Практика Shadowing: EYE STROKE - Retinal Vein Occlusion (Causes, Symptoms, Treatment) - Изучайте разговорный английский по видео

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so have you ever heard of somebody having a stroke within

their eye in eye care we call them retinal vein occlusions

and in this video i'm going to break down the pathogenesis of how it affects the eye ultimately our vision

and then the treatments for it that's today's video let's take a look hello

and welcome this is dr alan here from the dr eye health show helping you learn all about the eyes

and vision if you're new here to the channel definitely consider hitting

that subscribe button down below

so you don't miss any of my future videos about eye

care topics such as this one in fact this is a

huge shout out to many of the viewers who have requested this video specifically for almost a full year

and i apologize it took me this long to get to it

but here it goes first of all retinal vein occlusions are

a pretty big topic in eye care both in optometry

and ophthalmology this is something we all have to learn

and really know very well because it can be a serious cause of vision loss

and potentially other complications and issues within the eye

and oftentimes doctors will try to easily explain to their patients what's going on by just saying

that they had a stroke within their eye now there could be many things in the eye

that could be described as having a stroke this happens to

be a vein occlusion where one of the veins in the eye becomes occluded

and then you have all these problems there's also artery occlusions completely different thing we're going to save

that for another video sometime in the future but

when we talk about vein occlusions there's generally three types in

eye care there's a central retinal vein occlusion a hemicentral retinal vein occlusion

and a branch retinal vein occlusion you see the retina in

the back of the eye is known to have a dual blood supply this means it has arteries

and veins that go through the optic nerve and into the eye

and supply blood and oxygen and nutrients to the front surface of the retina

but then it also has another set of blood vessels on

the back of the eye through what is called the choroid now the veins

that i'm talking about in this condition these are the blood vessels within the retina

that go through the optic nerve

and actually supply the anterior portion of the retina now depending

on the location of the occlusion it could be in the

central retinal vein this is right where the blood vessels first enter

and exit the optic nerve going in

and out of the eye then there's the hemicentral retinal vein occlusion

which is a little bit more anterior to that

but then you have a full branch retinal vein occlusion this occurs more within the retina

and has a very distinct look to it

when someone has a central retinal vein occlusion such as this

the doctor will see a lot of blood throughout the entire

retina it affects all of the areas of the retina

and oftentimes in school we're learned to recognize this as blood and thunder.

Where somebody with a branch retinal vein occlusion this is where the retinal vein

that has a branch to it inside the eye

that one is selectively occluded and then it's just kind of a whole arm

or section of

that vein that's been blocked off such as in this picture

here where you can see the blood just kind of pooling in the retina just in one specific quadrant.

I think by far in my practice I see branch retinal vein occlusions much more often

and central retinal vein occlusions coming just kind of close second

but thankfully the pathogenesis for all these conditions are very similar

and i'll kind of want to break these down just so

that you understand what's happening within the eye now just for

simplicity sake let's go over branch retinal vein occlusions first we call them brvo's in the clinic

and i like to describe brvo's first to like students first

because the brvo's are a little bit simpler to understand and the same pathogenesis that is affecting the branch retinal vein occlusion, it can also be applied to all other forms of vein occlusions.

Now within the eye, the central retinal artery and vein, they travel through the optic nerve and then they spread out into different quadrants of the eye.

You have the superior temporal quadrant, the superior nasal quadrant, you have the inferior temporal quadrant and the inferior nasal quadrant.

Now when these blood vessels go out this direction, both the artery and the vein,

they travel together and the artery crosses over on top of the vein.

