Ocular Conditions and Diseases

Ocular Conditions

Myopia is a condition of the eye where light focuses in front, instead of on the retina. This causes distant object to be blurry while close objects appear normal to people with myopia.

Symptoms : blurred distance vision, headaches.

What research is needed this to be found: visual acuity test, refractive index measurement (describes how light propagates through the eye).

Treatment: nearsightedness can be corrected with glasses, contact lenses (negative), refractive surgery or LASIK– a procedure improving the visual acuity.

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Hypermetropia is the opposite of myopia. It is a condition of the eye where light focuses behind, instead of on, the retina. It occurs when the eyeball is shorter than normal. Hypermetropia can be a congenital condition or be brought on by other factors, most commonly ageing.

Symptoms: Hypermetropia causes close objects to be blurry while far objects may appear normal. It is possible that people with hypermetropia see blurry both close and distant objects.

What tests can detect it: visual acuity test, refractive index measurement (describes how light propagates through the eye).

Treatment: Hypermetropia and myopia can be corrected with glasses, contact lenses (positive), refractive surgery or LASIK procedures.

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It can be defined both as myopia and hypermetropia. This condition occurs when the cornea is irregular in shape, in consequence of which it refracts light and sharper at one point than at another. The focusing is on two points of the retina, rather than one. The result is distorted and blurred image.

 Symptoms: blurred objects, headache, fatigue.

What tests can detect it: visual acuity test, refractive index measurement (describes how light propagates through the eye).

Treatment: with glasses, contact lenses (positive), refractive surgery or LASIK procedures.

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The word is from the Greek word for ‘old man’ and is a condition associated with aging in which the eye exhibits a progressively diminished ability to focus on near objects. Presbyopia is a natural process associated with aging and affects almost everyone over 45 years, since after this age intraocular lens gradually loses its elasticity.

Symptoms: more difficult to focus on nearby objects, eye strain, headaches.

What tests can detect it: visual acuity test, refractive index measurement.

Treatment: can be corrected with glasses or contact lenses. Surgery is suitable for those who do not want to wear glasses or lenses.

How serious is the diagnosis: о left without interference, presbyopia can worsen considerably your vision and hamper your activities at work, at home, while driving and so on.

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Dry eye syndrome is one of the most common ailments suffered by people today. It affects over 20% of the population and is perceived as a disease of civilisation. It is characterised by reduced tear production or rapid tear evaporation from the eye surface. Dry eye is a condition where the tears are unable to maintain and clear cornea and conjunctiva, and thus they remain unprotected.

Paradoxical as it may seem, the dry eye syndrome е may occur in the form of excessive tear secretion, but with changed, and inadequate composition.

 Symptoms: fatigue, itching, redness, burning, foreign body sensation, dryness, sensitivity to light, rapid blinking, watery tears.

What tests can detect it: during a routine eye examination and specific qualitative and quantitative tests of the tear film.

Treatment: measures are calming the eye and control of symptoms. Lubricant eye drops known as artificial tears are usually the first step in dry eye treatment. In more serious cases special occlusion plugs can be used to allow retention of tears in the eye.

Highly moisturising eye cream or ointment can be used at night. More frequent blinking in front of the computer or TV helps for a better wetting of the eye.

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Periodic eye and vision examinations are an important part of preventive health care for good eyesight. Statistics show that over 80% of the diseases discovered in early childhood are treatable. Some serious eye problems have clearly pronounced symptoms, therefore children requirе preventive examinations at the age of 6 months, 1 year, 3 years, 6 years and then once every school year.

The most common problems and eye diseases in children:

  • Refractive errors – myopia, hypermetropia, astigmatism. These are related to the improper refraction of rays of the cornea or lens of the eye. Can be corrected with glasses or lenses;
  • Strabismus (squint) – deviation of one eyeball. Can be corrected with glasses or surgery, achieving a balance between stronger and weaker eye muscles. If no measures are taken, the child can develop amblyopia;
  • Amblyopia, also called lazy eye – the brain recognises the image from the stronger eye and suppress that of the weaker. After pupil dilation, dioptres are prescribed. Special exercises are needed to train the weaker eye (lazy) by closing the healthy one.

Factors adversely affecting children’s vision:

  • genetic predisposition;
  • prematurity,
  • prolonged eye strain;
  • insufficient lighting for reading and writing;
  • excessive screen time (every half hour at the computer you need a break for about 20 minutes);
  • prolonged glare.

