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Eye bottom is one of the vulnerable parts of the eye, since most of the pathologies affects this place. Some are characterized by a clearly prominent clinical picture, others are known for the long incubation period.

The survey of the Eye DNA for the presence today is a paramount task, since most diseases are able to lead to full blindness.

Eye bottom: how to check

In this article, we will tell about the eye bottom: as they check, for what and why it is done, and who can, and who is better not to do this.

About the Eye Dn.

In fact it is rear wall of the eye. It can be considered in detail when inspection. Doctors are interested in three things:

• vascular sheath;
• retina;
• nipple (initial section) of the optic nerve.

Two pigments are responsible for the color of this part of the eye - choroidal and retinal. Their amount is not constant. It depends, for example, from a person's race. Representatives of the Negroid race, the bottom, as a rule, is painted in a more dark color, in the Europeanoid - in the brightest. In addition, the intensity of the color varies depending on the density of the pigment data layer. If it decreases, the vessels of choriodic are clearly visible in the eye.

Driving nerve disk (in the future, the abbreviation of the DZN will be used for convenience) - a circle or oval of pinkish color. Its diameter is up to one and a half years in cross section. In the heart itself there is a small funnel, which can be seen with a practically naked eye. This funnel is a place where the central vein and the retinal artery are included.

Closer to the back of the ZN can be seen, although not so much, deepening in the form of "bowls". This is an excavation, the place through which the nerve retinal nerve fibers pass. If you compare the color of the medial part and the excavation, the latter will be paler.

Eye Night

The fact that the retina can be different color is normal. The color itself and its change depends on the following factors:

• quantity and density (if we talk about the location) of vessels;
• the blood volume circulating into them.

During the survey, for example, the retina acquires a reddish tint.

There are cases when the retina acquires a color resembling a dark red or dark brown. This is due to the pigment epithelium, which is located between the upper layer and the layer in which there are many capillaries.

If the number of pigment decreases, then we are talking about "parquet effect". It is clearly seen in the pattern of the retina. There are broad bands and dark areas go there.

The optic nerve, being in good condition, resembles a round pink spot. This stain has a pale temporal part. All this - on a red background. It is worth noting that the color of the disk is able to change. The number of capillaries plays a decisive role. However, that remains unchanged - this is a change in the color of the disk with an increase in the age of a person. The older is the paler.

The following factors also affect the shade shift.

1. An increase in pigment density.
2. The development of hypertension and other diseases.

In the case when a semicircle was found during the inspection in the Dzn area, the doctor can state the separation from the edge of the nerve of the vascular shell.

Why and when is checked?

The human body is literally laminated by a network of blood vessels. In the eye day, they are extremely sensitive to most of the common pathologies. The change in their state signals the presence of diseases that are not related to eyes. However, they are able to provide all the necessary information and bring to the root cause. Here is one of the reasons why the Eye Dno especially needs a detailed examination - ophthalmoscopy.

This procedure is not constantly, but periodically. It is worth passing even in the absence of any complaints about vision. Ophthalmoscopy will be extremely necessary for pregnant women, as they enter the risk group. In addition, the oculist is worth visiting and those who suffer from diabetes and other pathologies of the eye, the presence of which can be confirmed by the retinal inspection.

Inflammation - another reason for the lesion of the retina of the eye. The pathology of a non-inflammatory nature is usually observed in diabetes patients. Because of the partial loss of the ability of the vessels to the expansion, they begin to manifest themselves with signs of aneurysm in the eye day, which leads to a weakening of visual acuity.

Checking the Eye DNA is worth it to prevent. Despite the lack of unpleasant symptoms, this pathology can severely worsen the vision of the patient.

Usually, the retinal detachment is manifested by turbidity in front of the eyes and the presence of a peel, a suspension circle of review. This pathology can be found at ophthalmoscopy in both children and adults, since its main sign is the uneven arrangement of the retina.

Ophthalmoscopy reveals various diseases of the organ of vision, in particular, congenital defects. In the presence of a disease transferred to the child from parents or older generation, the child has gradual retinal destruction due to the accumulation of pigment in it. Before it completely go blind, he is manifested by a symptom of "chicken blindness". This symptom is a significant reason to visit the oculist, and this must be done necessarily.