This is important to remember think of it like the different hoses

that maybe you left out for watering your lawn one summer

the arteries are going to cross over on top of the vein

and what happens is that with age different lifestyle factors like inactivity people who don't exercise

and they have increased blood pressure people who eat really poorly who eat a lot of greasy burgers

and pizza as well as people who smoke they're at increased risk of developing what is called arterio

and artherosclerosis arteriosclerosis is where the blood vessel

that artery itself the walls of it become thicker and more rigid

and then atherosclerosis is where the cholesterol

and fatty plaques of your diet end up sticking on the inner lining of your blood vessels

and this ends up collecting and ultimately can become a plaque

that blocks up the artery and that's what we call a stroke

and eventually a heart attack so all these different things kind of accumulate

and cause the artery

which is again is running over on top of the vein to kind of swell up become more rigid and thick.

And they share what is called an adventitial sheath.

That's where the artery and vein cross over each other.

They share the same tissue.

And because the artery is getting thick, it starts to push on that vein, causing the vein the amount of space for the blood to flow through gets smaller and smaller.

And with that, you create more turbulent blood flow within the vein, which that turbulence causes damage to the inner lining of the vein.

And that inner lining called the endothelium, because it gets damaged the body tries to repair it

and with the repairing process the new tissue the new endothelium isn't quite the same

and ultimately with sustained increased blood pressure and continued damage eventually it ruptures

and that's when the blood breaks through the vein and just spreads throughout the back of the eye.

Now most commonly a branch retinal vein occlusion we will see in the superior temporal quadrant

because there's more crisscrossing of arteries and veins in that quadrant thankfully

if you're young under the age of 50 your risk of

having one of these conditions is much lower there's still a possibility especially

if you have a hyper coagulability issue such as factor 5 leiden

that maybe runs in your family

or maybe you take some sort of birth control like

if you're a woman you're taking birth control

that also carries a small risk of having a higher chance of one of these especially

when you're young and when an eye doctor sees this whether they're an optometrist

or ophthalmologist they're going to recognize whoa they have all this

blood in the back of the eye they have a brvo

okay we have to think do they have perfusion do they have blood flowing to the retinal tissue

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or not oftentimes in the clinic we can recognize white spots on the retina

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that we call cotton wool spots that's often an indication

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that there is not perfusion and we call

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that ischemic branch retinal vein occlusions

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or your doctor may order what is called a fluorescein angiogram

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which is where they put a fluorescein sodium dye through your arteries

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and veins and they take pictures of the back of the eye

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and they can literally see where blood is still flowing within the retinal tissues

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and in a brvo you can have the ischemic

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and non -ischemic versions the less blood flow

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or more ischemic versions of a vein occlusion the worse the vision

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and the consequences within the eye are going to be

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so people can have milder non -ischemic branch retinal vein occlusions

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that they may not even notice that they have any vision changes

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or any sort of problems in the eye at all

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or they can have very ischemic vein occlusions

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which ultimately lead to blank spots in their vision

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and even blurred vision now ultimately what happens

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because of these retinal vein occlusions how it affects your vision is

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that the retina itself is getting starved of oxygen and these nutrients and

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so the retina starts to release these inflammatory proteins these inflammatory

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mediators are going to cause the blood vessels around this kind

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of ischemic area that's not getting its proper nutrients to it's going to allow these blood vessels to start leaking

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and with this increased leakage

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and perfusion of fluid from the blood vessels it's going to cause swelling this increased amount of fluid

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which is supposed to essentially kind of heal the eye ends

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up causing kind of a blister formation within the retina

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and we call that macular edema and with

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that it changes the architecture of the retina

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and you lose a lot of your eyesight your vision becomes extremely blurry

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so if this doesn't happen

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if it's just a mild vein occlusion you may not notice any difference in your visual acuity

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and that's why it's really important to still see your eye doctor every year

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because they can often see

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that this happened maybe in the past maybe there's some sort of indication

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that you had this a long time ago or perhaps they're catching one live going on right now.

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I remember a time during my residency I had a gentleman

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coming in just for a pressure check for his glaucoma

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and I still looked inside of his eye to look at the optic nerve

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and I could see he was having a vein occlusion right that moment. So in

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that case I immediately said hey sir you're having another issue

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that's unrelated to your glaucoma your visit's going to last a little bit longer.

