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Choroby i dolegliwości Porady Specjalistyczne

Badania wzroku – dowiedz się, dlaczego tak ważne jest, by wykonywać je regularnie

eye-211610_1280Wszyscy wiedzą, że kiedy pogarsza się nam wzrok, trzeba odwiedzić lekarza okulistę. Jeśli przyczyną naszych dolegliwości jest wada wzroku: krótkowzroczność, nadwzroczność, czy astygmatyzm, zazwyczaj wystarcza prosta korekcja odpowiednio dobranymi okularami, czy soczewkami. Istnieje jednak szereg chorób oczu, dla których pogorszenie widzenia jest objawem późnym, obserwowanym wtedy, kiedy uszkodzenie wzroku jest już nieodwracalne. Taka sytuacja ma miejsce najczęściej w dwóch przypadkach: zmian związanych z cukrzycą i jaskry.

Uszkodzenie wzroku przez cukrzycę

O konieczności regularnych badań wzroku osób chorych na cukrzycę od lat alarmują diabetolodzy. Dlaczego jest to tak ważne? Ponieważ chory zwykle nie doświadcza żadnych objawów, mimo że choroba konsekwentnie uszkadza siatkówkę. Najczęściej dochodzi w przebiegu cukrzycy do tzw. retinopatii cukrzycowej oraz obrzęku plamki żółtej (makulopatia cukrzycowa). Konsekwencją tego powikłania cukrzycy jest nieodwracalne pogorszenie, a nawet utrata widzenia. Inne choroby oczu które mogą być związane z cukrzycą to np. zaćma, czy jaskra. Regularne badanie wzroku nie służy tylko wykryciu choroby, ale przede wszystkim stwarza możliwości zastosowania konkretnej terapii, na przykład zabiegu laserowego, który obok dobrej kontroli stężenia glukozy we krwi, będzie silnym czynnikiem zapobiegającym dalszemu rozwojowi choroby oczu. Ideą takiego wczesnego wykrywania powikłań cukrzycy jest bowiem odpowiednia interwencja lecznicza, zanim pojawią się nieodwracalne objawy.

Jaskra – milczący zabójca wzroku

Drugą, obok cukrzycy, chorobą, która w sposób podstępny, nie dając żadnych objawów, może uszkodzić nieodwracalnie wzrok, jest jaskra. Objawy tej choroby są niezauważalne i zazwyczaj się jej nie spodziewamy. Nie istnieją bowiem żadne badania z krwi, które tak jak w przypadku cukrzycy, mogłyby nas zaalarmować i skłonić do wykonania badania okulistycznego. Jaskra to choroba, której istotą jest charakterystyczne, widoczne w badaniu okulistycznym, uszkodzenie nerwu wzrokowego. Jej przebieg może być bardzo różny: czasem trwa latami, sukcesywnie uszkadzając wzrok w sposób niezauważalny dla pacjenta, innym razem może objawić się ostrym atakiem jaskry, objawy którego są tak gwałtowne i silne, że niemożliwe jest ich przeoczenie. Warto jednak nie dopuścić do ostrego ataku jaskry, gdyż jest to tzw. stan nagły w okulistyce, wymagający pilnej interwencji, który w bardzo krótkim czasie, w ciągu kilku godzin, może doprowadzić do całkowitej utraty wzroku.

Objawy jaskry

Jak już wspomniano, większość przypadków jaskry jest bezobjawowa. Czasami jednak zdarza się, że występują pewne symptomy, niezbyt nasilone i niecharakterystyczne, które mogą nasunąć nam podejrzenie jaskry i skłonić do odwiedzenia okulisty. Są to: pobolewanie głowy i gałek ocznych, ubytki w polu widzenia, przede wszystkim te obwodowe, dla pacjenta przejawiające się potykaniem o progi, czy schody, bądź przypadkowym strąceniem różnych przedmiotów. Współcześnie do możliwych objawów jaskry zalicza się także wzrost ciśnienia wewnątrz gałki ocznej. Kiedyś ten objaw był uważany za konieczny dla rozpoznania jaskry, dziś jednak wiadomo, że znaczna część przypadków tego schorzenia przebiega z prawidłowymi wartościami ciśnienia wewnątrzgałkowego. Wreszcie jaskra, występująca pod postacią ostrego ataku jaskry, objawia się silnym bólem głowy, gałki ocznej, zaczerwienieniem oka, nudnościami, wymiotami i znacznym pogorszeniem widzenia, często z postrzeganiem dodatkowo tęczowej otoczki wokół źródeł światła. Ostry atak jaskry powinien nas skłonić do natychmiastowego zgłoszenia się do okulisty.

Regularne badanie okulistyczne kluczem do pokonania jaskry

Wobec braku typowych objawów jaskry, kluczowe w wykrywaniu tej choroby są badania profilaktyczne, obejmujące: badanie dna oka, badanie pola widzenia i ocenę ciśnienia wewnątrz gałki ocznej. Tylko taki zestaw badań pozwala na wczesne wykrycie jaskry i podjęcie odpowiedniego leczenia. Trzeba bowiem wiedzieć, że nieleczona jaskra nieuchronnie prowadzi do całkowitej ślepoty. Wytyczne postępowania w jaskrze określają, że każdy kto ukończył 40r.ż. powinien raz na dwa lata wykonać badanie profilaktyczne w kierunku tej choroby, a ci, u których występują dodatkowe czynniki ryzyka jaskry, powinni takie badanie przechodzić raz do roku. Te czynniki ryzyka obejmują: dodatni wywiad rodzinny, czyli występowanie jaskry u rodziców lub rodzeństwa, krótkowzroczność, nadwzroczność, nadciśnienie tętnicze, ale też tendencję do niskiego ciśnienia tętniczego, cukrzycę i zażywanie glikokortykosteroidów.

Warto szczerze odpowiedzieć sobie na pytanie, jak u nas wygląda realizacja zaleceń specjalistów w sprawie badań przesiewowych w kierunku jaskry. A przecież chodzi o dobrą kondycję naszego wzroku – tak cennego zmysłu w naszym życiu. Dobrze więc już dziś podjąć decyzję o wykonywaniu regularnych badań, nawet jeśli nie odczuwamy żadnych dolegliwości.

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