When diagnosing thyrotoxicosis, eye symptoms play an important role. A rapid pulse, an increase in the size of the gland and bulging eyes are three signs of gland pathology.
Let's consider the reasons for the occurrence eye diseases, symptoms and treatment.
Causes of thyrotoxicosis
An increase in hormones - thyrotoxicosis, leads to an increase in the body's need for oxygen and increased heat production.
This is expressed in such signs as heavy sweating, tachycardia, hand tremors, anxiety.
The cardiovascular system is disrupted, changes occur in the skin, hair, and eye diseases appear.
Eye diseases are mainly associated with impaired movement of the eyes and facial muscles.
Main –
exophthalmos, protrusion of the eyeballs.
Most often it is unilateral. The autonomic system plays a certain role in this.
The reason is the increased tone of the extraocular muscles, the volume of tissue and fat increases.
All this leads to stagnation in the eyelids, increased pressure and swelling.
At the first suspicion of a disease, you should contact an endocrinologist and undergo diagnostics.
It includes an examination of hormone levels in the blood, ultrasound findings and a cardiogram.
Eye symptoms in thyrotoxicosis
When suffering from thyrotoxicosis, the palpebral fissures widen, and the person seems to be scared or surprised.
Increased shine is observed, patients complain of “sand” in the eyes, photophobia, and pain.
Symptoms of the disease include:
Delrymple - widening of the slits of the eyes (surprised look).
Shtelvaga - extremely rare blinking.
Gref - delay of the outer eyelid during eye movement. Occurs due to increased tone muscles that are responsible for the movement of the eyelid. Stripes of sclera are visible white. When the pupil moves, the eyeball moves freely with it.
Moebius - the convergence of the eyeballs is impaired, the ability to fix objects nearby. The result is greater tone of the oblique muscles than the internal rectus muscles.
Kochera - displacement of the eyelid towards the lower or upper edge of the orbit, thereby exposing the sclera. The displacement may be minor, unnoticeable, or expose the cornea.
Jellinek - staining of the eyelids and significant darkening of the skin occurs.
Geoffroy - Wrinkling of the forehead does not occur when looking up.
Rosenbach - tremor of the eyelids with closed eyes.
Brown - There is no narrowing of the eyes when laughing.
Ekrota - upper eyelid swells.
Wilder - the eyeball moves with stops, in steps.
Protrusion of eyeballs.
Impaired lacrimation — in patients with bulging eyes. Inflammation of the cornea occurs due to the inability to close your eyes either day or night.
All these signs of the disease, especially protrusion of the eyes and widened palpebral fissures, make the face of a sick person look as if he is frozen with fear.
Usually these symptoms are bilateral, less often unilateral.
With moderate and severe eye damage, vision is significantly reduced and there is double vision.
But eye symptoms do not always appear; some patients with serious illness They are not here.
Therefore, the disease cannot be assessed based on eye symptoms.
Doctors distinguish three severity of exophthalmos disease:
- I - minor - (15.9±0.2) mm, slight swelling of the eyelids occurs;
- II - average - (17.9±0.2) mm, with severe swelling of the eyelids and clear signs deformations of the eye muscles;
- III - strong - (22.8+1.1) mm, ulceration of the cornea, movement of the eyeballs is severely limited.
Treatment
It is carried out using methods: medications, surgery.
The severity of the disease determines the choice of drug. Treatment of eye symptoms:
- at initial signs diseases do not use large doses of the drug imidazole;
- will be prescribed in the future long-term use thyroid hormones with constant pulse monitoring;
- during treatment good action provide glucocorticosteroids and gamma therapy with simultaneous administration excessive doses of hormones;
- Daily administration of hydrocortisone helps.
If the disease is long-term, then regression is very difficult to achieve, due to the fact that about eye orbits a lot of fat and connective tissue accumulates.
Conventional treatment does not help; surgery to widen the orbit is necessary.
Treatment by means traditional medicine allowed as an adjuvant to the main treatment.
Brew from herbs: cinquefoil, rose hips, hawthorn, take tincture of walnuts.
These plants help support the body and reduce symptoms such as blood pressure and palpitations.
But before the appointment folk remedies,
agree with your doctor.
Nutrition during illness
Treatment of the disease includes complex therapy– medication and proper nutrition.
