Ophthalmochromoscopy

Ophthalmochromoscopy is a research method that was developed by Dr. Vodovozov in the second half of the 20th century. This technology involves the use of a special device - an electroophthalmoscope equipped with light filters. Thanks to this device, it is possible to examine the area of the fundus in different light (blue, purple, yellow, green, red), which increases the capabilities of the conventional ophthalmoscopy method, since in different light it is possible to better examine the areas of the affected retina.

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Indications for ophthalmochromoscopy

Ophthalmochromoscopy is a fairly important diagnostic method used for diseases of the visual organs. The method also serves as a source of necessary information for doctors of other narrow specialties.

The ophthalmochromoscopy procedure is prescribed in the following situations:

• for diagnostics of retinal diseases ( ruptures, detachments, degenerative processes );
• to clarify diagnoses, for more thorough ophthalmological examinations;
• patients with diabetic retinopathy;
• patients with hypertension;
• during pregnancy (to assess the possibility of natural childbirth);
• patients with traumatic brain injuries;
• for the diagnosis of oncological problems in the area of the retina.

The procedure also helps to prescribe effective treatment for such diseases of the retina as retinal artery obstruction. This is very important, because acute obstruction of the central artery is often considered a harbinger of such unfavorable vascular pathologies as stroke and heart attack - known diseases with a high mortality rate.

In diseases of the optic nerve, for example, in congested and pseudo-congested nipples, ophthalmochromoscopy allows to detect the areola pathological reflex at early stages. This is of great importance in the timely recognition of congestive phenomena and provides the opportunity to control the dynamics of the process that provoked the congested nipple.

In addition, ophthalmochromoscopy in many cases allows obtaining a fairly clear image of visual structures that are difficult to distinguish by visualization using other research methods.

Ophthalmochromoscopy in the diagnosis of CNS diseases

Clinical symptoms of CNS diseases are very diverse, and such pathologies may not have a single characteristic and specific sign that allows for immediate identification of the disease. For this reason, diagnostic errors in recognizing CNS diseases are observed in approximately 7-30% of cases.

It is very important to use the most informative procedures possible for diagnosis, allowing for a detailed examination of all possible areas of damage.

Visual impairments can be found in more than half of patients with nervous system pathologies. Most often, such impairments manifest themselves as optic neuritis, and occasionally as unilateral or bilateral visual impairment.

Of course, ophthalmochromoscopy is not prescribed to all patients with CNS diseases. As a rule, this diagnostic method is recommended for patients with decreased visual acuity, changes in the visual field and color perception, as well as for detecting pallor of the optic nerve and its atrophy, which is not determined by standard ophthalmoscopy.

Methodology for performing ophthalmochromoscopy

The patient does not need any special preparation for the procedure. A few minutes before the ophthalmochromoscopy, the health worker drops a preparation to dilate the pupil into the right and left eyes of the patient. This is necessary to expand and improve the field of vision during the examination. However, many state-of-the-art ophthalmoscopes can be used to conduct the examination without using such preparations.

The diagnostic manipulation is carried out in a darkened room. The doctor examines the fundus of the eye using the ophthalmoscopic device's eyepiece. Examination of one eye can take approximately five to fifteen minutes, and during the examination the specialist changes the light filters several times.

This diagnostic method is completely painless, but may cause some discomfort to the patient.

It should be taken into account that ophthalmochromoscopy may not be prescribed to everyone; there are some contraindications to the procedure:

• acute infectious inflammation of the anterior part of the eye and other pathological conditions of the eyes, which are accompanied by photophobia, contact lacrimation - symptoms that complicate the examination;
• glaucoma;
• atrophy of the orbicularis iris muscle.

Interpretation of ophthalmochromoscopy results

The ophthalmochromoscopy method involves the use of certain light filters: red, yellow and blue, as well as polychromatic shades – the so-called red-free (blue-green), yellow-green and purple.

The interpretation of the study is carried out taking into account the color transformation. For example, when using a purple shade that only transmits red and blue rays, any element that is not colored purple is separated. This information is often useful: in particular, the pallor of the optic disc in the case of atrophy becomes bluish.

The yellow element becomes almost black under blue light.

The yellow-green beam can be perfectly absorbed by the blood and also reflected by the retina. As a result, hemorrhages, capillaries and even small aneurysms are clearly defined due to the strong increase in contrast between the listed elements and the fundus.

Black elements on a yellow-green background are more clearly defined than red elements on a reddish background.

Yellow-green rays increase contrast and make details clearer. This is due to the fact that the human eye is more sensitive to the yellow-green spectral hue.

All the types of light filters used have their own advantages and disadvantages, so the doctor uses each of them for a specific purpose:

• red tint – helps to identify pigmented elements and defects of the vascular membrane;
• yellow tint - indicates hemorrhages under the retina of the eye, which have a dark brown color;
• blue tint – allows one to see mossy surface elements;
• purple hue – provides information about the severity of dystrophic changes in the retina;
• blue-green tint – indicates matte opacities of the retina, or more precisely, its central part.

When describing the results, the doctor lists all the pathological elements found (if any), indicating their size, structure, parameters and depth of penetration. Characteristic changes of these elements in various spectra are necessarily noted. In the final description, all the results are combined with the results of other studies, on the basis of which the diagnosis is made or clarified.

Ophthalmochromoscopy is performed by an ophthalmologist who will directly establish a diagnosis and prescribe treatment. This approach eliminates the occurrence of inaccuracies and errors that may occur when transferring information from one specialist to another.