Introduction. Keratoconus (KC) is a disease belonging to the group of primary keratectasias, characterized by pronounced irregularity of corneal topography and accompanied by irregular astigmatism, myopic refraction and higher order aberrations. It is established that accommodation in cases of ametropia is strongly influenced by the wave front of eye, but the influence of aberrations on ciliary muscle work in KC remains unstudied. The aim was to study the correlation of accommodation in KC with the ectasia-induced aberrations before and after optical correction with scleral rigid contact lenses (SRCL).

Materials and methods. Thirty people (60 eyes) with newly diagnosed bilateral KC, were included in the study: 26 eyes – stage I, 29 eyes – stage II, 5 eyes – stage III. Mean age of the patients was 26,2 ± 4,3 years. The clinical recruitment period was from January to September 2022. All patients were additionally evaluated for keratometric and aberration parameters of the cornea using a Scheimpflug camera besides a standard ophthalmological examination. Objective evaluation of accommodation was performed on the Righton Speedy-I device with determination of qualitative and quantitative indices. All investigations were performed before and after one month of wearing individual SRCL.

Results. According to the data of objective accomodography a state of spasmodic accommodation asthenopia was observed in 71% of cases before started wearing pressure lenses. There was a tendency to improvement of ciliary muscle function and a “stepped” course of the accommodative curve while wearing SRCL a month later. High values of corneal aberrations decreased by 4.5 times in the course of SRCL. Correlation analysis revealed a significant trend between the state of accommodation and the corneal wavefront.

Conclusion. Objective examination of the accommodation state in KC proves the signs presence of accommodative asthenopia mediated by irregular astigmatism. The revealed correlations between the indices of induced KC aberrations and accommodation state confirm the fact of ectasia negative influence on ciliary muscle work. It was proved that optical correction with SRCL in KC reduces corneal aberrations and significantly improves the state of accommodation.

Introduction. Penetrating keratoplasty (PKP) is known to lead to the occurrence of post-keratoplasty astigmatism (PA) that is often of a high degree and irregular shape. Phacoemulsification (PE) with implantation of toric intraocular lenses (toric IOLs) is able to compensate for regular PA. However, this method is not effective enough with irregular PA.

The aim was to conduct a clinical and functional analysis of the combined method for correcting irregular postkeratoplastic astigmatism (PA) in patients with cataract.

Materials and methods. The study has been conducting from February 2018 to September 2022. We operated on 27 eyes (27 patients) aged 38 to 52 years. Of these, there were 17 men and 10 women. All patients with a history of 4–6 years ago underwent penetrating keratoplasty for stage IV keratoconus and pellucid marginal degeneration of the cornea. In all patients, an irregular form of PA was noted according to keratotopography. Surgical treatment of these patients took place in 2 stages. At the stage I, in order to correct irregular PA and increase sphericity and regularity of the penetrating corneal graft, MyoRing was implanted into the intrastromal pocket having been formed in it using a femtosecond laser. One year after the MyoRing implantation, the stage II was performed – cataract phacoemulsification (CPE) with implantation of an intraocular lens (IOL). The follow-up period after the CPE with the IOL implantation was 1 year.

Results. One year after the MyoRing implantation into the penetrating corneal graft, a slight increase in visual acuity was noted. However, there was a pronounced decrease in corneal astigmatism by an average of 4.9 times, an increase in sphericity and regularity of the penetrating corneal graft according to keratotopography, as well as an increase in its biomechanical properties. One month after the operation, there was an increase in uncorrected visual acuity (UCVA) by 6.8 times and best corrected visual acuity (BCVA) – by 3.9 times, a decrease in the cylindrical component of refraction to –0.65 ± 0.28 D that no longer changed.

Conclusions. The combined method for correcting irregular PA in patients with cataract by MyoRing implantation into a penetrating corneal graft followed by CPE with IOL implantation showed a high refractive result, stability and safety in the late postoperative period.

Introduction. At present the major problem is the imperfection of the surgical approaches and the effectiveness of the surgical treatment for macular holes of various diameters associated with central retinal detachment in patients with high myopia and scleral staphyloma in the central zone. The main difficulty lies in creating the effective tamponade of the vitreous cavity necessary to close the macular hole. No less important is the effective blocking of the macular hole itself in the presence of deep scleral staphyloma. Silicone oils are currently used as a tamponing agent in most cases. Their viscous properties do not always allow the retina to be fully adapted. Searching for alternative highly effective methods of the surgical treatment for this pathology should increase anatomical and functional effectiveness of the treatment.

The aim of this work is to develop the methodology and analyze the results of the surgical treatment of patients with central retinal detachment against the background of the macular holes of various diameters in patients with high myopia and scleral staphyloma using autologous conditioned plasma (ACP) as the blocking rupture composite and pneumoretinopexy as the final tamponade.