You need to drink a lot of water, at least 3 liters per day. Diet for illness includes the following rules:
- increase daily calorie intake;
- increase micronutrient intake;
- ensure the most complete protein intake, this is the basis for building muscle tissue;
- do not consume stimulants - chocolate, spices, alcohol, coffee;
- do not include foods that stimulate fermentation in the diet - rice, grapes, plums, peaches;
- Avoid fried, salty, sweet foods.
Eating strawberries and peaches helps a lot.
Any meat can be used, as long as it is boiled.
Fish - preferably river, it does not contain iodine.
Only when proper nutrition and taking medications, you can improve your condition and alleviate the symptoms of the disease.
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Impact of diseases endocrine system for vision
Before it’s too late: how to recognize thyrotoxicosis in time?
Bug eyes are not an independent disease, but only a symptom caused by certain diseases. From a physiological point of view, bulging eyes are a displacement of the eyeballs when they protrude forward or move to the side. In medicine, “bulging eyes” is called “exophthalmos.”
Protruding eyes are treated not only by ophthalmologists, but also by endocrinologists, oncologists and other specialists. Treatment tactics are selected depending on the diagnosis.
Definition of disease
Protrusion or exophthalmos is a protrusion or strong displacement eyeball, provoked by damage to the shallow orbit. This pathology occurs in children and adults.
Manifestation of exophthalmos
Bug eyes can be pronounced or noticeable only when ophthalmological examination. Most often, the symptom is a consequence of eye pathologies not related to vision.
The eyeball may protrude straight forward or move slightly to the side; it depends on the localization of the pathological process inside the orbit.
Congenital bulging eyes occur, which may well be a variant of the physiological norm.
Kinds
Protrusion of the eyeball can be unilateral in the case of ophthalmological diseases and bilateral, which is observed in the general pathological condition of the body.
True exophthalmos, caused by swelling of the orbital tissues located behind the eyeball, must be distinguished from false bulging eyes, which develops as a result of an enlargement of the eyeball. The second option is observed with or .
In addition, doctors distinguish between intermittent exophthalmos. Such bulging eyes are noticeable when the head is tilted to one side. This option usually occurs with varicose veins of the orbit. Another type is pulsating exophthalmos, when the eyeball not only moves forward, but also pulsates in time with the blood flow (occurs with cerebral aneurysms).
Bilateral protrusion of the eyeball
Normally, the eyeball can extend beyond the orbit by no more than 20 mm. Depending on this indicator, there are 3 degrees of severity of bulging eyes. At mild degree exophthalmos, the protrusion indicator is 21-23 mm, frame medium degree end at 27 mm, and when severe form bulging eyes indicators go beyond 28 mm.
Causes
Acquired bulging eyes are a reflection pathological changes occurring in the body. The main reasons that can provoke this symptom, are:
- Hyperthyroidism due to Graves' disease;
- Orbital fractures;
- A brain tumor;
- Cerebral aneurysm;
- Inflammatory lesion paranasal sinuses;
- Myopia severe;
- Glaucoma;
Symptoms
Signs that help differentiate bulging eyes:
- The appearance of a white gap between the edge of the eyelid and the iris of the eye (to identify this sign, the patient is asked to look down);
- Darkening of the skin of the eyelids.
Bulging eyes may be accompanied by such manifestations from the organ of vision as:
- Diplopia, that is, due to projection disturbance;
- Increased lacrimation;
- Photophobia;
- Discomfortable sensations when blinking;
- Edema of the conjunctiva, eyelids, retina, .
Bug-eyed with strabismus
Possible complications
Bug eyes require immediate diagnosis and treatment. In addition to an unhealthy, unaesthetic appearance, this phenomenon negatively affects visual functions eyes and can lead to complete blindness.
Increased pressure on optic nerve can cause it, which subsequently leads to complete loss of vision.
Exophthalmos is serious clinical symptom, which brings aesthetic discomfort to both the patient and the people around him, and leads to functional disorders all structures of the eyeball.
Diagnostics
If you have bulging eyes, your doctor will prescribe the following types examinations:
- Examination using an ophthalmoscope;
- Biomicroscopic examination of the eye using a slit lamp;
- Ultrasound of the eye;
- Computed tomography of the brain;
- MRI of the brain;
- X-ray of the skull to exclude orbital fractures;
- Determination of the level of thyroid hormones in the blood;
- Determination of the level of iodine excretion in urine.