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We went and checked his blood pressure and his blood pressure was alarmingly high and

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that really takes me on to the treatment for something like

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a branch retinal vein occlusion now my job is to first recognize diagnose what is going on

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and also figure out if there is swelling of the retina

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and ultimately guide kind of treatment

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and management for this disease one of the big issues again like this gentleman

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that was in this story

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when i was at the va he had really high blood pressure

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so being that so much of this disease has to do with your blood pressure your cholesterol potentially

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if you have diabetes other things like that it's important

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that i manage

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and get this patient to be seen by a primary care physician their general practitioner order appropriate blood work

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so that we know what's going on what are the risks for potential stroke heart attack

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because that's life -threatening so in this particular case after we knew

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that gentleman had high elevated blood pressure

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that day we also made a direct referral to get blood work

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and then go see his family doctor so that he could get his blood pressure under control.

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Now, thankfully, that gentleman that day still had 2020 dis.. despite having a branch retinal vein occlusion, because his macula wasn't swollen at all.

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He had essentially a non -ischemic branch retinal vein occlusion.

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But that gentleman, we still had to watch him for several months because it's possible it could have gotten worse.

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He could have had macular edema that developed.

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If you are somebody who ever does develop vision changes from a vein occlusion, such as a BRVO, when you have

164

that swelling you are going to be referred to a retinal specialist with a retinal specialist they will again do

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that fluorescent angiogram so they know where the perfusion

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and non -perfusion is

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and then they will offer different treatments most commonly today the

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first line of treatment are injections of a medication known as the anti -veg f

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which stands for vaso endothelial growth factor

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and that's one of the special growth factors that's released from the retinal tissue

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when there is inflammation and not enough kind of not enough nutrients

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and going to the retina itself now i don't mean to scare people

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when i say you're going to get an injection a needle going into the eye

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but thankfully these treatments work amazing and oftentimes with repeated treatments

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and your close watching from your doctors they can get things under control

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and most people do have a good visual prognosis after a

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vein occlusion like this most people do have vision better than 2040 even

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if no treatment is given but even better when there is treatment

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and alongside the possible injections for treatment for this sort of

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macular edema from a vein occlusion your doctor could also recommend either laser

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or an injection of a steroid inside of the eye these have been kind of older technologies and treatments

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that we've used however they can still be used in conjunction with the anti -vegf injection again something

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that you'll have to leave open to discussion with your retinal specialist

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and believe me they know what they're doing so

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if i was having this i would just trust everything they say now in general these different treatments

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that i just described those are the same treatments

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that we use for all forms of retinal vein occlusions the

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central retinal hemiretinal vein occlusion it all happens for the same

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pathogenesis of the branch retinal vein occlusion except it's at different

190

locations within the eye however the central retinal vein occlusion is a little bit more dramatic

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and has a higher risk of other complications one of those big issues is a certain type of glaucoma

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that i want to kind of go over just a second what a central vein occlusion is

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so i can better explain what might be going on with

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that type of glaucoma now again the central retinal vein it's the central vein

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and so when

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that gets blocked off the entire back of the eye looks completely filled with blood again blood

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and thunder is what we call it in school that's what they train us to see

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and oftentimes this does come along with some sort of macular edema

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so oftentimes when the doctor

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when your eye doctor sees this they're going to send you to a retinal specialist right away

201

but it's also important for them to consider doing a certain

202

technique called gonioscopy this is a special type of contact lens

203

that's placed onto the eye after the eye has been numbed with some sort of eye drop medication.

204

And then your doctor is able to look through this special type of contact lens

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because it's got mirrors on it and allows us to look at the angle structure of where the aqueous humor,

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which is the fluid inside the eye that controls the eye pressure, we can see where that aqueous humor is draining out of the eye.

