Complex astigmatism: causes, symptoms, treatment

Various deviations in the quality of vision - not so rare in the modern world.This is due, of course, to an increased visual load on the eyes, as well as a decrease in the quality of the products used. And if about the short-sightedness or farsightedness most people have an idea, then what is astigmatism, few know, as well as the fact that there are several of its types.

Definition of disease

The optical system of the eye is based on the refraction of light rays when passing through the cornea and the lens, as well as displaying them in a focused state on a yellow spot - the main focus of nerve cells retina. Here, an image is formed, which later enters the brain in the transmission of nerve impulses. Deviations in any of the refractive media lead to a disease such as astigmatism.

Image quality may be compromised by abnormalities in the shape of the cornea, the lens, and the size of the eyeball.

In this case, the image does not come from one point to the retina, but from several, and sometimes instead of the point the patient sees lines, several dots or other figures. With astigmatism, two main meridians are identified, having the greatest difference in the curvature of the cornea and perpendicular to each other.

Depending on the types of refractive disorders, several types of astigmatism are distinguished:

• Hypermotropic or myopic simple- the presence of hyperopia or myopia in only one meridian;
• Complex (hypermetropic or myopic)- Deviations in the form of hyperopia or myopia are present in both meridians;
• Mixed- in one eye there are hypermetropic and myopic deviations in various forms.

Allocate astigmatism congenital and acquired, direct and reverse (depending on the position of the meridians), and also on the degree of violation - weak (up to 3D), medium (3-6D), strong (above 6D).

Causes

Each child is born with a certain degree of astigmatism, which is reduced to the normative indicators by about 3 years.Most people have astigmatism in a weak degree (before, D), which does not have any effect on the quality of life.

However, in some children, violations do not come back to normal and require mandatory correction, since its absence can lead to more severe consequences for vision.

Congenital astigmatism can not be treated, but the acquired can be corrected by glasses or surgical intervention. The development of a visual defect is influenced by the following factors:

• Traumatic injury: penetration of a foreign body, burn, postoperative changes in the form of the cornea;
• Diseases of the cornea: keratitis, keratoconus, corneal dystrophy;
• Diseases of the eyelids: all lesions that lead to changes in the shape of the cornea, direct or indirect.

Most often it is the acquired astigmatism manifested in a complicated form, when in one eye there are lesions on both meridians.

Symptoms

Often at the initial stage of the disease, the patient does not attach importance to the symptoms that appear, attributing to their usual fatigue and tiredness:

• Loss of clarity of the perceived image;
• The appearance of double vision in the eyes;
• Pain and redness of the conjunctiva;
• Later - the impossibility of distinguishing small print.

Acquired astigmatism can develop at any age, however, as with the treatment of the majority it is important to begin correction at the earliest stages in order to prevent progression symptoms.

The later stages are characterized by the following symptoms:

• Rapid fatigue even with short eye strain;
• Sensation of "sand in the eyes
• Sensitivity to light;
• Decreased visual acuity at dusk;
• Headaches in the area of ​​the eyebrow and temple.

It is possible to suspect that a small child may have visual defects, in particular astigmatism, because of his unusual behavior: squinting and tilting his head to get a clear images, uncertainty in orientation when walking or other movements, unwillingness to view beautiful pictures or learn to write and read, as well as any activities where enhanced work eyes.

Possible complications

Progression of a visual defect without adjustment and treatment can cause a significant deterioration in visual perception, which will invariably lead to a decrease in the quality of life.

Besides this, against the background of astigmatism, the development of other visual defects is possible:

• Amblyopia(lazy eye) - when the image becomes fuzzy and even begins to double, the visual center in the brain is not can take two pictures at once and "get out of position" as follows: disables the image from one eyes. As a result, this eye does not work at full strength - "lazy which results in a decrease in visual acuity;
• Strabismus- with fuzzy or twofold images, the visual apparatus tries to normalize the picture displayed in the brain, and one of the ways is to reduce the focuses to one point-to the nose. As a result of these attempts, the eye gets used to this position and already starts to move in the usual direction - a strabismus develops.

  Manifestation of amblyopia

If the astigmatic deviations have appeared in the child, the question of time is especially relevant - in fact in childhood, the visual apparatus is still being formed and very plastic. Any defect in case of wrong actions or inaction of parents can progress and cause big problems in the future. And even the appearance of astigmatism in an adult can severely disrupt the habitual rhythm of life, both professional and domestic.

Treatment

The beginning of medical measures is a correct diagnosis, when the doctor conducts a traditional examination using such methods as visometry, ophthalmoscopy, biomicroscopy.The patient undergoes a special test for astigmatism: viewing the mesh depicted on a sheet of white paper. When distorting the visual perception of the clarity and straightness of the lines, as well as the appearance of other disorders, astigmatism is diagnosed.

