Complex hyperopic astigmatism of the reverse type. Hypermetropic astigmatism - treatment methods and types. Operations specific to the type of disease

Hypermetropic astigmatism is an eye pathology that is characterized by curvature of the shape of the orbit and the sphere of the lens. Therefore, it is difficult for a person to see in front of him and in the distance.

With hypermetropic astigmatism, the functioning of the optical system of the eye is disrupted: light rays do not form the correct refraction. This occurs due to congenital or acquired changes in the eye.

According to medical data, the disease is more common with a predominance of hypermetropia -. The patient has difficulty concentrating on things nearby. The quality of life decreases with this diagnosis. But farsighted astigmatism is quickly treated in the early stages. Therefore, it is important to visit an ophthalmologist on time.

Classification

Pathology is divided into 2 types: simple and. In the first case, the patient is concerned about the incorrect refraction of light rays in one of the meridians.

With complex farsighted astigmatism, impaired refraction of light rays is noted in both main meridians. The course of the disease depends on the severity. This indicator indicates the presence or absence of additional symptoms of the disease.

With congenital astigmatism with hyperopia of both eyes, the ophthalmologist often diagnoses a complex type of disease. A simple type of hypermetropic astigmatism is found with an acquired form.

Causes

The causes of the described pathology include the following factors:

1. Newborn children more often suffer from physiological hypermetropia. This usually goes away by the first year of life.
2. Hypermetropic or farsighted astigmatism is passed on to children if one of the parents suffers from the disease.
3. After injuries or surgical operations, the eyes also develop improper refraction of light rays. A scar forms on the cornea, causing the image to appear blurry.
4. Bad habits during pregnancy negatively affect the visual ability of the unborn child.

Symptoms of the disease

Symptoms of hypermetropic astigmatism include the following:

• eye pain, headache;
• objects and people seem blurry;
• tension of blood vessels on the mucous membrane of the eyes.

Typically, these symptoms are enhanced if the diagnosis is congenital complex hypermetropic astigmatism in both eyes. A mild form of the disease involves imperceptible defragmentation of the image. When the ciliary muscle is tense, the object becomes clear.

But this leads to the development of periodic headaches. Therefore, the patient becomes nervous and irritable. There are also cases of frequent mood changes for no reason.

Sometimes additional symptoms appear with hypermetropic astigmatism:

• eye fatigue;
• difficulty reading text or looking at pictures up close;
• reduced visual acuity.

Diagnostic measures

The first symptoms of congenital hypermetropic astigmatism are invisible, since a small child is not able to explain this to his parents. The main thing is to carefully monitor the baby’s behavior. So, with an illness, a child often squints and winces when looking at pictures and toys.

To begin with, the doctor prescribes eye examinations. This diagnostic test is called visometry. The purpose of the procedure is to determine visual acuity. The patient closes one eye and puts a special lens on the other.

The first stage is a comprehensive eye examination. Externally, the ophthalmologist notices developmental anomalies, detects inflammatory diseases - conjunctivitis, blepharitis and others.

Sometimes the patient is prescribed skiascopy. A person sits down in a dark room, having previously put on special lenses. The essence of the study is to measure the refractive power of the eye and analyze the condition of the fundus vessels.

Nowadays diagnostic examinations are carried out using computer programs. In some cases, MRI and ultrasound are used.

Treatment

The disease cannot be treated at home. Only an ophthalmologist prescribes a correction. A simple form of the disease is treated if the patient complains of decreased visual acuity and discomfort in this area. It is important to have an annual examination with an ophthalmologist.

Today in medicine there are no drugs that specifically eliminate hypermetropic astigmatism. Pathology is often combated by other methods: with glasses or lenses. Sometimes carried out.

The listed treatment methods improve visual ability. Timely therapy eliminates further complications.

Conservative therapy

Treatment of complex hyperopic astigmatism of the eyes involves wearing glasses into which spherocylindrical glasses are inserted. The device is selected individually based on the severity of the disease and the presence of other eye pathologies.

Adults usually use glasses when working with documents and computers. Children with hypermetropic astigmatism are advised to constantly wear medical glasses. Otherwise, the child will develop complications in the future. The glasses are periodically changed by the attending physician.

Vision correction is carried out using hard and soft lenses. Many adults prefer to wear contact lenses because it is simple and comfortable. Correction with lenses is indicated only for adults and children over 8 years of age.

