Background. Convergence insufficiency is a common binocular vision disorder characterized by eyestrain, headaches, and blurred vision during near tasks. Vision therapy interventions involving vergence and oculomotor training aim to improve binocular coordination and reduce associated symptoms. Evidence suggests that short-term structured vision therapy programs may improve vergence function and visual comfort, highlighting the clinical importance of effective therapeutic approaches for individuals with high near-work demands.

   Purpose: to evaluate the effectiveness of a short-term targeted vision therapy program in improving the near point of convergence (NPC) and reducing symptoms of convergence insufficiency in young adults.

   Materials and methods. Thirty participants aged 18–25 years were enrolled and divided into two groups: an intervention group (n = 15) that received vision therapy and a control group (n = 15) that received no intervention. NPC was measured before and after the intervention using a Royal Air Force (RAF) rule. Objective refraction was determined by retinoscopy, and subjective refraction was also assessed. Symptom severity was evaluated using the Convergence Insufficiency Symptom Survey (CISS). The intervention group completed a three-week vision therapy program comprising vergence and oculomotor exercises. Non-therapeutic relaxation activities were used only as preparatory tasks.

   Results. Following the three-week intervention, mean NPC decreased from 8.4 ± 1.1 cm to 7.6 ± 1.0 cm in the intervention group, whereas only a minimal change was observed in the control group (from 8.3 ± 1.2 cm to 8.2 ± 1.1 cm). CISS scores decreased significantly from 33.0 ± 3.8 to 14.0 ± 2.9 in the intervention group, compared with a slight decrease from 32.0 ± 4.1 to 30.5 ± 3.6 in the control group. No significant changes in cylinder power or axis were observed in either group.

   Conclusion. The structured vision therapy program improved NPC and reduced symptoms associated with convergence insufficiency in young adults. These findings suggest that short-term interventions may improve binocular function, particularly in individuals who experience symptoms during sustained near work.

   Background. Keratorefractive surgery is widely used to correct myopia; however, surgery-induced changes in corneal shape inevitably affect corneal biomechanical properties. These changes reduce the accuracy of intraocular pressure measurements used in glaucoma assessment and complicate the evaluation of the risk of iatrogenic corneal ectasia in patients who have undergone surgery.

   Purpose: to evaluate how the relationships between corneal topographic and biomechanical parameters vary according to the type of keratorefractive surgery and to determine their implications for the interpretation of intraocular pressure measurements.

   Materials and methods. A total of 61 participants (121 eyes) aged 21–60 years were examined. The control group included 16 participants (31 eyes) with no history of ocular surgery. The study group included 45 patients (90 eyes) who had undergone LASIK (26 eyes), femtosecond laser-assisted LASIK; 32 eyes), or photorefractive keratectomy (32 eyes). The examination included corneal topography using the Pentacam, assessment of corneal biomechanical parameters using the Ocular Response Analyzer, including corneal hysteresis and corneal resistance factor, and elastotonometry.

   Results. Following LASIK and FS-LASIK, IOP measurements were underestimated: corneal-compensated intraocular pressure was 1.69–2.62 mm Hg lower and Goldmann-correlated intraocular pressure was 3.23–4.18 mm Hg lower than in the control group. After photorefractive keratectomy, corneal-compensated intraocular pressure and Goldmann-correlated intraocular pressure values were comparable to those in the control group. Procedures involving corneal flap creation were characterized predominantly by inverse correlations between corneal biomechanical parameters and corneal curvature. The strongest correlations were observed for corneal resistance factor and corneal hysteresis in the central and inner paracentral zones (|r| up to 0.6; p < 0.01). After photorefractive keratectomy and in intact corneas, direct correlations between these parameters and corneal curvature predominated.

   Conclusion. Different keratorefractive surgery techniques affect corneal biomechanical remodeling differently. These effects should be considered when interpreting tonometry results and assessing the risk of iatrogenic complications.

