Vision changes and problems can be caused by many different conditions. Some include:
· Presbyopia: difficulty focusing on objects that are close. This problem often becomes noticeable in your early to mid 40s.
· Cataracts: cloudiness over the eye lens, causing poor nighttime vision, halos around lights, and sensitivity to glare. Cataracts are common in the elderly.
· Glaucoma: increased pressure in the eye, which is most often painless. Vision will be normal at first, but over time you can develop poor night vision, blind spots, and a loss of vision to either side. Some types of glaucoma can also happen suddenly, which is a medical emergency.
· Macular degeneration: loss of central vision, blurred vision (especially while reading), distorted vision (straight lines will appear to be wavy), and colors that look faded. The most common cause of blindness in people over age 60.
· Eye infection, inflammation, or injury
· Floaters: tiny particles drifting inside the eye, which may be a sign of retinal detachment.
· Retinal detachment: symptoms include floaters, sparks, or flashes of light in your vision, or a sensation of a shade or curtain hanging across part of your visual field.
· Optic neuritis: inflammation of the optic nerve from infection or multiple sclerosis. You may have pain when you move your eye or touch it through the eyelid.
Your health care provider will check your vision, eye movements, pupils, the back of your eye (called the retina), and eye pressure. An overall medical evaluation will be done if needed.
It will be helpful to your provider if you can describe your symptoms accurately. Think about the following ahead of time:
· Has the problem affected your vision?
· Is there blurring, halos around lights, flashing lights, or blind spots?
· Do colors seem faded?
· Do you have pain?
· Are you sensitive to light?
· Do you have tearing or discharge?
· Do you have dizziness, or does it seem like the room is spinning?
· Do you have double vision?
· Is the problem in one or both eyes?
· When did this begin? Did it occur suddenly or gradually?
· Is it constant or does it come and go?
· How often does it occur? How long does it last?
· When does it occur? Evening? Morning?
· Is there anything that makes it better? Worse?
The provider will also ask you about any eye problems you have had in the past:
· Has this ever happened before?
· Have you been given eye medications?
· Have you had eye surgery or injuries?
· Have you recently traveled out of the country?
· Are there new things you could be allergic to, such as soaps, sprays, lotions, creams, cosmetics, laundry products, curtains, sheets, carpets, paint, or pets?
The provider will also ask about your general health and family history:
· Do you have any known allergies?
· When did you last have a general checkup?
· Are you taking any medications?
· Have you been diagnosed with any medical conditions, such as diabetes or high blood pressure?
· What kinds of eye problems do your family members have?
Regular eye checkups from an ophthalmologist or optometrist are important. They should be done once a year if you are over age 65. Some experts recommend annual eye exams starting at an earlier age.
How long you go between exams is based on how long you can wait before detecting an eye problem that has no symptoms. Your provider will recommend earlier and more frequent exams if you have known eye problems or conditions that are known to cause eye problems, such as diabetes or high blood pressure.
These important steps can prevent eye and vision problems:
· Wear sunglasses to protect your eyes.
· Wear safety glasses when hammering, grinding, or using power tools.
· If you need glasses or contact lenses, keep the prescription up to date.
· DO NOT smoke.
· Limit how much alcohol you drink.
· Stay at a healthy weight.
· Keep your blood pressure and cholesterol under control.
· Keep your blood sugar under control if you have diabetes.
· Eat foods rich in antioxidants, like green leafy vegetables.
Алып жасушалы артериит (АЖА) – бұл егде жастағы адамдарда орташа және ірі артериялардың жүйелі қабыну ауруы, бас ауыруымен және тұмаудағыдай симптомдармен қосарланады. Сондай-ақ, ол самайлық немесе краниалдық артериит (Хортон ауруы) ретінде де белгілі.
Алып жасушалы артериит беткері самайлық артерияның ісінуін және қалыңдауын туындатуы мүмкін. Беткері самайлық артерия – бұл сыртқы ұйқы артериясының жұқа соңғы сағасы.