Such conservative therapy is carried out using plus and minus cylindrical lenses. When using lenses, a person sees objects up close clearly. Vision correction with glasses is mainly used in children.

The method eliminates the development of strabismus and preserves visual acuity. The first stage of hypermetropic astigmatism involves the use of standard treatment.

A mild degree of hypermetropic astigmatism does not require proper treatment, because visual acuity is not impaired. In childhood, the anomaly goes away on its own if the image distortion does not go beyond 0.5 diopters.

In addition to the listed measures, the ophthalmologist prescribes strengthening procedures. These include contrast showers, eye gymnastics, swimming, massage of the collar area and special water procedures.

When using glasses or lenses in adults diagnosed with hypermetropic astigmatism, visual acuity only temporarily increases. You can completely get rid of the disease with surgery.

Conservative therapy does not imply complete relief of the patient from hypermetropic astigmatism. To completely cure the disease, surgical intervention is prescribed in which the cornea of ​​the eye is changed.

Additionally, see your doctor’s opinion on wearing spherocylindrical glasses for astigmatism:

Surgical intervention

This technique helps to completely cure hypermetropic astigmatism. Laser correction is common among operations. Surgical treatment is indicated for the treatment of mild to moderate severity of the disease.

Today, patients with hypermetropic astigmatism are offered several surgical options:

1. Thermokeratocoagulation. The essence of the method is to burn out the damaged area of ​​the cornea with a special needle under high temperatures. Therefore, burns appear in the form of dots. This helps collagen fibers contract. After the operation, the cornea is restored.
2. Laser coagulation. The method of therapeutic surgery is similar to thermokeratocoagulation. But in this case, the burns are caused by a laser emitter.
3. Hypermetropic laser keratomileusis is the most effective operation in the fight against the farsighted type of the disease. The microsurgical method is used in especially severe cases. During the operation, the laser emitter is directed to the peripheral area of ​​the cornea.

The latter procedure is very complex, since a flap is cut out and removed from the upper surface of the cornea. The incision helps to reach the middle layer of the cornea in the peripheral part. A small area in this layer is then evaporated using a laser. The previously cut flap is returned back.

This surgical therapy corrects the curved shape of the cornea, returning the patient to normal vision. The main advantage of the method is that visual ability is restored within 5 days from the date of surgery. Moreover, surgical intervention is possible on 2 eyes at once.

Complication and prognosis

Hypermetropic astigmatism, in addition to discomfort, leads to serious consequences if you do not consult a doctor in time. This is especially true for hereditary types of the disease.

Sometimes strabismus develops with hypermetropic astigmatism if the child was not examined at an early age. Consequently, parents miss out on therapeutic therapy. Amblyopia is considered a significant complication during the progression of hypermetropic astigmatism.

The complication is associated with a rapid decrease in vision, which develops due to the presence of a functional disorder of the visual analyzer. Therefore, the central nervous system cannot cope with signal processing.

Almost always, astigmatism and concomitant farsightedness are treated in childhood. At the same time, it is important to monitor the child: small children often take off their glasses due to inconvenience. But in adults, hypermetropic astigmatism does not go away on its own and requires microsurgical intervention.

Prevention

To prevent the development of pathology, the ophthalmologist will recommend the following preventive measures:

1. Avoid injury to the eyelid, protect your eyes during repair work and when interacting with chemicals.
2. Every year, for preventive purposes, you need to undergo an examination by an ophthalmologist.
3. If the lighting in the work area is incorrect or dim, the lighting fixtures need to be replaced.
4. If you experience excessive eye strain while working, it is recommended to take breaks for 5 minutes to give your eyes a little rest. It is useful to do exercises and massage for the eyes after 2 hours.
5. It is necessary to monitor the foods in your diet. A proper diet includes carrots, seafood, blueberries and spinach. Sometimes it's good to eat a slice of dark chocolate with a high cocoa content.

Hypermetropic astigmatism today is successfully treated conservatively and surgically. The main thing is to consult a specialist in time.