   Background. Macular neovascularization is one of the leading causes of irreversible central vision loss in older adults. However, the pathophysiological mechanisms underlying its development remain insufficiently understood. The effect of baseline refractive status on choroidal structural changes in macular neovascularization is of particular interest because it remains poorly studiedand the available evidence is conflicting. Clarifying these relationships may support personalized approaches to early diagnosis, prognostication, and treatment.

   Purpose. To characterize choroidal morphometry in eyes with macular neovascularization according to refractive status.

   Materials and methods. Choroidal parameters were analyzed in 126 eyes of 114 patients with macular neovascularization examined between 2017 and 2026. The eyes were stratified into three groups according to refractive status. Group 1 included 71 hyperopic patients (Hm; +0.5 to +4.5 D). Group 2 comprised 24 emmetropic patients (Em; spherical equivalent, –0.5 to +0.5 D inclusive). Group 3 comprised 19 myopic patients (Mh; spherical equivalent, –0.5 to –7.5 D). Macular optical coherence tomography (OCT) was performed with the DRI OCT Triton system (Topcon Healthcare, Japan).

   Results. Distinct patterns of choroidal change were identified. Choriocapillaris thinning was observed in hyperopic, myopic, and emmetropic eyes (p = 0.002, p = 0.0001 and p = 0.0001 respectively), while Sattler’s layer was thinner in emmetropic and myopic eyes (p = 0.021 and p = 0.0001 respectively). Haller’s layer thickness in eyes with macular neovascularization was within age-matched reference values in emmetropic eyes and exceeded them in myopic (p < 0.001) and hyperopic eyes (p < 0.001). Reduced vessel density was observed in all choroidal layers. The greatest vessel density deficit in eyes with macular neovascularization occurred in the choriocapillaris, reaching 28.5 % in emmetropic, 21.7 % in hyperopic, and 19.2 % in myopic eyes. The deficit was smaller in Sattler’s layer: 19 % in Hm, 16.7 % in Em, and 10.8 % in Mh. The smallest deficit was found in Haller’s layer: 12 % in Hm and 6.5 % in Mh.

   Conclusion. This study demonstrated that macular neovascularization is associated with significant thinning of the choriocapillaris and Sattler’s layer, together with an altered interlayer distribution of choroidal vessel density. The severity of these changes varied according to refractive status. The choriocapillaris vessel density deficit was greatest in emmetropic eyes and smallest in myopic eyes. Thus, choroidal morphometry in macular neovascularization is heterogeneous and should be interpreted in the context of refractive status; these findings may inform risk stratification and the selection of antiangiogenic treatment strategies.

   Background. Glaucoma is a major public health concern, accounting for 8% of blindness worldwide and 16.7 % of blindness in Nigeria. Early diagnosis and reduction of intraocular pressure (IOP) are critical for preventing optic nerve damage. Although topical medications are generally used as initial therapy, uncontrolled IOP may require surgical intervention. Laser peripheral iridotomy (LPI) is a standard procedure for primary angle-closure glaucoma (PACG) that relieves pupillary block, lowers IOP, and reduces the risk of vision loss.

   Purpose. To evaluate changes in IOP following Nd:YAG laser peripheral iridotomy in patients with PACG.

   Materials and methods. A retrospective analysis of 104 medical records of patients with PACG treated at the Makkah Specialist Eye Hospital in Kano, Nigeria, from January 2020 to December 2024, was conducted. Included were patients aged 31–80 years, with IOP measurements before and after LPI. Changes in IOP were evaluated using the paired t-test.

   Results. In the majority of patients (54 patients, 51.9 %), the IOP level was 20–29 mm Hg, followed by the range 30–39 mm Hg (22 patients, 21.2 %), and the smallest number of patients had pressure 10–19 mm Hg (8 patients, 7.7 %). Ten patients were lost to follow-up. Among the remaining 94 patients, the majority (63 patients, 67 %) achieved IOP in the range of 10–19 mm Hg, followed by the range 20–29 mm Hg (20 patients, 21.3 %), and only 3 (3.2 %) patients had pressure remaining within 40–49 mm Hg. Mean IOP decreased significantly from 28.63 ± 9.50 mm Hg before LPI to 18.22 ± 8.54 mm Hg after LPI (t (93) = 11.30, p < 0.001).