Ауру тек 50 жастан асқан ересектерде пайда болады, негізінен, егде жастағы адамдарды зақымдайды, көбінесе, ерлерге қарағанда әйелдер жиі шалдығады.
АЖА кезінде бассүйектің артериялары, көбінесе, самай артериялары, сондай-ақ, көздің артериялары зақымданады, демек АЖА көздің көрмеуіне апаруы мүмкін. Көруді жоғалтуды уақытылы анықтаумен және емдеумен алдын алуға болады.
Аурудың бастапқы кезінде диагнозды қою қиын, себебі, бұл ауру туралы мәліметтер аз.
Бастың артерияларының беткері артериялары ұзындығы бойына біркелкі емес түрде тығыздалады, иректеліп, дөңестенеді, үстінен басқанда жалпақ түрге ауыспайды.
Егде жастағы науқастың жалпы қан талдауында:
эритроциттердің шөгу жылдамдығының күрт артуы (СОЭ > 50 мм/ч)
гипохромдық анемия.
Диагнозды нақтылау үшін өткізу қажет:
контрастылық заттекті енгізумен самай артериясының рентгенологиялық зерттеуі (самай артериясының ангиографиясы)
зақымданған самайлық және/немесе басқа артерияның биопсиясы (анықтау мақсатында организмнен тіршілік етуінде жасушаларды немесе тіндерді (биоптат) алу әдісі), әрі қарай тіннің үлгісіне микроскопиялық зерттеу жүргізіледі
офтальмоскопия – арнайы аспаптар (офтальмоскоп немесе фундус-линзалар) көмегімен көз түбін қарау, бұл торқабықты, көру нервісінің дискін, көз түбінің тамырларын бағалауға мүмкіндік береді).
Емдеуді ерте бастау қажет, себебі, ауру көруді жоғалтуға апаруы мүмкін.
Бүгінде АЖА емдеудің ең тиімді тәсілі - кортикостероидтарды (гормондарды) қолдану. Емдеу схемасын дәрігер тағайындайды. АЖА күмән болса да гормондарды тағайындау негізделген. Әдетте, емдеу басталғаннан кейін симптомдар тез жойылады.
АЖА кезінде науқастар үшін болжамы - оң. Әдетте, ауру өлім-жітімге апармайды. Аурудың барысы меңдейді, бірақ, уақытылы басталған емдеу науқастың жағдайын тұрақтандырады.
Сумен шаю да көмектеспесе, көзді жабыңыз, мұқият түрде таңғыш салып, дәрігерге көрініңіз.
Meniere's disease is an inner ear disorder that affects balance and hearing.
Causes
The inner ear contains fluid-filled tubes called semicircular canals, or labyrinths. These canals, along with a nerve in your skull, help interpret your body's position and maintain your balance.
The exact cause of Meniere's disease is unknown. It may occur when the pressure of the fluid in part of the inner ear gets too high.
In some cases, Meniere's disease may be related to:
Attacks or episodes of Meniere's disease often start without warning. They may occur daily, or as rarely as once a year. The severity of each episode can vary.
Meniere's disease usually has four main symptoms:
Drop in hearing
Pressure in the ear
Ringing or roaring in the affected ear
Vertigo
Severe vertigo or dizziness is the symptom that causes the most problems. People who have vertigo feel as though they are spinning or moving, or that the world is spinning around them.
Severe nausea, vomiting, and sweating often occur.
Symptoms get worse with sudden movement.
Often, the person will need to lie down.
The dizziness and feeling of being off-balance will last from about 20 minutes to a few hours.
Hearing loss may occur. Usually the hearing loss is only in one ear, but it may affect both ears.
A person's hearing tends to recover between attacks but gets worse over time
Low frequency hearing is lost first
Roaring or ringing in the ear (tinnitus), as well as a sense of pressure in the ear are common
A brain and nervous system (neurological) examination may show problems with hearing, balance, or eye movement.