As additional diagnostic measures can be used:

• Automatic refractometryRefraction check;
• Cycloplegia- disconnection of accommodation with the help of medicines;
• Ultrasound Biometrics- examination of the anterior part of the eye;
• Pachymetry- examination of the thickness of the cornea;
• Computer keratotopography- investigation of the state of the cornea by laser beams.

  Pachymetry

Medication Therapy

For the treatment of astigmatism, medicinal preparations can be used only as a means of prevention. These can be moisturizing drops or eye vitamins, as well as other drugs that improve metabolism in the eye structures and have a positive effect on overall eye health.

The main method of conservative treatment with any forms of astigmatism is recognized as a correction:

• Points.To eliminate the lack of vision, special cylindrical lenses are used that look like a cast from a cylinder. They can be scattering or collecting - depending on the need for correction of a particular visual defect. An adult man tolerates such lenses with great difficulty, and the older he is, the worse the initial addiction goes. Therefore, it is recommended at the beginning of the correction not to write glasses with lenses exceeding 4D. After getting used to such glasses gradually replace with stronger ones, each time increasing their strength by 3/4 D;
• Lenses. Until recently, only hard lenses were used for correction, the selection of which was based on the same principles as glasses. However, they often caused negative changes in the cornea. Therefore, it is now recommended that soft lenses be used for astigmatism, and for children, disposable ones are preferred, and the risk of developing infectious inflammation is minimized;
• Night Lenses. The method is called orthokeratology and today it is recognized as the most progressive among all existing methods of correction. The patient wears special contact lenses at night, which softly affect the shape of the cornea. The effect of the adjustment is maintained for 24 hours;
• Apparatus.Special devices are used mainly for the treatment of children, when the optical system of the eye is plastic and the effect achieved can be fixed. Treatment courses are selected individually in each individual case and consist of 10-15 sessions for 1 hour. During the session, various devices are used, according to the doctor's prescription.

The methods of correction by the above methods have only a temporary effect and do not treat the visual defect. To get rid of astigmatism forever, you can only with the help of surgery.

Surgically

Methods of surgical treatment are the most effective for today, and modern technologies allow most of them to be performed in outpatient settings:

• Astigmatic keratotomy- application to the cornea of ​​incisions, after healing of curvature changing it;
• Photorefractive keratotomy- method of leveling the surface of the cornea with a laser. The method does not apply to a thin cornea;
• Laser thermokeratoplasty- application of the laser beam to the cornea, which causes an increase in the curvature of the corneal layer during the healing process;
• Thermokerukoagulation- in the course of the operation, point burns are applied to the cornea not with a laser, but with a heated metal needle;

Thermokeratoplasty with laser.

• Laser keratomilez(LASIK)- from the surface of the cornea, the thinest layer is cut off, after which the laser corrects its thickness. After that, the top layer returns to the place;
• Keratoplasty- replacement of the cornea with a donor or artificial implant (or placing it on the surface or in the thickness of the cornea);
• Implantation of phakic lenses- special lenses are placed in the anterior or posterior chamber of the eye;
• Refractive lens replacement- can be carried out in the event that the accommodation of the lens is lost completely or partially.

Transplantation of the lens

Operative treatment is prescribed in the case when the correction does not give the desired effect, or if the defect of vision is too fast. Each type of operation has a number of contraindications, so a full examination of the patient is necessary before a surgical correction.

Folk remedies

Of course, it is impossible to eliminate astigmatism with the help of folk remedies.However, using them as a supplement to the methods of traditional medicine can, at least, inhibit the progression of already existing visual defects.

Among these drugs can be attributed a certain diet, saturated with products with a high content of certain vitamins and trace elements:nuts and raisins, seafood and eggs, low-fat varieties of meat and, of course, vegetables and fruits (blueberries, carrots, bell peppers, greens, tomatoes, currants, ).

Prevention

Avoiding congenital astigmatism is unrealistic, but the progress of the condition or development of acquired forms - it is quite possible to prevent preventive measures:

• Special diet;
• The use of vitamins and trace elements (natural and synthetic);
• Elimination of eye strain;
• Use of special exercises for relaxation;
• Preventive examinations at the ophthalmologist.

Video

conclusions

Treatment of astigmatism by conservative methods is impossible - only correction: glasses, lenses, devices. Operative methods give a more stable effect for a long time, however, some of them are fraught with relapses.

Therefore, the most correct solution in the detection of even a weak degree of astigmatism will be the use of the fullest methods of prevention.