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Ophthalmologist

An ophthalmologist combines the diagnostic skills of a clinician, the therapeutic skills of a physician, technical skills of a micro surgeon and psychiatric skills in understanding the patient's psychology in one. Since the eye is structured in such a way that its components are transparent, the ophthalmologist is able to observe directly and read the abnormalities in a manner which is not possible for any other parts of the human body.


Professional qualifications for an ophthalmologist


Ophthalmologists are medical doctors who have completed medical school and four years training schedule in ophthalmology after medical school. An ophthalmologist can be a medical doctor with an M.D. degree in ophthalmology or doctors of osteopathy D.O. In the US, four years of training after medical school is a must. The first year is an internship and then three years of training in ophthalmology in a residency program approved by the Accreditation Council of Graduate Medical Education. An ophthalmologist may develop expertise in a sub-specialty such as:


  • Corneal disease
  • Retina and vitreous disease
  • Glaucoma
  • Pediatric eye problems
  • Plastic surgery

Services rendered by an ophthalmologist

By convention, an ophthalmologist specializes in the medical and surgical care of the eyes. The ophthalmologist aids in prevention of eye diseases and injury to the visual system. The full spectrum of care rendered by an ophthalmologist includes:


  • Routine eye examinations
  • diagnosis
  • Medical treatment of eye disorders and diseases
  • Prescription for eye glasses
  • Surgery
  • Management of eye problems caused by systemic illnesses

Eye surgeon

An ophthalmologist often performs surgery to prevent or improve vision related conditions. A variety of lasers are used nowadays to perform out-patient procedures which previously required admission to hospital. Also tremendous improvements in microsurgical instrumentation have led to development of operations not considered possible a decade ago. An increasing number of such surgeries are being performed by local anesthesia. The surgical work of a general ophthalmologist includes:


  • Cataract extraction
  • Squint surgery
  • Glaucoma surgery
  • Retinal, oculoplastic and nasolacrimal surgery

Some common emergency of the eye that require immediate intervention by an ophthalmologist are:


  • simple foreign body on the eye
  • chemical burns
  • angle closure
  • glaucoma
  • retinal detachment

Medical ophthalmologist

A medical ophthalmologist generally does not perform surgery. The sphere of interest embraces:


  • Diabetes and Endocrinology including laser treatment for diabetic retinopathy
  • Vascular disease of the eye
  • Uveitis
  • AIDS
  • Ramifications of dermatological and rheumatological disorders
  • Pediatric ophthalmology
  • Neuro ophthalmology
  • Genetics

Myopia

Myopia or nearsightedness is a condition where a person has trouble seeing things that are far away. The eye finds it difficult to focus the light directly on the retina since the physical length of the eye is greater than the optical length. Such a person suffering myopia finds distant objects blurred and might need to squint to see them clearer. Symptoms of myopia are eyestrain and sometimes headache. This is quickly noticed in school going children who have difficultly reading the blackboard. In fact myopia worsens during the growth years and then stabilizes after the teens. Regular eye tests with refraction test help in diagnosing the degree of refraction lens needed. Spectacles or contact lens are prescribed to correct the focus of the light image on the retina thereby producing a clear image. LASIK is also performed to correct myopia. Orthokeratology involves usage of special rigid contact lenses to flatten the cornea to reduce myopia.


Diplopia

Diplopia is one of the serious disorders of the eyes, which is associated with vision impairment. In common terms it is referred to as double vision. The occurrence of diplopia is closely associated with the cranial nerves. The effects caused by this optical disorder restrict normal activities of a person such as reading, walking and driving. The causes associated with diplopia when closely examined are myogenic and neurogenic in origin leading to an optical disruption both of vision and movement of the eyes.


Clinical manifestations and classification

Diplopia can be monocular or binocular in origin. Monocular Diplopia has preexisting-associated conditions such as cataracts, luxation of the lens and keratoconus, which results in light refraction within the eye. Macular degeneration and vitreous damage also causes light refraction retention inside eye causing blurred vision.


Binocular diplopia is caused by neurogenic impairments related to Oculomotor nerve damage, which is an important nerve in facilitating the movement of eye. The muscles associated with the respective functionality are also damaged in this condition. In most cases binocular diplopia is caused because of head injuries leading to cranial damage or traumas caused to the eyes. In some cases aniseikonia (condition which results in difference in the size of images as seen by the person) is also a predominant factor leading to binocular diplopia.


Diplopia occurrence and its respective effects can be further classified as sustained and short-lived forms. Intermittent or short-lived forms are usually a postoperative sequel especially in the case of cataract surgeries. However, diplopia of both continued and short-lived forms predominantly depend upon the thyroid hormone levels and underlying medical conditions such as myasthenia gravis.

Diagnosis of diplopia is a chronological aspect consisting of various factors. A patient complaining of blurred vision has to undergo series of medical and diagnostic investigations to rule out false positive findings. Since diplopia is associated with cranial nerves predominantly the oculomotor nerve, a gaze test is administered by the optometrist to estimate the functionality of nine cardinal vision factors.


This is prior to examining the patient history thoroughly in checking for conditions such as diabetes and hyperthyroidism. Important optometric examinations such as prism test, Bilshowsky test, Stereo acuity test and visual field testing are done to evaluate the impairments existing in the muscles associated with the eye. These tests are carried out after general examinations such as tonometry, fundoscopy and slit lamp examinations.


Treatment

Corrective measures are incorporated to treat the movements of the eye, which is affected drastically in this condition. Refraction errors are analyzed and corrected in order to rectify the blurred vision. Patients are given eye exercises to facilitate proper oculomotor nerve functionalities and also to prevent squint occurrence.


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Bibliography / Reference

Collection of Pages - Last revised Date: November 12, 2019