A hearing test or audiogram will show the hearing loss that occurs with Meniere's. Hearing may be near normal after an attack.
A procedure called caloric stimulation tests eye reflexes by warming and cooling the inner ear with water. Abnormal results on this test can be a sign of Meniere's disease.
The following tests may also be done to distinguish Meniere's disease from other causes of vertigo:
Other changes that may help with the symptoms and keep you safe include:
Avoid sudden movements, which may worsen symptoms. You may need help walking when you lose balance during attacks.
Avoid bright lights, TV, and reading during attacks, because they may make symptoms worse. Rest during severe episodes, and slowly increase your activity.
Avoid activities such as driving, operating heavy machinery, and climbing until 1 week after your symptoms disappear. A sudden dizzy spell during these activities can be dangerous.
Gradually resume your activity after episodes.
Keep still and rest when you have symptoms.
Symptoms of Meniere's disease can cause stress. Make healthy lifestyle choices to help you cope:
Eat a well-balanced, healthy diet. Don't overeat.
Exercise regularly, if possible.
Get enough sleep.
Learn and practice relaxation techniques, such as guided imagery, progressive muscle relaxation, yoga, tai chi, or meditation.
Limit caffeine and alcohol.
Your health care provider may prescribe medicines for nausea and vomiting. Symptoms such as dizziness and vertigo may respond to sedative/hypnotics and benzodiazepines.
You may need ear surgery if your symptoms are severe and do not respond to other treatments.
Cutting the vestibular nerve with a surgical procedure helps control vertigo. It does not damage hearing.
Placing an antibiotic called gentamicin directly into the middle ear can help control vertigo.
Removing part of the inner ear with a procedure called labyrinthectomy helps with vertigo, but it causes complete hearing loss.
Hearing aids may be needed for severe hearing loss.
Prognosis
The outcome varies. Meniere's disease can often be controlled with treatment.
The condition may get better on its own. However, Meniere's may be chronic or disabling.
Possible complications
Inability to walk or function due to uncontrollable vertigo
Hearing loss on the affected side
When to contact a doctor
Call for an appointment with your health care provider if symptoms of Meniere's disease, such as hearing loss, ringing in the ears, or dizziness, occur or worsen.
Prevention
There is no known prevention for Meniere's disease, but prompt treatment of ear infection and other related disorders may be helpful.
One of the most common eyelid problems is blepharitis, or inflammation of the eyelid margin. Patients typically experience itching, burning, mild foreign-body sensation, tearing and crusting around the eyes on awakening. On examination, the eyelid margins are erythematous, and thickened with crusts and debris within the lashes
Conjunctival injection or a mild mucus discharge may be present. Blepharitis occurs with chronic bacterial lid infection, meibomian gland dysfunction, seborrhea and acne rosacea that affects the eye, known as ocular rosacea.1 The diagnosis of rosacea is supported by the presence of dilated telangiectatic blood vessels on the lid margins, cheeks, nose and chin.
Treatment of blepharitis consists initially of warm compresses, eyelid scrubs and application of antibiotic ointment. Warm compresses should be applied for 15 minutes twice a day. This step loosens irritating crusts in the eyelashes and melts the oil produced by the meibomian glands, which can occlude the gland orifices. The eyelids should be scrubbed after the warm compress is removed. Baby shampoo mixed with water produces a soapy solution. With the eyelids closed, the eyelid margin region should be gently scrubbed with this solution, using a cotton-tipped applicator, wash cloth or finger. Erythromycin or another antibiotic ointment should then be applied to the lid margin. The ointment should be applied only at bedtime, because it may temporarily blur vision. If an obvious infection is present, antibiotic eye-drops may also be used.
