Purpose. To analyze the acquired myopia (AM) development features from the perspective of the adaptation theory and to evaluate the effectiveness of its primary prevention in elementary school children using the optical kinesiotherapy (OKT) method with Zenica optical simulators sets (Zenica LLC, international patent number
WO 95/31743).

Material and methods. Acquired myopia can be considered as the result of passive adaptation of the visual system (VS) in case its operation is inadequate in near vision, according to the theory of adaptation. Therefore, the main goal of myopia preventive measures is to increase the visual system’s adaptive capabilities to adverse visual work conditions to the adequate level. 48 schoolchildren (96 eyes) with emmetropic refraction were observed during two academic years, starting from the first grade. There were 23 children in the main group who underwent 5 courses of OKT during the observation period. Preventive treatment was not carried out for children in the comparison group (25 children).

Results. There was no change in refraction in the main group by the end of the two-year observation period, while myopic refraction increased in 8 (8%) eyes in the comparison group. Positive-relative accommodation (PRA) increased by an average of 3.5±0.36 D (p<0.001) in the main group as a result of treatment, while in the comparison group its values improved on average by only 1.2±0.48 D (p<0.001) as a result of the natural PRA development. The stability of visual perception (SVP) to hyperopic retinal defocus (HRD) increased by an average of 38%, and width of the divergence of the graph’s curves increased average of 4.0 D as a result of the visual system adaptive resource correction using optical simulators in the main group. The SVP to HRD increased only by an average of 10%, and the width of the divergence of the graph’s curves increased by 0.75 D in schoolchildren of the comparison group over the same period, due natural development of the visual system.

Conclusion. Correction of the adaptive resources of visual system in elementary school students by OKT helps increase adaptive resources to an adequate level during the educational process, which helps prevent the risks of myopia.

Purpose: To quantify and characterize higher-order aberrations in eyes of children with amblyopia caused by different etiology factors; to evaluate the relationship between the wavefront profile and the effectiveness of the amblyopia treatment.

Material and methods.This study involved 26 children (52 eyes) from 3 to 9 years old (average age 6.2±3 years) with different types of amblyopia: unilateral amblyopia due to impaired binocular vision and anisometropia, as well as unilateral or bilateral amblyopia caused by hyperopia. Patients were divided into four groups depending on the effectiveness of pleoptic treatment: 14 children (24 eyes) – with positive treatment results, 8 children (12 eyes) – with refractory amblyopia, 4 pre-treatment newly diagnosed patients (6 eyes) without previous history of optical correction, and 10 non-amblyopic contralateral eyes (control group). All patients had central fixation and didn`t have any severe systemic diseases.

Higher-order aberrations were measured with iTrace Visual Function Analyzer (Tracey Technologies, Houston, TX) after instillation of 1% cyclopentolate eyedrops.

Results and discussion. Wavefront profiles were significantly different in the studied groups. Total spherical aberrations and astigmatism were significantly higher in group with refractory amblyopia (-0.53±1.19 and 2.25±1.07, p=0.02) compared with all the other groups: the group of patients before pleoptic treatment (-0.17±0.23 and 1.79±1.47), group treated with high efficiency (-0.31±0.81 and 1.04±0.13) and with control group (-0.13±0.17 and 1.38±0.11). Total coma-like aberrations didn`t show statistically significant differences in all studied groups (р=0.06).

The level of corneal higher-order aberrations (total, coma, spherical) in all three amblyopic groups was higher than in the control group without amblyopia.

Conclusion. We revealed statistically significant differences in the wavefront profiles in children with amblyopia of various etiologies in comparison with the control group, including higher-order aberrations.

The data obtained indicate that an amblyopic eye with hyperopia has higher level of spherical aberrations and astigmatism due to higher level of internal HOAs, particularly spherical aberrations and astigmatism, which is typical for patients with unsuccessful treatment. Therefore, that type of aberrations is likely to be the main cause of refractory amblyopia.

We described two clinical cases of ortho-k lenses fitting for patients with “non-typical” corneal curvature/diameter ratio. The main goal was to acknowledge effective and safe use of this myopia correction method in patients with corneal diameter greater than 11 mm. Individual approach to each patient is the key to a successful and safe ortho-k lenses fitting.

A clinical case of bilateral retinopathy consisting of typical zones of ischemia – Purtscher spots, hemorrhages and cotton-like retinal exudates after acute pancreatitis is presented. Typical zones of retinal ischemia and the
transparency of ocular media (vitreous) were considered as Purtscher-like retinopathy.

