tv [untitled] March 11, 2023 10:30am-11:00am EET
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[000:00:00;00] became about the fact that glaucoma can actually progress due to the fact that a person has received a certain injury, and you know what worries me very often, we talk about it in the news and you probably very often hear that during the shelling, during the bombing of our ukrainian cities , something happens people get civilian injuries as well as military people, they get injuries more often , it can be contusions, and we hear about the fact that people were given medical help on the spot, that is , the person was examined, it seems that everything is fine . similarly, there is no such injury in the military. that's all and here we are with a concussion, especially with a concussion irina, you know a concussion is such a complex disease in terms of the consequences of a person who is conscious there everything has been removed, but when
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a concussion occurs, a person falls and often ruptures. the capsule and the water gets there swells and supports the iris and here the pressure rises and here the cause must first be determined. is it glaucoma or is it torn ? he says, "so you say that the symptoms are so small, and our soldiers. you know that those who come to us for examination and after the operation, they go there immediately, they do not say that they will stay here, no, no, you quickly make us a doctor , we need to go to the front line and well, we are persuading at least a month to prepare a person for full vision. because our victory is one hundred percent vision. well, i know that since 2014 you have actually been constantly going to war zones and conducting examinations there and
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conducting examinations of our military as are there any such ophthalmological examinations ? are there doctors coming? do they still invite more soldiers to their clinics? you know , they still bring the most patients from there with combined injuries. you understand that they don’t take us to the front lines. first aid first aid is provided and then specialized aid and it is important that among all eye injuries the most important is not cataracts not glaucoma not averter surgery and this is plastic surgery it is bone damage the face is a multidisciplinary approach, we operate together on the maxillofacial and we, that is, you already know this, rehabilitation for several years of cataracts can be done in one day and then observed for a week, and that’s it. there are no isolated cataracts in war trauma, there are very few, and mostly there is a combined trauma , which requires just prepare that in the next
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5-7 years we will have to work on the rehabilitation of these patients and in addition, we must remember that there is a concept of delayed changes in the optic nerve that occurs 3-4 months after the injury, i.e. secondary non-ascending ischemic optic neuropathy that does not manifest itself immediately and therefore such patients must be observed and we all understand that the consequences of the injury will manifest much later and much later there may be a decrease in the functions of narrowing the fields of vision and other changes that will have to be influenced and treated as well our viewers need to know if an injury has already occurred, if there were any precedents, maybe a person fell, maybe there was a bombardment, that a one-time examination and assistance is not enough, that is, after how much, how much it takes time to consult three months, sometimes six months. that is, it will be necessary
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to consult an ophthalmologist again in two or three months. then six months, then 8-10 months, in order to then assess the possible consequences and precede them, just as with the coronavirus, we did not know why in a month after discharge from the hospital, patients develop hemorrhages and swelling on the fundus, we still do not know why exactly because, after all, it is desirable to be examined two months after the concussion, if there are no complaints , if there are complaints, then urgently and again i want to provide some statistical data here. would you please explain to me and our viewers how this really happens , according to the results of studies, the probability of blindness in one eye 20 years after the onset of the disease and the start of treatment is 27%, in both eyes 9%. so, as i understand it, glaucoma progresses differently in each person
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after it began to progress or , for example , it was detected. how long does it take for a person to become really blind? it is necessary to tell the truth to the patient. although now they say that no , psychologists do not need to tell the complete truth that the patient will become blind, because it is already a difficult time, but when the patient trusts you, i always say that you have been diagnosed with primary glaucoma. stage of glaucoma how old are you 65 theoretically you will go blind in 30 years if without treatment the average life expectancy of people in ukraine is 95 men 65 years old women 75 the average life expectancy and i am repelled by these statistics and i honestly tell the patient that he
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will die blindly and one should not be afraid to be treated, but here is the case when you say that the person did not know and the mana is in a tight head , the person comes. and we already understand that for 8-10 years we can still operate drips and that is also a long period of 10 years, you see. the fact is that if you do not lower the internal eye pressure, a person can go blind even overnight, everything depends on the level of internal pressure, if it is subcompensated, it can last for a year and a half, and as a rule, if a person does not know, he comes a year later and already one eye is blind you understand. if you don’t know and you didn’t intervene and you didn’t prescribe treatment in time, if you start treatment and correctly, it can delay it for 10-15 years, that is, i emphasize that glaucoma cannot be cured, you can only postpone blindness and prevention for them is the very concept of delaying, that is, providing the entire complex assistance of all procedures and this will be a complex complex intervention, i.e.
