Physiotherapy of eye diseases. Eye physiotherapy

Magnetotherapy at home and in a hospital is an almost universal way to treat diseases of various organs and systems. Home magnetotherapy does not cause practically any problems associated with other physiotherapy methods, and even not the most prosperous person can buy a magnetotherapy device - their prices start at 2,500 rubles. The indications for magnetotherapy, in which cases magnetotherapy is contraindicated - the instructions for the devices list along with the methods of use. And it is impossible not to pay attention to the fact that the list of indications significantly exceeds the list of diseases and conditions in which magnetic therapy is prohibited. Contraindications to the procedure barely exceed a dozen points, while recommendations for its implementation go over a hundred.

Application in this field of medicine

Ophthalmic diseases are no exception: magnetic therapy is widely used against them. Procedures are usually done not with the help of standard home devices, such as AMT-01 or Almag, but with the help of specialized devices. One of them is the AMO-Atos device with the Amblio-1 prefix.

In what cases does magnetic therapy help?

• The use of edematous exophthalmos contributes to the rapid removal of excess fluid and subsidence of edema.
• With glaucoma, magnetotherapy also removes excess fluid. Magnet treatment, in addition, increases the effectiveness of medications used to reduce intraocular pressure.
• You can buy a magnetotherapy device as an aid in the treatment of amblyopia and myopia. The positive influence of the magnetic field on tissues is not able to reverse the pathological process, but it stops the development of diseases.
• Inflammatory diseases of all parts of the eye, from conjunctivitis to iridocyclitis, are successfully affected by the device. Two three procedures will clearly demonstrate whether magnetotherapy helps - these diseases develop rapidly and disappear just as quickly with proper treatment.
• Since regenerative processes are activated after magnetic therapy, a course of procedures is often recommended during the rehabilitation period some time after surgery.
• The magnetotherapy deserved the most positive reviews in the use of eyelid diseases: barley, chalazion.

An important advantage that, regardless of whether Almag, AMO-Atos or AMT is used, magnetotherapy differs from many other methods of physiotherapy is its rather deep penetrating ability. During the procedure, no contact of the applicator with the eye is required, the magnetic field easily passes through the eyelid and protective gauze bandage.

Need to know

You can get acquainted with the cost of a course of treatment in a hospital on the website of the selected clinic, and with the prices for home devices - in any search engine on the request "buy magnetotherapy" or "magnetotherapy price".

Physiotherapy for the eyes involves the use of natural physical factors: magnetic floor, electric current, UV radiation, light. The procedures carried out within its framework are painless and have a long-lasting effect. They can be combined with each other and included in complex treatment along with medication.

Ophthalmologists note the "rejuvenation" of eye diseases in the modern world of electronic gadgets. Today, visual impairments are increasingly being detected in children, so preventive measures come first (along with adequate, safe treatment). They include not only physiotherapy, but also self-prophylaxis, which involves reducing eye strain and good rest.

The Sfera clinic invites you to undergo diagnostics and a course of treatment of ophthalmopathologies in Moscow. We have a unique set of equipment that allows us to detect diseases at an early stage and carry out their effective treatment.

The essence of physiotherapy of eye structures

Physiotherapy is one of the oldest areas of medical science, the methods of which are described by Avicenna and Hippocrates. Today, her methods are an important component of complex treatment, they involve the use of physical factors in order to improve metabolic processes, stimulate local blood circulation and work of retinal photorecepts, as well as expand the accommodation reserve.

This approach makes it possible to exclude the development of a number of serious pathologies, improve visual function, expand the field of view, eliminate the rapid fatigue of the organs of vision, and thereby increase efficiency. One of the advantages is the absence of age restrictions and side effects.

Indications and contraindications for physiotherapy

Electrophoresis for the eyes

Electrical stimulation for the eyes is indicated for:

• refractive disorders of the myopic type;
• pathological conditions of the retina;
• hemorrhages in various structures of the eye;
• traumatic injuries.

In the process, a special apparatus is used that creates a weak electric current, and medications that can decompose into ions. They are selected by a doctor on an individual basis. Due to the influence of currents, nerve cells are stimulated and stagnant processes are eliminated. Blood flow and the supply of nutrients to the retina and ciliary muscle increases, due to which the contractility of the lens improves.

During the procedure, the electrodes are fixed on the outside of the eye. The current strength is selected individually, taking into account the age, gender, clinical picture and general condition of the patient. The procedure is painless and does not cause discomfort. The introduction of drugs in the process is aimed at their improved absorption and increase the effect of the application.

UHF therapy

It implies the use of a continuous or pulsed electric field of ultrahigh frequencies. Applies to:

• penetrating wounds;
• the development of infectious complications;
• inflammation, accompanied by the formation of pus;
• abscesses of the internal structures of the eye.