Material and methods. Surgical tactics included subtotal vitrectomy 25+, 27G, peeling of the inner limiting membrane, pneumoretinopexy, introduction of ACP into the area of scleral staphyloma through the macular hole. After formation of the plasma seal at the base ACP was applicated to the surface of the retina in the hole area in 2–3 layers up to formation of the resistant ACP layer. The operation was completed seamlessly, blocking the scleroconjunctival access by applying 2–3 layers of ACP to the surface of the sclera and conjunctiva. Using this technique, 22 patients with central retinal detachment and macular hole with a diameter of 700–2200 microns against the background of high myopia and with severe scleral staphyloma were operated.

Results. As a result of the treatment, in the early and late postoperative period the retina was completely adjacent and the macular hole was blocked in all the patients.

Conclusion. In this way, this technique is the most sparing and highly effective. It allows to achieve the full anatomical fit of the retina and the closure of the macular hole, to eliminate the need for silicone tamponade, to minimize the risk of the postoperative complications in patients with central retinal detachment and the macular holes of various diameters in patients with high myopia and scleral staphyloma.

Primary rhegmatogenous retinal detachment (RRD) is a severe, potentially disabling ophthalmic pathology that requires timely surgical treatment to prevent progressive loss of vision.

Purpose. To analyze the incidence of RRD in the Udmurt Republic for the three-year period and to study an influence of clinical and sociodemographic factors to an occurrence of the studied pathology.

Methods. Retrospective assessment of 523 clinical cases of the first time diagnosed primary rhegmatogenous retinal detachment for the period from 2019 to 2021 was conducted. Data analysis was performed on the basis of the Republican Ophthalmological Clinical Hospital of the Ministry of Health of Udmurt Republic.

Results. The overall annual average RRD in the Udmurt Republic was 11.5 per 100,000 inhabitants (95% CI, 10.7–11.9). Men on average is more often than women (37.37 vs 32.17 respectively, p < 0.05). However, in the group of 50 years and older the female sex prevails. The highest incidence was found in the age group of 60–69 years in both sexes. A right eye was affected more often (51.43%) than a left one (45.89%) but equally in both men and women (p = 0.515). In the most subjects (50.48%) refraction was myopic. It was found that the age of myopes among all the patients with RRD was statistically significantly less than among hypermetropes (p = 0.008) and emmetropes (p < 0.001). Previous cataract extraction was noted in 21.22% that was 2.38 times more often in men (28%) than in women (15%, p < 0.001) and the age was comparable.

Conclusion. The obtained results of the rhegmatogenous retinal detachment incidence among the population of the Udmurt Republic are comparable with the incidence data of the most countries in Western Europe. The most significant risk factors for Udmurtia are male gender, old age, myopia and pseudophakia.

Background. A study of colour vision in patients with various ophthalmopathologies is one of the urgent tasks of modern ophthalmology. Only a small number of publications are devoted to results of the study of colour vision in children with amblyopia. This may be due to disadvantages of the currently existing methods of diagnosing colour vision, most of which are designed mainly for diagnosing colour vision in adults and teenagers or require complex equipment.

Purpose: to study possibilities of using the developed own method of quantitative and qualitative assessment of colour vision in children with amblyopia.

Material and methods. 81 school-age children were observed from the beginning of September 2021 to the beginning of June 2022. According to the results of standard ophthalmological examination they were divided into two groups: 1) 35 children (70 eyes) in the group with amblyopia, 2) 46 children (92 eyes) in the control group with normal visual acuity. The classic Farnsworth–Munsell Dichotomous D-15 test and our developed method of quantitative and qualitative assessment of colour vision were used to study colour vision in all children.

Results. In the group of children with amblyopia, only 28.6% children with amblyopia in the study of the best-seeing eye and 14.3% in the study of the worst-seeing eye were able to perceive all colour tones correctly. Unlike in the control group, at least half of the children successfully coped with determining all the using colour tones testing each eye. Quantitative assessment of colour vision conducted using our developed method in the children with amblyopia showed significantly higher average values of the total error of perception of colour tones for the best-seeing eye (M = 15.4 ± 2.1°) compared with the worst-seeing eye (M = 30.5 ± 3.3°) and significantly higher (p < 0.05) similar values compared to the children in the control group. The severity of colour vision disorders in the children with amblyopia has a significant direct dependence on the duration of the disease and a significant inverse dependence on visual acuity (r = –0.47, p < 0.001). Most often, colour vision disorders detected in the children in the control group relate to the perception of red, green and blue color tones when examining both eyes. In the children with amblyopia the perception of green and blue tones is more often detected when examining the best-seeing eye and the perception of red, green, blue and purple tones is detected when examining the worst-seeing eye.

Conclusion. Our developed method makes possible to effectively carry out quantitative and qualitative assessment of colour vision in children with amblyopia.

Introduction. It is often very difficult to single out the leading type of a disorder in children, especially with impaired or underdeveloped vision. There is a risk to overlook other types of health restrictions in boarding schools for blind and tender-eyed children. The need to solve the problem of comprehensive support for persons with disabilities is conditioned by the provisions of the Universal Declaration of Human Rights, the UN Convention on the Rights of the Child and the UN Convention on the Rights of Persons with Disabilities.

Purpose. To analyze the comorbidity of congenital visual impairment and rare eye diseases with multiorgan pathology in school-age children.