Ophthalmoscopy - fast and effective method Detection of many pathologies, such as:

• malignant neoplasms;
• defeat vessels or optic nerve;
• retinal detachment that can be detected even in the first stages;

Pamp Makula - a separate case. It appears due to secondary retinopathy in the primary disease - diabetes mellitus. Also, the emergence of this pathology may contribute to the injury of the eye or various kinds of inflammation of the vascular shell.

Interesting! Makula - the retina plot of the eye responsible for central eyesight. Externally resembles a yellow stain.

It is necessary to carry out this procedure for adults once a year, and children in the first, fourth and sixth year of life, and then every two years.

It is dangerous to carry out the following persons:

• women (during the entire period of pregnancy);
• newborn (as a rule, we are talking about premature);
• people suffering from diabetes or inflammation of the kidneys, as well as hypertensive.

Extraordinary passage of ophthalmoscopy is carried out under the following pathologies:

• weakening of vision and change of color perception;
• card and brain injury;
• reducing visual acuity in the dark;
• violation of the vestibular apparatus;
• frequent and strong headaches, as well as in
• blindness.

When detaching the retina, due to which emergency ophthalmoscopy is prescribed, there are no contraindications. If the patient is inflamed of the front of the eye, which constantly flows the tears and increases the sensitivity to the light, then there are obstacles to the survey of the eye bottom and, in this case, the best solution will postpone the procedure to the recovery itself.

Ophthalmoscopy is one of the standard procedures of the modern ophthalmologist, which, despite its simplicity, nevertheless is quite informative. It happens that the data obtained as a result of ophthalmoscopy is required for studying and other doctors. Consider examples.

Table No. 1. Doctors and causes of their interest in the results of ophthalmoscopy.

Doctors	The reasons
Therapists and cardiologists	It is interesting for them to learn about the state of the vascular in the eye of the eye during hypertension or atherosclerosis. Based on the results of ophthalmoscopy, they write a conclusion about the degree of expression of pathology.
Neurologists	Ophthalmoscopy provides them with valuable information on the state of the DZN, the central artery and Vienna. They are subjected to destructive changes in the development of cervical osteochondrosis, increasing the PCF (intracranial pressure), strokes and other diseases arising on the nervous soil.
Obsushet-gynecology	With this procedure, it is easier for them to predict the flow rate. They can determine the ability to detach the retina during consultation in case the woman will give birth natural way. Therefore, before giving birth, future mothers should consult with an ophthalmologist.
Endocrinology	They use data from ophthalmoscopy to determine the state of the vascular bottom bottom with diabetes mellitus. On their basis, they find out the stage and severity of inflammation. For this reason, diabetics are obliged to observe an ophthalmologist, since diabetic retinopathy and cataracts are frequent complications of diabetes.

Research methods

Do not forget that before each conduct of this kind of procedure, the patient needs to be consulted with an ophthalmologist, since the information received on the Internet is only a familiarization. If we talk about techniques of ophthalmoscopy, then there are only two of them:

• straight;
• reverse.

Direct ophthalmoscopy Allows an ophthalmologist to obtain an image on which it is possible to consider the area affected by the disease. This is achieved due to the scaling through an electric ophthalmoscope. Reverse ophthalmoscopy (so it is called due to an inverted image obtained due to the special structure of ophthalmoscope optics) helps determine the overall condition of the eye bottom.

At the same time there is another, less popular. The ophthalmologist can inspect the patient with the help of a Goldman lens. It is capable of increasing the image of the eye bottom.

Different colors rays, ranging from red and finishing yellow-green, helps an ophthalmologist to detect invisible details of the eye dna. If the exact image of the retinal vessels is required to estimate their condition in the future, the doctor may assign fluorescent angiography.

Fundamentals of the procedure

The mechanism of its holding is pretty simple. The procedure is equally used for adults and for children.

First, ophthalmologist uses a special diagnostic device called ophthalmoscope. It is a circular concave mirror. It has a small hole in the center. Through it and gets a narrow beam of light into the eye bottom. Thanks to this doctor, as it were, "through the pupil" can be seen.

Secondly, the doctor, if necessary, burst into the eyes of the patient medicines designed to expand pupilThat will facilitate the procedure for inspection of the eye bottom. The fact is that the wider the pupil - the more visible in the eye day.

