What can you tell about a person’s health from their eyes?

A number of common diseases show up as ocular symptoms, sometimes very typical. Ocular changes may be the first manifestation of a serious disease, such as metabolic or neurological disorders or certain cancers. At other times, they accompany and complicate the lives of patients with cardiovascular disorders, systemic autoimmune diseases, rheumatological, and dermatological conditions, in addition to many others. Therefore, colleagues from other medical fields refer their patients to ophthalmologists to help them establish or confirm their diagnosis or to monitor the success of their treatment. A typical example of interdisciplinary collaboration is caring for patients with diabetes. This disease can cause changes in the eyes that lead to severe visual impairment, however, with early detection and treatment, the severity of the condition can be reduced.

Is there anything we can do to improve our eyesight?

Taking good care of your eyes involves getting them checked by a professional opthalmologist during regular preventive eye examinations. This will reveal any hidden risks or visible defects and diseases. If you have a refractive error, correct it with glasses or contact lenses. An uncorrected defect leads to excessive eye strain with a range of unpleasant accompanying symptoms. If you work most of the day focusing your gaze up close, take breaks to focus your gaze into the distance or do some eye exercises. Protect your eyes with goggles, shields, etc. when working in a hazardous environment. Do not delay an eye examination if you have vision problems or symptoms such as redness or pain. Only early detection of eye disorders and diseases will lead to appropriate treatment to protect your eyes and vision.

What eye defect do you see most often in your practice?

In today's computer age, one of the common but less serious problems is tear film disorders which causes dry eye syndrome. Fortunately, pharmaceutical companies market a large selection of moisturizing eye drops that can effectively help most people.

More serious conditions include cataracts and glaucoma. Although we refer to both as 'glaucoma', they are two completely different conditions. Cataracts is usually a sign of ageing of the eye, when the lens itself loses its transparency, leading to varying degrees of visual impairment. This can be treated very successfully with surgery, after which the patient's vision returns.

Glaucoma is a progressive disorder of the optic nerve leading to visual field disturbances and, in advanced stages, irreversible visual impairment and blindness. The treatment is long-term, usually conservative in the form of drops or surgery. However, even this does not cure glaucoma and the patient must accept lifelong check-ups with an ophthalmologist.

The incidence of age-related macular degeneration (AMD) increases with increasing age. It is a non-inflammatory progressive disease of the central retinal area that is the leading cause of severe central visual acuity impairment in developed countries.

You mentioned eye surgery. What do they solve?

Almost all intraocular surgeries on both the anterior and posterior segment of the eye are now performed by microsurgery. The anterior segment of the eye is everything that we can see from the outside of the eye up to the lens. What is behind the lens is the posterior segment. The most common procedure is cataract removal. This is followed by glaucoma surgery, corneal surgery including corneal transplantation, iris surgery, retinal and vitreous surgery, etc.

How long does such a procedure take?

This varies greatly. Cataract surgery usually takes no more than ten minutes. It takes longer to prepare the patient before surgery. Other microsurgical procedures vary in time depending on the complexity, but usually fit within two hours. Only highly specialised procedures and procedures in which several operations are performed at the same time are longer.

Is it possible to treat some kind of blindness with surgery?

The lay definition of blindness is different from blindness in the professional sense. The general public usually perceives blindness as a state of severe visual impairment, which experts refer to as practical blindness, where at least the remnants of vision are preserved. The possibilities of cure depend on its cause. Curing blindness is seen by some as restoration of normal vision, but in some cases it may be an improvement in vision at least beyond practical blindness. This, too, is of considerable importance to the person concerned. Blindness in the medical sense is a condition in which the eye cannot tell the difference between light and dark. This condition is virtually always irreversible.

And what about the children, who come to your practice?

The predominant defects in children are refractive defects - that is, defects that need spectacle correction, such as farsightedness, nearsightedness and astigmatism. It is very important to detect these defects at the earliest possible age to prevent the development of dullness, or a condition in which the eye will not be able to see a sharp image of the world around it even with the help of an optical compensatory aid.

When should parents pay attention?

Something may be wrong with a child's eyesight if they are not following toys with their eyes, turning their head to one side, holding objects very close to their face or squinting. These should be disclosed to the paediatrician who will assess whether the child needs to be examined by an ophthalmologist.

There is plenty of optical equipment in your office. What are is it used for?

The surgery of an opthalmologist is usually filled with various medical devices; without them, we might as well close up shop. We use optotypes for basic examinations of the central visual acuity at a distance and charts for near. The anterior segment of the eye is examined with a slit lamp, which is a biomicroscope with the ability to magnify the image up to 40×. The posterior segment of the eye can also be examined with a slit lamp using optical aids - lenses with a thickness of 60-90 diopters, or an ophthalmoscope. A tonometer is used to measure intraocular pressure and a pachymeter to measure corneal thickness. The examination of the visual field is carried out by perimeter and the examination of the colorvocity by pseudoisochromatic charts. We also have an OCT machine that allows examination of optical coherence tomography, which is an imaging method of the posterior segment of the eye.

You have been in the industry since the early 1980s. How has ophthalmology developed throughout your career?

I see progress on several fronts. For example, when I joined the General University Hospital after my attestation, cataract surgery involved a few days in a hospital bed. After many weeks of recovery, the patient received heavy glasses with thick lenses, with which the quality of vision really wasn’t ideal. The advent of the operating microscope then contributed to improved visualization of the surgical field, more precise work of the surgeon, better closure of surgical wounds with significantly lower postoperative complications. Investigative methods were also improved, which made it possible to investigate the pathogenetic causes of a number of diseases. This has led to more accurate diagnoses and a diversification of diagnoses for conditions that previously fell into one large group.