Ophthalmology: A Brief Introduction

Ophthalmology is a surgical branch of medicine that focuses on the identification and treatment of conditions affecting the eyes.

A doctor who has completed specialist training in both medical and surgical eye care is called an ophthalmologist. Ophthalmology specialists must do extra postgraduate residency training in that discipline after receiving their medical degrees. An integrated one-year internship that includes more comprehensive medical training in disciplines like internal medicine or general surgery may be part of this.

Ophthalmologists use laser therapy, do surgery when necessary, and prescribe drugs to treat conditions such eye disorders. Primary and specialized medical and surgical eye care are both offered by ophthalmologists. At some time during their training, the majority of ophthalmologists take part in academic research on eye problems, and many go on to make research their profession.

Diseases Treated by Ophthalmologists 

• Cataract: A cataract is a hazy spot in the eye's lens that causes vision to deteriorate. Cataracts can harm one or both eyes and frequently progress slowly. Symptoms could include halos surrounding lights, faded colours, hazy or double vision, problems with bright lights, and issues seeing at night. As a result, you can have problems reading, driving, or identifying people.An increased risk of falling and depression may also be brought on by cataracts' impact on vision.In the world, cataracts account for 33% of visual impairment and 51% of cases of blindness.
• Excessive Tearing (Tear Duct Obstruction): Epiphora is an excess of tears on the face that is not the result of regular crying. Insufficient tear film drainage from the eyes is a clinical symptom or ailment when tears flow down the face instead of through the nasolacrimal system.
• Thyroid Eye Disease: An autoimmune inflammatory illness of the orbit and periorbital tissues known as Graves' ophthalmopathy, or thyroid eye disease (TED), is characterised by upper eyelid retraction, lid lag, swelling, redness (erythema), conjunctivitis, and bulging eyes (exophthalmos). It happens more frequently in people with Graves' disease than in those with Hashimoto's thyroiditis or in people who are euthyroid.
• Eye Tumors: Eye tumours can be benign or malignant (cancer), and they can affect any component of the eye. Metastatic cancer, which has moved from another organ to the eye, is different from primary eye cancer, which begins within the eye. Breast cancer and lung cancer are the two most frequent malignancies that move from another organ to the eye. The prostate, kidney, thyroid, skin, colon, and blood or bone marrow are additional, less typical sources of genesis.
• Diabetic Retinopathy: Diabetes mellitus causes damage to the retina, which is a condition known as diabetic retinopathy or diabetic eye disease.
• Dry Eye Syndrome: Dry eyes are a disorder known as dry eye syndrome, also called keratoconjunctivitis sicca Eye dryness, inflammation, redness, discharge, impaired vision, and quickly worn-out eyes are among the symptoms. The symptoms can be moderate and sporadic or severe and ongoing. Dry eye syndrome can cause changes in the eye, including the neurosensory system, impaired vision, instability of the tear film, increased risk of ocular surface damage such scarring of the cornea, and changes to the ocular surface.
• Glaucoma: A series of eye conditions known as glaucoma cause vision loss by harming the optic nerve or retina. The drainage angle for fluid within the eye remains open in open-angle (wide angle, chronic simple) glaucoma, which is the most prevalent form. Less common forms include closed-angle (narrow angle, acute congestive) glaucoma and normal-tension glaucoma.
• Macular Degeneration: Age-related macular degeneration (AMD or ARMD), often known as macular degeneration, is a medical disorder that can cause clouded or absent vision in the centre of the visual field. Initially, there are frequently no symptoms. On the other hand, some people over time have a gradual deterioration in their eyesight, which may damage one or both eyes.

Diagnosis 

Eye Examination 

• Visual acuity assessment: Visual acuity (VA) is a term that describes how sharply a person can distinguish between minute details, however it is more usually used to describe how clear one's eyesight is. Optical and neurological variables affect visual acuity. The sharpness of an image on the retina of the eye is influenced by optical variables. Neural factors include the retina's health and functionality, the brain's neural connections, and the interpretive centre of the brain.
• Ocular tonometry to determine intraocular pressure: To measure the intraocular pressure (IOP), or fluid pressure inside the eye, eye care practitioners use a process called tonometry. It is a crucial test in the assessment of glaucoma-risk patients.The usual ocular pressure ranges from 10 to 21 mmHg (13-28 hPa), and the majority of tonometers are calibrated to measure pressure in millimetres of mercury (mmHg).
• Extraocular motility and ocular alignment assessment: The seven extrinsic muscles of the human eye are known as the extraocular muscles or extrinsic ocular muscles. Six of the extraocular muscles, the four recti muscles, the superior and inferior oblique muscles, and the levator palpebrae superioris, govern eye movement and eyelid raising, respectively. The six muscles that control eye movement operate according to the position of the eye at the moment of muscle contraction.
• Slit lamp examination: A slit lamp is a device used in ophthalmology and optometry that consists of a powerful light source that may be focussed to shine a thin sheet of light into the eye. It is combined with a biomicroscope for utilisation. The lamp makes it easier to examine the human eye's cornea, iris, natural crystalline lens, eyelid, sclera, conjunctiva, and anterior and posterior segments. Anatomical diagnoses can be made for a range of eye disorders thanks to the stereoscopic enlarged picture of the eye structures provided by the binocular slit-lamp examination. The retina is inspected using an additional hand-held lens.

Specialized Tests 

Optical Coherence Tomography

With the use of optical coherence tomography (OCT), optical scattering media, such as biological tissue, can be seen in two and three dimensions with micrometer-resolution using low-coherence light. It is employed in industrial nondestructive testing (NDT) and medical imaging. Low-coherence interferometry, which is frequently done using near-infrared light, is the foundation of optical coherence tomography. By using light with a relatively long wavelength, the scattering medium can be penetrated. Another optical approach, confocal microscopy, often penetrates the sample less deeply but with higher resolution.

Electroretinography

The electrical responses of different retinal cell types, such as photoreceptors (rods and cones), inner retinal cells (bipolar and amacrine cells), and ganglion cells, are measured using electroretinography. To assess retinal reactions, electrodes are positioned on the corneal surface (DTL silver/nylon fibre string or ERG jet) or on the skin around the eye (sensor strips).

Electrooculography

It is a method for calculating the corneo-retinal standing potential, which is the difference in electrical potential between the front and the back of the human eye. The electrooculogram is the name of the resulting signal. The two main uses are in tracking eye movements and ophthalmological diagnostics.

Visual Field Testing

An eye exam known as a visual field test can identify abnormalities in central and peripheral vision that may be brought on by a number of illnesses, including glaucoma, stroke, pituitary disease, brain tumours, or other neurological deficiencies. By keeping the subject's gaze fixed while showing objects at various locations throughout their visual field, visual field testing can be done clinically. Simple manual tools can be utilized, such as the Amsler grid or the tangent screen test. A perimeter is what is employed when specialized equipment is used.

Ophthalmic Surgery 

Ophthalmologists who specialize in eye surgery, commonly referred to as ocular surgery, operate on the eye or its adnexa. Because the eye is a delicate organ, surgery must be performed with the utmost care. The right surgical treatment must be chosen for the patient, and essential safety measures must be taken, according to an eye surgeon.

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