The doctor answers

When describing your medical history, you forgot to indicate that you suffer from amblyopia in the right eye. In common parlance - his laziness. The disease can only be treated in childhood. An adult with such a diagnosis must come to terms with the fact that 100% vision is not available to him. Amblyopia leads to different eyes and difficulties with spectacle correction.

Ophthalmologist
Tamara Kurasova
doctor of the highest category, Moscow

Astigmatism and myopia are not a death sentence

I have astigmatism and myopia in my right eye. On the left - myopia. In March I had surgery in Novosibirsk on my right eye. After the operation, I can only see 0.30 in the distance, but I can’t see well up close. They refused to have surgery on my left eye, since it seems to be the only 100% sighted one. Is there anything else I can do to improve my vision? And yet, after the operation, all objects appear slightly elongated vertically, for example, with my left eye I see a circle, and with my right eye -
more like an oval. As a result, the image seems to double and I cannot focus my vision on the subject. Could this normalize over time as I have been told, or is additional correction necessary? I am enclosing extracts and tomography of the macular area to the letter.
Anatoly Mikhailovich Gatin, 38 years old, Kiselevsk, Kemerovo region


Anatoly Mikhailovich, you can be congratulated on the good results of a complex operation (laser coagulation and lens replacement due to cataracts): just 20 days after it, visual acuity in the operated eye, judging by the extracts sent, doubled, and physiological indicators improved almost 13 times. Your vision will improve for another six months, only then will it be possible to evaluate the effect of surgical intervention.

When describing your medical history, you forgot to indicate that you suffer from amblyopia in the right eye. In common parlance - his laziness. The disease can only be treated in childhood. An adult with such a diagnosis must come to terms with the fact that 100% vision is not available to him. Amblyopia leads to different eyes and difficulties with spectacle correction. In this regard, your binocular vision has most likely been weakened since childhood. The left eye remained dominant. After the operation, visual acuity in the right eye increased, this changed the situation of perception of visual images in the central nervous system, which is not yet ready for this. As a result of the operations, not only visual acuity increased, but also a small optical defect appeared in the form of a small mixed astigmatism, which makes it even more difficult to merge two images, so it is difficult for you to focus your gaze on an object (mixed astigmatism, that is, you are farsighted on one axis and nearsighted on the other). It was impossible not to perform laser coagulation: with a low degree of myopia, the risk of retinal detachment during lens implantation is high, and this operation is the most effective preventive measure.

In addition, doctors noted changes in the macula of your right eye - pronounced destruction and areas of degeneration in the pigment epithelium. This also leads to the fact that with your right eye you see objects elongated. For macular pathology, drug treatment is prescribed.

One can hope that within six months, as healing progresses, the situation with astigmatism will improve and it will be possible to reduce the manifestations of this symptom with glasses correction.

There is no point in operating on the left eye, because with glasses correction, visual acuity in it is 100%. And this is a great happiness, inaccessible to many.

Pediatrician
Olesya Butuzova, Moscow

What to do to prevent your child from coughing

Advise what to do to prevent the child from coughing. My son is five years old, and sometimes he starts coughing for no reason, and not because he has a cold, it just breaks my heart.
Inga, Sverdlovsk region

Based on the duration of the period during which the child coughs, cough can be divided into acute (lasting less than 21 days) and chronic (lasting 2 months or more). And by its nature, the cough can be dry (that is, without sputum) and wet - accompanied by the production of sputum. It is very important to correctly determine the type of cough, because treatment tactics depend on this.

Surveys

Firstly, the doctor asks the parents about when the baby’s cough began, how long it lasts, and what its nature is. Did your temperature rise when you coughed? Does the child have allergies?

After a detailed interview, the doctor makes a preliminary diagnosis, to confirm which he may prescribe the following studies:

X-ray examination of the chest (important for bronchitis and pneumonia);
X-ray examination of the paranasal sinuses (for the diagnosis of frontal sinusitis, sinusitis and sinusitis);
bronchoscopy (detects a foreign body, it is also indicated for frequent bronchitis and pneumonia);
sputum examination (allows you to find the pathogen or diagnose an allergy);
prick tests to identify allergies.

Treatment

The regime should be gentle, but not bed rest. The child should move, this improves the discharge of sputum from the bronchi. But at the same time, you should give up excessively active games during your illness. You need a light diet, and an extended drinking regime. The air in the room where the coughing child is located must be well humidified and certainly fresh.

Medications prescribed include those that thin mucus and stimulate its release, as well as anti-inflammatory ones. In severe cases, antibacterial agents are used, which are necessary to eliminate inflammation of the trachea, bronchi and lungs, which is what causes coughing.

To remove mucus, you can also recommend a light massage of the chest and feet. Inhalations using nebulizers are effective (these devices create a cloud with tiny particles of medicine, which, when inhaled, immediately enters the bronchi and lungs of the child).

Causes of cough

Inflammation of the ENT and respiratory organs, for example bronchitis, chronic rhinitis, tonsillitis, pharyngitis, sinusitis.
Enlarged tonsils (adenoids).
A sharp, unexpected coughing attack can be caused by a foreign body.
Bronchial asthma.
A cough may be a sign of heart disease or digestive system disease.
Many children begin to cough in smoky rooms, in rooms with polluted or too dry air.
The most common cause of cough is, of course, a cold.