ophthalmology

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ophthalmology

(ŏf'thălmŏl`əjē), branch of medicine specializing in the anatomy, function and diseases of the eyeeye,
organ of vision and light perception. In humans the eye is of the camera type, with an iris diaphragm and variable focusing, or accommodation. Other types of eye are the simple eye, found in many invertebrates, and the compound eye, found in insects and many other
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. Ophthalmologists specialize in the medical and surgical treatment of eye disorders, vision measurements for glasses (refraction), eye muscle exercises (orthoptics), and the prevention of blindness and care of the blind. Some of the major causes of blindness in adults are cataract, glaucoma, diabetic retinopathy, senile macular degeneration, retinal detachment and opacities of the cornea. Cataract is the loss of transparency of the lens in the eye; it may follow injury, infection, or aging. Glaucoma occurs when the pressure inside the eye becomes so high that it damages the optic nerve. In diabetic retinopathy, blood cells and serum leak out of the blood vessels and damage the retina. Retinal detachment occurs when the retina is separated from the underlying choroid and sclera, the fibrous base of the eye. The most frequent causes of visual loss in childhood are trauma to the eye and amblyopia (lazy eye). The ability to adjust focus from far to near gradually decreases with age. Important developments in opthalmology include Allvar Gullstrand's slit-lamp (1911), which illuminates the interior of the eye with a beam of light; the tonometer, an instrument used to measure the fluid pressure in the eye; the opthalmometer, which measures the eye's dimensions, capacity, and refractive errors; and the laser, which can be used to perform precise, delicate operations on the human eye. Radial keratotomy alters the curvature of the cornea by means of thin knife incisions, changing the refractive power of the cornea so that people no longer need glasses. Similar procedures are also done using lasers and radio waves. Still in the experimental stages, transforming growth factor beta (TGF-beta) shows promise of use as a sort of "retinal glue" to save sight in cases where there is no other treatment available.

Bibliography

See historical study by G. Gorin (1982).

Ophthalmology

 

the medical discipline that is concerned with both the normal and pathological eye; in a narrower sense, ophthalmology is the branch of medicine that deals with eye diseases.

The earliest information on the eye and eye diseases is found in ancient Egyptian literary texts, in the works of Hippocrates, and in the writings of Indian and Chinese physicians. In the Middle Ages, at the high point of Arabic culture, ophthalmology reached a relatively high level of development. Several Arabic treatises were written on ophthalmology, for example, by Ibn Sina; these became available in Europe in the 14th and 15th centuries.

During the 17th century in Europe, the German scientist J. Kepler discovered that light is perceived by the retina and not by the crystalline lens, as had formerly been believed. The crystalline lens is merely one of the light-refracting mediums of the eye. The description of a cataract as an opacification of the lens was proposed in the 17th century, by the French physician P. Brisseau, and the technique of cataract removal was developed in the 18th century by the French ophthalmologist J. Daviel.

In Europe, ophthalmology became an independent branch of medicine in the years between 1818 and 1838, during which special eye hospitals and departments of eye diseases in universities were opened in Austria and Hungary.

Most ophthalmological research of the first half of the 19th century was devoted to diseases of the eye’s surface. After H. Helmholtz’ invention of the ophthalmoscope in 1851, rapid progress was made in the study of diseases of the deeper structures of the eye, for instance, the optic nerve, the retina, and the choroid. Research in physiological optics dates to the mid-19th century, as do the theories of refraction and accommodation.

Especially characteristic of ophthalmological research during the second half of the 19th century were anatomical studies that revealed the morphological basis of many eye diseases. The last quarter of the 19th century was marked by major advances in bacteriology, which were applied to establishing the infectious nature of several eye diseases. Advances in ophthalmic surgery, for example, many operations for glaucoma and the extraction of foreign bodies from the eye with a magnet, were also made during the 19th century.

In Russia, the earliest information on physicians who specialized in the eye dates to the 17th century, when these specialists were called ochnye mastera, literally, “eye masters.” Russia’s first special hospital for the treatment of eye disorders and loss of vision was organized by and opened under the directorship of F. A. Gil’denbrandt in 1805 in Moscow. The first subdepart-ment of eye diseases was founded at the Medical and Surgical Academy in St. Petersburg in 1818. An eye hospital was founded there in 1824, and a second eye hospital was founded in Moscow in 1826; both hospitals exist today. There existed no state ophthalmological care.

