty. The essence of the operation is the same as the previous one, but the burns are caused not with a hot microscopic needle, but with a laser.
3. Hypermetropic laser mileage. The most modern and safe operation. The laser evaporates an area in the inner layer of the cornea of ​​the required thickness in the right place. The intervention technique is the same as Lasik surgeries for myopia and Since evaporation occurs at the periphery of the cornea, the central part becomes more convex and increases the refraction of rays, collecting them at one point on the retina.

Complications of the disease

If children have early age astigmatism develops in the right or left eye, it can lead to the appearance