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please tell us about this complex of procedures, what it can be because , for example, serhiy oleksandrovych said about what to say to our patients and listeners, what when you were operated on and they said that you were operated on for glaucoma, they think that we cut out their glaucoma and that there will be no more glaucoma, we simply compensated for the pressure, the glaucoma remains and we continue to drip , please don't be afraid of the laser we have very few referrals for laser treatment in time let's go, please because now we have already confused our viewers and i am afraid that they will not be able to understand, let's step by step, who is prescribed what, who is prescribed some kind of surgical intervention, who is prescribed a laser and who is prescribed simply to drip, it all depends on do you understand the type of type and stage of glaucoma, that is, you need to make a timely diagnosis and it will give an understanding of each eye separately, what type of type
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and stage is the most important, and depending on that, there will be a treatment plan, or just one drop is enough, or do you need to do a laser or do you need to do a combined one treatment with the removal of the lens, and today in our country there are more modern laser procedures. and the most important thing is that there are doctors who know how to do it, and you should not be afraid to refer to this type of treatment in time , because it guarantees a very long and a good reduction of internal pressure, you understand. if it is done, where before starting to drip the drops, the gold standard is a hypotensive therapy that lowers the internal eye pressure, but all the drops have a destructive effect on the surface , and you also need to remember about those schemes , the possibilities of unified drugs for today , the whole the spectrum of modern medicine of hypotensive drugs is available in ukraine, there are better domestic producers who produce very
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good hypotensive drugs, it is very important that we do not confuse our viewers because the first diagnosis, then we start prescribing drops. no one should be afraid of me. we operate on one type of drop at once. if it is not enough, we add another type of drops. if it is not enough , we perform laser interventions. remove that clear lens because the block of the angle of the anterior chamber and we know that if we operate, we warn the patient that he will not be able to see, you will not get better, and you do not need a unit of vision, but we will make a pathogenetic referral reconstruction of the anterior angle, glaucoma is difficult even for doctors, so you understand irina, but for patients, they are looking for, if one doctor does not help, they will look for a second
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, third, fourth, you really need to go to those centers where there is a glaucoma office, where there is equipment, because the course of glaucoma depends on the dynamics of one the examination will not give anything to the field of vision, when we see three fields of vision during the year, then we understand what the drug is, how much we can tell the patient and when to come to us, when he will not come to us again don't forget about congenital glaucoma, the fact that these children are our future, because congenital glaucoma is treated only surgically and only with its timely detection and timely intervention, and again, these are the most modern centers that will be able to correctly diagnose under the right conditions, that it is a complex of examinations it is only necessary to do the child under anesthesia and carry out timely surgical treatment, it is carried out in state clinics, because children under one year old must be examined under anesthesia and monitored
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for several days. this may be okhmatdit our institute is philatelic and so on for children, i want to ask you what is the current situation with medicines because we are talking about what needs to be administered and we know that there were some problems with medicines and how is it now in the first eye days of the war when the pharmacies will be closed and everything - they still took out these drops, tried to compensate, and first, of course, contact lenses and glaucoma drops for the war at the front because it was necessary and no one thought about themselves, the one who was safe and very grateful to the pharmacological companies who simply
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warehouses were opened that sent these drugs. ukraine coped and the ophthalmologists coped, we are happy that they returned to ukraine. levels, i.e. all the leading ophthalmology in ukraine and all the means are available and the company is domestic and works and there are the necessary hypotensive drugs of all directions and foreign, the most modern and effective, too the account of the company of volunteers, they are available to our population, and with regard to drugs, we once calculated how much money the state needs to provide glaucoma patients with drugs in europe, it is completely provided at the expense of the state, because there is mandatory medical insurance, that is, people do not buy there on their own, but receive they don't buy from the state and those macular edemas when it is necessary to inject the factor from the ophthalmologist and so on. that's all . sometimes you just sit like eyes like sulfur. you understand what
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is needed and i know when i say it to the patient one cried and left my appointment, you understand. and i would like us to have full-fledged medicine, to have insurance medicine and for the doctor not to say how much the treatment costs. the doctor must prescribe what is needed according to the treatment protocol. well, i want you to give some advice today as we understand that a lot of people are left without the opportunity to undergo examinations and are in those territories where unfortunately, they cannot undergo them even in the de-occupied territories. you know, not everywhere people can it is possible to undergo a full examination. contact them with what symptoms they should be experiencing in order to know that they urgently need to go. it is possible to go to larger cities and contact ophthalmologists. the first thing is the field of vision . what is the field of vision ?