When exposed, heat is generated, which has anti-inflammatory, antispasmodic effects, stimulating blood and lymph flow. The course of treatment includes seven to fifteen sessions every day, lasting from five to ten minutes.

Magnetotherapy for the eyes

It consists in the use of a constant or pulsed magnetic field in order to improve blood microflow, metabolic processes, reduce edema and pain symptoms. In the process, devices that create a low-frequency MF are used, and they act directly on the eyes. It takes ten to fifteen sessions lasting a quarter of an hour. The procedure is carried out with:

• inflammation of the cornea, uveal tract;
• thinning of the cornea and its adoption of the shape of a cone - keratoconus;
• degenerative lesions of the retina;
• development of complications in the postoperative period;
• partial atrophy of the optic nerve;
• spasms of the ciliary muscle;
• moving the eyeballs forward.

With the right selection and observance of the technique of conducting magnetotherapy gives an excellent effect.

Phototherapy of the eyes

Light therapy involves exposure of the eye to light waves of various lengths, depending on which infrared, ultraviolet and laser eye therapy are isolated. Penetrating into tissues, the waves are transformed into thermal and chemical energy and stimulate biochemical processes and blood flow, expanding the lumen of blood vessels, positively affecting metabolism, enhancing regeneration processes.

mechanotherapy

Mechanical treatment is represented by a complex of accurate mechanical influences that allow to influence the condition of the eye tissues. This is a massage in the form of stroking, rubbing, kneading the eyes and providing vibration effects. It allows you to solve the following tasks:

• Vasodilation and improvement of local blood flow;
• Acceleration of metabolism;
• Increase in the general tone of the eye.

Thus, accelerated recovery of the affected structures is achieved: edema subsides, sensitivity decreases, as well as inflammatory processes, drainage of intraocular fluid improves, pathologically increased IOP decreases. Massage activities can be carried out using special devices for vibration effects or by hand. Contraindications are purulent processes, penetrating wounds, ulcerative lesions of the stratum corneum, a high degree of myopia, neoplasms of malignant etiology.

Myopia or nearsightedness is a visual acuity disorder in which a person can clearly see an object of interest to him only at close range. This is due to the fact that the rays emanating from the distant objects under consideration do not focus on the retina, as is the case with normal refraction, but are concentrated in front of it. As a result, the image of a distant object is blurry.

According to statistics, 80% of the world's population suffers from myopia of various forms. The main percentage of patients falls on. But without treatment, it can progress rapidly, and the person will become worse and worse to see objects located far away.

Myopia can be of several degrees:

• (up to -3 diopters);
• (from -3 to -6 diopters);
• strong, in which vision deteriorates to -6 diopters or more.

The main cause of the disease is a genetic predisposition to myopia. If both parents do not see well into the distance, then the child in 50% of cases. In addition to heredity, the appearance of myopia provokes weakness of the muscles of the accommodative apparatus, which are responsible for the timely change in the curvature of the lens when looking near and far. If the muscles are weak, the eyeball quickly elongates, leading to the development of myopia. Visual acuity is also affected by constant increased stress on the organs (working with small details, reading in a moving vehicle, sitting in front of a computer monitor for many hours), lack of rest for the eyes.

Symptoms at the beginning of the development of the disease practically do not bother the patient. But over time, a person sees farther and worse, there is discomfort when trying to consider distant objects. Eyes quickly get tired, redden, become dry.

Physiotherapy

True myopia cannot be completely cured, but it is quite possible to stop it. In the complex treatment of myopia, doctors often use physiotherapy, which increases the efficiency of the eye muscles and improves the nutrition of their tissues.

The main physiotherapeutic procedures that are prescribed for myopia are:

