юнит 7. Unit 7 Ophthalmology The normal eye
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Unit 7 Ophthalmology The normal eye. The eyeball is so positioned in the orbit that the anterior surface of the cornea is just the line with the superior and inferior orbital margins- a useful relation in the assessment of proptosis. The cornea joins the sclera at the limbus, the corneal epithelium of the conjunctiva becoming continuous with the epithelium of the conjunctiva which adherent here to the underlying episcleral tissue. The anterior chamber is the space enclosed by the cornea anteriorly and the lens and iris posteriorly. Нормальный глаз. Глазное яблоко расположено на орбите так, что передняя поверхность роговицы представляет собой прямую линию с верхним и нижним краями орбиты - полезное соотношение при оценке проптоза. Роговица соединяется со склерой в лимбе, эпителий роговицы конъюнктивы становится непрерывным с эпителием конъюнктивы, который прикрепляется здесь к подлежащей эписклеральной ткани. Передняя камера - это пространство, ограниченное роговицей спереди и хрусталиком и радужкой сзади. The pupillary margin of the iris is in constant contact with the anterior surface of the lens, although aqueous humour is able to flow from the posterior chamber through the pupil into the anterior chamber, from which it drains through the trabeculae into Schlemm's canal. The iris, ciliary body and choroid form a continuos structure called the uveal tract. Зрачковый край радужки находится в постоянном контакте с передней поверхностью хрусталика, хотя водянистая влага может течь из задней камеры через зрачок в переднюю камеру, откуда она стекает через трабекулы в канал Шлемма. Радужка, цилиарное тело и сосудистая оболочка образуют непрерывную структуру, называемую увеальным трактом. The inner layer, the retina, is composed of visual purple, made up of rods and cones. The retina has three spots, the macula lutea or yellow spot, the fovea centralis and the optic disc, where it is pierced by optic nerve. Внутренний слой, сетчатка, состоит из зрительного пурпура, состоящий из палочек и колбочек. Сетчатка имеет три пятна: желтое пятно или желтое пятно, центральную ямку и диск зрительного нерва, где он пронизан зрительным нервом. The eyelids consist essentially of a plate of condensed fibrous tissue lined internally by conjuctiva and covered externally by the orbicularis muscle and skin. The Meibomian glands are embedded in the tarsal plate and open on the free margin of the lid very close to its posterior border. The inner and outer angles of the palpebral fissure are known as the inner and outer canthi; the caruncle and plica semilunaris can be seen at the inner canthus. The punctum lacrimalis, through which the tears flow, lies in the close apposition to the globe and cannot normally be seen unless the lid is everted. Веки состоят в основном из пластинки уплотненной фиброзной ткани, выстланной изнутри конъюнктивой и покрытой снаружи круговой мышцей и кожей. Мейбомиевы железы внедряются в пластинку предплюсны и открываются на свободном крае века очень близко к его задней границе. Внутренний и внешний углы глазной щели известны как внутренний и внешний угол глазка; на внутреннем уголке глаза видны мясистые кости и полулунные складки. Слезная протока, по которому текут слезы, находится в непосредственной близости от глазного яблока и обычно не может быть видна, если веко не вывернуто. The eye is moved by the eye muscles. The visual pathways include the optic nerves, the optic chiasma, with crossed and uncrossed fibres, the medial and lateral geniculate bodies, the superior quadrigeminal bodies, optic radiations and the occipital cortex. Глаз приводится в движение глазными мышцами. Зрительные пути включают зрительные нервы, зрительный перекрест с пересеченными и непересекающимися волокнами, медиальное и латеральное коленчатые тела, верхние тела четверохолмия, зрительные излучения и затылочную кору. Visual acuity is tested by reading Snellen's test types; the error is measured by refractions. Errors of refraction are classified as hypermetropia, myopia, presbyopia, and astigmatism. Острота зрения проверяется чтением типов тестов Снеллена; ошибка измеряется по преломлениям. Ошибки рефракции классифицируются как гиперметропия, миопия, пресбиопия и астигматизм. A squint or strabismus is a fairly common condition in children. It is treated by prescribing spectacles to correct the error of refraction. If one eye is amblyopic, occlusion of the good eye is often useful. If all fails, operation may be needed to correct