Afakia: features of the disease and methods of treatment

Afakia - a dangerous ophthalmological disease, characterized by the absence of the lens in the structure of the eyeball.Most often, pathology leads to complete or partial blindness, vision can be restored only in rare situations. Today there are effective methods of treating the disease, but more often the question is only about minor correction of visual functions. In recent years, diagnosed cases of acquired aphakia have become more frequent, and some experts predict an increasing spread of the disease, especially in urban countries.

Definition of disease

The lens is one of the most significant elements of the visual system. It represents a natural natural lens, which is necessary for focusing on objects far and near.Any changes and violations of this important organ directly affect the quality of vision.

Afakia is an acquired or congenital disease, in which the lens is completely absent in the eyeball. At the same time, refraction becomes completely impossible, since there is no organ refracting the light rays. That is why the visual acuity is reduced, up to complete blindness. In addition, there is a constant trembling of the iris (iridonodes), as the pathological deepening of the anterior chamber of the eye occurs.

To date, the incidence of this disease has not been fully investigated, but there is a tendency to increase clinical cases, since aphakia often appears as a complication after surgery.

Types and Classification

There are two main types of disease:

• One-way (monocular) aphakia. This is the most common form in which the lens is missing only on one eye;
• Two-way (binocular) aphakia. It occurs much less often. Usually occurs in severe forms of cataracts, when deformation of both lenses occurs.

One-way aphakia eyes

In connection with etiology, isolatedacquired and inheritedaphakia. The second option is less common and is always more severe clinically, since restoration of vision is possible only after two years, when the growth and development of visual apparatus.

The risk of developing acquired form of aphakia increases after 40 years. This is largely due to the fact that with age, some eye cells are restored much slower or degenerative processes begin at all.

Causes

Due to the fact that the disease can develop both during embryonic development and be acquired, the causes of the onset are completely dependent on etiology.Afakia can be a consequence of the pathology of lens development during the in-tube period, less often the acquired illness arises from the resorption (resorption) of this visual structure due to a genetic mutation, the effects of hormonal, narcotic, psychotropic substances and transferred diseases during pregnancy.

It has been experimentally proved that even a slight delay in the development of eyeball structures in the embryo leads to pathologies of the cornea or lens.

Acquired reasons for the occurrence of aphakia there is much more.Disease can appear due to a transferred ophthalmic operation, as a complication against the background of cataracts (turbidity and deformation of the lens), and also after mechanical or chemical exposure, including burns by welding, to the ocular an Apple.

Symptoms

During the illness, physiological and anatomical changes occur. Sharply reduced visual acuity, up to complete or partial blindness. Visual functions can only be restored in exceptional cases.There are various ophthalmologic pathologies, for example, a different perception of the object by a healthy and sore eye, due to which it is impossible to obtain a real image of the object.Regardless of the type of aphakia, problems arise when focusing the vision. The difference in perception of visual information, as a rule, leads to amblyopia.

Symptom of aphakia

Anatomical symptoms are directly related to the lack of an important structural element of the visual apparatus. The anterior chamber of the eye deepens, which is noticeable even with the naked eye.In all cases, there is iridodonez - the shivering of the iris with any movement of the eyeball.Sometimes a pupil forms a hernia, rarely the vitreous contents flow into the enlarged anterior chamber.

Possible complications

Untimely treatment of the disease can lead to a complete and irreversible loss of visual acuity, in which further correction rarely results.In addition to reducing visual functions, there is an aniseikoniya - a significant difference in the amount of perception of objects by one and the second eye.If the disease is accompanied by the exit of the vitreous body into the anterior chamber of the eye, there is a risk of developing a complex form of keratitis and the formation of microscopic scars on the cornea.

Diagnostics

Afakia has pronounced visual manifestations, so the diagnosis of the disease is not particularly difficult.To differentiate the disease from a dislocation or subluxation of the lens, the following procedures are necessary:

• Visometry. It is necessary to determine the level of vision loss;
• Gonioscopy. Allows to determine the presence of a deepening of the anterior chamber of the eyeball;
• Ophthalmoscopy. Using it, you can diagnose various pathologies of the visual apparatus for developing a treatment strategy;
• Ultrasound of the eye. Assigned to complex forms of aphakia, it allows to determine the violation of the anatomical integrity of nearby structures.

Checking visual acuity (visometry)

If an operation for the restoration of the lens is prescribed, additional procedures are necessary. The traditional set of diagnostic methods in this case is complemented by tonometry, refractometry and biomicroscopy.

Treatment

To date, there are no effective pharmacological treatments for aphakia, therapy is represented only by optical correction of vision, and in severe cases a surgical operation is prescribed.

Optical correction

The selection of corrective optics is usually assigned if the operation is impossible. With two-sided aphakia, a pair of glasses is produced in two copies - to distinguish objects near and far.As a rule, the disease is accompanied by astigmatism, so eyeglass lenses are quite difficult to manufacture and represent a massive construction.In addition, thick glasses are often the reason for the regular appearance of ring-flickering cattle, which significantly degrades the quality of life.

Astigmatism with aphakia

If before the development of aphakia, the patient had myopia, then the selection of glasses would not be of any use - the lenses would only enhance the aniseukonium.

Contact lenses are a modern and common way to improve vision with the help of optics.It is believed that this is generally the only method for correcting visual functions with a binocular aphakia, because even the manufacture of eyeglass lenses for this form of disease represents a huge complexity. The choice of material depends on the age of the patient, recently the technology has moved far ahead and contact lenses can be selected even for young children. In childhood, more often used silicone variants, and adults are selected soft or hard analogs, depending on the characteristics of the pathology.

Hard and soft contact lenses for aphakia

Surgical methods

The only operative way of treating aphakia is the introduction of an intraocular lens.This is the installation of an implant from a special plastic of the appropriate force into the area of ​​the lens missing or altered by the disease. The features of an artificial lens in each clinical case are calculated individually, based on all the required parameters - the thickness, refractive power of the cornea, the size of the anterior chamber of the eyeball and others.

Implantation of intraocular lens

The operation is possible only after two years, since up to this time the growth and development of the main visual structures occurs.

Four main types of intraocular lenses were developed, depending on the method of installation: with the attachment in the corner of the anterior chamber, the lens on the pupil, extracapillary and posterior chamber.The latter option is the most optimal for aphakia, since it does not interfere with the whole movement of the pupil, and also takes the natural place of the lens. The procedure allows you to almost completely restore your eyesight or create the possibility of selecting corrective optics. Observance of all postoperative requirements is one of the most important conditions for successful treatment.

Prevention

There are no reliable measures to prevent the development of aphakia.It is necessary to regularly undergo ophthalmologic examination, as well as avoid eye injuries.Due to the fact that older people have an increased risk of developing a disease, after 45 years as often as possible to be examined by an ophthalmologist and take vitamin supplements to preserve visual functions.

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conclusions

Afakiya eyes - a serious disease, often leading to disability in sight.Despite the effective methods of modern medicine, in rare cases it is possible to completely restore visual processes. Therefore, only timely access to a doctor and observance of simple prevention of eye health allow to avoid the development of this disease.