Interestingly, most private clinics are already practicing the use of electronic ophthalmoscope, which is built in a halogen lamp.

Video - Malysheva about the eye day

Check in adults

As a rule, adults have two possible procedures - direct or reverse ophthalmoscopy. Both of them possess their characteristic features, and the effectiveness of the survey rises at times if they are used together. Direct ophthalmoscopy will consider in detail the main areas of the eye bottom, and the opposite helps fluently inspect everything.

For high-quality and accurate results, doctors apply the following techniques:

• biomicroscopy where light from the slotted source is used;
• multicolored rays according to water technology;
• laser ophthalmoscopy, which is an enhanced and reliable procedure.

The need for the last of the listed techniques occurs in people suffering from clouding the vitreous body and lens. Laser ophthalmoscopy flaws should be noted - the price and black and white image in which little will be seen.

Check in children

If adults have this procedure enough, it is worse with children. Ophthalmoscopy is conjugate with certain difficulties. For example, reflexes for light. Adults control them can, while children are not. They close their eyes. So they protect them from light beams.

Because of this, a 1% homatropine solution is buried before the procedure. At this point, the head is fixed. If the child closes and after that eyes, the doctor applies the eyelid. Alternative option - Focusing look at the subject.

The appearance of the eye bottom in the infants will vary greatly with the usual picture for doctors. Unlike adults, in children of small age, the color is mostly light yellow. Dzn is clearly visible, and there is no macular reflex. Externally, it is pale pink, but there are sulfur-colored. They persist until the child achievement of the two-year-old age.

Children who have undermined asphyxia have small-type hemorrhages. The form they are incorrect. Somewhere on the sixth day of life, they disappear, but under the condition that they were located along the Aregol. Another kind (we are talking about preset) is observed much longer. They relate to recurrent features, that is, they can appear again.

When the DzN color loss is detected, the doctor diagnoses atrophy of the optic nerve. It causes the narrowing of blood vessels (in particular - arteries) and the appearance of clearly defined borders.

After conducting ophthalmoscopy, the baby may suffer for some time in the peace. It's quite normal. We just need to wait until the body displays the entire drug used by the doctor.

Contraindications

Ophthalmoscopy is usually not carried out for people who cause high light sensitivity and constant tears. They better wait for them, as they may make it difficult to conduct the procedure and eventually level its benefit. People with narrow pupils that cannot be expanded even with medicines will also not be able to receive any favor from this survey.

The clouded crystal, as well as the vitreous body, will prevent the doctor to correctly assess the situation with the eye bottom of the patient.

People with heart pathologies do not allow the procedure of ophthalmoscopy. As a rule, this reports to the patient or therapist, or a cardiologist.

Precautions

As mentioned earlier, ophthalmoscopy - Simple, Safe and Effective Diagnostic Method. However, it is worth remembering the following points if you want to keep eye health for a long time:

• if the doctor used a drop before the examination, then the patient temporarily violates eyes and it is better for three to four hours not to get behind the wheel;

• it is not worth focusing the look during the actions of the drop - there is no sense from it, but the eyes get sick;
• because of the light from an ophthalmoscope, a patient appears stains before their eyes. It is better for him to simply wait - they will be held half an hour and hour;
• going outside after ophthalmoscopy, the patient is worth wearing sunglasses at first. High photosensitivity, which appeared as a result of the examination procedure, is able to cause pain and unpleasant discomfort in the eyes. However, there is no reason for concern - the phenomenon is temporary and it will pass.

RESULTS

The danger of the defeat of the eyebound is in the irreversible subsequently at the started lesion stage - the full blindness, from which you can not heal. Various degenerative-destructive changes undergoing this area of \u200b\u200bthe eye are formed earlier than other signs of organism diseases. It is for this reason that the patient will be better to find the time for ophthalmoscopy so as not to regret further about the missed opportunity to cure.

This procedure will allow to detect dangerous pathologies at the beginning of development, as well as prevent their further development.

How is the eye examination? What does it show? Does special preparation for the procedure need? Let's try to answer all questions in detail.

What it is?

Ophthalmoscopy call an eye examination with a special device, an ophthalmoscope.