1. SMV therapy. Treatment of the eyes with currents of the centimeter range, as a result of which heat is generated in the eye tissues. Due to this, the capillaries of the eyes expand, blood flow increases. At the same time, tension and fatigue of the organs of vision disappear. For physiotherapy, electrodes are applied to the eyelids and a current is started, the power of which is regulated depending on the patient's condition. He should not experience discomfort, only warmth on his face. The impact lasts 10 minutes. It is necessary to complete a course that includes 10 daily procedures.
2. ultrasound therapy. Treatment is carried out with special eye ultrasonic vibrators. A medicinal solution is applied to the patient's eyelids and an emitter similar to binoculars is pressed. The exposure time is 5 minutes. To improve vision, you need to spend at least 10 daily sessions. Under the influence of ultrasound, regenerative processes are launched in the eye tissues, muscle spasm is relieved. Ultrasonic physiotherapy is not performed for myopia, if ophthalmic pathology is combined with venous diseases, malignant neoplasms, endocrine and cardiac pathologies.
3. Electrophoresis with vitamin B2(riboflavin). Physiotherapy is carried out in the supine position. First, the patient's nose is washed with saline. Then the vitamin is injected into the nasal mucosa using weak currents. To do this, the doctor abundantly moistens cotton swabs with riboflavin and inserts them into the nostrils with tweezers. Electrodes are attached to the tampons, through which a current of 1 mA is set. Penetrating into the bloodstream, riboflavin quickly reaches the eye structures and increases the rate of biochemical processes, improves visual function, and stimulates tissue respiration. To improve the condition of the eyes, 15 sessions of 15 minutes are needed.
4. Diadynamometry. Physiotherapy consists in exposing the eyes to low-frequency pulsed currents that pass through special electrodes in the form of plates. Hydrophilic pads are placed under the electrodes. The plates are placed on the patient's eyelids, the current is turned on, gradually increasing its strength until the person feels vibrating movements. The impact lasts no more than 10 minutes. The required course is 10-15 procedures. The procedure improves blood supply and lymph flow in the structures of the organs of vision.
5. Photochromotherapy with green light. Exposure to green improves the tone of the vessels of the eyes, restores the clarity of the visual fields, normalizes cerebral circulation, normalizes blood pressure (eye and blood pressure), and has an anticonvulsant effect. If myopia causes headaches, exposure to green light on the neck with a special lamp helps. Thanks to the physiotherapy, spasmodic muscles relax, blood circulates better in the cervical vessels, delivering oxygen and nutrients to the organs of vision, which leads to an improvement in the condition of a patient with myopia. Photochromotherapy with green color stabilizes visual acuity after about a month by 0.2 diopters. At the same time, patients note not only an improvement in the clarity of vision, but also a greater color saturation of visible objects.
6. Magnetotherapy. The eyes are exposed to a low frequency alternating magnetic field. Against the background of the therapy, the pain syndrome decreases, the restoration of damaged tissues improves, and blood flow increases.
7. Laser therapy. The therapeutic effect of physiotherapy is provided by the influence of a low-intensity laser, which helps to freely circulate fluid inside the eye by opening the membrane pores of the cells. Thus, blood flow in the eye tissues is increased. The patient is put on special treatment glasses, in which he sees flashes of red from the laser beam directed at them. It passes through the pupil into the eye, and enters the ciliary muscle, stimulating its contraction. The procedure lasts 5-10 minutes. The course of treatment is 5 sessions. Laser therapy is not carried out in children under a month old, in the presence of heart disease, sepsis. Physiotherapy shows the greatest effect in children and adolescents.

Precautionary measures

Physiotherapy for myopia refers to safe methods of influencing tissues. But he also has contraindications.

26-11-2018, 16:39

Description

Physiotherapy- one of the methods of conservative treatment, widely used in the complex treatment of eye diseases. Physiotherapeutic methods for the treatment of eye diseases include electrotherapy, physicopharmaceutical treatment, phototherapy, mechanotherapy and barotherapy.

electrotherapy

The basis of the impact on the body of these methods is the use of various types of electric current. In the practice of treating eye diseases, a low-voltage direct current (galvanization), low-voltage pulsed currents (diadynamic therapy, electrical stimulation), high-voltage electric fields (UHF therapy), exposure to an alternating magnetic field (low-frequency magnetotherapy), electroreflexotherapy are used.

The most common physiotherapeutic method of treatment in ophthalmology is drug electrophoresis.

Medicinal electrophoresis

Medicinal electrophoresis- a combined physico-chemical method of local exposure to direct electric current and drugs (PM) introduced from aqueous solutions by electric current.

Synonym: iontophoresis.

Rationale

Features of medicinal electrophoresis are due to the influence of both the applied drugs and direct electric current.

When passing through the tissues from one electrode to another, the electric current encounters resistance, which depends on the electrical conductivity of the tissues. In the eyeball, intraocular fluid has the highest electrical conductivity, and the epidermis of the eyelids has the lowest. To overcome places with the lowest electrical conductivity, significant current energy is expended, which leads to the occurrence of galvanic reactions of tissues, accompanied by significant generation of heat, redistribution of ions in the cellular and intercellular substance, changes in the pH of the medium, the formation of biochemically active substances, activation of enzymes and metabolic processes. All this causes a significant local activation of blood circulation, hyperemia of tissues, a burning sensation at the site of exposure to the electrodes.

During galvanization, blood and lymph circulation is enhanced, the resorption capacity of tissues is increased, metabolic and trophic processes are stimulated, the secretory function of the glands is increased, and the permeability of the hematoophthalmic barrier is significantly increased. Due to electrophoresis, the effect of drugs is prolonged at a dose lower than that usually used for parenteral administration. In addition, the cornea serves as an ideal semi-permeable membrane through which ions penetrate into the eye. The increased permeability of the blood-ophthalmic barrier under the action of galvanization leads to a greater penetration of drugs into the eye than when they are injected into the tissues around the eyeball. In addition, drugs accumulate in the tissues, which leads to their prolonged effect on pathologically altered tissues.

