Arthur – what about this terrible word I learned – keratoconus?  

Well, you aren’t obligated to know.  Keratoconus is a fairly rare disease where the cornea becomes thinner and takes on a conical shape, manifesting itself as various symptoms, including sudden changes in vision in one eye.  A normal and healthy cornea is round like a basketball, and keeps its shape thanks to tiny protein fibers.  When these fibers weaken, they can no longer support this roundness.  As a result, the cornea begins to gradually protrude and becomes like a cone, and that’s keratoconus.

The cornea can change quickly or slowly, and those changes can stop suddenly or conversely continue for years.  In more difficult cases, stretched fibers can lead to serious damage of the cornea.  It’s also worthwhile to note that keratoconus is often inherited.  Therefore, with this kind of “family tradition”, you have to start checking a child’s vision after about 10 years old.  The disease begins in adolescence in the majority of cases, but also happens in people between 30 and 40.

An atypical shape of the cornea manifests as impaired vision.  Depending on different indicators, I will ask about the following symptoms during the examination:

This next word isn’t the most pleasant, like any other disease.  We have spoken about this problem more than once, but even my friends didn’t know anything about it – macular degeneration. 

Well, that’s something they should know!  Macular degeneration is a disease that affects over 10 million of our fellow countrymen, and it’s the main cause in loss of vision among Americans older than 55.  Macular degeneration, as the name implies, is a degeneration of the macula itself, the part of the retina that is responsible for clear central vision, which is important for driving a car or reading.  There are two kinds – wet and dry.  Most often it is dry, but the wet has more serious consequences.  Dry is an early form of it.  Causes include age-related changes and a thinning of the macular tissues, pigment disturbances, or all these things at once.  The problem becomes obvious when the macula develops a yellow discoloration. About 10% of dry cases become wet.  With wet, new blood vessels start to grow under the retina, which leads to leakage of eye moisture and blood.  As a result, retinal cells can be damaged and begin to die, causing blind spots in central vision.

Well, that’s something they should know!  Macular degeneration is a disease that affects over 10 million of our fellow countrymen, and it’s the main cause in loss of vision among Americans older than 55.  Macular degeneration, as the name implies, is a degeneration of the macula itself, the part of the retina that is responsible for clear central vision, which is important for driving a car or reading.  There are two kinds – wet and dry.  Most often it is dry, but the wet has more serious consequences. Causes include age-related changes and a thinning of the macular tissues, pigment disturbances, or all these things at once.  The problem becomes obvious when the macula develops a yellow discoloration.  Gradual deterioration in vision is inherent to dry macular degeneration, which isn’t as much as if it was wet, but dry can develop into something more serious.  About 10% of dry cases become wet.  With wet, new blood vessels start to grow under the retina, which leads to leakage of eye moisture and blood.  As a result, retinal cells can be damaged and begin to die, causing blind spots in central vision.

Is it possible to not notice it’s happening?

Usually macular degeneration leads to a painless and gradual loss of vision.  Less often there’s a sudden loss.  Here are some early symptoms:

So hallucinations aren’t necessarily schizophrenia.  Now we turn to diabetic retinopathy.  Some of these are frightening words, so why don’t we call them something beautiful instead?

Diabetes is one of the main causes of blindness, so if you have it keep in mind that it can also affect vision.  Diabetic retinopathy, as understood from the name, affects the retina, and if the problem isn’t detected on time then there’s no escaping the consequences.  Small red dots, known as microaneurysms, are small bleedings in the eye that can lead to lack of bloodflow which in turn leads to the formation of blood vessels in the wrong places and can rupture the retina.

And it’s clear that the latter can affect eyesight. 

What’s more is that the disease can progress asymptomatically and remain unnoticed for a long time.  That’s why it’s necessary to check for it during a regular exam.

Laser options (photocoagulation) can be effective, although it doesn’t treat the actual disease.  But it can soften, pause, or even bring back good eyesight.  Without laser treatment or surgery, loss of vision will worsen until blindness, so it’s nothing to joke about.  So it’s important to catch the problem on time, especially as it develops quickly.  Remember, controlling blood sugar will prevent diabetic retinopathy.