the cosmetic defect. Косоглазие или косоглазие - довольно частое заболевание у детей. Лечится назначением очков для исправления аномалии рефракции. Если один глаз амблиопичен, часто бывает полезна окклюзия здорового глаза. В случае неудачи может потребоваться операция по исправлению косметического дефекта. The eyelids may be affected by several diseases. Orbital cellulitis is an infection that extends from the nasal sinuses giving rise to acute swelling of the orbital tissue. The condition is serious because of the possibility of meningitis or cavernous sinus thrombosis. Веки могут поражаться несколькими заболеваниями. Орбитальный целлюлит - это инфекция, которая распространяется из носовых пазух и вызывает острый отек тканей глазницы. Состояние серьезное из-за возможности менингита или тромбоза кавернозного синуса. Acute dacryoadenitis is rare but may occur as a complication of mumps. A painful swelling appears in the outer region of the upper lid, causing some degree of ptosis. A dermoid cyst as well as a drooping lid on one or both sides is a congenial defect. Острый дакриоаденит возникает редко, но может возникать как осложнение паротита. Во внешней области верхнего века появляется болезненная припухлость, вызывающая некоторую степень птоза. Дермоидная киста, а также опущенное веко с одной или обеих сторон - врожденный дефект. Ectropion is a condition in which the lower lid falls away from the globe and becomes everted; in entropion the lid turns inwards and the lashes cause much irritation by rubbing on the cornea. Эктропион - это состояние, при котором нижнее веко отрывается от глазного яблока и выворачивается; при энтропионе веко поворачивается внутрь, и ресницы вызывают сильное раздражение, натирая роговицу. Inflammatory lesions of the lids include marginal cysts. Blepharitis is a chronic inflammation of the lid margin. In severe form it affects the lash follicles, leading to destruction of the lashes and deformity of the lid margin (ulcerative blepharitis) and to molluscum contagiosum, a virus disease. Among skin conditions of the lids contact dermatitis is very common, which may follow the topical application of drugs, cosmetics or any foreign material. The thin skin and loose subcutaneous tissue of the lids predispose to oedema in this region. Local inflammations, renal disease, myxoedema are some of the many causes. Воспалительные поражения век включают краевые кисты. Блефарит - хроническое воспаление края века. В тяжелой форме поражаются фолликулы ресниц, приводя к разрушению ресниц и деформации края век (язвенный блефарит) и к вирусному заболеванию контагиозного моллюска. Среди кожных заболеваний век очень распространен контактный дерматит, который может возникать после местного применения лекарств, косметики или любого инородного материала. Тонкая кожа и рыхлая подкожная клетчатка век предрасполагают к возникновению отеков в этой области. Местные воспаления, заболевания почек, микседема - вот некоторые из многих причин. Xanthelasma, deposition of lipid material, does not cause any symptoms but may require excision for cosmetic reasons. Ксантелазма, отложение липидного материала, не вызывает никаких симптомов, но может потребовать удаления по косметическим причинам. Herpes opthalmicus may occur in the area of the ophthalmic division of the trigeminal nerve. Офтальмологический герпес может возникать в области офтальмологического отдела тройничного нерва. Hemangioma, neurofibroma, papilloma are neoplasms of the lids of benign type. Malignant neoplasms must be excised and careful follow-up examination is necessary for many years. Гемангиома, нейрофиброма, папиллома - новообразования век доброкачественного типа. Злокачественные новообразования необходимо удалять, и необходимо тщательное последующее обследование в течение многих лет. The most common diseases of the conjuctiva are inflammations: acute catarrhal conjunctivitis, vernal, chronic, angular, and viral conjunctivitis. Наиболее частыми заболеваниями конъюнктивы являются воспаления: острый катаральный конъюнктивит, весенний, хронический, ангулярный и вирусный конъюнктивит. The cornea, being an avascular structure, is very rarely the site of origin of a tumour. Many new growths, however, arise from the limbus, which is the site of transition from conjuctival to corneal epithelium, and these are grouped together under he title of bulbar tumours (epibulbar dermoid hemangioma, cystic nevus, epithelioma, sarcoma). Inflammations of the cornea include the dendritic ulcer, mycotic ulcer, superficial, interstitial, or disciform keratitis. Keratoconus