The most common eye pathology in children of all ages is astigmatism. It manifests itself in incorrect refraction of light caused by disturbances in the structure of the cornea or, much less commonly, the lens. The image is projected onto the retina at several points, causing distortion of the outlines of surrounding objects. Hypermetropic astigmatism in children is the simultaneous presence of astigmatism and farsightedness. Farsightedness prevents a clear vision of objects located nearby, and in combination with astigmatism, the child is practically unable to distinguish the contours of things. As a result, the baby’s quality of life is significantly reduced.

Most children are born with a slight physiological astigmatism. By the age of one year, it decreases to 0.5-1 diopter, does not require treatment, and does not cause discomfort in the child. A pronounced pathology in a newborn is the reason that the baby sees the world distorted from the first days of life. This can subsequently seriously impair vision.

The main cause of hypermetropic astigmatism is considered to be a hereditary factor. If one of the baby’s relatives has been diagnosed with hypermetropia, it is highly likely that it will be passed on to the child. The pathology can be acquired: its appearance is caused by scars on the tissue of the eyeball resulting from injuries. Deformation of the cornea is also possible if there is a defect in the development of the dental system, which puts pressure on the walls of the orbit.

Types of hyperopic astigmatism

Farsighted astigmatism is divided into several types:

1. The simplest and most common type. Vision problems occur in only one eye. There are options when the image is distorted only at a certain position of the eyeball. In other cases, the child sees normally.

With farsightedness up to 0.5 diopters, a simple form of astigmatism does not require treatment. The baby does not experience discomfort and makes no complaints. Regular monitoring by an ophthalmologist is indicated in order to detect possible progress of the disease in time.

For farsightedness up to 0.5 diopters, a simple form of astigmatism, regular observation by an ophthalmologist is indicated

1. Compound hyperopic astigmatism in children is associated with damage to both eyes. In this case, the degree of damage to the left and right organs of vision may differ. Image distortion does not depend on the position of the eyeballs. The condition is subject to correction for the child’s normal functioning. The baby's vision is significantly impaired, leading to stumbling when walking, falling down the stairs, and other traumatic incidents.
2. Mixed type is the most severe type of hypermetropia. Astigmatism in both eyes is complicated by the fact that a child who is farsighted in one eye becomes nearsighted in the other. The eyes distinguish objects, but they are not able to transmit information about their size and shape in the correct form to the brain.

Symptoms of pathology

Symptoms of hypermetropia largely depend on the degree of its severity. A mild degree of pathology is detected during an examination by an ophthalmologist, since nothing bothers the child. In addition, doctors say that hypermetropic astigmatism up to 0.5 diopters should be treated as normal in young children. It can disappear without a trace by the age of 9-10 and requires only regular monitoring by an ophthalmologist.

Moderate astigmatism is characterized by frequent child complaints of headaches.

When a moderate degree of astigmatism develops, the child begins to complain of:

• discomfort while reading, playing with puzzles, working with small pictures;
• fog in the eyes;
• headache;
• split image.

Severe degree is noted:

• severe blurred vision;
• a feeling of burning in the eyes;
• severe headaches that can cause nausea;
• dizziness;
• nervousness, irritability, sleep disturbances due to headaches.

As a complication of hypermetropia, the baby may develop strabismus. Children with a complex form of pathology have difficulty studying; they find it difficult to perceive small pictures, letters and numbers. This leads to a lag in learning and emotional experiences of the child that he is not like his peers.

A child's nervousness and irritability can cause severe astigmatism.

To accurately diagnose and determine the severity of hypermetropic astigmatism, various examinations are carried out:

• vasometry - involves checking vision using tables;
• ophthalmoscopy - magnification and examination of the fundus of the eye using a special device;
• keratometry - measurement of corneal curvature;
• refractometry using a computer - the type and degree of damage to the visual organs is most accurately determined;
• slit lamp – allows you to examine all structures of the eye under magnification.

Treatment methods

Until the child reaches 2 years of age, neither farsightedness nor astigmatism requires treatment. The organs of vision at this age are still developing, disturbances in the perception of surrounding things are acceptable and are considered a variant of the norm.

Farsighted astigmatism up to 0.5 diopters after 2 years is subject to treatment only if the child has strabismus and very rapid eye fatigue - asthenopia. In the absence of these complications, only regular monitoring is indicated.

