Ophthalmology

Ophthalmology is the branch of medicine that deals with the anatomy, physiology and diseases of the eye. An ophthalmologist is a specialist in medical and surgical eye problems. Since ophthalmologists perform operations on eyes, they are considered to be both surgical and medical specialists.

Although blinding eye diseases may occur in any age, they are much more common after 40. During the 40’s also, presbyopia begins to trouble the average person. All too often considerable sight is lost from uveitis, glaucoma and other serious eye conditions while the individual attributes his lack of clear vision merely to the need of a pair of glasses. It is particularly important that ophthalmologists who examine individuals in this age group make use of the ophthalmoscope, which will often uncover not only signs of eye disease but also evidence of such conditions as hypertension, diabetes, atherosclerosis, nephritis, and the leukemias.

One of the most common eye diseases is glaucoma. Glaucoma is the cause of about 12 per cent of all blindness in the United States, and the incidence of this condition appears to be increasing.

Chronic simple glaucoma develops so gradually, so insidiously that the individual may lose the considerable amount of peripheral vision before he develops symptoms sufficient to bring him to any doctor. There may be occasional headaches or eye pain in dim light, in the evening, looking a TV, at the movies or at other times when illumination is reduced. There may be headaches or eye pain upon awakening in the morning. Rarely is eye trouble suspected at this stage. Not until later, usually, does the patient complain of halos or rainbows around light. Sometimes in the early stages the patient is not quite satisfied with his glasses and will have them changedseveral times.

The patient may also have an uncomfortable feeling in his eye, blurred vision, or tearing in times of excitement or worry, since emotional upset appear to produce the elevation of the ocular tension of glaucoma patient. This dangerously mild course may last for months or even for two or three years before the patient becomes aware of a defect in side vision or before there is loss of central vision.

If glaucoma is recognized and treated properly in early stages the patient has an excellent chance of preserving useful vision, although he will require observation and treatment for the rest of his life.

There is much that the ophthalmologist can do, particularly among the patients who are over 40, that will lead to the detection of glaucoma much earlier than is now the case. Six points which have been recommended are: 1) ask patient about the occurrence of occasional blurring or clouding of vision, seeing rainbow effects around a distantlight, one-sided headaches, discomfort in or around the eyes after excitement or worry, or under reduced illumination. Inquire if he experiences difficulty in reading despite prescribed glasses; 2) ask if there is a case of glaucoma in the family; 3) measure acuity of vision. Causes of lowered vision in one or both eyes should be investigated; 4) note size of pupils and their reaction to light. Unequal or sluggish reaction should be investigated; 5) examine each eye with ophthalmoscope to see if optic disks appear pale or cupped; 6) check ocular tension and test visual fields. Digital palpation for tension and confrontation test for fields are crude and of value only in advanced cases.

Nowadays both laser and conventional surgeries are performed to treat glaucoma.Surgery is the primary therapy for those with congenital glaucoma. Generally, these operations are a temporary solution, as there is not yet a cure for glaucoma.