is of the degenerative character. Deficiency of tear production leads to keratitis sicca, a characteristic picture in the cornea and conjunctiva which loses its normal lustre and on microscopic examination with the slit-lamp the precorneal tear film can be seen to be reduced. Роговица, будучи бессосудистой структурой, очень редко является местом возникновения опухоли. Однако многие новообразования возникают из лимба, который является местом перехода от конъюнктивального эпителия к роговичному, и они сгруппированы вместе под названием бульбарные опухоли (эпибульбарная дермоидная гемангиома, кистозный невус, эпителиома, саркома). Воспаления роговицы включают дендритную язву, грибковую язву, поверхностный, интерстициальный или дискообразный кератит. Кератоконус носит дегенеративный характер. Недостаток слезоотделения приводит к сухому кератиту, характерной картине роговицы и конъюнктивы, которая теряет свой нормальный блеск, и при микроскопическом исследовании с помощью щелевой лампы видно, что предкорнеальная слезная пленка уменьшается. The sclera may be affected by episcleritis probably allergic in nature in some type and by less common scleritis. Scleromalacia perforans is characterized by the appearance of degenerate areas in the sclera. Склера может быть поражена эписклеритом, вероятно, аллергической природы у некоторых типов и реже склеритом. Перфорированная склеромаляция характеризуется появлением дегенеративных участков склеры. Acute iridocyclitis is accompanied with pain, photophobia lacrimation and blurring of vision. Chronic anterior uveitis occurs in two main types: one caused by granulomatous disease such as tuberculosis and sarcoidosis is characterized by severe destructive lesions, often with nodules in the iris; the other type is a quiet process involving more particularly the ciliary body. Острый иридоциклит сопровождается болью, светобоязненным слезотечением и нечеткостью зрения. Хронический передний увеит бывает двух основных типов: первый, вызванный гранулематозным заболеванием, таким как туберкулез и саркоидоз, характеризуется тяжелыми деструктивными поражениями, часто с узелками в радужной оболочке; другой тип - это тихий процесс, затрагивающий, в частности, цилиарное тело. The lens, being an avascular structure, is never the site of a new growth, but the iris and ciliary body may be the site of tumorous growths similar to those occurring in the choroid, the commonest being neuroectodermal in origin, such as nevus, leiomyoma of the iris, malignant melanoma of ciliary body or iris, ring sarcoma of the iris. The anterior segment may suffer some trauma. Perforation wounds of the cornea frequently involve the iris and lens. The thinnest part of the iris is at its origin from the ciliary body, and a contusion of the eye may tear the iris at this point, causing iridodialysis. Contusion injuries may rupture the zonule of the lens and dislocation, laterally or downwards. Хрусталик, будучи бессосудистой структурой, никогда не является местом новообразования, но радужная оболочка и цилиарное тело могут быть местом опухолевых разрастаний, подобных тем, которые возникают в сосудистой оболочке, наиболее распространенными из которых являются нейроэктодермальные образования, такие как невус, лейомиома. радужной оболочки, злокачественная меланома цилиарного тела или радужки, кольцевая саркома радужки. Передний сегмент может получить травму. Перфорационные раны роговицы часто затрагивают радужку и хрусталик. Самая тонкая часть радужной оболочки происходит от цилиарного тела, и ушиб глаза может привести к разрыву радужки в этой точке, вызывая иридодиализ. Ушибы могут привести к разрыву зоны хрусталика и вывиху сбоку или вниз. A wide variety of foreign bodies may enter the eye in injuris. The immediate symptoms may be slight, and a small corneal wound is easily overlooked. Radiography of the eye should be taken after every injury which it is at all revealed by radiography, an examination with a slit-lamp microscope may enable it to be seen in the segment. При травме в глаз могут попасть самые разные инородные тела. Непосредственные симптомы могут быть незначительными, а небольшую рану роговицы легко не заметить. Рентгенографию глаза следует делать после каждой травмы, которая вообще выявляется при рентгенографии, исследование с помощью микроскопа с щелевой лампой может позволить увидеть его в сегменте. The lens may be affected by congenital, coronary, senile or diabetic cataract. Surgical treatment is indicated in most cases. Хрусталик может быть поражен врожденной, коронарной, старческой или диабетической катарактой. В большинстве случаев показано хирургическое лечение. Glaucoma is a condition in which raised intraocular pressure causes pathological changes in the eye. Глаукома - это состояние, при котором повышенное внутриглазное давление вызывает патологические изменения в глазу. Vocabulary