A scleral contact lens (SCL) can be defined as a lens that only rests on the sclera. Raised from the cornea and limbus, the total diameter must be greater than the horizontal visible iris diameter (HVID) and the extension of the limbus. Currently, the most commonly used lenses are scleral lenses with a diameter between 15.0 and 17.0 mm, the so-called mini-scleral lenses. The existing nomenclature of scleral lenses is based only on HVID and total diameter. It is therefore important to further differentiate smaller minisclera lenses from lager ones.

Purpose. To analyze domestic and foreign scientific publications over the past 5 years, reflecting the issues of accommodation and accommodation disorders. To assess the presence or absence of changes in the classification of accommodation disorders. To evaluate the role of various accommodation disorders in the development and progression of myopia.

Relevance. Given the significant increase in the number of people with myopia in recent decades, interest in the study of accommodation and accommodation disorders has increased again. This is due not only to the fact that accommodative insufficiency (AI, weak accommodation), is considered one of the leading factors in the development of myopia, but also because the use of one or another method of myopia control affects the process of accommodation, increasing or reducing accommodation reserves, affecting the functioning of the binocular system.

New developments in the field of visualization of intraocular structures (anterior segment imaging by OCT, Sheimpflug imaging, UBM) allows carry out previously impossible studies of changes in the crystalline lens, ciliary body, at different levels of accommodation response, in different age groups in vivo, which itself affects the development and testing of new concepts related to the mechanism of the accommodation.

Thus, the dynamics of the changes that are taking place motivates ophthalmologists to take a fresh look at the already established concepts of the accommodation mechanism, to assess the consistency of previously adopted approaches to the classification of accommodation disorders, which in turn can affect changes in the tactics of myopia control, which is especially crucial as myopization of the population, especially in children, is accelerating every day.

Our task was to evaluate domestic and foreign scientific publications over the past 5 years, reflecting the results of studies of the accommodation mechanism, assessing the influence of accommodation disorders on the progression of myopia. The task was also to assess the prospect of creating a unified classification of accommodative disturbances, the ability to create a unified algorithm for controlling progression, based on accommodation parameters.

Search strategy. A review of English and Russian sources related to the study of the mechanism of accommodation was conducted; the effect of accommodation disorders on the progression of myopia and their classification was studied using the following databases: PubMed, Cyberleninka, Google scholar, Elibrary. The search depth was 5 years (20142019), excluding the historical sources.

The sources included:

– original research;

– historical issue, scanned publications;

– studies / descriptions of accommodation disorders and their relationship with myopia;

– abstracts and full-text publications;

– literary reviews; – monographies. The exclusion criteria were:

– themed issues with closed or restricted access.

During the process of searching and processing information, the data obtained were not systematized according to the level of reliability due to the fact that the purpose of the review is to obtain a general idea of the views on this issue, assess the presence or absence of unity in the formation of diagnostic criteria, without the task of suggesting practical recommendations.

The following search queries were made to search the databases:

1) english-language sources − mechanism of accommodation, accommodation AND history issue, accommodation AND Helmholtz AND Tsherning, accommodation AND myopia, accommodation AND myopia control AND myopia progression, accommodation disorders OR accommodation anomalies, accommodative excess AND accommodative infacility AND accommodative insufficiency, epidemiology myopia AND etiology myopia, near work AND myopia AND children;

2) russian-language sources − the history of the study of accommodation, the mechanism of accommodation, classification of accommodation disorders, accommodation, accommodation disorders with myopia, accommodation and the progression of myopia, weakness of accommodation, habitual excess tension of accommodation; progressive myopia, myopia control. 

Laser vision correction is a simple and safe way to improve vision in cases of myopia, hyperopia and astigmatism. We analyzed differences of the existing laser vision correction technologies, their risks and side effects. The main objective of laser vision correction is to change corneal curvature in order to change its refractive power. Laser refractive
surgery is the most common method of eliminating need for glasses or contact lenses. The presented data was obtained from the analysis of scientific publications and by practical means.

Proper presbyopia correction has become increasingly relevant for clinical practice in recent years.

This problem arises from both the population ageing as a whole and the need for a higher vision quality that directly affects the quality of patients life.

There are many factors that require comfortable and high-quality vision correction with soft contact lenses, such as active sports, the desire not to change usual activities and feel younger, the reluctance to use extra reading glasses and glasses in general.

We have to look for soft contact lenses with the wettest surface, lenses that can maintain tear film for as long as possible due to following reasons: disruption of eye surface
wetting; dry eye syndrome, that sometimes arise with age; medicine use, one of the side effects of which is usually the reduction of tear production. The review provides re- commendations for the fitting of multifocal contact lenses through the example of Biofinity Multifocal with different designs: distance-center and near-center.

Conclusion: It is possible not only to achieve high vision quality at all distances in patients, but also to maintain their accustomed lifestyle and to minimize their astenopic complaints with the help of proper presbyopia correction.