Eye diseases. Methods for identifying pathological conditions of the eye (the most important)

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Eye diseases. Methods for identifying pathological conditions of the eye (the most important)

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11. Methods for detecting pathological conditions of the eye

Gonioscopy (from the Latin gonia "angle") is a special method for studying the angle of the anterior chamber. It can only be carried out using optical instruments, gonioscopes. The study of the chamber angle is of great importance for the diagnosis, therapy and prognosis of a number of diseases (glaucoma, uveitis, trauma, etc.). The most important route for the outflow of intraocular fluid begins from the corner of the chamber. The angle may be narrowed, obliterated, foreign bodies or a growing tumor may be found in it.

Tonometry is a necessary study in all cases when there is a thought that the patient has glaucoma, secondary eye hypertension or hypotension, in various general and local diseases.

Approximate pressure in the eye can be determined by palpation. In this case, it is necessary that the patient looks down, and the researcher, with his index fingers located above the level of the cartilage, takes turns pressing through the upper eyelid (when looking up through the lower) on the eyeball (similar to examining the fluctuation of an abscess). When analyzing pressure, it is necessary to compare its value in one and the other eye.

If the ophthalmotonus is within normal limits, it is designated as TN if its value is 2835 mmHg. Art. T + 1, more than 36 mm T + 2, if hypotension of about 1522 mm Hg is detected. Art. T 1, less than 12 mm Hg. Art. T 2.

For the quantitative determination of ophthalmotonus in Russia, the Maklakov tonometer is most widely used.

Tonography is a method for studying the hydrodynamics of the eye. It allows you to determine the state of the outflow of intraocular fluid and is used mainly when examining patients with glaucoma or when it is suspected. The degree of reduction is different in healthy individuals and in patients with glaucoma, which is reflected in the nature of the tonographic curve. Graphic registration of changes in ophthalmotonus becomes possible by connecting a recording device. Data is recorded on a moving paper tape.

To study the optical system of the eye, measure the anteroposterior and other dimensions, the method of ultrasound echo-ophthalography is used. It consists of recording ultrasonic signals reflected from the interfaces between the media and tissues of the eye with different acoustic properties.

Studies are carried out on the diagnostic device echo-ophthalograph.

Ultrasound examination is also used to detect foreign bodies in the eye, for the purpose of diagnosing retinal detachments, tumors, etc., especially in cases where examination of the fundus of the eye is impossible due to clouding of the transparent media.

If a patient has exophthalmos or enophthalmos (protrusion or retraction of the eyeball), special devices are used to quantify them and judge the dynamics of the process (orbital tumor, retrobulbar hematoma, fracture of orbital bones, etc.). The most common is a mirror exophthalmometer.

Author: Shilnikov L.V.

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