Exercises I. Answer the following questions: 1. What parts does the eye consist of? The eye is made up of three coats, or layers, enclosing various anatomical structures. The outermost layer, known as the fibrous tunic, is composed of the cornea and sclera, which provide shape to the eye and support the deeper structures. The middle layer, known as the vascular tunic or uvea, consists of the choroid, ciliary body, pigmented epithelium and iris. The innermost is the retina, which gets its oxygenation from the blood vessels of the choroid (posteriorly) as well as the retinal vessels (anteriorly). 2. How is the eyeball positioned? The eyeball is so positioned in the orbit that the anterior surface of the cornea is just the line with the superior and inferior orbital margins. 3. Where do the cornea and the sclera join? The cornea joins the sclera at the limbus, the corneal epithelium of the conjunctiva becoming continuous with the epithelium of the conjunctiva which adherent here to the underlying episcleral tissue. 4. Describe the anterior chamber. The anterior chamber is the space enclosed by the cornea anteriorly and the lens and iris posteriorly. 5. What is the function of the conjunctiva? The primary functions of the conjunctiva are: Keep the front surface of the eye moist and lubricated. Keep the inner surface of the eyelids moist and lubricated so they open and close easily without friction or causing eye irritation. Protect the eye from dust, debris and infection-causing microorganisms. The conjunctiva has many small blood vessels that provide nutrients to the eye and lids. It also contains special cells that secrete a component of the tear film to help prevent dry eye syndrome. 6. What do we call the uveal tract? The iris, ciliary body and choroid form a continuos structure called the uveal tract. 7. What is the retina composed of? The inner layer, the retina, is composed of visual purple, made up of rods and cones. 8. What spots do we distinguish there? The retina has three spots, the macula lutea or yellow spot. 9 Where does the optic nerve enter the eye? The fovea centralis and the optic disc, where it is pierced by optic nerve. 10. Can you describe the structure of the eyelids? The eyelids consist essentially of a plate of condensed fibrous tissue lined internally by conjuctiva and covered externally by the orbicularis muscle and skin. 11. Where are the Meibomian glands? The Meibomian glands are embedded in the tarsal plate and open on the free margin of the lid very close to its posterior border. 12. What are the canthi? The inner and outer angles of the palpebral fissure are known as the inner and outer canthi. 13. Where is the caruncle? The caruncle and plica semilunaris can be seen at the inner canthus. 14. What muscles make the eye move? The eye is moved by the eye muscles. 15. Can the punctum lacrimalis normally be seen? . The punctum lacrimalis, through which the tears flow, lies in the close apposition to the globe and cannot normally be seen unless the lid is everted. 16. What do you understand under the term the visual pathways? The visual pathways include the optic nerves, the optic chiasma, with crossed and uncrossed fibres, the medial and lateral geniculate bodies, the superior quadrigeminal bodies, optic radiations and the occipital cortex. 17. What is used for testing visual acuity? Visual acuity is tested by reading Snellen's test types; the error is measured by refractions. 18 How are the errors of refraction classified? Errors of refraction are classified as hypermetropia, myopia, presbyopia, and astigmatism. 19. What is a squint? A squint or strabismus is a fairly common condition in children. A squint, or strabismus, is a condition in which the eyes do not align properly. One eye turns inwards, upwards, downwards, or outwards, while the other one focuses at one spot. 20. How is it treated? It is treated by prescribing spectacles to correct the error of refraction. 21. What may be useful if one eye is amblyopic? If one eye is amblyopic, occlusion of the good eye is often useful. If all fails, operation may be needed to correct the cosmetic defect. 22. What diseases may affect the eye? Common Eye Disorders and Diseases Refractive Errors. Age-Related Macular Degeneration. Cataract. Diabetic Retinopathy. Glaucoma. Amblyopia. Strabismus. 