Indications

Acute and chronic inflammatory and dystrophic eye diseases: barley, phlegmon, chalazions, cicatricial changes of the eyelids, episcleritis, keratitis, iridocyclitis, adhesive processes in the anterior segment of the eye, hemophthalmos, clouding of the ST, chorioretinitis, central and peripheral chorioretinal degeneration, macular degeneration, post-thrombotic retinopathy, neuritis and atrophy of the optic nerve.

Contraindications

General (valid for all physiotherapeutic methods):

• benign and malignant neoplasms;
• diseases of the blood and blood-forming organs (hemorrhagic conditions, blood clotting disorders);
• epilepsy;
• acute infectious diseases and febrile conditions of unknown etiology;
• chronic infectious diseases in the acute stage (tuberculosis, brucellosis, etc.);
• decompensated diseases of the heart, lungs and other internal organs;
• hypertension stage III.

Local: intraocular metallic foreign bodies.

Training

For electrophoresis, devices such as Potok-1, Potok-2, Elfor, etc. are used, generating continuous direct current, or Amplipulse and Tonus-2, which serve as a source of pulsating or intermittent direct currents. As electrodes, metal (or well-conducting current) plates with gaskets made of hydrophilic fabric are used, at least 1 cm thick and 1.5 cm larger than the plate. The gaskets are pre-sterilized.

Technique and aftercare

Medicinal electrophoresis is carried out in different ways.

• Electrophoresis according to Bourguignon. An electrode with a pad impregnated with a drug solution is placed on the closed eyelids, and the second electrode is placed on the back of the neck. In this way, medicinal substances are administered for diseases of the eyelids and the anterior segment of the eye.
• Tray electropheresis often used to influence the intraocular structures. With this method, the dissolved drugs are in a special eye tray with an electrode. The patient in a sitting position tilts his head and applies the bath to the open eyeball, immersing it in the solution. The second electrode is attached to the back of the neck. This method is used to treat inflammatory and degenerative processes of the anterior segment of the eye.
• Endonasal electrophoresis of drugs carried out with special pads placed in the nasal passages. Cotton turundas wound on metal electrodes are also used. The second electrode is fixed on the back of the neck. The method is used for more efficient delivery of drugs to the posterior segment of the eye in inflammatory and degenerative processes in the retina and vascular membranes.
• Local electrophoresis carried out from a special "point" electrode. In addition, the method is used for diagnosing corneal diseases and assessing intraocular fluid flow in glaucoma.

During electrophoresis by the described methods, the current strength is 0.5-1.0 mA, the duration of the procedure is 10-20 minutes. The course of treatment includes 10-15 procedures daily or every other day. Depending on the specific nosological forms and the clinical picture of the disease, vasodilators and enzyme preparations, neuro- and angioprotectors, miotics, mydriatics and other agents are used. Drug solutions are injected from the anode or cathode according to their polarity. Preliminarily experimentally establish the stability of the drugs and the electric field, the possibility of the formation of toxic metabolites, determine the polarity of the drugs, the optimal concentration of administration. All drugs for electrophoresis are approved by the Ministry of Health of the Russian Federation and are included in a special list of drugs for physiotherapy, in which they are arranged according to polarity and indicate the concentration for administration.

Alternative Methods

Diadynamophoresis, magnetophoresis, phonophoresis.

Diadynamophoresis

Diadynamophoresis- a combined physiotherapeutic method of treatment, involving the introduction of drugs using direct current with pulses of a half-sinusoidal shape, with a frequency of 50 and 100 Hz.