For farsighted astigmatism of more than 0.75 diopters, glasses are recommended

Wearing glasses is recommended for farsighted astigmatism of more than 0.75 diopters. It is also possible to use cylindrical lenses; as the child grows, they are replaced with toric ones. Wearing glasses and lenses helps to avoid deterioration of vision and complications such as strabismus, and restore the child’s normal functioning at school.

Glasses with lenses only temporarily improve vision, but do not treat the cause. Therefore, after the child reaches 18 years of age, when the visual system is fully formed, surgical treatment methods are recommended.

1. Coagulation. Changing the damaged shape of the cornea is done using high temperatures and pinpoint burns, which are applied with a laser or a special needle. This leads to contraction of collagen fibers, as a result of which the shape of the cornea is corrected.
2. Laser keratomileusis is the most progressive and effective method for correcting hypermetropia. The surface of the cornea is corrected with a laser: first, a flap is cut from its top layer, the middle layer is carefully removed, and the top layer is returned in its place. As a result, the curvature of the cornea is corrected. The undoubted advantage of such an operation is the restoration of eye functions within a few days. Complications such as corneal opacity are excluded.

If it is impossible to perform treatment with these two methods, the lens is replaced with an artificial analogue or an intraocular lens implant is installed.

Surgical correction methods can only be used after the child reaches 18 years of age.

Eye gymnastics are recommended as preventive measures aimed at preventing the development of astigmatism in a child and reducing the risks of hypermetropia progression. It can be done in the form of a game from an early age:

• circular movements of the eyes;
• alternating gaze up and down;
• closing your eyes and then blinking slowly;
• drawing eights with eyes;
• alternately move your gaze from the index finger at a distance of 40 cm from the eye to objects outside the window.

Physical activity, swimming, running, hardening, and inclusion of carrots and parsley in the daily diet have a positive effect on visual acuity.

Hypermetropic astigmatism can seriously affect the quality of a child’s vision, his success in school, the state of the nervous system, and socialization in a team. It is necessary to understand that this is not a disease, but a condition of the cornea that is subject to correction. Therefore, it is extremely important to visit an ophthalmologist from the first months of the baby’s birth. This will help to detect pathology in time and formulate an effective monitoring or treatment regimen.

Dec 16, 2016 Doc

Conservative treatment is usually carried out for a simple form and involves spectacle correction using glasses with cylinders or contact correction with toric ones (with a shifted center of gravity). The disadvantage of spectacle correction in this pathological condition is the need for frequent replacement due to gradually increasing astigmatism. The selection of glasses should only be done by an ophthalmologist to avoid further deterioration of vision. The ophthalmologist should tell parents of children with astigmatism what it is and how complications can be avoided.

There are several types of operations for the disease:

1. Thermokeratocoagulation. Today, the operation is outdated and is being replaced by safer ones. Pinpoint coagulates (burns) are applied to the cornea with a special instrument. In this case, the periphery of the cornea becomes flattened, and the central part becomes more convex.
2. Thermokeratoplasty. The essence of the operation is the same as the previous one, but the burns are caused not with a hot microscopic needle, but with a laser.
3. Hypermetropic laser mileage. The most modern and safe operation. The laser evaporates an area in the inner layer of the cornea of ​​the required thickness in the right place. The intervention technique is the same as for Lasik surgery for myopia and. Since evaporation occurs at the periphery of the cornea, the central part becomes more convex and increases the refraction of rays, collecting them at one point on the retina.

Complications of the disease

If children develop astigmatism in the right or left eye at an early age, it can lead to

Complex hyperopic astigmatism in children is not a disease, but rather a visual defect. Normal astigmatism develops due to the irregular shape of the cornea and lens of the eye. Instead of being perfectly spherical, they are shaped like a rugby ball or a melon, for example, and therefore do not refract the resulting light rays correctly. As a result: a person sees the image as distorted and unclear.

But we are talking about complex hypermetropic astigmatism. This form of vision pathology differs from classic astigmatism in that it is accompanied by hyperopia (farsightedness). The latter is characterized by a violation of the correct focusing of the image (behind the retina), which makes nearby objects blurry. Since the pathology is complex, both eyes are affected. However, only one of the organs of vision can be farsighted. All this negatively affects the child’s life, because problems arise with learning and perception of surrounding objects.

Hypermetropic astigmatism in children is more often congenital, but a child can still acquire it after receiving an eye injury or suffering from diseases such as:

• eye cataract;
• keratoconus of the eye.

