Treatment of astigmatism in adults: basic methods

Astigmatism is a pathology of the structure of the eye, in which the lens or cornea has an irregular (non-spherical) shape. That is, the optical system has a complex curvature of the surface. The rays of light passing through the cornea are refracted in different ways, partially not reaching the retina, focusing at a few points in the cut. The effect of different curvatures of different parts of the eye surface leads to a loss of ability to clearly see the surrounding. The image with astigmatism is formed highly distorted. The rays of light converge on the retina not at one point (as in normal functioning), the "image" of the point in the end turns out to be similar to a blurred ellipse, segment or eight. In some cases, vertical lines may seem fuzzy, in others - horizontals and diagonals are outside the focus area.

Definition of disease

Astigmatism in most cases is not the only ophthalmic problem, but is combined with manifestations of myopia or hyperopia.The third type of astigmatism - mixed - combines elements and myopia and hyperopia.In this case, parts of the image can be focused behind or behind the retina. However, this disease can not be equated with manifestations of myopia or hyperopia.A person with astigmatism experiences difficulties with the perception of both distant and intimate objects. This is due to the fact that the cornea has a stronger refractive power.The characteristics of the degree of astigmatism are:

• The difference in the refraction of the strongest and weakest meridians (measured in diopters);
• Direction of meridians (measured in degrees).

Specialists distinguish three degrees of development of pathology:

• Weak degree- up to three diopters;
• Average degree- from three to six diopters;
• High degree- above six diopters.

But even astigmatism in one dioptry worsens the visual perception and creates discomfort.

Causes

The causes of the appearance of a defect in the structure of the eye are not fully understood even by modern researchers. The main factor that causes manifestations of astigmatism is heredity.Such astigmatism (together with myopia or farsightedness) can be detected already in the first years of life.However, not all cases of manifestation of astigmatism are due to heredity. Astigmatism is the result of injuries or operations in the eyes, which cause serious scarring on the cornea.

Thus, depending on the cause of development of astigmatism, there are:

• Congenital astigmatism;
• Acquired astigmatism.

It should be noted that a weak degree of congenital astigmatism (no more than 0.5 diopters) is found in most people. This is the so-called "functional" astigmatism.He does not have a significant effect on visual acuity. A pathology exceeding one dioptre seriously worsens visual perception.

In some cases, the cause of astigmatism can become corneal disease.

Symptoms

Despite the fact that a violation of uniform curvature of the cornea or lens causes a distortion visual sensations, in many cases the disease is detected only with a careful ophthalmologic survey.A person suffering from astigmatism, may not pay attention to the reduction in visual acuity, if it is insignificant (less diopter).The visual discomfort will not be too great. However, under certain conditions, the patient notes significant vision problems. The perception of objects can become bifurcated or warped. Patients complain of rapid fatigue or pain in the eyes, the occurrence of headaches when working with a computer, reading small text, watching TV.

Such symptoms can occur with severe fatigue or stress.

If you leave these signals without proper attention, then the deterioration in vision becomes more noticeable.When a person suspects manifestations of astigmatism in his body, suspicions can be easily verified by looking at one eye with dark parallel lines.If you rotate the sheet before your eyes, you can see that the lines are blurred, then again become clear.

As a person with astigmatism sees

Possible complications

If astigmatism is detected rather late and progresses, this leads to a sharp deterioration in visual ability and to the development of strabismus.

Treatment

Any of the methods used in modern ophthalmology for the treatment of astigmatism aims to change refractive force of the optical system of the eye in such a way that the image is focused in a certain areas of the retina.Conservative treatment of astigmatism involves the use of the following techniques:

• Selection of special types of glasses;
• Use of contact lenses;
• Methods of hardware treatment;
• Method of orthokeratology (use of night contact lenses).

The most "popular" method of vision correction with astigmatism is glasses.

Conservative methods

Depending on the type of astigmatism, glasses with positive or negative cylindrical lenses are used which have different degrees of curvature horizontally and vertically.In common cases of a combination of astigmatism with farsightedness or nearsighted glasses for glasses are made spherocylindrical. Glasses must be precisely selected for each eye separately.