Slit lamp
To identify the exact cause of bulging eyes, a comprehensive diagnostic examination is carried out involving medical specialists different profiles (ophthalmologists, endocrinologists, therapists, traumatologists, neurologists, etc.).
Treatment
The treatment of exophthalmos is carried out, as already mentioned, not only by ophthalmologists, but also by other specialists, since in most cases this symptom is a sign of a general pathological process occurring in the body.
Accordingly, certain diseases that lead to bulging eyes require specific treatment methods, which are prescribed by doctors after a series of tests and installation accurate diagnosis.
If the cause of bulging eyes is endocrine, doctors prescribe glucocorticosteroids.
Endocrine ophthalmopathy
Inflammatory processes are suppressed with the help of and.
Oncological diseases that cause bulging eyes are subject to treatment typical for these diseases (radiation and chemotherapy, surgery);
If this symptom is provoked by compression of the optic nerve, then the patient is usually offered surgical intervention, during which the adipose tissue. As a result, pressure on the nerve is reduced.
If the cornea is damaged due to protrusion of the eyeball, doctors perform temporary stitching of the eyelids in order to strengthen it. In addition, restorative ointments are prescribed.
Performing eyelid stitching surgery
Exophthalmos is never a separate disease, but just a symptom. That is why treatment of this symptom should be carried out against the background of treatment of the identified underlying pathology. In some cases, protruding eyes are not required at all symptomatic treatment, since it goes away on its own after the cause is eliminated. For example, with thyrotoxicosis: the patient only has to lower the level of thyroxine in the blood to normal indicators, as the swelling of the tissues of the orbit subsides and exophthalmos disappears by itself.
Symptomatic treatment of bulging eyes is necessary only if it is accompanied by additional manifestations: pain, inflammation of the eyelids, conjunctiva and cornea, double vision, and also when it severely disfigures the face. In such cases, the patient is prescribed:
- Steroid hormones (Prednisolone, Hydrocortisone);
- Antihistamines (for example, Diazolin);
- Radiotherapy;
- Surgical correction.
Diazolin is an antihistamine
False physiological exophthalmos with protrusion of the apples up to 2 mm due to abnormalities of the palpebral fissures and skull cannot be treated. This is a physiological phenomenon; however, the patient should monitor the eyes and visit an ophthalmologist annually.
Conservative therapy is indicated to eliminate swelling, inflammation and pain. Surgical correction used when treatment medications turns out to be ineffective, as well as in severe cases of symptom manifestation.
Prevention
The main place in the prevention of exophthalmos is occupied by careful monitoring of patients who are found to have physiological bulging eyes. They are the ones in the group increased risk and require dynamic monitoring in order to identify the early stages of the disease.
In addition, the prevention of bulging eyes consists of the following measures:
- Eating iodized salt and seafood to prevent the development of goiter;
- Regular visits to the ophthalmologist if there are risk factors;
- Timely examination by a neurologist;
- Prevention of thromboembolic complications.
Video
conclusions
In conclusion, it should be noted that bulging eyes are a sign of pathology if the protrusion of the eye is more than 2 mm. In such a situation, the patient needs a thorough diagnostic examination to identify the cause pathological condition. After an accurate diagnosis has been established, treatment appropriate to the diagnosis is indicated. In most cases, therapy is carried out not by ophthalmologists, but by doctors of a different profile, which is due to the cause of exophthalmos
The most common cause of exophthalmos of the eyes is Basedow's disease. Excessive synthesis of thyroid hormones leads to swelling of the muscles of the orbit and body of the eye. Swelling increases the size of the orbits, puts pressure on the eye sockets and the eye protrudes, causing bulging eyes.
Experts who list the signs of Graves' disease always mention exophthalmos or bulging eyes. Normally, the extension of the eyeball beyond the limits should not exceed twenty millimeters. Bug-eyedness has three degrees, the most severe is when the eyeball extends beyond its limits by twenty-seven millimeters or more.
Exophthalmos is not the only symptom Graves' disease, manifested in the eye area. The eyes become red, the eyelids and conjunctiva swell, and eye mobility is limited. The eyelids cannot be closed tightly, so the cornea dries out and becomes inflamed, its surface becomes covered with ulcers.
