fiziologicheskaya optika

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___________________________________________________________________ tema 1: fiziologicheskaya optika. refraktsiya i akkomodatsiya. podbor ochkov. fokusnaya tochka – mesto sxojdeniya parallelnix luchey. fokusnoe rasstoyanie – rasstoyanie ot linzi do fokusnoy tochki. 1-dioptriya – prelomlyayushaya sila linzi, fokusnoe rasstoyanie kotoroy = 1 metru. chem dlinnee fokusnoe rasstoyanie, tem menshe prelomlyayushaya sila linzi i naoborot. naprimer: esli fokusnoe rasstoyanie = 2 m, to prelomlyayushaya sila = 0,5d. esli fokusnoe rasstoyanie = 0,5 m, to prelomlyayushaya sila = 0,2d. stepen anomalii refraktsii takje opredelyaetsya dioptriey. kak vsyakie linzi, glaz imeet opticheskuyu sistemu (sleza, rogovichnaya obolochka, jidkost peredney i zadney kameri, xrustalik, chastichno steklovidnoe telo) i razmer (diametr) glaznogo yabloka (20-24 mm). eti dva faktora igrayut vajnuyu rol v refraktsii. refraktsiya ot latinskogo slova – repringere – prelomlenie. eto fizicheskoe opredelenie sila prelomleniya opticheskix linz glaza. po professoru p.f. arxangelskomu klinicheskaya refraktsiya – eto anatomo-fiziologicheskaya ustanovka glaza, kotoraya prednaznachena dlya prelomleniya parallelno idushix svetovix luchey s tselyu polucheniyaya izobrajeniya …

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vetochuvstvitelnosti setchatki visus mojet snijatsya do 0,8-0,7. hipermetropia (hm) – dalnozorkost – prelomlyayushaya sila opticheskoy sistemi nesorazmerno mala i ne sootvetstvuet dline osi glaza, fokus parallelnix luchey okazivaetsya pozadi setchatki. pochti vse rojdayutsya gipermetropami, so vremenem (s razvitiem glaza) stanovyatsya emmetropami i daje miopami. razlichayut gipermetropiyu: 1) skrituyu = + 1,5 – ta chast kotoraya skrita za schet napryajeniya akkomodatsii. 2) yavnaya 3) totalnaya po stepeni: gipermetropiya slaboy stepeni do +2,0 d. gipermetropiya sredney stepeni +2,0 - +5,0 d. gipermetropiya visokoy stepeni vishe +5,0 d. pri gipermetropii slaboy stepeni so storoni glaza vneshnie priznaki ne proyavlyayutsya, osobix jalob bolnie ne pred'yavlyayut. vsledstvie napryajeniya akkomodatsii, izmeneniya vipuklosti i prelomlyayushey sili xrustalika glaza mojet perexodit v emmetropiyu. poetomu ostrota zreniya u molodix = 1,0, to est oni vidyat xorosho vdal i vblizi, v svyazi s etim v korrektsii ne nujdayutsya. pri gipermetropii sredney stepeni mojet bit melkovataya perednyaya kamera, sujenie zrachka (napryajenie …

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ii (ot utomleniya akkomodatsionnoy mishtsi tsilliarnogo tela) voznikaet akkomodativnaya astenopiya. ona proyavlyaetsya golovnimi bolyami, bolyami i chuvstvom davleniya v glazax, bukvi nachinayut slivatsya. bolnie na vremya vinujdeni zakrivat glaza i boli so vremenem proxodyat. astenopiya lechitsya naznacheniem sootvetstvuyushix ochkov. 2. vsledstvie postoyannogo napryajeniya akkomodatsii narushaetsya binokulyarnoe zrenie i mojet razvitsya sodrujestvennoe sxodyashee kosoglazie. binokulyarnoe zrenie – sposobnost ob'edinit zritelnoe izobrajenie kajdogo iz glaz v odin zritelniy obraz. 3. pri otsutstvii korrektsii, postoyannoe napryajenie akkomodatstsii vizivaet zastoy v glazu, privodit k uxudsheniyu pitaniya glaza, umensheniyu soprotivlyaemosti chto privodit k chastomu vozniknoveniyu yachmeni, kon'yunktivitov, blefaritov. glaznoe dno u gipermetropov. daje i pri sredney stepeni gipermetropii inogda nablyudaetsya psevdonevrit, kogda disk zritelnogo nerva gipermirovan, uvelichen v razmere, granitsi stushovani, arterii i veni rasshireni, izvitie. psevdonevrit otlichaetsya ot istinnogo nevrita: 1) otsutstviem progressivnogo padeniya ostroti zreniya. 2) pole zreniya ne menyaetsya, s korrektsiey visus uluchshaetsya, kartina glaznogo dna v dalneyshem ne uxudshaetsya. miopiya (m) …