The study gives visualize the condition of the disk of the optic nerve, a macular and peripheral zone and retinal vessels.

The procedure is carried out by S. narrow The pupil with the help of an indirect ophthalmoscope, as well as a goldman lens and a hazelnus lens, so does not need special training. Direct ophthalmoscopy is most often carried out with wide Pupil, so you need to instill special drops causing mydriasis.

Indications for use

Most often, the procedure is assigned to the oculist in such cases:

• Diagnosis of retinal pathology: the presence of a break, detachment, dystrophic changes or hemorrhages;
• Patient diabetes;
• Hypertonic disease;
• The fetal tool period: to conclude about the method of delivery;
• Obtaining a cranial injury;
• Brain tumors;
• Multiple sclerosis;
• Suspicion of oncological neoplasms in the field of the eyeball.

Views

There are several ways to conduct ophthalmoscopy that differ in the instrument used.

Direct ophthalmoscopy

Allows you to inspect the retinal state of the studied. It is performed using a non-flexural ophthalmoscope or special nozzles for a slit lamp.

The doctor examines the eye bottom with a wide pupil. The image is obtained by an increased up to 20 times and in unreserved form. It gives to detect even the smallest violations in the retina.

Ophthalmoscopy under midryaz requires the preliminary use of drugs that expand the pupil: Tropics. Then the oculist is approaching the instrument to the eye of the patient, directing the beam of light into the organ of vision, until the retina is obtained.

Video:

Despite the obvious advantages, the direct ophthalmoscopy of the Eye DNA has the disadvantages :

• using the procedure, it is difficult to consider the peripheral retinal departments, which is why you can skip the dystrophy sites and ruptures;
• lack of volumetric picture: In the case of retinal edema, it is difficult to identify it and evaluate its degree of propagation.

Ophthalmoscopy with Fundus lenses and Goldman lenses

This study is carried out in contact method. A lens is applied to the corneal shell, and the doctor using a slit lamp can learn the eye bottom.

Any lens that contacts the cornea requires an immersion medium to improve its fixation. The procedure can be carried out even with a narrow pupil of the patient. However, during damage to the cornea, it is recommended to refrain from contact research.

Indirect ophthalmoscopy

Most often used when examining children. The method is carried out by a special concave mirror with a magnifying glass.

The light source is in such a way that it is from the left side and rear from the patient's head. So on the study, the shadow is created, facilitating the inspection of a specialist. Located in front of a person, the oculist brings the device to its eye.

The doctor sends a beam of light, and an ophthalmic lens with a strength of +13.0 or +20.0 D is located between its 1 and 2 fingers of the left hand and is placed in front of the organ under study. The doctor asks for a person not to close a different eye so that he looked past the right eye of the eyepiece. The rays are reflected from the retina and refracted on the lens, giving a specialist a slightly enlarged inverted picture.

The binocular ophthalmoscope for reverse ophthalmoscopy is used to appear the surround image. The doctor puts the device on his head.

Dignity method:

• obtaining a clear picture of any retinal departments;
• allows inspection even with the loss of transparency in the structures of the organ of vision;
• there is no direct contact with the eye of the patient;
• it can be used in low light illumination.

TO disadvantages reverse ophthalmoscopy includes insufficiently enlarged eye for research, as well as obtaining an inverted picture, which may worsen the interpretation of the results especially in the case of a novice specialist.

Price

Depending on the region of residence, as well as from the institution where the procedure is carried out, the cost of the service may differ. In addition, the survey with a wide pupil will also cost more, as the drugs causing the MIDRAZ are used.

• Indirect ophthalmoscopy: the price is approximately 1000 rubles.
• Inspection with a wide pupil (Goldman lens, a direct ophthalmoscope, a hazelnus lens) costs about 1200 rubles.

In case of a sudden impairment of vision or the presence of chronic diseases, ophthalmoscopy is an indispensable procedure for inspecting the eye bottom. It allows you to see pathological processes in the retina: hemorrhages, breaks, dystrophic changes.

The examination of the ophthalmologist should also have children, and adults. Moreover, it is important to turn to the oculists not only when you noticed that the acuity of your vision is reduced, or if you need a medical certificate for obtaining a driver's license.