   Conclusion. In this retrospective study, YAG laser peripheral iridotomy was associated with a statistically significant mean reduction in IOP of 10.4 mm Hg in patients with PACG, supporting its role as a first-line intervention in this patient population.

   Background. The number of laser in situ keratomileusis (LASIK) and femtosecond laser-assisted LASIK (FemtoLASIK) procedures performed worldwide continues to increase. Although these procedures are safe, predictable, and effective, the presence of a corneal flap is a risk factor in ocular trauma. Flap displacement frequently leads to secondary epithelial ingrowth.

   Purpose. To present a clinical case of successful surgical management of post-traumatic corneal flap displacement with epithelial ingrowth.

   Materials and methods. In December 2024, a 32-year-old woman with a history of LASIK for moderate bilateral myopia in 2011 presented to the Helmholtz National Medical Research Center of Eye Diseases. In September 2024, she had sustained a cat-claw injury to the left eye and subsequently received conservative treatment. At presentation, she reported reduced visual acuity, discomfort, photophobia, foreign-body sensation, and upper eyelid ptosis in the left eye. Visual acuity in OS was 0.15 and improved to 0.3 with sph − 1.50 D, cyl −2.25 D, axis 150°. Biomicroscopy of OS revealed moderate injection, superonasal displacement and inversion of the corneal flap with fibrotic changes, and epithelial ingrowth beneath the flap. Post-traumatic corneal flap displacement with epithelial ingrowth was diagnosed, and on December 10, 2024, the patient underwent flap revision and repositioning.

   Results. No intraoperative or postoperative complications occurred. On postoperative day 7, uncorrected visual acuity in OS was 0.2 and improved to 0.7 with sph − 0.75 D, cyl −2.50 D, axis 145°. At 6 months after surgery, visual acuity in OS was 0.8 and did not improve with correction; autorefraction showed sph − 1.00 D, cyl −1.25 D, axis 80°. The eye was quiet, and the corneal flap was well apposed. A round, whitish, 1 mm area was visible beneath the flap superior to the pupil, and whitish inclusions consistent with epithelial ingrowth were observed along the inferior flap margin at the 7 o’clock position. Over the 1 year follow-up period, visual acuity and refractive parameters improved, and discomfort and upper eyelid ptosis resolved. The flap remained well apposed, with no evidence of recurrent epithelial ingrowth.

   Conclusion. Timely diagnosis and surgical management of post-traumatic flap displacement result in favorable functional outcomes and reduce the risk of epithelial ingrowth, scarring, and striae formation.

   Background. Strabismic amblyopia is a form of functional amblyopia caused by impaired binocular vision. The condition involves inhibitory activity that spreads centrifugally from the cerebral cortex to the retina, together with projection of the image formed by the deviating eye onto noncorresponding retinal points. These mechanisms slow the development of visual function in children during the sensitive period. Treatment after the end of this period – that is, after the age of 18 years – is generally considered ineffective.

   Case presentation. A 37-year-old patient with congenital intermittent esotropia and a paretic component underwent three stages of surgical treatment and four courses of diploptic therapy at the S. Fyodorov Eye Microsurgery Federal State Institution. Historically, this approach was not considered optimal. For example, children usually undergo pleoptic treatment before progressing to diploptic training. In adults, however, both pleoptic and diploptic therapies are rarely used because most ophthalmologists consider them ineffective. In this patient, we achieved a subjective reduction in diplopia, which substantially improved quality of life, while best-corrected visual acuity in the amblyopic eye increased from 0.3 to 0.8. Unlike standard regimens, each treatment course was individualized to target the components of the motor and sensory deficits that had the greatest impact on the patient’s binocular balance at that point in time. Treatment should be administered in courses of 10–15 sessions at 3–4-month intervals. Patients should be warned that skipping a course may cause diplopia to worsen again and visual acuity to decline.

