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According to doctors, elderly patients often complaining of poor vision "debit" everything related to aging and do not think that the doctor can solve their problem in an hour
. Ophthalmologist, Professor Alvydas Paunkysnis at the Kaunas Republican Hospital
– Eye drops (cataracts) are a common illness. Why do people often hear this diagnosis?
– With age, the lens of the eye becomes less flexible, it decreases the soluble protein and increases the insolubility that makes the lens shine. This is the most common cause of cataracts. Cataracts are also affected by smoking, high levels of alcohol and the use of certain hormones (corticosteroids). This disease is more common in hypertensive diabetic patients
Unfortunately, there are no studies to prevent cataracts or slow down their progression. There is also no evidence that antioxidants, in the form of tablets, can protect against cataracts. However, a healthy diet rich in vitamins and minerals can reduce the risk of developing cataracts. While cataract is considered a disease of the elderly, but sometimes it is diagnosed in thirty-year-olds, they are often diagnosed with a cataract, for which the disease may be conbad or results from eye trauma, chronic diseases. Unfortunately, if the patient does not dare to operate the lens, he may become obstructed.
Therefore, if you get worse suddenly, you often have to change glbades, feel eye pain, blink, double in one eye, increase sensitivity to light. perhaps the first symptoms of a cataract that needs to be treated immediately!
– You mentioned that you will not cure cataracts without surgical treatment. But the word "surgery" probably does not scare any of your patients …
– Three ophthalmologists operating at the Kaunas Republican Hospital perform more than 60 operations each month of lens surgery. During this operation, a small cut of 2-3 millimeters is made, which does not even need to be sewn. An experienced doctor performs this surgery in 8 to 10 minutes (not counting the time spent preparing for the surgery).
Lens replacement surgery is usually performed daily under surgical conditions when the patient spends 24 or 48 hours in the hospital. Cataract operations are very effective because patients are very likely to experience a result, and if there is no serious concomitant illness, they recover 100 percent of their vision. In addition, the lens is replaced for life, it does not need to be changed every few years. Of course, there are different situations in life. For example, if the patient experiences eye trauma, the lens may move out of place. Occasionally, after removal of the cataract, the posterior capsule of the lens is damaged – this problem can be easily resolved by a pain-free procedure when the capsule is cleaned by laser
– Often elderly patients have no surgery. What advice would you give to those who think?
– I can give examples of examples. Recently, one of my acquaintances, who has been in the 91-uosious year, has developed a cataract – the vision has improved. When my lens changed lens, my vision also improved and she was 92 years old. The problem with the media was the Queen of England, that the cataract was removed last year. After this operation, the monarch was healed just one day and did not cancel any visit or official meeting … I think that it is not necessary to erase everything for old age, but rather to be more determined to solve problems that concern you, regardless of age.
– How often do you need to check your eyes? Is it true that by looking at the eyes you can discover diseases that you do not know?
– I advise you to check the eyes of someone who has no eyes to inspect every few years. For some patient groups, eye exams are required once a year. Older people should also be more insightful about the health of their eyes.
Once a year, an ophthalmologist should consult with people with cardiovascular disease, diabetes, or high blood pressure. Patients in this group should consult an ophthalmologist every year, as there can sometimes be degenerative lesions during a year or even in the lower half
. concomitant illness. The patient may also be advised to consult an endocrinologist because he has a history of diabetes mellitus in his eyes
– What kind of diagnostic tests are performed at a family doctor or ophthalmologist?
– The patient admitted to an ophthalmologist is controlled by a rega (when the patient looks at the letter and the chart of the different symbols and says what he sees), the measured intraocular pressure (the patient is examined for a glaucoma – increased pressure of the eye) The bottom of the image is an badessment of vascular and neoplastic conditions
In my opinion, a primary care practitioner with a family doctor or family doctor should do initial eye exams (eye exam, eye pressure measurement). Unfortunately, today, only in a rare polyclinic, a family doctor performs a complete diagnosis of the eye, although often in his office I see the necessary equipment, already obsolete and polluted. Of course, family physicians who only have 20 minutes to care for the patient and who have a variety of records can be understood, and such a visit simply lacks time.
Nevertheless, I think we should encourage active family physicians to participate in the screening of eye diseases. With the help of advanced tools and technologies, family physicians could, along with ophthalmologists, provide high quality patient care services.
For example, a family doctor will take a picture of the bottom of the eye with the equipment available and if he sees that something is wrong, he will send this photo to the ophthalmologists, who badess the situation and decide if treatment is needed. In this way, family physicians, together with ophthalmologists, not only have more tools in their work, but they also provide the patient with the necessary help more quickly. I hope that the institutions responsible for health policy will make the necessary decisions in the future to make the necessary changes.
Now, we often meet a patient who has not been examined in detail and who immediately receives a consultation from a doctor where he performs all three researches and evaluations of the results of the research determine what is wrong. need to do: is it only necessary to monitor the need for larger diagnoses, or perhaps the person is completely healthy?
© Private Label Photo Before starting the conversation, you mentioned that you are often dealing with "abandoned" eyes. Why does this happen? Why do not people seek help on time?
– After initial studies and observation of the problem, the patient needs a broader diagnosis. But here we face the problem: patients have to spend more time for a more detailed consultation, often additional tests are done in different rooms, on different days. It is a little easier to adapt to a person living in a city that has more opportunities to come to the consulting polyclinic.
But if a person comes from a province where a bus drives twice a day in the city, the morning and evening becomes problematic. So, often when we visit people in rural areas, we detect a very neglected cataract or other advanced eye diseases. No doubt, people in the city sometimes forget to take care of them.
After evaluating all these aspects, we have developed an ophthalmology office in the Polyclinic of Kaunas Republican Hospital Consultation, which has a wide range of diagnostic equipment . A patient who has come to the hospital for an ophthalmologist consultation does not need to go from the office to the office. Not only primary research but also most more detailed research is done on the first visit to the doctor, but some studies may require additional visits.
For example, during the initial visit, if necessary, we perform an ultrasound of the eye when we examine and evaluate not only the eye but also the tissues located behind the eye. Early diagnosis of glaucoma involves computer perimetry. We also perform a coherent optical tomography, when we highly evaluate the state of the retina, the macula and the optic nerve and even capture the slightest damage
At the first visit to the doctor to help of an ultrasonic measurement system, which has a cataract, decides to remove it.
In complementary studies, we provide the patient with comprehensive badistance. Yes, for a more detailed search, a person must spend an extra half-hour to several hours, but she no longer has to go to a treatment center multiple times until she that a definitive diagnosis is made.
It is very important for the person to be aware and take active care of their health. Although speaking globally, Lithuanians are reluctant to consult a doctor in a timely manner. It is even remarkable that, for example, Lithuanians born in America, who may not even have seen Lithuania, are treated in exactly the same way as Lithuanians living here in Lithuania – without consulting a foreigner. doctor. Apparently, we have such a national trait.
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