A timely inspection of intraocular pressure and the eye study will help in the early stages to identify the presence of serious diseases and in time to prescribe their treatment.

In Greek eyes - Ophthalmos, and in Latin - Oculus, so the doctor, an eye specialist, is called an ophthalmologist, and an oculist.

A person can live all his life and never ask for help from the doctors of some narrow specialties, but it is necessary to see an ophthalmologist at the middle age.

What will definitely check the oculist during the medical examination?

Check of visual acuity

Usually the very first study when visit to the eyepiece - check of visual acuity. Reception begins with it. It is not so simple, as it seems at first glance, if there is an abnormal refraction.

Normal urgency is the ability of the eye to distinguish separately two glowing points at an angle of view of 1 °.

Today, as a rule, visual sharpness is checked by determining the smallest objects (most often black on white), which can be perceived by the eye, but in ancient Rome it was checked on the stars. If a person distinguished two little stars in the constellation of a big bear, he could become a legionnaire.

Tables Golovin-Sivzva.

In our country, the visual sharpness is most often determined using the Golovin-Sivzian tables.

In the preparation of tables used a certain dependence between the value of the visible object and the distance on which the patient is located. The study is carried out from a distance of 5 meters.

In these tables, according to which the vision of the eyepieces is checked, each row differs from the following 0.1 visual acuity.

Normal visual acuity (doctors are often called one hundred percent vision) designated as 1.0. In this case, the patient reads the 10th row of the table. Some people with particularly greedy eyes can read the 11th row and even the last, 12th.

How to check the vision of the eyepieces if a person can not even read the first line of the table?

After determining the visual acuity without glasses, an ophthalmologist in the event of a decrease in visual acuity (less than 1.0) begins checking with glasses. At the same time, lenses are used with a positive or negative value, and, if necessary, the so-called cylindrical glasses for the detection of astigmatism.

In some diseases, the patient cannot read from 5 meters and the first string. Then he is offered to count the fingers of the doctor's hands shown on a dark background with a closer distance.

If a person cannot determine the number of fingers, an ophthalmologist with the help of the beam of light checks the correctness of determining the direction where the source is shining from (from above, bottom, right, left).

Cancer-Sivzian tables for visiting vision at the oculist are shown on these photos:

Currently, checking visual sharpness and choose glasses has become much easier, because ophthalmologists often use special equipment - autoresometers.

This device quickly measures the patient with refraction, and the doctor receives the data on which the vision is focused.

Measuring intraocular pressure

The organ of view has a certain tone - this is an intraocular pressure (WGD). Normal intraocular pressure is very important in order forces to retain the right form.

In addition, its role is significant in metabolism, the eye and the state of optical functions.

Currently, intraocular pressure is measured different waysTherefore, there are various values \u200b\u200bof the norm. The doctor will help you in these figures.

The norm of true VGD is from 10 to 21 mm Hg. Art. (Usually, the testimony is removed by a tonphone, pneumotonometer and other special tonometers).

When measuring intraocular pressure, the maclakova tonometer (the still common method in the polyclinic) is 15-26 mm Hg. Art.

Measuring VGD Tonometer Maclakova is carried out in the position lying after the patient's anesthetic drops. The site of the tonometer is lubricated with special paint. Then the device is lowered on the cornea.

At the same time, a light circle appears on its platform, the diameter of which is inversely proportional to the height of intraocular pressure. Tonometer plot prints put on paper and measure the testimony with a special tonometric ruler.

It should be noted that intraocular pressure can change during the day. Normally, these oscillations are 2-3 mm Hg. Art., less often 4-6 mm Hg. Art. Usually in the morning in the morning, than in the evening.

Currently, the method of tongue is widely used to determine the WGD. This study helps to determine not only the pressure in the eye, but also producing, as well as the outflow of the eye fluid. At the same time, a special sensor is put on the eyes for 4 minutes, which registers several indicators at once.

Game on wind instruments increases intraocular pressure

The change in intraocular pressure can be observed when exposed to a body of a number of factors. WGD increases at an eye pressure, slopes, game on wind instruments, increasing body temperature, some hormonal shifts, in particular hyperthyroidism, as well as at the beginning of menopause.

Reception of certain groups of drugs (in particular, hormonal) can also lead to an increase in WGD.