This is how glasses with cylindrical lenses look

This method of vision correction has several advantages: it is the safest, easiest and cheapest method of treating astigmatism. However, using glasses, you can face a number of problems:

• Glasses can not provide full vision correction;
• Points limit spatial perception, lateral vision, violate stereoscopic effect;
• With insufficiently accurate selection of glasses, the eyes will become tired, which will lead to the progression of astigmatism;
• In the event of a fall or other traumatic circumstances, lenses can cause serious damage to the eyes;
• Points give the owner discomfort, restrict his activities (for example, the opportunity to play sports).

In the case of increased astigmatism, wearing glasses is contraindicated. At a significant degree of the disease, a person feels dizzy and hurt.Contact lenses correct weak (up to three diopters) degree of astigmatism.The ophthalmologist appoints special toric lenses, which must be carefully selected. If necessary, cylindrical lenses are combined with lenses to correct myopia or hyperopia.Like glasses, contact lenses are selected individually, separately for each eye.

The principle of the orthokeratological lens

The method of orthokeratology is a method of temporary correction of astigmatism, with the help of rigid gas permeable contact lenses (night lenses), which, with the help of the reorganization of the epithelium of the cornea, improve the acuteness view.This method of treatment is used to achieve some flattening of the corneal epithelium under a special lens. The superficial cells of the cornea gradually become more flat in the center and increase in the peripheral regions. The anatomy of the cornea and the integrity of its layers remain normal.

Hardware treatment methods suggest stimulation of less active parts of the eye, which helps to improve visual acuity, and also prevents the development of myopia.

Surgical way

Special glasses or lenses correct up to two diopters of astigmatism. Astigmatism requires more use of other methods of treatment. Actually, to treat, and not to correct vision, can only be through surgical intervention. There are various ways of such treatment:

• Laser correction;
• Thermokerukoagulation;
• Keratotomy;
• Laser coagulation.

Laser coagulation and thermokeratocoagulation use the method of cauterizing certain areas of the cornea. These methods are used to correct farsighted astigmatism.Keratotomy is an operation in which cuts are made on the cornea, reducing its curvature.This method of treatment is necessary for patients with mixed and short-sighted types of astigmatism. Laser correction is painless and seamless and operation.

Using the laser, you can access the deep layers of the cornea.This method allows you to align the cornea and giving it the original shape.The laser does not affect the internal structure of the eyes, its impact is felt only by the refractive medium: its shape changes, the image is focused correctly on the retina of the eye. The operation is performed under local anesthesia. The patient does not even need to be in the hospital after it is finished.

The most radical method of reconstructing the eye's optical system is eye surgery (eye microsurgery).It is used in difficult cases, when there are reasons preventing the laser correction.Such reasons are high degrees of astigmatism or the presence of contraindications (eye diseases, common diseases of the body).

To correct astigmatism, operations are performed to replace the lens with a toric IOL. Implantation into the eye of the phakic lenses can also be performed.

Prevention

To prevent the development and progression of astigmatism, it is necessary to create conditions for the normal functioning of the organs of vision:

• The correct "working" position when reading and writing at the table.Lighting should be sufficient and directed from the left side. For reading, you can use the top light, but not the "daylight" lamps;
• The load on the eyes is important to alternate with active rest.It is necessary to introduce physical exercises into the regime of the day, including special gymnastics for the eyes;
• The food should be balanced.

Specialized gymnastics for the eyes with astigmatism is necessary to relieve tension from the muscle of the eye, which helps to focus the optical system when looking from distant to nearby objects and back.

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conclusions

Astigmatism is a pathology of the structure of the eye, in which the sphericity of the cornea is disturbed. The main cause of the disease is heredity. Low degrees of development of astigmatism are practically not felt, but over time the disease progresses, leading to a significant loss of visual acuity. It is often only the doctor who can diagnose the disease.

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