Higher is the risk for prematurely born children and children with family health history. In that case examination by an ophthalmologist is required in the first month of birth in order to prevent the occurrence of retinopathy of premature babies. The frequency of prophylactic examinations is determined by the specialist.

For beautiful and healthy children’s eyes our experts recommend the consumption of products rich in vitamin A, B and C (carrots, tomatoes, dairy products, parsley, mushrooms, citrus fruits, etc.), walking outdoors; wearing sunglasses and regular preventive examinations are required.

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Eye Diseases

Cataract is the main cause of deterioration of vision in adults over 55 years of age. A cataract is a clouding of the lens in the eye. This lens is located behind the iris and acts like a camera – it focuses the light images on the retina, which sends signals to the brain.

Human lens can be blurred to such an extent as to prevent light and images to reach the retina.

Cataract can be the reason for the images to look blurry, bright colours to seem shabby or night vision to become extremely difficult. If bifocal lenses or glasses no longer help, it is possible cataract to be the reason for this inconvenience. Patients compare this condition to staring through a curtain, because the images are blurry and unclear. Hence the commonly known name of the disease – a geriatric or internal curtain.

Cataract cannot be prevented, since the most common reason for its occurrence is quite natural – the process of aging.

 Symptoms: one can be blinded by normal light, have reduced vision, difficulty reading, colour fading and others.

What tests can detect it: a routine eye examination.

Treatment: The only effective way of treating is through surgical intervention where the clouded lens is replaced with a new one. More about the surgical treatment of cataracts learn HERE

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Glaucoma is among the main reasons for vision loss. According to statistics people suffering from glaucoma are more than 67 million in the whole world and more than 70 000 in our country. Glaucoma is a disease that left without treatment leads to vision loss. It is caused by cell death of nerve cells and damage to the optic nerve. In the majority of cases the disease is associated with elevated intraocular pressure, although it is not always equivalent to glaucoma. Normal intraocular pressure is from 10 to 20 mmHg (millimetres of mercury). When it exceeds 20 mmHg, a person is threatened by glaucoma. The strong pressure of the fluid impairs the nerve cells of the retina. However, this process is usually painless and the patient does not feel it. Thus, a large part of the optic nerve can be damaged without any symptoms. Damages that occur are irreversible. Family history is of a great importance.

 Symptoms:

  • blurred vision;
  • occurrence of coloured circles that look like those of the rainbow, especially when you look at a glowing lamp;
  • discomfort in the eye, feeling of heaviness and tension;
  • minor pain around the eyes;
  • loss of peripheral vision;

What tests can detect it: annual eye exams are vital to detect glaucoma in time. The following tests are necessary to be carried out:

  • test of visual acuity;
  • tonometry – measurement of eye pressure;
  • computer perimetry – measures the peripheral vision, which is limited in glaucoma;
  • funduscopic examination – to examine the retina and optic nerve;
  • optical coherence tomography (OCT) – detect the earliest changes in glaucoma.

Burgas Specialised Eye Hospital owns an optical coherence tomograph, the only one of its kind for the Southeast Bulgaria, which examines the fundus more precisely than any other device. It is helpful in diagnosing glaucoma, macular degeneration, retinal disease, etc.

Treatment: the treatment methods are eye drops, laser and traditional surgery. Efforts are directed towards normalisation and stabilisation of eye pressure. Of particular importance for the early diagnosis is prevention. More about the treatment of glaucoma learn HERE.

Make a test Am I familiar with glaucoma disease ?’.

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Diabetes is first among the diseases leading to loss of vision of the two eyes at a young age. Eye disorder is expected to occur in about 10 years after diagnosing the insulin-dependent diabetes, but many factors such as poor blood sugar control, arterial hypertonia, smoking, pregnancy, etc. can accelerate this process.

The increased amount of blood sugar, due to lack of insulin in the blood damages the small vessels (capillaries in the retina). On the one hand, they increase their permeability, which leads to haemorrhages and edema, and on the other retina nutrition is deteriorated. Tissue ischemia is developed, stimulating the formation of new dysfunctional vessels with thin walls, that can easily tear and bleed. These changes are generally called diabetic retinopathy.

