When a person has a gradual deterioration in vision at night, they should be examined for the presence of hemeralopia. In the people, hemeralopia is called "night blindness"; and is characterized by the gradual development of visual impairment in twilight conditions. Timely detection of hemeralopia and its causes can significantly improve the prognosis of treatment. You can learn about the causes and mechanism of development of hemeralopia in our previous article. In this article, we will consider the first signs and symptoms of the development of hemeralopia, as well as methods of treating certain types of "night blindness".

The first signs of the development of hemeralopia. How not to miss the disease?

The first signs of the development of "night blindness" appear in early childhood. Suspicion appears with a persistent decrease in visual acuity, which is not amenable to treatment. Hemeralopia is accompanied by a decrease in visual acuity at night and twilight, in the twilight the patient feels visual discomfort. The main symptoms of the patient with the development of hemeralopia is difficult differentiation of surrounding objects. Light adaptation is impaired, visual fields are narrowed, problems with color perception appear. Orientation is lost in low light, as well as when moving from a well-lit room to a dark one. In the daytime, with good lighting, vision is not impaired.

Specific symptoms in the development of essential hemeralopia:

  • the patient constantly feels dryness in the eyes, there is a feeling of "sand"; in the eyes;
  • small children with "night blindness" afraid of the dark, acting restless and crying;
  • Hemeralopia is also characterized by a narrowing of the visual fields and a decrease in the perception of blue and yellow colors;
  • Essential hemeralopia is characterized by the appearance of xerotic plaques of Iskersky on the conjunctiva – Bito. These are dry flat spots located within the palpebral fissure;
  • in addition to eye symptoms, patients complain of dryness of the mucous membranes and skin, areas of hyperkeratosis and scratching on the skin of the body, peeling of the skin, bleeding gums;
  • Vitamin A deficiency is manifested by softening and ulceration of the cornea (keratomalacia).

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What is the diagnostic process for suspected hemeralopia?

If there is the first suspicion of hemeralopia, you should consult an ophthalmologist to eliminate its possible causes. First, visual acuity is determined. Essential hemeralopia is often not accompanied by a decrease in visual acuity. Carrying out color and achromatic perimetry makes it possible to detect concentric narrowing of the visual fields and a violation of the Purkinje phenomenon.

With hemeralopia, the ophthalmoscopic picture has its own characteristics. In all forms of hemeralopia, except for essential, there are specific changes that are characteristic only of hemeralopia. Essential hemeralopia is not accompanied by changes in the fundus. Congenital hemeralopia with ophthalmoscopy is characterized by the detection of small round foci of degeneration on the retina.

In order to study dark adaptation, adaptometry is performed. With the help of electroretinography and other electrophysiological studies, the functional state of the retina is assessed. Finding out the causes of symptomatic hemeralopia is carried out after refractometry, optical coherence tomography, tonography, biomicroscopy with a Goldman lens. It is necessary to consult an endocrinologist and a gastroenterologist.

Is it possible to treat hemeralopia? Main treatments

Acquired forms of hemeralopia are subject to treatment by eliminating the causes that lead to a violation of dark adaptation. Hemeralopia, which is associated with hereditary pathology, is incurable.

If hemeralopia is provoked by myopia, an individual selection of glasses and contact lenses is carried out, or laser correction of myopia and refractive surgery are performed. In the presence of hemeralopia against the background of cataracts or glaucoma, surgical treatment of the underlying disease is recommended. Retinal detachment is an indication for laser photocoagulation.

The treatment of essential hemeralopia is based on the normalization of nutrition. This refers to the use of natural foods enriched with carotene and retinol (milk, cod liver, cheese, egg yolk, tomatoes, carrots, spinach, butter). It is also advisable to instill vitamin eye drops, take vitamin A, nicotinic acid orally.

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