Уже не первый год ведя беседы с известным вам глазным хирургом Артуром Бенджамином, я постепенно становился жертвой иллюзии, что и сам неплохо разбираюсь в офтальмологии.  Тем более, что именно такую партийную кличку – Офтальмолог – приобрел среди отдельных знакомых. Некоторые даже приветствуют меня словами: «Как дела, как пациенты?» Да и действительно: о чем мы с Артуром только не говорили за отчетный период, и кое-что из сказанного осело даже в моей – феноменально дырявой – памяти. Но недавно в более тесном кругу мне «как профессионалу» задали несколько вопросов, и я с ужасом обнаружил, что не знаю даже приблизительного ответа. Да-да,  я оказался в положении Штирлица, который не успел выучить немецкий язык. Или, если угодно, «поплыл» на экзамене.  В конце концов, я нашелся и посоветовал им направить стопы в легендарное здание на Сансет-бульваре. Думаю, это был правильный – такой, что ли, общий – ответ.

В эпоху википедии уже и кошка в курсе, что такое 

, и чем она отличается от 

. Но меня спросили о более простых вещах! После того памятного вечера я провел опрос среди друзей и выяснилось, что всех этих «элементарных вещей» почти никто из них не знает! И понял, что тема стоит свеч, т.е. отдельной беседы. А. Б., как всегда, охотно откликнулся.

– Артур, а что это за страшное слово я узнал – кератоконус? Даже запомнить не смог с первого раза.

– Ну вы это знать и не обязаны. Кератоконус – довольно редкое заболевание, при котором роговица истончается и принимает коническую форму, проявляясь в разных симптомах, включая резкое изменение зрения в одном глазу. Нормальная, т.е. здоровая роговица – круглая, как баскетбольный мяч, и держит форму благодаря крошечным протеиновым волокнам. Когда эти волокна ослабевают, они уже не могут поддерживать эту «круглость». В результате роговица начинает постепенно выдаваться вперед и становится похожей на конус, что и есть кератоконус.

– Лечится, не лечится? Какой прогноз?

– Это состояние глаз – непредсказуемо. Роговица может изменяться быстро или медленно, изменения могут вдруг прекратиться  или, наоборот, длиться годами. В сложных случаях растянутые волокна могут привести к серьезным повреждениям роговицы. Имеет смысл знать, что кератоконус часто передается по наследству. Поэтому при такой семейной «традиции» начинать проверять зрение у детей лучше лет с десяти. В большинстве случаев болезнь начинается в подростковом возрасте, но бывает и у людей за 30-40.

– А какие симптомы должны тревожить?

– Нетипичная форма роговицы проявляется и в ухудшении зрения. В зависимости от разных показателей, я при обследовании спрашиваю о таких симптомах:

Внезапное изменение зрения, особенно в одном глазу

Не искажены ли объекты, как близкие, так и дальние

Не видит ли человек гало вокруг ярких источников света

– Следующее слово – тоже не из самых приятных, как и у любой, впрочем, болезни. Об этой проблеме мы не раз говорили, но вот мои знакомые не знали и этого: макулодистрофия

– Ну уж это они должны бы знать! Макулодистрофия – болезнь, которой страдают более 10 млн наших соотечественников.

– Наши соотечественники – американцы. Это главная причина потери зрения среди людей старше 55 лет в США. Макулодистрофия, как и следует из названия, это вырождение макулы, т.е. той части сетчатки, которая ответственна за четкое центральное зрение, столь важное в вождении автомобиля или чтении. Есть две формы – влажная и сухая. Чаще бывает сухая, но именно влажная ведет к более серьезным последствиям.

– Подробнее можно об этих формах?

– Сухая – это ранняя форма. Причины – возрастные изменения и утончение тканей макулы, появление в ней пигмента, или все сразу. Проблема становится явной, когда в макуле возникает желтое пятно. Постепенное ухудшение зрения присуще сухой макулодистрофии, оно не так велико, как при влажной, но и сухая может «допрогрессироваться» до серьезных масштабов. Тем более, что примерно в 10% случаев сухая становится влажной. При этой форме новые кровяные сосуды начинают расти под сетчаткой, что приводит к утечкам глазной влаги и крови. В итоге могут быть повреждены клетки сетчатки – они просто начинают отмирать, образуя слепые пятна в центральном зрении.

– А можно ее не заметить, пропустить?

– Обычно макулодистрофия ведет к постепенной и безболезненной потере зрения. Реже бывает внезапная потеря. Вот некоторые ранние признаки:

Темноватые зоны в центральном зрении

Кривое центральное зрение

Хочется включить более яркий свет для чтения

Галлюцинаторные геометрические формы или даже люди, но это в запущенном случае.

– Значит галлюцинации – это не обязательно шизофрения. Тогда переходим к диабетической ретинопатии. Какие-то это все пугающие слова, но не называть же их, с другой стороны, прекрасными женскими именами.

