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"description": "Катаракта – это частичное или полное помутнение хрусталика глаза, расположенного внутри глазного яблока между радужкой и стекловидным телом. Хрусталик от природы прозрачный и играет роль естественной линзы, преломляющей световые лучи и пропускающей их к сетчатке. Потерявший прозрачность хрусталик при катаракте перестаёт пропускать свет и зрение ухудшается вплоть до полной потери. Старческая (возрастная) катаракта развивается у большинства людей в возрасте старше 50 лет.",
"etiology": "<p>Основная причина развития возрастной катаракты – изменение биохимического состава хрусталика, обусловленное возрастными процессами в организме. Развитию катаракты способствуют эндокринные расстройства (нарушение обмена веществ, сахарный диабет), авитаминоз, некоторые глазные заболевания, неблагоприятная экологическая обстановка, длительный приём определённых лекарственных препаратов. В последние годы было доказано, что причиной катаракты может также стать активное курение.</p>",
"pathogenesis": "<p>Механизм развития возрастных катаракт является многофакторным и изучен не полностью. С возрастом увеличиваются масса и толщина хрусталика и уменьшается его преломляющая сила.</p>\r\n<p>Нарушается физико-химические свойства в хрусталике. На начальном этапе патологического процесса повышается содержание воды, затем нарастает концентрация ионов натрия, кальция, хлора, увеличивается содержание аминокислот; при этом происходит уменьшение количества водорастворимых белков, сульфгидрильных групп, глутатионов, АТФ, рибофлавина, аскорбиновой кислоты. Это сопровождается снижением активности ферментов, принимающих участие в процессе окисления глюкозы, уменьшением потребления кислорода, нарушением перекисного окисления липидов.</p>\r\n<p>Ядро хрусталика подвергается сдавлению новыми слоями волокон, формирующихся концентрично, и становится тверже. В результате прозрачность хрусталика резко уменьшается. Химически измененные белки ядра постепенно прокрашиваются. С возрастом хрусталик принимает оттенки от желтого до коричневого.</p>",
"diagnostics": "<p>Офтальмологическое обследование при подозрении на катаракту включает визометрию (оценка остроты зрения), периметрию (определение полей зрения), цветовое тестирование, тонометрию (измерение внутриглазного давления), биомикроскопию (исследование глазного яблока при помощи щелевой лампы), офтальмоскопию (изучение глазного дна). В совокупности стандартное офтальмологическое обследование позволяет выявить такие признаки катаракты, как снижение остроты зрения, нарушение цветовосприятия; исследовать структуру хрусталика, оценить локализацию и величину помутнения, обнаружить дислокацию хрусталика.</p>\r\n<p>Определенное значение имеет исследование энтопических феноменов (например, механофосфен, феномен аутоофтальмоскопии и др.). Эти простые методы позволяют предположительно судить о сохранности нейрорецепторного аппарата сетчатки при выраженных помутнениях в хрусталике, исключающих возможность осмотра глазного дна.</p>\r\n<p>К специальным методам обследования при катаракте относят рефрактометрию, офтальмометрию, ультразвуковое сканирование глаза, ультразвуковую биомикроскопию и др. эти методы применяется, в основном, при выраженных помутнениях в хрусталике и стекловидном теле для диагностики и локализации структурных изменений в полости глаза, а также определении их характера и распространенности.</p>\r\n<p> Для оценки функционального состояния сетчатки, зрительного нерва и центральных отделов зрительного анализатора при катаракте проводятся электрофизиологические исследования: электроокулография (ЭОГ), электроретинография (ЭРГ), регистрация зрительных вызванных потенциалов (ЗВП).</p>",
"treatment": "<p>Единственным действенным способом лечения катаракты является хирургическое вмешательство, которое заключается в замене помутневшего хрусталика на искусственный.</p>\r\n<p> </p>\r\n<p>Наибольшее распространение получила ультразвуковая факоэмульсификация. Основана на фрагментации вещества хрусталика ультразвуком и удалении его из полости глазного яблока. Данная технология обеспечивает ряд принципиальных преимуществ, включая атравматичность, отсутствие необходимости наложения швов, уменьшение степени индуцированного астигматизма, высокие функциональные результаты и сокращение сроков реабилитации пациента</p>\r\n<p>Интракапсулярная экстракция катаракты (ИЭК). Её рекомендуется выполнять при выраженной патологии связочного аппарата хрусталика, когда сохранение капсульного мешка представляется технически невозможным.</p>\r\n<p>Традиционная экстракапсулярная экстракция катаракты (ЭЭК). Предполагает выведение хрусталика целиком или фрагментарно из глазногояблока, требует наложения швов и, как правило, сопровождается развитием послеоперационного астигматизма.</p>\r\n<p>Ультразвуковая факоэмульсификация (УЗФ). Представляет собой наиболее малоинвазивную методику и является современным стандартом хирургического лечения катаракты.</p>",
"prevention": "<p>Для предотвращения развития старческой катаракты необходима антиоксидантная защита организма, ранее лечение сопутствующей общей и офтальмологической патологии, предупреждение травм глаза, ежегодные профосмотры офтальмологом.</p>\r\n<p> </p>",
"clinical_picture": "<p>В зависимости от стадии зрелости старческие катаракты разделяют на 4 группы:</p>\r\n<p>1. Начальная.</p>\r\n<p>2. Незрелая.</p>\r\n<p>3. Зрелая.</p>\r\n<p>4. Перезрелая.</p>\r\n<p>Выраженность клинических проявлений зависит от стадии катаракты. Острота зрения при начальной катаракте может не страдать. Ранними признаками заболевания могут являться двоение предметов (диплопия), мелькание «мушек» пред глазами, нечеткость зрения («как в тумане»), окрашивание видимых предметов в желтоватый оттенок. Пациенты с катарактой отмечают затруднения при письме, чтении, работе с мелкими деталями.</p>\r\n<p>Для клиники катаракты типична повышенная чувствительность глаз к свету, ухудшение ночного видения, ослабление цветовосприятия, необходимость использования яркого освещения при чтении, появление «ореола» при взгляде на любые источники света. Зрение при катаракте изменяется в сторону близорукости, поэтому пациенты с выраженной дальнозоркостью иногда вдруг обнаруживают, что прекрасно видят вблизи без очков. Видимое изображение расплывается перед глазами, однако скорректировать его с помощью очков или контактных линз никак не удается, несмотря на смену уровня диоптрий.</p>\r\n<p>В стадии незрелой и особенно зрелой катаракты острота зрения резко снижается, утрачивается предметное зрение, сохраняется только светоощущение. В процессе созревания катаракты цвет зрачка становится молочно-белым вместо черного.</p>",
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}
]
}