• Rationale. The main features of the action of diadynamic currents in the body are blocking of sensitive nerve endings and an increase in the threshold of pain sensitivity, stimulation of trophic processes, tissue metabolism and resorption of perineural edema. Diadynamic currents also contribute to the resorption of hemorrhages and turbidity of the CT.
• Indications. Keratitis of various etiologies, especially accompanied by pain syndrome; dystrophic and neurotrophic processes in the cornea; episcleritis, acute iridocyclitis; paresis of the oculomotor muscles.
• Contraindications. Fresh hemorrhages and injuries, purulent inflammation of the eyes (conjunctivitis, etc.).
• Training. For diadynamic therapy and diadynamophoresis, domestic devices are used: "SNIM-1", "Topus-1", "Tonus-2", foreign devices: "Diadynamic" (France), "Ridan" (Poland), "Biopulsar" (Bulgaria). ). The devices modulate various types of pulsed current. In ophthalmic practice, three types of current are used: push-pull fixed, modulated by short periods and modulated by long periods.
• Methodology and aftercare. For diadynamic therapysmall local bipolar electrodes and plate electrodes are used. Usually, the active electrode (cathode) is placed in the projection of the exit site of the supraorbital nerve on the skin of the forehead above the eyebrow or infraorbital nerve (the skin of the lower orbital margin). The second electrode is placed in the temporal region, at the outer corner of the palpebral fissure. The current strength is 1.0-1.5 mA, the duration of the procedure is 6-8 minutes. A pad of hydrophilic fabric moistened with novocaine solution or isotonic solution is placed on the active electrode. During the procedure, the patient feels a vibration or slight tingling. In the presence of plate electrodes, one is applied to the skin of closed eyelids above the eyeball, the other is applied to the skin of the temporal region. The current strength in this case is 0.2-0.5 mA, the duration of the procedure is 3-6 minutes. In one procedure, it is recommended to use several types of current. For diadynamophoresismore often, oval-shaped electrodes are used, which are placed on the closed eyelids of the diseased eye and on the area of ​​the superciliary arch. The activity of the electrode is determined by the polarity of the administered drug. One-layer filter paper pads are wetted with drug solutions, which are placed between the skin and a hydrophilic cloth pad, on top of which an electrode is applied. Before the procedure, 1-2 drops of the injected substance are installed in the conjunctival cavity. First, a push-pull continuous current is applied for 10 minutes, then for 2 3 minutes - modulation in short periods. The current strength is regulated according to the subjective sensations of the patient (small vibration), but not more than 2 mA. The course of treatment is 6-8 procedures, daily. To increase the effectiveness of treatment, diadynamophoresis can be used according to the bath technique.
• Alternative methods. Medicinal electrophoresis, magnetophoresis.

electrical stimulation

electrical stimulation- the impact of weak impulses of an electric current of a certain structure and sequence on the sensory and neuromuscular apparatus of the eye.

Rationale

The therapeutic effect of electrical stimulation is due to the functional induction of excessive anabolism, which manifests itself in the activation of reparative processes of intracellular and tissue regeneration. As a result of these processes in the optic nerve and retina, the working capacity of those elements that remain viable against the background of a decrease in the conduction of nerve impulses is restored. The effects of electrical stimulation are used in diseases accompanied by damage to neuroreception and the reflex arc.

There are transcutaneous, transconjunctival and implantation electrical stimulation. Transcutaneous electrical stimulation is most commonly used.

Indications

Optic nerve atrophy of various etiologies, amblyopia in children of the refractive and obscurative type, myopia, retinal dystrophy, primary open-angle compensated glaucoma, neurogenic keratitis.

Contraindications

Tumors of the orbit and the eyeball, purulent processes to the orbit, thrombosis, embolism of the branches of the central vein and retinal artery, uncompensated glaucoma.

Training

For electrical stimulation, the following devices are used: ESU-2, ESO-2, Phosphen, Carnelian.

Technique and aftercare

The most common technique in which the active electrode is applied to the upper eyelid of the patient alternately temporally and nasally. An indifferent electrode with a large contact surface is attached to the forearm. In order to determine the parameters of the stimulating current, the current intensity is determined by the thresholds for the occurrence of electrophosphenes, and its frequency is determined by the critical frequency of the decrease and disappearance of electrophosphenes. Monophasic negative rectangular pulses with a duration of 10 ms with a repetition rate of 5-30 Hz and a current amplitude of 10-800 μA are fed through the active electrode. Electrical stimulation is carried out in a pattern mode (4-8 pulses) at a pattern repetition rate of 0.5-20 Hz. 4-6 series of pulses lasting 15-45 s are applied to each eyeball, the interval between series is 1 min. The course of treatment is 5-10 sessions, daily. If necessary, after 3-6 months. treatment can be repeated.

UHF therapy

UHF therapy is a method of treatment, which consists in exposing parts of the body to a continuous or pulsed electric field of ultra-high frequency (40.68 and 27.12 MHz).

Rationale

The electric field of ultrahigh frequency causes vibrations of ions with the same frequency, rotation of dipole molecules, polarization of dielectric particles. These phenomena are accompanied by the formation of intracellular heat, the amount of which depends on the electrical conductivity and dielectric properties of tissues. UHF radiation freely penetrates through air spaces, skin, subcutaneous adipose tissue, bone tissue, i.e., into those structures that remain inaccessible to other types of energy. Most UHF energy is absorbed in the subcutaneous adipose tissue. It is here that the greatest heating of tissues occurs.

Indications

Dacryocystitis, phlegmon of the lacrimal sac, barley, keratitis, uveitis.

Local contraindications

Lacrimation, dense chalazions, fresh or recurrent hemorrhages in the CT, uncompensated glaucoma, malignant tumors of the eye and orbit.

Training

In eye practice, such devices as UHF-62, UHF-30, UHF 4, etc. are used. A two-electrode technique is used.

