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MODERN CLINICAL METHODS OF USING GENETIC RESEARCH IN THE
DIAGNOSIS OF HEREDITARY RETINAL DISEASES
Scientific supervisor: Jalalova Dilfuza Zuhridinovna
Department of Ophthalmology, Samarkand State Medical University
Eshimov Elbek
Samarkand State Medical University, Department of Ophthalmology, 1st year clinical
https://doi.org/10.5281/zenodo.15636957
Annotasiya.
The main symptom of dry eye syndrome is dryness of the conjunctiva and
cornea. It is manifested by discomfort in the eyes, which is a consequence of increased friction of
the eyelids on the mucous membrane. When the tear film becomes too thin, there is a burning
sensation, a feeling of sand or a foreign div. Against the background of dryness, there is a
temporary increase in the production of tear fluid - lacrimation begins, but this does not lead to
an improvement in the situation due to the instability of the formed film. Symptoms increase in
the evening or under the influence of an eye-irritating factor - wind, smoke, eye drops.
Keywords
: Redness of the conjunctiva, Tired eyes, worse in the evening., Changes in
visual acuity during the day, Increase the sensitivity of the eyes to light.
Diagnostic methods
The first thing an ophthalmologist does when dealing with a patient with suspicion of dry
eye is to conduct a survey, collect anamnesis, and perform an examination to identify symptoms
characteristic of dry eye syndrome. The doctor determines the causes and severity of the disease
by conducting the following studies:
Analysis of tear fluid allows to evaluate its microbiological and chemical composition.
Biomicroscopy - assessment of the height of the tear meniscus and the condition of the
cornea.
The Schirmer test is a method of assessing the rate of tear production using a litmus strip.
The Norn test is a method of estimating the rate of evaporation from the surface of the
eye. If you have dry eye symptoms, drops that color the tear film can help you understand how
quickly it evaporates.
When diagnosing dry eye syndrome, an ophthalmologist looks for symptoms that are
characteristic of it. If mucin threads are detected, tear meniscus reduction, corneal erosion,
insufficient tear production or rapid evaporation, the diagnosis is confirmed.
Methods of treatment of dry eye syndrome
It is not possible to completely cure dry eye syndrome, but it is possible to eliminate its
symptoms and prevent their occurrence in the future. Regardless of the cause of dry eye
syndrome, treatment always includes the use of eye drops to moisten the surface of the
conjunctiva and cornea. They form a stable tear film and eliminate dryness. For mild symptoms
of dry eye syndrome, the ophthalmologist prescribes low-viscosity agents. In severe cases,
treatment of dry eye syndrome with medium-viscosity drops or gel-like preparations is indicated.
For severe symptoms of dry eye syndrome, the doctor also prescribes treatment with
drops that have anti-inflammatory, metabolic and immunostimulating effects. They help to
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eliminate the effects of dry membranes and prevent changes in the cornea that can cause vision
impairment.
Treatment with drops for dry eye syndrome is the main, but not the only, method of
combating dryness. If conservative treatment is not effective enough, the ophthalmologist may
recommend surgery. Types of operations performed for dry eye syndrome:
Blocking the tear ducts - they stay on the surface of the eye longer. The operation can be
performed in different ways, but usually the tear ducts are closed with silicone plugs - this is a
minimally invasive and safe method.
Keratoplasty is an operation aimed at eliminating defects of the cornea and restoring its
shape and functions. This is done in the case of pathological changes in the cornea,
ineffectiveness of conservative therapy and closure of the lacrimal ducts.
Lateral tarsorrhaphy is an operation aimed at reducing the evaporation of tear fluid. It is
performed in patients with incomplete eyelid closure. The surgeon sews the upper and lower
eyelids in the outer corner. After that, the palpebral fissure begins to close completely when
blinking, so the entire front surface of the eye is wet with tears.
Treatment for dry eye syndrome may include transplantation of the patient's own salivary
glands or the installation of soft tissue dacryoreservoirs with a tube inserted into the conjunctival
cavity.
The main goal in the treatment of dry eye syndrome (DES) is to preserve the cornea,
protect its structures from damage and reduce discomfort. Several treatment methods can be used
at the same time.