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put your second finger in one point and the second one and you look like this. and now you saw that this is a normal field of vision, it is almost 90%. the second hand was placed and you also saw that here i have, for example, relatively a little less from top to bottom, that is, the field of vision should be 9 80 above 70 below 80 field of vision as soon as you look at what you see, you see a finger here, the eye does not hurt with glaucoma and the vision does not fall with glaucoma for a very long time, but the field of vision decreases and when you look at some bright light and you you see gala, that is, such rings are very dangerous, it means that you have very high blood pressure, you need to consult an ophthalmologist . well, the main thing is that those patients who already have glaucoma, who know that they have glaucoma, in any possible way, they
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should support that regime that they had prescribed if there is no access to those drugs any hypotensive drugs to use which are available and which are within reach for them in no way stop do not stop and do not stop instilling these drugs this is the main thing i always say that as our father we pray in the morning and in the evening yes exactly we must instill glaucoma drops early and in the evening. if a person misses one instillation, the probability of getting blindness is much higher. well , look. we found out today that glaucoma is a genetic disease, but still i i understand that it is possible to postpone its manifestations. how to do it, or are there any such tips that a person should do every day? for example, if she knows that she has glaucoma in her family, her parents, grandparents, and grandfathers had glaucoma, so what should she do every day, what kind of lifestyle should she lead? maybe there
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prophylactically, you need to instill some drops or something else. well, tell me the most important thing is if a person has glaucoma. i want our state to have an examination at birth for glaucoma. and there is such an examination - it's a genetic examination. it's just expensive and in the state unavailable, and if we have glaucoma in our family, then of course if a baby is born in the family, it is necessary to examine whether there is a risk or not, and if there is a risk, then why do we have to wait 40 years, that is , the risk, then we start from four to five years old to apply drops to this child is good. i saw it if it is genetic. and you, iryna vasylivna, what do you advise? i will advise if there is glaucoma in the family , it is necessary to remember once a year that you need to undergo a comprehensive multidisciplinary examination with all modern diagnostic methods and determine whether there are changes in the head of the optic nerve, which are pathognomonic and changes in functions in the field of vision, and of course the control
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of intraocular pressure, which used to be the standard measurement once a year. it should also be remembered that this is only one factor that can be dynamically influenced. and lifestyle does not have a sufficient effect, it is precisely those possibilities of early diagnosis and then preventive supervision or correct treatment that are already personalized for each eye and planned by an ophthalmologist and we, mr. serhiu we already talked to you about the fact that these are all stressful situations, that people find themselves, well, you can say, closed for a certain period of time , and all the parking lots are in basements, and people don’t often start walking now, let ’s say that in the fresh air, because they can , children
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children sit and study, a lot of children study online, so they also do not attend educational institutions. this also contributes to the fact that ukrainians lose their eyesight even against the background of stress . practical what to do for families who have children, what to do for adults , etc. maybe you can share these tips today on our broadcast 10 years ago, ophthalmologists were thinking about how to warn, how to ban , for example, a tv gadget, how much, and so on. but after the war, we have already decided to simply limit, it is impossible to simply recommend , so here are these recommendations, these are the worldwide recommendations of ophthalmologists, you need to work with a gadget , an office space, students, students, you work for 20 minutes
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, you work with a gadget for 20 seconds, exactly 20 seconds you look into the distance at a distance of 20 feet 20 20 feet is 6 m or more, that is, every 20 minutes from 20 seconds you look out the window more and more ophthalmologists have not come up with any prevention, besides that, believe me , no one has yet gone blind from a gadget, it is about the fact that a person gets tired from a gadget, a headache appears, nausea in children, and so on, because of that it is important to choose the color of the gas from the screen so that it is not blue, we talked about this because it has a toxic effect on the retina and the child then gets tired ot size clarity of letters ot it is necessary to pay attention to the quality of gadgets , you must also pay attention and we definitely recommend fresh air fresh air is a walk outside because the child i advise you to buy a dog for children for sure then it disciplines the child early and takes the child out in the evening dog for one hour at a time and this prevention is also close, i'm afraid that now
