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Tuesday, December 2, 2014

Review of Ophthalmology

What is ophthalmology?


Ophthalmology is the study of diseases and disorders of the eye, its appendages, as well as the sense of vision and their medical treatment. It is one of the oldest medical disciplines. Ophthalmologist (synonym: ophthalmologist, outdated: Okulist) is the professional title of specialist doctor who specializes in ophthalmology.

The anatomical boundaries of ophthalmology constitute forward the eyelid and facial skin and the bone behind the eye socket. The investigation possibilities of the visual pathway of the visual cortex and they extend beyond that to the back of the skull. There are close links with the Otolaryngology, Dermatology and Neurology for. Due to the frequent involvement of the eye to general diseases and the possibility of making microscopic examinations of living tissue, ophthalmic findings are often used to diagnosis for internal medicine and neurology used (neuro ophthalmology).

Modern ophthalmologic examination methods require extensive and costly technical and instrumental equipment. The main study unit is the slit lamp, a special control and with lighting provided Mechanics, strong stereo microscope.

Ophthalmology is one of the surgical disciplines, although their number, effective and sophisticated drugs and aids are available. With the operation of cataract (cataract), the ophthalmology the most frequently performed and most costly in the total operation of the medical world.

History


Already in the Tablets of the Law of Hammurabi over 3600 years rules for eye surgeries were adopted: The physician should receive a successful operation a reward of 10 shekels, whereas both hands he should be cut when failure.
Add to Hippocrates attributed works of ancient Greece ophthalmology is not described in detail, but here too there some evidence of ophthalmic therapies.
For ancient Rome the treatment of eye diseases and injuries is detected.
Since the Middle Ages, the task of Ophthalmologists of specialized craft surgeon was perceived (by the so-called Star engravers), whose most famous doctor Eisenbarth was. Using a special knife, the cloudy lens of the eye ("Cataracts") was pressed into the eye. Johann Sebastian Bach died possibly the result of a cataract operation. Although George Frideric Handel survived the surgery, but remained blind to his death.

Ophthalmology belonged first to surgery and took shape only in the course of the 18th century, and especially of the 19th century, as an independent expert. Until the 18th century the anatomy and function of the eye was unclear. It was not until the 19th century details were by the advent of the microscope known and made systematically used for therapy. 1800 coined the name Carl Gustav Himly Ophthalmology, the same year Thomas Young described the astigmatism.

First clinics have opened in Erfurt and Budapest early 19th century. The first chair of ophthalmology occupied Georg Joseph Beer (1763-1821), who became in 1818 professor of ophthalmology in Vienna in the year. Previously, he had opened there in 1813 the first university clinic for eye patients.

A revolutionary invention in the field of diagnosis was the invention of the ophthalmoscope by Hermann von Helmholtz (1821-1894) in 1851 and the invention of the perimeter by Richard Forster (1825-1902). Significant progress has been the surgical treatment of glaucoma by Albrecht von Graefe (1828-1870), considered the "father of Ophthalmology", and the first successful transplantation of the cornea (keratoplasty) in 1905 by Eduard Zirm (1863-1944).

Like all disciplines of evidence-based medicine, ophthalmology constantly evolving. Milestones in the last 50 years

-The development of the intraocular lens, which has rendered superfluous the Star Glasses
-The discovery of Sonnenlichtkoagulation 1949 by Gerhard Meyer-Schwickerath, forerunner of laser photocoagulation as a way of treatment of diabetic retinopathy, which has reduced the rate of blindness among diabetics to less than 1/10 of the previous values
-The development of vitrectomy (removal of the vitreous body), with many of the leading diseases are treatable today before blindness.
-The introduction of Pflasterokklusion (temporary and possibly alternately cover each eye a) for the successful treatment or prevention of amblyopia (early acquired, functional amblyopia)

Recently, more and more electronically controlled laser systems are used, such as in refractive surgery or in the diagnosis of retinal and optic nerve (optical coherence tomography).

The outpatient ophthalmology in Germany is now the capital market as a worthwhile investment. The growth of full draw, so Wolfgang Pföhler, CEO of Rhön-Klinikum AG, "outside the traditional hospital market, since the patients were blinded a few years ago, are now preserved by an ambulatory surgery from that fate" could. His company acquired in 2010, thus ten specialist seats with augenchirurgischem focus in Dusseldorf.

Important Ophthalmological examination techniques and devices


See also: List augenheilkundlicher Testing Equipment

-Tonometry: Measurement of intraocular pressure
-Perimetry: examination of the visual field
-Slit lamp microscopy: Microscopic examination of the anterior, middle and posterior portions of the eye, optionally with the aid of a contact glass
-Gonioscopy examination of the chamber angle
-Refractometry: Investigation on optical refractive errors (ametropia)
-Ophthalmoscopy: direct and indirect reflection of the fundus
-Visusprüfung: determination of visual acuity
-Orthoptics: Investigation of the position and movement of the eyes and binocular vision
-Fluorescein angiography: vascular imaging, especially of the retinal vessels, using fluorescein
-Optical coherence tomography: presentation layer of the retina and vitreous, more recently, the choroid and anterior segment
-Corneal topography (Videokeratographie, keratometry): Representation of the corneal shape

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