If the condition is unresponsive to treatment, eyelid cultures should be obtained to rule out the possibility of resistant organisms. Oral antibiotics may be used in such cases, or in patients with the diagnosis of ocular rosacea. If severe, blepharitis may result in corneal infiltrates or ulcers. Rarely, sebaceous cell carcinoma may masquerade as unilateral or bilateral intractable blepharitis.
Patients must be cautioned that blepharitis is a chronic disease and that eyelid hygiene may need to be continued indefinitely. When the process is brought under better control, once-daily eyelid scrubs may be sufficient to keep the problem in check.
Пресбиопия (старческая дальнозоркость) – это естественный процесс ухудшения зрения, связанный с возрастными изменениями в организме человека.
Роговица и хрусталик глаза участвуют в процессе фокусировки зрения. Рефракция - способность глаза преломлять свет Аномальные рефракции – это проблемы со зрением, которые происходят, когда измененная форма глаза не позволяет правильно сфокусировать зрение на видимых объектах. Причиной рефракции может быть форма глазного яблока (длиннее или короче), изменения формы роговицы, или возрастные изменения эластичности хрусталика глаза и ослабление цилиарной мышцы, отвечающей за фокусировку.
По мере старения организма хрусталик глаза претерпевает изменения: он становится толще и теряет свою эластичность. Именно эластичность хрусталика обеспечивает возможность фокусировки изображения. Утрата такой возможности приводит к нарушению зрения, которая выражается в развитии старческой дальнозоркости – пресбиопии.
В зависимости от степени нарушения зрения вам могут понадобиться очки. На сегодняшний день разработан целый ряд хирургических и лазерных методов коррекции зрения. Врач посоветует операцию, если посчитает, что она поможет откорректировать ваше зрение и не вызовет осложнений.
Гигантоклеточный артериит (ГКА) - это системное воспалительное поражение средних и крупных артерий у людей пожилого возраста, сопровождающееся головной болью и симптомами как при гриппе. Также оно известно, как височный или краниальный артериит (болезнь Хортона).
Гигантоклеточный артериит может вызвать отек и утолщение поверхностной височной артерии.
Болезнь появляется только у взрослых старше 50 лет, в основном поражает пожилых людей, чаще женщин, чем мужчин.
При ГКА поражаются артерии черепа, главным образом височные артерии, а также артерии глаз, следовательно, ГКА может привести к потере зрения. Потеря зрения может быть предотвращена своевременной диагностикой и лечением.
В начале болезни поставить диагноз очень сложно, так, как об этом заболевании известно, немного.
Можно увидеть, что поверхностные артерии головы неравномерно уплотняются по всей длине, становятся извитыми, выпуклыми, болезненными и при надавливании их невозможно сделать более плоскими.
У пожилого пациента в общем анализе крови будет:
резко повышена скорость оседания эритроцитов (СОЭ > 50 мм/ч)
гипохромная анемия.
Также для уточнения диагноза нужно провести:
рентгенологическое исследование височной артерии с введением контрастного вещества (ангиография височной артерии)
биопсию пораженной височной и/ или другой пораженной артерии(метод исследования, при котором проводится прижизненный забор клеток или тканей (биоптата) из организма с диагностической целью) с последующим микроскопическим исследованием образца ткани
офтальмоскопию - это осмотр глазного дна с помощью специальных инструментов (офтальмоскопа или фундус-линзы), который позволяет оценить сетчатку, диск зрительного нерва, сосуды глазного дна).
Лечение необходимо начать как можно скорее, так как болезнь может привести к потере зрения.
На сегодня самый эффективный способ лечения ГКА– это применение кортикостероидов (гормонов). Схему лечения назначает врач. Причем назначение гормонов обосновано даже при подозрении на ГКА. Обычно после начала лечения симптомы быстро исчезают.
Прогноз при ГКА для жизни больных благоприятен. Обычно болезнь не приводит к смертельному исходу. Течение заболевания прогрессирующее, но своевременно начатое лечение может привести к стойкой стабилизации состояния пациента (ремиссии).