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our viewers will not thank you very much for themselves to take on the responsibilities of the parents for the dog, it disciplines the child, just ask the child you will go for a walk early in the evening, the child says i will then buy everything from your side. i also consider it necessary to emphasize the fact that both against the background of the coronavirus infection and against the background of currently excessive stressful situations , the refraction is changing. coronaviruses, the command changed and now against the background of stress. therefore, we must remember that refractive errors, i.e. hyperopia , myopia, must be carefully and correctly corrected, i.e. detected in time, and if there are
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violations, they must be corrected, i.e. children to examine, prescribe the correct correction and, if necessary, and according to world standards, the most complete correction of myopia with contact lenses - these are modern means of treatment of refraction anomalies, what concerns people who are already elderly after 40 years, timely correction of presbyopia, the fact that this is also a proven factor described that uncorrected presbyopia is increases the level of internal pressure and if there are genetics and other factors - all this accelerates the development of this disease, i.e. the correct and timely correction of presbyopia is at the age of 45 when a person begins to see poorly up close and begins to withdraw his hands and does not want to go to the doctor because, well, i already put on glasses, so there are scientific achievements research that clearly emphasized that if a person did not put on glasses in a timely manner and did not correct them, you understand, then he has heart pain why so that there is a relationship through the brain and a person, angina appears, and wearing
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glasses will cure it, that is , the correct regimen and the correct correction. and now the ophthalmologists of the world have come to the conclusion that especially pediatric ophthalmologists should give maximum correction what is it in glasses you can see 0.8 you can see 100%, you have to give 100%. vision, then the child gets a full quality of life, and we used to give a hand so that the child could see 0.8 0.8 per eye and did not think that for some reason we were taking something away from the child, i.e. the brightness of the world and so on , as if we were treating it. now we have come to the conclusion 100 the child should have % of vision in glasses and contact lenses and then there will be no spasmodic combat, tension, accumulation , i.e. internal muscle and, of course, training
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parents because it is necessary to use modern possibilities. i mean contact lenses, they are almost no longer operated on, progressive myopia is precisely due to the fact that modern contact correction is used, these operations are already traumatic, those who did them before do not carry them out, and we contusion ruptured capsule and i say look you see 100%. first, we will model for you with a contact lens what you will see during the surgical intervention. and after two months, the military comes. and after that we are already operating and he can see how in those contact lines my guests, i am very grateful to you, in fact, for all these tips, for the fact that you stopped by today. it is also nice for me , as they say, to finally see live guests in the studio, and not some skype connection language online, so i am very grateful to you. i want to remind our viewers that serhiy rykov, a well-known ukrainian ophthalmologist
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, professor, and iryna shargorod , ophthalmologist, glaucomatologist, doctor of medical sciences and professor, were our guests today. the main thing is that we today we found out with you what we have to convey to our viewers that you should undergo an examination not to listen that there is something wrong with you but to go and purposefully pass these examinations that my guests in the studio said about today and this should be mandatory it is not necessary to have a comprehensive examination . you just came to have an ophthalmologist look at any visual deviations so that there is such equipment that today we showed you in our story every month and a half, you measure the eye pressure , the field of vision and do a ct scan, everything is correct that's right and for patients with lovcola, you must give yourself and your eyes a break. and then everything will definitely be fine . thank you once again and thank you to all the viewers who were with us today. it was a program about
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