23. Why is orbital cellulitis a serious disease? Orbital cellulitis is an infection that extends from the nasal sinuses giving rise to acute swelling of the orbital tissue. The condition is serious because of the possibility of meningitis or cavernous sinus thrombosis. 24. Describe the symptoms of acute dacryoadenitis. A painful swelling appears in the outer region of the upper lid, causing some degree of ptosis. 25. What disease is it associated with? Acute dacryoadenitis is rare but may occur as a complication of mumps. 26. What is meant by ectropion and entropion? Ectropion is a condition in which the lower lid falls away from the globe and becomes everted; in entropion the lid turns inwards and the lashes cause much irritation by rubbing on the cornea. 27. What skin conditions of the lids are very common? Among skin conditions of the lids contact dermatitis is very common, which may follow the topical application of drugs, cosmetics or any foreign material. 28. What other condition of the lids can you name? Inflammatory lesions of the lids include marginal cysts. Blepharitis is a chronic inflammation of the lid margin. In severe form it affects the lash follicles, leading to destruction of the lashes and deformity of the lid margin (ulcerative blepharitis) and to molluscum contagiosum, a virus disease. 29. Do neoplasms affect the eyes? Hemangioma, neurofibroma, papilloma are neoplasms of the lids of benign type. Malignant neoplasms must be excised and careful follow-up examination is necessary for many years. 30. What are the most common diseases of the conjunctiva? The most common diseases of the conjuctiva are inflammations: acute catarrhal conjunctivitis, vernal, chronic, angular, and viral conjunctivitis. 31. Where do tumours usually arise from? Many new growths, however, arise from the limbus, which is the site of transition from conjuctival to corneal epithelium, and these are grouped together under he title of bulbar tumours (epibulbar dermoid hemangioma, cystic nevus, epithelioma, sarcoma). 32. What is keratoconus? Keratoconus (KC) is a disorder of the eye which results in progressive thinning of the cornea. 33. What is the probable cause of episcleritis? The sclera may be affected by episcleritis probably allergic in nature in some type and by less common scleritis. 34. Name the most common disease of the iris. A common iris problem is when the iris becomes inflamed. This malady is called iritis. Infections such as tuberculosis, toxoplasmosis, herpes, syphilis, lyme disesase, and tuberculosis may cause inflammation of the iris. Blunt trauma to the eye can cause traumatic inflammation to the iris. 35. Do new growths appear in the lens? The lens, being an avascular structure, is never the site of a new growth, but the iris and ciliary body may be the site of tumorous growths similar to those occurring in the choroid. 36. What parts of the eye may suffer from trauma? The anterior segment may suffer some trauma. 37. What injuries may it cause? Perforation wounds of the cornea frequently involve the iris and lens. 38. What may complicate an injury to the eye? The thinnest part of the iris is at its origin from the ciliary body, and a contusion of the eye may tear the iris at this point, causing iridodialysis. Contusion injuries may rupture the zonule of the lens and dislocation, laterally or downwards. 39. What is used in order to reveal a foreign body in the eye? A wide variety of foreign bodies may enter the eye in injuris. The immediate symptoms may be slight, and a small corneal wound is easily overlooked. Radiography of the eye should be taken after every injury which it is at all revealed by radiography, an examination with a slit-lamp microscope may enable it to be seen in the segment. 40. What diseases may affect the lens? The lens may be affected by congenital, coronary, senile or diabetic cataract. Surgical treatment is indicated in most cases. II. Translate the sentences. Pay particular attention to the verbs, whose meaning is "to become": 1. The patient was getting better. 2. He became head surgeon only in 1997. 3. The sick man soon grew tired. 4. Everything will come right in the end. 5. How did you come to hear it? 6. The patient went blind. 7. The milk has turned sour. 8. Dan fell ill a few days ago. 9. Sally's dress has worn thin. 10. Their supplies of medicaments are running short. 11. We seem to have run out of cotton wool. 1. Пациенту стало лучше. 2. Он стал главным хирургом только в 1997 году. 3. Больной вскоре устал. 