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This angle, which is formed by the iris and then the cornea, they come together at a certain spot

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and that's where the fluid drains out of now what happens is

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because a central vein occlusion is

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so dramatic there's really really no nutrient getting to the retina it's being starved very quickly

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so new blood vessels start to grow inside the eye these new blood vessels

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which we call neovascularization these new blood vessels can grow within the angle within

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that drain and that means that there's nowhere for

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that aqueous humor fluid to go

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so the eye pressure starts to go up really high

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and this can be a very serious form of glaucoma because

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that increased eye pressure can push on the optic nerve

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and it can kill the nerve and once the nerve is dead bye -bye vision

219

and in eye care we call that 90 day glaucoma

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because within the first one to three months that's

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when a person's most at risk of developing this glaucoma from

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a central retinal vein occlusion now the ultimate takeaway i hope

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you get from this video is not just understanding the pathogenesis of a retinal vein occlusion

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and its treatments but to take advocacy for your own health

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if you're having vision changes make sure you see your eye doctor

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and based on their recommendations follow whether they want you back in a month

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if they prescribe you treatment make sure you follow that treatment they want what's best for you and your vision.

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And then second of all, be an advocate for your health in regards to your blood pressure, your diet, and your lifestyle in general.

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If you're somebody who is already getting in your older age, you're over the age of 50, maybe you have not eaten very well in your life.

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If you eat a lot of greasy foods, cheeseburgers, pizza, and things like that, that's not necessarily good for your body.

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And if you're inactive, if you're someone who doesn't exercise very much, I know it can be tough for a lot of us and it's something I'm working on, but being active, eating healthy,

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not smoking, these all can contribute to having less chances of having a vein occlusion, whether that's in one eye or both eyes

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and it's overall going to reduce your chance of having a heart attack

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and stroke and i think we can all agree those are all important things

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so if you like today's video going deeper into an eye health condition go ahead

236

and smash that like button for me

237

and leave a comment in the section below of either your story involving something like a vein occlusion

238

or if you have another question about an eye health related topic

239

or disease or treatment again drop a question

240

or comment in the section below because i read those comments

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and i would love to get back to you

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and possibly make a video all about that topic otherwise

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if you are new here to the channel make sure to hit

244

that subscribe button down below

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so you don't miss any of my future videos again this

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is dr joseph allen here from dr eye health keep an eye on it and we'll talk to you soon

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Лексика и советы по произношению к этому уроку

Этот урок разговорной практики построен на видео «EYE STROKE - Retinal Vein Occlusion». Чаще всего повторяются слова: vein, eye, occlusion, blood, retinal. В этом видео 82 предложений и 3175 слов для шедоуинга. Речь длится 16:39. Говорящий говорит быстро, около 191 слов в минуту, поэтому звуки часто сливаются и сокращаются. Только 80% слов входят в 3000 самых частых слов английского языка, поэтому лексика сложная.

Ключевая лексика этого видео

15 слов из видео, которые стоит выучить, с произношением и значением:

Слово	Произношение	Значение
vein существительное	/veɪn/	ве́на, жи́ла
artery существительное	/ˈɑɹ.təɹ.i/	арте́рия
vessel существительное	/ˈvɛsəl/	су́дно, кора́бль
nerve существительное	/nɝv/	нерв
optic прилагательное	/ˈɑp.tɪk/	оптический
tissue существительное	/ˈtɪʃ.(j)u/	ткань
fluid существительное	/ˈflu.ɪd/	жи́дкость, флюи́д
gentleman существительное	/ˈd͡ʒɛn.təl.mən/	господи́н, су́дарь
injection существительное	/ɪnˈd͡ʒɛk.ʃən/	инъе́кция, уко́л
swell глагол	/swɛl/	раздува́ться, набуха́ть
nutrient существительное	/ˈnuː.tɹi.ənt/	пита́тельное вещество́
topic существительное	/ˈtɑpɪk/	те́ма, предме́т
specialist существительное	/ˈspɛʃəlɪst/	специали́ст, специали́стка
thankfully наречие		сла́ва бо́гу
superior прилагательное	/sʊˈpɪɹ.i.ɚ/	вышестоя́щий, вы́сший