Method of application

When exposed to the region of the eyeball, electrodes No. 1 (3.8 cm) are placed tangentially: one at a distance of 1 cm from the eye, the second at a distance of 4-5 cm from the auricle. A gap of 2 cm is left between the skin and the electrodes. The exposure dose is non-thermal or low-thermal. The duration of exposure is 6-8 minutes. The course of treatment is from 3 to 10 procedures. With dacryocystitis, the active electrode is placed on the area of ​​the lacrimal sac with a gap of 1-1.5 cm, the other electrode is placed on the opposite side of the nose at a distance of 3-4 cm from the nasolabial fold.

Aftercare

After the procedure, it is desirable to stay indoors for 15-20 minutes.

Alternative Methods

Diadynamic therapy, drug electrophoresis.

Magnetotherapy

Magnetotherapy- use for therapeutic purposes of variable or intermittent constant magnetic fields of low frequency.

Rationale

Magnetic fields have a pronounced anti-inflammatory, analgesic and anti-edematous effect. Magnetotherapy helps to improve trophism, accelerate the processes of tissue regeneration, epithelization of ulcerative surfaces, and improve microcirculation. Treatment is carried out with a constant, variable and less often pulsed magnetic field. An alternating magnetic field has advantages, since a lower field strength is required to achieve the desired therapeutic effect and the exposure time is significantly shortened.

Magnetotherapy is used to relieve inflammation and relieve edema, resorption of infiltrates, exudate and intraocular hemorrhages, accelerate metabolic processes, improve blood circulation (microcirculation), improve trophism and better healing of corneal wounds. Magnetotherapy has advantages over other methods of physiotherapy: the procedure does not require contact of the eyeball with the inductor, since the magnetic field passes through closed eyelids and gauze bandages.

Indications

Diseases of the eyelids (blepharitis, barley), keratitis of various etiologies, keratoconus, iridocyclitis, postoperative complications, tapetoretinal and other retinal dystrophies, myopia and accommodation disorders, partial atrophy of the optic nerve, ischemic conditions of the retina, hemorrhages in the membranes and environments of the eye, edematous exophthalmos.

Local contraindications

Intraocular foreign bodies, recurrent hemorrhages in the CT, hemorrhagic vasculitis.

Training

For low-frequency magnetotherapy, the Polus-1 and Polus-2 devices are more often used.

Method of application

Mode of procedures: 1st intensity, corresponding to a magnetic induction of about 10 mT, sinusoidal magnetic field, continuous mode. The magnetic field inductor is placed directly in front of the diseased eye. The procedure can be carried out through a gauze bandage. The duration of exposure is 7-10 minutes. for a course of 10-15 daily procedures.

Magnetophoresis

Magnetophoresis- a physiotherapeutic method of treatment that allows you to enter drugs using a low-frequency magnetic field.

Rationale

In addition to the effects of drugs, the therapeutic effect is achieved due to the influence of a magnetic field, which has vasoactive (mainly on microcirculation), anti-inflammatory (decongestant), trophic, local anesthetic, and hypocoagulant effects. Unlike electrophoresis, there is no need to establish polarity for the administration of drugs, and the substances are administered in the usual therapeutic doses. The bath method of administration is also used, and the more commonly used method of administration through closed eyelids, when the medicinal substance is applied to the eyelids or pre-injected into the conjunctival cavity.

Indications

Acute and chronic inflammatory and dystrophic (degenerative) processes in the anterior and posterior segment of the eye, for example, in diseases such as endocrine ophthalmopathy, conjunctivitis, episcleritis, keratitis, epithelial-endothelial corneal dystrophy, dry eye syndrome, iridocyclitis, various dystrophic and edematous forms diseases of the retina and vascular membranes of the eye.

Contraindications

The same as with magnetotherapy.

Electroreflexotherapy

Electroreflexotherapy- therapeutic and prophylactic effects of various physical factors on the point areas of the human body acupuncture points.

Synonym: puncture physiotherapy.

Rationale

Puncture physiotherapy owes its origin to acupuncture, which originated in ancient times. It is based on the concept of internal energy channels communicating between the internal organs and the skin. In reflexology, the areas of the body that are affected are called acupuncture points. It is believed that acupuncture points are zones of maximum concentration of nerve elements, a peripheral reflex element through which, for therapeutic purposes, various stimuli can be applied to the body (electro-, phono-, laser-, magnetopuncture, etc.).

Indications

Progressive myopia, accommodation spasms, amblyopia, glaucoma, cataracts. degenerative diseases of the retina and optic nerve.

Training

The exact location of points and the impact on them by physical factors is carried out using the devices "ELAN", "ELITE", "ATOS", "Karat". The latest generation of devices allows you to influence acupuncture points with direct and pulsed currents, "packages" of impulses, automatically switch the polarity of the current, and simultaneously act on 5-6 points.