The disease affects both eyes, though in unequal degrees. In a more advanced stage diabetic retinopathy causes sharp reduction of vision to complete loss of vision.

 Symptoms: the disease has no early symptoms. When vision is reduced it is already too late and possibilities for the ophthalmologist are limited. That is why all people with diabetes and with no retinopathy should visit the eye doctor at least once a year. Those with proven diabetic retinopathy, depending on the form and stage, this period is much shorter: 6, 3 or 1 month. Often doctors can tell by the eyes if the patient has diabetes – he may have had it for years, but without knowing that.

What tests are needed to detect the disease:

  • visual acuity test;
  • tonometry – eye pressure measurement;
  • dilated-pupil fundus examination;
  • fluorescein angiography, so-called colour fundus photography;
  • optical coherence tomography (OCT).

Treatment: the only proven treatment for diabetic retinopathy is the laser photocoagulation, destroying part of the retina affected by diabetes in order to maintain vision and delay disease progression. If laser photocoagulation is carried out in time, loss of vision can be reduced considerably and vision can be stabilised. Otherwise it will lead to massive haemorrhages, and the only treatment is the so called vitrectomy (link to vitreoretinal surgery). It is best if laser photocoagulation is performed after the fundus photography.

Burgas Specialised Eye Hospital own an eye scanner, which is the only one of its kind in the Southeast Bulgaria. The super modern device enables our ophthalmologists to identify even the smallest deviations and determine exactly the patient’s condition. The operating room is equipped with a composite and compound device for surgeries of the anterior and posterior eye segment, which is the only one of its kind in the Burgas region. Patients with diabetic retinopathy, to undergo surgery with us, are consulted by one of the most famous ophthalmologists in Bulgaria – Assoc. Prof. Dr. Borislav Dabov.

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Age-related macular degeneration (AMD) is a disease that affects the central part of the retina, called macula, which is a key area of vision. The disease causes loss of central vision only, and not peripheral. So the affected people can see an object or person, but cannot distinguish their features. Therefore, they are unable to perform normal daily activities such as reading, writing, sewing or driving.

The first symptoms of the disease can go unnoticed, but with its development affected people begin to see dark areas or their vision becomes blurred or distorted. It is vital to consult an ophthalmologist and inform him of these signs, so the progression of the condition could be avoided for as long as possible.

There are many risk factors that negatively affect the protective mechanisms of the eye and cause AMD – aging (primary factor), familial genetic predisposition, poor diet, obesity, direct exposure to sunlight, smoking, high blood pressure, bright irises.

Symptoms: distorted images, a dark spot in the centre of the visual field, reduced vision mostly when looking at objects close up.

What tests are needed to determine the disease:

  • routine examination,
  • fluorescein angiography, the so-called colour fundus photography;
  • optical coherence tomography (OCT)
  • Amsler grid test .

Treatment: Treatment is difficult and often unsuccessful. A healthy, varied diet is important. Ophthalmologists recommend vitamins and minerals (especially zinc, lutein and zeaxanthin) that prevent and strengthen the macula.

In an advanced stage Anti-VEGF therapy (injections into the eye) is applied, in order to limit the process.

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Retina is the most delicate inner coat of the eye. Cells which build this light-sensitive layer of tissue capture the light and sends light impulses to the brain. In this way a person perceives the images of the world around him.

As we age, the gel-like substance, which fills the vitreous humor becomes thinner and separates from the retina. Typically, the process does not involve any problems, but when the vitreous detachment is hard enough that can separate the retina from the underlying tissue in one or more locations.

Retinal holes are treated with laser coagulation to seal retina layers around the hole and prevent retinal detachment .

In the case of retinal detachment patients undergo surgery to return of the retina in its normal position. Various surgical techniques depending on the type and location of the detachment are used.

The improvement of vision can take several months or in some cases vision may never be restored completely. Unfortunately, some patients’ vision does not improve at all, despite of successful surgery to return the retina to its anatomical place.

What are the alarm symptoms of retinal detachment

  • Lightnings
    • Emerging eye floaters in front of the eye
    • A gray curtain moving across the field of vision
    Conditions increasing the risk of retinal detachment
  • Myopia
    • Patient has undergone cataract extraction
    • Glaucoma
    • Severe eye injury

• Previous detachment of the retina of the other eye
• Family history
• Presence of risk areas in the retina

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