Abstract
L’obiettivo di questo lavoro è quello di fornire una panoramica di come agiscono le
principali aberrazioni nell’occhio, attraverso una descrizione di come vengono riconosciute
e classificate.
Considereremo gli aspetti dello studio attraverso il wavefront utilizzando i polinomi di
Zernike, per poi riportarli alla pratica di tutti i giorni nell’ottica geometrica, che è un
campo più famigliare per l’oftalmologo. Parleremo del comportamento delle aberrazioni in
alcune patologie come il cheratocono e la cataratta, cercando di trovare gli elementi che ci
possano guidare verso una diagnosi più articolata.
Focalizzeremo l’attenzione sulla lettura dei particolari rilevanti collegati alle patologie presenti nella topoaberrometria, che è un esame comune e di facile realizzazione. Verranno quindi esaminati gli effetti della chirurgia refrattiva, degli impianti di IOL, della radicale trasformazione del sistema ottico dell’occhio e delle implicazione nei successivi trattamenti e correzioni.
Introduzione
Fino ad una trentina di anni fa, il lavoro dell’oftalmologo si limitava alla determinazione ed alla successiva correzione del difetto refrattivo dei propri pazienti tramite la miglior lente oftalmica disponibile , al fine di consentire la miglior visione possibile.
Con gli strumenti a disposizione era quindi possibile trattare due tipologie di aberrazione , il defocus e l’astigmatismo, unicamente tramite lenti oftalmiche classiche. Il limite di questo approccio è che, in casi di cornee irregolari o in presenza di altri fattori per i quali si venissero a generare situazioni diverse, il defocus e soprattutto l’astigmatismo risulterebbero incorreggibili con le lenti classiche, in quanto generati da aberrazione di ordine superiore. A questo punto solo conoscendo quali altre aberrazioni risultino presenti possiamo determinare come, e soprattutto, se è possibile correggerle. Per fare questo dobbiamo scoprire le caratteristiche di ognuna di esse e tramite quali strumenti esaminarle… continua
Se desiderate la versione completa del lavoro in pdf potete contattarmi via mail: riccardo.pavonello@paverik.it
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Городская среда Калининграда специфична: морской ветер, сезонные пробки, яркие витрины в вечерние часы. Эти факторы часто усиливают тревожность и мешают засыпанию. Поэтому мы проектируем выезд «мягко»: согласованная парковка, немаркированный вход, короткий маршрут до места процедуры, отсутствие громких звонков и «визуального шума» у порога. Родственникам предоставляем «тихие окна» связи — короткие апдейты в заранее оговорённое время без лишних подробностей. Такой формат не просто комфортнее, он клинически полезен: чем меньше стимулов, тем меньше потребность в ночных «усилениях» и тем стабильнее проходит первая ночь.
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В «Центр Трезвости Воронеж» приватность не обсуждается — она проектируется. Выбор нейтральных формулировок в чеках, немаркированные выезды, «беззвучные» уведомления, отдельные входы и доступ к карте наблюдения только по ролям — это норма, а не «услуга». Пациент может назначить доверенное лицо, чтобы получать краткие апдейты в согласованные временные окна.
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Запой — это не только выраженная тяга к алкоголю, но и комплекс физиологических нарушений: обезвоживание, колебания давления, тахикардия, бессонница, тремор, дефициты электролитов. Чем дольше длится эпизод, тем выше риск делирия и декомпенсаций. Мы оцениваем картину целиком: стаж употребления, фоновые болезни, уже принятые препараты, прошлые эпизоды судорог или потерь сознания. По итогам первичной беседы врач рекомендует формат старта — визит на дому или стационар.
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Конфиденциальность — не обещание на бумаге, а практический стандарт. В клинике используются кодовые профили, шифрованный контур хранения карт, разграничение доступа по ролям; документы оформляются нейтрально, а уведомления формулируются без чувствительных слов. Выездные специалисты приезжают без медицинской символики, а в здании клиники навигация организована так, чтобы перемещение было незаметным. Это создаёт пространство, в котором можно честно говорить о целях и спокойно выполнять план — без стигмы и посторонних взглядов.
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