Study of peripheral vision

The study of peripheral view ophthalmologists are carried out by determining its fields - spaces visible with one eye when it is fixed, fixed, position. Most often find out the perimeter of the field of view, with the help of which its boundaries and defects in it are determined.

The obtained data is entered into the scheme. In any case, the field of view must be examined by at least eight meridians.

Changes in the field of view may manifest itself or in the form of a narrowing of its boundaries, or in the form of decays in it. The narrowing of the boundaries of the field of view can be concentric and reach such degrees that only a small central site (tunnel field of view) will remain from the entire field.

The narrowing of the field of view is possible in diseases of the visual nerve, some pathological states of the retina, quinine poisoning, etc. Of the functional reasons, hysteria, neurasthenia, traumatic neurosis are possible.

Changing the field of view may be in the form of cattle, that is, a limited defect - a small area, in which the vision is significantly reduced, but still continues to be saved.

A more accurate study is a computer perimetry.

The survey is carried out using special devices to identify small defects in sight and detect the first signs of certain eye diseases (glaucoma, maculodystrophy, etc.).

In a normal field of view, there is always a physiological scotoma, or a blind spot, which is located from the temporal side along the horizontal meridian between 10 ° and 20 ° from the fixation point.

This is a projection of the disk of the optic nerve. Scotoma here is due to the lack of a light-crossing layer of the retina.

The increase in the blind spot zone can be caused by the lesions of the optic nerve, the retina and the vascular shell, glaucoma, myopia. By location, the cattle and peripherals are distinguished.

Research of the Eye DNA.

When examining the deeper parts of the eye (the vitreous body, the retina) in ophthalmology, we use expanding pupil drops.

Previously, it was only an atropine - alkaloid contained in different plants of the family of the Parenic: Handicraft (ATROPA EELLADONNA L.), Belen (Hyoscyamus Niger L), etc. Atropine is a beauty based drug.

Its disadvantage is a long expansion of the pupil (up to several days), which is uncomfortable to patients, since due to the paralysis of accommodation, problems are inevitable when working at close range, in particular reading.

In addition, the medication expansion of the pupil causes discomfort during bright lighting, because the protective reaction of the eye to the bright light is the narrowing of the pupil - does not work. Before you to order Atropine, the doctor will warn you about these phenomena.

However, currently, droplets, the action of which lasts about an hour, and all problems with accommodation and the response to the light pass in 50 minutes, are currently used to explore the ocular bottom.

Inspection of the eyebound is carried out with the help of a special apparatus ophthalmoscope. In this study, the doctor can identify the diseases of the retina and the optic nerve.

Preparation for a visit to the ophthalmologist

The above is the main surveys that the ophthalmologist holds during the first inspection. Along with this, there are many special studies that the doctor prescribes if necessary, revealing certain changes in the eye.

In ophthalmology for surveys and treatment, laser devices, computer and magnetic tomographs, not to mention optical and ultrasound technologies, are widely used.

If you are going to apply to the doctor ophthalmologist, you need a certain preparation:

• If you wear contact lenses, they are 4-5 days before the reception (sometimes more) should be removed and replaced with glasses.
• On the day of the visit, it is advisable to do not use personal vehicles - not to drive the car yourself, since after reception some visual inconvenience may arise.
• If the day is clear, take sunglasses with you, because after the expansion of the pupil is in the bright sun you will be uncomfortable.

The eye bed is called the inner surface of the eye lined. His study, which is called ophthalmoscopy, allows you to identify many ophthalmological pathologies and in some cases it is carried out in diseases of other organism systems (for example, nervous, cardiovascular, endocrine), since their first symptoms can manifest itself on this section of the visual system.

In this article, we will introduce you to varieties, indications, contraindications, patient preparation rules and methods for conducting an eye study. This information will help to make an idea of \u200b\u200bophthalmoscopy, and you can ask the doctor who arise.

At ophthalmoscopy, the doctor may inspect the retina itself and its individual structures: the visual nerve, the vessels, the zone of the yellow stain and the peripheral areas. In addition, during the study, the specialist may notice the existing turbidity of the vitreous body or lens. The whole procedure is carried out quickly, almost safe, non-invasive, completely painless, has a slight number of contraindications and requires minimal patient preparation. Sometimes for such a methodology of the survey, another name is applied - retinoscopy.