With bulging eyes, there is pain in the eyes, photophobia, double vision, and farsightedness develops. Exophthalmos in Graves' disease is characterized by Graefe's symptom, in which looking down reveals a white stripe above the pupil.
Diagnosis of the disorder
To detect bulging eyes, the ophthalmologist uses an exophthalmometer or ruler. To determine the cause of the disorder, an x-ray is used, as well as a tomogram of the eye orbit.
If you suspect that bulging eyes are caused endocrine reasons, the patient is sent to hormonal tests and on ultrasound thyroid gland. If necessary, a radioisotope study is prescribed.
Consultation with specialists necessary for the development of bulging eyes:
- endocrinologist;
- ophthalmologist;
- neurologist;
- Oncologist.
Treatment of exophthalmos
Bug-eye is not a disease, but a symptom, so therapy for the disorder is carried out simultaneously with treatment of the underlying disease. In some cases, exophthalmos goes away when the underlying cause is eliminated. A decrease in the level of the hormone thyroxine in the blood relieves the symptom of edema and the bulging eyes disappear.
Exophthalmos requires separate symptomatic therapy if the patient experiences severe pain, if he has vision problems, the eyelids, conjunctiva and corneas are inflamed. In such cases, the patient is prescribed:
- Citramon;
- Diazolin;
- Hydrocortisone;
- Prednisolone;
- radiotherapy;
- surgical intervention.
Therapeutic treatment is aimed at eliminating inflammation, swelling and pain in the eyes. Surgery recommended when drug therapy ineffective, and also severe forms exophthalmos, disfiguring the face. Surgically The orbital walls are removed and thus the pressure on the eyeball is relieved.
The use of immunosuppressive therapy involves patients taking prednisolone, a drug belonging to the glucorticoid class. Prednisolone relieves swelling and inflammation of the eyelids. Retrobulbar injections of corticosteroids are used to treat inflammatory processes. Glucorteoids are completely contraindicated for pancreatitis, intestinal and stomach ulcers, thrombophlebitis, oncology and poor blood clotting. Immunosuppressive therapy is supplemented with cryopharesis, plasmaphoresis, hemosorption and immunosorption.
Treatment with methylprednisolone and radiotherapy are used for a sharp drop in diopters and the threat of blindness.
To normalize metabolic processes in tissues with endocrine ophthalmopathy, actovegin is prescribed in injections, prozerin in drops, gels and ointments, vitamin E and A.
For endocrine exophthalmos, physiotherapy with electrophoresis and magnetotherapy are used on the eye area.
Surgical intervention for endocrine exophthalmos is carried out in three ways:
- decompression of the ocular orbit;
- eyelid surgery;
- surgery on the eye muscles.
Decompression is used to relieve severe exophthalmos, neuropathy, corneal ulcers, and subluxation of the eyeball.
Surgical intervention on eye muscles necessary if paralytic strabismus or painful diplopia develops.
Indications for eyelid surgery:
- hernia accompanied by orbital prolapse;
- prolapse of the lacrimal glands;
- lagophthalmos;
- retraction.
If you suspect bulging eyes, you should immediately consult a doctor. Endocrine exophthalmos cannot be treated with herbs or at home; neglecting this advice can lead to unpredictable consequences.
There is an opinion that to treat this disease you need to see an ophthalmologist, but this is not entirely true. In most cases, the treatment of bulging eyes is carried out by completely different specialists: an endocrinologist, a neurologist, a traumatologist, an otolaryngologist or an oncologist. And the choice of treatment methods depends on the reasons that caused this condition.
Types of bulging eyes
What comes as a surprise to most patients is that bulging eyes are not a disease. This is only a symptom, and a symptom of many diseases. Bug eyes manifest themselves in different ways, however, in medicine it is customary to distinguish three types:
Unilateral exophthalmos, when one eye protrudes from the orbit;
Bilateral exophthalmos, when both eyes protrude from the socket;
False bulging eyes, when the protrusion of the eyeball is physiological norm and does not exceed a difference of 2 mm (such patients are also at risk and should be observed by a doctor).
A slight protrusion of the eyes from the orbits (from 15 to 18 mm) is considered a physiological norm. About bulging eyes as a symptom of some anxiety disease we are talking when these indicators are exceeded by 2-8 mm.