Methodology

Stimulation of biologically active points carry out with an electric current with a power of 20 to 500 μA at a voltage of not more than 9 V. The current strength depends on the location of biologically active points: for example, in the auricle area, the permissible level is 20-50 μA, and in the axillary mass of the gluteal region - up to 500 μA. During the procedure, the patient may feel a slight tingling, bursting, warmth in the area of ​​​​the acupuncture point.

Phototherapy

Phototherapy combines methods that use the energy of electromagnetic oscillations of light and close to it wave ranges, in particular ultraviolet, infrared, visible radiation. In ophthalmology, laser therapy is most widely used.

laser therapy

laser therapy- the use for therapeutic purposes of irradiating certain parts of the body with coherent monochromatic radiation obtained using quantum generators called lasers.

Rationale

Electromagnetic oscillations, which are coherent and monochromatic, make it possible to obtain high density at low output power (up to 50 mW). When exposed to laser radiation, a photodynamic effect occurs, which manifests itself in the activation of the nuclear apparatus of the cell, ribosomes, intracellular enzyme systems, cytochrome oxidase, catalase, etc.

The main clinical effects of laser therapy (analgesic, anti-inflammatory, decongestant, antispasmodic, regenerative, desensitizing, immunocorrective, vasoactive, hypocholesterolemic, vagotonic, bactericidal and bacteriostatic) have been used in the treatment of many eye diseases.

Indications

Diseases of the anterior and posterior segment of the eye: blepharitis, barley, chalazion, keratitis, edematous forms of corneal dystrophy, dry eye syndrome, corneal healing disorders, inflammatory diseases of the eyelids. Laser stimulation of the ciliary muscle has a therapeutic effect in case of spasms of accommodation, mild myopia, asthenopia. Laser stimulation of the retina and optic nerve is indicated for amblyopia, degenerative diseases of the retina and optic nerve.

Methodology

Numerous devices have been proposed that generate laser radiation at therapeutic doses, with instructions and detailed descriptions of the methods approved by the Ministry of Health of the Russian Federation. Either direct irradiation of the elements of the eyeball with laser radiation is carried out (devices "LOT", "LAST", etc.), or the reflected radiation affects the neuro-receptor apparatus of the visual analyzer by observing the laser speckle by the patient (devices "Speckle", "LOT", etc. .). The irradiation time usually does not exceed 5-10 minutes, the diameter of the laser radiation spot is 5-15 mm. During irradiation, up to 200 μW/cm laser radiation flux density is used. Depending on the area of ​​irradiation, different nozzles are used. The course of treatment is prescribed 5-10 procedures, daily or every other day.

quantum therapy

quantum therapy- biorhythmic effect on the organ of vision of light quanta with low-intensity energy and different wavelengths.

Rationale

The therapeutic effect is due to the regulation of subcortical-cortical bioelectrical processes, the exchange of neurotransmitters of the endorphin and immune systems, the hormonal activity of the endocrine glands, and the improvement of neuro- and hemodynamics.

Indications

Accommodation disorders, progressive myopia, asthenopia.

Method of application

Spectral ophthalmological devices are used, which carry out color-impulse exposure at different frequencies. Some devices combine both quantum exposure and laser therapy in the infrared range.

mechanotherapy

Phonophoresis

It includes the use of various types of massage, vibration therapy, ultrasound therapy for therapeutic purposes. In ophthalmology, such a treatment method as phonophoresis is widely used.

Phonophoresis- combined physico-chemical method of exposure to acoustic vibrations of ultrahigh frequency and LS.

Rationale

Features of the method and clinical effects are due to both the influence of drugs and the impact of ultrasound, which has therapeutic effects. The mechanical effect is associated with the impact of alternating acoustic pressure due to the alternation of compression and rarefaction zones at the subcellular and cellular level (the so-called vibration micromassage). The thermal effect is associated with the effect of transformation of the absorbed energy of ultrasonic vibrations into heat. The main clinical effects of ultrasound are anti-inflammatory, analgesic, antispasmodic, metabolic, defibrosing.

Indications

Chalazion, cicatricial skin lesions of the eyelids, dystrophic processes in the anterior and posterior segments of the eye: corneal opacities, adhesive processes in the anterior segment of the eye with iridocyclitis and after surgery, clouding of the ST, hemophthalmia, macular degeneration, fibrous changes in the retina and vascular membranes.

Contraindications

Fresh hemorrhages in the ST, acute iridocyclitis and uveitis.

Training

For phonophoresis, domestic devices are used, such as UZT-104, UZT-3.06, etc. The devices differ in the frequency at which they operate. For deeper penetration of ultrasound, a frequency of 880 kHz is used, and for the anterior segment of the eye - 2640 kHz.