4. В конце концов, все будет хорошо. 5. Как вы узнали об этом? 6. Пациент ослеп. 7. Молоко скисло. 8. Дэн заболел несколько дней назад. 9. Платье Салли истончилось. 10. У них не хватает медикаментов. 11. Кажется, у нас закончилась вата. III. Supply a suitable substitute for "to become" to express change: Example: We must be going: It's ... late. We must be going: It's getting late. 1. When a man gets old his eyesight is dimmer and dimmer. 2. He must have been mad because his behaviour is quite irresponsible. 3. You could see he was angry; his face suddenly changed into pale. 4. When John got married, she turned into Mrs. Wilson. 5. This pair of shoes had better be discarded; I have worn them thin. 6. This car needs a thorough overhaul or it is bound to fall to pieces. 7. After five years of service as a houseman, Dr. Brown becomes registrar at St. Bartholomew's Hospital. 8. The consultant suit angry when he heard that the department's supply of procaine had been allowed to get shorter. 9. If the patient gets better by the end of the month he will be allowed to leave hospital. 10. Keratitis sicca means that the eyes have get unable to produce tears. 11. He used to have a fine head of hair, but after fifty he gradually went bald. 12. I am now perfectly accustomed to getting up early; but it did take me some time before I got used accustomed to it. 13. When did you have to realize that there was something wrong with your left eye? 14. We had been working hard for at least ten hours before we realized that we were getting tired. 15. It was as if Flemming's dreams had set true when he saw so many lives saved as a result of his discovery. IV. Translate the sentences paying particular attention to the verb "put" with a preposition:
V. Substitute the verb in bold print with "put + preposition": Example: The director will not tolerate any negligence. The director will not put up with any negligence. 1. Most disease of the conjunctiva can be ascribed (put up ) to inflammation. 2. I hope it will not inconvenience (not put out) you too much if we have you moved to another ward. 3. Over the past two years, I saved (put aside) enough money to be able to afford a holiday abroad. 4. Three car accidents in two years are enough to discourage (put off) me from wanting to drive the car any more. 5. The man in the eye ward was to be operated on for glaucoma but in the end surgery had to be postponed (put away) owing to a heart complication. 6. When you phone the hospital ask the operator to connect (put together) you with the Matron's office. 7. What is wrong with your wrist? I think I forced it out of joint(put out) as I fell off the stepladder. 8. I should now like to say (put about) something that may not sound too pleasant to you. 9. I like Prof. Black, especially his way of communicating (putting across) his original ideas on the treatment of strabismus in children. 10. I can't find my textbook on ophthalmology; somebody must have hidden (put it away) somewhere here. IX. Translate into English: 1. Він нервує, коли йому доводиться звертатися до лікаря. 2. Хворий оглух після того, як переніс інфекційне захворювання в тяжкій формі. 3. Після кризи хворий спав спокійно цілу ніч. 4.Для того щоб мати змогу оплатити лікувания, потрібно відкладати гроші. У цьому вам допоможе система медичного страхування. 5. Пiсля шести років навчання вона стала лікарем. 6. Я записала все, що сказав мені лікар під час мого останнього візиту до ньoго. 7. На зборах були висунуті нові пропозиції. 8. Операцію дитині довелося відкласти через спалах епідемії кору в дитячому відділенні. 9. Фармацевтичний завод "Галфарм" випускає чимало високоякісних медичних препаратів. 10. Хворий не повинен миритися з некомпетентністю лікаря. Він має право вимагати кваліфікованої медичної допомоги. 1. He gets nervous when he has to see a doctor. 2. The patient is deaf after suffering a severe infectious disease. 3. After the crisis, the patient slept peacefully all night. 4. In order to be able to pay for treatment, you need to save money. The health insurance system will help you with this. 5. After six years of study, she became a doctor. 6. I wrote down everything the doctor told me during my last visit to him. 7. New proposals were put forward at the meeting. 8. The child's operation had to be postponed due to an outbreak of measles in the children's ward. 9. Pharmaceutical plant "Gulfarm" produces many high quality drugs. 10. The patient should not put up with the incompetence of the doctor. He has the right to demand qualified medical care. |