The cause of bulging eyes is what occurs in the body pathological processes. Therefore, detection of exophthalmos requires full examination person to make an accurate diagnosis. After all, curing bulging eyes is possible only by defeating the disease that caused it.
All pathologies causing exophthalmos will be divided into three groups:
1. Endocrine diseases. The most common cause of bulging eyes in this category is Graves' disease (goiter). It is during goiter that the thyroid gland produces an excessive amount of hormone, which causes immune system enhance cell formation. Actually, these cells load the tissues of the organ of vision, causing thickening of the extraocular muscles, caused by edema.
2. Diseases different systems body. These include tumors of the brain and paranasal sinuses, inflammatory processes sinuses, blood diseases, thrombosis and aneurysms of cerebral vessels, fractures of the orbital bones accompanied by hemorrhage, trichinosis.
3. Eye diseases. Here, the “culprits” for bulging eyes can be: thrombosis of the orbital vein, strong, benign or malignant tumors orbits.
Elimination of the manifestations of exophthalmos occurs only after the intervention of a doctor of narrow specialization.
Signs and consequences of bulging eyes
By fighting the manifestations of diseases that cause exophthalmos, the patient saves his eyes. After all, bulging eyes in themselves is not only an aesthetic problem. Exophthalmos has a significant bad influence on the functions of the entire visual system, the violation of which may threaten complete vision.
Bug eyes are probably one of the few cases where the symptom itself has a number of symptomatic manifestations. After all, people with exophthalmos are characterized not only by external manifestations violations.
On the part of the organ of vision, there is a disturbance in the mobility of the eyes, visible objects, a feeling of pressure on the eyes. Due to the lack of tight contact between the eyelid and the eyeball, it is not fully moisturized, which can lead to its possible destruction or inflammation. There is swelling of the eyelids and discs.
This condition threatens complete blindness, which may occur due to compression of the optic nerve from high blood pressure in the cavity of the eye. In this case, it will simply die (atrophy).
Diagnosis of bulging eyes
Timely and accurate diagnosis exophthalmos significantly accelerates the start of treatment of the underlying disease. Bug-eyedness can also be false, but the first suspicion of such a deviation should, in any case, prompt you to consult a doctor: a therapist or an ophthalmologist. And the doctor, based on a personal survey, will recommend the right specialist.
Modern diagnostic methods will help to accurately determine the presence or absence of exophthalmos. For this use:
Ophthalmological examination;
Computer or magnetic resonance imaging;
Laboratory research.
Treatment of bulging eyes
For bulging eyes caused by Graves' disease, correction of thyroid function is necessary. Courses of glucocorticosteroids will help with this.
The basis for treating inflammation processes is therapy or surgery.
Surgery cannot be ruled out if an oncological diagnosis is made. For cancer, procedures such as chemotherapy and radiation are also indicated, usually in combination.
Elimination of compression of the optic nerve is achieved during surgery, when fatty tissue is partially removed. If the cornea is damaged, the eyelids are completely or partially sutured.
And relief from the symptoms of bulging eyes itself will be provided by 5 basic rules recommended by experts:
1. Maintaining constant moisture of the eyeballs. This is achieved by using special commercially available ophthalmic ointments, which are applied at night.
2. Wearing dark glasses. High-quality glasses with tinted glass lenses can protect your eyes from both wind and sunlight, and also disguise bulging eyes.
3. Refusal of salt. Reducing salt intake reduces the formation of fluid in the body, which means the fluid pressure on the eye area will also decrease.
4. Using an elevated head position when sleeping. Even 15 cm plus the normal position of the head during sleep will help to avoid swelling of the eyelids, which increases the appearance of bulging eyes.
5.Usage eye drops. However, it is very important to remember that instilling drops to successfully combat the redness of the conjunctiva gives an effect only for the first 3 days. Abuse of this procedure will only cause greater dilation of blood vessels.
Treatment of bulging eyes is a long process, sometimes it can even take several years. The prognosis is usually favorable, but to achieve it, the patient must consult a specialist in time and scrupulously follow his recommendations.
It is important to choose one eye clinic, where they will really help you, and will not “brush it off” or “pull” money without solving the problem. Below is a rating of specialized ophthalmological institutions where you can undergo examination and treatment if you are diagnosed with bulging eyes.