For the first time, the technique of ophthalmoscopy was proposed in 1851 by Dr. Helmholz. Since then, this method of diagnosis has improved in every way and now in its informativeness has no analogues in this area of \u200b\u200bresearch.

Views of ophthalmoscopy

The study of the eye dna can be carried out in several methods. The varieties of ophthalmoscopy effectively complement each other and in each clinical case to examine the patient you can choose one or another variant or a combination of them.

Direct ophthalmoscopy

With this method of examining the eye bottom, the specialist can inspect it at a 15-fold increase. For the procedure applies the following equipment:

• ophthalmic slot lamp nozzle;
• manual electric and large non-flexural ophthalmoscopes.

During the procedure, the distance between the eye and the devices should not be more than 4 cm. First, the doctor inspects a vascular beam, leaving the center of the Eye Dna. After that, a study of a yellow stain is conducted, which is the central part of the retina. And in the conclusion of the procedure, an inspection of peripheral areas of the Eye DNA is performed.

Direct ophthalmoscopy allows you to study the examined areas in detail in a multiple increase, and this characteristic is the advantage of this technique. However, this method of studying the eye bottom has some drawbacks:

• does not allow to accurately assess the height of the retinal detachment and the degree of its swelling;
• it does not make opportunities with accuracy to visualize the entire periphery of the eye bottom and does not always allow to notice the retinal detachment.

Reverse ophthalmoscopy

Modern, highly informative method of research of the eye dna - reverse ophthalmoscopy.

To perform such a study, mono- or binocular ophthalmoscopes are used. Their modern models can be equipped with a video camera transmitting the resulting image to the computer monitor. The optical system of such devices includes lenses are distinguished from direct ophthalmoscope, and the study is carried out at a distance from the patient. At the same time, the specialist gets like an inverted image of the Eye Structure of the Eye DNA, enlarged up to 5 times.

Reverse ophthalmoscopy is the leading method of examining patients in need of conducting vitreoretinal surgical interventions (operations on the eyeball or retina).

The advantages of this technique are as follows:

• makes it possible to study in detail the peripheral retinal zones;
• has a wide view field (up to 360 °);
• makes it possible to inspect the areas under study even if there are supervisors in the eyeball;
• allows you to get a high-quality stereoscopic (volume) image.

Among the shortcomings of reverse ophthalmoscopy, such characteristics of the study are:

• there is no possibility to obtain an image with an increase of 15 times (as with direct ophthalmoscopy);
• the resulting image is inverted.

Ophthalmoscopy with a slit lamp (or biomicroscopy)

This type of ophthalmoscopy is performed using a slit lamp and collecting lenses (70-80 diopters), which is located in front of the eye of the patient. This technique allows you to receive an inverted image with an increase in the structures under consideration 10 times.

Inspection using Goldman lenses

This method of ophthalmoscopy allows you to study the condition of the eye bottom from its center to the periphery. These data can be obtained thanks to the use of mirrors. Inspection of the periphery of the retinal eye with the help of a goldman lens is particularly shown in myopia or during pregnant women (to eliminate the complicated childbirth due to risk).

Ophthalmchromoscopy.

Such a method for studying the Eye DNA is performed using an electrophthalmoscope equipped with special light filters of different colors (orange, red, blue, green and yellow). Ophthalmchromoscopy allows you to detect even the most minor deviations. It is the norms that are impossible to identify during normal lighting (white).

Laser ophthalmoscopy

To carry out such a survey of the state of the fundus, a laser beam is used as lighting, which is reflected in the tissues of the eyeball. The resulting image is displayed on the monitor, and the procedure can be recorded as a video.

Laser ophthalmoscopy is a modern and high-tech way of examining the eye bottom and makes it possible to obtain the most accurate data even during vitreous body or lens. This technique has no deficiencies except one - the high cost of the procedure.

How to prepare for the procedure

Preparation for ophthalmoscopy does not imply special events. Before studying the patient, it is necessary to remove points, and when using contact lenses, clarify the doctor if they should be removed.

A few minutes before ophthalmoscopy in the eyes for the expansion of the pupil, drop-midities are buried. After the start of their action, the patient passes into a specially equipped dark room, and the doctor conducts research.