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ya perednyaya kamera, shirokiy zrachok. slabie stepeni miopii otnosyatsya k statsionarnoy miopii. srednyaya, osobenno visokaya stepeni blizorukosti progressiruyut. progressiruyushaya miopiya (shkolnaya, professionalna, zlokachestvennaya) schitaetsya vtorichnoy, voznikayushey v rezultate patologicheskogo izmeneniya formi i dlini osi glaza. miopi korregiruyutsya dvoyakovognutimi ochkami, odnako ne vsegda polnostyu vosstanavlivaetsya ostrota zreniya. osobenno pri miopii vishe 6,0-10,0 d ostrota zreniya s korrektsiey do 1,0 bivaet ochen redko. prichini razvitiya blizorukosti. miopiya vstrechaetsya u 15 - 20% lyudey, v osnovnom voznikaet v shkolnie godi. razvitie miopii v shkolnom vozraste svyazano s tem, chto etot period yavlyaetsya periodom rosta voobshe. 1) erisman i amyuk schitayut, chto neblagopriyatnie gigienicheskie usloviya vneshney sredi – ploxoe osveshenie v klassax, parti ne sootvetstvuyut rostu i vozrastu uchashixsya, melkie shrifti, yarkiy blesk doski i t.d., yavlyayutsya vajnim faktorom v proisxojdenii miopii. v takix usloviyax deti vinujdeni zanimatsya na blizkom rasstoyanii, chto privodit k napryajeniyu akkomodatsii i konvergentsii. narujnaya pryamaya i nijnyaya kosaya mishtsi …

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i zakritii odnogo glaza – pri viklyuchenii konvergentsii). 2. u miopov, osobenno pri mishechnoy astenopii, chasto narushaetsya binokulyarnoe zrenie, oslabevaet konvergentsiya i odin iz glaz mojet otklonitsya v storonu – voznikaet rasxodyasheesya kosoglazie. 3. miopicheskiy konus – v vide dugoobraznogo serpa belogo, jeltovato-belogo tsveta, v visochnoy polovine diska zritelnogo nerva (s pigmentnimi tochkami na granitse s glaznim dnom). voznikaet v rezultate rastyajeniya skleri i atrofii sloya pigmentnogo epiteliya setchatki. 4. stafiloma skleri – istinnoe vipyachivanie skleri, pri visokoy stepeni miopii – oftalmologicheski vokrug diska zritelnogo nerva ona otdelyaetsya dugoobraznoyy liniey, s peregibom retinnix sosudov, na etom meste sosudistaya obolochka atrofiruetsya, obnajaetsya sklera. ostrota zreniya pri etom ne stradaet, uvelichiv, slepoe pyatno, esli ono doxodit do jeltogo pyatna visus padaet. 5. miopicheskaya degeneratsiya setchatki – voznikaet vsledstvie rastyajeniya obolochek glaza, treshini sosudistoy obolochki. oftalmoskopiya: belovatie, jeltovatie ochajki, gemaragicheskie ochagi v oblasti jeltogo pyatna, v posledstvii atroficheskie belie ochajki. 6. krovoizliyanie v …

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___________________________________________________________________ tema 1: fiziologicheskaya optika. refraktsiya i akkomodatsiya. podbor ochkov. fokusnaya tochka – mesto sxojdeniya parallelnix luchey. fokusnoe rasstoyanie – rasstoyanie ot linzi do fokusnoy tochki. 1-dioptriya – prelomlyayushaya sila linzi, fokusnoe rasstoyanie kotoroy = 1 metru. chem dlinnee fokusnoe rasstoyanie, tem menshe prelomlyayushaya sila linzi i naoborot. naprimer: esli fokusnoe rasstoyanie = 2 m, to prelomlyayushaya sila = 0,5d. esli fokusnoe rasstoyanie = 0,5 m, to prelomlyayushaya sila = 0,2d. stepen anomalii refraktsii takje opredelyaetsya dioptriey. kak vsyakie linzi, glaz imeet opticheskuyu sistemu (sleza, rogovichnaya obolochka, jidkost peredney i zadney kameri, xrustalik, chastichno steklovidnoe telo) i ra...

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