– Тем более, что диабет – одна из главных причин слепоты. И если у вас его нашли, то имейте в виду, что это может коснуться зрения. Диабетическая ретинопатия, как вы поняли из названия, поражает сетчатку, и если проблему не обнаружить вовремя, то не избежать последствий. Мелкие красные точки, известные как микроаневризма, – это небольшие кровоизлияния в глазу, которые могут вести к недостатку кровотока, что в свою очередь ведет к образованию кровяных сосудов в неправильных местах и чревато разрывами сетчатки.

– Понятно, что последнее норовит повлиять на зрение.

– Причем эта болезнь может прогрессировать бессимптомно и долгое время оставаться незамеченной. Вот почему при обычной проверке зрения мы обязательно проверяем и это.

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What is keratoconus? - Benjamin Eye Institute

ЗРЕНИЕ: ЭЛЕМЕНТАРНЫЕ ВЕЩИ (1)

We will open up about whether there is at least something beautiful behind these magic words - macular degeneration and diabetic retinopathy. What kind of unpleasant disease lies under such an interesting "keratoconus" and what is the connection with the cone? 

Снимем завесу тайны со слов, звучащих как заклинание —  макулодистрофия и диабетическая ретинопатия, узнаем что за неприятное состояние кроется под «кератоконусом» и причём какие либо конусы? 



What is keratoconus?

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⭐️ My review of LASIK after one year ⭐️I told Dr. Benjamin I would do this a while ago, but I kind of feel like it says a lot I have kept this on my checklist for a year. I feel like a year is a good amount of time to review a procedure like this and give my honest thoughts and recommendation.So, let me tell you about my journey to getting LASIK and how I ended up in the amazing care of Dr. Benjamin. After going to an optometrist for years and him advising against LASIK because of my genetically dry eyes, I finally got a second opinion from an ophthalmologist (Dr. Benjamin). I didn’t know the difference between an optometrist vs. opthalmologist, but once I learned it kind of made sense why my optometrist didn’t want me getting LASIK lol. Because he couldn’t sell me on contact lenses or glasses for the foreseeable future if I got my vision corrected :) I mean, who knows, but I am glad I got a second opinion.I figured being in Los Angeles with some of the best doctors in the world… if anyone is going to touch my big, blue eyeballs, might as well get it done while I’m here. I found this business due to the reviews and they seemed to really know what they were doing and how to talk to clients.Upon meeting Dr. Benjamin he told me that I wasn’t a candidate for LASIK with my dry eyes, but he could put me through treatments for dry eyes and reevaluate after; and that these treatments had a good success rate for most.So, I started doing two treatments every other week for about 2.5 months - IPL laser treatment and Lipiflow. Lipiflow, especially, was a weird painless experience but highly recommend anyone with dry eyes to ask about it regardless of LASIK. I could tell my eyes felt way less dry a couple days after each treatment. There are videos on YouTube that talk about this treatment… Who knew this stuff existed. I’m not gonna lie, it’s an investment to do all these treatments on top of LASIK, but my eyes rarely feel dry anymore so if you’re going to get it done - do it right.Finally, I was approved for LASIK. I ended up waiting until the end of year to make sure I saved up the funds to do it and had some time to heal. I also took advantage of an end of year deal they were offering. $1000 off was a pretty nice forcing function to get me to finally do it after prepping my eyes with the treatments. The procedure itself I couldn’t feel anything even though I was awake the entire time (medicated). Even the scary part when bubbles form on your eyes Dr. Benjamin let me know about in advance so when it happened I just went with the flow. I think the worst part was the recovery the few days after and coming home drugged up lol. I remember day 1 thinking omg what did I do to my eyes. My eyes just hurt and felt weird, but omg I could see 20/15 immediately. And then, day by day it gradually got better. It took a few weeks for my eyes to heal, but after 1 month you couldn’t even tell I had surgery. One eye was a bit more bloodshot than the other.I can see 20/15. It’s been life changing for the past year not having to worry about contacts or glasses. I just got married and was able to walk down the aisle with clear vision. I only wish I had the means to have done this earlier in life. If you’re considering it - do it! And definitely consider Dr. Benjamin to do it right.Lastly, to continue treating my dry eyes, Dr. Benjamin gave me an extra LipiFlow treatment, and also recommended I try punctal plugs (painless plugs inserted into your lids that help your tears last longer). He placed the plugs in my eyes under 5 mins. Wild.I heard from people during the LASIK process they have been nervous to get the procedure so I wrote this to help and because I think highly of this business for changing my life. And, some of the dry eye treatments I would’ve never known about had it not been for them. Again, I wish I would have had been able to do this years ago. It is so, so worth it!Thank you, Dr. Benjamin (and staff!)

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