In 1920, after the October Revolution of 1917, the People’s Commissariat for Public Health of the RSFSR prepared a plan for the organization of ophthalmological care that included both therapeutic and preventive measures. Particular emphasis was placed on the control of eye diseases that were widespread mostly as a result of social conditions, for example, trachoma and traumas of the eye. Trachoma has been virtually eliminated in the USSR as a mass disease. Medicinal and surgical treatment of glaucoma has improved greatly, and special dispensaries offer preventive checkups to detect and treat the disease as early as possible. Eye injuries in industry have decreased sharply, and tuberculosis and other infectious diseases of the eyes are successfully treated today.

Among the schools that played an important role in the development of ophthalmology in Russia were those in Kazan (E. V. Adamiuk, V. V. Chirkovskii), Kiev (A. V. Ivanov), Kharkov (L. L. Girshman), St. Petersburg (L. G. Belliarminov), Moscow (S. S. Golovin, A. N. Maklakov, A. A. Kriukov, V. P. Odintsov, M. I. Averbakh), and Odessa (V. P. Filatov, N. A. Puchkovskaia). Several ophthalmological research institutes have been founded, and institutes for postgraduate medicine provide specialized and advanced training for ophthalmologists.

Ophthalmological diagnosis has been facilitated in the 20th century by new instrumental methods, including microscopy, roentgenography of the eye and orbit with X-ray location of foreign bodies, electrodiagnosis, isotopic tracer studies of eye tumors, and fluorescein funduscopy. Methods of correcting refraction anomalies have been greatly improved. Anastigmatic lenses, contact lenses, and telescopic eyeglasses are now used in addition to ordinary eyeglasses. New drugs have proved effective, including sulfanilamides, antibiotics, and hormones, and many new surgical operations have been developed, for example, keratoplasty, correction of retinal detachment, and photocoagulation of intraocular tumors. Laser therapy and microsurgery of the eye have become widespread in the second half of the 20th century.

Specialized ophthalmological journals in the USSR include Vestnik oftal’mologii (Review of Ophthalmology, published since 1937) and Oftal’mologicheskii zhurnal (Ophthalmological Journal, published since 1946). The All-Union Society of Ophthalmology was founded in 1937, and republic and all-Union congresses devoted to current problems in ophthalmology are held periodically.

Among the best-known foreign ophthalmologists are W. Duke-Elder in Great Britain, who specializes in the pathogenesis, symptoms, and treatment of glaucoma; B. Becker and J. Gass in the United States, whose specialties are glaucoma treatment and retinal diseases; R. Etienne in France, who works with glaucoma and the physiology of vision; M. Radnót and P. Weinstein in Hungary, who specialize in the symptoms and treatment of a variety of eye diseases; and T. Krwawicz in Poland, who was the first to use cryosurgery in ophthalmology. Foreign specialized journals include American Journal of Ophthalmology (since 1884), British Journal of Ophthalmology (1917), Klinische Monatsblaetter für Augenheilkunde (Federal Republic of Germany, 1863), Annales d’Oculistique (France, 1838), Klinika Oczna (Poland, 1923), and Československá Oftalmologie (Čzechoslovakiá, 1935).

REFERENCES

Filatov, V. P. Opticheskaia peresadka rogovitsy i tkanevaia terapiia. Moscow, 1945.
Averbakh, M. I. Oftal’mologicheskie ocherki. Moscow, 1949.
Mnogotomnoe rukovodstvo po glaznym bolezniam, vol. 3, book 1. Moscow, 1962.
Arkhangel’skii, V. N. Glaznye bolezni, 2nd ed. Moscow, 1969.
Beiträge zur Geschichte der Ophthalmologie. Basel-New York, 1957.
Systemic Ophthalmology, 2nd ed. Edited by A. Sorsby. London, 1958.

M. L. KRASNOV

ophthalmology

[‚äf‚thal′mäl·ə·jē]
(medicine)
The study of the anatomy, physiology, and diseases of the eye.

ophthalmology

the branch of medicine concerned with the eye and its diseases
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