In addition, nearsightedness, farsightedness and astigmatism may appear after eye surgery.

It is known that hereditary astigmatism is transmitted to children from parents with a probability of 50%, if it is not acquired and is present only in the father or mother. When both spouses have a congenital vision pathology, it is passed on to the unborn child with a 100% probability.

Symptoms

The symptoms of hypermetropic astigmatism are difficult to distinguish from the symptoms of other vision pathologies, especially when the child is small (2-4 years) and cannot correctly explain his sensations. But if you pay attention to the baby’s behavior, you will notice how he constantly squints and refuses to look at the color pictures in children’s books.

Older children complain of the following symptoms:

1. A fuzzy image far and near, or rather, its curvature.
2. Blurred image up close and sometimes far away.
3. Headache (may occur due to excessive eye strain).

Often the child has:

• irritability;
• academic lag;
• dislike of reading and drawing.

The degree of astigmatism and farsightedness is not the same for both eyes. It is impossible to determine it on your own. If the above symptoms occur, parents should immediately take the child to an ophthalmologist.

Diagnostics

Parents should remember that they cannot select glasses and contact lenses for their child on their own, as this will only worsen already poor vision. Only an ophthalmologist can determine the degree of astigmatism and farsightedness using the following studies:

1. Measuring intraocular pressure.
2. Ultrasound of the eye.
3. Visometry.
4. Computed tomography of the eye.

Nevertheless, a sign with letters still helps to identify any of the visual impairments.

Depending on the severity and prognosis, the doctor chooses the optimal treatment.

Treatment

Young children from 0 to three years old usually do not undergo any treatment. Even after reaching this age, some methods are contraindicated. There are modern and conservative methods for vision correction in children with severe hypermetropic astigmatism. They allow you to completely normalize vision or correct it over a certain period of time.

Glasses

Wearing glasses is the best and inexpensive option. Even three-year-old children can wear them. The vision correction device must be equipped with toric lenses. These glasses allow you to correctly refract light and focus the image. Older children, in addition to wearing the device, should be taught to do eye exercises. At absolutely any age, the daily menu must be enriched with foods with a large amount of vitamin A. The cost of such treatment will cost parents $25-35.

Contact lenses

This method is used for children from the age of eight. Contact lenses, like the lenses of astigmatic glasses, have a cylindrical shape on one side and a spherical shape on the other (toric lens), but they are thin and light, and therefore comfortable to wear. They work the same way as glasses: they correctly refract and focus the resulting image, due to which vision is corrected. The cost of this method will cost parents $35-52.

Laser correction

Since we are talking about children, first of all we need to mention the contraindications to this popular operation. So, laser correction cannot be performed on children and adults with corneal dystrophy and eye diseases such as conjunctivitis, blepharitis, and stye. In addition, this correction is contraindicated for children from 0 to 5 years old.

The operation involves the administration of anesthesia, removal of the upper part of the sclera, and correction of the shape of the cornea and lens with laser beams. It lasts 15-20 minutes and allows you to get rid of complex hypermetropic astigmatism and other vision defects once and for all. Its cost is $350-1750.

Implantation of the actual intraocular lens

The operation involves separating the upper part of the eye sclera using laser beams, exposing the anterior or posterior eye chamber. A small, specially prepared toric lens is inserted into it. The top of the eye is then put back into place. The correction is intended to last a lifetime. Its cost is $1750-3500.

Hypermetropic astigmatism in children is a very complex visual impairment that can be corrected by methods such as wearing glasses, wearing lenses, exposure to laser beams, and implanting an intraocular lens. The choice of any of the methods must be agreed with the doctor.

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What is hypermetropic astigmatism? - This is astigmatism, which is combined with farsightedness.

Normally, a beam of light passes through the optical medium (cornea and lens) and is focused on the retina at one point. However, under the influence of various factors, the surface of the cornea or lens is distorted and then the image is projected onto the retina at two points at once. This phenomenon is called astigmatism.

Reasons for appearance

There are two main reasons that cause the disease:

• Changes in the shape of the cornea;
• Lens deformation.

Unfortunately, to date it has not been reliably established why the lens and cornea change their shape. Researchers have several assumptions about this:

• It is believed that Lens deformation is a congenital developmental anomaly and very rarely develops during life.
• Changes in the shape of the cornea can occur due to scar changes (for example, after surgery or injury).