How the study is carried out

The procedure of ophthalmoscopy can be carried out in a specially equipped dark ophthalmologist in a clinic or in specialized ophthalmic centers.

For the study, a special device is applied - an ophthalmoscope consisting of a concave round mirror with a small hole inside. Through it, a beam of light comes into the eyeball through the pupil, allowing you to examine the eye bottom. In most cases, drop-midities are buried to expand the pupil before the patient's eye (for example, tropicamid, I and Four% or cycled). Through the Advanced Pupil, the doctor may consider the wider area of \u200b\u200bthe Eye DNA, and the study becomes more informative. In addition, during the examination, another light source can be used (i.e. reflected).

During the study, the doctor asks the patient to send a glance in different directions. This technique allows you to consider the status of all retinal structures. The inspection procedure is carried out quickly and lasts about 10 minutes.

Thanks to the introduction of technical advances in the practice of ophthalmologists, the eye-field study can now be carried out using an electronic ophthalmoscope, which is built into the source of halogen light. Such a procedure is carried out faster.

All techniques of ophthalmoscopy make it possible to estimate the status of the retina and its structures in real time. According to statistics, the accuracy of such a study is 90-95%. In addition, the technique allows you to identify pathology even at the early stage of its development.

Indications

Ophthalmoscopy will help the doctor to detect the pathology of the retina, cataract, as well as the signs of a number of general general diseases.

Ophthalmoscopy can be assigned to identify the following pathologies and diseases of the visual system:

• metsky hemorrhage;
• mesh formation;
• fixed pathologies in the field of yellow stains;
• retinal detachment;
• the need to inspect the optic nerve;
• retinopathy in premature children;
• suspicion of retinal dystrophy;
• any changes on the periphery of the retina;
• diabetic and other types of retinopathies;
• genetic patterns of retina (for example, with "chicken blindness");

The eye study study can be appointed not only by an ophthalmologist, but also by specialists of other industries of medicine: a cardiologist, a neurologist, an endocrinologist, a gynecologist (when making pregnancy to assess the risk of retinal peeling during childbirth). In such cases, ophthalmoscopy may be assigned under the following diseases:

• blood diseases (et al.);
• after;
• intracranial neoplasms;
• neurological diseases;
• autoimmune diseases (multiple sclerosis, etc.).

Ophthalmoscopy can be assigned when the following states appear:

• head injuries;
• frequent loss of equilibrium (changes in the vestibular apparatus);
• a sharp decrease in visual acuity;
• violation of the ability to distinguish colors;
• frequent headaches;
• receive some medicines.

In prophylactic purposes, the study of the fundus should be conducted:

• adults - 1 time per year;
• children - in 3 months, at 4 and 6-7 years old (before school).

Contraindications

There are no absolute contraindications for ophthalmoscopy. In some cases, it is necessary to refuse to fulfill this study in the following conditions and diseases:

• lights or tears - such symptoms of certain diseases significantly make it difficult to research, and it becomes a little-informative;
• the impossibility of medical expansion of the pupil with its "searches" - due to such a violation, the doctor cannot fully explore the eye bottom;
• clouding lens and vitreous body - such changes may make it difficult to carry out certain types of ophthalmoscopy;
• the impossibility of using the droplets to expand pupils in certain diseases of the heart and blood vessels - without the use of such funds, the doctor will not be able to maximally examine the state of the eye bottom (which is why before studying some patients an ophthalmologist appoints a Cardiologist consultation).

After the procedure

During ophthalmoscopy, the patient has some time with uncomfortable sensations from bright lighting directed. In this regard, after the study, he may have a dizziness and the appearance of "spots" before the eyes. These symptoms quickly pass independently, if extensive pupils have not been used for ophthalmoscopy.

When using mydriatics, such uncomfortable sensations may be present for 2-3 hours. That is why after the procedure, you should not sit behind the wheel or immediately go outside (to protect the eye from bright light, it is better to wear sunglasses). Best way Solutions to this problem will be the presence of accompanying.

In extremely rare cases, ophthalmoscopy can be complicated by allergic reactions to the drops used to expand the pupils. Such symptoms can be eliminated by the appointment of antiallergic agents.