Material and methods. 101 children of a boarding school for children with disabilities (blind and visual impairment) were examined during January–May 2020. Analysis of medical documentation was conducted. Examination by an ophthalmologist: biomicroscopy of the eyeball using a slit lamp; refraction was studied by autorefractometry and visual acuity. All studies were conducted with the informed consent of parents. For statistical processing, the following applications were used: for database creation – spreadsheet editor “Microsoft Excel” and for processing – software package “Statistica” (ver. 6.1). The condition for determining statistically significant differences was taken a value p < 0.05.

Results. The study revealed the high prevalence of the comorbid pathology in children with visual impairments: diseases of the cardiovascular system (12.87%), mental disorders (34.65%) and neurological pathology (57.43%). Special ophthalmological examination showed the significant proportion (88%) of the other ophthalmological pathology detected for the first time in children with rare eye diseases.

Conclusions. The comprehensive approach to in-depth diagnosis of combined visual pathology, comorbid disorders of the cardiovascular system, neurological and mental health is necessary for children with RED.

Introduction. Eyelid coloboma is a rare craniofacial pathology, that usually affects the patient congenitally. Eyelid coloboma in addition to being a cosmetic disfigurement, also affects the cornea, vision and if associated with other systemic abnormalities can cause severe morbidity. Complications of eyelid coloboma are mainly due to corneal exposure from large upper eyelid defects resulting in exposure keratopathy and corneal ulceration if left untreated.

The aim of case study: to analyze a clinical case of bilateral upper eyelid coloboma complicated by exposure keratophathy and irregular astigmatism, resulting in low visual acuity in a 4-year-old girl.

Description of the case. The patient was born with Manitoba-oculo-trichio-anal (MOTA) syndrome, which was accompanied by bifid nose and eyelid coloboma. The patient had multiple reconstructive surgeries. She was referred to the Miami Contact Lens Institute (MCLI) for Scleral Contact Lens fit (SCL). The examination revealed bilateral acquired infantile corneal opacities of mild density, which occluded the visual axis; complex hypermetropic astigmatism 6.5 diopters; high-grade amblyopia in both eyes -best corrected visual acuity was OD 0.13 and OS 0.05. Scleral contact lenses were fitted to prevent progressive symblepharon, protect the ocular surface, restore vision and to provide comfort due to the severity of dry eye. SCL’s had ideal clearance in the center and at the periphery and provided visual acuity OD 0.2 and OS 0.1.

Conclusion. Patients with congenital anomalies are often difficult to treat, especially after multiple reconstructive eyelid surgeries. The mechanical effect of the eyelids on the cornea and the high risk of developing symblepharon and severe amblyopia influenced our decision to fit the patient with SCL. These lenses create a fluid reservoir that provides hydration, comfort, and protection to the exposed surface of the eye and restores vision. Ophthalmologists and pediatricians should pay more attention to the advantages of SCL specifically for patients that require corneal protection from exposure and mechanical damage.

Introduction. Myopia is the main cause of preventable blindness and is widespread around the world at an alarming rate, especially in Asian countries. The age of the onset of myopia is getting younger. The prevalence of myopia and high myopia is sharply increasing, which requires clinicians to use new and safe methods of its stabilization. The main methods of correction are optical. This group is based on the hypothesis of induced peripheral myopic defocus.

Aim: to study the domestic and international experience with the use of the optical methods in treatment of progressive myopia according to the literature and factors, as well as factors affecting their effectiveness.

Materials and methods. More than 200 publications on PubMed, eLibrary, and Crossref Metadata over the past 10 years were analyzed. Our analysis includes a review of 60 publications.

Results. Over the past years, there has been a strong interest of researchers in the problem of progressive myopia. This is reflected by a more than four-fold increase in the number of publications devoted to the causes and methods of treatment in patients with progressive myopia. Publications demonstrate the importance of using the modern optical methods, such as spectacle lenses, multifocal and bifocal soft contact lenses and orthokeratology in the routine practice of ophthalmologists and optometrists in order to stabilize the progression of myopia in children and adolescents. On the one hand, the results of analysis show their high efficiency. On the other hand, we need an individual approach in choosing the method for myopia control in each specific case. The factors influencing the result are identified: the diameter of the optical zone, the force of addition that creates the peripheral myopic defocus and the time of use myopia correction during the day.

Conclusion. No method of treating progressive myopia demonstrates clear superiority. Orthokeratology, multifocal and bifocal soft contact lenses, special glasses and low doses atropine instillation demonstrates the similar effect with some clauses. When choosing optical methods for myopia control, the factors affecting their effectiveness should be taken into account.

Orthokeratology (OK) is a therapy aimed at correcting refractive errors by briefly changing a curvature of the corneal surface through the programmed use of rigid gas permeable reverse geometry contact lenses.

The method is currently widespread, especially in children, because of the number of advantages, and has also proved to be an effective way to slow progression of myopia.

In this article it is discussed the difficulties encountered in the process of fitting orthokeratology contact lenses (OK-lens) by specialists with different training levels as well as the reasons of difficulties. Recommendations are given on how to avoid these problems and how to solve them in order to make the fitting of OK-lens more effective and comfortable for both the practitioner and the patient and to ensure their safe use.