Фразовые глаголы, которые вы услышите

Слово	Произношение	Значение
end up глагол		зака́нчиваться, зако́нчиться
go over глагол		хорошо́ принима́ться
break down глагол		ломаться, сломаться
figure out глагол		разбира́ться, разобра́ться
go ahead глагол	/ˌɡoʊ əˈhɛd/	дава́й, приступа́йте
go out глагол		выходи́ть, вы́йти
go up глагол		поднима́ться, подня́ться

Грамматика в этом видео

Конструкции, которые говорящий использует чаще всего, с точными словами из видео:

Конструкция	В видео
Пассивный залог be + причастие прошедшего времени — важно, что происходит, а не кто это делает	could be described · is known · is called
Present Perfect have/has + причастие прошедшего времени — прошлое действие, важное сейчас	have you ever heard · have requested · that's been blocked
Придаточные определительные who / which + предложение — уточнение о человеке или предмете	people who don · people who eat · people who smoke

Произношение, на которое стоит обратить внимание

Говорящий использует 41 сокращённых и редуцированных форм, например you're, gonna, they're. Произносите их коротко, так, как слышите.

Звуки «th»: thick /θɪk/, thunder /ˈθʌndɚ/, threaten /ˈθɹɛt.n̩/, pathogenesis /ˌpæθ.ə(ʊ)ˈd͡ʒɛn.ə.sɪs/, atherosclerosis /ˌæθɚoʊskləˈɹoʊsəs/
Звуки «sh» и «zh»: tissue /ˈtɪʃ.(j)u/, injection /ɪnˈd͡ʒɛk.ʃən/, specialist /ˈspɛʃəlɪst/, essentially /ɪˈsɛnʃəli/, potentially /pəˈtɛnʃ(ə)li/
Длинные слова — следите за ударением: superior /sʊˈpɪɹ.i.ɚ/, essentially /ɪˈsɛnʃəli/, potentially /pəˈtɛnʃ(ə)li/, medication /mɛdɪˈkeɪʃən/, indication /ɪndɪˈkeɪʃən/

Звуки, трудные для русскоязычных:

/w/ — губы округлены, это не /v/: swell /swɛl/, nowhere /ˈnoʊ.(h)wɛɹ/, consequence /ˈkɑn.sɪ.kwəns/, wool /wʊl/, whoa /woʊ/
/h/ — лёгкий выдох, а не русское «х»: humour /ˈhjuːmɚ/, whoever /huˈɛvɚ/, nowhere /ˈnoʊ.(h)wɛɹ/, heal /ˈhiːl/
Звонкие согласные в конце слова — не оглушайте их: nerve /nɝv/, fluid /ˈflu.ɪd/, lens /lɛnz/, mild /ˈmaɪld/, subscribe /səbˈskɹaɪb/

Как заниматься с этим видео

Прослушайте всё видео один раз молча и выпишите незнакомые слова.
Начните со скорости 0,75×, повторяйте предложение за предложением и вернитесь к обычной скорости, когда станет легко.
Запишите себя и сравните с оригиналом, обращая внимание на такие слова, как vein, artery, vessel.

Что такое техника Shadowing?

Shadowing — это научно обоснованная техника изучения языка, изначально разработанная для подготовки профессиональных переводчиков и популяризированная полиглотом доктором Александром Аргуэльесом. Метод прост, но эффективен: вы слушаете аудио на английском от носителей языка и немедленно повторяете вслух — как тень, следующая за говорящим с задержкой в 1–2 секунды. В отличие от пассивного прослушивания или грамматических упражнений, Shadowing заставляет мозг и мышцы рта одновременно обрабатывать и воспроизводить реальные речевые паттерны. Исследования показывают, что это значительно улучшает точность произношения, интонацию, ритм, связную речь, понимание на слух и беглость речи — что делает его одним из самых эффективных методов для подготовки к IELTS Speaking и реального общения на английском.

Техника шедоуинга: читать полное пошаговое руководство →

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