Vision screening begins with an external examination of the ocular apparatus. Optometrist (more modern title of specialist in eye diseases ophthalmologist) determines the state of the eyelids, cornea, iris, pupil, etc.
Then we will examine the sharpness of distance vision. Doctors traditionally use the table Sivtseva. It either hangs on the wall or projected on a white screen. This table consists of 12 lines of different letters from large to very small. Twenty feet from her chair. You offer to sit, and to call specified doctor of letters: large, then smaller and smaller.
First check the visual acuity of the right eye while you close the manual shutter of the left eye. Then Vice versa. Every line is 10% visual acuity.
If you clearly see the letter of the tenth line from the top – you have full vision (of 1.0 unit). The eleventh and twelfth lines are usually well distinguished, characterized by farsightedness.
If you see less than ten rows, then the doctor selects or glasses or contact lenses. He wears you to the spectacle frame with grooves, which alternately inserts a few lenses.
The degree of vision correction with their help determined by reading the rows of the table Sivtseva. From the several options you choose the one that produces the maximum number of clearly visible lines.
It is important to avoid discomfort from prescribed lenses. If the eyes are "cut", they are watering, the picture "ghosting", or you have a headache, slight dizziness, tell certainly. The doctor will choose the lens with less diopters. Glasses should always be a little "weaker".
Children who cannot read, vision is tested or on the table Golovin, which depicts the decreasing rings with slits in different directions, or the grid Orlova pictures. On them and choose either glasses or contact lenses.
Near vision ophthalmologist checks, offering to read short texts on the card, which also differ in the size of the font. To read these lines should be holding the card in front of him at a distance of 35 cm.
If the vision is very weak and the patient will not even see a huge letter of the first line "sh" and "B", the optometrist determines the visual acuity on the fingers. He shows the patient a different number of fingers on your hand, gradually moving away from him. And the result determines the distance from itself to the patient.
Modern eye clinic is equipped with electronic optical devices which determine the visual acuity instantly, and not empirically, by tables, and automatically. To deceive them is absolutely impossible.
There are people for which, for example, red and green are one and the same. Correct vision optometrist determines the Atlas with colored optical tests. They consist of dots and circles, out of which only "lurking" numbers or geometric shapes. The doctor offers to call them. If the patient sees them or sees other figures and shapes, then he is colorblind.
It is very important to also check the fundus. The doctor digs in both eye drops, pupils are soon greatly enlarged, and he well illustrated the condition of the retina, blood vessels, macula.
Equally important indicators such as intraocular pressure. If it increased, developing glaucoma. Modern automatic device pneumotonometer goes to the eyes exhaust, and the pressure is measured instantaneously. The norm is 15-16 mm Hg. article
And the old fashioned way, intraocular pressure is measured by tonography small cylinder, the bottom of which is painted with a special paint. Monograph is placed on the eyeball, pre-treated mild analgesic drops. The imprint is transferred onto paper in the form of a circle, then its diameter is measured with a ruler. The norm – up to 24 mm Hg. article
If there is pain, "floaters" or the fiery circles in the eyes, the outlines of objects seen vaguely painful to look at light, immediately contact the optometrist. Sometimes for the salvation of man from blindness every hour is crucial!
Special preparation for examinations is not necessary. But you should know that sleepy state, fatigue, alcohol, adopted in a day or two before, may affect the objectivity of the results. Also, before it is advisable to take any medication.
Advice 2: Optometrist differs from an ophthalmologist
In modern medicine there are constantly new and new terms in which ordinary people difficult to understand. Frequently cause trouble, even like the well-known medical expertise – for example, what's the difference between an ophthalmologist from ophthalmologist?
Today, ophthalmology is an area that includes the study of vision problems, concomitant diseases and General physiology of the eye. So, an ophthalmologist depth study of the structure, development, age changes and pathology of the eyeball and the system connected to it for centuries, nerves, eye muscles.
Patients come to an ophthalmologist with diseases of the above organs, in the same way as to the optometrist.
There is a perception that ophthalmology, in contrast to the conservative ophthamology is the science that studies and performs in practice, more innovative and modern methods of treatment of complex diseases and surgical interventions in the organs of vision. However, this is completely the wrong concept, resulting from the medical ignorance of the population.
What is the difference between optometrist and ophthalmologist.
The majority of patients believed that the optometrist and ophthalmologist represent a variety of medical specialization. It affects their first impression from the name of a profession, because the term "ophthalmologist" sounds much more reliable and respectable than unrepresentative "optometrist" as used in ordinary clinics. Eye doctor called an ophthalmologist in all European countries, whereas in former Soviet countries, he continues to remain a humble optometrist.
This is used by many private clinics, luring customers advanced and educated "ophthalmologists" who have a large amount of knowledge.
In fact, an ophthalmologist is no different from an ophthalmologist. It's just synonymous names for the same medical specialty, in which treat the organs of vision. These terms originated from Latin oculus "eye" and the Greek ophthalmos – also "eyes". Based on them and created two different names for the profession. Coming to the optometrist, the patient receives and the most modern facilities, and innovative treatment methods, and progressive surgery.