Simple and complex hypermetropic astigmatism

In clinical practice, there are two types of the disease:

• Simple, in which astigmatism is observed in one eye;
• Complex, which is characterized by the presence of hyperopic astigmatism in both eyes. However, the severity of astigmatism in each eye may be different.

Symptoms

Clinical manifestations of hypermetropic astigmatism depend on the degree of its severity.

The mild form is often not accompanied by noticeable symptoms. A person may not pay attention to the fact that his vision is deteriorating for a long time. As a rule, a mild degree of astigmatism is detected during annual preventive examinations.

In moderate cases, complaints such as blurred vision accompanied by double vision, dizziness or headache appear. At the same time, it is difficult for a person to concentrate on doing work that requires visual strain. It is at this stage that people most often turn to an ophthalmologist for help.

Severe degree of hypermetropic astigmatism is characterized by vivid clinical symptoms. First of all, people complain of double vision and severe blurred vision. During work, there is pain or pain in the eyes, headache, sometimes nausea, irritability. During the examination, a significant decrease in visual acuity is detected.

Treatment

There are two fundamental methods of vision correction:

1. Conservative;
2. Operational.

Neither glasses nor contacts can cure astigmatism.

Astigmatism can only be cured with surgery. Modern ophthalmology offers several types of operations to eliminate astigmatism.

Laser thermokeratoplasty

The essence of the method is that certain areas of tissue are exposed to a laser beam, causing thermal burns. Under the influence of high temperature, collagen fibers contract, which leads to a change in the curvature of the cornea. In the central part it is rounded, and on the periphery, on the contrary, it becomes flattened.

Thermokeratocoagulation

The essence of the operation is the same as in the previous method, however, the thermal burn is produced not by a laser, but by a special needle.

This technique is considered the most highly effective and safe today.. Used to treat moderate to severe forms of the disease.

Keratomileusis includes several stages:

1. A small piece of tissue is cut out in the area of ​​the upper layer of the cornea and turned to the side.
2. They work with a laser in the freed space and “evaporate” the required area, so that the surface of the cornea becomes smooth again.
3. The top layer flap is returned to its place.

This method has several advantages:

1. This operation can be performed on both eyes at once.
2. Vision after keratomileusis is restored quickly. Already a few hours after the intervention, the patient feels improvement.
3. After the intervention, there is no clouding of the cornea.

For certain indications, interventions such as removal of the lens and replacing it with an implant, keratoplasty, and installation of an intraocular lens can be performed.

Hypermetropic astigmatism in children

Few people know that complex hypermetropic astigmatism in both eyes in children under one year of age is a physiological (normal) phenomenon.

As for older children, the disease manifests itself in them in the same way as in adults. At the same time, the child’s complaints may be vague (indefinite) in nature: fatigue, burning in the eyes, pain in the frontal part of the head, reluctance to read, draw or write.

Astigmatism test for children

To do this, take a white sheet of paper and draw 5-10 intersecting lines on it. Now close each of the child’s eyes in turn and ask him to answer: what color are the lines in the picture?

What a healthy child and a child with astigmatism see:

If all the lines seem equally dark to the baby, then most likely there are no problems with vision. But if even one line appears gray or blurry, you need to see an eye doctor for further examination.

Correction of disease in children

Mild forms of hypermetropic astigmatism do not require special correction

Mild forms of the disease do not require special correction. Usually doctors select special exercises for the eyes and register the child at the dispensary.

More pronounced forms require mandatory correction, which is achieved by wearing glasses or contact lenses. The correct selection of glasses can only be carried out by an experienced ophthalmologist.. For correction, lenses with varying degrees of refraction are used, which are made individually to order.

As for contact lenses, they are best used by children starting from middle school age. This is due to the fact that it will be difficult for a small child to use the lenses and properly care for them.

Laser correction can only be performed after reaching 20 years of age when the eyeball is fully formed and stops growing.

To prevent the occurrence of childhood astigmatism, it is necessary to accustom the child from a very early age to the correct distribution of eye strain.

Prevention

The only direction for preventing hypermetropic astigmatism is maintaining visual hygiene and timely contacting an ophthalmologist. The earlier astigmatism is detected, the greater the chance of stopping its progression.