   Conclusion. Courses of diploptic therapy may be used in adults to reduce diplopia and thereby improve quality of life. In addition to having a beneficial effect on binocular status, this treatment may also improve visual acuity.

   Background. Orthokeratology lenses (OK lenses) are widely used for myopia control in children and adolescents. Their overnight wear has specific effects on ocular surface structures, including the corneal epithelium, tear film, and meibomian glands. Despite advances in OK lens design and materials, the risk of complications persists. The role of patient compliance — adherence to the prescribed lens wear and care regimen— remains a key yet insufficiently systematized aspect of orthokeratology safety.

   Purpose: To summarize current evidence on the safety of orthokeratology treatment in children and adolescents, with emphasis on ocular surface status, complications, and the role of compliance.

   Materials and methods. An analytical review of Russian and international literature indexed in PubMed/MEDLINE and eLIBRARY was conducted. The review included 30 publications – clinical studies, case series, systematic reviews, and other reviews – reporting data on ocular surface status, complications, or compliance in children and adolescents. Studies involving mixed-age populations were included when their findings were applicable to pediatric practice.

   Results. A substantial proportion of candidates for orthokeratology treatment already have subclinical signs of lacrimal functional unit dysfunction before OK lens fitting. Short-term changes are heterogeneous: increased corneal staining is the most consistently reported finding, whereas changes in the tear film and meibomian glands are often minimal. OK lens wear for more than 5 years is associated with greater meibomian gland loss in the lower eyelid. Participation in water sports and meibomian gland dysfunction were identified as modifiable risk factors for infiltrative keratitis; infection prevention requires avoiding any contact between lenses and water. In a large multicenter study, the incidence of microbial keratitis during orthokeratology treatment was comparable to that associated with daytime wear of soft contact lenses. The available evidence supports the need for systematic assessment of ocular surface structures before OK lens fitting, education of patients and their parents or families, and ongoing monitoring of ocular surface status throughout orthokeratology treatment.

   Conclusion. Compliance is a central determinant of safe OK lens use. The patient’s and family’s ability to comply with lens wear and care requirements should be considered a mandatory component of screening, alongside clinical evaluation of the ocular surface.

   Background. Sex steroid hormones, including estrogens, progesterone, and testosterone, play a key role not only in regulating reproductive function but also in maintaining homeostasis in multiple tissues, including ocular tissues. They exert their effects through specific intracellular and membrane receptors, thereby modulating both genomic and rapid nongenomic signaling pathways.

   Purpose. To synthesize current evidence on the distribution and functions of sex hormone receptors in ocular tissues and their role in the pathophysiology of anterior segment diseases.

   Materials and methods. We reviewed and analyzed 39 articles published in peer-reviewed Russian and international journals over the preceding 35 years. The literature search was conducted in PubMed, Scopus, and Web of Science using the following keywords: sex hormones, estrogen, progesterone, testosterone, receptors, cataract, dry eye disease, and cornea.

   Results. Ex hormone receptors are widely expressed in ocular tissues, including the lens, cornea, lacrimal glands, and meibomian glands. Their involvement in key physiological processes, including neuroprotection, regulation of lipogenesis and inflammatory responses, and maintenance of tissue homeostasis, has been demonstrated. An imbalance in sex hormone levels is associated with the risk of developing ocular diseases. The effects of sex hormones vary depending on the specific disease, the patient’s sex, and hormonal status.

   Conclusion. Sex hormone receptors play an important role in regulating ocular tissue function. Understanding their role opens new avenues for the development of personalized therapeutic strategies that take the patient’s hormonal status into account.

   Background. Autonomic nervous system activity influences the functioning of the peripheral visual system. The use of methods for assessing autonomic function, particularly heart rate variability analysis, in ophthalmology remains under investigation.

   Purpose. To provide a rationale for using heart rate variability analysis parameters to assess autonomic function in ophthalmic practice.