Ophthalmologists distinguish several types of therapy for the treatment of dry eye
syndrome.
⦁
Reparative therapy to eliminate damage to the eye surface. Reparative drugs are aimed
at restoring damaged areas. Usually these are ointments and gel-based products.
Tear replacement therapy aims to replace insufficient tear volume and prevent tear film
rupture. Many drugs contain hyaluronic acid.
Tear conservation therapy allows you to conserve your own tears. Therapy is prescribed
as an adjunct to drug treatment and very often as an alternative to eye drops. Occluders are
installed in lacrimal holes, some of them dissolve by themselves;
Anti-inflammatory therapy relieves inflammation and prevents the development of the
disease. To supplement natural tear production, tetracyclines, cyclosporine drops, and anti-
inflammatory drugs are prescribed.
Stimulation therapy restores and normalizes the activity of the secretory glands. Usually
these are dietary supplements - omega-3, mineral complexes, vitamins.
Physiotherapy stimulation, therapeutic effects methods are used to release natural tear
production:
exposure to polychrome light;
laser stimulation;
magnetic stimulation;
subconjunctival administration of drugs with autologous blood plasma - PRP technology.
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The frequency and number of physiotherapy sessions depends on the level of
dysfunction, the stage of the syndrome and the dynamics of the result. One of the causes of dry
eye syndrome is a malfunction of the meibomian glands. Conservative methods are used for
treatment - eyelid hygiene and warm compresses. Ophthalmologists also prescribe antibiotics,
fatty acids, anti-inflammatory drugs, demodex infestation control, and hormonal therapy.
Preventive measures
To prevent the development of dry eye syndrome and reduce the symptoms of the
existing disease, you need:
Monitor your blink rate during reading, computer work, and other activities that require
increased visual attention.
If possible, reduce the time spent on the computer, phone, tablet, TV, books, etc.
Keep your computer monitor or phone screen below eye level.
Maintain normal air humidity in buildings (50-60%). You can use humidifiers for this.
Avoid using eye drops that contain preservatives.
Avoid harmful effects on the eyes (e-cigarette vapor, tobacco smoke).
Do not use contact lenses for longer than recommended by the manufacturer.
Optimizing working conditions. The risk of DHS is high among firefighters, cooks, auto
repair workers, paramedics, miners, welders, construction workers: those who work with
extreme temperatures, dust, fumes and chemical fumes. Prevention consists in reducing the
effects of harmful working conditions. For example, if the work involves dust, wear construction
goggles.
Pay attention to air humidity. The room should have optimal air humidity - at least 50-
60%. If the figure drops below 30%, consider purchasing a humidifier. Additional helpers will be
indoor plants and regular wet cleaning.
Reduce the time spent on a computer, tablet or smartphone. When working at the
computer for a long time, the frequency of blinking decreases and the strain on the eyes
increases. Editors, office workers, copywriters, IT professionals and designers are at risk. If your
work is related to the computer and it is not possible to reduce screen time, do not forget about
regular eye exercises and proper organization of your workplace. Try not to take other gadgets
while on vacation, but look at the distance. Also, take care of adjusting the screen (you can
reduce the brightness) and the proper lighting of the room (you can install blinds and thick
curtains to prevent glare on the screen).
The risk of developing dry eye syndrome is reduced by following a drinking regimen and
proper nutrition enriched with vitamins and minerals. Timely detection and treatment of diseases
of the endocrine system is important for eye health.
Summary
Dry eye syndrome is a disease whose main symptoms are dryness and associated
discomfort. Tear glands develop when they do not produce enough fluid to lubricate the cornea
and conjunctiva, or for some reason, the fluid evaporates too quickly. According to the
diagnostic results, only a doctor can tell you how to get rid of dry eye syndrome. Self-treatment
is not allowed, because it only relieves the symptoms of dry eye syndrome, and worse, worsens
its course. Therefore, if your eyes are dry or burning, you should consult an ophthalmologist.
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Diagnosis and treatment of dry eye syndrome in Moscow is carried out in the network of
Mositalmed clinics. Call to make an appointment with an ophthalmologist or submit an online
request for a call back.
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