Methodology

Continuous or pulsed mode is used with an ultrasound intensity of 0.05 to 1.0 W/cm squared (usually 0.2-0.4 W/cm squared according to the bath technique). The duration of the procedure is 5-7 minutes, daily or every other day. Various drugs are used, more often proteolytic agents: collalisin, hyaluronidase, aloe preparations, etc.

Combined physiotherapy procedures are offered:

• phonoelectrophoresis- combined use of ultrasound, direct electric current and drugs;
• superelectrophoresis- preliminary scoring by ultrasound followed by phonoelectrophoresis.

Alternative Methods

Medicinal electrophoresis, magnetophoresis.

True myopia cannot be cured, but its development can be stopped. Doctors often use physiotherapy as one of the auxiliary methods of treatment. Exposure to physical factors helps to increase the efficiency of the eye muscles and improve the nutrition of eye tissues.

Treatment options

The following methods are recognized as effective in the fight against the disease:

1. Centimeter wave (CMW) therapy. It implies treatment with currents of the centimeter range. During the procedure, heat is generated in the tissues of the eye, which causes the expansion of capillaries and the acceleration of blood flow. More nutrients and oxygen begin to flow to the organs of vision. At the same time, spasmodic muscles relax, the feeling of tension and fatigue in the eyes disappears.

For therapy, special electrodes in the form of half masks are used, which are applied to the eyelids. The procedure is dosed according to the power of the current and the sensations of the patient. During the treatment, there should be no unpleasant tingling or burning sensation. The patient should feel only a slight warmth in the upper part of the face. Power is set within 2 watts. Exposure to currents lasts no more than 10 minutes. Sessions are carried out daily for 10-12 days.

Absolute contraindications to electrotherapy are cataracts, glaucoma, thyrotoxicosis, epilepsy, pregnancy, current intolerance and the presence of a pacemaker.

1. Ultrasound (US) therapy. Under the action of ultrasound, metabolism in tissues is activated, blood flow increases, and reparative processes improve. All these factors have a beneficial effect on the work of the eye muscles. A characteristic feature of the procedure is also its pronounced antispasmodic effect.

The therapy is carried out with the help of ultrasonic vibrators for the eyes, shaped like binoculars. A contact medium is applied to the patient's eyelids (water or medicinal solution - at the doctor's discretion), after which the emitter is pressed against the eyes. The exposure time is 3-5 minutes. No discomfort is felt during the procedure. The course of treatment includes 10 sessions, which are carried out daily.

Ultrasound therapy is not prescribed for severe cardiovascular diseases, endocrine disorders, thrombophlebitis, malignant neoplasms and during pregnancy.

1. with riboflavin(vitamin B2). The medicinal substance is administered with the help of weak currents into the nasal mucosa (endonasal). Once in the blood, riboflavin reaches the organs of vision and has a metabolic effect: it increases the rate of biochemical processes, stimulates tissue respiration, and improves visual function.

Before the start of the session, the nasal cavity is washed with saline. The procedure is performed in the supine position. With tweezers, the doctor inserts cotton turundas moistened with a vitamin solution into the patient's nostrils. An electrode is pressed to the ends of the turundas. The device is set to a current strength of not more than 1 mA.

During the procedure, the patient feels a slight tingling and warmth. Therapy time is 10-15 minutes. The course is assigned 15-20 sessions.

Treatment is not resorted to in the presence of acute infectious pathologies, bleeding disorders, oncological diseases and current intolerance.

1. Electrophoresis with iodine. The therapy is in many ways similar to the previous one, only in this case the drug is injected directly into the skin of the eyelids. Iodine has a reparative, anti-inflammatory and metabolic effect. Its use is especially effective in progressive myopia.

For the procedure, the patient is placed on the couch. On the eyelids, hydrophilic pads moistened with a solution of potassium iodide are placed. Plate electrodes are placed on top. The recommended current strength is 1 mA. The exposure time is 10-15 minutes. Sessions are repeated daily for 10 days. Contraindications for all types of electrophoresis are the same.

1. . The patient's eyes are exposed to low-frequency pulsed currents. The procedure improves blood and lymph circulation, stimulates tissue metabolism reactions, and has an analgesic effect. Immediately after the end of the session, patients notice a decrease in visual fatigue.

The therapy is performed using plate electrodes that are applied to the eyelids. Ion-exchange membranes or hydrophilic spacers are placed under the plates. The intensity of exposure is dosed according to sensations. The current strength is increased until the patient feels a distinct vibration. Sessions are 10 minutes long. The course may require 10 to 15 procedures.

Diadynamic treatment is not prescribed for blood diseases, epilepsy, thrombophlebitis, bleeding and current intolerance.

During the period of physiotherapy, it is important to observe the rules of visual hygiene and follow them, otherwise noticeable success in the fight against myopia will not be achieved.