   Materials and methods. The review included scientific and methodological publications retrieved from PubMed, Medline, Google Scholar, Frontiers, BioMed Central, CyberLeninka, elibrary.ru, and other electronic databases and online resources. Publications from 2021 through 2026 were reviewed. The methods included analysis and data systematization. A total of 75 sources in Russian and other languages were examined, of which 28 were selected for inclusion in the review.

   Results. The use of heart rate variability analysis in ophthalmology is currently under active investigation. Analysis of mean group heart rate variability parameters in patients with neurogenic ophthalmopathy and healthy individuals showed significant autonomic nervous system dysfunction in the patient group. Several theoretical models proposed to explain heart rate variability describe relationships among rhythmocardiographic parameters, vagal tone (n. vagus), and key pathophysiological processes. Mathematical analysis of heart rate variability parameters is used to assess the contribution of autonomic nervous system imbalance to ocular pathology. The review discusses the role of the autonomic nervous system in the pathogenesis of ocular disorders, including glaucoma, progressive myopia, and choroidal vascular disorders. The direction of changes in autonomic regulation depends on the form and etiology of myopia. Complicated acquired myopia has been shown to be accompanied by a shift in autonomic balance toward vagotonia (parasympathetic predominance), which is considered an unfavorable prognostic factor. By contrast, complicated high congenital myopia is associated with autonomic nervous system imbalance characterized by predominant sympathetic activity. Impaired choroidal blood flow is also associated with autonomic dysfunction. This finding supports the nonmechanical theory of glaucoma development, in which vascular regulation, in addition to intraocular pressure, is a key factor. Evidence has accumulated regarding the beneficial effects of graded physical activity on autonomic regulation of the visual system, supporting the inclusion
of graded physical activity in the comprehensive treatment of ocular diseases to improve tissue nutrition and microcirculation. Accordingly, HRV analysis is recommended as a diagnostic tool for assessing autonomic reactivity.

   Conclusion. A diagnostic approach incorporating heart rate variability assessment is intended to identify individuals with a predominance of sympathetic or parasympathetic autonomic nervous system activity, which is relevant to the early diagnosis and prognostication of several ophthalmic disorders. The use of rhythmocardiography as part of the diagnostic workup allows for the early detection of these conditions through assessment of autonomic regulation.

   For over half a century, rigid gas permeable (GP) contact lens material development has focused on increasing oxygen permeability (Dk). Modern hyper-Dk materials such as Optimum Infinite and Breathe have largely overcome corneal hypoxia, but further gains in Dk offer diminishing clinical returns and make it increasingly difficult to maintain the overall balance of material properties. Today, the main barriers to successful GP lens wear are comfort-related, determined not only by wettability but also by surface lubricity and the interaction of the lens with the tear film, eyelids and ocular surface. Future progress is shifting from modifying the bulk material towards developing durable or renewable surface technologies that become an integral part of the lens and ensure harmonious interaction with the eye.

   This article provides an overview of the scientific and clinical evidence for the new PRECISION7 weekly replacement silicone hydrogel contact lenses. The properties of the novel serafilcon A material and the ACTIV-FLO technology, which maintains lens surface hydration throughout the 7-day replacement cycle, are described. Laboratory and clinical findings demonstrate sustained comfort, visual performance, and resistance to lipid deposition during prolonged wear, including under conditions of increased digital device use. The weekly replacement schedule is discussed as a novel reusable lens modality that may simplify adherence to recommended replacement schedules and support patient compliance with practitioner recommendations for contact lens wear.

   On May 22–23, 2026, the 14th scientific and educational project “Day of Vision – 2026” was held in the “Octava” cluster (Tula), organized by the National Myopia Institute. The event brought together more than 300 participants from various regions of Russia. Program It was structured in a single‑stream format and covered fundamental issues of refractogenesis, clinical algorithms for managing patients with ocular surface pathology, modern methods for controlling myopia, personalized orthokeratology, and the transformation of business models for ophthalmic clinics and opticians.