Thus, optometrist and ophthalmologist, in fact, are exactly the same concepts that have nothing to do with the level of medical expertise or specialist status. It's all in the stereotypes that remained in people from the Soviet era, and the desire to get the highest quality service at a good European doctor "ophthalmologist", not banal ophthalmologist.
Advice 3: As children test the fundus
Eye bottom called the inner part of the eyeball lined by the retina. It check for the detection of certain diseases. Examination of the eye fundus (ophthalmoscopy) are performed by a doctor-ophthalmologist.
Especially the study of the fundus in children
The fundus of the eye in children check with the purpose of identifying eye diseases, pathologies of blood vessels, brain, and signs of hypertension. For ophthalmoscopy used several methods. Most often the physician uses the Ophthalmoscope mirror, some experts prefer electronic device. In some cases the research is conducted by the method of fluorescent antigraffio (FAGD).
Perform ophthalmoscopy in a dark room. Left and slightly behind the patient set frosted lamp having a power of about 100 watts. The doctor is at a distance of 30-40 cm from the patient and right eye looks through the hole of the eye mirror of the Ophthalmoscope, directing the pupil of the patient beam of light. Light enters eyesand then reflected from the pigment epithelium and the choroid.
When checking the fundus of the eye in children appears a number of difficulties, because young patients are not able to overcome the reflex and close my eyes to protect from light. Therefore, in order to improve pupil before the procedure they buried 1% solution of "Homatropine". If a child cannot cope with zamurovannye, the doctor applies the eyelid retractor. Older children are asked to focus on some picture, object.
The fundus of the eye in children: norm and pathology
The fundus of the eye in children is different from the fundus of an adult. Newborns in norm it has a light yellow color, the optic nerve disc pale pink with a slight gray tint, no macular reflex. Greyish tint of the optic disc is preserved up to 2 years.
Born in asphyxia of children during the inspection will be revealed small hemorrhages, are irregular in shape. If these areas are located along the arterioles, they dissolve on the 6th day of life. Hemorrhage with preretinal character, persist longer and can be repeated. If the inspection revealed a sharp pallor of the temporal half of the disc, this indicates a congenital atrophy of the optic nerve. In this case the boundaries are very clear, there is a narrowing of the arteries. In different brain lipoidosis (hereditary abnormalities of lipid metabolism) in the region of the macula (the Central part of the retina) detected by the spot of cherry-red color.
Normally, the retina can have different shades, depending on the volume of blood circulating in the vessels. In some cases the pigment epithelium, located between the upper and the capillary layer, attached retina dark red or dark brown color. By reducing the amount of pigment effect appears parquet fundus: the retina image has wide stripes, alternating with dark patches. Normal optic nerve looks like a round pink spot. It is located on the red background of the fundus and has pale temporal part. The color of the disk will depend on the number of capillaries with age it becomes paler. The hue can affect the development of hypertension and other pathologies, as well as the accumulation of pigment. If the inspection found that the disk is surrounded by a semicircle, this would indicate a detachment from the edge of the nerve of the choroid.
Advice 4: From what distance to check visual acuity
To visit an ophthalmologist must be at least once a year to avoid possible problems with vision. This event will not take much time, but the doctor will conduct all the necessary tests: test of visual acuity, fundus examination. And if necessary pick up points.
A healthy eye has a visual acuity of 1.0. Visual acuity — the eye's ability to distinguish between two equidistant points at a minimum distance from each other. Determine this figure by using the table Sivtseva-Golovin, named after outstanding Soviet ophthalmologists. It is a white poster in the left part of which has black letters and the right black closed rings (Landolt rings). And letters, and a ring divided into 12 rows on size: the largest are on the top line, the smallest on the bottom. To the left of each row shows the figures indicating the distance at which healthy eyes should distinguish this line. On the right side shows the value that indicates the visual acuity for each row. The healthy eye sees the tenth row with distance of 5.0 meters.
Procedure visual acuity is as follows. The table is placed on the wall approximately at the level of human growth. Table lighting should be very good, otherwise possible distortion, giving the wrong information to the doctor. The patient is seated on a chair at a distance of five meters from the table. One eye (usually the left) closed the special flap, the other eye the patient examine table. To increase the speed of check visual acuity is often proposed to call only 1-2 letters from each row, and read out only the latest distinct rows. Then similarly, the left eye. Usually for simplicity of notation use the letter part of the table (table Sivtseva).
When using a table Sivtseva there is a risk of getting incorrect data, because the letters are always arranged in the same order, and to remember them is not difficult. This is especially important when conducting surveys in children (in order not to miss a decrease in visual acuity) and under the military-medical commissions. To this end, all the same more efficiently using a table Golovin with the Landolt rings. However, in modern ophthalmic practice, the most used development Sivtseva, as a more simple and understandable for the explanation and for reading.
In Russia it is accepted to measure visual acuity from a distance of 5.0 meters. It is believed that at this distance the eye is able to distinguish between those values that are accepted for the absolute visual acuity. There are two parallel sticks the letter "W" in the tenth line are located at a distance of 1.45 mm from each other. In foreign medicine vision is tested by Snellen table. This table is similar to table Sivtseva, but uses letters of the Latin alphabet. By the way, abroad decided to check vision from a distance of 6.0 meters, so the size of the letters there are different from the Russian version.