An effective remedy to restore vision without surgery or doctors, recommended by our readers!
There are quite a few different eye diseases. One of them is bulging eyes. The disease is rather a symptom another disease. In medicine, protrusion of the eyeball, sometimes moving it to the side, is called exophthalmos. Characterized by the appearance of a white lumen, which can be observed between upper eyelid and the iris. Depending on the underlying disease, treatment of bulging eyes is carried out by neurologists, ophthalmologists, otolaryngologists, endocrinologists, traumatologists and oncologists.
Classification of exophthalmos
Most often, doctors divide pathology into imaginary and true. Let's look at them in more detail:
- true is the result of inflammation, trauma, orbital tumors and diseases of the whole body;
- The imaginary form manifests itself with abnormal development of the cranium, congenital asymmetry of the orbits, and widening of the eye slit.
There is also a classification according to the course of the pathology:
- constant exophthalmos. The appearance of this form is facilitated by the identified neoplasm in the orbit;
- throbbing. It becomes a consequence of injuries and the development of an aneurysm of the ophthalmic arteries. A noticeable symptom is pulsation in the eye. Associated symptoms are constant pain heads, hum in auditory organ. At later stages, the veins on the temples and the frontal part of the head begin to increase in size;
- intermittent. The cause is pathology of the orbital veins. Characterized by bulging of the eye orbits during intense physical exertion.
When a person's eyes bulge, he does not experience pain. If the thyroid gland does not function properly or after its removal, edematous exophthalmos may develop with diffuse toxic goiter. This is due to hormonal imbalance.
What causes pathology?
The causes of this orbital disease are as follows:
- general: abnormal development of the skull, diffuse goiter, diseases of the hematopoietic system, hydrocephalus, inflammation of the sinuses;
- local: pathologies of the ophthalmic veins, orbital tumors, eye injuries, inflammation of the orbit.
Symptoms of pathology
A slight protrusion of the eye practically does not cause discomfort to a person. But the longer the deviation progresses, the more signs manifests itself. These include:
- Decreased visual acuity and double vision.
- The sclera turns red and swells.
- A sign of the appearance of a neoplasm or inflammation in the orbit is inactivity of the eyeball.
- It is possible to develop keratitis due to incomplete closure of the eyelid, which leads to drying of the sclera.
- Upon examination, doctors detect neuritis, hemorrhages, and nerve atrophy.
Important! If the optic nerve is compressed long time, blindness cannot be avoided. Unfortunately, this phenomenon is irreversible.
Is it possible to get rid of pathology?
Protruding eyes are treated only after drawing up a complete picture of the deviation through a full examination, medical history, and exophthalmometry. It is also necessary to find out the factors causing pathology. Therefore, the patient is obliged to visit all doctors to make an accurate diagnosis. Only after it is known what triggered exophthalmos, the doctor prescribes treatment.
If bulging eyes occur as a result of inflammation, doctors prescribe vitamin therapy, sedatives, antibiotic, sulfonamides.
When cancer is diagnosed, chemotherapy is used radiation therapy. The tumor is removed through surgery if necessary.
Endocrinologists treat exophthalmos if the reasons for its progression are problems in the functioning of the thyroid gland. After studying the results of hormone tests, doctors prescribe appropriate medications ( radioactive iodine, mercazoline). At their discretion, specialists prescribe pulse therapy with prednisolone.
In case of injury, a pressure bandage and hemostatic medications are used.
If compression of the nerve is detected, surgery is necessary. Otherwise, the person faces blindness.
Preventive measures
First you need to take care of your immunity and improve your lifestyle. To do this, give up everything bad habits, if any, play sports and protect yourself from stress. Don't forget about proper nutrition. Fresh fruits and vegetables have a beneficial effect on the overall health of the body. Thanks to healthy food You can also protect yourself from protruding eyes. After all, a common cause of this phenomenon is Trichinella, which is found in raw pig fat.
If a person is seen by a doctor due to any illness, he must follow all his instructions. Otherwise, the result of an irresponsible attitude towards one’s health may be bulging eyes. Illness on initial stage does not bring trouble, but no one is immune from complications.
It is much easier to prevent any disease than to treat it later. Exophthalmos is no exception. In order to see well and not lose your vision forever, do not neglect visits to ophthalmologists, seek advice on every question that arises.
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